Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2011

Open Access 01-12-2011 | Research article

Semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts of the knee at 3T MRI: A comparison between intermediate-weighted fat-suppressed spin echo and Dual Echo Steady State sequences

Authors: Daichi Hayashi, Ali Guermazi, C Kent Kwoh, Michael J Hannon, Carolyn Moore, John M Jakicic, Stephanie M Green, Frank W Roemer

Published in: BMC Musculoskeletal Disorders | Issue 1/2011

Login to get access

Abstract

Background

Choice of appropriate MR pulse sequence is important for any research studies using imaging-derived data. The aim of this study was to compare semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts using intermediate-weighted (IW) fat-suppressed (fs) spin echo and Dual Echo Steady State (DESS) sequences on 3 T MRI.

Methods

Included were 201 subjects aged 35-65 with frequent knee pain. 3T MRI was performed with the same sequence protocol as in the Osteoarthritis Initiative (OAI). In a primary reading subchondral bone marrow edema-like lesions were assessed according to the WORMS system. Two hundred subregions with such lesions were randomly chosen. The extent of subchondral bone marrow edema-like lesions was re-evaluated separately using sagittal IW fs and DESS sequences according to WORMS. Lesion size and confidence of the differentiation between subchondral bone marrow edema-like lesions and subchondral cysts located within or adjacent to them was rated from 0 to 3. Wilcoxon signed-rank tests and chi-square statistics were used to examine differences between the two sequences.

Results

Of 200 subchondral bone marrow edema-like lesions detected by IW fs sequence, 93 lesions (46.5%) were not depicted by the DESS sequence. The IW fs sequence depicted subchondral bone marrow edema-like lesions to a larger extent than DESS (p < 0.0001), and the opposite was true for subchondral cysts. Confidence scores for differentiation of the two types of lesions were not significantly different between the two sequences.

Conclusions

In direct comparison the IW fs sequence depicts more subchondral bone marrow edema-like lesions and better demonstrate the extent of their maximum size. The DESS sequence helps in the differentiation of subchondral bone marrow edema-like lesions and subchondral cysts. The IW fs sequence should be used for determination of lesion extent whenever the size of subchondral bone marrow edema-like lesions is the focus of attention.
Appendix
Available only for authorised users
Literature
1.
Crema MD, Roemer FW, Marra MD, Guermazi A: MR imaging of intra- and periarticular soft tissues and subchondral bone in knee osteoarthritis. Radiol Clin N Am. 2009, 47: 687-701. 10.1016/j.rcl.2009.04.001.CrossRefPubMed
2.
Roemer FW, Guermazi A, Javaid MK, Lynch JA, Niu J, Zhang Y, Felson DT, Lewis CE, Torner J, Nevitt MC: Change in MRI-detected subchondral bone marrow lesions is associated with cartilage loss: the MOST Study. A longitudinal multicentre study of knee osteoarthritis. Ann Rheum Dis. 2009, 68 (9): 1461-1465. 10.1136/ard.2008.096834.CrossRefPubMed
3.
Marra MD, Crema MD, Chung MC, Roemer FW, Hunter DJ, Zaim S, Diaz L, Guermazi A: MRI features of cystic lesions around the knee. Knee. 2008, 15: 423-438. 10.1016/j.knee.2008.04.009.CrossRefPubMed
4.
Crema MD, Roemer FW, Zhu Y, Marra MD, Niu J, Zhang Y, Lynch JA, Javaid MK, Lewis CE, El-Khoury GY, Felson DT, Guermazi A: Subchondral cystlike lesions develop longitudinally in areas of bone marrow edema-like lesions in patients with or at risk for knee osteoarthritis: detection with MR imaging--the MOST study. Radiology. 2010, 256 (3): 855-862. 10.1148/radiol.10091467.CrossRefPubMedPubMedCentral
5.
Peterfy CG, Gold G, Eckstein F, Cicuttini F, Dardzinski B, Stevens R: MRI protocols for whole-organ assessment of the knee in osteoarthritis. Osteoarthritis Cartilage. 2006, 14 (Suppl A): A95-111.CrossRefPubMed
6.
Zanetti M, Bruder E, Romero J, Hodler J: Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings. Radiology. 2000, 215 (3): 835-840.CrossRefPubMed
7.
Wang Y, Wluka AE, Pelletier JP, Martel-Pelletier J, Abram F, Ding C, Cicuttini FM: Meniscal extrusion predicts increases in subchondral bone marrow lesions and bone cysts and expansion of subchondral bone in osteoarthritic knees. Rheumatology (Oxford). 2010, 49 (5): 997-1004. 10.1093/rheumatology/keq034.CrossRef
8.
Eckstein F, Burstein D, Link TM: Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis. NMR Biomed. 2006, 19 (7): 822-854. 10.1002/nbm.1063.CrossRefPubMed
9.
Roemer FW, Hunter DJ, Guermazi A: MRI-based semiquantitative assessment of subchondral bone marrow lesions in osteoarthritis research. Osteoarthritis Cartilage. 2009, 17 (3): 414-415. 10.1016/j.joca.2008.07.019. author reply 416-417CrossRefPubMed
10.
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW: Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988, 15 (12): 1833-1840.PubMed
11.
Peterfy CG, Schneider E, Nevitt M: The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee. Osteoarthritis Cartilage. 2008, 16: 1433-1441. 10.1016/j.joca.2008.06.016.CrossRefPubMedPubMedCentral
12.
Peterfy CG, Guermazi A, Zaim S, Tirman PF, Miaux Y, White D, Kothari M, Lu Y, Fye K, Zhao S, Genant HK: Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthritis Cartilage. 2004, 12 (3): 177-190. 10.1016/j.joca.2003.11.003.CrossRefPubMed
13.
Rosner B, Glynn RJ, Lee ML: The Wilcoxon signed rank test for paired comparisons of clustered data. Biometrics. 2006, 62 (1): 185-192. 10.1111/j.1541-0420.2005.00389.x.CrossRefPubMed
14.
Felson DT, Niu J, Guermazi A, Roemer FW, Aliabadi P, Clancy M, Torner J, Lewis CE, Nevitt MC: Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging. Arthritis Rheum. 2007, 56: 2986-2992. 10.1002/art.22851.CrossRefPubMed
15.
Roemer FW, Neogi T, Nevitt MC, Felson DT, Zhu Y, Zhang Y, Lynch JA, Javaid MK, Crema MD, Torner J, Lewis CE, Guermazi A: Subchondral bone marrow lesions are highly associated with, and predict subchondral bone attrition longitudinally: the MOST study. Osteoarthritis Cartilage. 2010, 18 (1): 47-53. 10.1016/j.joca.2009.08.018.CrossRefPubMed
16.
Roemer FW, Khrad H, Hayashi D, Jara H, Ozonoff A, Fotinos-Hoyer AK, Guermazi A: Volumetric and semiquantitative assessment of MRI-detected subchondral bone marrow lesions in knee osteoarthritis: a comparison of contrast-enhanced and non-enhanced imaging. Osteoarthritis Cartilage. 2010, 18 (8): 1062-1066. 10.1016/j.joca.2010.05.006.CrossRefPubMed
17.
Schmid MR, Hodler J, Vienne P, Binkert CA, Zanetti M: Bone marrow abnormalities of foot and ankle: STIR versus T1-weighted contrast-enhanced fat-suppressed spin-echo MR imaging. Radiology. 2002, 224 (2): 463-469. 10.1148/radiol.2242011252.CrossRefPubMed
18.
Mayerhoefer ME, Breitenseher MJ, Kramer J, Aigner N, Norden C, Hofmann S: STIR vs. T1-weighted fat-suppressed gadolinium-enhanced MRI of bone marrow edema of the knee: computer-assisted quantitative comparison and influence of injected contrast media volume and acquisition parameters. J Magn Reson Imaging. 2005, 22 (6): 788-793. 10.1002/jmri.20439.CrossRefPubMed
19.
Yoshioka H, Stevens K, Hargreaves BA, Steines D, Genovese M, Dillingham MF, Winalski CS, Lang P: Magnetic resonance imaging of articular cartilage of the knee: comparison between fat-suppressed three-dimensional SPGR imaging, fat-suppressed FSE imaging, and fat-suppressed three-dimensional DEFT imaging, and correlation with arthroscopy. J Magn Reson Imaging. 2004, 20 (5): 857-864. 10.1002/jmri.20193.CrossRefPubMed
20.
Duc SR, Koch P, Schmid MR, Horger W, Hodler J, Pfirrmann CW: Diagnosis of articular cartilage abnormalities of the knee: prospective clinical evaluation of a 3D water-excitation true FISP sequence. Radiology. 2007, 243 (2): 475-482. 10.1148/radiol.2432060274.CrossRefPubMed
21.
Kijowski R, Blankenbaker DG, Klaers JL, Shinki K, De Smet AA, Block WF: Vastly undersampled isotropic projection steady-state free precession imaging of the knee: diagnostic performance compared with conventional MR. Radiology. 2009, 251 (1): 185-194. 10.1148/radiol.2511081133.CrossRefPubMed
22.
Kijowski R, Blankenbaker DG, Woods MA, Shinki K, De Smet AA, Reeder SB: 3.0-T evaluation of knee cartilage by using three-dimensional IDEAL GRASS imaging: comparison with fast spin-echo imaging. Radiology. 2010, 255 (1): 117-127. 10.1148/radiol.09091011.CrossRefPubMed
23.
Roemer FW, Frobell R, Hunter DJ, Crema MD, Fischer W, Bohndorf K, Guermazi A: MRI-detected subchondral bone marrow signal alterations of the knee joint: terminology, imaging appearance, relevance and radiological differential diagnosis. Osteoarthritis Cartilage. 2009, 17 (9): 1115-1131. 10.1016/j.joca.2009.03.012.CrossRefPubMed
24.
Kornaat PR, Bloem JL, Ceulemans RY, Riyazi N, Rosendaal FR, Nelissen RG, Carter WO, Hellio Le Graverand MP, Kloppenburg M: Osteoarthritis of the knee: association between clinical features and MR imaging findings. Radiology. 2006, 239: 811-817. 10.1148/radiol.2393050253.CrossRefPubMed
25.
Torres L, Dunlop DD, Peterfy C, Guermazi A, Prasad P, Hayes KW, Song J, Cahue S, Chang A, Marshall M, Sharma L: The relationship between specific tissue lesions and pain severity in persons with knee osteoarthritis. Osteoarthritis Cartilage. 2006, 14 (10): 1033-1040. 10.1016/j.joca.2006.03.015.CrossRefPubMed
26.
Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, Kazis L, Gale DR: The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med. 2001, 134: 541-549.CrossRefPubMed
27.
Roemer FW, Kwoh CK, Hannon MJ, Crema MD, Moore CE, Jakicic JM, Green SM, Guermazi A: Semiquantitative assessment of focal cartilage damage at 3T MRI: A comparative study of dual echo at steady state (DESS) and intermediate-weighted (IW) fat suppressed fast spin echo sequences. Eur J Radiol. 2010
Metadata
Title
Semiquantitative assessment of subchondral bone marrow edema-like lesions and subchondral cysts of the knee at 3T MRI: A comparison between intermediate-weighted fat-suppressed spin echo and Dual Echo Steady State sequences
Authors
Daichi Hayashi
Ali Guermazi
C Kent Kwoh
Michael J Hannon
Carolyn Moore
John M Jakicic
Stephanie M Green
Frank W Roemer
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2011
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-12-198

Other articles of this Issue 1/2011

BMC Musculoskeletal Disorders 1/2011 Go to the issue

Research article

Idiopathic toe-walking in children, adolescents and young adults: a matter of local or generalised stiffness?

Research article

Asian-Specific total knee system: 5-14 year follow-up study

Research article

Infraglenoidal scapular notching in reverse total shoulder replacement: a prospective series of 60 cases and systematic review of the literature

Technical advance

Double-plating of ovine critical sized defects of the tibia: a low morbidity model enabling continuous in vivo monitoring of bone healing

Research article

A randomized controlled trial of vitamin D dosing strategies after acute hip fracture: No advantage of loading doses over daily supplementation

Research article

Is there a role for expectation maximization imputation in addressing missing data in research using WOMAC questionnaire? Comparison to the standard mean approach and a tutorial