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Two for One -- Combined Morphologic and Quantitative Knee Joint MRI Using a Versatile Turbo Spin-Echo Platform

arXiv (Cornell University)

Abstract

Introduction: Quantitative MRI techniques such as T2 and T1\r{ho} mapping are beneficial in evaluating knee joint pathologies; however, long acquisition times limit their clinical adoption. MIXTURE (Multi-Interleaved X-prepared Turbo-Spin Echo with IntUitive RElaxometry) provides a versatile turbo spin-echo (TSE) sequence platform for simultaneous morphologic and quantitative joint imaging yet lacks comparative evaluation in basic and translational research contexts. Methods: Two MIXTURE sequences were designed along clinical requirements: (i) MIX1, combining proton density (PD)-weighted fat-saturated (FS) images and quantitative T2 mapping (acquisition time: 4:59 min), and (ii) MIX2, combining T1-weighted images with quantitative T1\r{ho} mapping (6:38 min). MIXTURE sequences and their reference 2D and 3D TSE counterparts were acquired from ten human cadaveric knee joints using a clinical 3T MRI scanner and knee coil. Contrast, contrast-to-noise ratios, and coefficients of variation were comparatively evaluated using parametric tests. Clinical radiologists (n=3) assessed diagnostic quality as a function of sequence and anatomic structure using 5-point Likert scales and ordinal regression. The significance level was set to α=0.01. Results: MIX1 and MIX2 had at least equal diagnostic quality compared to the 2D and 3D TSE sequences of the same image weighting. Contrast, contrast-to-noise ratios, and coefficients of variation were largely similar for the PD-weighted FS and T1-weighted images. Discussion: In clinically feasible scan times, the MIXTURE sequence platform yields (i) morphologic images of diagnostic quality and adjustable TSE-based contrasts and (ii) quantitative parameter mapping with additional insights on soft tissue composition and ultrastructure.

Authors 11

  1. RWTH Aachen University

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology , Medical Faculty , RWTH Aachen University , Aachen , Germany

    Department of Diagnostic and Interventional Radiology Medical Faculty RWTH Aachen University Pauwelsstraße 30 52074 Aachen Germany

  2. RWTH Aachen University

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology , Medical Faculty , RWTH Aachen University , Aachen , Germany

  3. RWTH Aachen University

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology , Medical Faculty , RWTH Aachen University , Aachen , Germany

  4. Philips (Germany)

    Affiliation as printed

    Philips GmbH Market DACH , Hamburg , Germany

  5. Philips Japan, Limited (Japan)

    Affiliation as printed

    Philips Japan , Tokyo , Japan

  6. RWTH Aachen University

    Affiliation as printed

    Institute of Molecular and Cellular Anatomy , Medical Faculty , RWTH Aachen University , Aachen , Germany

  7. RWTH Aachen University

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology , Medical Faculty , RWTH Aachen University , Aachen , Germany

  8. RWTH Aachen University

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology , Medical Faculty , RWTH Aachen University , Aachen , Germany

  9. RWTH Aachen University

    Affiliation as printed

    Department of Diagnostic and Interventional Radiology , Medical Faculty , RWTH Aachen University , Aachen , Germany

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