3D CAIPIRINHA SPACE versus standard 2D TSE for routine knee MRI: a large-scale interchangeability study

Area of Science:

• Radiology and Medical Imaging
• Orthopedic MRI
• Advanced MRI Techniques

Background:

• Standard 2D TSE protocols are time-consuming for knee MRI.
• 3D CAIPIRINHA SPACE TSE offers potential for accelerated knee imaging.
• Assessing the diagnostic interchangeability of 3D CAIPIRINHA SPACE TSE with standard 2D TSE is crucial for clinical adoption.

Purpose of the Study:

• To compare the diagnostic performance and interchangeability of 3D CAIPIRINHA SPACE TSE with standard 2D TSE for knee MRI.
• To evaluate image quality, diagnostic confidence, and accuracy in identifying knee pathologies between the two MRI protocols.

Main Methods:

• Prospective study of 250 patients undergoing 3T knee MRI with both 3D CAIPIRINHA SPACE TSE (9:26 min) and standard 2D TSE (12:14 min) protocols.
• Two radiologists assessed image quality and diagnosed meniscal, ligamentous, and cartilaginous abnormalities using a 4-point Likert scale.
• Interchangeability, interreader reliability, and intermethod concordance were statistically evaluated.

Main Results:

• Protocols were interchangeable for most knee abnormalities, with exceptions for patellar and trochlear cartilage defects.
• Standard 2D TSE demonstrated higher image quality and diagnostic confidence compared to 3D CAIPIRINHA SPACE TSE.
• Interreader reliability and intermethod concordance were substantial to almost perfect for both protocols.

Conclusions:

• Multicontrast 3D CAIPIRINHA SPACE TSE is diagnostically interchangeable with standard 2D TSE for knee abnormalities, excluding patellofemoral cartilage defects.
• Despite a radiologist preference for 2D TSE, the time-saving 3D CAIPIRINHA SPACE TSE protocol is justified for routine knee MRI.
• Further optimization of 3D TSE techniques may enhance diagnostic confidence and image quality for cartilage assessment.