Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Similar Reliability of DESS and TSE Magnetic Resonance Imaging Sequences in the Assessment of Bone Marrow Lesions in Knee Osteoarthritis Patients: Data From the Osteoarthritis Initiative Cohort.
Raynauld1, Jean-Pierre, Wildi1, Lukas M., Abram2, François, Moser3, Thomas, Girard2, Manon, Martel-Pelletier1, Johanne, Pelletier1, Jean Pierre
Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Notre-Dame Hospital, Montreal, QC
ArthroVision Inc., Montreal, QC
Department of Radiology, University of Montreal Hospital Centre (CHUM), Notre-Dame Hospital, Montreal, QC
To assess bone marrow lesions (BML) in a head to head comparative study using a T2/T1-weighted steady-state gradient echo (DESS) and a fluid-sensitive intermediate-weighted turbo spin echo (TSE) sequence and the sensitivity to change over time of these sequences. Using a subset of the Osteoarthritis Initiative (OAI) cohort (public MR image sets), we assessed the BML prevalence, lesion size, and change over time comparing data from a TSE to a DESS magnetic resonance imaging (MRI) sequence.
A subgroup of 144 patients (mean age 61.3 ± 9.8, mean BMI 30.0 ± 4.3, 51.4% were female) was selected from the OAI cohort of progressors who all had DESS and TSE MRI acquisitions at baseline and 24 months. BML were assessed blindly using a semi-quantitative score (scale, 03) for the global knee, as well as the medial and lateral compartments. Intra-reader reliability was assessed on a subset of 51 patients. Statistical analysis used a Spearman rho for intra-reader correlation, and a Fisher exact test or Wilcoxon signed rank test for comparison between DESS and TSE where appropriate.
Intra-reader reliability was very good: Spearman rho for DESS sequence were 0.89 for the global knee, 0.91 for the medial compartment, and 0.78 for the lateral compartment; for the TSE sequence, 0.85, 0.86, and 0.77 were found respectively. The prevalence (presence or absence) of BML at baseline was only slightly greater for TSE compared to DESS sequences and this difference did not reach statistical significance (global knee, 80.6% vs. 79.2%; medial compartment, 70.1% vs. 68.1%; lateral compartment, 53.5% vs. 48.6%, respectively; p=ns). As expected, the mean BML score at baseline was lower for DESS than TSE sequences (2.7 ± 2.4 vs. 3.4 ± 3.0 for the global knee respectively, 1.7 ± 1.9 vs. 2.2 ± 2.3 for the medial compartment, and 0.9 ± 1.2 vs. 1.2 ± 1.6 for the lateral compartment, all p<=0.006). However, change at 24 months was similar for DESS and TSE sequences for the global knee (increment of 1.1 ± 1.7 vs. 1.0 ± 2.2 respectively, p=0.18) and for the lateral compartment (0.5 ± 1.0 vs. 0.6 ± 1.5, p=0.33), but superior for DESS in the medial compartment (0.6 ± 1.5 vs. 0.4 ± 1.6, p=0.03).
This is the first report of a direct comparison between DESS and TSE MRI sequences in the assessment of BML and their changes over time. Contrary to common belief, these results demonstrate a similar sensitivity to assess BML prevalence as well as their changes over time in the global knee and lateral compartment, and a slightly superior evaluation of changes over time for the DESS in the medial compartment. These data show that the use of the DESS sequence may have an advantage in clinical trials since, in contrast to the TSE sequence, it could be used for both BML and cartilage volume assessments.
To cite this abstract, please use the following information:
Raynauld, Jean-Pierre, Wildi, Lukas M., Abram, François, Moser, Thomas, Girard, Manon, Martel-Pelletier, Johanne, et al; Similar Reliability of DESS and TSE Magnetic Resonance Imaging Sequences in the Assessment of Bone Marrow Lesions in Knee Osteoarthritis Patients: Data From the Osteoarthritis Initiative Cohort. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2006