Systematic review and meta-analysis of the reliability and discriminative validity of cartilage compositional MRI in knee osteoarthritis.
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Publication Date
2018-09Journal Title
Osteoarthritis and cartilage
ISSN
1063-4584
Publisher
Elsevier
Volume
26
Issue
9
Pages
1140-1152
Language
eng
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
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MacKay, J., Low, S., Smith, T., Toms, A., McCaskie, A., & Gilbert, F. (2018). Systematic review and meta-analysis of the reliability and discriminative validity of cartilage compositional MRI in knee osteoarthritis.. Osteoarthritis and cartilage, 26 (9), 1140-1152. https://doi.org/10.1016/j.joca.2017.11.018
Abstract
Objective
To assess reliability and discriminative validity of cartilage
compositional magnetic resonance imaging (MRI) in knee osteoarthritis
(OA).
Design
The study was carried out per PRISMA recommendations. We searched MEDLINE
and EMBASE (1974 - present) for eligible studies. We performed
qualitative synthesis of reliability data. Where data from at least 2
discrimination studies were available, we estimated pooled standardized
mean difference (SMD) between subjects with and without OA.
Discrimination analyses compared controls and subjects with mild OA
(Kellgren-Lawrence (KL) grade 1-2), severe OA (KL grade 3-4) and OA not
otherwise specified (NOS) where not possible to stratify. We assessed
quality of the evidence using QAREL and QUADAS-2 tools.
Results
Fifty-eight studies were included in the reliability analysis and 25
studies were included in the discrimination analysis, with data from a
total of 1,989 knees. Intra-observer, inter-observer and test-retest
reliability of compositional techniques were excellent with most
intraclass correlation coefficients > 0.8 and coefficients of variation <
10%. T1rho and T2 relaxometry were significant discriminators between
subjects with mild OA and controls, and between subjects with OA (NOS)
and controls (p < 0.001). T1rho showed best discrimination for mild OA
(SMD [95% CI] = 0.73 [0.40 to 1.06], p < 0.001) and OA (NOS) (0.60 [0.41
to 0.80], p < 0.001). Quality of evidence was moderate for both parts of
the review.
Conclusions
Cartilage compositional MRI techniques are reliable and, in the case of
T1rho and T2 relaxometry, can discriminate between subjects with OA and
controls.
Keywords
Cartilage, Articular, Humans, Osteoarthritis, Knee, Magnetic Resonance Imaging, Severity of Illness Index, Sensitivity and Specificity, Case-Control Studies, Reproducibility of Results, Reference Values, Aged, Middle Aged, Female, Male
Sponsorship
Addenbrooke's Charitable Trust (ACT) (24/15 A)
MRC (MC_PC_12009)
Identifiers
External DOI: https://doi.org/10.1016/j.joca.2017.11.018
This record's URL: https://www.repository.cam.ac.uk/handle/1810/271716
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/