Repository logo
 

Systematic review and meta-analysis of the reliability and discriminative validity of cartilage compositional MRI in knee osteoarthritis.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

MacKay, JW 
Low, SBL 
Smith, TO 
Toms, AP 
McCaskie, AW 

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 two 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 Quality Appraisal of Diagnostic Reliability (QAREL) and Quality Assessment of Diagnostic Accuracy (QUADAS-2) tools. RESULTS: Fifty-eight studies were included in the reliability analysis and 26 studies were included in the discrimination analysis, with data from a total of 2,007 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.

Description

Keywords

Cartilage composition, Cartilage mapping, Knee osteoarthritis, Magnetic resonance imaging, Quantitative cartilage imaging, Aged, Cartilage, Articular, Case-Control Studies, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Osteoarthritis, Knee, Reference Values, Reproducibility of Results, Sensitivity and Specificity, Severity of Illness Index

Journal Title

Osteoarthritis Cartilage

Conference Name

Journal ISSN

1063-4584
1522-9653

Volume Title

26

Publisher

Elsevier BV
Sponsorship
Addenbrooke's Charitable Trust (ACT) (24/15 A)
Medical Research Council (MC_PC_12009)