3D MRI may surpass 2D for detecting knee cartilage defects

Technological advancements over the past three decades have placed 3D MRI on par with its 2D counterpart in depicting cartilage defects, according to a July 17 study in Radiology. With specific alterations, the modality may be able to replace traditional MRI.

Twenty-seven studies, comprising 1,710 3D MRI exams, were included in the meta-analysis. Sixteen of those studies compared the diagnostic performance of 3D and 2D MRI. Arthroscopy and/or surgery was used as the standard of reference.

Overall, lead author Delaram Shakoor, with Johns Hopkins University in Baltimore, and colleagues found that 3D MRI did not perform better than 2D MRI in detecting cartilage defects, but it did provide “comparable” performance.

Authors also performed a subanalysis that compared different types of 3D MRI sequences and found that 3D fast spin echo (FSE) sequences had a higher sensitivity and specificity than 2D. Additionally, using a 3.0-T field strength achieved a higher diagnostic odds radio when compared to 1.5 T or lower field strength.

Those 3D MRI studies that utilized a multiplanar reformation technique also had a higher specificity than traditional MRI.

Shakoor and colleagues noted their results were at odds with previous meta-analyses tackling the same issue. However, Shakoor et al. noted past research included less than 10 studies and did not separately examine 3D MRI and 2D MRI.

“Considering these conflicting data in the literature, we performed a meta-regression to consider the evolution of 3D MRI sequences and found a statistically significant improvement in diagnostic performance of 3D MRI during the past 3 decades,” authors wrote.

The researchers claimed 3D MRI could replace 2D, but they cautioned further research will be needed to determine the best pairing of 3D and 2D sequences to detect defects in those with knee pain.