Mackay, James
ORCID: https://orcid.org/0000-0001-7558-3800, Low, Samantha B. L., Smith, Toby, Toms, Andoni, McCaskie, Andrew and Gilbert, Fiona
(2018)
Systematic review and meta-analysis of the reliability and discriminative validity of cartilage compositional MRI in knee osteoarthritis.
Osteoarthritis and Cartilage, 26 (9).
pp. 1140-1152.
ISSN 1063-4584
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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.
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