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Three-Dimensional Zero Echo Time Magnetic Resonance Imaging Versus 3-Dimensional Computed Tomography for Glenoid Bone Assessment

      Purpose

      To evaluate the 3-dimensional (3D) zero echo time (ZTE) magnetic resonance imaging (MRI) technique and compare it with 3D computed tomography (CT) for the assessment of the glenoid bone.

      Methods

      ZTE MRI using multiple resolutions and multislice CT were performed in 6 shoulder specimens before and after creation of glenoid defects and in 10 glenohumeral instability patients. Two musculoskeletal radiologists independently generated 3D volume-rendered images of the glenoid en face. Post-processing times and glenoid widths were measured. Inter-modality and inter-rater agreement was assessed.

      Results

      Intraclass correlation coefficients (ICCs) for inter-modality assessment showed almost perfect agreement for both readers, ranging from 0.949 to 0.991 for the ex vivo study and from 0.955 to 0.987 for the in vivo patients. Excellent interobserver agreement was found for both the ex vivo (ICCs ≥ 0.98) and in vivo (ICCs ≥ 0.92) studies. For the ex vivo study, Bland-Altman analyses for CT versus MRI showed a mean difference of 0.6 to 1 mm at 1.0-mm3 MRI resolution, 0.3 to 0.6 mm at 0.8-mm3 MRI resolution, and 0.3 to 0.6 mm at 0.6-mm3 MRI resolution for both readers. For the in vivo study, Bland-Altman analyses for CT versus MRI showed a mean difference of 0.6 to 0.8 mm at 1.0-mm3 MRI resolution, 0.5 to 0.6 mm at 0.8-mm3 MRI resolution, and 0.4 to 0.8 mm at 0.7-mm3 MRI resolution for both readers. Mean post-processing times to generate 3D images of the glenoid ranged from 32 to 46 seconds for CT and from 33 to 64 seconds for ZTE MRI.

      Conclusions

      Three-dimensional ZTE MRI can potentially be considered as a technique to determine glenoid width and can be readily incorporated into the clinical workflow.

      Level of Evidence

      Level II, development of diagnostic criteria (consecutive patients with consistently applied reference standard and blinding).
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      References

        • Yang N.P.
        • Chen H.C.
        • Phan D.V.
        • et al.
        Epidemiological survey of orthopedic joint dislocations based on nationwide insurance data in Taiwan, 2000-2005.
        BMC Musculoskelet Disord. 2011; 12: 253
        • Enger M.
        • Skjaker S.A.
        • Melhuus K.
        • et al.
        Shoulder injuries from birth to old age: A 1-year prospective study of 3031 shoulder injuries in an urban population.
        Injury. 2018; 49: 1324-1329
        • Zacchilli M.A.
        • Owens B.D.
        Epidemiology of shoulder dislocations presenting to emergency departments in the United States.
        J Bone Joint Surg Am. 2010; 92: 542-549
        • Burkhart S.S.
        • De Beer J.F.
        Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion.
        Arthroscopy. 2000; 16: 677-694
        • Chalmers P.N.
        • Christensen G.
        • O'Neill D.
        • Tashjian R.Z.
        Does bone loss imaging modality, measurement methodology, and interobserver reliability alter treatment in glenohumeral instability?.
        Arthroscopy. 2020; 36: 12-19
        • Bishop J.Y.
        • Jones G.L.
        • Rerko M.A.
        • Donaldson C.
        • Group M.S.
        3-D CT is the most reliable imaging modality when quantifying glenoid bone loss.
        Clin Orthop Relat Res. 2013; 471: 1251-1256
        • Chuang T.Y.
        • Adams C.R.
        • Burkhart S.S.
        Use of preoperative three-dimensional computed tomography to quantify glenoid bone loss in shoulder instability.
        Arthroscopy. 2008; 24: 376-382
        • Saliken D.J.
        • Bornes T.D.
        • Bouliane M.J.
        • Sheps D.M.
        • Beaupre L.A.
        Imaging methods for quantifying glenoid and Hill-Sachs bone loss in traumatic instability of the shoulder: A scoping review.
        BMC Musculoskelet Disord. 2015; 16: 164
        • Chang E.Y.
        • Du J.
        • Chung C.B.
        UTE imaging in the musculoskeletal system.
        J Magn Reson Imaging. 2015; 41: 870-883
        • Ma Y.J.
        • West J.
        • Nazaran A.
        • et al.
        Feasibility of using an inversion-recovery ultrashort echo time (UTE) sequence for quantification of glenoid bone loss.
        Skeletal Radiol. 2018; 47: 973-980
        • Gyftopoulos S.
        • Yemin A.
        • Mulholland T.
        • et al.
        3DMR osseous reconstructions of the shoulder using a gradient-echo based two-point Dixon reconstruction: A feasibility study.
        Skeletal Radiol. 2013; 42: 347-352
        • Stillwater L.
        • Koenig J.
        • Maycher B.
        • Davidson M.
        3D-MR vs. 3D-CT of the shoulder in patients with glenohumeral instability.
        Skeletal Radiol. 2017; 46: 325-331
        • Breighner R.E.
        • Endo Y.
        • Konin G.P.
        • Gulotta L.V.
        • Koff M.F.
        • Potter H.G.
        Technical developments: Zero echo time imaging of the shoulder: Enhanced osseous detail by using MR imaging.
        Radiology. 2018; 286: 960-966
        • Carl M.
        • Bydder G.M.
        • Du J.
        UTE imaging with simultaneous water and fat signal suppression using a time-efficient multispoke inversion recovery pulse sequence.
        Magn Reson Med. 2016; 76: 577-582
        • Delso G.
        • Wiesinger F.
        • Sacolick L.I.
        • et al.
        Clinical evaluation of zero-echo-time MR imaging for the segmentation of the skull.
        J Nucl Med. 2015; 56: 417-422
        • Wiesinger F.
        • Sacolick L.I.
        • Menini A.
        • et al.
        Zero TE MR bone imaging in the head.
        Magn Reson Med. 2016; 75: 107-114
        • Breighner R.E.
        • Bogner E.A.
        • Lee S.C.
        • Koff M.F.
        • Potter H.G.
        Evaluation of osseous morphology of the hip using zero echo time magnetic resonance imaging.
        Am J Sports Med. 2019; 47: 3460-3468
        • Lenart B.A.
        • Freedman R.
        • Van Thiel G.S.
        • et al.
        Magnetic resonance imaging evaluation of normal glenoid length and width: An anatomic study.
        Arthroscopy. 2014; 30: 915-920
        • Landis J.R.
        • Koch G.G.
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33: 159-174
        • Bland J.M.
        • Altman D.G.
        Statistical methods for assessing agreement between two methods of clinical measurement.
        Lancet. 1986; 1: 307-310
        • Rerko M.A.
        • Pan X.
        • Donaldson C.
        • Jones G.L.
        • Bishop J.Y.
        Comparison of various imaging techniques to quantify glenoid bone loss in shoulder instability.
        J Shoulder Elbow Surg. 2013; 22: 528-534
        • Yanke A.B.
        • Shin J.J.
        • Pearson I.
        • et al.
        Three-dimensional magnetic resonance imaging quantification of glenoid bone loss is equivalent to 3-dimensional computed tomography quantification: Cadaveric study.
        Arthroscopy. 2017; 33: 709-715
        • Vopat B.G.
        • Cai W.
        • Torriani M.
        • et al.
        Measurement of glenoid bone loss with 3-dimensional magnetic resonance imaging: A matched computed tomography Analysis.
        Arthroscopy. 2018; 34: 3141-3147
        • Lansdown D.A.
        • Cvetanovich G.L.
        • Verma N.N.
        • et al.
        Automated 3-dimensional magnetic resonance imaging allows for accurate evaluation of glenoid bone loss compared with 3-dimensional computed tomography.
        Arthroscopy. 2019; 35: 734-740
        • Levoy M.
        Display of surfaces from volume data.
        IEEE Computer Graphics and Applications. 1988; 8: 29-37
        • Gyftopoulos S.
        • Hasan S.
        • Bencardino J.
        • et al.
        Diagnostic accuracy of MRI in the measurement of glenoid bone loss.
        AJR Am J Roentgenol. 2012; 199: 873-878
        • Provencher M.T.
        • Peebles L.A.
        • Akamefula R.A.
        Editorial commentary: Methodology of measuring bone loss in recurrent shoulder instability surgery: Traditional computed tomography scan and magnetic resonance imaging do not tell the full story.
        Arthroscopy. 2020; 36: 20-22
        • Weiger M.
        • Brunner D.O.
        • Dietrich B.E.
        • Muller C.F.
        • Pruessmann K.P.
        ZTE imaging in humans.
        Magn Reson Med. 2013; 70: 328-332
        • Lu A.
        • Gorny K.R.
        • Ho M.L.
        Zero TE MRI for craniofacial bone imaging.
        AJNR Am J Neuroradiol. 2019; 40: 1562-1566
        • Di Giacomo G.
        • Itoi E.
        • Burkhart S.S.
        Evolving concept of bipolar bone loss and the Hill-Sachs lesion: From "engaging/non-engaging" lesion to "on-track/off-track" lesion.
        Arthroscopy. 2014; 30: 90-98