Faculty Bibliography

OBJECTIVE:This study aims to determine the diagnostic performance of sub-5-min combined sixfold parallel imaging (PIx3)-simultaneous multislice (SMSx2)-accelerated deep learning (DL) super-resolution 3T knee MRI in children and adolescents. MATERIALS AND METHODS/METHODS:Children with painful knee conditions who underwent PIx3-SMSx2-accelerated DL super-resolution 3T knee MRI and arthroscopy between October 2022 and December 2023 were retrospectively included. Nine fellowship-trained musculoskeletal radiologists independently scored the MRI studies for image quality and the presence of artifacts (Likert scales, range: 1 = very bad/severe, 5 = very good/absent), as well as structural abnormalities. Interreader agreements and diagnostic performance testing was performed. RESULTS:Forty-four children (mean age: 15 ± 2 years; range: 9-17 years; 24 boys) who underwent knee MRI and arthroscopic surgery within 22 days (range, 2-133) were evaluated. Overall image quality was very good (median rating: 5 [IQR: 4-5]). Motion artifacts (5 [5-5]) and image noise (5 [4-5]) were absent. Arthroscopy-verified abnormalities were detected with good or better interreader agreement (κ ≥ 0.74). Sensitivity, specificity, accuracy, and AUC values were 100%, 84%, 93%, and 0.92, respectively, for anterior cruciate ligament tears; 71%, 97%, 93%, and 0.84 for medial meniscus tears; 65%, 100%, 86%, and 0.82 for lateral meniscus tears; 100%, 100%, 100%, and 1.00 for discoid lateral menisci; 100%, 95%, 96%, and 0.98 for medial patellofemoral ligament tears; and 55%, 100%, 98%, and 0.77 for articular cartilage defects. CONCLUSION/CONCLUSIONS:Clinical sub-5-min PIx3-SMSx2-accelerated DL super-resolution 3T knee MRI provides excellent image quality and high diagnostic performance for diagnosing internal derangement in children and adolescents.

The past decade has witnessed remarkable advancements in musculoskeletal radiology, driven by increasing demand for medical imaging and rapid technological innovations. Contrary to early concerns about artificial intelligence (AI) replacing radiologists, AI has instead enhanced imaging capabilities, aiding in automated abnormality detection and workflow efficiency. MRI has benefited from acceleration techniques that significantly reduce scan times while maintaining high-quality imaging. In addition, novel MRI methodologies now support precise anatomic and quantitative imaging across a broad spectrum of field strengths. In CT, dual-energy and photon-counting technologies have expanded diagnostic possibilities for musculoskeletal applications. This review explores these key developments, examining their impact on clinical practice and the future trajectory of musculoskeletal radiology.

OBJECTIVES/OBJECTIVE:To perform a Delphi-based consensus on published evidence on image-guided injections for facet joint pain (FJP) and provide clinical indications. METHODS:We report the results of an evidence-based Delphi consensus of 38 experts from the European Society of Musculoskeletal Radiology and the European Society of Neuroradiology, who reviewed the published literature for evidence on image-guided injections for FJP. Experts drafted a list of statements and graded them according to the Oxford Centre for evidence-based medicine levels of evidence. Consensus was considered strong when ≥ 95% of experts agreed with the statement or broad when > 80% but < 95% agreed. The results of the consensus were used to write the paper. RESULTS:Twenty statements on image-guided FJP treatment have been drafted. Eighteen statements received strong consensus, while two received broad consensus. Three statements reached the highest level of evidence, all of them regarding the lumbar spine. All radiological methods are used for image-guided injections for FJP, and regardless of the radiological method used, all show good safety and efficacy. Facet joint injections and medial branch blocks are used in all spinal regions to treat FJP, and both show similar clinical outcomes. Advanced technological solutions have been studied in the field of lumbar FJP; however, the level of evidence for these is low. CONCLUSION/CONCLUSIONS:Despite promising results reported by published papers on image-guided injections for FJP, there is still a lack of evidence on injection efficacy, appropriateness of imaging methods, and optimal medication. KEY POINTS/CONCLUSIONS:Question Image-guided injections to treat facet joint pain (FJP) are performed throughout the spine; however, the highest level of evidence exists for the lumbar spine. Findings Regardless of the imaging method used, image-guided injections for facet joint pain treatment are safe, with only minor adverse events in rare cases. Clinical relevance All imaging methods are used for injection guidance to treat FJP, each with advantages and disadvantages. These statements on image-guided injections for FJP provide a concise and up to date overview on the topic, serving as a list of clinical indications.

Dual-energy computed tomography (DECT) has emerged as a transformative tool in the past decade. Initially employed in gout within the field of rheumatology to distinguish and quantify monosodium urate crystals through its dual-material discrimination capability, DECT has since broadened its clinical applications. It now encompasses various rheumatic diseases, employing advanced techniques such as bone marrow edema assessment, iodine mapping, and collagen-specific imaging. This review article aims to examine the unique characteristics of DECT, discuss its strengths and limitations, illustrate its applications for accurately evaluating various rheumatic diseases in clinical practice, and propose future directions for DECT in rheumatology.

PURPOSE/OBJECTIVE:mapping technique for imaging of body parts containing metal hardware, based on magnitude images acquired with turbo spin echo (TSE) pulse sequences. THEORY AND METHODS/METHODS:values were validated against gradient-recalled and spin echo dual angle methods, as well as a vendor-provided TurboFLASH-based mapping sequence, in gel phantoms and human subjects without and with metal implants. RESULTS:shimming. CONCLUSION/CONCLUSIONS:values in regions near metal hardware, overcoming susceptibility-related and narrow-range limitations of standard mapping techniques.