Takahashi, Tsuneari, Thaker, Siddharth, Lettieri, Giovanni, Redmond, Anthony, Backhouse, Michael, Stone, Martin, Pandit, Hemant and O'Connor, Philip (2022) Reliability of slice-encoding for metal artefact correction (SEMAC) MRI to identify prosthesis loosening in patients with painful total hip arthroplasty – a single centre, prospective, surgical validation study. The British Journal of Radiology, 95 . 20210940. doi:10.1259/bjr.20210940 ISSN 0007-1285.

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Abstract

Objectives:
To validate reliability of slice-encoding for metal artefact correction (SEMAC)-MRI findings in prosthesis loosening detection by comparing them to surgical outcomes (gold standard) in symptomatic patients following hip arthroplasties. To evaluate periprosthetic anatomical structures in symptomatic patients to identify an alternative cause of hip symptoms.

Methods:
We prospectively followed 47 symptomatic patients (55 hips, 39 painful hips – group P and 16 control hips – group C) at our institution from 2011 to 2016. We acquired 1.5 T MRI conventional and SEMAC-MRI images for all patients. Two consultants scored MRI for osteolysis and marrow oedema zone-wise using predefined signal characteristics and settled scoring variations by consensus. We used Spearman Rank-Order Correlation for correlation analysis and used OMERACT (Outcome Measures in Rheumatology) filter pillars to validate SEMAC-MRI findings.

Results:
Eleven patients needed revision surgery, all from group P. None from group C required revision surgery. Remaining 28 hips in the group P were managed conservatively pain completely resolved in 21 hips, eight hips had trochanteric bursitis, eight had extraarticular cause and the remaining five hips had spontaneous pain resolution. We found moderate-to-weak correlation between SEMAC-MRI findings for prosthesis loosening and revision surgery outcomes. Sensitivity, Specificity, PPV and NPV in Group P were (72.7, 64.3, 44.4, 85.7%) in T1W-SEMAC, (90.9, 46.4, 40.0, 92.9%) in STIR-SEMAC and (36.3, 78.5, 40.0, 75.8%) in PDW-SEMAC.

Conclusion:
Negative SEMAC-MRI results can effectively exclude prosthesis loosening confirmed on revision surgery and SEMAC-MRI can detect alternative cause of hip pain accurately.

Advances in knowledge:
Negative SEMAC-MRI in painful THA patients can effectively exclude prosthesis loosening as a cause.

Item Type:	Journal Article
Subjects:	R Medicine > RD Surgery
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Metals in surgery, Prosthesis , Total hip replacement , Hip joint -- Magnetic resonance imaging, Hip joint
Journal or Publication Title:	The British Journal of Radiology
Publisher:	British Institute of Radiology
ISSN:	0007-1285
Official Date:	11 February 2022
Dates:	Date Event 11 February 2022 Published 23 December 2022 Accepted
Volume:	95
Article Number:	20210940
DOI:	10.1259/bjr.20210940
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	17 February 2022
Date of first compliant Open Access:	22 February 2022

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