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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
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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
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WRAP-reliability-slice-encoding-metal-artefact-correction-(SEMAC)-MRI-identify-prosthesis-loosening-patients-with-painful-total-hip-arthroplasty-Backhouse-2022.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (271Kb) | Preview |
Official URL: http://dx.doi.org/10.1259/bjr.20210940
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 | ||||||
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| 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 |
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| 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: |
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| Volume: | 95 | ||||||
| Article Number: | 20210940 | ||||||
| DOI: | 10.1259/bjr.20210940 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access |
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