Are contrast-enhanced and non-contrast MRI findings reflecting synovial inflammation in knee osteoarthritis: a meta-analysis of observational studies

Shakoor D, Demehri S, Roemer F, Loeuille D, Felson DT, Guermazi A (2020)

Publication Type: Journal article, Review article

Publication year: 2020

Journal

Osteoarthritis and Cartilage Elsevier

DOI: 10.1016/j.joca.2019.10.008

Abstract

Objective: To determine the correlation between knee synovitis assessed on contrast-enhanced (CE) and non-contrast enhanced (NCE) magnetic resonance imaging (MRI) with histology in patients with knee osteoarthritis. Methods: A comprehensive literature search was performed, and related articles published through July 2018 were extracted. Spearman correlation coefficients of MRI-based scores with histology reports were pooled using random effects model. To evaluate presence of publication bias, Egger test was performed. Results: Of 2377 identified records, eight studies consisting of 246 MRI exams were included. Two studies reported results of dynamic CE (DCE)-MRI examinations (81 knees) and two studies reported results of NCE-MRI. There were moderate positive correlations between CE-MRI scores and macroscopic (r = 0.53 (95% Confidence Interval (CI):0.37–0.66), P < 0.001) as well as microscopic (r = 0.56 (0.39–0.69), P < 0.001) histology. DCE-MRI were strongly correlated (r = 0.71 (0.58–0.80), P-value<0.001), with microscopic histology reports, while the correlation for NCE-MRI was low positive (r = 0.44 (0.20–0.63), P < 0.001). Meta-regression analysis showed that pooled correlation coefficients of DCE-MRI were significantly higher than CE-MRI (Slope = 0.29, SE = 0.13, P-value = 0.02). CE-MRI were also correlated with inflammatory infiltrate (r = 0.42), while the correlations for cell number of synovial lining (r = 0.27) and level of fibrosis (r = 0.29, P < 0.001) were very low. Conclusion: Static and dynamic CE-MRI evaluation of knee synovitis were positively correlated with macroscopic and microscopic features of synovial membrane inflammation. Among the features of synovial tissue inflammation, CE-MRI scores correlated best with the inflammatory infiltrates of synovial tissue. Paucity of current evidence warrants further studies to assess performance of NCE-MRI on determining knee synovitis.

Authors with CRIS profile

Frank Roemer Institute of Radiology

Involved external institutions

Johns Hopkins University (JHU) US United States (USA) (US) Centre Hospitalier Universitaire de Nancy / CHU Hôpitaux de Brabois FR France (FR) Boston Medical Center (BMC) US United States (USA) (US)

How to cite

APA:

Shakoor, D., Demehri, S., Roemer, F., Loeuille, D., Felson, D.T., & Guermazi, A. (2020). Are contrast-enhanced and non-contrast MRI findings reflecting synovial inflammation in knee osteoarthritis: a meta-analysis of observational studies. Osteoarthritis and Cartilage. https://doi.org/10.1016/j.joca.2019.10.008

MLA:

Shakoor, D., et al. "Are contrast-enhanced and non-contrast MRI findings reflecting synovial inflammation in knee osteoarthritis: a meta-analysis of observational studies." Osteoarthritis and Cartilage (2020).

BibTeX: Download