ABSTRACT
Objective: To validate a semi-automated software method of quantifying knee osteoarthritis (KOA) related effusion-synovitis (ES) and Hoffa-synovitis (HS) on MRI. Materials and methods: 301 subjects were randomly selected from the FNIH sub cohort, a nested case control study within the Osteoarthritis Initiative (OAI), and distributed into 4 groups based on pain and radiographic progression. Measurements of ES and HS volume were made by 2 readers. Criterion validation was assessed through comparison with the MRI Osteoarthritis Knee Score (MOAKS) and the Spearman correlation coefficient r value. Reader reliability was measured on a subset of 30 subjects and intra-class correlation coefficients (ICCs). Clinical validity was assessed based on case control status using logistic regression and the area under the curve (AUC). Results: ES volume was highly correlated with MOAKS Scores (r â= â0.74), as was the HS measure but to a lesser extent (r â= â0.55). For ES, the intra-reader and intra-reader precision ICCs were 0.83 and 0.95 respectively and 0.98 and 0.96 for HS. For clinical validity, we found similar AUC values when comparing the software method to MOAKS. The average reader time was less than 15 âmin per knee for both ES and HS. Conclusion: We have demonstrated the validity of an efficient, accurate, and rapid ES and HS measurement method for KOA using MRI. To our knowledge, this is the first such software to measure both ES and HS. This method will offer an objective and efficient tool for clinical trials and other epidemiologic studies of KOA.
ABSTRACT
RATIONALE AND OBJECTIVES: Many medical specialties have incorporated portable ultrasound into their educational curriculum. Our objective was to determine the utility of an individual smart portable ultrasound device (iSPUD) as an educational tool in resident and fellowship Musculoskeletal Radiology training. MATERIALS AND METHODS: After Institutional Review Board approval, volunteer radiology trainees were instructed to use the iSPUD (Philips Lumify ultrasound probe and Samsung Galaxy Tab S2 8 inch tablet), asked to identify 10 wrist structures with the iSPUD and completed a Likert scale-based, pretest survey. Trainees were then given the iSPUD for 3 days of independent scanning practice. Afterward, trainees were asked to identify the same 10 wrist structures with the iSPUD and to complete a Likert scale-based, post-test survey. RESULTS: Twenty trainees volunteered to participate. Trainee performance on the 10-wrist structure identification test with the iSPUD resulted in a pretest mean number correct of 2.5 ± 2.16 and a post-test mean number correct of 9.85 ± 0.37 (p < 0.001). On the pretest survey, 68.42% (13/20) had never performed and 42.11% (8/20) had never interpreted a musculoskeletal ultrasound. On the post-test survey, 18/20 (94.74%) strongly agreed that access to an iSPUD would improve their ability to perform musculoskeletal ultrasound, improve ultrasound-guided interventional skills, and help them become better Radiologists. CONCLUSION: The use of an iSPUD as a tool in Musculoskeletal Radiology resident and fellow education can improve clinical ultrasound skills, build trainee technical confidence during diagnostic ultrasound procedures, and help trainees achieve their goal of becoming a competent Radiologist.
Subject(s)
Fellowships and Scholarships , Internship and Residency , Musculoskeletal System/diagnostic imaging , Radiology/education , Ultrasonography/instrumentation , Clinical Competence , Computers, Handheld , Fellowships and Scholarships/methods , Humans , Internship and Residency/methods , Wrist/diagnostic imagingABSTRACT
OBJECTIVES: Sonoelastography is an emerging technology that has been used to evaluate the musculoskeletal system including the brachial plexus of peripheral nerves, which has been only recently considered for study by shear wave elastography. The purpose of this study is to establish the normal sonoelastographic features of the C5-C7 nerve roots of the brachial plexus. METHODS: Forty healthy individuals (21 males and 19 females) were enrolled in the study. Shear wave elastography was used to evaluate the C5-C7 nerve roots of the brachial plexus at the interscalene interval. Normal sonoelastographic values were obtained. RESULTS: The mean shear elastic modulus of the C5 nerve root was 16.9 kPa (range 5.9-28.8 ± 4.9 standard deviation, SD), 15.7 kPa (range 5.4-26.3 ± 4.3 SD) for the C6 nerve root, and 16 kPa (range 8-29 ± 4.6 SD) for the C7 nerve root. There was a significant statistical difference between both sexes in the elastic modulus at the C6 and C7, but not at the C5 nerve roots. Significant inverse correlation with height was noted at the C6 nerve root. There was no statistical significant difference in tissue stiffness between right- and left-handed subjects, age, and body mass index. CONCLUSION: The elastic modulus of the C5-C7 nerve roots has been determined in asymptomatic individuals and can serve as a reference when studying pathological conditions of these structures. ABBREVIATIONS: BMI: body mass index; SWE: shear wave elastography.
