Assessment of proximal tibial fractures with 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI—intra-individual comparison with CT.
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| Title: | Assessment of proximal tibial fractures with 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI—intra-individual comparison with CT. |
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| Authors: | Ristow, Inka1 (AUTHOR) i.ristow@uke.de, Zhang, Shuo2 (AUTHOR), Riedel, Christoph1 (AUTHOR), Lenz, Alexander1 (AUTHOR), Akoto, Ralph3 (AUTHOR), Krause, Matthias4 (AUTHOR), Adam, Gerhard1 (AUTHOR), Bannas, Peter1 (AUTHOR), Henes, Frank Oliver1,5 (AUTHOR), Well, Lennart1 (AUTHOR) |
| Source: | European Radiology. Sep2025, Vol. 35 Issue 9, p5418-5426. 9p. |
| Subjects: | Tibial fractures, Knee injuries, Computer-assisted image analysis (Medicine), Cross-sectional imaging, Classification, Image quality in imaging systems, Radiation exposure |
| Abstract: | Objectives: To evaluate the feasibility and diagnostic performance of a 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI sequence for the detection and classification of proximal tibial fractures compared with CT. Methods: We retrospectively included 126 patients (85 male; 39.6 ± 14.5 years) from two centers following acute knee injury. Patients underwent knee MRI at 3 T including FRACTURE-MRI. Additional CT was performed in patients with tibial fractures (32.5%; n = 41) as the reference standard for fracture classification. Two radiologists independently evaluated FRACTURE-MRI for the presence of fractures and classified them according to AO/OTA, Schatzker, and the 10-segment classification. Diagnostic performance of FRACTURE-MRI was assessed using crosstabulations. Inter-reader agreement was estimated using Krippendorff's alpha. Image quality was graded on a five-point scale (5 = excellent; 1 = inadequate definition of fracture lines and fracture displacement) and assessed using estimated marginal means. Results: Fractures were detected by FRACTURE-MRI with a sensitivity of 91.5% (83.2–96.5%) and a specificity of 97.1% (93.3–99.0%). Regarding fracture classification, diagnostic performances were slightly lower, with the 10-segment classification yielding the best sensitivity of 85.7% (81.4–89.3%) and specificity of 97.4% (96.6–98.0%), and the Schatzker classification yielding the lowest sensitivity of 78.2% (67.4–86.8%) and specificity of 97.7% (94.1–99.4%). Inter-reader agreement across the whole cohort was excellent (Krippendorff's alpha 0.89–0.96) and when considering only patients with fractures, good to acceptable (0.48–0.91). Image quality was rated good (estimated marginal mean 4.3 (4.1–4.4)). Conclusion: FRACTURE-MRI is feasible at 3 T enabling accurate delineation of fracture lines for precise diagnosis and classification of proximal tibial fractures. Key Points: QuestionCT-like MRI is increasingly being evaluated for its advantages in bone imaging but is not yet established in routine practice. FindingsThe 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI sequence is feasible at 3 T, allowing for diagnosis and classification of proximal tibial fractures. Clinical relevanceFRACTURE-MRI might be a helpful alternative to computed tomography in an acute trauma setting by reducing costs and radiation exposure in patients requiring a preoperative MRI anyway. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Items | – Name: Title Label: Title Group: Ti Data: Assessment of proximal tibial fractures with 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI—intra-individual comparison with CT. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Ristow%2C+Inka%22">Ristow, Inka</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> i.ristow@uke.de</i><br /><searchLink fieldCode="AR" term="%22Zhang%2C+Shuo%22">Zhang, Shuo</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Riedel%2C+Christoph%22">Riedel, Christoph</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lenz%2C+Alexander%22">Lenz, Alexander</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Akoto%2C+Ralph%22">Akoto, Ralph</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Krause%2C+Matthias%22">Krause, Matthias</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Adam%2C+Gerhard%22">Adam, Gerhard</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bannas%2C+Peter%22">Bannas, Peter</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Henes%2C+Frank+Oliver%22">Henes, Frank Oliver</searchLink><relatesTo>1,5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Well%2C+Lennart%22">Well, Lennart</searchLink><relatesTo>1</relatesTo> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Sep2025, Vol. 35 Issue 9, p5418-5426. 9p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Tibial+fractures%22">Tibial fractures</searchLink><br /><searchLink fieldCode="DE" term="%22Knee+injuries%22">Knee injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Computer-assisted+image+analysis+%28Medicine%29%22">Computer-assisted image analysis (Medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22Cross-sectional+imaging%22">Cross-sectional imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Classification%22">Classification</searchLink><br /><searchLink fieldCode="DE" term="%22Image+quality+in+imaging+systems%22">Image quality in imaging systems</searchLink><br /><searchLink fieldCode="DE" term="%22Radiation+exposure%22">Radiation exposure</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: To evaluate the feasibility and diagnostic performance of a 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI sequence for the detection and classification of proximal tibial fractures compared with CT. Methods: We retrospectively included 126 patients (85 male; 39.6 ± 14.5 years) from two centers following acute knee injury. Patients underwent knee MRI at 3 T including FRACTURE-MRI. Additional CT was performed in patients with tibial fractures (32.5%; n = 41) as the reference standard for fracture classification. Two radiologists independently evaluated FRACTURE-MRI for the presence of fractures and classified them according to AO/OTA, Schatzker, and the 10-segment classification. Diagnostic performance of FRACTURE-MRI was assessed using crosstabulations. Inter-reader agreement was estimated using Krippendorff's alpha. Image quality was graded on a five-point scale (5 = excellent; 1 = inadequate definition of fracture lines and fracture displacement) and assessed using estimated marginal means. Results: Fractures were detected by FRACTURE-MRI with a sensitivity of 91.5% (83.2–96.5%) and a specificity of 97.1% (93.3–99.0%). Regarding fracture classification, diagnostic performances were slightly lower, with the 10-segment classification yielding the best sensitivity of 85.7% (81.4–89.3%) and specificity of 97.4% (96.6–98.0%), and the Schatzker classification yielding the lowest sensitivity of 78.2% (67.4–86.8%) and specificity of 97.7% (94.1–99.4%). Inter-reader agreement across the whole cohort was excellent (Krippendorff's alpha 0.89–0.96) and when considering only patients with fractures, good to acceptable (0.48–0.91). Image quality was rated good (estimated marginal mean 4.3 (4.1–4.4)). Conclusion: FRACTURE-MRI is feasible at 3 T enabling accurate delineation of fracture lines for precise diagnosis and classification of proximal tibial fractures. Key Points: QuestionCT-like MRI is increasingly being evaluated for its advantages in bone imaging but is not yet established in routine practice. FindingsThe 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI sequence is feasible at 3 T, allowing for diagnosis and classification of proximal tibial fractures. Clinical relevanceFRACTURE-MRI might be a helpful alternative to computed tomography in an acute trauma setting by reducing costs and radiation exposure in patients requiring a preoperative MRI anyway. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-025-11522-3 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 9 StartPage: 5418 Subjects: – SubjectFull: Tibial fractures Type: general – SubjectFull: Knee injuries Type: general – SubjectFull: Computer-assisted image analysis (Medicine) Type: general – SubjectFull: Cross-sectional imaging Type: general – SubjectFull: Classification Type: general – SubjectFull: Image quality in imaging systems Type: general – SubjectFull: Radiation exposure Type: general Titles: – TitleFull: Assessment of proximal tibial fractures with 3D FRACTURE (fast field echo resembling a CT using restricted echo-spacing) MRI—intra-individual comparison with CT. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Ristow, Inka – PersonEntity: Name: NameFull: Zhang, Shuo – PersonEntity: Name: NameFull: Riedel, Christoph – PersonEntity: Name: NameFull: Lenz, Alexander – PersonEntity: Name: NameFull: Akoto, Ralph – PersonEntity: Name: NameFull: Krause, Matthias – PersonEntity: Name: NameFull: Adam, Gerhard – PersonEntity: Name: NameFull: Bannas, Peter – PersonEntity: Name: NameFull: Henes, Frank Oliver – PersonEntity: Name: NameFull: Well, Lennart IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 09 Text: Sep2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 35 – Type: issue Value: 9 Titles: – TitleFull: European Radiology Type: main |
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