ArticleSkeletal radiology2026
Real-world diagnostic performance of knee MRI protocols accelerated using simultaneous multi-slice acquisition and deep learning reconstruction.
Article in Skeletal radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo assess whether accelerated knee MRI protocols using simultaneous multi-slice (SMS) and deep learning reconstruction (DLR) are non-inferior to a conventional parallel imaging protocol for detecting internal derangement injuries.
methodsThis retrospective cohort study included 1055 patients who underwent knee MRI followed by arthroscopy within 180 days. Patients were scanned using either a conventional protocol (n = 226), an accelerated SMS protocol (n = 406), or a SMS with DLR protocol (n = 423). Each group included consecutive exams. Imaging was performed on 3 T MRI using five standardized two-dimensional turbo spin echo sequences. Radiology interpretations were compared with arthroscopy (reference standard) for anterior cruciate ligament (ACL), medial meniscus (MM), and lateral meniscus (LM) tears. Sensitivity and specificity were calculated with 95% confidence intervals using non-parametric bootstrapping. Non-inferiority was concluded if the upper bound of the 95% confidence interval for the difference in sensitivity and specificity was ≤ 0.05.
resultsAmong all patients, 666 had MM tears, 417 had LM tears, and 220 had ACL tears. Sensitivity for ACL tears was higher with accelerated protocols (0.96 and 0.98) than the conventional (0.85), with non-inferiority confirmed. Specificity was ≥ 0.98 across all protocols. MM sensitivity (0.94-0.95) met non-inferiority criteria. MM specificity (0.88-0.91) and LM sensitivity (0.63-0.68) were not statistically different across protocols but did not meet the non-inferiority margin. LM specificity (0.94) met non-inferiority criteria.
conclusionAccelerated MRI protocols using SMS and DLR demonstrated comparable diagnostic performance to the reference protocol. Although not all metrics met the strict non-inferiority margin, none showed statistically significant reductions in sensitivity or specificity. These findings support the clinical adoption of accelerated protocols for faster, high-throughput knee imaging.
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