Journal article
Diagnostic Accuracy of Proton Density Versus Proton Density Fat-Saturated MRI Sequences in Meniscal Tear Evaluation: A Multireader ROC Analysis
Clinical radiology, 107314
03/2026
DOI: 10.1016/j.crad.2026.107314
Abstract
Compare the diagnostic performance of proton density and proton density fat-saturated MRI sequences in detecting meniscal tears using receiver operating characteristic curve analysis with multiple independent readers.
This retrospective, institutional review board approved study included 98 patients who underwent knee arthroscopy for suspected meniscal tears between July 1, 2020, and January 31, 2021. Sagittal proton density and proton density fat-saturated MRI sequences were independently reviewed by three musculoskeletal radiologists on separate days. Readers rated diagnostic confidence on a 5 point scale. Diagnostic accuracy was assessed using area under the curve, DeLong tests, sensitivity, specificity, positive predictive value, and negative predictive value, with arthroscopy as the reference standard. Binary classification was based on reader scores of 4 or 5, and agreement from at least two of three readers was required.
For medial meniscal tears, proton density sequences yielded an area under the curve of 0.9302, sensitivity of 93.2%, and specificity of 87.5%. Proton density fat-saturated sequences yielded an area under the curve of 0.9229, sensitivity of 95.9%, and specificity of 79.2% (DeLong p = 0.575). For lateral meniscal tears, area under the curve was 0.8329 for proton density and 0.8088 for proton density fat-saturated sequences (DeLong p = 0.339).
Both sequences demonstrated high diagnostic performance for meniscal tear detection. Fat-saturated sequences showed slightly higher sensitivity but lower specificity. No significant difference in diagnostic accuracy was observed between sequences.
•PD and PD-FS show comparable diagnostic accuracy for meniscal tears.•Tear conspicuity does not significantly differ between sequences.•PD imaging alone may be sufficient for meniscal tear evaluation.
Details
- Title: Subtitle
- Diagnostic Accuracy of Proton Density Versus Proton Density Fat-Saturated MRI Sequences in Meniscal Tear Evaluation: A Multireader ROC Analysis
- Creators
- Garrick J. Gama - University of California, DavisCatherina Zadeh - University of IowaHoward O’Rourke - University of IowaD. Lee Bennett - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Clinical radiology, 107314
- DOI
- 10.1016/j.crad.2026.107314
- ISSN
- 0009-9260
- Publisher
- Elsevier Ltd
- Language
- English
- Electronic publication date
- 03/2026
- Academic Unit
- Radiology
- Record Identifier
- 9985149416302771
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