René Panduro Poggenborg1, Susanne Juhl Pedersen2, Iris Eshed3, Inge Juul Sørensen4, Jakob M Møller3, Ole Rintek Madsen3, Henrik S Thomsen3, Mikkel Østergaard4. 1. Copenhagen Center for Arthritis Research, Copenhagen Center for Rheumatology and Spinal Diseases, University Hospital Copenhagen Glostrup, Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Department of Rheumatology and Medicine, University Hospital Copenhagen Gentofte, Copenhagen, Denmark, Department of Diagnostic Imaging, Sheba Medical Center, Tel Giborim, Tel Aviv University Israel and Department of Radiology, University Hospital Copenhagen Herlev, Copenhagen, Denmark Copenhagen Center for Arthritis Research, Copenhagen Center for Rheumatology and Spinal Diseases, University Hospital Copenhagen Glostrup, Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Department of Rheumatology and Medicine, University Hospital Copenhagen Gentofte, Copenhagen, Denmark, Department of Diagnostic Imaging, Sheba Medical Center, Tel Giborim, Tel Aviv University Israel and Department of Radiology, University Hospital Copenhagen Herlev, Copenhagen, Denmark poggenborg@dadlnet.dk. 2. Copenhagen Center for Arthritis Research, Copenhagen Center for Rheumatology and Spinal Diseases, University Hospital Copenhagen Glostrup, Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Department of Rheumatology and Medicine, University Hospital Copenhagen Gentofte, Copenhagen, Denmark, Department of Diagnostic Imaging, Sheba Medical Center, Tel Giborim, Tel Aviv University Israel and Department of Radiology, University Hospital Copenhagen Herlev, Copenhagen, Denmark Copenhagen Center for Arthritis Research, Copenhagen Center for Rheumatology and Spinal Diseases, University Hospital Copenhagen Glostrup, Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Department of Rheumatology and Medicine, University Hospital Copenhagen Gentofte, Copenhagen, Denmark, Department of Diagnostic Imaging, Sheba Medical Center, Tel Giborim, Tel Aviv University Israel and Department of Radiology, University Hospital Copenhagen Herlev, Copenhagen, Denmark Copenhagen Center for Arthritis Research, Copenhagen Center for Rheumatology and Spinal Diseases, University Hospital Copenhagen Glostrup, Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Department of Rheumatology and Medicine, University Hospital Copenhagen Gentofte, Copenhagen, Denmark, Department of Diagnostic Imaging, Sheba Medical Center, Tel Giborim, Tel Aviv University Israel and Department of Radiology, University Hospital Copenhagen Herlev, Copenhagen, Denmark. 3. Copenhagen Center for Arthritis Research, Copenhagen Center for Rheumatology and Spinal Diseases, University Hospital Copenhagen Glostrup, Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Department of Rheumatology and Medicine, University Hospital Copenhagen Gentofte, Copenhagen, Denmark, Department of Diagnostic Imaging, Sheba Medical Center, Tel Giborim, Tel Aviv University Israel and Department of Radiology, University Hospital Copenhagen Herlev, Copenhagen, Denmark. 4. Copenhagen Center for Arthritis Research, Copenhagen Center for Rheumatology and Spinal Diseases, University Hospital Copenhagen Glostrup, Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Department of Rheumatology and Medicine, University Hospital Copenhagen Gentofte, Copenhagen, Denmark, Department of Diagnostic Imaging, Sheba Medical Center, Tel Giborim, Tel Aviv University Israel and Department of Radiology, University Hospital Copenhagen Herlev, Copenhagen, Denmark Copenhagen Center for Arthritis Research, Copenhagen Center for Rheumatology and Spinal Diseases, University Hospital Copenhagen Glostrup, Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Department of Rheumatology and Medicine, University Hospital Copenhagen Gentofte, Copenhagen, Denmark, Department of Diagnostic Imaging, Sheba Medical Center, Tel Giborim, Tel Aviv University Israel and Department of Radiology, University Hospital Copenhagen Herlev, Copenhagen, Denmark.
Abstract
OBJECTIVES: By whole-body MRI (WBMRI), we aimed to examine the frequency and distribution of inflammatory and structural lesions in PsA patients, SpA patients and healthy subjects (HSs), to introduce global WBMRI inflammation/damage scores, and to assess WBMRI's reproducibility and correlation with conventional MRI (convMRI). METHODS: WBMRI (3.0-T) of patients with peripheral PsA (n = 18) or axial SpA (n = 18) and of HS (n = 12) was examined for proportion of evaluable features (readability) and the presence and pattern of lesions in axial and peripheral joints. Furthermore, global WBMRI scores of inflammation and structural damage were constructed, and WBMRI findings were compared with clinical measures and convMRI (SpA/HS: spine and SI joints; PsA/HS: hand). RESULTS: The readability (92-100%) and reproducibility (intrareader intraclass correlation coefficient: 0.62-1.0) were high in spine/SI joint, but lower in the distal peripheral joints. Wrists, shoulders, knees, ankles and MTP joints were most commonly involved, with frequency of synovitis > bone marrow oedema (BMO) > erosion. WBMRI global BMO scores of peripheral and axial joints were higher in PsA {median 7 [interquartile range (IQR) 3-15]} and SpA [8 (IQR 2-14)] than in HSs [2.5 (IQR 1-4.5)], both P < 0.05. WBMRI global structural damage scores (erosion, fat infiltration and ankylosis) were higher in SpA [7 (IQR 3-12)] than HSs [1.5 (IQR 0-4.5)], P = 0.012. Correlations between WBMRI and convMRI spine and SI joint scores were ρ = 0.20-0.78. CONCLUSION: WBMRI allows simultaneous assessment of peripheral and axial joints in PsA and SpA, and the distribution of inflammatory and structural lesions and global scores can be determined. The study strongly encourages further development and longitudinal testing of WBMRI techniques and assessment methods in PsA and SpA.
OBJECTIVES: By whole-body MRI (WBMRI), we aimed to examine the frequency and distribution of inflammatory and structural lesions in PsA patients, SpApatients and healthy subjects (HSs), to introduce global WBMRI inflammation/damage scores, and to assess WBMRI's reproducibility and correlation with conventional MRI (convMRI). METHODS: WBMRI (3.0-T) of patients with peripheral PsA (n = 18) or axial SpA (n = 18) and of HS (n = 12) was examined for proportion of evaluable features (readability) and the presence and pattern of lesions in axial and peripheral joints. Furthermore, global WBMRI scores of inflammation and structural damage were constructed, and WBMRI findings were compared with clinical measures and convMRI (SpA/HS: spine and SI joints; PsA/HS: hand). RESULTS: The readability (92-100%) and reproducibility (intrareader intraclass correlation coefficient: 0.62-1.0) were high in spine/SI joint, but lower in the distal peripheral joints. Wrists, shoulders, knees, ankles and MTP joints were most commonly involved, with frequency of synovitis > bone marrow oedema (BMO) > erosion. WBMRI global BMO scores of peripheral and axial joints were higher in PsA {median 7 [interquartile range (IQR) 3-15]} and SpA [8 (IQR 2-14)] than in HSs [2.5 (IQR 1-4.5)], both P < 0.05. WBMRI global structural damage scores (erosion, fat infiltration and ankylosis) were higher in SpA [7 (IQR 3-12)] than HSs [1.5 (IQR 0-4.5)], P = 0.012. Correlations between WBMRI and convMRI spine and SI joint scores were ρ = 0.20-0.78. CONCLUSION: WBMRI allows simultaneous assessment of peripheral and axial joints in PsA and SpA, and the distribution of inflammatory and structural lesions and global scores can be determined. The study strongly encourages further development and longitudinal testing of WBMRI techniques and assessment methods in PsA and SpA.
Authors: Xenofon Baraliakos; Philip G Conaghan; Maria-Antonietta D'Agostino; Walter Maksymowych; Esperanza Naredo; Mikkel Ostergaard; Georg Schett; Paul Emery Journal: Eur J Rheumatol Date: 2019-01