Motoshi Fujimori1, Tamotsu Kamishima2, Masaru Kato3, Yumika Seno4, Kenneth Sutherland5,6, Hiroyuki Sugimori2, Mutsumi Nishida7, Tatsuya Atsumi3. 1. 1 Master Course of Health Sciences, Graduate School of Health Sciences, Hokkaido University, Sapporo , Hokkaido , Japan. 2. 2 Department of Biomedical Science and Engineering, Faculty of Health Sciences, Hokkaido University , Hokkaido, Sapporo , Japan. 3. 3 Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo , Japan. 4. 4 Department of Health Sciences,Hokkaido University , Sapporo, Hokkaido , Japan. 5. 5 Global Station for Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University , Sapporo, Hokkaido , Japan. 6. 6 Division of Photonic Bioimaging, Faculty of Medicine Research Center for Cooperative Projects, Hokkaido University , Sapporo , Japan. 7. 7 Division of Laboratory and Transfusion Medicine/Diagnostic Center for Sonography, Hokkaido University Hospital , Sapporo, Hokkaido , Japan.
Abstract
OBJECTIVE: Power Doppler ultrasonography (PDUS) and MRI are independently useful to predict structural damage in patients with rheumatoid arthritis (RA). We hypothesize that there is a complementary relationship between these modalities. The aim of this study is, therefore, to investigate the usefulness of the predictive value of composite assessment of PDUS and contrast-enhanced MRI in radiographic outcomes in patients with RA. METHODS: 20 patients (17 females and 3 males) with RA on disease-modifying antirheumatic drugs underwent PDUS and MRI of both hands at baseline. Radiography of the bilateral hands was performed at baseline and at 1 year. Articular synovitis on PDUS was evaluated according to quantitative measurement. Synovitis, bone marrow edema and bone erosion were scored according to the RA MRI scoring method. The changes of joint space narrowing and bone erosion on radiograph were assessed by the Sharp/van der Heijde method. We applied t-statistics to combine the assessment of quantitative PDUS with semiquantitative MRI. RESULTS: Structural damage progression for radiography was not correlated with any evaluations for MRI, while it showed significant correlation with synovitis on PDUS (rs = 0.597, p = 0.005). The composite assessment of both modalities (synovitis for PDUS and bone marrow edema for MRI) was correlated with structural damage progression on radiograph (rs = 0.792, p < 0.0001). CONCLUSION: Composite assessment of PDUS and MRI may have a stronger predictive value in radiographic progression than PDUS or MRI alone in RA. Advances in knowledge: Composite assessment of PDUS and MRI may be an effective predictor of structural damage in RA.
OBJECTIVE: Power Doppler ultrasonography (PDUS) and MRI are independently useful to predict structural damage in patients with rheumatoid arthritis (RA). We hypothesize that there is a complementary relationship between these modalities. The aim of this study is, therefore, to investigate the usefulness of the predictive value of composite assessment of PDUS and contrast-enhanced MRI in radiographic outcomes in patients with RA. METHODS: 20 patients (17 females and 3 males) with RA on disease-modifying antirheumatic drugs underwent PDUS and MRI of both hands at baseline. Radiography of the bilateral hands was performed at baseline and at 1 year. Articular synovitis on PDUS was evaluated according to quantitative measurement. Synovitis, bone marrow edema and bone erosion were scored according to the RA MRI scoring method. The changes of joint space narrowing and bone erosion on radiograph were assessed by the Sharp/van der Heijde method. We applied t-statistics to combine the assessment of quantitative PDUS with semiquantitative MRI. RESULTS:Structural damage progression for radiography was not correlated with any evaluations for MRI, while it showed significant correlation with synovitis on PDUS (rs = 0.597, p = 0.005). The composite assessment of both modalities (synovitis for PDUS and bone marrow edema for MRI) was correlated with structural damage progression on radiograph (rs = 0.792, p < 0.0001). CONCLUSION: Composite assessment of PDUS and MRI may have a stronger predictive value in radiographic progression than PDUS or MRI alone in RA. Advances in knowledge: Composite assessment of PDUS and MRI may be an effective predictor of structural damage in RA.
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