Sara K Tedeschi1, Fabio Becce2, Tristan Pascart3, Ali Guermazi4, Jean-François Budzik5, Nicola Dalbeth6, Georgios Filippou7, Annamaria Iagnocco8, Minna J Kohler9, Jean-Denis Laredo10, Stacy E Smith11, F Joseph Simeone12, Janeth Yinh9, Hyon Choi9, Abhishek Abhishek13. 1. Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital and Harvard Medical School, Boston, United States. 2. Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. 3. Department of Rheumatology, Lille Catholic University, Lille, France. 4. Department of Radiology, Boston VA Healthcare System, Boston University School of Medicine, Boston, USA. 5. Department of Diagnostic and Interventional Radiology, Lille Catholic Hospitals, Lille, France. 6. Department of Medicine, University of Auckland, Auckland, New Zealand. 7. Division of Rheumatology, Luigi Sacco University Hospital, Milan, Italy. 8. Academic Rheumatology Centre, Dipartimento Scienze Cliniche e Biologiche, Università degli Studi di Torino, Turin, Italy. 9. Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital and Harvard Medical School, Boston, United States. 10. Department of Orthopedic Surgery, Hôpital Lariboisière, Assistance Publique des Hôpitaux de Paris, UMR CNRS 7052, Université de Paris, Paris, France. 11. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, United States. 12. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, United States. 13. Department of Academic Rheumatology, University of Nottingham, Nottingham, United Kingdom.
Abstract
OBJECTIVES: To develop definitions for imaging features being considered as potential classification criteria for calcium pyrophosphate deposition (CPPD) disease, additional to clinical and laboratory criteria, and to compile example images of CPPD on different imaging modalities. METHODS: The ACR/EULAR CPPD classification criteria Imaging Advisory Group (IAG) and Steering Committee drafted definitions of imaging features that are characteristic of CPPD on conventional radiography (CR), conventional computed tomography (CT), dual-energy CT (DECT), and magnetic resonance imaging (MRI). An anonymous expert survey was undertaken by a 35-member Combined Expert Committee including all IAG members. The IAG and five external musculoskeletal radiologists with expertise in CPPD convened virtually to further refine item definitions, and voted on example images illustrating CR, CT, and DECT item definitions with ≥90% agreement required to deem them acceptable. RESULTS: The Combined Expert Committee survey indicated consensus on all CR definitions. The IAG and external radiologists reached consensus on CT and DECT item definitions, which specify that calcium pyrophosphate deposits appear less dense than cortical bone. The group developed an MRI definition and acknowledged limitations of this modality for CPPD. Ten example images for CPPD were voted acceptable (4 CR, 4 CT, 2 DECT), and three example images of basic calcium phosphate deposition were voted acceptable to serve as contrast against imaging features of CPPD. CONCLUSION: An international group of rheumatologists and musculoskeletal radiologists defined imaging features characteristic of CPPD on CR, CT, and DECT, and assembled a set of example images as a reference for future clinical research studies. This article is protected by copyright. All rights reserved.
OBJECTIVES: To develop definitions for imaging features being considered as potential classification criteria for calcium pyrophosphate deposition (CPPD) disease, additional to clinical and laboratory criteria, and to compile example images of CPPD on different imaging modalities. METHODS: The ACR/EULAR CPPD classification criteria Imaging Advisory Group (IAG) and Steering Committee drafted definitions of imaging features that are characteristic of CPPD on conventional radiography (CR), conventional computed tomography (CT), dual-energy CT (DECT), and magnetic resonance imaging (MRI). An anonymous expert survey was undertaken by a 35-member Combined Expert Committee including all IAG members. The IAG and five external musculoskeletal radiologists with expertise in CPPD convened virtually to further refine item definitions, and voted on example images illustrating CR, CT, and DECT item definitions with ≥90% agreement required to deem them acceptable. RESULTS: The Combined Expert Committee survey indicated consensus on all CR definitions. The IAG and external radiologists reached consensus on CT and DECT item definitions, which specify that calcium pyrophosphate deposits appear less dense than cortical bone. The group developed an MRI definition and acknowledged limitations of this modality for CPPD. Ten example images for CPPD were voted acceptable (4 CR, 4 CT, 2 DECT), and three example images of basic calcium phosphate deposition were voted acceptable to serve as contrast against imaging features of CPPD. CONCLUSION: An international group of rheumatologists and musculoskeletal radiologists defined imaging features characteristic of CPPD on CR, CT, and DECT, and assembled a set of example images as a reference for future clinical research studies. This article is protected by copyright. All rights reserved.
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