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Computer-aided and manual quantifications of MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss in rheumatoid arthritis of the wrist

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Abstract

Purpose

To investigate the reliability and validity of computer-aided automated and manual quantification as well as semiquantitative analysis for MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss of the wrist in rheumatoid arthritis (RA) compared to the OMERACT-RAMRIS.

Methods and materials

Wrist MRI was performed at 3 T in 16 patients with RA. Synovial volume and perfusion, bone marrow edema-like lesion (BMEL) volume, signal intensity and perfusion, and erosion dimensions were measured manually and using an in-house-developed automated software algorithm; findings were correlated with the OMERAC-RAMRIS gradings. In addition, a semiquantitative MRI cartilage loss score system was developed. Intraclass correlation coefficients (ICCs) were used to test the reproducibility of these quantitative and semiquantitative techniques. Spearman correlation coefficients were calculated between lesion quantifications and RAMRIS and between the MRI cartilage score and radiographic Sharp van der Heijde joint space narrowing scores.

Results

The intra- and interobserver ICCs were excellent for synovial, BMEL and erosion quantifications and cartilage loss grading (all >0.89). The synovial volume, BMEL volume and signal intensity, and erosion dimensions were significantly correlated with the corresponding RAMRIS (r = 0.727 to 0.900, p < 0.05). Synovial perfusion parameter maximum enhancement (Emax) was significantly correlated with synovitis RAMRIS (r = 0.798). BMEL perfusion parameters were not correlated with the RAMRIS BME score. Cartilage loss gradings from MRI were significantly correlated with the Sharp joint space narrowing scores (r = 0.635, p = 0.008).

Conclusion

The computer-aided, manual and semiquantitative methods presented in this study can be used to evaluate MRI pathologies in RA with excellent reproducibility. Significant correlations with standard RAMRIS were found in the measurements using these methods.

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Conflict of Interest

The study was supported by a UCSF Radiology Seed Grant, UCSF Academic Senate Research Grant and Natural Science Foundation Project of CQ CSTC (cstc2011jjA10082).

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Haitao Yang

  2. Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), 185 Berry St, Suite 350, San Francisco, CA, 94107, USA

    Haitao Yang, Julien Rivoire, Michael Hoppe, Waraporn Srikhum, Thomas M Link & Xiaojuan Li

  3. Department of Radiology, Thammasat University, Pathumthani, Thailand

    Waraporn Srikhum

  4. Department of Medicine, San Francisco and Division of Rheumatology, San Francisco General Hospital, University of California, San Francisco, CA, USA

    John Imboden

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  1. Haitao Yang
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  2. Julien Rivoire
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Correspondence to Xiaojuan Li.

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Yang, H., Rivoire, J., Hoppe, M. et al. Computer-aided and manual quantifications of MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss in rheumatoid arthritis of the wrist. Skeletal Radiol 44, 539–547 (2015). https://doi.org/10.1007/s00256-014-2059-3

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  • DOI: https://doi.org/10.1007/s00256-014-2059-3

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