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Can radiomics replace the SPARCC scoring system in evaluating bone marrow edema of sacroiliac joints in patients with axial spondyloarthritis?

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Abstract

Objectives

To develop an objective and efficient method based on radiomics to evaluate bone marrow edema (BMO) of sacroiliac joints (SIJs) by magnetic resonance imaging (MRI) in patients with axial spondyloarthritis (axSpA) and to compare with the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system.

Methods

From September 2013 to March 2022, patients with axSpA who underwent 3.0T SIJ-MRI were included and were randomly divided into training and validation cohorts at a ratio of 7:3. The optimal radiomics features selected from the SIJ-MRI in the training cohort were included to generate the radiomics model. The performance of the model was evaluated by ROC analysis and decision curve analysis (DCA). Rad scores were calculated using the radiomics model. The responsiveness was compared for Rad scores and SPARCC scores. We also assessed the correlation between the Rad score and SPARCC score.

Results

A total of 558 patients were finally included. The radiomics model showed favorable discrimination of a SPARCC score <2 or ≥2 both in the training (AUC, 0.90; 95% CI: 0.87–0.93) and validation cohorts (AUC, 0.90; 95% CI, 0.86–0.95). DCA confirmed that the model was clinically useful. Rad score showed higher responsiveness to treatment-related change than SPARCC score. Furthermore, a significant correlation was noted between the Rad score and SPARCC score when scoring the status of BMO (rs=0.80, P < 0.001), and a strong correlation was noted when scoring the change in BMO (r=0.70, P < 0.001).

Conclusion

The study proposed a radiomics model to accurately quantify the BMO of SIJs in patients with axSpA, providing an alternative to the SPARCC scoring system.

Key Points

• The Rad score is an index with high validity for the objective and quantitative evaluation of bone marrow edema (BMO) of the sacroiliac joints in axial spondyloarthritis.

• The Rad score is a promising tool to monitor the change of BMO upon treatment.

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Funding

This work was supported by Wenzhou Basic Research Project (Y2020163).

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325015, China

    Mo Zheng, Shouliang Miao, Fei Yao, Qinqin Xiao & Guanxia Zhu

  2. Department of Rheumatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325015, China

    Dan Chen & Lusi Ye

  3. Wenzhou Medical University, Wenzhou, Zhejiang, 325035, China

    Chenqiang Pan, Tao Lei & Chenhao Ye

  4. Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325015, China

    Yunjun Yang

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Contributions

Lusi Ye and Yunjun Yang designed and supervised the study. Material preparation, data collection, and analysis were performed by Shouliang Miao, Dan Chen, Mo Zheng, Fei Yao, Qinqin Xiao, Guanxia Zhu, Chenqiang Pan, Tao Lei, and Chenhao Ye. The first draft of the manuscript was written by Mo Zheng and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yunjun Yang or Lusi Ye.

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Zheng, M., Miao, S., Chen, D. et al. Can radiomics replace the SPARCC scoring system in evaluating bone marrow edema of sacroiliac joints in patients with axial spondyloarthritis?. Clin Rheumatol 42, 1675–1682 (2023). https://doi.org/10.1007/s10067-023-06543-6

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