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Digital tomosynthesis as a new diagnostic tool for evaluation of spine damage in patients with ankylosing spondylitis

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Abstract

We aimed to compare digital tomosynthesis (DTS) with radiographs for the assessment of spinal bone damage in patients with ankylosing spondylitis (AS). The study comprised 68 patients with AS who underwent both DTS and radiographs of the cervical and lumbar spine on the same day. Spinal bone damage was assessed using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) and the presence of facet joint damage. The Wilcoxon signed-rank test and McNemar’s test were used to compare spinal bone damage between the two modalities. In 68 AS patients with mean 4.5 years of disease duration, the mean mSASSS was 11.7 ± 11.3 with radiographs and 13.1 ± 11.5 with DTS (p = 0.001). A grade 1 (erosion, sclerosis, or squaring) score in the mSASSS system was higher with DTS than with radiographs (p = 0.001), but grade 2 (syndesmophyte) and grade 3 (bridge) scores (p > 0.005 each) were not. In particular, the grade 1 score was higher with DTS than with radiographs at the cervicothoracic (p < 0.001) and thoracolumbar (p = 0.003) junctions. With regard to facet joint damage, erosion/sclerosis of facet joints was better depicted by DTS than by radiographs in the cervical (54.4 vs. 22.1%, p < 0.001) and lumbar spine (72.1 vs. 11.8%, p < 0.001). DTS depicted more subtle damage of spinal vertebrae in patients with AS than radiographs did. Moreover, erosion/sclerosis of facet joints was better detected with DTS than with radiographs.

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Authors’ contributions

YBJ participated in the design of the study, performed the statistical analysis, and wrote the manuscript. T-HK collected data from the medical records, participated in the design of the study and wrote the manuscript. JP collected data, scored radiograph and DTS and helped draft the manuscript. KBJ collected data and scored radiograph and DTS. YS collected data and scored radiograph and DTS. SL participated in the design of the study, scored radiograph and DTS, and helped draft the manuscript. All authors read and approved the final manuscript. They have met the International Committee of Medical Journal Editors Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals (ICMJE Recommendations 2013) recommend criteria for authorship.

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    Authors and Affiliations

    1. Department of Rheumatology, St. Vincent’s Hospital, The Catholic University of Korea, Suwon, Republic of Korea

      Young Bin Joo

    2. Department of Rheumatology, Hanyang University Hospital for Rheumatic Disease, Seoul, Republic of Korea

      Tae-Hwan Kim

    3. Department of Radiology, Hanyang University Hospital for Rheumatic Diseases, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 133-792, Republic of Korea

      Jina Park, Kyung Bin Joo, Yoonah Song & Seunghun Lee

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    1. Young Bin Joo
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    Correspondence to Seunghun Lee.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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    The need for informed consent was waived as study design of this study was retrospective.

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    Young Bin Joo and Tae-Hwan Kim contributed equally to this work.

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    Joo, Y.B., Kim, TH., Park, J. et al. Digital tomosynthesis as a new diagnostic tool for evaluation of spine damage in patients with ankylosing spondylitis. Rheumatol Int 37, 207–212 (2017). https://doi.org/10.1007/s00296-016-3627-8

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    • DOI: https://doi.org/10.1007/s00296-016-3627-8

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