European Radiology

, Volume 24, Issue 7, pp 1686–1693 | Cite as

Pixel-by-pixel analysis of DCE-MRI curve shape patterns in knees of active and inactive juvenile idiopathic arthritis patients

  • Robert HemkeEmail author
  • Cristina Lavini
  • Charlotte M. Nusman
  • J. Merlijn van den Berg
  • Koert M. Dolman
  • Dieneke Schonenberg-Meinema
  • Marion A. J. van Rossum
  • Taco W. Kuijpers
  • Mario Maas



To compare DCE-MRI parameters and the relative number of time–intensity curve (TIC) shapes as derived from pixel-by-pixel DCE-MRI TIC shape analysis between knees of clinically active and inactive juvenile idiopathic arthritis (JIA) patients.


DCE-MRI data sets were prospectively obtained. Patients were classified into two clinical groups: active disease (n = 43) and inactive disease (n = 34). Parametric maps, showing seven different TIC shape types, were created per slice. Statistical measures of different TIC shapes, maximal enhancement (ME), maximal initial slope (MIS), initial area under the curve (iAUC), time-to-peak (TTP), enhancing volume (EV), volume transfer constant (K trans), extravascular space fractional volume (V e) and reverse volume transfer constant (k ep) of each voxel were calculated in a three-dimensional volume-of-interest of the synovial membrane.


Imaging findings from 77 JIA patients were analysed. Significantly higher numbers of TIC shape 4 (P = 0.008), median ME (P = 0.015), MIS (P = 0.001) and iAUC (P = 0.002) were observed in clinically active compared with inactive patients. TIC shape 5 showed higher presence in the clinically inactive patients (P = 0.036).


The pixel-by-pixel DCE-MRI TIC shape analysis method proved capable of differentiating clinically active from inactive JIA patients by the difference in the number of TIC shapes, as well as the descriptive parameters ME, MIS and iAUC.

Key Points

The pixel-by-pixel TIC shape method differentiates clinically active and inactive JIA patients

Significantly higher numbers of TIC shape 4 were observed in clinically active patients

DCE-MRI parameters ME, MIS and iAUC differ between active and inactive patients

The pixel-by-pixel analysis method allows direct visualization of the heterogeneously distributed disease

The DCE-MRI TIC shape method may serve as a quantitative outcome measure


Juvenile idiopathic arthritis Dynamic contrast-enhanced Magnetic resonance imaging Outcome measure Knee joint 



The scientific guarantor of this publication is Prof. Dr. M. Maas. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. A research grant was received from the Reumafonds (NR 10-1-403); Dutch Arthritis Association (Amsterdam, the Netherlands). The Dutch Arthritis Association was not involved in designing and conducting this study, did not have access to the data, and was not involved in data analysis or preparation of this manuscript. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, multicenter study.


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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Robert Hemke
    • 1
    Email author
  • Cristina Lavini
    • 1
  • Charlotte M. Nusman
    • 1
    • 2
  • J. Merlijn van den Berg
    • 2
  • Koert M. Dolman
    • 3
    • 4
  • Dieneke Schonenberg-Meinema
    • 2
  • Marion A. J. van Rossum
    • 2
    • 3
  • Taco W. Kuijpers
    • 2
  • Mario Maas
    • 1
  1. 1.Department of Radiology, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children’s Hospital AMCUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Pediatric Rheumatology, ReadeAmsterdamThe Netherlands
  4. 4.Department of PediatricsSt. Lucas Andreas HospitalAmsterdamThe Netherlands

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