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Whole-body MRI in patients with Non-bacterial Osteitis: Radiological findings and correlation with clinical data

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To correlate clinical findings of Non-bacterial Osteitis (NBO) with whole-body MRI (WB-MRI) findings and determine a radiologic index for NBO (RINBO) which allows standardized reporting of WB-MRI.

Methods and materials

In a prospective study, 40 patients with diagnosis of NBO underwent clinical examination and WB-MRI in which STIR- and T1- weighted images were assessed for NBO-typical lesions. Parameters of interest for RINBO were: number of radiologically active lesions (RAL), size of the patients’ maximum RAL presence of extramedullary and spinal involvement. Results were tested for statistical agreement of clinical and MR-based lesion detection. RINBO was tested for correlation with clinical activity.

Results

62/95 clinically/radiologically active lesions were found in 30/33 patients. In 45 % of the cohort, more active lesions were detected by WB-MRI than by clinical examination. RINBO was a significant predictor for the presence of clinically active lesions.

Conclusion

WB-MRI is a powerful diagnostic tool for patients with NBO which can reveal asymptomatic disease activity. With RINBO a standardized evaluation approach is proposed which helps assessing radiologic disease burden and predicts clinical disease activity.

Key Points

• Whole body MRI is a powerful diagnostic tool for patients with non-bacterial Osteitis.

• Whole body MRI can reveal asymptomatic disease activity.

• The radiologic index RINBO offers a standardized evaluation approach.

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Abbreviations

NBO:

Non-bacterial Osteitis

CRMO:

Chronic Recurrent Multifocal Osteomyelitis

WB-MRI:

Whole Body Magnetic Resonance Imaging

RINBO:

Radiologic index for Non-bacterial Osteitis

LMU:

Ludwig-Maximilians-University

CAL:

Clinically active lesions

VAS:

Visual analogue scale

CRP:

C-reactive protein

ESR:

Erythrocyte sedimentation rate

STIR:

Short tau inversion recovery

DWI:

Diffusion weighted Imaging

RAL:

Radiologically active lesions

RNAL:

Radiologically not active lesions

SI:

Signal intensity

POI:

Parameter of interest

lpp:

Lesions per patient

AUC:

Area under the curve

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Acknowledgments

The scientific guarantor of this publication is PD Dr. Annette Jansson. 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. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have been previously reported in: Voit AM, Arnoldi AP, Douis H et al (2015) Whole-body Magnetic Resonance Imaging in Chronic Recurrent Multifocal Osteomyelitis: Clinical Longterm Assessment May Underestimate Activity. J Rheumatol 42:1455-1462. Methodology: prospective, diagnostic study, performed at one institution.

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Author notes

    Authors and Affiliations

    1. Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Nussbaumstrasse 20, 80336, Munich, Germany

      A. P. Arnoldi & L. L. Geyer

    2. Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany

      C. L. Schlett & S. Weckbach

    3. Department of Radiology, University Hospital Birmingham, Birmingham, B15 2TH, United Kingdom

      H. Douis

    4. Department of Rheumatology & Immunology, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany

      A. M. Voit, F. Bleisteiner & A. F. Jansson

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    1. A. P. Arnoldi
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    Correspondence to A. P. Arnoldi.

    Additional information

    A. F. Jansson and S. Weckbach contributed equally to this work.

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    Arnoldi, A.P., Schlett, C.L., Douis, H. et al. Whole-body MRI in patients with Non-bacterial Osteitis: Radiological findings and correlation with clinical data. Eur Radiol 27, 2391–2399 (2017). https://doi.org/10.1007/s00330-016-4586-x

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    • DOI: https://doi.org/10.1007/s00330-016-4586-x

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