Novel Automatic Tool for Magnetic Resonance Imaging Quantification of Bone Erosion Scoring in Rheumatoid Arthritis

  • Patrizia Parascandolo
  • Lorenzo CesarioEmail author
  • Loris Vosilla
  • Francesca Barbieri
  • Marco Amedeo Cimmino
  • Gianni Viano
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 9281)


Rheumatoid arthritis (RA) is a systemic disease that affects the synovial joints. Currently, the gold standard measurement for tracking the progression of the disease involves a semi-quantitative assessment of bone erosion, bone marrow edema and synovitis, as seen in magnetic resonance images (MRI). The work presented in this paper identifies how computer automation can be used to quantify bone erosion volumes in MRI without expert and time consuming interventions. This tool is fully integrated in a computer aided diagnosis (CAD) system named RheumaSCORE (Softeco Sismat Srl). Preliminary results of qualitative and quantitative validation are presented and discussed at the end of the paper.


Computer aided diagnosis (CAD) Erosion scoring Image processing Principal component analysis (PCA) Shape reconstruction Rheumascore Rheumatoid arthritis 


  1. 1.
    Tan, Y.K., Conaghan, P.G.: Imaging in rheumatoid arthritis. Best Pract. Res. Clin. Rheumatol. 25(4), 569–584 (2011)CrossRefGoogle Scholar
  2. 2.
    Schett, G., Redlich, K., Smolen, J.S.: Inflammation-induced bone loss in the rheumatic diseases. In: Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 2nd edn., pp. 482–488. John Wiley & Sons, USA (2013)Google Scholar
  3. 3.
    Farrant, J.M., Grainger, A.J., O’Connor, P.J.: Advanced imaging in rheumatoid arthritis: part 2: erosions. Skeletal Radiol. 36, 381–389 (2007)CrossRefGoogle Scholar
  4. 4.
    Sokka, T.: Radiographic scoring in rheumatoid arthritis: a short introduction to the methods. Bull. NYU Hosp. Jt. Dis. 66, 166–168 (2008)Google Scholar
  5. 5.
    McQueen, F.M., Stewart, N., Crabbe, J., Robinson, E., Yeoman, S., Tan, P.L., McLean, L.: Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at four months after symptom onset. Ann. Rheum. Dis. 57, 350–356 (1998)CrossRefGoogle Scholar
  6. 6.
    Conaghan, P., O’Connor, P., McGonagle, D., Astin, P., Wakefield, R.J., Gibbon, W.W., Quinn, M., Karim, Z., Green, M.J., Proudman, S., Isaacs, J., Emery, P.: Elucidation of the relationship between synovitis and bone damage: a randomized magnetic resonance imaging study of individual joints in patients with early rheumatoid arthritis. Arthritis Rheum. 48, 64–71 (2003)CrossRefGoogle Scholar
  7. 7.
    Lindegaard, H.M., Vallø, J., Hørslev-Petersen, K., Junker, P., Østergaard, M.: Low-cost, low-field dedicated extremity magnetic resonance imaging in early rheumatoid arthritis: a 1-year follow-up study. Ann. Rheum. Dis. 65, 1208–1212 (2006)CrossRefGoogle Scholar
  8. 8.
    Crowley, A.R., Dong, J., McHaffie, A., Clarke, A.W., Reeves, Q., Williams, M., Robinson, E., Dalbeth, N., McQueen, F.M.: Measuring bone erosion and edema in rheumatoid arthritis: a comparison of manual segmentation and RAMRIS methods. J. Magn. Reson. Imaging 33, 364–371 (2011)CrossRefGoogle Scholar
  9. 9.
    Emond, P.D., Inglis, D., Choi, A., Tricta, J., Adachi, J.D., Gordon, C.L.: Volume measurement of bone erosions in magnetic resonance images of patients with rheumatoid arthritis. Magn. Reson. Med. 67, 814–823 (2012)CrossRefGoogle Scholar
  10. 10.
    Østergaard, M., Peterfy, C., Conaghan, P., McQueen, F., Bird, P., Ejbjerg, B., Shnier, R., O’Connor, P., Klarlund, M., Emery, P., Genant, H., Lasser, M., Edmonds, J.: OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Core set of MRI acquisitions, joint pathology definitions, and the OMERACT RA-MRI scoring system. J. Rheumatol. 30, 1385–1386 (2003)Google Scholar
  11. 11.
    Lassere, M., McQueen, F., Østergaard, M., Conaghan, P., Shnier, R., Peterfy, C., Klarlund, M., Bird, P., O’Connor, P., Stewart, N., Emery, P., Genant, H., Edmonds, J.: OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Exercise 3: an international multicenter reliability study using the RA-MRI score. J. Rheumatol. 30, 1366–1375 (2003)Google Scholar
  12. 12.
    Østergaard, M., Klarlund, M., Lassere, M., Conaghan, P., Peterfy, C., McQueen, F., O’Connor, P., Shnier, R., Stewart, N., McGonagle, D., Emery, P., Genant, H., Edmonds, J.: Interreader agreement in the assessment of magnetic resonance images of rheumatoid arthritis wrist and finger joints – an international multicenter study. J. Rheumatol. 28, 1143–1150 (2001)Google Scholar
  13. 13.
    Conaghan, P., Lassere, M., Østergaard, M., Peterfy, C., McQueen, F., O’Connor, P., Bird, P., Ejbjerg, B., Klarlund, M., Shnier, R., Genant, H., Emery, P., Edmonds, J.: OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Exercise 4: an international multicenter longitudinal study using the RA-MRI score. J. Rheumatol. 30, 1376–1379 (2003)Google Scholar
  14. 14.
    Parascandolo, P., Cesario, L., Vosilla, L., Pitikakis, M., Viano, G.: Smart brush: a real time segmentation tool for 3D medical images. In: 8th International Symposium on Presented at Image and Signal Processing and Analysis (ISPA), pp. 689–694 (2013)Google Scholar
  15. 15.
    Cootes, T.F., Taylor, C.J., Graham, J.: Active shape models- their training and applications. Comput. Vis. Image Underst. 61, 38–59 (1995)CrossRefGoogle Scholar
  16. 16.
    Bartz, D., Orman, J., Gürvit, Ö.: Accurate volumetric measurements of anatomical cavities. Methods of Information in Medicine 43(4), 331–335 (2004)Google Scholar
  17. 17.
    Lorensen, W.E., Cline, H.E.: Marching cubes: a high resolution 3D surface construction algorithm. In: Proc. of ACM SIGGRAPH, pp. 163–169 (1987)Google Scholar
  18. 18.
    Dice, L.R.: Measures of the Amount of Ecologic Association Between Species. Ecology 26(3), 297–302 (1945)CrossRefGoogle Scholar
  19. 19.
  20. 20.
    Barbieri, F., Parascandolo, P., Vosilla, L., Cesario, L., Viano, G., Cimmino, M.A.: Assessing MRI erosions in the rheumatoid wrist: a comparison between RAMRIS and a semiautomated segmentation software. Ann. Rheum. Dis. 71(Suppl 3) (2012)Google Scholar
  21. 21.
    Catalano, C.E., Robbiano, F., Parascandolo, P., Cesario, L., Vosilla, L., Barbieri, F., Spagnuolo, M., Viano, G., Cimmino, M.A.: Exploiting 3D part-based analysis, description and indexing to support medical applications. In: Greenspan, H., Müller, H., Syeda-Mahmood, T. (eds.) MCBR-CDS 2012. LNCS, vol. 7723, pp. 21–32. Springer, Heidelberg (2013)CrossRefGoogle Scholar
  22. 22.
    Parascandolo, P., Cesario, L., Vosilla, L., Viano, G.: Computer aided diagnosis: state-of-the-art and application to musculoskeletal diseases. In: 3D Multiscale Physiological Human, pp. 277–296. Springer London (2014)Google Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Patrizia Parascandolo
    • 1
  • Lorenzo Cesario
    • 1
    Email author
  • Loris Vosilla
    • 2
  • Francesca Barbieri
    • 1
  • Marco Amedeo Cimmino
    • 2
  • Gianni Viano
    • 1
  1. 1.Softeco Sismat S.r.l.GenoaItaly
  2. 2.DIMI, Dipartimento di Medicina Interna, Clinica ReumatologicaUniversità degli Studi di GenovaGenoaItaly

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