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Mono-exponential and bi-exponential model-based diffusion-weighted MR imaging and IDEAL-IQ sequence for quantitative evaluation of sacroiliitis in patients with ankylosing spondylitis

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Abstract

To evaluate the utility of mono-exponential and bi-exponential model-based diffusion-weighted MR imaging and IDEAL-IQ sequence for differentiating the activity of sacroiliitis in ankylosing spondylitis (AS). AS patients were divided into active group (n = 30) and inactive group (n = 28) according to Ankylosing Spondylitis Disease Activity Score (ASDAS) with C-reactive protein (CRP). In addition, 30 healthy volunteers were chosen as healthy group. Subjects were scanned by conventional MRI, diffusion-weighted imaging, and IDEAL-IQ sequence. Apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and fat fraction (FF) values were measured, and their relative values (rADC, rD, rD*, rf) were calculated by the formula ADC (D,D*,f)lesion/ADC (D,D*,f)reference, respectively. The ADC, D, rADC, and rD of active group were the highest among the three groups, followed by inactive and healthy group. However, D* and rD* showed no significant difference among the three groups. FF was significantly higher in inactive group than in healthy and active group. ADC and D had significantly higher AUCs than f for differentiating active group from healthy group, while FF had the highest AUC for distinguishing inactive sacroiliitis from healthy group. DWI and IDEAL-IQ imaging are helpful in quantitatively assessing the activity of sacroiliitis in AS patients.

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References

  1. Braun J, Baraliakos X, Godolias G, Böhm H (2005) Therapy of ankylosing spondylitis–a review. Part I: conventional medical treatment and surgical therapy. Scand J Rheumatol 34:97–108

    Article  CAS  PubMed  Google Scholar 

  2. Mok CC, Li OC, Chan KL, Ho LY, Hui PK (2015) Effect of golimumab and pamidronate on clinical efficacy and MRI inflammation in axial spondyloarthritis: a 48-week open randomized trial. Scand J Rheumatol 44:480–486

    Article  CAS  PubMed  Google Scholar 

  3. Lambert RG, Bakker PA, van der Heijde D, Weber U, Rudwaleit M, Hermann KG et al (2016) Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group. Ann Rheum Dis 75:1958–1963

    Article  PubMed  Google Scholar 

  4. van der Heijde D, Landewé R, Hermann KG, Rudwaleit M, Østergaard M, Oostveen A et al (2007) Is there a preferred method for scoring activity of the spine by magnetic resonance imaging in ankylosing spondylitis? J Rheumatol 34:871–873

    PubMed  Google Scholar 

  5. Landewe RB, Hermann KG, van der Heijde DM, Baraliakos X, Jurik AG, Lambert RG et al (2005) Scoring sacroiliac joints by magnetic resonance imaging. A multiple-reader reliability experiment. J Rheumatol 32:2050–2055

    PubMed  Google Scholar 

  6. Maksymowych WP, Inman RD, Salonen D, Dhillon SS, Williams M, Stone M, Conner-spady B, Palsat J, Lambert RGW (2005) Spondyloarthritis research consortium of Canada magnetic resonance imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis. Arthritis Rheum 53:703–709

    Article  PubMed  Google Scholar 

  7. Zhang P, Yu K, Guo R, Shah S, Morelli JN, Runge VA et al (2015) Ankylosing spondylitis: correlations between clinical and MRI indices of sacroiliitis activity. Clin Radiol 70:62–66

    Article  CAS  PubMed  Google Scholar 

  8. Douis H, Davies MA, Sian P (2016) The role of diffusion-weighted MRI (DWI) in the differentiation of benign from malignant skeletal lesions of the pelvis. Eur J Radiol 85:2262–2268

    Article  PubMed  Google Scholar 

  9. Suh CH, Yun SJ, Jin W, Lee SH, Park SY, Ryu CW (2018) ADC as a useful diagnostic tool for differentiating benign and malignant vertebral bone marrow lesions and compression fractures: a systematic review and meta-analysis. Eur Radiol 28:2890–2902. https://doi.org/10.1007/s00330-018-5330-5

    Article  PubMed  Google Scholar 

  10. Park S, Kwack KS, Chung N, Hwang J, Lee HY, Kim JH (2017) Intravoxel incoherent motion diffusion-weighted magnetic resonance imaging of focal vertebral bone marrow lesions: initial experience of the differentiation of nodular hyperplastic hematopoietic bone marrow from malignant lesions. Skelet Radiol 46:675–683

    Article  Google Scholar 

  11. Ai F, Ai T, Li X, Hu D, Zhang W, Morelli JN (2012) Value of diffusion-weighted magnetic resonance imaging in early diagnosis of ankylosing spondylitis. Rheumatol Int 32:4005–4013

    Article  PubMed  Google Scholar 

  12. Dallaudiere B, Dautry R, Preux PM, Perozziello A, Lincot J (2014) Schouman-Claeys E, et al .Comparison of apparent diffusion coefficient in spondylarthritis axial active inflammatory lesions and type 1 Modic changes. Eur J Radiol 83:366–370

    Article  PubMed  Google Scholar 

  13. Bozgeyik Z, Ozgocmen S, Kocakoc E (2008) Role of diffusion-weighted MRI in the detection of early active sacroiliitis. AJR Am J Roentgenol 191:980–986

    Article  PubMed  Google Scholar 

  14. Sanal HT, Yilmaz S, Simsek I, Cinar M, Erdem H, Pay S et al (2013) Apparent diffusion coefficients of sacroiliitis in patients with established ankylosing spondylitis. Clin Imaging 37:734–739

    Article  PubMed  Google Scholar 

  15. Boy FN, Kayhan A, Karakas HM, Unlu-Ozkan F, Silte D, Aktas İ (2014) The role of multi-parametric MR imaging in the detection of early inflammatory sacroiliitis according to ASAS criteria. Eur J Radiol 83:989–996

    Article  PubMed  Google Scholar 

  16. Maksymowych WP, Morency N, Conner-Spady B, Lambert RG (2013) Suppression of inflammation and effects on new bone formation in ankylosing spondylitis: evidence for a window of opportunity in disease modification. Ann Rheum Dis 72:23–28

    Article  PubMed  Google Scholar 

  17. Baraliakos X, Heldmann F, Callhoff J, Listing J, Appelboom T, Brandt J, van den Bosch F, Breban M, Burmester GR, Dougados M, Emery P, Gaston H, Grunke M, van der Horst-Bruinsma IE, Landewé R, Leirisalo-Repo M, Sieper J, de Vlam K, Pappas D, Kiltz U, van der Heijde D, Braun J (2014) Which spinal lesions are associated with new bone formation in patients with ankylosing spondylitis treated with anti-TNF agents? A long-term observational study using MRI and conventional radiography. Ann Rheum Dis 73:1819–1825

    Article  CAS  PubMed  Google Scholar 

  18. Song IH, Hermann KG, Haibel H, Althoff CE, Poddubnyy D, Listing J et al (2016) Inflammatory and fatty lesions in the spine and sacroiliac joints on whole-body MRI in early axial spondyloarthritis--3-year data of the ESTHER trial. Semin Arthritis Rheum 45:404–410

    Article  PubMed  Google Scholar 

  19. Machado P, Landewé R, Lie E, Kvien TK, Braun J, Baker D et al (2011) Ankylosing spondylitis disease activity score (ASDAS): defining cut-off values for disease activity states and improvement scores. Ann Rheum Dis 70:47–53

    Article  PubMed  Google Scholar 

  20. Yan C, Xu J, Xiong W, Wei Q, Feng R, Wu Y, Liu Q, Li C, Chan Q, Xu Y (2017) Use of intravoxel incoherent motion diffusion-weighted MR imaging for assessment of treatment response to invasive fungal infection in the lung. Eur Radiol 27:212–221

    Article  PubMed  Google Scholar 

  21. Zhao YH, Li SL, Liu ZY, Chen X, Zhao XC, Hu SY, Liu ZH, MS YJM, Chan Q, Liang CH (2015) Detection of active Sacroiliitis with ankylosing spondylitis through Intravoxel incoherent motion diffusion-weighted MR imaging. Eur Radiol 25:2754–2763

    Article  PubMed  Google Scholar 

  22. Guo W, Luo D, Lin M, Wu B, Li L, Zhao Y, Yang L, Zhou C (2016) Pretreatment intra-voxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in predicting induction chemotherapy response in locally advanced Hypopharyngeal carcinoma. Medicine (Baltimore) 95:e3039

    Article  Google Scholar 

  23. Liau J, Shiehmorteza M, Girard OM, Sirlin CB, Bydder M (2013) Evaluation of MRI fat fraction in the liver and spine pre and post SPIO infusion. Magn Reson Imaging 31(6):1012–1016

    Article  PubMed Central  PubMed  Google Scholar 

  24. Neubauer H, Evangelista L, Morbach H, Girschick H, Prelog M, Köstler H et al (2012) Diffusion-weighted MRI of bone marrow oedema, soft tissue oedema and synovitis in paediatric patients: feasibility and initial experience. Pediatr Rheumatol Online J 31:20

    Article  Google Scholar 

  25. Schaefer PW, Grant PE, Gonzalez RG (2000) Diffusion-weighted MR imaging of the brain. Radiology 217:331–345

    Article  CAS  PubMed  Google Scholar 

  26. Padhani AR, van Ree K, Collins DJ, D'Sa S, Makris A (2013) Assessing the relation between bone marrow signal intensity and apparent diffusion coefficient in diffusion-weighted MRI. AJR Am J Roentgenol 200:163–170

    Article  PubMed  Google Scholar 

  27. Subhawong TK, Jacobs MA, Fayad LM (2014) Diffusion-weighted MR imaging for characterizing musculoskeletal lesions. Radiographics 34:1163–1177

    Article  PubMed  Google Scholar 

  28. Herneth AM, Friedrich K, Weidekamm C, Schibany N, Krestan C, Czerny C et al (2005) Diffusion weighted imaging of bone marrow pathologies. Eur J Radiol 55:74–83

    Article  PubMed  Google Scholar 

  29. Wang F, Wang Y, Zhou Y, Liu C, Xie L, Zhou Z, Liang D, Shen Y, Yao Z, Liu J (2017) Comparison between types I and II epithelial ovarian cancer using histogram analysis of monoexponential, biexponential, and stretched-exponential diffusion models. J Magn Reson Imaging 46:1797–1809

    Article  PubMed  Google Scholar 

  30. Zhang M, Zhou L, Huang N, Zeng H, Liu S, Liu L (2017) Assessment of active and inactive sacroiliitis in patients with ankylosing spondylitis using quantitative dynamic contrast-enhanced MRI. J Magn Reson Imaging 46:71–78

    Article  PubMed  Google Scholar 

  31. Henkelman RM (1990) Does IVIM measure classical perfusion? Magn Reson Med 16:470–475

    Article  CAS  PubMed  Google Scholar 

  32. Qi J, Olsen NJ, Price RR, Winston JA, Park JH (2008) Diffusion-weighted imaging of inflammatory myopathies: polymyositis and dermatomyositis. J Magn Reson Imaging 27:212–217

    Article  PubMed  Google Scholar 

  33. Andreou A, Koh DM, Collins DJ, Blackledge M, Wallace T (2013) Leach MO,et al. measurement reproducibility of perfusion fraction and pseudodiffusion coefficient derived by intravoxel incoherent motion diffusion-weighted MR imaging in normal liver and metastases. Eur Radiol 23:428–434

    Article  CAS  PubMed  Google Scholar 

  34. Kakite S, Dyvorne H, Besa C, Cooper N, Facciuto M, Donnerhack C, Taouli B (2015) Hepatocellular carcinoma: short-term reproducibility of apparent diffusion coefficient and intravoxel incoherent motion parameters at 3.0T. J Magn Reson Imaging 41:149–156

    Article  PubMed  Google Scholar 

  35. Hu L, Zha YF, Wang L, Li L, Xing D, Gong W, Li L, Xing D, Gong W, Wang J, Lin Y, Zeng FF, Lu XS (2018) Quantitative evaluation of vertebral microvascular permeability and fat fraction in Alloxan-induced diabetic rabbits. Radiology 287:128–136

    Article  PubMed  Google Scholar 

  36. Machado PM, Baraliakos X, van der Heijde D, Braun J, Landewé R (2016) MRI vertebral corner inflammation followed by fat deposition is the strongest contributor to the development of new bone at the same vertebral corner: a multilevel longitudinal analysis in patients with ankylosing spondylitis. Ann Rheum Dis 75:1486–1493

    Article  PubMed  Google Scholar 

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Funding

This study was supported by the National Scientific Foundation of China (No. 81701648).

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Authors and Affiliations

  1. Peking University Third Hospital, Department of Radiology, 49 North Garden Road, Haidian District, Beijing, 100191, People’s Republic of China

    Cui Ren, Qiao Zhu & Huishu Yuan

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  1. Cui Ren
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  2. Qiao Zhu
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  3. Huishu Yuan
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Correspondence to Huishu Yuan.

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This prospective study was approved by Institute Ethics Committee and written informed consent was obtained from all participants.

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Ren, C., Zhu, Q. & Yuan, H. Mono-exponential and bi-exponential model-based diffusion-weighted MR imaging and IDEAL-IQ sequence for quantitative evaluation of sacroiliitis in patients with ankylosing spondylitis. Clin Rheumatol 37, 3069–3076 (2018). https://doi.org/10.1007/s10067-018-4321-x

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