Abstract
Objective
To study the value of 3 T dynamic contrast-enhanced (DCE)-MRI for assessment of synovitis of the interphalangeal joints in patients with erosive osteoarthritis (EOA) for treatment response monitoring.
Materials and methods
The interphalangeal joints of fingers two to five were examined at 3 T MRI in nine patients with EOA. Two musculoskeletal radiologists recorded erosions, bone marrow oedema (BME), synovitis and osteophytes. Interobserver reliability was calculated using κ statistics. In six patients, DCE-MRI time intensity curves of synovitis in two affected joints were analysed. The maximum upslope, absolute and relative enhancement of synovitis were compared with MRI after 12 months of anti-tumour necrosis factor treatment. Intraobserver reproducibility was calculated using intra-class correlation coefficient.
Results
Interobserver reliability was ‘good’ for detection of erosions (κ = 0.70), BME (κ = 0.77) and synovitis (κ = 0.77), but ‘poor’ for osteophytes (κ = 0.12). Post-treatment DCE-MRI showed decreasing maximum upslope (p = 0.002) and absolute (p = 0.002) and relative (p = 0.01) enhancement compared to the initial scan. Intraobserver reproducibility of DCE-MRI was ‘almost perfect’ or ‘strong’ for all parameters.
Conclusions
3 T DCE-MRI demonstrates changes in time intensity curves of synovitis in EOA of the interphalangeal joints in a longitudinal study, indicating this technique is promising for monitoring therapy response.
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References
Banks SE. Erosive osteoarthritis: a current review of a clinical challenge. Clin Rheumatol. 2010;29:697–706.
Resnick D, et al. Degenerative disease of extrapinal locations. In: Resnick D, editor. Diagnosis of bone and joint disorders, 4th ed. Philadelphia: Saunders; 2002. p. 1271–381.
Verbruggen G, Wittoek R, Vander Cruyssen B, Elewaut D. Morbid anatomy of ‘erosive osteoarthritis’ of the interphalangeal finger joints: an optimised scoring system to monitor disease progression in affected joints. Ann Rheum Dis. 2010;69:862–7.
Grainger AJ, Farrant JM, O’Connor PJO, et al. MR imaging of erosions in interphalangeal joint osteoarthritis: is all osteoarthritis erosive? Skeletal Radiol. 2007;36:737–45.
Wittoek R, Jans L, Lambrecht V, Carron P, Verstraete K, Verbruggen G. Reliability and construct validity of ultrasonography of soft tissue and destructive changes in erosive osteoarthritis of the interphalangeal finger joints: a comparison with MRI. Ann Rheum Dis. 2011;70:278–83.
Vlychou M, Koutroumpas A, Malizos K, et al. Ultrasonographic evidence of inflammation is frequent in hand of patients with erosive osteoartritis. Osteoarthritis Cartilage. 2009;17:1283–7.
Szkudlarek M, Klarlund M, Narvestad E, et al. Ultrasonography of the metacarpophalangeal and proximal interphalangeal joints in rheumatoid arthritis: a comparison with magnetic resonance imaging, conventional radiography and clinical examination. Arthritis Res Ther. 2006;8:R52.
Verstraete KL, Dierick A, De Deene Y, et al. First-pass images for musculoskeletal lesions: a new and useful diagnostic application of dynamic contrast-enhanced MRI. Magn Reson Imaging. 1994;12:687–702.
Schraml C, Schwenzer NF, Martirosian P, et al. Assessment of synovitis in erosive osteoarthritis of the hand using DCE-MRI and comparison with that in its major mimic, the psoriatic arthritis. Acta Radiol. 2011;18:804–9.
Tan AL, Grainger AJ, Tanner SF, et al. High-resolution magnetic resonance imaging for the assessment of hand osteoarthritis. Arthritis Rheum. 2005;52:2355–65.
Kirkhus E, Bjornerud A, Thoen J, et al. Contrast-enhanced dynamic magnetic resonance imaging of the finger joints in osteoarthritis and rheumatoid arthritis: an analysis based on pharmacokinetic modelling. Acta Radiol. 2006;47:845–51.
Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum. 1990;33:1601–10.
Ostergaard M, Peterfy C, Conaghan P, et al. OMERACT rheumatoid arthritis magnetic tesonance imaging studies. Core set of MRI acquisitions, joint pathology definition, and the OMERACT RA-MRI scoring system. J Rheumatol. 2003;30:1385–6.
Verbruggen G, Veys EM. Numerical scoring systems for the anatomic evolution of osteoarthritis of the finger joints. Arthritis Rheum. 1996;39:308–20.
Verstraete KL, De Deene Y, Roels H, Dierick A, Uyttendaele D, Kunnen M. Benign and malignant musculoskeletal lesions: dynamic contrast-enhanced MR imaging parametric first-pass images depict tissue vascularization and perfusion. Radiology. 1994;192:835–43.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.
Shrout PE, Fleiss JL. Intraclass correlations; uses in assessing rater reliability. Psychol Bull. 1979;86:420–8.
Workie DW, Dardzinski BJ, Graham TB, Laor T, Bommer WA, O’Brien KJ. Quantification of dynamic contrast-enhanced MR imaging of the knee in children with juvenile rheumatoid arthritis based on pharmacokinetic modelling. Magn Reson Imaging. 2004;22:1201–10.
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Jans, L., De Coninck, T., Wittoek, R. et al. 3 T DCE-MRI assessment of synovitis of the interphalangeal joints in patients with erosive osteoarthritis for treatment response monitoring. Skeletal Radiol 42, 255–260 (2013). https://doi.org/10.1007/s00256-012-1453-y
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DOI: https://doi.org/10.1007/s00256-012-1453-y