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  • Improved detection of erosions in the sacroiliac joints on MRI with volumetric interpolated breath-hold examination (VIBE): results from the SIMACT study

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Clinical and epidemiological research
Improved detection of erosions in the sacroiliac joints on MRI with volumetric interpolated breath-hold examination (VIBE): results from the SIMACT study
  1. Torsten Diekhoff1,
  2. Juliane Greese1,
  3. Joachim Sieper2,
  4. Denis Poddubnyy2,
  5. Bernd Hamm1,
  6. Kay-Geert A Hermann1
  1. 1 Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
  2. 2 Clinic of Rheumatology, Medical Department I, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
  1. Correspondence to Dr Kay-Geert A Hermann, Department of Radiology (CCM), Charité – Universitätsmedizin Berlin, Berlin, 10117, Germany; kgh{at}charite.de

Abstract

Objective To compare the performance of a new three-dimensional MRI sequence (volumetric interpolated breath-hold examination; MR-VIBE) with a conventional T1-weighted sequence (MR-T1) for the detection of erosions in the sacroiliac joints (SIJs) using low-dose CT (ldCT) as reference.

Methods ldCT and T1-MRI and MR-VIBE of 110 prospectively included patients with low back pain and suspected axial spondyloarthritis (axSpA) were scored for erosions by two readers. The presence of erosions on the patients’ level, the erosion sum score, sensitivity and specificity of both MRI sequences using ldCT as a reference as well as agreement between the readers were assessed.

Results MR-VIBE had a higher sensitivity than MR-T1 (95% vs 79%, respectively) without a decrease in specificity (93% each). MR-VIBE compared with MR-T1 identified 16% more patients with erosions (36 vs 30 of 38 patients with positive ldCT findings). The erosion sum score was also higher for MR-VIBE (8.1±9.3) than MR-T1 (6.7±8.4), p=0.003. The agreement on erosion detection was also higher for MR-VIBE (κ=0.71) compared with MRI-T1 (κ=0.56).

Conclusion VIBE detected erosions in the SIJs with higher sensitivity without a loss of specificity and superior reliability compared with a standard T1-weighted sequence. Its value for the diagnosis of axSpA has still to be determined.

  • spondyloarthritis
  • ankylosing spondylitis
  • magnetic resonance imaging

https://doi.org/10.1136/annrheumdis-2018-213393

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors TD: conception and design of the study, design of scoring system, image scoring, data evaluation, statistical calculations, article draft, critical revision of the manuscript for important intellectual content. JG: patient acquisition, data management, image scoring, critical revision of the manuscript for important intellectual content. JS: patient acquisition, conception and design of the study with critical revision of the manuscript for important intellectual content. DP: patient acquisition, critical revision of the manuscript for important intellectual content. BH: conception of the study, critical revision of the manuscript for important intellectual content. K-GAH: conception and design of the study, design of scoring system, image scoring, data evaluation, with critical revision of the manuscript for important intellectual content and final approval of the version to be published.

    • Funding This work was supported by a research grant to TD from the Assessment of Spondyloarthritis international Society (ASAS).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Institutional Review Board of Charité Medical School, Berlin, Germany.

    • Provenance and peer review Not commissioned; externally peer reviewed.