Development and Preliminary Validation of a Digital Overlay-based Learning Module for Semiquantitative Evaluation of Magnetic Resonance Imaging Lesions in Osteoarthritis of the Hip

Maksymowych, Walter P.; Pitts, Meaghan; Budak, Matthew; Gracey, David; Lambert, Robert G.; McDougall, David; Pianta, Marcus; Rennie, Winston J.; Wichuk, Stephanie; Winn, Naomi; Jaremko, Jacob L.

doi:10.3899/jrheum.141574

Cited by 14 publications

(17 citation statements)

References 8 publications

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“…To classify FF images, we evaluated bone marrow fat deposition using Maksymowych et al’s SI joint structural scoring system . A normal bone marrow signal in the ilium and sacrum, which are far from the SI joint, was regarded as normal marrow fat (normal FF).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of disease chronicity by bone marrow fat fraction using sacroiliac joint magnetic resonance imaging in patients with spondyloarthritis: A retrospective study

et al. 2019

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Aim: This study investigated the use of fat fraction (FF) measurements in the sacroiliac (SI) joint to determine radiologic progression in patients with spondyloarthritis (SpA). Method:A total of 138 patients who underwent pelvic magnetic resonance imaging (MRI) between September 2014 and March 2015 were retrospectively evaluated.The FF based upon fat deposition (%) using fat signaling on T1 and T2 weighted images in the sacroiliac joint was quantified using a 6-echo variant of the modified Dixon technique. We defined the normal bone marrow as normal FF, bone marrow edema as active inflammatory FF, and fat metaplasia as post-inflammatory FF. Results:The mean FF of normal marrow was 52.0% ± 10.4% and 50.5% ± 10.1% in the left and right SI joints, respectively. The mean FF of post-inflammatory fat deposition was 81.9% ± 9.7% and 82.3% ± 9.6% in the left and right SI joints, respectively.The mean FF of active inflammatory fat deposition was 15.8% ± 5.9% and 13.5% ± 6.7% in the left and right SI joints, respectively. In multiple linear regression, post-inflammatory FF was found to be significantly associated with radiologic progression, such as symptom duration, SI joint grade, and modified Stoke Ankylosing Spondylitis Spine Score. Conclusion:Post-inflammatory FF indicates the chronicity of SpA. Evaluating FF using MRI in the SI joint will help to determine radiologic progression. K E Y W O R D S fat fraction, magnetic resonance imaging, modified Dixon, sacroiliac joint, spondyloarthritis S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Koo BS, Song Y, Shin JH, Lee S, Kim T-H. Evaluation of disease chronicity by bone marrow fat fraction using sacroiliac joint magnetic resonance imaging in patients with spondyloarthritis: A retrospective study. Int J Rheum Dis. 2019;22:734-741. https://doi.

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Section: Methodsmentioning

confidence: 99%

Evaluation of disease chronicity by bone marrow fat fraction using sacroiliac joint magnetic resonance imaging in patients with spondyloarthritis: A retrospective study

et al. 2019

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“…In this study, we aimed to apply the HIMRISS (the Hip Inflammation Magnetic Resonance Imaging Scoring System) to patients with SpA. HIMRISS was developed by rheumatologists and radiologists to focus on the assessment of bone marrow lesions (BMLs), synovitis, and effusion on fluid‐sensitive sequences . The feasibility and reliability of this imaging instrument has already been well validated in osteoarthritis.…”

Section: Introductionmentioning

confidence: 99%

Application and preliminary validation of the hip inflammation MRI scoring system (HIMRISS) in spondyloarthritis

et al. 2018

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Aims: Spondyloarthritis (SpA) is an inflammatory rheumatic disease and hip involvement often results in severe deformities and functional impairment. Magnetic resonance imaging (MRI) is a powerful imaging tool for detecting early hip lesions in SpA.The aims of this study are to apply the hip inflammation MRI scoring system (HIMRISS) in SpA patients and to evaluate its reproducibility and validity.Methods: Four readers new to HIMRISS (two radiologists and two rheumatologists) scored the MRI scans obtained from a total of 55 SpA patients with hip lesions in two separate exercises (33 patients in exercise 1 and 22 patients in exercise 2). After the training and review process for exercise 1, these well-trained readers with expertise in the HIMRISS method scored the scans obtained from 22 patients and evaluated the association between HIMRISS and clinical activity of SpA, including Ankylosing Spondylitis Disease Activity Score (ASDAS), laboratory features, Bath Ankylosing Spondylitis Disease Activity Index and Harris hip scores. Results: HIMRISS is a reliable MRI scoring method for bone merrow lesions (BML)and synovitis in SpA. After 2 training exercises, the reliability improved from 0.67 to 0.90. The reliability for detecting femoral BML, acetabular BML, and synovitis effusion was very good after the 2 exercises (overall intraclass correlation coefficient = 0.73, 0.84 and 0.88, respectively). The clinical correlations between HIMRISS and ASDAS were most significant, and the correlations were closer to summed bilateral HIMRISS scores than just the worse side. HIMRISS was found to be an excellent tool for the early diagnosis of inflammation before the occurrence of structural damage, which was not significantly reflected in the systemic diagnosis.Conclusion: HIMRISS offers a reliable MRI scoring method for hip joint in SpA, and it is beneficial for early detection and fast quantification in disease activity assessment. K E Y W O R D SDiagnosis, Hip, magnetic resonance imaging, spondyloarthritis | 229 ZHENG Et al.

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“…22 Digital overlay patterns and knowledge transfer modules have been developed in scoring of hip OA using MRI to validate changes following intervention. 23 Furthermore, radiographs and CT may be used to identify entities with risk factors that may predispose to OA including fractures, avascular necrosis, infection, developmental dysplasia, and FAI (►Fig. 2).…”

Section: Radiographymentioning

confidence: 99%

Standard and Advanced Imaging of Hip Osteoarthritis. What the Radiologist Should Know

Huang

Tan

Scherer

et al. 2019

Semin Musculoskelet Radiol

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Osteoarthritis (OA) of the hip is caused by degeneration of articular cartilage and the underlying bone and can be divided into two types: primary (associated with advancing age) and secondary (subsequent to fractures, avascular necrosis, infection, developmental dysplasia, and femoroacetabular impingement). Radiography remains the first-line imaging modality for diagnosing and monitoring OA, due to its accessibility, low cost, and ease of interpretation. Kellgren-Lawrence and Tönnis classification systems are radiographic OA grading systems used primarily in research, and they reflect the degree of joint space narrowing, sclerosis, cysts, deformity of the femoral head and acetabulum, and osteophytes. Unenhanced computed tomography (CT) provides detailed visualization of the hip joint segments that may be difficult to appreciate on radiographs, such as the inferoposterior and posterolateral hip joint. CT arthrography, magnetic resonance imaging (MRI), and magnetic resonance arthrography with two-dimensional reconstructions can delineate labral abnormalities, cartilage lesions, and other intra-articular hip pathology. T2 and T2* mapping, delayed gadolinium-enhanced MRI of cartilage, T1rho, ultra-short echo time, and zero echo time are investigative MR techniques with promising evaluation of hip OA.

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Development and Preliminary Validation of a Digital Overlay-based Learning Module for Semiquantitative Evaluation of Magnetic Resonance Imaging Lesions in Osteoarthritis of the Hip

Abstract: Development and validation of a systematic method for KT may enhance external validation of certain imaging instruments.

Cited by 14 publications

References 8 publications

Evaluation of disease chronicity by bone marrow fat fraction using sacroiliac joint magnetic resonance imaging in patients with spondyloarthritis: A retrospective study

Evaluation of disease chronicity by bone marrow fat fraction using sacroiliac joint magnetic resonance imaging in patients with spondyloarthritis: A retrospective study

Application and preliminary validation of the hip inflammation MRI scoring system (HIMRISS) in spondyloarthritis

Standard and Advanced Imaging of Hip Osteoarthritis. What the Radiologist Should Know

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