Does low-field dedicated extremity MRI (E-MRI) reliably detect bone erosions in rheumatoid arthritis? A comparison of two different E-MRI units and conventional radiography with high-resolution CT scanning

Duer-Jensen, Anne; Ejbjerg, Bo; Albrecht‐Beste, Elisabeth; Vestergaard, Aage; Døhn, Uffe Møller; Hetland, Merete Lund; Østergaard, Mikkel

doi:10.1136/ard.2008.093591

Cited by 26 publications

(26 citation statements)

References 18 publications

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“…The superiority of MRI including E-MRI over conventional radiography has been confirmed in several studies [6,13]. Similarly, MRI erosion score was significantly higher in the established RA group compared to the early RA group, whereas there was no difference in sharp score between the two groups.…”

Section: Discussionmentioning

confidence: 73%

“…The MRI scoring system based on bone erosions, bone oedema and synovitis, developed by Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT) in 2002, known as the RA MRI scoring system (RAMRIS), has been accepted widely for use in RA trials [5]. Studies that evaluated the role of E-MRI in rheumatoid arthritis have shown that they provided information on bone erosions and synovitis comparable to that of high-field MRI [6,7]. Studies that evaluated the role of E-MRI in rheumatoid arthritis have shown that they provided information on bone erosions and synovitis comparable to that of high-field MRI [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Peripheral blood T helper type 17 frequency shows an inverse correlation with disease activity and magnetic resonance imaging-based osteitis and erosions in disease-modifying anti-rheumatic drug- and steroid-naive established rheumatoid arthritis

Edavalath

Singh

Soni

et al. 2016

Clinical and Experimental Immunology

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An increased expansion of T helper type 17 (Th17) cells in the synovium has been shown to play a key role in cartilage and bone destruction in rheumatoid arthritis (RA). Because the correlation of the peripheral blood helper T cell subsets and various inflammatory cytokines with the magnetic resonance imaging (MRI)-based parameters have not been studied adequately to date, we sought to look for the same in this study. RA patients with disease duration less than 36 months, disease-modifying anti-rheumatic drugs (DMARDs) and steroid-naive, were recruited. MRI of the dominant hand and wrist was performed using a 0·2 Tesla MRI machine. Peripheral blood Th1 and Th17 were enumerated by flow cytometry and serum interleukin (IL)-6 and IL-17 by enzyme-linked immunosorbent assay (ELISA). Forty consecutive seropositive RA patients [33 females, mean disease duration 12·2 months, mean disease activity score (DAS)28 = 4·4] were included. MRI revealed erosions in 80% of these subjects. On subgroup analysis, prevalence of erosions (94 versus 68%) as well as mean erosion score (11·5 ± 18·9 versus 3·5 ± 6·0) were significantly higher in established RA (13-36 months' duration) compared to early RA (0-12 months). The median peripheral blood Th17 frequencies were significantly higher in patients (1·4%) compared to healthy controls (0·7%) and had a strong negative correlation with MRI parameters of erosion and osteitis as well as with DAS28 in the established RA subgroup. The frequency of peripheral blood Th17 subset was significantly expanded in established RA which correlated inversely with disease activity as well as MRI based erosions and osteitis.

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Section: Discussionmentioning

confidence: 73%

Section: Introductionmentioning

confidence: 99%

Peripheral blood T helper type 17 frequency shows an inverse correlation with disease activity and magnetic resonance imaging-based osteitis and erosions in disease-modifying anti-rheumatic drug- and steroid-naive established rheumatoid arthritis

Edavalath

Singh

Soni

et al. 2016

Clinical and Experimental Immunology

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“…Conventional radiography is the best-validated imaging technique to assess bone damage so far, but there are limitations due to the two-dimensional character of radiographs 5. In consequence, MRI and CT gain importance for the assessment of bone erosions in RA 4 13. CT is often considered as the gold standard for detection of bone erosion as it combines the advantages of radiography for the assessment of bone structure with the strengths of tomographic techniques such as high degree of resolution and the three-dimensional character 3.…”

Section: Introductionmentioning

confidence: 99%

The structural basis of MRI bone erosions: an assessment by microCT

et al. 2012

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Objective To determine whether erosions appearing in MRI in patients with rheumatoid arthritis (RA) represent true erosions. Methods 50 RA patients received 1.5 T MRI and microCT (μCT) of the dominant hand. Erosion counts were assessed in coronal T1 weighted MRI sections and in coronal as well as axial μCT sections of the metacarpophalangeal (MCP) joints II-IV. Extent of erosions was assessed by RA MRI Score (RAMRIS) erosion score (MRI) and by three-dimensional assessment of erosion volume (μCT). Results 111 of the 600 evaluated joint regions showed erosions in the MRI and 137 in the μCT. In only 28 regions false negative lesions (μCT positive, MRI negative) were found, all of which were very small lesions with a volume of less than 10 mm 3 . Only two results were false-positive (μCT negative, MRI positive). RAMRIS erosion scores were strongly correlated to erosion volumes in the μCT (Pearson's r=0.514, p<0.001). Mean RAMRIS erosion scores were below 1 with erosion volumes up to 1.5 mm 3 , below 2 with erosion volumes up to 20 mm 3 and over 2 with volumes of more than 20 mm 3 . Discussion MRI erosions are generally based on true cortical breaks as shown by μCT. MRI is sensitive to detect bone erosions and only very small lesions escape detection. Moreover, RAMRIS erosion scores are closely linked to the absolute size of bone erosions in the μCT.

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“…The Journal of on July 11, 2015 -Published by www.jrheum.org Downloaded from studies 9,10,11,12,13,14 , in which details on population characteristics and MRI techniques are described.…”

Section: Rheumatologymentioning

confidence: 99%

Patterns of Magnetic Resonance Imaging Bone Erosion in Rheumatoid Arthritis — Which Bones Are Most Frequently Involved and Show the Most Change?: Figure 1.

Østergaard¹,

Døhn²,

Duer-Jensen³

et al. 2011

J Rheumatol

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The distribution and frequency of bone erosion and erosive progression as detected by MRI in RA wrists and MCP joints were identified. No pattern differences between early versus established disease and dominant versus nondominant sides were detected. No bones showed erosive progression. Thus, no self-evident simplification of the RAMRIS erosion score was identified. Bone involvement patterns may be considered, when joints are selected for MRI protocols for clinical trials and practice.

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Does low-field dedicated extremity MRI (E-MRI) reliably detect bone erosions in rheumatoid arthritis? A comparison of two different E-MRI units and conventional radiography with high-resolution CT scanning

Abstract: With CT as the reference method for detecting erosions in RA hands, the Artoscan showed higher sensitivity than the MagneVu and CR. All imaging modalities had high specificities. The better performance of the Artoscan should be considered when selecting an imaging method in RA.

Cited by 26 publications

References 18 publications

Peripheral blood T helper type 17 frequency shows an inverse correlation with disease activity and magnetic resonance imaging-based osteitis and erosions in disease-modifying anti-rheumatic drug- and steroid-naive established rheumatoid arthritis

Peripheral blood T helper type 17 frequency shows an inverse correlation with disease activity and magnetic resonance imaging-based osteitis and erosions in disease-modifying anti-rheumatic drug- and steroid-naive established rheumatoid arthritis

The structural basis of MRI bone erosions: an assessment by microCT

Patterns of Magnetic Resonance Imaging Bone Erosion in Rheumatoid Arthritis — Which Bones Are Most Frequently Involved and Show the Most Change?: Figure 1.

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