Magnetic resonance methods for measurement of disease progression in rheumatoid arthritis

Waterton, John C.; Rajanayagam, Vasanthan; Ross, Brian D.; Brown, David G.; Whittemore, Anthony R; Johnstone, D

doi:10.1016/0730-725x(93)90222-y

Cited by 37 publications

(19 citation statements)

References 10 publications

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“…One major problem with the validation of Vsm determination by MRI lies in the identification of appropriate gold standards. A semi-automated method based on computerized counting of pixels fulfilling certain criteria can be used [16,17,18,19], volume measurements can be restricted to one or few slices per joint, or a semi-quantitative grading of synovial hypertrophy can be performed [3,20,21,22]. These methods are less time-consuming and faster and more attractive for applicability in larger clinical studies or in clinical routine.…”

Section: Discussionmentioning

confidence: 99%

MRI of the arthritic small joints: comparison of extremity MRI (0.2 T) vs high-field MRI (1.5 T)

et al. 2001

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The aim of this study was to compare the diagnostic capabilities of extremity MRI (E-MRI) with high-field MRI in arthritic small joints, and to evaluate the patients' acceptance and perceptions of the two MR systems. One hundred three patients (group 1 = 28 patients with RA < 3 years, group 2 = 25 patients with reactive and psoriatic arthritis and mixed connective tissue disease, group 3 = 25 patients with rheumatoid arthritis (RA) more than 3 years and group 4 = 25 patients with arthralgia) underwent dedicated E-MRI and high-field MRI of the wrist and finger joints. Coronal short tau inversion recovery and transversal 3D T1-weighted images before and after gadodiamide (Gd) were performed in both cases to outline the volume of the synovial membrane (Vsm) and to evaluate joints with enhancement, effusion, bone edema, and erosions. Investigators blinded to the clinical findings evaluated the images. Patients' compliance and acceptance of E-MRI and high-field MRI were evaluated. The median Vsm obtained on E-MRI did not differ significantly from that obtained on high-field MRI. Vsm = 1 ml (E-MRI) and 1.1 ml (high-field MRI) before Gd and Vsm = 0.1 ml (E-MRI) and 0 ml (high-field MRI) after Gd (Wilcoxon test, p > 0.05). The difference in agreement was 8% for joint enhancement, 2% for joint effusion, 3% for bone edema, and 4% for bone erosions. Of the patients, 64% preferred E-MRI due to more comfortable positioning and less claustrophobia and noise. Extremity MRI of the small arthritic joints is comparable to high-field MRI and more readily accepted than high-field MRI by this patient group.

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Section: Discussionmentioning

confidence: 99%

MRI of the arthritic small joints: comparison of extremity MRI (0.2 T) vs high-field MRI (1.5 T)

et al. 2001

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“…The volume estimations have been obtained either by manual computer-assisted outlining based on visual analysis of the images (9-12,15), as in the present study, or by semiautomatic computerized counting of pixels with a post-Gd-DTPA signal enhancement above a certain threshold (13,14,23). The semiautomatic methods are very sensitive to the enhancement thresholds chosen (23). Manual methods appear more reliable but are also more time consuming.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging‐determined synovial membrane and joint effusion volumes in rheumatoid arthritis and osteoarthritis. Comparison with the macroscopic and microscopic appearance of the synovium

Østergaard

Stoltenberg

Løvgreen‐Nielsen

et al. 1997

Arthritis & Rheumatism

221

140

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Objective. To evaluate the relationship between synovial membrane and joint effusion volumes determined by magnetic resonance imaging (MRI) and macroscopic and microscopic synovial pathologic findings in patients with rheumatoid arthritis (RA) and osteoarthritis (OA).Methods. Synovial biopsies were performed, and macroscopic grades of synovitis assigned, at preselected knee sites during arthroscopy or arthrotomy in 17 knees with RA and 25 with OA. Synovial inflammation and 9 separate tissue characteristics were graded histologically. Synovial membrane and joint effusion volumes were determined by preoperative MRI, enhanced with intravenous gadopentetate dimeglumine.Results. MRI-determined synovial membrane volumes were correlated with the overall histologic assessment of synovial inflammation (Spearman's a = 0.55, P C 0.001), with fibrin deposition, with subsynovial mononuclear and polymorphonuclear leukocyte infiltration

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“…Quantitation of fluid and pannus volumes used methods similar to those published elsewhere 28 9 Briefly, fluid volume was obtained from T2 weighted (PSIF) scans by manual segmentation using Siemens image analysis software. The area calculated for each slice was multiplied by the slice separation to give the total volume.…”

Section: Methodsmentioning

confidence: 99%

Quantitative magnetic resonance imaging of the knee: a method of measuring response to intra-articular treatments

Creamer

Keen

Zananiri

et al. 1997

Annals of the Rheumatic Diseases

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Objectives-To investigate the potential of quantitative magnetic resonance imaging (MRI) to diVerentiate between therapeutically induced changes in inflammation and synovial proliferation in rheumatoid arthritis (RA) of the knee. Methods-MRI of the knee was performed on patients with RA before and one week after injection with corticosteroid (triamcinolone acetonide, TA group, n=9) and before, four, and 12 weeks after injection with yttrium-90 plus TA (TA+Y group, n=7). MRI scans were analysed by subjective visual grading by a trained observer and by computer aided quantitation for three features: synovial fluid volume, synovial pannus volume, and synovial enhancement after intravenous contrast agent. Results-All TA subjects improved clinically at one week but the eVects of TA+Y were more variable. TA significantly reduced synovial enhancement and eVusion volume, whereas TA+Y at 12 weeks tended to increase synovial enhancement and decrease pannus volume. Quantitative MRI values agreed well with subjective assessment of scans. Comparison of calculated change on MRI scan before and immediately after aspiration with actual volume aspirated showed high correlation (r=0.96). Conclusions-Quantitative MRI correlates with subjective visual assessment and, at least for synovial fluid, is accurate. MRI can diVerentiate actions of two therapeutic modalities on various pathological processes and is sensitive enough to detect change after one week. With the additional advantage of lack of observer bias, it will probably become a useful tool in the development and assessment of existing and novel treatments.

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Magnetic resonance methods for measurement of disease progression in rheumatoid arthritis

Cited by 37 publications

References 10 publications

MRI of the arthritic small joints: comparison of extremity MRI (0.2 T) vs high-field MRI (1.5 T)

MRI of the arthritic small joints: comparison of extremity MRI (0.2 T) vs high-field MRI (1.5 T)

Magnetic resonance imaging‐determined synovial membrane and joint effusion volumes in rheumatoid arthritis and osteoarthritis. Comparison with the macroscopic and microscopic appearance of the synovium

Quantitative magnetic resonance imaging of the knee: a method of measuring response to intra-articular treatments

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