OMERACT Hip Inflammation Magnetic Resonance Imaging Scoring System (HIMRISS) Assessment in Longitudinal Study

Jaremko, Jacob L.; Lambert, Robert G.; Pedersen, Susanne Juhl; Weber, Ulrich; Lindsay, Duncan D.; Al-Ani, Zeid; Steer, K.; Pianta, Marcus; Wichuk, Stephanie; Maksymowych, Walter P.

doi:10.3899/jrheum.181043

Cited by 7 publications

(3 citation statements)

References 6 publications

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“…[56][57][58][59] We have previously reported that BML may change within an 8-week window in patients with hip OA undergoing imaging-guided intra-articular injections of steroid. 60 This repair hypothesis is further supported by limited data from therapeutic studies of patients with knee OA and BML where drugs targeting bone remodeling, such as bisphosphonates and strontium ranelate, led to a reduction in size of BMLs, reduced pain and cartilage loss, and delayed need for total knee replacement. 13,14 In addition, tumor necrosis factor inhibitors, which may reduce vascularization, have also been shown to reduce BMLs in OA.…”

Section: Discussionmentioning

confidence: 97%

Comparative validation of the knee inflammation MRI scoring system and the MRI osteoarthritis knee score for semi-quantitative assessment of bone marrow lesions and synovitis-effusion in osteoarthritis: an international multi-reader exercise

Maksymowych

Jaremko

Pedersen

et al. 2023

Therapeutic Advances in Musculoskeletal

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Background: Bone marrow lesions (BMLs) and synovitis on magnetic resonance imaging (MRI) are associated with symptoms and predict degeneration of articular cartilage in osteoarthritis (OA). Validated methods for their semiquantitative assessment on MRI are available, but they all have similar scoring designs and questionable sensitivity to change. New scoring methods with completely different designs need to be developed and compared to existing methods. Objectives: To compare the performance of new web-based versions of the Knee Inflammation MRI Scoring System (KIMRISS) with the MRI OA Knee Score (MOAKS) for quantification of BMLs and synovitis-effusion (S-E). Design: Retrospective follow-up cohort. Methods: We designed web-based overlays outlining regions in the knee that are scored for BML in MOAKS and KIMRISS. For KIMRISS, both BML and S-E are scored on consecutive sagittal slices. The performance of these methods was compared in an international reading exercise of 8 readers evaluating 60 pairs of scans conducted 1 year apart from cases recruited to the OA Initiative (OAI) cohort. Interobserver reliability for baseline status and baseline to 1 year change in BML and S-E was assessed by intra-class correlation coefficient (ICC) and smallest detectable change (SDC). Feasibility was assessed using the System Usability Scale (SUS). Results: Mean change in BML and S-E was minimal over 1 year. Pre-specified targets for acceptable reliability (ICC ⩾ 0.80 and ⩾ 0.70 for status and change scores, respectively) were achieved more frequently for KIMRISS for both BML and synovitis. Mean (95% CI) ICC for change in BML was 0.88 (0.83–0.92) and 0.69 (0.60–0.78) for KIMRISS and MOAKS, respectively. KIMRISS mean SUS usability score was 85.7 and at the 95th centile of ranking for usability versus a score of 55.4 and 20th centile for MOAKS. Conclusion: KIMRISS had superior performance metrics to MOAKS for quantification of BML and S-E. Both methods should be further compared in trials of new therapies for OA.

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Section: Discussionmentioning

confidence: 97%

Comparative validation of the knee inflammation MRI scoring system and the MRI osteoarthritis knee score for semi-quantitative assessment of bone marrow lesions and synovitis-effusion in osteoarthritis: an international multi-reader exercise

Maksymowych

Jaremko

Pedersen

et al. 2023

Therapeutic Advances in Musculoskeletal

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“…Bone marrow lesions (BML) in the hip are assessed on fluid-sensitive MRI scans using an electronic overlay on a webbased interface positioned over the femoral head and extending into the acetabulum on consecutive coronal slices through the hip joint (scoring range 0-100) (Figure 1) [57]. It has been shown to have very good to excellent reliability for detecting change in BML for patients with OA receiving glucocorticoid injections [58]. In the KIMRISS method, BML is scored using specific web-based electronic overlays for the femur, tibia, and patella on consecutive sagittal slices through the knee joint (scoring range 0-500) (Figure 2) [56].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Advances in Imaging for Clinical Trials in Rheumatic Diseases

Maksymowych

2023

Proc Shevchenko Sci Soc Med Sci

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The successful execution of clinical trials for novel anti-rheumatic compounds is increasingly approaching the limits of what can be achieved using radiographic outcomes for the assessment of disease modification. Moreover, there is a growing need for more objective tools to assess joint inflammation, especially for disorders such as axial spondyloarthritis where spinal symptoms are often non-specific and physical findings may be minimal until later stages of disease. The use of MRI to evaluate inflammation in the synovium and bone marrow as well as erosions in peripheral joints of patients with RA and PsA represents a major new advance that should now be routinely implemented in clinical trials of RA. MRI-based scoring systems have been well validated and demonstrate that, for RA, MRI changes after therapeutic intervention may be observed in a month and precede findings on radiography that only become evident after a year. The assessment of disease activity on MRI of the sacroiliac joints and spine using a standardized and well-validated method, such as the SPARCC instruments, is indispensable to the evaluation of efficacy for new agents aimed at the treatment of spondyloarthritis. Further advances include the use of whole-body MRI evaluation to assess inflammation in both the axial and peripheral skeleton as well as sequences that dispense with the requirement for the use of contrast agents, such as gadolinium, and data processing techniques that permit full automation and absolute quantification. This review will discuss how imaging is transforming clinical trials in rheumatic diseases.

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“…For adults with rheumatoid arthritis, several validated scoring systems for hip involvement exist, including the Hip Inflammation Magnetic Resonance Imaging Scoring System (HIMRISS) and Hip Osteoarthritis MRI Scoring System (HOAMS) [ 10 , 11 ]. For children, however, although several scoring systems have been proposed [ 12 – 16 ], no child- and hip-specific scoring system including both inflammatory and permanent changes has been validated [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

A novel magnetic resonance imaging scoring system for active and chronic changes in children and adolescents with juvenile idiopathic arthritis of the hip

et al. 2022

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Background Hip involvement predicts severe disease in juvenile idiopathic arthritis (JIA) and is accurately assessed by MRI. However, a child-specific hip MRI scoring system has not been validated. Objective To test the intra- and interobserver agreement of several MRI markers for active and chronic hip changes in children and young adults with JIA and to examine the precision of measurements commonly used for the assessment of growth abnormalities. Materials and methods Hip MRIs from 60 consecutive children, adolescents and young adults with JIA were scored independently by two sets of radiologists. One set scored the same MRIs twice. Features of active and chronic changes, growth abnormalities and secondary post-inflammatory changes were scored. We used kappa statistics to analyze inter- and intraobserver agreement for categorical variables and a Bland–Altman approach to test the precision of continuous variables. Results Among active changes, there was good intra- and interobserver agreement for grading overall inflammation (kappa 0.6–0.7). Synovial enhancement showed a good intraobserver agreement (kappa 0.7–0.8), while the interobserver agreement was moderate (kappa 0.4–0.5). Regarding acetabular erosions on a 0–3 scale, the intraobserver agreement was 0.6 for the right hip and 0.7 for the left hip, while the interobserver agreement was 0.6 for both hips. Measurements of joint space width, caput–collum–diaphyseal angle, femoral neck–head length, femoral width and trochanteric distance were imprecise. Conclusion We identified a set of MRI markers for active and chronic changes in JIA and suggest that the more robust markers be included in future studies addressing clinical validity and long-term patient outcomes.

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OMERACT Hip Inflammation Magnetic Resonance Imaging Scoring System (HIMRISS) Assessment in Longitudinal Study

Cited by 7 publications

References 6 publications

Comparative validation of the knee inflammation MRI scoring system and the MRI osteoarthritis knee score for semi-quantitative assessment of bone marrow lesions and synovitis-effusion in osteoarthritis: an international multi-reader exercise

Comparative validation of the knee inflammation MRI scoring system and the MRI osteoarthritis knee score for semi-quantitative assessment of bone marrow lesions and synovitis-effusion in osteoarthritis: an international multi-reader exercise

Advances in Imaging for Clinical Trials in Rheumatic Diseases

A novel magnetic resonance imaging scoring system for active and chronic changes in children and adolescents with juvenile idiopathic arthritis of the hip

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