Whole-Body Magnetic Resonance Imaging Assessment of Joint Inflammation in Rheumatoid Arthritis—Agreement With Ultrasonography and Clinical Evaluation

Abstract

Objective: To compare joint inflammation seen by whole-body magnetic resonance imaging (WBMRI), with "whole-body" ultrasound and clinical assessments, in patients with active rheumatoid arthritis (RA) before and during tumor necrosis factor-inhibitor (TNF-I, adalimumab) treatment. Methods:In 18 patients with RA, clinical assessment for joint tenderness and swelling, WBMRI, and ultrasound were obtained at baseline and week 16. Wrist, metacarpophalangeal (MCP) and proximal interphalangeal (PIP), elbow (except for WBMRI), shoulder, knee, ankle, and metatarsophalangeal joints were examined. Joint inflammation was defined by WBMRI as the presence of synovitis and/or osteitis and by ultrasound as gray-scale synovial hypertrophy grade >2 and/or color Doppler grade >1. On patient level, agreement was assessed by Spearman correlation coefficients (rho) for sum scores for 28 joints (i.e., wrists, MCPs, PIPs, elbows, shoulders, and knees) between clinical examination (DAS28CRP), ultrasound (US28), and WBMRI (WBMRI26; elbows not included). On joint level, agreement on inflammation between WBMRI, ultrasound, and clinical findings was calculated with Cohen's kappa (κ).Results: At patient level, WBMRI26 and US28 sum scores showed good correlation (rho = 0.72; p < 0.01) at baseline, but not at follow-up (rho = 0.25; p = 0.41). At joint level, moderate agreement was seen for hand joints (κ = 0.41-0.44); for other joints κ < 0.40. No correlation with DAS28CRP was seen. No statistically significant correlations were observed between changes in WBMRI26, US28, and DAS28CRP during treatment.Conclusions: WBMRI and ultrasound joint inflammation sum scores at patient level showed good agreement in clinically active RA patients before TNF-I initiation, whereas agreement was poorer at joint level, and after treatment.

Validity of an ultrasonographic joint-specific scoring system in juvenile idiopathic arthritis: a cross-sectional study comparing ultrasound findings of synovitis with whole-body magnetic resonance imaging and clinical assessment

“…A strong association between ultrasound synovitis sum scores and whole-body MRI joint inflammation sum scores has also been reported in adults with rheumatoid arthritis. 31 To the best of our knowledge, no study has compared ultrasound findings of synovitis in multiple joints with MRI in patients with JIA. Laurell et al compared ultrasound with contrast enhanced MRI of the wrist, knee and ankle joints to evaluate disease activity in JIA, but only one joint was assessed with MRI in each patient.…”

Molecular Design of Magnetic Resonance Imaging Agents Binding to Amyloid Deposits

“…A number of metal-based (mainly gadolinium-based) contrast agents have been developed which increase the relaxation rate in the immediate vicinity of the metal and improve the visibility of pathologies [ 69 ]. Conventional or contrast-enhanced 1 H MRI has been successfully used to diagnose many different pathological conditions: neurological tumors [ 70 ]; issues with the structure and function of the heart [ 71 , 72 ]; joint diseases and soft tissue tumors [ 73 , 74 , 75 , 76 ]; stenosis or aneurysm of the arteries [ 77 ]; and lesions of the liver, pancreas, and bile ducts [ 78 , 79 , 80 ].…”