Differentiation between early rheumatoid arthritis patients and healthy persons by conventional and dynamic contrast-enhanced magnetic resonance imaging

Mette Bjørndal Axelsen; B J Ejbjerg; M L Hetland; H Skjødt; O Majgaard; Ulrik Birk Lauridsen; K Hørslev-Petersen; M Boesen; O Kubassova; H Bliddal; Mikkel Østergaard

doi:10.3109/03009742.2013.824022

Differentiation between early rheumatoid arthritis patients and healthy persons by conventional and dynamic contrast-enhanced magnetic resonance imaging

Mette Bjørndal Axelsen, B J Ejbjerg, M L Hetland, H Skjødt, O Majgaard, Ulrik Birk Lauridsen, K Hørslev-Petersen, M Boesen, O Kubassova, H Bliddal, Mikkel Østergaard

Department of Clinical Medicine

16 Citations (Scopus)

Abstract

OBJECTIVES: To identify the magnetic resonance imaging (MRI) parameter that best differentiates healthy persons and patients with early rheumatoid arthritis (RA), and to investigated responsiveness to treatment of various MRI parameters.

METHOD: Conventional MRI and dynamic contrast-enhanced (DCE)-MRI of the hand were performed once for 26 healthy persons, and before and after 6 and 12 months of disease-modifying anti-rheumatic drug (DMARD) treatment for 14 early RA patients, using a 1.0-T MRI unit. One-slice DCE-MRI was analysed using Dynamika version 4.2. The number of enhancing voxels (Nvoxel), the initial rate of enhancement (IRE), the maximum enhancement (ME), ME×Nvoxel, and IRE×Nvoxel were calculated for wrist and 2nd-5th metacarpophalangeal (MCP) joints. Conventional MR images were evaluated using the RA MRI scoring system (RAMRIS) synovitis score.

RESULTS: Using DCE-MRI, enhancement was demonstrated in 61.5% of healthy persons and in 91.7% of RA patients at baseline, with a median Nvoxel of 3 and 362, respectively. At baseline, all parameters were higher for patients than for healthy persons (all p ≤ 0.003). Only one patient had a baseline RAMRIS synovitis score below the 95th percentile of the healthy persons. The corresponding number of patients was 3 for Nvoxel, ME×Nvoxel and IRE×Nvoxel, and 10 for IRE and ME. The RAMRIS synovitis score and IRE showed the highest responsiveness, with a standardized response mean (SRM) of -1.00 and -0.88, respectively.

CONCLUSIONS: The RAMRIS synovitis scoring of conventional MRI, and to a lesser extent the one-slice DCE-MRI parameters of synovial volume, differentiated early RA patients and healthy persons. The decrease in RAMRIS synovitis score, Nvoxel, and IRE showed sensitivity to change during treatment.

Original language	English
Journal	Scandinavian Journal of Rheumatology
Volume	43
Issue number	2
Pages (from-to)	109-118
Number of pages	10
ISSN	0300-9742
DOIs	https://doi.org/10.3109/03009742.2013.824022
Publication status	Published - 2014

Keywords

Adult
Antirheumatic Agents
Arthritis, Rheumatoid
Case-Control Studies
Dose-Response Relationship, Drug
Female
Humans
Magnetic Resonance Imaging
Male
Metacarpophalangeal Joint
Middle Aged
Sensitivity and Specificity
Synovitis
Time Factors
Wrist Joint

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10.3109/03009742.2013.824022

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Axelsen, M. B., Ejbjerg, B. J., Hetland, M. L., Skjødt, H., Majgaard, O., Lauridsen, U. B., Hørslev-Petersen, K., Boesen, M., Kubassova, O., Bliddal, H., & Østergaard, M. (2014). Differentiation between early rheumatoid arthritis patients and healthy persons by conventional and dynamic contrast-enhanced magnetic resonance imaging. Scandinavian Journal of Rheumatology, 43(2), 109-118. https://doi.org/10.3109/03009742.2013.824022

Differentiation between early rheumatoid arthritis patients and healthy persons by conventional and dynamic contrast-enhanced magnetic resonance imaging. / Axelsen, Mette Bjørndal; Ejbjerg, B J; Hetland, M L et al.

In: Scandinavian Journal of Rheumatology, Vol. 43, No. 2, 2014, p. 109-118.

Research output: Contribution to journal › Journal article › Research › peer-review

Axelsen, MB, Ejbjerg, BJ, Hetland, ML, Skjødt, H, Majgaard, O, Lauridsen, UB, Hørslev-Petersen, K, Boesen, M, Kubassova, O, Bliddal, H & Østergaard, M 2014, 'Differentiation between early rheumatoid arthritis patients and healthy persons by conventional and dynamic contrast-enhanced magnetic resonance imaging', Scandinavian Journal of Rheumatology, vol. 43, no. 2, pp. 109-118. https://doi.org/10.3109/03009742.2013.824022

@article{b009f8721d724c4da10a77c8a89e7792,

title = "Differentiation between early rheumatoid arthritis patients and healthy persons by conventional and dynamic contrast-enhanced magnetic resonance imaging",

abstract = "OBJECTIVES: To identify the magnetic resonance imaging (MRI) parameter that best differentiates healthy persons and patients with early rheumatoid arthritis (RA), and to investigated responsiveness to treatment of various MRI parameters.METHOD: Conventional MRI and dynamic contrast-enhanced (DCE)-MRI of the hand were performed once for 26 healthy persons, and before and after 6 and 12 months of disease-modifying anti-rheumatic drug (DMARD) treatment for 14 early RA patients, using a 1.0-T MRI unit. One-slice DCE-MRI was analysed using Dynamika version 4.2. The number of enhancing voxels (Nvoxel), the initial rate of enhancement (IRE), the maximum enhancement (ME), ME×Nvoxel, and IRE×Nvoxel were calculated for wrist and 2nd-5th metacarpophalangeal (MCP) joints. Conventional MR images were evaluated using the RA MRI scoring system (RAMRIS) synovitis score.RESULTS: Using DCE-MRI, enhancement was demonstrated in 61.5% of healthy persons and in 91.7% of RA patients at baseline, with a median Nvoxel of 3 and 362, respectively. At baseline, all parameters were higher for patients than for healthy persons (all p ≤ 0.003). Only one patient had a baseline RAMRIS synovitis score below the 95th percentile of the healthy persons. The corresponding number of patients was 3 for Nvoxel, ME×Nvoxel and IRE×Nvoxel, and 10 for IRE and ME. The RAMRIS synovitis score and IRE showed the highest responsiveness, with a standardized response mean (SRM) of -1.00 and -0.88, respectively.CONCLUSIONS: The RAMRIS synovitis scoring of conventional MRI, and to a lesser extent the one-slice DCE-MRI parameters of synovial volume, differentiated early RA patients and healthy persons. The decrease in RAMRIS synovitis score, Nvoxel, and IRE showed sensitivity to change during treatment.",

keywords = "Adult, Antirheumatic Agents, Arthritis, Rheumatoid, Case-Control Studies, Dose-Response Relationship, Drug, Female, Humans, Magnetic Resonance Imaging, Male, Metacarpophalangeal Joint, Middle Aged, Sensitivity and Specificity, Synovitis, Time Factors, Wrist Joint",

author = "Axelsen, {Mette Bj{\o}rndal} and Ejbjerg, {B J} and Hetland, {M L} and H Skj{\o}dt and O Majgaard and Lauridsen, {Ulrik Birk} and K H{\o}rslev-Petersen and M Boesen and O Kubassova and H Bliddal and Mikkel {\O}stergaard",

year = "2014",

doi = "10.3109/03009742.2013.824022",

language = "English",

volume = "43",

pages = "109--118",

journal = "Scandinavian Journal of Rheumatology",

issn = "0300-9742",

publisher = "Taylor & Francis",

number = "2",

}

TY - JOUR

T1 - Differentiation between early rheumatoid arthritis patients and healthy persons by conventional and dynamic contrast-enhanced magnetic resonance imaging

AU - Axelsen, Mette Bjørndal

AU - Ejbjerg, B J

AU - Hetland, M L

AU - Skjødt, H

AU - Majgaard, O

AU - Lauridsen, Ulrik Birk

AU - Hørslev-Petersen, K

AU - Boesen, M

AU - Kubassova, O

AU - Bliddal, H

AU - Østergaard, Mikkel

PY - 2014

Y1 - 2014

N2 - OBJECTIVES: To identify the magnetic resonance imaging (MRI) parameter that best differentiates healthy persons and patients with early rheumatoid arthritis (RA), and to investigated responsiveness to treatment of various MRI parameters.METHOD: Conventional MRI and dynamic contrast-enhanced (DCE)-MRI of the hand were performed once for 26 healthy persons, and before and after 6 and 12 months of disease-modifying anti-rheumatic drug (DMARD) treatment for 14 early RA patients, using a 1.0-T MRI unit. One-slice DCE-MRI was analysed using Dynamika version 4.2. The number of enhancing voxels (Nvoxel), the initial rate of enhancement (IRE), the maximum enhancement (ME), ME×Nvoxel, and IRE×Nvoxel were calculated for wrist and 2nd-5th metacarpophalangeal (MCP) joints. Conventional MR images were evaluated using the RA MRI scoring system (RAMRIS) synovitis score.RESULTS: Using DCE-MRI, enhancement was demonstrated in 61.5% of healthy persons and in 91.7% of RA patients at baseline, with a median Nvoxel of 3 and 362, respectively. At baseline, all parameters were higher for patients than for healthy persons (all p ≤ 0.003). Only one patient had a baseline RAMRIS synovitis score below the 95th percentile of the healthy persons. The corresponding number of patients was 3 for Nvoxel, ME×Nvoxel and IRE×Nvoxel, and 10 for IRE and ME. The RAMRIS synovitis score and IRE showed the highest responsiveness, with a standardized response mean (SRM) of -1.00 and -0.88, respectively.CONCLUSIONS: The RAMRIS synovitis scoring of conventional MRI, and to a lesser extent the one-slice DCE-MRI parameters of synovial volume, differentiated early RA patients and healthy persons. The decrease in RAMRIS synovitis score, Nvoxel, and IRE showed sensitivity to change during treatment.

AB - OBJECTIVES: To identify the magnetic resonance imaging (MRI) parameter that best differentiates healthy persons and patients with early rheumatoid arthritis (RA), and to investigated responsiveness to treatment of various MRI parameters.METHOD: Conventional MRI and dynamic contrast-enhanced (DCE)-MRI of the hand were performed once for 26 healthy persons, and before and after 6 and 12 months of disease-modifying anti-rheumatic drug (DMARD) treatment for 14 early RA patients, using a 1.0-T MRI unit. One-slice DCE-MRI was analysed using Dynamika version 4.2. The number of enhancing voxels (Nvoxel), the initial rate of enhancement (IRE), the maximum enhancement (ME), ME×Nvoxel, and IRE×Nvoxel were calculated for wrist and 2nd-5th metacarpophalangeal (MCP) joints. Conventional MR images were evaluated using the RA MRI scoring system (RAMRIS) synovitis score.RESULTS: Using DCE-MRI, enhancement was demonstrated in 61.5% of healthy persons and in 91.7% of RA patients at baseline, with a median Nvoxel of 3 and 362, respectively. At baseline, all parameters were higher for patients than for healthy persons (all p ≤ 0.003). Only one patient had a baseline RAMRIS synovitis score below the 95th percentile of the healthy persons. The corresponding number of patients was 3 for Nvoxel, ME×Nvoxel and IRE×Nvoxel, and 10 for IRE and ME. The RAMRIS synovitis score and IRE showed the highest responsiveness, with a standardized response mean (SRM) of -1.00 and -0.88, respectively.CONCLUSIONS: The RAMRIS synovitis scoring of conventional MRI, and to a lesser extent the one-slice DCE-MRI parameters of synovial volume, differentiated early RA patients and healthy persons. The decrease in RAMRIS synovitis score, Nvoxel, and IRE showed sensitivity to change during treatment.

KW - Adult

KW - Antirheumatic Agents

KW - Arthritis, Rheumatoid

KW - Case-Control Studies

KW - Dose-Response Relationship, Drug

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Metacarpophalangeal Joint

KW - Middle Aged

KW - Sensitivity and Specificity

KW - Synovitis

KW - Time Factors

KW - Wrist Joint

U2 - 10.3109/03009742.2013.824022

DO - 10.3109/03009742.2013.824022

M3 - Journal article

C2 - 24191910

SN - 0300-9742

VL - 43

SP - 109

EP - 118

JO - Scandinavian Journal of Rheumatology

JF - Scandinavian Journal of Rheumatology

IS - 2

ER -

Differentiation between early rheumatoid arthritis patients and healthy persons by conventional and dynamic contrast-enhanced magnetic resonance imaging

Abstract

Keywords

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