scholarly journals The smallest detectable difference and sensitivity to change of magnetic resonance imaging and radiographic scoring of structural joint damage in rheumatoid arthritis finger, wrist, and toe joints: A comparison of the omeract rheumatoid arthritis magnetic resonance imaging score applied to different joint combinations and the sharp/van der heijde radiographic score

2005 ◽  
Vol 52 (8) ◽  
pp. 2300-2306 ◽  
Author(s):  
Bo Jannik Ejbjerg ◽  
Aage Vestergaard ◽  
Søren Jacobsen ◽  
Henrik S. Thomsen ◽  
Mikkel ØStergaard
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Joint Damage ◽  
Sensitivity To Change ◽  
Resonance Imaging ◽  
Radiographic Score ◽  
Structural Joint ◽  
Detectable Difference ◽  
Smallest Detectable Difference

scholarly journals The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group

2017 ◽  
Vol 44 (11) ◽  
pp. 1706-1712 ◽  
Author(s):  
Mikkel Østergaard ◽  
Charles G. Peterfy ◽  
Paul Bird ◽  
Frédérique Gandjbakhch ◽  
Daniel Glinatsi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Working Group ◽  
Scoring System ◽  
Research Agenda ◽  
Image Resolution ◽  
Sensitivity To Change ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Objective.The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS.Methods.MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined.Results.Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research.Conclusion.Updated 2016 RAMRIS recommendations and a research agenda were developed.

scholarly journals The Relationship Between Synovial Pathobiology and Magnetic Resonance Imaging Abnormalities in Rheumatoid Arthritis: A Systematic Review

2017 ◽  
Vol 44 (9) ◽  
pp. 1311-1324 ◽  
Author(s):  
Frances Humby ◽  
Arti Mahto ◽  
Muaaze Ahmed ◽  
Andrew Barr ◽  
Stephen Kelly ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Systematic Review ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Bone Erosion ◽  
Critical Role ◽  
Joint Damage ◽  
Resonance Imaging ◽  
The Relationship

Objective.Magnetic resonance imaging (MRI) has been increasingly recognized as a critical tool for the assessment of patients with rheumatoid arthritis (RA) and is able to reliably identify synovitis, bone marrow edema, bone erosion, and joint space narrowing (JSN)/cartilage loss. Understanding the exact relationship between each MRI feature and local synovial pathobiology is critical to dissect disease pathogenesis as well as develop future predictive models.Methods.A systematic review was performed of the current published literature examining the relationship between MRI abnormalities and synovial pathobiology in patients with RA.Results.Eighteen studies were identified; most focused on validation of MRI as a tool to detect and quantify synovitis, with a significant relationship demonstrated. Additionally, from the limited data available, a critical role seems likely for synovial pathways, at least in driving joint damage. However, there was a lack of data examining the relationship between synovial pathobiology and bone marrow abnormalities and JSN.Conclusion.Although understanding the interrelationship of these disease biomarkers offers the potential to enhance the predictive validity of modern imaging with concomitant synovial pathobiological analysis, further studies integrating MRI with synovial tissue analysis in well-controlled cohorts at distinct disease stages before and after therapeutic intervention are required to achieve this.

Reliability and sensitivity to change of the OMERACT rheumatoid arthritis magnetic resonance imaging score in a multireader, longitudinal setting

2005 ◽  
Vol 52 (12) ◽  
pp. 3860-3867 ◽  
Author(s):  
Espen A. Haavardsholm ◽  
Mikkel Østergaard ◽  
Bo J. Ejbjerg ◽  
Nils P. Kvan ◽  
Till A. Uhlig ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Sensitivity To Change ◽  
Resonance Imaging

Magnetic resonance imaging in rheumatoid arthritis

2020 ◽  
pp. 207-218
Author(s):  
Mikkel Østergaard ◽  
Philip G. Conaghan ◽  
Charles Peterfy
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Joint Damage ◽  
Resonance Imaging ◽  
Established Disease ◽  
Tissue Changes ◽  
Magnetic Resonance Imaging Mri ◽  
Soft Tissue Changes

In rheumatoid arthritis (RA), early diagnosis combined with early initiation of appropriate therapy and tight control of inflammation have been recognized as essential for optimal clinical outcomes. Conventional radiography, though able to detect structural joint damage in patients with established disease, is not sensitive in detecting early disease manifestations such as soft tissue changes and bone damage at its earliest stages. Magnetic resonance imaging (MRI) allows multiplanar tomographic imaging of the body in any plane without geometric distortions associated with projectional techniques, such as radiography, and no ionizing radiation is used. Early bone involvement and inflammatory soft tissue changes of synovitis and tenosynovitis, which are not detectable by conventional clinical, biochemical, and radiographic methods, can be directly visualized and evaluated in detail by MRI. MRI is an increasingly available sensitive technique which has documented utility in the diagnosis, monitoring, and prognostication of patients with RA, and important new knowledge and technical improvements are continuously being acquired.

scholarly journals Magnetic Resonance Imaging (MRI) Results Following Discontinuation of Methotrexate in Rheumatoid Arthritis Treated with Subcutaneous Tocilizumab: The COMP-ACT MRI Substudy

2019 ◽  
Vol 47 (3) ◽  
pp. 325-332
Author(s):  
Charles Peterfy ◽  
Joel Kremer ◽  
William Rigby ◽  
Nora Singer ◽  
Christine Birchwood ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Activity ◽  
Joint Damage ◽  
Cartilage Loss ◽  
Resonance Imaging ◽  
Low Disease Activity ◽  
Magnetic Resonance Imaging Mri ◽  
And Cartilage

Objective.To assess differences in joint damage and inflammation using magnetic resonance imaging (MRI) between patients with rheumatoid arthritis (RA) who achieved low disease activity with tocilizumab (TCZ) + methotrexate (MTX) and subsequently continued or discontinued MTX.Methods.In the COMP-ACT trial, US patients with RA received subcutaneous TCZ 162 mg + MTX. Those who achieved 28-joint count Disease Activity Score calculated with erythrocyte sedimentation rate (DAS28-ESR) ≤ 3.2 at Week 24 were randomized 1:1 (double-blind) to discontinue MTX (TCZ monotherapy; mono) or continue TCZ + MTX until Week 52. In a subset of patients, 1.5-Tesla MRI was used to obtain images of bilateral hands and wrists at weeks 24 and 40. Outcomes included changes in MRI-assessed synovitis, osteitis, erosion, and cartilage loss from Week 24 to Week 40, and in the proportion of patients with progression of each score.Results.Of 296 patients who achieved DAS28-ESR ≤ 3.2 at Week 24, 79 were enrolled in the pilot MRI substudy and randomized to TCZ mono (n = 38) or TCZ + MTX (n = 41). Treatment with either TCZ mono or TCZ + MTX suppressed erosion progression, synovitis, osteitis, and cartilage loss. The proportion of patients with no progression in each outcome measure was similar between groups (range, TCZ mono: 84.8–97.0%; TCZ + MTX: 92.3–100%).Conclusion.In a subset of patients who achieved low disease activity with TCZ + MTX, MRI changes were minimal in intraarticular inflammation and damage measures in patients who discontinued MTX versus those who continued TCZ + MTX.

Validation of the OMERACT Magnetic Resonance Imaging Joint Space Narrowing Score for the Wrist in a Multireader Longitudinal Trial

2015 ◽  
Vol 42 (12) ◽  
pp. 2480-2485 ◽  
Author(s):  
Daniel Glinatsi ◽  
Siri Lillegraven ◽  
Espen A. Haavardsholm ◽  
Iris Eshed ◽  
Philip G. Conaghan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Joint Space Narrowing ◽  
Intraclass Correlation ◽  
Joint Space ◽  
Sensitivity To Change ◽  
Resonance Imaging ◽  
Change Scores ◽  
Smallest Detectable Change

Objective.To assess the intrareader and interreader agreement and sensitivity to change of the Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis Magnetic Resonance Imaging Joint Space Narrowing (RAMRIS-JSN) score in the rheumatoid arthritis (RA) wrist in a longitudinal multireader exercise.MethodsCoronal T1-weighted MR image sets of 1 wrist from 20 patients with early RA were assessed twice for JSN at 17 sites at baseline and after 36 or 60 months by 4 readers blinded to patient data but not time order. The joints were scored 0–4 according to the OMERACT RAMRIS-JSN score. Intraclass correlation coefficients (ICC), smallest detectable change (SDC), percentage exact/close agreement (PEA/PCA), and standardized response mean (SRM) were calculated.Results.Median baseline and change score was 10.3 and 1.9, respectively. Intrareader ICC for baseline and change scores was good (≥ 0.50) to very good (≥ 0.80) for all and 3 of 4 readers, respectively. Interreader ICC was very good for change (0.93), while poor for baseline score if all 4 readers were included (0.36), but very good if 1 reader was excluded (0.87). Intrareader and interreader SDC was low (2.34–3.18), except for the intrareader SDC for 1 reader (6.75). The mean PEA/PCA was high for baseline and change scores both within and between the readers (51.5–99.2), except for interreader baseline PEA (14.4). SRM was moderate for all readers (0.55–0.77).Conclusion.The OMERACT RAMRIS-JSN score showed high overall intrareader and interreader reliability, and moderate sensitivity to change, supporting inclusion of the measure as part of the OMERACT RAMRIS system.

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