Feasibility of dual phase 99mTc-MDP SPECT/CT imaging in rheumatoid arthritis evaluation

AbstractObjectivesTo prospectively demonstrate the feasibility of performing dual-phase SPECT/CT for the assessment of the small joints of the hands of rheumatoid arthritis (RA) patients, and to evaluate the reliability of the quantitative and qualitative measures derived from the resulting images.MethodsA SPECT/CT imaging protocol was developed in this pilot study to scan both hands simultaneously in RA patients, in two phases of 99mTc-MDP radiotracer uptake; namely the soft-tissue blood pool phase (within 15 minutes after radiotracer injection) and osseous phase (after 3 hours). Joints were evaluated qualitatively (normal vs. abnormal uptake) and quantitatively (by measuring the maximum corrected count ratio [MCCR]). Qualitative and quantitative evaluations were repeated to assess reliability.ResultsFour participants completed seven studies (all four were imaged at baseline, and three of them at follow-up after 1-month of arthritis therapy). A total of 280 joints (20 per hand) were evaluated. The MCCR from soft-tissue phase scans was significantly higher for clinically abnormal joints compared to clinically normal ones; p<0.001, however the MCCR from the osseous phase scans were not different between the two groups. Intraclass Correlation Coefficient (ICC) for MCCR was excellent (0.9789, 95% confidence interval [CI]: 0.9734-0.9833). Intra-observer agreement for qualitative SPECT findings was good for both the soft-tissue phase (kappa=0.78, 95%CI: 0.72-0.83) and osseous-phase (kappa=0.70, 95%CI: 0.64-0.76) scans.ConclusionExtracting reliable quantitative and qualitative measures from dual-phase 99mTc-MDP SPECT/CT hand scans is feasible in RA patients. SPECT/CT may provide a unique means for assessing both synovitis and osseous involvement in RA joints using the same radiotracer injection.

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Feasibility of dual-phase 99mTc-MDP SPECT/CT imaging in rheumatoid arthritis evaluation

Quantitative Imaging in Medicine and Surgery ◽

10.21037/qims-20-996 ◽

2021 ◽

Vol 11 (6) ◽

pp. 2333-2343

Author(s):

Yasser G. Abdelhafez ◽

Felipe Godinez ◽

Kanika Sood ◽

Rosalie J. Hagge ◽

Robert D. Boutin ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Ct Imaging ◽

Dual Phase

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The Reliability of Ultrasound in the Assessment of Hyaline Cartilage in Rheumatoid Arthritis and Healthy Metacarpal Heads

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1285-4602 ◽

2020 ◽

Author(s):

Edoardo Cipolletta ◽

Emilio Filippucci ◽

Andrea Di Matteo ◽

Giulia Tesei ◽

Micaela Ana Cosatti ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Scoring System ◽

Quantitative Assessment ◽

Hyaline Cartilage ◽

Scoring Systems ◽

Thickness Measurement ◽

Cartilage Thickness ◽

Observer Agreement ◽

Very High Frequency ◽

Observer Reliability

Abstract Purpose i) To assess the inter- and intra-observer reliability of ultrasound (US) in the evaluation of the hyaline cartilage (HC) of the metacarpal head (MH) in patients with rheumatoid arthritis (RA) and in healthy subjects (HS) both qualitatively and quantitatively. ii) To calculate the smallest detectable difference (SDD) of the MH cartilage thickness measurement. iii) To correlate the qualitative scoring system and the quantitative assessment. Materials and Methods US examination was performed on 280 MHs of 20 patients with RA and 15 HS using a very high frequency probe (up to 22 MHz). HC status was evaluated both qualitatively (using a five-grade scoring system) and quantitatively (using the average value of the longitudinal and transverse measures). The HC of MHs from II to V metacarpophalangeal joint of both hands were scanned independently on the same day by two rheumatologists to assess inter-observer reliability. All subjects were re-examined using the same scanning protocol and the same US setting by one sonographer after a week to assess intra-observer reliability. Results The inter-observer agreement and intra-observer agreement were moderate to substantial (k = 0.66 and k = 0.73) for the qualitative scoring system and high (ICC = 0.93 and ICC = 0.94) for the quantitative assessment. The SDD of the MH cartilage thickness measurement was 0.09 mm. A significant correlation between the two scoring systems was found (r = –0.35; p < 0.001). Conclusion The present study describes the main methodological issues of HC assessment. Using a standardized protocol, both the qualitative and the quantitative scoring systems can be reliable.

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Effect of Point-Spread Function Reconstruction for Indeterminate PSMA-RADS-3A Lesions on PSMA-Targeted PET Imaging of Men with Prostate Cancer

Diagnostics ◽

10.3390/diagnostics11040665 ◽

2021 ◽

Vol 11 (4) ◽

pp. 665

Author(s):

Wajahat Khatri ◽

Hyun Woo Chung ◽

Rudolf A. Werner ◽

Jeffrey P. Leal ◽

Kenneth J. Pienta ◽

...

Keyword(s):

Prostate Cancer ◽

Soft Tissue ◽

Point Spread Function ◽

Prospective Trial ◽

Blood Pool ◽

True Positive ◽

Point Spread ◽

Standardized Uptake Values ◽

Spread Function

Purpose: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is emerging as an important modality for imaging patients with prostate cancer (PCa). As with any imaging modality, indeterminate findings will arise. The PSMA reporting and data system (PSMA-RADS) version 1.0 codifies indeterminate soft tissue findings with the PSMA-RADS-3A moniker. We investigated the role of point-spread function (PSF) reconstructions on categorization of PSMA-RADS-3A lesions. Methods: This was a post hoc analysis of an institutional review board approved prospective trial. Around 60 min after the administration of 333 MBq (9 mCi) of PSMA-targeted 18F-DCFPyL, patients underwent PET/computed tomography (CT) acquisitions from the mid-thighs to the skull vertex. The PET data were reconstructed with and without PSF. Scans were categorized according to PSMA-RADS version 1.0, and all PSMA-RADS-3A lesions on non-PSF images were re-evaluated to determine if any could be re-categorized as PSMA-RADS-4. The maximum standardized uptake values (SUVs) of the lesions, mean SUVs of blood pool, and the ratios of those values were determined. Results: A total of 171 PSMA-RADS-3A lesions were identified in 30 patients for whom both PSF reconstructions and cross-sectional imaging follow-up were available. A total of 13/171 (7.6%) were re-categorized as PSMA-RADS-4 lesions with PSF reconstructions. A total of 112/171 (65.5%) were found on follow-up to be true positive for PCa, with all 13 of the re-categorized lesions being true positive on follow-up. The lesions that were re-categorized trended towards having higher SUVmax-lesion and SUVmax-lesion/SUVmean-blood-pool metrics, although these relationships were not statistically significant. Conclusions: The use of PSF reconstructions for 18F-DCFPyL PET can allow the appropriate re-categorization of a small number of indeterminate PSMA-RADS-3A soft tissue lesions as more definitive PSMA-RADS-4 lesions. The routine use of PSF reconstructions for PSMA-targeted PET may be of value at those sites that utilize this technology.

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Micro-CT imaging of Thiel-embalmed and iodine-stained human temporal bone for 3D modeling

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-021-00522-0 ◽

2021 ◽

Vol 50 (1) ◽

Author(s):

Sebastian Halm ◽

David Haberthür ◽

Elisabeth Eppler ◽

Valentin Djonov ◽

Andreas Arnold

Keyword(s):

Soft Tissue ◽

Temporal Bone ◽

Middle Ear ◽

3D Modeling ◽

Soft Tissues ◽

Ct Imaging ◽

Micro Ct ◽

Data Set ◽

Iodine Staining ◽

Tissue Structures

Abstract Introduction This pilot study explores whether a human Thiel-embalmed temporal bone is suitable for generating an accurate and complete data set with micro-computed tomography (micro-CT) and whether solid iodine-staining improves visualization and facilitates segmentation of middle ear structures. Methods A temporal bone was used to verify the accuracy of the imaging by first digitally measuring the stapes on the tomography images and then physically under the microscope after removal from the temporal bone. All measurements were compared with literature values. The contralateral temporal bone was used to evaluate segmentation and three-dimensional (3D) modeling after iodine staining and micro-CT scanning. Results The digital and physical stapes measurements differed by 0.01–0.17 mm or 1–19%, respectively, but correlated well with the literature values. Soft tissue structures were visible in the unstained scan. However, iodine staining increased the contrast-to-noise ratio by a factor of 3.7 on average. The 3D model depicts all ossicles and soft tissue structures in detail, including the chorda tympani, which was not visible in the unstained scan. Conclusions Micro-CT imaging of a Thiel-embalmed temporal bone accurately represented the entire anatomy. Iodine staining considerably increased the contrast of soft tissues, simplified segmentation and enabled detailed 3D modeling of the middle ear.

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An Injectable Multifunctional Dual‐Phase Bead‐Reinforced Gelatin Matrix Permissive of Mesenchymal Stem Cell Infiltration for Musculoskeletal Soft Tissue Repair

Advanced Healthcare Materials ◽

10.1002/adhm.202100626 ◽

2021 ◽

pp. 2100626

Author(s):

Dajiang Du ◽

Zhen Liu ◽

Wanting Niu ◽

Ding Weng ◽

Teck Chuan Lim ◽

...

Keyword(s):

Stem Cell ◽

Soft Tissue ◽

Mesenchymal Stem Cell ◽

Tissue Repair ◽

Cell Infiltration ◽

Dual Phase ◽

Soft Tissue Repair ◽

Gelatin Matrix

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Reliability and Change in Erosion Measurements by High-Resolution peripheral Quantitative Computed Tomography in a Longitudinal Dataset of Rheumatoid Arthritis Patients

The Journal of Rheumatology ◽

10.3899/jrheum.191391 ◽

2020 ◽

pp. jrheum.191391 ◽

Cited By ~ 1

Author(s):

Stephanie Finzel ◽

Sarah L. Manske ◽

Cheryl Barnabe ◽

Andrew J. Burghardt ◽

Hubert Marotte ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Computed Tomography ◽

High Resolution ◽

Intraclass Correlation ◽

Quantitative Computed Tomography ◽

Correlation Coefficients ◽

Peripheral Quantitative Computed Tomography ◽

Good Reliability ◽

Change Over Time ◽

Over Time

Objective The aim of this multi-reader exercise was to assess the reliability and change over time of erosion measurements in rheumatoid arthritis (RA) patients using high-resolution peripheral quantitative computed tomography (HR-pQCT). Methods HR-pQCT scans of 23 patients with RA were assessed at baseline and 12 months. Four experienced readers examined the dorsal, palmar, radial, and ulnar surfaces of the metacarpal head (MH) and phalangeal base (PB) of the 2nd and 3rd digits, blinded to time order. In total, 368 surfaces (23 patients x16 surfaces) were evaluated per time point to characterize cortical breaks as pathological (erosion) or physiological, and to quantify erosion width and depth. Reliability was evaluated by intraclass correlation coefficients (ICC), percentage agreement, and Light’s kappa; change over time was defined by means ± SD of erosion numbers and dimensions. Results ICCs for the mean measurements of width and depth of the pathological breaks ranged between 0.819 - 0.883, and 0.771 - 0.907 respectively. Most physiological cortical breaks were found at the palmar PB, whereas most pathological cortical breaks were located at the radial MH. There was a significant increase in both the numbers and the dimensions of erosions between baseline and follow-up (p=0.0001 for erosion numbers, width, and depth in axial plane, and p=0.001 for depth in perpendicular plane). Conclusion This exercise confirmed good reliability of HR-pQCT erosion measurements and their ability to detect change over time.

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PET/CT Imaging of Human TNFα Using [89Zr]Certolizumab Pegol in a Transgenic Preclinical Model of Rheumatoid Arthritis

Molecular Imaging and Biology ◽

10.1007/s11307-019-01363-0 ◽

2019 ◽

Vol 22 (1) ◽

pp. 105-114 ◽

Cited By ~ 4

Author(s):

Denis R. Beckford-Vera ◽

Alba Gonzalez-Junca ◽

Jessica S. Janneck ◽

Tony L. Huynh ◽

Joseph E. Blecha ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Certolizumab Pegol ◽

Ct Imaging ◽

Preclinical Model ◽

Pet Ct

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Serial magnetic resonance imaging and ultrasound examinations demonstrate differential inflammatory lesion patterns in soft tissue and bone upon patient-reported flares in rheumatoid arthritis

Arthritis Research & Therapy ◽

10.1186/s13075-020-2105-6 ◽

2020 ◽

Vol 22 (1) ◽

Cited By ~ 2

Author(s):

Dorota Kuettel ◽

Daniel Glinatsi ◽

Mikkel Østergaard ◽

Lene Terslev ◽

Jette Primdahl ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Soft Tissue ◽

Inflammatory Lesion ◽

Resonance Imaging ◽

Serial Magnetic Resonance Imaging ◽

Patient Reported

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Film-Screen Vs. Digital Radiography in Rheumatoid Arthritis of the Hand

Acta Radiologica ◽

10.1177/028418519403500401 ◽

1994 ◽

Vol 35 (4) ◽

pp. 311-318 ◽

Cited By ~ 16

Author(s):

Á. Jónsson ◽

A. Borg ◽

P. Hannesson ◽

K. Herrlin ◽

K. Jonsson ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Soft Tissue ◽

Digital Radiography ◽

Joint Space Narrowing ◽

Digital Images ◽

Roc Curves ◽

Joint Space ◽

Hard Copy ◽

Significant Difference ◽

Soft Tissue Swelling

In a prospective investigation the diagnostic accuracy of film-screen and digital radiography in rheumatoid arthritis of hands was compared. Seventy hands of 36 patients with established rheumatoid arthritis were included in the study. Each of 11 joints in every hand was evaluated regarding the following radiologic parameters: soft tissue swelling, joint space narrowing, erosions and periarticular osteopenia. The digital images were obtained with storage phosphor image plates and evaluated in 2 forms; as digital hard-copy on film and on a monitor of an interactive workstation. The digital images had a resolution of either 3.33 or 5.0 lp/mm. ROC curves were constructed and comparing the area under the curves no significant difference was found between the 3 different imaging forms in either resolution group for soft tissue swelling, joint space narrowing and erosions. The film-screen image evaluation of periarticular osteopenia was significantly better than the digital hard-copy one in the 3.33 lp/mm resolution group, but no significant difference was found in the 5.0 lp/mm group. These results support the view that currently available digital systems are capable of adequate diagnostic performance.

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