Validity and diagnostic performance of Fluorescence Optical Imaging measuring synovitis in hand osteoarthritis. Baseline results from the Nor-Hand cohort.

Abstract Objective: Fluorescence Optical Imaging (FOI) demonstrates enhanced microcirculation in finger joints as a sign of inflammation. We wanted to assess the validity and diagnostic performance of FOI measuring synovitis in persons with hand OA, comparing it with magnetic resonance imaging (MRI)- and ultrasound-detected synovitis. Methods: 221 participants with hand OA underwent FOI and ultrasound (grey scale synovitis and power-Doppler activity) of the bilateral hands and contrast-enhanced MRI examination of the dominant hand. Fifteen joints in each hand were scored on semi-quantitative scales (grade 0-3) for all modalities. Four FOI images were evaluated: one composite image (Prima Vista Mode; PVM) and three images representing phases of fluorescent dye distribution. Spearman’s correlation coefficients were calculated between sum scores of FOI, MRI and ultrasound. Sensitivity, specificity and area under the curve (AUC) was calculated for FOI using MRI or ultrasound as reference. Results: FOI did not demonstrate enhancement in the thumb base, and the joint was excluded from further analyses. FOI sum scores showed poor to fair correlations with MRI (rho 0.01-0.24) and GS synovitis sum scores (rho 0.12-0.25). None of the FOI images demonstrated both good sensitivity and specificity, and the AUC ranged from 0.50-0.61 and 0.51-0.63 with MRI and GS synovitis as reference, respectively. FOI demonstrated similar diagnostic performance with PD activity and GS synovitis as reference. Conclusion: FOI enhancement correlated poorly with synovitis assessed by more established imaging modalities, questioning the value of FOI for the evaluation of synovitis in hand OA.

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Validity and diagnostic performance of Fluorescence Optical Imaging measuring synovitis in hand osteoarthritis. Baseline results from the Nor-Hand cohort.

10.21203/rs.2.24840/v1 ◽

2020 ◽

Author(s):

Øystein Maugesten ◽

Alexander Mathiessen ◽

Hilde Berner Hammer ◽

Sigrid Hestetun ◽

Tore Kristian Kvien ◽

...

Keyword(s):

Optical Imaging ◽

Diagnostic Performance ◽

Power Doppler ◽

Area Under The Curve ◽

Correlation Coefficients ◽

Hand Osteoarthritis ◽

Fluorescence Optical Imaging ◽

Magnetic Resonance Imaging Mri ◽

Sum Scores ◽

Sensitivity Specificity

Abstract Objective: Fluorescence Optical Imaging (FOI) demonstrates enhanced microcirculation in finger joints as a sign of inflammation. We wanted to assess the validity and diagnostic performance of FOI measuring synovitis in persons with hand OA, comparing it with magnetic resonance imaging (MRI)- and ultrasound-detected synovitis.Methods: 221 participants with hand OA underwent FOI, contrast-enhanced MRI and ultrasound (grey scale synovitis and power-Doppler activity) examinations of the hands. Fifteen joints in each hand were scored on semi-quantitative scales (grade 0-3) for all modalities. Four FOI images were evaluated: one composite image (Prima Vista Mode; PVM) and three images representing phases of fluorescent dye distribution. Spearman’s correlation coefficients were calculated between sum scores of FOI, MRI and ultrasound. Sensitivity, specificity and area under the curve (AUC) was calculated for FOI using MRI or ultrasound as reference.Results: FOI did not demonstrate enhancement in the first carpometacarpal joint, which was excluded from further analyses. FOI sum scores showed poor to fair correlations with MRI (rho 0.01-0.24) and GS synovitis sum scores (rho 0.12-0.25). None of the FOI images demonstrated both good sensitivity and specificity, and the AUC ranged from 0.50-0.61 and 0.51-0.63 with MRI and GS synovitis as reference, respectively. FOI demonstrated similar diagnostic performance with PD activity and GS synovitis as reference.Conclusion: To conclude, FOI enhancement correlated poorly with synovitis assessed by more established imaging modalities, questioning the value of FOI for the evaluation of synovitis in hand OA.

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Analysis of distribution and severity of inflammation in patients with osteoarthitis compared to rheumatoid arthritis by ICG-enhanced fluorescence optical imaging and musculoskeletal ultrasound: a pilot study

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-207345 ◽

2015 ◽

Vol 75 (3) ◽

pp. 566-570 ◽

Cited By ~ 26

Author(s):

A-M Glimm ◽

S G Werner ◽

G R Burmester ◽

M Backhaus ◽

S Ohrndorf

Keyword(s):

Rheumatoid Arthritis ◽

Optical Imaging ◽

Joint Inflammation ◽

Musculoskeletal Ultrasound ◽

Imaging Method ◽

Hand Osteoarthritis ◽

Dominant Hand ◽

Fluorescence Optical Imaging ◽

Inflammatory Status ◽

Inflammatory Changes

BackgroundIn rheumatoid arthritis (RA), hand synovitis appears especially in wrist, metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. In hand osteoarthritis (OA), potential inflammatory changes are mainly present in PIP and distal interphalangeal (DIP) joints. Joint inflammation can be visualised by fluorescence optical imaging (FOI) and musculoskeletal ultrasound (US).ObjectiveComparison of the amount and distribution of inflammatory signs in wrist and finger joints of the clinically dominant hand in patients with OA and RA by FOI and gray-scale (GSUS) and power Doppler US (PDUS).MethodsFOI and GSUS/PDUS were performed in 1.170 joints (wrists, MCP, PIP, DIP) in 90 patients (67 RA, 23 OA). Joint inflammation was graded by a semiquantitative score (0–3) for each imaging method.ResultsGSUS/PDUS showed wrist and MCP joints mostly affected in RA. DIP joints were graded higher in OA. In FOI, RA and OA featured inflammatory changes in the respective joint groups depending on the phase of fluorescence dye flooding.ConclusionsUS and FOI detected inflammation in both RA and OA highlighting the inflammatory component in the course of OA. The different inflammatory patterns and various shapes of fluorescence enhancement in FOI may offer opportunities to distinguish and determine the inflammatory status in both diseases.

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Associations between fluorescence optical imaging and magnetic resonance imaging and symptoms in hand osteoarthritis

Rheumatology ◽

10.1093/rheumatology/keab085 ◽

2021 ◽

Author(s):

Øystein Maugesten ◽

Sarah Ohrndorf ◽

Barbara Slatkowsky-Christensen ◽

Tore K Kvien ◽

Till Uhlig ◽

...

Keyword(s):

Pain Intensity ◽

Optical Imaging ◽

Physical Function ◽

Joint Pain ◽

Finger Joint ◽

Dominant Hand ◽

Fluorescence Optical Imaging ◽

Finger Joints ◽

Hand Pain ◽

Sum Scores

Abstract Objectives To investigate whether Fluorescence Optical Imaging (FOI) enhancement and MRI-defined synovitis are associated with pain and physical function in hand OA patients. Methods Bilateral FOI scans and MRI of the dominant hand were available for 221 patients. Finger joints were examined for tenderness on palpation. Pain in individual finger joints during the last 24 h and last 6 weeks and hand pain intensity by the Australian/Canadian hand index and Numeric Rating Scale were self-reported. On joint level, we applied logistic regression with generalized estimating equations to examine whether FOI enhancement and MRI-defined synovitis were associated with pain in the same joint. On subject level, we applied linear regression to assess whether FOI and MRI sum scores were associated with pain intensity and physical function. Results Metacarpophalangeal and thumb base joints were excluded from analyses due to little/no FOI enhancement. Finger joints with FOI enhancement on the composite image had higher odds (95% CI) of pain during the last 6 weeks [grade 1: 1.4 (1.2–1.6); grade 2–3: 2.1 (1.7–2.6)]. Similar results were found for joint pain during the last 24 h and joint tenderness in fingers. Numerically stronger associations were found between MRI-defined synovitis and finger joint pain/tenderness. FOI and MRI sum scores demonstrated no/weak associations with hand pain and physical function. Conclusion FOI enhancement and MRI-defined synovitis were associated with pain in the same finger joint. None of the imaging modalities demonstrated consistent associations with pain, stiffness and physical function on subject level.

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Validity and diagnostic performance of fluorescence optical imaging measuring synovitis in hand osteoarthritis: baseline results from the Nor-Hand cohort

Arthritis Research & Therapy ◽

10.1186/s13075-020-02185-0 ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Øystein Maugesten ◽

Alexander Mathiessen ◽

Hilde Berner Hammer ◽

Sigrid Valen Hestetun ◽

Tore Kristian Kvien ◽

...

Keyword(s):

Optical Imaging ◽

Diagnostic Performance ◽

Hand Osteoarthritis ◽

Fluorescence Optical Imaging

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Correction to: Validity and diagnostic performance of fluorescence optical imaging measuring synovitis in hand osteoarthritis: baseline results from the Nor-Hand cohort

Arthritis Research & Therapy ◽

10.1186/s13075-021-02469-z ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Øystein Maugesten ◽

Alexander Mathiessen ◽

Hilde Berner Hammer ◽

Sigrid Valen Hestetun ◽

Tore Kristian Kvien ◽

...

Keyword(s):

Optical Imaging ◽

Diagnostic Performance ◽

Hand Osteoarthritis ◽

Fluorescence Optical Imaging

An amendment to this paper has been published and can be accessed via the original article.

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Fluorescence optical imaging: ready for prime time?

RMD Open ◽

10.1136/rmdopen-2020-001497 ◽

2021 ◽

Vol 7 (2) ◽

pp. e001497

Author(s):

Sarah Ohrndorf ◽

Anne-Marie Glimm ◽

Mads Ammitzbøll-Danielsen ◽

Mikkel Ostergaard ◽

Gerd R Burmester

Keyword(s):

Optical Imaging ◽

Power Doppler ◽

Joint Inflammation ◽

Diagnostic Process ◽

The Novel ◽

The European Union ◽

Fluorescence Optical Imaging ◽

Disturbed Microcirculation ◽

The Usa ◽

Magnetic Resonance Imaging Mri

The novel technique of fluorescence optical imaging (FOI, Xiralite), which is approved in the European Union and the USA for clinical use, has been the object of studies since 2009. Indocyanine green-based FOI can demonstrate an impaired microcirculation caused by inflammation in both hands in one examination. Several studies have investigated FOI for detection of joint inflammation by comparing FOI to magnetic resonance imaging (MRI) and/or musculoskeletal ultrasound (MSUS). The results have shown a generally good agreement (>80%) between FOI and clinical examination, MRI and MSUS by power Doppler in inflammatory joint diseases. Moreover, characteristic enhancements in skin and nails are seen in PsA, which potentially can be useful in the diagnostic process of early undifferentiated arthritis. Furthermore, FOI has been investigated for the visualisation of a disturbed microcirculation in the hands and fingers of patients with systemic sclerosis (SSc), highlighting the potential of monitoring vascular changes in SSc and other vasculopathies. The available data indicate that it is time to consider FOI as a useful part of the imaging repertoire in rheumatology clinical practice, particularly where MSUS and MRI are not easily available.

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Parasite-derived circulating microRNAs as biomarkers for the detection of human Schistosoma japonicum infection

Parasitology ◽

10.1017/s0031182019001690 ◽

2019 ◽

Vol 147 (8) ◽

pp. 889-896 ◽

Cited By ~ 1

Author(s):

Yi Mu ◽

Pengfei Cai ◽

Remigio M. Olveda ◽

Allen G. Ross ◽

David U. Olveda ◽

...

Keyword(s):

Schistosoma Japonicum ◽

Diagnostic Performance ◽

Area Under The Curve ◽

Infection Intensity ◽

The Philippines ◽

Pcr Analysis ◽

Rt Pcr ◽

Serum Samples ◽

Sensitivity Specificity ◽

Pcr Targeting

AbstractNovel tools for early diagnosis and monitoring of schistosomiasis are urgently needed. This study aimed to validate parasite-derived miRNAs as potential novel biomarkers for the detection of human Schistosoma japonicum infection. A total of 21 miRNAs were initially validated by real-time-polymerase chain reaction (RT-PCR) using serum samples of S. japonicum-infected BALB/c mice. Of these, 6 miRNAs were further validated with a human cohort of individuals from a schistosomiasis-endemic area of the Philippines. RT-PCR analysis showed that two parasite-derived miRNAs (sja-miR-2b-5p and sja-miR-2c-5p) could detect infected individuals with low infection intensity with moderate sensitivity/specificity values of 66%/68% and 55%/80%, respectively. Analysis of the combined data for the two parasite miRNAs revealed a specificity of 77.4% and a sensitivity of 60.0% with an area under the curve (AUC) value of 0.6906 (P = 0.0069); however, a duplex RT-PCR targeting both sja-miR-2b-5p and sja-miR-2c-5p did not result in an increased diagnostic performance compared with the singleplex assays. Furthermore, the serum level of sja-miR-2c-5p correlated significantly with faecal egg counts, whereas the other five miRNAs did not. Targeting S. japonicum-derived miRNAs in serum resulted in a moderate diagnostic performance when applied to a low schistosome infection intensity setting.

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Diagnostic Performance of Risk of Ovarian Malignancy Algorithm Against CA125 and HE4 in Connection With Ovarian Cancer: A Meta-analysis

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000804 ◽

2016 ◽

Vol 26 (9) ◽

pp. 1586-1593 ◽

Cited By ~ 30

Author(s):

Farshid Dayyani ◽

Steffen Uhlig ◽

Bertrand Colson ◽

Kirsten Simon ◽

Vinzent Rolny ◽

...

Keyword(s):

Ovarian Cancer ◽

Confidence Interval ◽

Late Stage ◽

Diagnostic Performance ◽

Clinical Decision Making ◽

Early Stage ◽

Area Under The Curve ◽

Ovarian Malignancy ◽

Eligibility Criteria ◽

Sensitivity Specificity

ObjectivesThe aim of this study was to determine whether the Risk of Ovarian Malignancy Algorithm (ROMA) is more accurate than the human epididymis 4 (HE4) or carbohydrate antigen 125 (CA125) biomarkers with respect to the differential diagnosis of women with a pelvic mass. The secondary objective is to assess the performance of ROMA in early-stage ovarian cancer (OC) and late-stage OC, as well as premenopausal and postmenopausal patient populations.Methods/MaterialsThe PubMed and Google Scholar databases were searched for relevant clinical studies. Eligibility criteria included comparison of ROMA with both HE4 and CA125 levels in OC (unspecified, epithelial, and borderline ovarian tumors), use of only validated ROMA assays, presentation of area under the curve and sensitivity/specificity data, and results from early-stage OC, late-stage OC and premenopausal and postmenopausal women. Area under the curve (AUC), sensitivity/specificity, and the diagnostic odds ratio (DOR) results were summarized.ResultsFive studies were selected comprising 1975 patients (premenopausal, n = 1033; postmenopausal, n = 925; benign, n = 1387; early stage, n = 192; and late stage, n = 313). On the basis of the AUC (95% confidence interval) data for all patients, ROMA (0.921 [0.855–0.960]) had a numerically greater diagnostic performance than CA125 (0.883 [0.771–0.950]) and HE4 (0.899 [0.835–0.943]). This was also observed in each of the subgroup populations, in particular, the postmenopausal patients and patients with early OC. The sensitivity and specificity (95% confidence interval) results showed ROMA (sensitivity, 0.873 [0.752–0.940]; specificity, 0.855 [0.719–0.932]) to be numerically superior to CA125 (sensitivity, 0.796 [0.663–0.885]; specificity, 0.825 [0.662–0.919]) and HE4 (sensitivity, 0.817 [0.683–0.902]; specificity, 0.851 [0.716–0.928]) in all patients and for the early- and late-stage OC subgroups. Finally, the ROMA log DOR results were better than HE4 and CA125 log DOR results especially for the early-stage patient group.ConclusionsThe results presented support the use of ROMA to improve clinical decision making, most notably in patients with early OC.

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