Fluorescence optical imaging is helpful in the decision for rituximab (RTX) re-therapy in patients with rheumatoid arthritis

2020 ◽  
Author(s):  
Schahrasad Lisa Ridha Ali ◽  
Anne-Marie Glimm ◽  
Gerd Ruediger Burmester ◽  
Paula Hoff ◽  
Gabriela Schmittat ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Optical Imaging ◽  
Clinical Laboratory ◽  
Area Under The Curve ◽  
Imaging Data ◽  
Laboratory Parameters ◽  
Fluorescence Optical Imaging ◽  
Synovitis Score ◽  
Global Disease Activity ◽  
One Year

Abstract Objective: To evaluate the ability of fluorescence optical imaging (FOI) Xiralite® in the prediction of RTX re-therapy in rheumatoid arthritis (RA) patients - in comparison to clinical, laboratory and musculoskeletal ultrasound (US) parameters.Patients and methods: Patients with established RA were prospectively followed over one year by DAS28, patient’s global disease activity (VAS 0-100 mm), CRP and ESR, US7 score and FOI in phases 1-3 and automatically generated PrimaVistaMode (PVM) at baseline (before RTX) and after 3, 6, and 12 months. The need for RTX re-therapy was decided by the treating rheumatologist – blinded to imaging data.Results: 31 patients (female 77.4%, mean age 60.1±11.4, mean disease duration 14.9±7.1 years) were included. Fourteen patients (45.2%) received RTX re-therapy within 12 months. In the group with RTX re-therapy, FOI in PVM mode was the only parameter that presented significant increase over time (beta 0.40, CI 0.08-0.71; p=0.013) – compared to the group without re-therapy. In the prediction model via ROC analysis, FOI in PVM reached the highest values of all imaging, clinical and laboratory parameters for the prediction of re-therapy over one year with an area under the curve (AUC) of 0.78 (OR 0.84, CI 0.72;0.98, p=0.031). US7 GS synovitis score revealed similar predictive power with an AUC of 0.73 (p=0.049).Conclusion: US7 GS synovitis score and FOI in PVM are able to discriminate between patients with and without need for RTX re-therapy better than clinical and laboratory parameters.

scholarly journals Is the fluorescence optical imaging (FOI) able to discriminate between rheumatoid arthritis patients with and without need of rituximab retherapy? A cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047713
Author(s):  
Schahrasad Lisa Ridha Ali ◽  
Anne-Marie Glimm ◽  
Gerd R Burmester ◽  
Paula Hoff ◽  
Gabriela Schmittat ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Optical Imaging ◽  
Clinical Laboratory ◽  
Area Under The Curve ◽  
Imaging Data ◽  
Laboratory Parameters ◽  
Fluorescence Optical Imaging ◽  
Synovitis Score ◽  
Global Disease Activity

ObjectiveTo evaluate the ability of fluorescence optical imaging (FOI) Xiralite in the discrimination between rheumatoid arthritis (RA) patients with and without need of rituximab (RTX) retherapy—in comparison to clinical, laboratory and musculoskeletal ultrasound parameters.Patients and methodsPatients with established RA were prospectively followed over 1 year by Disease Activity Score 28, patient’s global disease activity (visual analogue scale 0–100 mm), C reactive protein and erythrocyte sedimentation rate, ultrasound seven joint (US7) score and FOI in phases 1–3 and automatically generated PrimaVista mode (PVM) at baseline (before RTX) and after 3, 6 and 12 months. The need for RTX retherapy was decided by the treating rheumatologist—blinded to imaging data.Results31 patients (female 77.4%, mean age 60.1±11.4, mean disease duration 14.9±7.1 years) were included. Fourteen (45.2%) patients received RTX retherapy within 12 months. In the group with RTX retherapy, FOI in PVM mode was the only parameter that presented significant increase over time (β: 0.40, 95% CI: 0.08 to 0.71, p=0.013)—compared with the group without retherapy. In the prediction model via ROC analysis, FOI in PVM reached the highest values of all imaging, clinical and laboratory parameters which was associated with retherapy over 1 year with an area under the curve (AUC) of 0.78 (OR: 0.84, 95% CI: 0.72 to 0.98, p=0.031). US7 GS synovitis score revealed similar association with an AUC of 0.73 (p=0.049).ConclusionUS7 GS synovitis score and FOI in PVM are able to discriminate between patients with and without need for RTX retherapy better than clinical and laboratory parameters.

Near-infrared Fluorescence Optical Imaging in Early Rheumatoid Arthritis: A Comparison to Magnetic Resonance Imaging and Ultrasonography

2015 ◽  
Vol 42 (7) ◽  
pp. 1112-1118 ◽  
Author(s):  
Michaela Krohn ◽  
Sarah Ohrndorf ◽  
Stephanie G. Werner ◽  
Bernd Schicke ◽  
Gerd-Rüdiger Burmester ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Optical Imaging ◽  
Early Rheumatoid Arthritis ◽  
Near Infrared ◽  
Resonance Imaging ◽  
Near Infrared Fluorescence ◽  
Fluorescence Optical Imaging ◽  
Early Ra

Objective.Near-infrared fluorescence optical imaging (FOI) is a novel imaging technology in the detection and evaluation of different arthritides. FOI was validated in comparison to magnetic resonance imaging (MRI), greyscale ultrasonography (GSUS), and power Doppler ultrasonography (PDUS) in patients with early rheumatoid arthritis (RA).Methods.Hands of 31 patients with early RA were examined by FOI, MRI, and US. In each modality, synovitis of the wrist, metacarpophalangeal joints (MCP) 2–5, and proximal interphalangeal joints (PIP) 2–5 were scored on a 4-point scale (0–3). Sensitivity and specificity of FOI were analyzed in comparison to MRI and US as reference methods, differentiating between 3 phases of FOI enhancement (P1–3). Intraclass correlation coefficients (ICC) were calculated to evaluate the agreement of FOI with MRI and US.Results.A total of 279 joints (31 wrists, 124 MCP and 124 PIP joints) were evaluated. With MRI as the reference method, overall sensitivity/specificity of FOI was 0.81/0.00, 0.49/0.84, and 0.86/0.38 for wrist, MCP, and PIP joints, respectively. Under application of PDUS as reference, sensitivity was even higher, while specificity turned out to be low, except for MCP joints (0.88/0.15, 0.81/0.76, and 1.00/0.27, respectively). P2 appears to be the most sensitive FOI phase, while P1 showed the highest specificity. The best agreement of FOI was shown for PDUS, especially with regard to MCP and PIP joints (ICC of 0.57 and 0.53, respectively), while correlation with MRI was slightly lower.Conclusion.FOI remains an interesting diagnostic tool for patients with early RA, although this study revealed limitations concerning the detection of synovitis. Further research is needed to evaluate its full diagnostic potential in rheumatic diseases.

A Novel Fluorescence Optical Imaging Scoring System for Hand Synovitis in Rheumatoid Arthritis – validity and agreement with ultrasound

Rheumatology ◽  
2021 ◽  
Author(s):  
Mads Ammitzbøll Danielsen ◽  
Daniel Glinatsi ◽  
Lene Terslev ◽  
Mikkel Østergaard
Keyword(s):  
Rheumatoid Arthritis ◽  
Optical Imaging ◽  
Scoring System ◽  
Moderate Correlation ◽  
Treatment Intensification ◽  
Fluorescence Optical Imaging ◽  
Reliable Assessment ◽  
Intraclass Correlations ◽  
Reader Reliability ◽  
Foie Gras

Abstract Objectives To develop and validate a new semiquantitative Fluorescence Optical Imaging (FOI) scoring system – the FOI Enhancement-Generated rheumatoid arthritis (RA) Score (FOIE-GRAS) for synovitis assessment in the hand. Methods The development of FOIE-GRAS was based on consensus of 4 experts in musculoskeletal imaging. Forty-six RA patients, eligible for treatment intensification and with ≥1 clinically swollen joint in the hands and 11 healthy controls were included. FOI, ultrasound and clinical assessment of both hands were obtained at baseline and for RA patients after 3- and 6-months’ follow-up. Twenty RA patients had an FOI rescan after 4 hours. Synovitis was scored using FOIE-GRAS and the OMERACT ultrasound synovitis scoring system. All FOI images were scored by 2 readers. Inter-scan, inter-and intra-reader reliability were determined. Furthermore, FOIE-GRAS agreement with ultrasound and responsiveness was assessed. Results FOIE-GRAS synovitis was defined as early enhancement and scores based on the degree of coverage of the specific joint region after 3 seconds (0–3). Inter-scan, intra- and inter-reader intraclass correlations coefficients (ICC) were good-excellent for all baseline scores (0.76-0.98) and moderate-to-good for change (0.65-76). The FOIE-GRAS had moderate agreement with ultrasound (ICC 0.30-0.54) for total score, a good standardized response mean (>0.80), and moderate correlation with clinical joint assessment and DAS28-CRP. The median (IQR) reading time per FOI examination was 133 (109;161) seconds. Scores were significantly lower in controls 1(0;4) than RA patients 11(6;19). Conclusion The FOIE-GRAS offers a feasible and reliable assessment of synovitis in RA, with a moderate correlation with ultrasound and DAS28CRP, and good responsiveness.

scholarly journals AB1165 FLUORESCENCE OPTICAL IMAGING XIRALITE® IS HELPFUL IN THE DECISION FOR RITUXIMAB RE-THERAPY IN PATIENTS WITH RHEUMATOID ARTHRITIS

2019 ◽  
Author(s):  
Sarah Ohrndorf ◽  
Lisa Ridha ◽  
Anne-Marie Glimm ◽  
Gerd Rüdiger Burmester ◽  
Gabriela Schmittat ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Optical Imaging ◽  
Fluorescence Optical Imaging

scholarly journals 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

2015 ◽  
Vol 75 (3) ◽  
pp. 566-570 ◽  
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.

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

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 ◽  
Dominant Hand ◽  
Fluorescence Optical Imaging ◽  
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 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.

scholarly journals Quantitative assessment of synovitis in patients with rheumatoid arthritis using fluorescence optical imaging

2013 ◽  
Vol 15 (5) ◽  
pp. R124 ◽  
Author(s):  
Valentin S Schäfer ◽  
Wolfgang Hartung ◽  
Patrick Hoffstetter ◽  
Jörn Berger ◽  
Christian Stroszczynski ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Optical Imaging ◽  
Quantitative Assessment ◽  
Fluorescence Optical Imaging

scholarly journals PaO2/FiO2 and IL-6 are risk factors of mortality for intensive care COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yanli Gu ◽  
Donghui Wang ◽  
Cen Chen ◽  
Wanjun Lu ◽  
Hongbing Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Clinical Laboratory ◽  
Area Under The Curve ◽  
Oxygenation Index ◽  
Categorical Variables ◽  
Imaging Data ◽  
Chi Square ◽  
Independent Risk Factors ◽  
Student’S T

AbstractTo identify the risk factors of mortality for the coronavirus disease 19 (COVID-19) patients admitted to intensive care units (ICUs) through a retrospective analysis. The demographic, clinical, laboratory, and chest imaging data of patients admitted to the ICU of Huoshenshan Hospital from February 10 to April 10, 2020 were retrospectively analyzed. Student's t-test and Chi-square test were used to compare the continuous and categorical variables, respectively. The logistic regression model was employed to ascertain the risk factors of mortality. This retrospective study involved 123 patients, including 64 dead and 59 survivors. Among them, 57 people were tested for interleukin-6 (IL-6) (20 died and 37 survived). In all included patients, the oxygenation index (PaO2/FiO2) was identified as an independent risk factor (odd ratio [OR] = 0.96, 95% confidence interval [CI]: 0.928–0.994, p = 0.021). The area under the curve (AUC) was 0.895 (95% CI: 0.826–0.943, p < 0.0001). Among the patients tested for IL-6, the PaO2/FiO2 (OR = 0.955, 95%CI: 0.915–0.996, p = 0.032) and IL-6 (OR = 1.013, 95%CI: 1.001–1.025, p = 0.028) were identified as independent risk factors. The AUC was 0.9 (95% CI: 0.791–0.964, p < 0.0001) for IL-6 and 0.865 (95% CI: 0.748–0.941, p < 0.0001) for PaO2/FiO2. PaO2/FiO2 and IL-6 could potentially serve as independent risk factors for predicting death in COVID-19 patients requiring intensive care.

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