Artikel
Quantification of Dynamic MRI examinations in Juvenile Idiopathic Arthritis
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Autoren
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Nikolay Tzaribachev
- Pediatric Rheumatology Research Institute, Kinderrheumatologie, Bad Bramstedt
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Polymnia Louka
- Image Analysis, Clinical Trials and Research, London, Great Britain
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Romiesa Hagoug
- Image Analysis, Imaging, Clinical Research, London, Great Britain
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Chiara Trentin
- Image Analysis, Imaging, Clinical Research, London, Great Britain
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Olga Kubassova
- Image Analysis, Imaging, Clinical Research, London, Great Britain
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Mark Hinton
- Image Analysis, Imaging, Clinical Research, London, Great Britain
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Mikael Boesen
- Copenhagen University Hospital Bispebjerg and Frederiksberg, Department of Radiology and Parker Institute, Copenhagen, Denmark
| Veröffentlicht: | 29. August 2016 |
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Gliederung
Text
Background: In RA, the value of quantitative imaging biomarkers such as the volume and severity of the disease as imaged with DCE-MRI has been studied1. In children with JIA similar knowledge is very limited.
The aim of the studywas to compare treatment changes of clinical scores in patients with JIA and automated DCE-MRI quantitative parameters analyzed with a dedicated software Dynamika.
Methods: In 8 Caucasian patients (7 girls, median age 13,6 years), polyarticular JIA, with standardized DMARD treatment, DCE-MRI of the MCP 2-5 joints (most affected hand) were performed at 3 time points 3 months apart using 0.2 Tesla Esaote C-Scan. Clinical scores included active joints (AJ) counts. All scans were quantified with DynamikaTM and imaging measures of the inflammatory volume (DEMRIQ-Volume) and the degree of perfusion/inflammation (DEMRIQ-Inflammation) were calculated. DCE-MRI data were analyzed using Region-of-Interest (ROIs) covering synovium of MCPJ 2-5.
Differences in DEMRIQ scores between visits, were analyzed using the t-test (p<0.05* = statistically significant, p<0.25** = clinically meaningful). Correlations were also assessed using the Pearson’s Correlation Coefficient.
Results: At 3 and 6 months all patients showed statistically significant and/or clinically meaningful changes mainly in DEMRIQ ME. Six patients achieved clinical improvement over time. At 6 months, in all 6 patients but one, DEMRIQ ME persisted or worsened (compared to previous examinations) predicting a clinical flare within the next 2 to 6 months after last DCE-MRI. One patient had persistent clinical activity with corresponding DEMRIQ ME score. Another patient showed clinical worsening but improving DEMRIQ ME, where clinical improvement followed later during disease course.
Conclusion: Dynamika based scores show to be useful for depicting disease activity in JIA. Moreover, persistence or worsening of Dynamika based scores could predict clinical flares (in this study within 2–6 months) despite of global clinical improvement. Dynamika based DCE-MRI calculations could be of high importance for disease management and a supportive tool in treatment decisions in pediatric rheumatology.
