Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Construct Validity and Responsiveness of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Early Rheumatoid Arthritis A Comparison with Conventional Magnetic Resonance Imaging and Clinical Measures of Disease Activity.
Axelsen1, Mette Bjørndal, Ejbjerg2, Bo J., Hetland1, Merete L., Horslev-Petersen3, Kim, Boesen4, Mikael, Kubassova5, Olga, Lauridsen1, Ulrik B.
Copenhagen University Hospital at Glostrup, Copenhagen, Denmark
Copenhagen University Hospital at Slagelse, Slagelse, Denmark
University of Southern Denmark, Graasten, Denmark
The Parker Institute, Copenhagen University Hospital at Frederiksberg, Frederiksberg, Denmark
Image Analysis Ltd., Leeds, United Kingdom
ZiteLab ApS, Copenhagen, Denmark
The aim of the study was to assess the responsiveness and construct validity of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters during aggressive treatment of early rheumatoid arthritis (RA), by comparison with conventional MRI and clinical measures of disease activity.
DCE-MRI and conventional contrast-enhanced MRI of the non-dominant hand (wrist and 2.-5. metacarpophalangeal joints (MCP)) and clinical assessment were performed at months 0, 6 and 12 in 14 patients with early RA treated with disease modifying antirheumatic drugs (DMARDs) (methotrexate +/- cyclosporine) and intra-articular glucocorticoid in an investigator initiated clinical trial . Conventional MRI was evaluated using the Rheumatoid Arthritis MRI score (RAMRIS). DCE-MRI (one coronal slice) was analysed using a computer-aided approach by which the temporal contrast uptake is characterized by parameters such as the Initial Rate of Enhancement (IRE), Maximal Enhancement (ME) and number of enhancing voxels (Nvoxel) . The analysis was performed for 2 manually outlined Regions of Interest (ROIs) covering the wrist and 2.5. MCP, respectively, and for the sum of wrist and MCP ROIs, ('Wrist+MCP').
All DCE-MRI parameters in the 'Wrist+MCP' declined significantly from month 0 to 12 (see table for separate wrist and MCP values and SRMs). The SRMs for RAMRIS synovitis was -0.67 to -1.05 from month 06 and 012. DAS28, and tender and swollen joint counts declined similarly (SRMs -0.51 to -1.11). Correlations with RAMRIS synovitis were high for ME (rho 0.560.87, p<0.04), Nvoxel (rho 0.760.80, p<=0.002) and IRExNvoxel (rho 0.730.81, p<=0.003), and lowmoderate for IRE (0.090.56, p <=0.040.76).
Table 1. Responsiveness of DCE-MRI, Conventional MRI and Clinical Parameters
All DCE-MRI parameters declined significantly during treatment. With regard to responsiveness, DCE-MRI was comparable to DAS28 but inferior to RAMRIS synovitis. DCE-MRI demonstrated construct validity and moderate responsiveness.
To cite this abstract, please use the following information:
Axelsen, Mette Bjørndal, Ejbjerg, Bo J., Hetland, Merete L., Horslev-Petersen, Kim, Boesen, Mikael, Kubassova, Olga, et al; Construct Validity and Responsiveness of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Early Rheumatoid Arthritis A Comparison with Conventional Magnetic Resonance Imaging and Clinical Measures of Disease Activity. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :946