Dynamic gadolinium-enhanced magnetic resonance imaging allows accurate assessment of the synovial inflammatory activity in rheumatoid arthritis knee joints: a comparison with synovial histology

Mette Bjørndal Axelsen, M. Stoltenberg, R. Poggenborg, O. Kubassova, M. Boesen, H. Bliddal, K. Hørslev-Petersen, Lars G. Hanson, M. Østergaard

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objective: To determine whether dynamic contrast-enhanced magnetic resonance
imaging (DCE-MRI) evaluated using semi-automatic image processing software
can accurately assess synovial inflammation in rheumatoid arthritis (RA) knee
joints. Methods: In 17 RA patients undergoing knee surgery, the average grade of
histological synovial inflammation was determined from four biopsies obtained
during surgery. A preoperative series of T(1)-weighted dynamic fast low-angle shot
(FLASH) MR images was obtained. Parameters characterizing contrast uptake
dynamics, including the initial rate of enhancement (IRE), were generated by the
software in three different areas: (I) the entire slice (Whole slice); (II) a manually
outlined region of interest (ROI) drawn quickly around the joint, omitting large
artefacts such as blood vessels (Quick ROI); and (III) a manually outlined ROI
following the synovial capsule of the knee joint (Precise ROI). Intra- and interreader
agreement was assessed using the intra-class correlation coefficient (ICC).
Results: The IRE from the Quick ROI and the Precise ROI revealed high
correlations to the grade of histological inflammation (Spearman's correlation
coefficient (rho) = 0.70, p = 0.001 and rho = 0.74, p = 0.001, respectively). Intraand
inter-reader ICCs were very high (0.93-1.00). No Whole slice parameters
were correlated to histology. Conclusion: DCE-MRI provides fast and accurate
assessment of synovial inflammation in RA patients. Manual outlining of the joint
to omit large artefacts is necessary.
Original languageEnglish
JournalScandinavian Journal of Rheumatology
Volume41
Issue number2
Pages (from-to)89-94
ISSN0300-9742
DOIs
Publication statusPublished - 2012

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