Journal
SCANDINAVIAN JOURNAL OF RHEUMATOLOGY
Volume 41, Issue 2, Pages 89-94Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/03009742.2011.608375
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Funding
- Oak Foundation
- Abbott Laboratories
- Foundation of 17-12-81
- University of Copenhagen
- Danish Rheumatism Association
- Thomas and Elisabeth Frolund Nielsen Foundation
- Danish Medical Research Council
- Johann and Hanne Weimann f. Seedorf's grant
- Danish Hospital Foundation for Medical Research, Region of Copenhagen
- Faroe Islands and Greenland
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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 T1-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 inter-reader 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.
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