ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1119

Quantification Of Inflammatory Disease Of Spine In Ankylosing Spondylitis Using Volumetric Magnetic Resonance Imaging Analysis

Ejaz Pathan1, Adrian Lim2, Andy Graham3, Keshthra Satchithananda2, Dobrina Hull4, Sonya Abraham5, Anshul Rastogi6, Andrew Keat7, Mark Hinton8, Olga Kubassova9, Peter C. Taylor10 and J.V. Hajnal11, 1Clinical Trials Unit, Kennedy Institute of Rheumatology, London W6 8RF, United Kingdom, 2Radiology, Imperial College Healthcare NHS Trust, London, United Kingdom, 3QABC Minster House, Image Analysis, London, United Kingdom, 4Clinical Trials Unit, The Kennedy Institute of Rheumatology, London, United Kingdom, 5Rheumatology, Charing Cross Hospital, Imperial college NHS trust London UK, London W6 8RF, United Kingdom, 6Radiology, Barts and the London NHS Trust, London, United Kingdom, 7Rheumatology, Northwick Park Hospital, Harrow, United Kingdom, 8Image Analysis Ltd, London, United Kingdom, 9Image Analysis Ltd., Leeds, United Kingdom, 10NDORMS, Botnar Research Centre, University of Oxford, Oxford, United Kingdom, 11Division of Imaging Sciences, King's College London, London, United Kingdom

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Imaging of Rheumatic Diseases II: Imaging in Spondyloarthritis and Osteoarthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose: To develop methodology for quantification of spinal inflammation in AS using a volumetric MRI-based technique and to explore relationships between these findings and clinical measures of disease activity.

Methods:

MRI scans were undertaken using the same scanning protocol on a 3T Philips Achieva system in 11 AS patients prior to and 12 weeks after commencing anti-TNF therapy. Scans were anonymized for patient identity and time points. They were initially scored using the Berlin method by 2 musculoskeletal radiologists (AL and KS) concurrently. Images were subsequently assessed using Dynamika software to perform volumetric analysis by 2 independent scorers (scorer 1-EP and scorer 2- AL). Areas in mm2, volumes in mm3 and intensity of corresponding lesions drawn by both scorers were also compared using Bland-Altman plots. The product of volume in mm3 and mean intensity was calculated. The volume in mm3 of lesions was compared to total Berlin scores as well as BASDAI scores using Spearman Rank correlation. Percentage change in volume, intensity and the product of volume and intensity was also compared to percentage change in BASDAI scores.

Results: Bland-Altman plots showed good inter-observer variability for corresponding areas in mm2, volume in mm3 and mean intensity of lesions but compared most favourably for maximum intensity.

Correlations were observed between total volume scores and total Berlin scores, more so at baseline (r=0.7, p = 0.01 for scorer 1, r=0.63, p=0.04 for scorer 2) than at follow-up (r=0.4, p value = 0.14). No correlation was seen between volumes and BASDAI scores. However, good correlations were seen between percentage change in BASDAI and percentage change in volume in mm3 (r=0.8, p=0.002 for scorer 1 and r=0.6, p=0.04 for scorer 2) as well as the product of volume and intensity (r=0.7 for both scorers, p=0.02 for scorer 1 and p=0.03 for scorer 2). A poor correlation was seen between percentage change in Berlin scores and percentage change in BASDAI (r=0.2, p=0.56).

Conclusion: Volumetric analysis of active bone oedema lesions compares well to semi-quantitative scoring using the Berlin method. Unlike semi-quantitative scoring, volumetric analysis also shows a good correlation to change in BASDAI.

Disclosure:

E. Pathan,
None;

A. Lim,
None;

A. Graham,

Image Analysis,

3;

K. Satchithananda,
None;

D. Hull,
None;

S. Abraham,
None;

A. Rastogi,
None;

A. Keat,
None;

M. Hinton,

Image Analysis,

3;

O. Kubassova,

Image Analysis,

3;

P. C. Taylor,
None;

J. V. Hajnal,

Philips Healthcare,

2.

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