Session Type: Abstract Submissions (ACR)
To evaluate whether combined multi-pinhole single photon emission computed tomography (MPH-SPECT) with technetium-99m-labelled disphosphonates (Tc99m-DPD) and magnetic resonance imaging (MRI) detect changes in inflammation in early rheumatoid arthritis (ERA) patients under methotrexat (MTX) therapy and to investigate the relation between Tc99m-DPD uptake and the development of erosion.
MPH-SPECT and MRI of metacarpophalangeal joints (MCP) have been prospectively performed in 10 consecutive ERA patients (8 female, 2 male; 49 ± 13 years [mean ± SD]), range: 24 – 68) prior to and 6 months after initiation of MTX. The Tc99m-DPD uptake was measured using a region of analysis. The course of synovitis, bone marrow edema (BME) and erosions were scored according to the Rheumatoid Arthritis MRI Score (RAMRIS) criteria.
The frequency of increased Tc99m-DPD uptake, synovitis and BME decreased under MTX therapy; but the number of bone erosions increased. Joints with progressive and newly developed erosions on follow-up had a higher baseline Tc99m-DPD uptake (2.64 ±1.23 vs. 1.43 ±0.91) (p< 0.001). Joints with persistent synovitis did not show higher Tc99m-DPD uptake values (1.56 ±1.27 vs. 1.47 ± 0.75) (p= 0.74). There was no correlation between persistence of synovitis and the development of erosions (Fc= 0.3, p= 0.12).
Persistence of synovitis seems to be independent from Tc99m-DPD uptake and the development of erosions, while early increased bone metabolism is found in MCP joints which show erosive progression under MTX therapy. Hybrid MPH-SPECT and MRI might thus provide valuable additional information for individual risk-stratified therapeutic decisions.
H. J. Wittsack,
« Back to 2012 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/combined-high-resolution-single-photon-emission-computed-tomography-and-magnetic-resonance-imaging-for-therapy-monitoring-in-rheumatoid-arthritis/