Radiocarpal Cartilage Matrix Changes 3-Months after Anti-TNF Treatment for Rheumatoid Arthritis – Feasibility Study Using MR T1ρ� Imaging

Eric Ku¹, Valentina Pedoia², Matthew Tanaka³, Ursula Heilmeier¹, John Imboden⁴, Jonathan D. Graf⁵, Thomas M. Link⁶ and Xiaojuan Li⁷, ¹Department of Radiology & Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, UCSF, San Francisco, CA, ²Department of Radiology & Biomedical Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, ³University of California Berkeley, Berkeley, CA, ⁴Rheumatology, Rheumatology, University of California San Francisco, San Francisco, CA, ⁵Rosalind Russell / Ephraim P. Engleman Rheumatology Research Center, University of California, San Francisco, San Francisco, CA, ⁶Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, UCSF, San Francisco, CA, ⁷Radiology & Biomedical Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Biomarkers, cartilage, imaging techniques and rheumatoid arthritis (RA), MRI

Session Information

Date: Monday, November 9, 2015

Title: Imaging of Rheumatic Diseases Poster II: X-ray, MRI, PET and CT

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

Standard assessment of Rheumatoid Arthritis (RA) on MRI relies on semi-quantitative joint space narrowing scores that are not sensitive to cartilage focal lesions or early biochemical damage^1,2. MRI T1ρ has been shown to quantitatively evaluate cartilage proteoglycan loss, collagen matrix changes, and water content³. The purpose of our study was to evaluate the feasibility of radiocarpal cartilage T1ρ as a biomarker in RA clinical trials.

Methods:

Nine patients were included in this study: 6 RA patients with active disease despite methotrexate (MTX) treatment started on certolizumab pegol (CZP) and 3 RA patients with low disease on MTX treatment alone. 3T MR was performed at baseline (immediately before CZP initiation) and after 3 months for all subjects. A coronal T1ρ sequence was used (Time of Spin-Lock = 0/10/20/50ms; spin lock frequency = 500Hz, resolution 0.21×0.21x3mm) for lunate, scaphoid, and radius cartilage segmentations. All echoes and follow-up images were registered to baseline images with piecewise rigid registration using individual bone masks (Fig. 1). Paired t-tests were used to compare T1ρ values at baseline and 3-month. Progression of T1ρ values (ΔT1ρ) were correlated (Spearman’s rho) with progression of Disease Activity Scores, Michigan Hand Questionnaires, and Health Assessment Questionnaires.

Results:

Patient characteristics are presented in Tab. 1. MTX alone patients showed an increase in Global T1ρ (37.4±1.4 to 39.3±1.6 ms) after 3 months while CZP + MTX patients did not show any significant changes in T1ρ. A statistically significant correlation was found between ΔGlobal T1ρ and ΔDAS28-ESR, ΔMHQ, and ΔHAQ (Fig. 2).

Conclusion:

We previously reported excellent in vivo reproducibility of wrist cartilage T1ρ (1.42% – 5.62% CV)⁴. The overall non-significant change of cartilage T1ρ at 3 months for CZP + MTX patients suggests cartilage responds positively to anti-TNF treatment through joint structure protection. Despite the small sample size, there are already strong correlations between progression of cartilage T1ρ with DAS28, MHQ, and HAQ, encouraging further research with more patients and time points.

References:

[1] Dohn et al., J of Rheumatol 2014 [2] Duvvuri et al., Magn Reson in Med 1997 [3] Li et al., Osteoarthritis Cartilage 2007 [4] Pedoia et al., ACR Abstract 2014

Disclosure: E. Ku, None; V. Pedoia, None; M. Tanaka, None; U. Heilmeier, None; J. Imboden, None; J. D. Graf, None; T. M. Link, None; X. Li, None.

To cite this abstract in AMA style:

Ku E, Pedoia V, Tanaka M, Heilmeier U, Imboden J, Graf JD, Link TM, Li X. Radiocarpal Cartilage Matrix Changes 3-Months after Anti-TNF Treatment for Rheumatoid Arthritis – Feasibility Study Using MR T1ρ� Imaging [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/radiocarpal-cartilage-matrix-changes-3-months-after-anti-tnf-treatment-for-rheumatoid-arthritis-feasibility-study-using-mr-t1%ef%bf%bd-imaging/. Accessed .

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