Session Type: Abstract Submissions (ACR)
In assessment of ankylosing spondylitis (AS), accurate scoring of modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) is important to evaluate the treatment effects or follow-up results. Until now, lateral plain radiographs of cervical and lumbar spine were used for the assessment of mSASSS. We assessed the potential of tomosynthesis in evaluation of AS with mSASSS.
This study aimed to demonstrate the benefit of tomosynthesis in assessment of mSASSS, compared with plain radiographs.
The study group comprised 68 (55 men and 13 women; mean age, 32 years) patients with AS who underwent tomosynthesis and plain radiographs of cervical and lumbar spine on the same day. Two experienced radiologists (reader 1 and 2) independently assessed mSASSS with tomosynthesis and reader 1 assessed mSASSS with plain radiographs. Reader 1 also assessed the presence of facet narrowing or ankylosis on each level with tomosynthesis. Statistical agreements between tomosynthesis and plain radiographs in assessing total mSASSS score and scores on each spinal level were analyzed. And we analyzed the interobserver reliability between reader 1 and 2 in the interpretation of tomosynthesis.
In scoring the anterior corner lesions, tomosynthesis and plain radiographs showed fair agreement in upper border of C3, upper border of C5 and upper border of L1 (kappa value of 0.324, 0.358 and 0.391, respectively). In lower border of C4, lower border of T12, lower border of L1 and upper border of L3, tomosynthesis and plain radiographs showed moderate agreement (kappa value of 0.584, 0.43, 0.573 and 0.541). 44 of 68 patients (64.7%) showed higher total mSASSS score on tomographic evaluation as compared with radiographic studies. The mean mSASSS with tomography and plain radiographs were 13 and 11.6, respectively. On tomosynthesis, cervical facet arthropathies were detected in 15 of 68 patients (22%) and lumbar facet arthropathies were detected in 23 of 68 patients (33.8%). Interobserver agreement between two readers in tomographic evaluation of total mSASSS score and scores on C-spine and L-spine levels showed excellent agreement (kappa values of 0.974, 0.924 and 0.969, respectively).
We suggest that tomosynthesis is an excellent method for evaluation of AS with mSASSS. Tomosynthesis is superior to plain films in detecting and assessing anterior corner lesions. And also, it is good method to evaluate facet joint involvement in AS patients.
T. H. Kim,
J. B. Jun,
K. B. Joo,
Y. B. Joo,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/tomosynthesis-as-a-new-diagnostic-tool-for-evaluation-of-ankylosing-spondylitis-with-modified-stoke-ankylosing-spondylitis-spinal-score-a-comparison-with-plain-radiographs/