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Cartilage quantification using contrast-enhanced MRI in the wrist of rheumatoid arthritis: cartilage loss is associated with bone marrow edema.

ABSTRACT: To quantify wrist cartilage using contrast MRI and compare with the extent of adjacent synovitis and bone marrow edema (BME) in patients with rheumatoid arthritis (RA).18 patients with RA underwent post-contrast fat-suppressed T1weighted coronal imaging. Cartilage area at the centre of the scaphoid-capitate and radius-scaphoid joints was measured by in-house developed software. We defined cartilage as the pixels with signal intensity between two thresholds (lower: 0.4, 0.5 and 0.6 times the muscle signal, upper: 0.9, 1.0, 1.1, 1.2 and 1.3 times the muscle signal). We investigated the association of cartilage loss with synovitis and BME score derived from RA MRI scoring system.Cartilage area was correlated with BME score when thresholds were adequately set with lower threshold at 0.6 times the muscle signal and upper threshold at 1.2 times the muscle signal for both SC (rs=-0.469, p < 0.05) and RS (rs=-0.486, p < 0.05) joints, while it showed no significant correlation with synovitis score at any thresholds.Our software can accurately quantify cartilage in the wrist and BME associated with cartilage loss in patients with RA. Advances in knowledge: Our software can quantify cartilage using conventional MR images of the wrist. BME is associated with cartilage loss in RA patients.

SUBMITTER: Fujimori M

PROVIDER: S-EPMC5858812 | biostudies-other | 2017 Aug

REPOSITORIES: biostudies-other

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Cartilage quantification using contrast-enhanced MRI in the wrist of rheumatoid arthritis: cartilage loss is associated with bone marrow edema.

Fujimori Motoshi M Nakamura Satoko S Hasegawa Kiminori K Ikeno Kunihiro K Ichikawa Shota S Sutherland Kenneth K Kamishima Tamotsu T

The British journal of radiology 20170714 1077

<h4>Objective</h4>To quantify wrist cartilage using contrast MRI and compare with the extent of adjacent synovitis and bone marrow edema (BME) in patients with rheumatoid arthritis (RA).<h4>Methods</h4>18 patients with RA underwent post-contrast fat-suppressed T<sub>1</sub>weighted coronal imaging. Cartilage area at the centre of the scaphoid-capitate and radius-scaphoid joints was measured by in-house developed software. We defined cartilage as the pixels with signal intensity between two thres ...[more]

PMID: 28707530

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Project description:Treatment of severely destroyed rheumatoid wrists with total wrist arthroplasty or total wrist arthrodesis relies on patient and surgeon preferences rather than rigorous prospective outcomes data. The purpose of this study is to develop a decision analytic model of arthroplasty and arthrodesis in rheumatoid arthritis (RA) using utility values obtained from a random sample of hand surgeons.A utility survey using a time trade-off design was administered to 175 members of the American Society for Surgery of the Hand. Based on the results of the survey, the utility values that surgeons assign to health states associated with arthroplasty and arthrodesis and their complications were calculated. By combining utility values with complication rates in the published literature, we developed a decision tree to calculate the expected quality-adjusted life years (QALYs) for each procedure compared to living with a painful RA wrist.Based on surgeon preferences, living for 30 years with a painful, poorly functioning RA wrist (utility = 0.54) is associated with 16.2 QALYs. Treatment with arthroplasty (utility = 0.85) is associated with 25.5 QALYs, a gain of 9.3 QALYs over nonsurgical management. Arthrodesis (utility = 0.82) is associated with 24.6 QALYs, a gain of 8.4 QALYs over nonsurgical management. Arthroplasty is associated with a small incremental increase in QALYs (0.9) compared to arthrodesis.Based on utility scores, hand surgeons feel that living with a painful, poorly functioning RA wrist for 30 years is worth approximately half as many years with a painless, well-functioning wrist. The outcomes for arthroplasty and arthrodesis are valued more than nonsurgical management. On the basis of its higher expected gain in QALYs, arthroplasty should be the preferred treatment. The minimal increase in utility for arthroplasty over arthrodesis suggests however, that surgeons do not view arthroplasty as superior to arthrodesis.Economic and decision analysis IV.

Dataset Information

Cartilage quantification using contrast-enhanced MRI in the wrist of rheumatoid arthritis: cartilage loss is associated with bone marrow edema.

Publications

Cartilage quantification using contrast-enhanced MRI in the wrist of rheumatoid arthritis: cartilage loss is associated with bone marrow edema.

Similar Datasets

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