Consensus approach for 3D joint space width of metacarpophalangeal joints of rheumatoid arthritis patients using high-resolution peripheral quantitative computed tomography

Stok, Kathryn S.; Burghardt, Andrew J.; Boutroy, Stéphanie; Peters, M.; Manske, Sarah L.; Stadelmann, Vincent A.; Vilayphiou, Nicolas; Bergh, Joop van den; Geusens, Piet; Li, Xiaojuan; Marotte, Hubert; Rietbergen, Bert van; Boyd, Steven K.; Barnabé, Cheryl

doi:10.21037/qims.2019.12.11

Cited by 27 publications

(21 citation statements)

References 26 publications

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“…Volumetric joint space was quantified using an algorithm developed by consensus from the SPECTRA collaboration. [29] 3D JSW including mean (JSW.Mean, mm), maximum (JSW.Max, mm), minimum (JSW.Min, mm), standard deviation (JSW.SD, mm), asymmetry (defined as JSW.Asymm = ratio of JSW.Max/JSW.Min, [1]) as well as volume (JSV, mm 3 ) were calculated. Erosion presence was identified by a rheumatologist with extensive HR-pQCT expertise (SF).…”

Section: Methodsmentioning

confidence: 99%

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Bone changes assessed with High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT) in early inflammatory arthritis: a 12-month cohort study

Brunet

Finzel

Engelke

et al. 2019

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Objectives: We sought to determine the sensitivity of high resolution peripheral quantitative computed tomography (HR-pQCT) to detect change and identify erosions in comparison with conventional radiography (CR) in early inflammatory arthritis patients. We also explored which prognostic factors contribute to bone damage assessed by HR-pQCT in the first year of diagnosis. Methods: 46 patients with arthritic symptoms less than one year, and a clinical diagnosis of inflammatory arthritis were prospectively imaged at baseline and 12-months. HR-pQCT scans of the 2nd and 3rd MCP joints and CR of the hands and feet were performed. Joint space width (JSW), total bone mineral density (Tt.BMD), erosion presence and volume were assessed with HR-pQCT. Scan-rescan precision was assessed to define an individual-level least significant change (LSC) criterion. Regression analyses explored prognostic factors for bone damage progression. Results: We observed no significant group-level changes in JSW, Tt.BMD or erosion volume. 20% or fewer joints demonstrated individual-level changes greater than the LSC criterion for mean JSW, Tt.BMD and erosion volume. HR-pQCT detected more erosions than CR in the 2nd and 3rd MCP. Increased symptom duration at diagnosis was associated (p < 0.10) with lower JSW minimum and higher JSW standard deviation. Conclusions: We have demonstrated stability in erosion, bone density and JSW over 12-months in most patients receiving treatment for inflammatory arthritis using a LSC criterion, although patients with longer symptom duration prior to treatment initiation had demonstrable negative effects on JSW estimates. HR-pQCT captures bone damage and progression undetectable by CR in the imaged joints.

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Section: Methodsmentioning

confidence: 99%

“…Precision of JSW outcomes was previously reported in this cohort. [29] Here precision of erosion volume and Tt.BMD are reported.…”

Section: Methodsmentioning

confidence: 99%

Bone changes assessed with High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT) in early inflammatory arthritis: a 12-month cohort study

Brunet

Finzel

Engelke

et al. 2019

Preprint

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“…Three different algorithms were developed using a similar methodology (11,13). A consensus method has recently been published by the SPECTRA Collaboration (Figure 10), this method is proposed for universal use in ongoing and future clinical trials of arthritic conditions (70). The established joint space width (JSW) metrics include mean, minimum and maximum JSW as well as standard deviation, asymmetry (maximum/minimum) and joint space volume.…”

Section: Joint Space Widthmentioning

confidence: 99%

High-Resolution Peripheral Quantitative Computed Tomography for Bone Evaluation in Inflammatory Rheumatic Disease

et al. 2020

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High resolution peripheral quantitative computed tomography (HR-pQCT) is a 3-dimensional imaging modality with superior sensitivity for bone changes and abnormalities. Recent advances have led to increased use of HR-pQCT in inflammatory arthritis to report quantitative volumetric measures of bone density, microstructure, local anabolic (e.g., osteophytes, enthesiophytes) and catabolic (e.g., erosions) bone changes and joint space width. These features may be useful for monitoring disease progression, response to therapy, and are responsive to differentiating between those with inflammatory arthritis conditions and healthy controls. We reviewed 69 publications utilizing HR-pQCT imaging of the metacarpophalangeal (MCP) and/or wrist joints to investigate arthritis conditions. Erosions are a marker of early inflammatory arthritis progression, and recent work has focused on improvement and application of techniques to sensitively identify erosions, as well as quantifying erosion volume changes longitudinally using manual, semi-automated and automated methods. As a research tool, HR-pQCT may be used to detect treatment effects through changes in erosion volume in as little as 3 months. Studies with 1-year follow-up have demonstrated progression or repair of erosions depending on the treatment strategy applied. HR-pQCT presents several advantages. Combined with advances in image processing and image registration, individual changes can be monitored with high sensitivity and reliability. Thus, a major strength of HR-pQCT is its applicability in instances where subtle changes are anticipated, such as early erosive progression in the presence of subclinical inflammation. HR-pQCT imaging results could ultimately impact decision making to uptake aggressive treatment strategies and prevent progression of joint damage. There are several potential areas where HR-pQCT evaluation of inflammatory arthritis still requires development. As a highly sensitive imaging technique, one of the major challenges has been motion artifacts; Klose-Jensen et al. HR-pQCT for Inflammatory Rheumatic Disease motion compensation algorithms should be implemented for HR-pQCT. New research developments will improve the current disadvantages including, wider availability of scanners, the field of view, as well as the versatility for measuring tissues other than only bone. The challenge remains to disseminate these analysis approaches for broader clinical use and in research.

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“…HR-pQCT allows for the resolution of individual trabeculae ( 4 ), and the ability to quantitatively evaluate joint properties. Semi-automated techniques have been developed to assess periarticular bone mineral density and microarchitecture, joint space width as well as erosion volume ( 5 – 8 ). An overview of these techniques is provided in a review by Klose-Jensen et al ( 9 ) in this special issue.…”

Section: Multi-modal Imaging: Utilizing Each Individual Imaging Modalmentioning

confidence: 99%

“…Three-dimensional (3D) volumetric joint space width (JSW; volume, minimum, maximum, and mean) was quantified on HR-pQCT images ( 5 ). Erosion volume was quantified on HR-pQCT images at baseline and follow-up using the Medical Image Analysis Framework [MIAF, University of Erlangen; ( 6 )].…”

Section: Using Hr-pqct and Mri To Investigate The Role Of Inflammatiomentioning

confidence: 99%

Multi-Modal Imaging to Assess the Interaction Between Inflammation and Bone Damage Progression in Inflammatory Arthritis

et al. 2020

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Combining results from multiple imaging techniques (i.e., multi-modal imaging) through image registration can result in the better characterization of joint tissue characteristics. In the context of inflammatory arthritis conditions, high-resolution peripheral quantitative computed tomography (HR-pQCT) provides excellent bone contrast while magnetic resonance imaging (MRI) provides superior contrast and resolution of soft tissue and inflammatory characteristics. Superimposing these imaging results upon each other provides a robust characterization of the joint. In a preliminary study of nine rheumatoid arthritis (RA) participants in clinical remission, we acquired HR-pQCT and MR images of their 2nd and 3rd metacarpophalangeal (MCP) joints at two timepoints 6 months apart. We present the benefits of a multi-modal imaging approach, in which we demonstrate the ability to localize regions of inflammation with subtle changes in bone erosion volume. Using HR-pQCT and MRI to visualize bone damage and inflammation, respectively, will improve our understanding of the impact that subclinical inflammation has on bone damage progression, and demonstrating if bone repair occurs where inflammation is resolved. The presented multi-modal imaging technique has the potential to study the progression of bone damage in relation to inflammation that otherwise would not be possible with either imaging technique alone. The multi-modal image registration technique will be helpful to understanding the development and pathogenesis of RA-associated bone erosions. Additionally, multi-modal imaging may provide a technique to probe the tissue-level changes that occur as a result of treatment regimes.

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Consensus approach for 3D joint space width of metacarpophalangeal joints of rheumatoid arthritis patients using high-resolution peripheral quantitative computed tomography

Cited by 27 publications

References 26 publications

Bone changes assessed with High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT) in early inflammatory arthritis: a 12-month cohort study

Bone changes assessed with High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT) in early inflammatory arthritis: a 12-month cohort study

High-Resolution Peripheral Quantitative Computed Tomography for Bone Evaluation in Inflammatory Rheumatic Disease

Multi-Modal Imaging to Assess the Interaction Between Inflammation and Bone Damage Progression in Inflammatory Arthritis

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