Critical appraisal of the International Prophylaxis Study Group magnetic resonance image scale for evaluating haemophilic arthropathy

Tolend, Mirkamal; Majeed, Haris; Soliman, Mahmoud A.; Daruge, Paulo; Bordalo-Rodrigues, Marcelo; Dertkigil, Sérgio; Gibikote, Sridhar; Keshava, Shyamkumar N.; Stimec, Jennifer; Dunn, Amy L.; Li, Ying Jia; Blanchette, Victor S.; Lundin, Björn; Doria, A.

doi:10.1111/hae.14032

Cited by 10 publications

(15 citation statements)

References 36 publications

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“…Furthermore, the clinical implications of minor changes revealed by MRI in terms of individual joint function remain to be determined 39 . In addition, in case of moderate/large haemosiderin deposition in the joint, the MRI visualization of synovial hypertrophy may be compromised by gradient‐echo susceptibility artefacts, challenging synovial hypertrophy detection and scoring 42 …”

Section: Resultsmentioning

confidence: 99%

Diagnosis and treatment of chronic synovitis in patients with haemophilia: consensus statements from the Italian Association of Haemophilia Centres

et al. 2021

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Although synovitis is recognized as a marker of joint disease activity, its periodic assessment is not included in routine clinical surveillance of patients with haemophilia (PwH). In order to evaluate the current knowledge and to identify controversial issues, a preliminary literature search by the Musculoskeletal Committee of the Italian Association of Haemophilia Centres (AICE) has been conducted. Statements have been established and sent to the Italian AICE members to collect their level of agreement or disagreement by a Delphi process. Thirty-seven consensus recommendations have been drafted. We found a general agreement on the indication to consider the presence of synovitis as a marker of joint disease activity in PwH. Accordingly, there was agreement on the indication to search for synovitis both in patients reporting joint pain and in asymptomatic ones, recognizing ultrasound as the most practical imaging technique to perform periodic joint screening. Interestingly, after detection of synovitis, there was agreement on the indication to modify the therapeutic approach, suggesting prophylaxis in patients treated on demand and tailoring treatment in patients already under prophylaxis. Whereas the need of an early consultation with a physiotherapist is recommended for PwH affected by chronic synovitis, the exact timing for an orthopaedic surgeon consultation is currently unknown.

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Section: Resultsmentioning

confidence: 99%

Diagnosis and treatment of chronic synovitis in patients with haemophilia: consensus statements from the Italian Association of Haemophilia Centres

et al. 2021

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“…This study and the MRI IPSG scoring system made comprehensive assessments and quantification of arthropathy in terms of articular soft tissue and osteochondral lesions [ 19 ]. Articular soft tissue lesions included hemosiderin deposition, synovial hyperplasia, and joint effusion or hematocele.…”

Section: Discussionmentioning

confidence: 99%

Artificial Intelligence Algorithm‐Based Magnetic Resonance Imaging to Evaluate the Effect of Radiation Synovectomy for Hemophilic Arthropathy

Zhang

Duan

Xiao

et al. 2022

Contrast Media & Molecular Imaging

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This study aimed to discuss magnetic resonance imaging (MRI) based on artificial intelligence (AI) algorithm to evaluate the effect of radiation synovectomy for hemophilic arthropathy (HA). MRI based on the Canny algorithm was applied and compared with conventional MRI to evaluate its application effects according to the PSNR and SSIM. Sixty patients diagnosed with HA were selected as the research subjects. According to the detection method, the patients were divided into group A (pathological detection after radiation synovectomy), group B (conventional MRI detection), and group C (MRI detection based on the Canny algorithm). The application value of MRI based on the Canny algorithm was judged by comparing the differences between the two detection methods and pathological results. The results displayed that the reconstruction effect of the Canny algorithm was remarkably better than that of the traditional algorithm regarding the peak signal-to-noise ratio (PSNR) and structural similarity (SSIM), which showed a clearer synovial contour. The results of the IPSG score of joint effusion and hemorrhage showed that there was a difference in the detection rate of joints between conventional MRI and pathological results on the score of 1 and 2 ( P < 0.05 ); and there was no significant difference between the MRI and pathological results based on the Canny algorithm ( P > 0.05 ). The results of the IPSG score of synovial hyperplasia showed that the detection rate of conventional MRI was different from pathological results on the score of 1 and 2 ( P < 0.05 ); and there was no significant difference between the MRI and pathological results based on the Canny algorithm ( P > 0.05 ). The results of the IPSG score of hemosiderin deposition showed that the detection rate of conventional MRI was different from the pathological results on the score of 1 and 2 ( P < 0.05 ); and there was no significant difference between the MRI and pathological results based on the Canny algorithm ( P > 0.05 ). The synovial volume of patients after surgery was reduced compared with that before surgery. One-factor variance was used to analyze the clinical hemorrhage frequency before and after surgery, and the results showed that the differences were statistically significant ( P < 0.05 ). Therefore, MRI on account of AI algorithm made it easier to detect synovial contour, which was helpful to evaluate the efficacy of polygenic risk scores (PRS) surgery in HA patients. MRI based on the Canny algorithm had less differences between the score of hemophilic arthropathy and pathological results, which could replace conventional MRI examination and have clinical application value.

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“…We also found a weak correlation between age and IPSG MRI scores. This may be due to the fact that the IPSG MRI scoring system has known limitations in its ability to detect very early functional changes in the joints, not visible macroscopically 17,21 …”

Section: Discussionmentioning

confidence: 99%

“…Anatomic data were interpreted independently and blindly (to patient's clinical information) initially by a musculoskeletal pediatric staff radiologist (A.S.D.) with over 15 years of experience using the International Prophylaxis Study Group (IPSG) MRI scale (0–17 scores), which includes osteochondral (0–8 scores) and soft tissue (0–9) domain 16,17 . The scores obtained by this reader were compared afterwards with scores provided by different board‐certified staff radiologists of our department (range, 4–40 years of experience in radiology) at the time of reporting of the anatomic part of the MRI examinations for clinical purposes, which were available on Picture Archive and Communication System (PACS).…”

Section: Methodsmentioning

confidence: 99%

Understanding Early Hemophilic Arthropathy in Children and Adolescents Through MRI T₂ Mapping

Majeed

Ahmed

Sussman

et al. 2020

Magnetic Resonance Imaging

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Background Persons with hemophilia experience hemarthrosis, which can lead to cartilage degeneration, causing physical impairment. MRI T2 mapping has the potential to be used as a tool to evaluate early arthropathic changes and cartilage degeneration in patients with hemophilia. Purpose To assess the value of MRI‐T2 mapping as a tool for investigating the cartilage status of children and adolescents with hemophilic arthropathy. Study Type Prospective, cross‐sectional. Subjects Twenty‐eight boys with hemophilia (aged 5–17 years) and 23 healthy boys (aged 7–17 years). Field Strength/Sequences A multiecho spin‐echo T2‐weighted gradient echo sequence was used on a 3.0T magnet. Assessment MRI‐T2 maps of ankle (tibia‐talus) (n = 19) or knee (femur‐tibia) (n = 9) cartilage were assessed in hemophilia and healthy groups. An anatomically‐based MRI score was also assigned to each ankle/knee. Statistical Tests Pearson's correlation coefficient (r), linear regression, intraclass correlation coefficient (ICC), and analysis of variance (ANOVA) test. Results Negative associations between age and ankle/knee cartilage T2 relaxation times were found in hemophilia (r = –0.72 [P = 0.03] to –0.55 [P = 0.01]) and healthy (r = –0.84 [P < 0.001] to –0.55 [P = 0.20]) groups. There were nonsignificant associations between ankle cartilage T2 relaxation times and MRI scores (r = –0.15 [P = 0.54] to 0.31 [P = 0.19]). Data Conclusion Results of this clinical investigation emphasize the potential importance of MRI‐T2 maps as a tool to understand the functional status of cartilage in children and adolescents with hemophilic arthropathy, while holding promise for the detection of early cartilage degeneration prior to macroscopic characterization by conventional MRI. MRI‐T2 mapping may provide novel information that is not reflected in the anatomically‐based MRI scoring system. Level of Evidence 3 Technical Efficacy Stage 2

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Critical appraisal of the International Prophylaxis Study Group magnetic resonance image scale for evaluating haemophilic arthropathy

Cited by 10 publications

References 36 publications

Diagnosis and treatment of chronic synovitis in patients with haemophilia: consensus statements from the Italian Association of Haemophilia Centres

Diagnosis and treatment of chronic synovitis in patients with haemophilia: consensus statements from the Italian Association of Haemophilia Centres

Artificial Intelligence Algorithm‐Based Magnetic Resonance Imaging to Evaluate the Effect of Radiation Synovectomy for Hemophilic Arthropathy

Understanding Early Hemophilic Arthropathy in Children and Adolescents Through MRI T₂ Mapping

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Critical appraisal of the International Prophylaxis Study Group magnetic resonance image scale for evaluating haemophilic arthropathy

Cited by 10 publications

References 36 publications

Diagnosis and treatment of chronic synovitis in patients with haemophilia: consensus statements from the Italian Association of Haemophilia Centres

Diagnosis and treatment of chronic synovitis in patients with haemophilia: consensus statements from the Italian Association of Haemophilia Centres

Artificial Intelligence Algorithm‐Based Magnetic Resonance Imaging to Evaluate the Effect of Radiation Synovectomy for Hemophilic Arthropathy

Understanding Early Hemophilic Arthropathy in Children and Adolescents Through MRI T2 Mapping

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Understanding Early Hemophilic Arthropathy in Children and Adolescents Through MRI T₂ Mapping