Dynamic contrast-enhanced magnetic resonance imaging in the assessment of disease activity in patients with juvenile idiopathic arthritis

Malattia, Clara; Damasio, Maria Beatrice; Basso, Curzio; Verri, Alessandro; Magnaguagno, Francesca; Viola, Stefania; Gattorno, Marco; Ravelli, Angelo; Tomà, Paolo; Martini, Alberto

doi:10.1093/rheumatology/kep343

Cited by 65 publications

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“…Notably, MRI measurement of synovitis, which provides information limited to the inflammatory status of a single joint, was more responsive than most ACRp outcome variables which reflect global inflammation. This observation, together with the encouraging correlations between MRI measurement of inflammation of the wrist and conventional measures of disease activity,13 24 33 argues for the potential utility of changes in the inflammatory status of the wrist as a marker for evaluating the systemic response. Since one of the major limitations of MRI is its ability to explore only a few joints per session, the impact of such an ‘informative’ joint is intuitive.…”

Section: Discussionmentioning

confidence: 99%

MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

et al. 2012

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Section: Discussionmentioning

confidence: 99%

MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

et al. 2012

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“…The main advantage of MRI over conventional radiography is the direct visualization of synovitis, cartilage, and early erosive lesions. Dynamic contrast-enhanced MRI (DCE-MRI) enables the analysis of the time course of signal changes following gadolinium administration [56]. A peculiar lesion detectable by MRI is periarticular bone marrow edema.…”

Section: Diagnosismentioning

confidence: 99%

Juvenile Idiopathic Arthritis: Diagnosis and Treatment

et al. 2016

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Juvenile idiopathic arthritis is a broad term that describes a clinically heterogeneous group of arthritides of unknown cause, which begin before 16 years of age. This term encompasses several disease categories, each of which has distinct presentation, clinical manifestations, and, presumably, genetic background and etiopathogenesis. Although none of the available drugs has curative potential, prognosis has greatly improved as a result of substantial progresses in disease management. The most important new development has been the introduction of the biologic medications, which constitute a valuable treatment option for patients who are resistant to conventional antirheumatic agents. Further insights into the disease pathogenesis and treatment will be provided by the continuous advances in understanding of the mechanisms related to the immune response and inflammatory process, and by the development of new drugs that are capable of selectively inhibiting single molecules or pathways.

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“…In 2010, the first step towards the use of dynamic contrast-enhanced MRI of children with JIA was made through the assessment of its reliability and construct validity in a pilot study of 12 patients with wrist involvement [13]. The current study adds to the previous work by describing the differences in dynamic contrast-enhanced MRI measures in two clinical subgroups of children with JIA and wrist involvement, adding time-intensity-curve shape analysis to the outcome measures and performing movement registration to improve image quality.…”

Section: Discussionmentioning

confidence: 99%

Dynamic contrast-enhanced magnetic resonance imaging of the wrist in children with juvenile idiopathic arthritis

et al. 2016

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BackgroundDynamic contrast-enhanced MRI provides information on the heterogeneity of the synovium, the primary target of disease in children with juvenile idiopathic arthritis (JIA).ObjectiveTo evaluate the feasibility of dynamic contrast-enhanced MRI in the wrist of children with JIA using conventional descriptive measures and time-intensity-curve shape analysis. To explore the association between enhancement characteristics and clinical disease status.Materials and methodsThirty-two children with JIA and wrist involvement underwent dynamic contrast-enhanced MRI with movement-registration and were classified using validated criteria as clinically active (n = 27) or inactive (n = 5). Outcome measures included descriptive parameters and the classification into time-intensity-curve shapes, which represent the patterns of signal intensity change over time. Differences in dynamic contrast-enhanced MRI outcome measures between clinically active and clinically inactive disease were analyzed and correlation with the Juvenile Arthritis Disease Activity Score was determined.ResultsComprehensive evaluation of disease status was technically feasible and the quality of the dynamic dataset was improved by movement registration. The conventional descriptive measure maximum enhancement differed significantly between clinically active and inactive disease (P = 0.019), whereas time-intensity-curve shape analysis showed no differences. Juvenile Arthritis Disease Activity Score correlated moderately with enhancing volume (P = 0.484).ConclusionDynamic contrast-enhanced MRI is a promising biomarker for evaluating disease status in children with JIA and wrist involvement. Conventional descriptive dynamic contrast-enhanced MRI measures are better associated with clinically active disease than time-intensity-curve shape analysis.Electronic supplementary materialThe online version of this article (doi:10.1007/s00247-016-3736-2) contains supplementary material, which is available to authorized users.

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Dynamic contrast-enhanced magnetic resonance imaging in the assessment of disease activity in patients with juvenile idiopathic arthritis

Cited by 65 publications

References 36 publications

MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

MRI versus conventional measures of disease activity and structural damage in evaluating treatment efficacy in juvenile idiopathic arthritis

Juvenile Idiopathic Arthritis: Diagnosis and Treatment

Dynamic contrast-enhanced magnetic resonance imaging of the wrist in children with juvenile idiopathic arthritis

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