Fluorescence optical imaging and 3T-MRI for detection of synovitis in patients with rheumatoid arthritis in comparison to a composite standard of reference

Thuermel, Klaus; Neumann, Jan; Jungmann, Pia M.; Schäffeler, C.; Waldt, Simone; Heinze, Alexander; Beckmann, Alexander; Hauser, Christine; Hasenau, Anna-Lena; Wildgruber, Moritz; Clotten, Sigrun; Sievert, Matti; Haller, Bernhard; Woertler, Klaus; Harasser, Norbert; Rummeny, Ernst J.; Meier, Reinhard

doi:10.1016/j.ejrad.2017.02.016

Cited by 18 publications

(13 citation statements)

References 23 publications

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“…For example, investigation was performed in the detection of in amed joints in RA. (28,30,(39)(40)(41) Following studies concentrated on the examination of OA with different in ammatory patterns (36) or decreased blood ow in systemic sclerosis. (33,34) To our knowledge, we are the rst group to investigate potential subclinical in ammation of the skin in Pso/PsA patients.…”

Section: Discussionmentioning

confidence: 99%

Detection of subclinical skin manifestation in patients with psoriasis and psoriatic arthritis by fluorescence optical imaging

Schmidt

Glimm

Haugen

et al. 2020

Preprint

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Objectives: To investigate the frequency of subclinical skin inflammation in both hands by fluorescence optical imaging (FOI) in patients with psoriasis/psoriatic arthritis (Pso/PsA) vs. rheumatoid arthritis (RA) and healthy individuals, and to correlate these findings with cardiovascular (CV) risk factors.Patients and Methods: The FOI scans were analyzed retrospectively to detect clinically invisible skin enhancement (0-3 scale) in both hands without relationship to underlying joints or blood vessels. We further characterized the FOI patterns and sorted the scans into groups based on the assumed diagnosis (Pso/PsA, RA and healthy controls), which was compared with the physician’s diagnosis. Furthermore, the associations between CV risk factors and imaging findings were investigated by regression analyses.Results: We included FOI scans of patients with Pso/PsA (n=80), RA (n=78) and healthy controls (n=25). Subclinical skin enhancement on the back of their hands was more common in Pso/PsA (72.5%) than in RA patients (20.5%) and healthy individuals (28.0%) (p<0.001). Based on the FOI pattern, the majority of patients with Pso/PsA (72.5%), RA (76.9%) and healthy controls (68.0%) were classified correctly using the physician-based diagnosis as reference (overall agreement of 74%, kappa=0.57). No CV risk factors except body weight (kg) was associated with subclinical skin enhancement (OR 1.04, 95% CI 1.02-1.06; p<0.001). Conclusion: Subclinical subdermal skin inflammation was common in Pso/PsA patients using FOI. Based on the FOI pattern, most patients with Pso/PsA and were classified with the correct diagnosis. We demonstrated an important influence of the body weight on our FOI results. FOI may be a helpful novel tool to study microcirculation in rheumatic diseases with skin involvement.

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Section: Discussionmentioning

confidence: 99%

Detection of subclinical skin manifestation in patients with psoriasis and psoriatic arthritis by fluorescence optical imaging

Schmidt

Glimm

Haugen

et al. 2020

Preprint

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“…The examination lasted six minutes recording one image per second adding up to a cluster of 360 images. The examination included 30 joints of both hands (the wrist, MCP-, PIP-, (D)IP-joints of both hands) (11)(12)(13). The analyses of the images referred to evaluation of the first 240 images forming the automatically generated PrimaVistaMode (PVM) (11)(12)(13).…”

Section: Fluorescence Optical Imaging (Foi)mentioning

confidence: 99%

“…The examination included 30 joints of both hands (the wrist, MCP-, PIP-, (D)IP-joints of both hands) (11)(12)(13). The analyses of the images referred to evaluation of the first 240 images forming the automatically generated PrimaVistaMode (PVM) (11)(12)(13). In addition, three phases in position to the fingertips with regard to development of signal intensities were defined and analysed (11)(12)(13).…”

Section: Fluorescence Optical Imaging (Foi)mentioning

confidence: 99%

“…The analyses of the images referred to evaluation of the first 240 images forming the automatically generated PrimaVistaMode (PVM) (11)(12)(13). In addition, three phases in position to the fingertips with regard to development of signal intensities were defined and analysed (11)(12)(13). Phase 1 includes the period between starting the investigation, application of the dye and increased signal intensities in the fingertips; the last image before the dye leaves the fingertips (in yellow or in red or in white -not in green) from distal to proximal in wrist direction was used for scoring.…”

Section: Fluorescence Optical Imaging (Foi)mentioning

confidence: 99%

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Fluorescence optical imaging is helpful in the decision for rituximab (RTX) re-therapy in patients with rheumatoid arthritis

Ali

Glimm

Burmester

et al. 2020

Preprint

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Objective: To evaluate the ability of fluorescence optical imaging (FOI) Xiralite® in the prediction of RTX re-therapy in rheumatoid arthritis (RA) patients - in comparison to clinical, laboratory and musculoskeletal ultrasound (US) parameters.Patients and methods: Patients with established RA were prospectively followed over one year by DAS28, patient’s global disease activity (VAS 0-100 mm), CRP and ESR, US7 score and FOI in phases 1-3 and automatically generated PrimaVistaMode (PVM) at baseline (before RTX) and after 3, 6, and 12 months. The need for RTX re-therapy was decided by the treating rheumatologist – blinded to imaging data.Results: 31 patients (female 77.4%, mean age 60.1±11.4, mean disease duration 14.9±7.1 years) were included. Fourteen patients (45.2%) received RTX re-therapy within 12 months. In the group with RTX re-therapy, FOI in PVM mode was the only parameter that presented significant increase over time (beta 0.40, CI 0.08-0.71; p=0.013) – compared to the group without re-therapy. In the prediction model via ROC analysis, FOI in PVM reached the highest values of all imaging, clinical and laboratory parameters for the prediction of re-therapy over one year with an area under the curve (AUC) of 0.78 (OR 0.84, CI 0.72;0.98, p=0.031). US7 GS synovitis score revealed similar predictive power with an AUC of 0.73 (p=0.049).Conclusion: US7 GS synovitis score and FOI in PVM are able to discriminate between patients with and without need for RTX re-therapy better than clinical and laboratory parameters.

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“…In short, four images are assessed with the FOI activity score (FOIAS); PVM and three images representing phase 1, 2, and 3 based on the distribution and washing out of the fluorescent dye in relation to the fingertips (Figure 1). The distal interphalangeal (DIP), proximal interphalangeal (PIP) including the 1 st interphalangeal and metacarpophalangeal (MCP) joints and the thumb base were graded on 0-3 scales based on color intensity and width of enhancement according to the FOIAS (8,10,21). All FOI images were scored by one reader (SH) blinded for MRI and ultrasound results and all clinical data except age and sex.…”

mentioning

confidence: 99%

Validity and diagnostic performance of Fluorescence Optical Imaging measuring synovitis in hand osteoarthritis. Baseline results from the Nor-Hand cohort.

Maugesten

Mathiessen

Hammer

et al. 2020

Preprint

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Objective: Fluorescence Optical Imaging (FOI) demonstrates enhanced microcirculation in finger joints as a sign of inflammation. We wanted to assess the validity and diagnostic performance of FOI measuring synovitis in persons with hand OA, comparing it with magnetic resonance imaging (MRI)- and ultrasound-detected synovitis. Methods: 221 participants with hand OA underwent FOI and ultrasound (grey scale synovitis and power-Doppler activity) of the bilateral hands and contrast-enhanced MRI examination of the dominant hand. Fifteen joints in each hand were scored on semi-quantitative scales (grade 0-3) for all modalities. Four FOI images were evaluated: one composite image (Prima Vista Mode; PVM) and three images representing phases of fluorescent dye distribution. Spearman’s correlation coefficients were calculated between sum scores of FOI, MRI and ultrasound. Sensitivity, specificity and area under the curve (AUC) was calculated for FOI using MRI or ultrasound as reference. Results: FOI did not demonstrate enhancement in the thumb base, and the joint was excluded from further analyses. FOI sum scores showed poor to fair correlations with MRI (rho 0.01-0.24) and GS synovitis sum scores (rho 0.12-0.25). None of the FOI images demonstrated both good sensitivity and specificity, and the AUC ranged from 0.50-0.61 and 0.51-0.63 with MRI and GS synovitis as reference, respectively. FOI demonstrated similar diagnostic performance with PD activity and GS synovitis as reference. Conclusion: FOI enhancement correlated poorly with synovitis assessed by more established imaging modalities, questioning the value of FOI for the evaluation of synovitis in hand OA.

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Fluorescence optical imaging and 3T-MRI for detection of synovitis in patients with rheumatoid arthritis in comparison to a composite standard of reference

Cited by 18 publications

References 23 publications

Detection of subclinical skin manifestation in patients with psoriasis and psoriatic arthritis by fluorescence optical imaging

Detection of subclinical skin manifestation in patients with psoriasis and psoriatic arthritis by fluorescence optical imaging

Fluorescence optical imaging is helpful in the decision for rituximab (RTX) re-therapy in patients with rheumatoid arthritis

Validity and diagnostic performance of Fluorescence Optical Imaging measuring synovitis in hand osteoarthritis. Baseline results from the Nor-Hand cohort.

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