Improved detection of erosions in the sacroiliac joints on MRI with volumetric interpolated breath-hold examination (VIBE): results from the SIMACT study

Diekhoff, Torsten; Greese, Juliane; Sieper, Joachim; Poddubnyy, Denis; Hamm, Bernd; Hermann, Kay-Geert A.

doi:10.1136/annrheumdis-2018-213393

Cited by 74 publications

(73 citation statements)

References 17 publications

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“…Interpretation of local reader data is compromised by lack of data recorded in the ASAS-CC CRF as to which types of MRI lesion were observed. The assessment of structural lesions, especially erosion, is increasingly being performed using MRI sequences that can enhance the contrast between the joint space and bone 25 .…”

Section: Discussionmentioning

confidence: 99%

Central reader evaluation of MRI scans of the sacroiliac joints from the ASAS classification cohort: discrepancies with local readers and impact on the performance of the ASAS criteria

et al. 2020

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ObjectivesThe Assessment of SpondyloArthritis international Society (ASAS) MRI working group conducted a multireader exercise on MRI scans from the ASAS classification cohort to assess the spectrum and evolution of lesions in the sacroiliac joint and impact of discrepancies with local readers on numbers of patients classified as axial spondyloarthritis (axSpA).MethodsSeven readers assessed baseline scans from 278 cases and 8 readers assessed baseline and follow-up scans from 107 cases. Agreement for detection of MRI lesions between central and local readers was assessed descriptively and by the kappa statistic. We calculated the number of patients classified as axSpA by the ASAS criteria after replacing local detection of active lesions by central readers and replacing local reader radiographic sacroiliitis by central reader structural lesions on MRI.ResultsStructural lesions, especially erosions, were as frequent as active lesions (≈40%), the majority of patients having both types of lesions. The ASAS definitions for active MRI lesion typical of axSpA and erosion were comparatively discriminatory between axSpA and non-axSpA. Local reader overcall for active MRI lesions was about 30% but this had a minor impact on the number of patients (6.4%) classified as axSpA. Substitution of radiography with MRI structural lesions also had little impact on classification status (1.4%).ConclusionDespite substantial discrepancy between central and local readers in interpretation of both types of MRI lesion, this had a minor impact on the numbers of patients classified as axSpA supporting the robustness of the ASAS criteria for differences in assessment of imaging.

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Section: Discussionmentioning

confidence: 99%

Central reader evaluation of MRI scans of the sacroiliac joints from the ASAS classification cohort: discrepancies with local readers and impact on the performance of the ASAS criteria

et al. 2020

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“…However, current high-resolution three-dimensional MR sequences increase erosion conspicuity and allow for their sensitive MR detection as well. 40 Erosions were shown to be specific for the diagnosis of axSpA and were observed in up to 90% of patients with radiographic axSpA with disease duration < 10 years. 41 -Fat metaplasia: Thought to represent the replacement of inflammation by fat and defined as increased subchondral bone signal intensity on T1-weighted images, along with suppressed or decreased signal on fat-saturated fluidsensitive sequences or STIR (►Figs.…”

Section: Structural Lesionsmentioning

confidence: 96%

Top-Ten Tips for Effective Imaging of Axial Spondyloarthritis

Reijnierse

Eshed

Gaalen

2019

Semin Musculoskelet Radiol

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Axial spondyloarthritis (axSpA) is a chronic inflammatory condition that encompasses ankylosing spondylitis as well as nonradiographic axSpA and can lead to chronic pain, structural damage, and disability. The disease is strongly associated with the presence of human leukocyte antigen-B27. Early diagnosis of axSpA is significant due to new treatment regimens leading to reduction of inflammation and potentially delaying disease progression. Imaging of the sacroiliac joints and the spine plays an important role in the early diagnosis of spondyloarthritis. In the current review, the top-ten tips for the effective imaging of axSpA are presented to help both radiologists and rheumatologists in using imaging properly and effectively in their clinical practice.

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“…In daily practice, the combination of STIR and T1-weighted sequences is usually sufficient for diagnostic purposes when axial SpA is suspected. Recently, a volumetric interpolated breath-hold examination (VIBE) sequence was found to be comparable to computer tomography (a gold standard for detection of bony changes) for detection of erosions that might be highly relevant for the differential diagnosis of axial and contextual interpretation of bone marrow oedema and that is not always well captured by conventional STIR and T1-weighted sequences [ 38 ].…”

Section: Which Parameters Are Relevant For the Diagnosis And Classifimentioning

confidence: 99%

Classification vs diagnostic criteria: the challenge of diagnosing axial spondyloarthritis

Poddubnyy

2020

Rheumatology

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In recent years, significant progress has been made in improving the early diagnosis of spondyloarthritides (SpA), including axial SpA. Nonetheless, there are still issues related to the application of classification criteria for making the primary diagnosis of SpA in the daily practice. There are substantial conceptional and operational differences between the diagnostic vs classification approach. Although it is not possible to develop true diagnostic criteria for natural reasons as discussed in this review, the main principles of the diagnostic approach can be clearly defined: consider the pre-test probability of the disease, evaluate positive and negative results of the diagnostic test, exclude other entities, and estimate the probability of the disease at the end. Classification criteria should only be applied to patients with an established diagnosis and aimed at the identification of a rather homogeneous group of patients for the conduction of clinical research.

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Improved detection of erosions in the sacroiliac joints on MRI with volumetric interpolated breath-hold examination (VIBE): results from the SIMACT study

Abstract: VIBE detected erosions in the SIJs with higher sensitivity without a loss of specificity and superior reliability compared with a standard T1-weighted sequence. Its value for the diagnosis of axSpA has still to be determined.

Cited by 74 publications

References 17 publications

Central reader evaluation of MRI scans of the sacroiliac joints from the ASAS classification cohort: discrepancies with local readers and impact on the performance of the ASAS criteria

Central reader evaluation of MRI scans of the sacroiliac joints from the ASAS classification cohort: discrepancies with local readers and impact on the performance of the ASAS criteria

Top-Ten Tips for Effective Imaging of Axial Spondyloarthritis

Classification vs diagnostic criteria: the challenge of diagnosing axial spondyloarthritis

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