Low-dose CT detects more progression of bone formation in comparison to conventional radiography in patients with ankylosing spondylitis: results from the SIAS cohort

Koning, Anoek de; Bruin, F. de; Berg, Rosaline van den; Smolen, Josef S; Baraliakos, Xenofon; Braun, J.; Gaalen, Floris A van; Reijnierse, M.; Heijde, Desirée van der

doi:10.1136/annrheumdis-2017-211989

Cited by 81 publications

(62 citation statements)

References 19 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MRI and CT (low‐dose CT if available) should be performed to monitor AS progression only when necessary . Recommended MRI sequence is T1W sequence for structural changes.…”

Section: Recommendationsmentioning

confidence: 99%

“…However, the sensitivity of vertebral inflammation and fat dysplasia on MRI in predicting new syndesmophyte formation remains questionable and still requires further supporting research data . In addition, a recent study has introduced low‐dose CT as an emerging option for monitoring AS progression, as it allows visualization of the whole vertebral column, including the thoracic spine, with higher sensitivity and imaging resolution in detecting new and growing syndesmophytes compared to CR . Low‐dose CT may be considered for a lower cost, relatively lower radiation hazard, fast imaging time, and with advanced sensitivity in monitoring structural changes.…”

Section: Recommendationsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical practice recommendations for the use of imaging in the diagnosis and management of axial spondyloarthritis in Taiwan

et al. 2019

View full text Add to dashboard Cite

Objective: Axial spondyloarthritis (axSpA) is a chronic inflammatory disease bearing challenges in early diagnosis. To improve clinical diagnosis and management of axSpA, recommendations were developed with current axSpA classification criteria and recent advances in medical imaging applications. Methods: A systematic literature review was conducted by 10 rheumatologists and radiologists in Taiwan to retrieve research evidence on the utilization of imaging modalities, including conventional radiography (CR), magnetic resonance imaging (MRI), computed tomography (CT), ultrasound (US), quantitative sacroiliac scintigraphy (QSS), and dual-energy X-ray absorptiometry (DXA). The panel of experts proposed six key issues on the role of imaging in early diagnosis of axSpA, monitoring of disease activity and structural changes, predicting treatment effects, and assessing complications such as osteoporosis and spinal fracture. The consensus was established on the basis of research evidence, clinical experiences and expert opinions. For each | 25 WEI Et al.

show abstract

“…MRI and CT (low‐dose CT if available) should be performed to monitor AS progression only when necessary . Recommended MRI sequence is T1W sequence for structural changes.…”

Section: Recommendationsmentioning

confidence: 99%

Section: Recommendationsmentioning

confidence: 99%

Clinical practice recommendations for the use of imaging in the diagnosis and management of axial spondyloarthritis in Taiwan

et al. 2019

View full text Add to dashboard Cite

show abstract

“…In contrast, CT scan methods provide a 360‐degree evaluation of the entire vertebral body, and a better visualization of thoracic spine. Using CT scanning, it has been shown that syndesmophytes develop more commonly at the thoracolumbar junction and thoracic spine, rather than the lumbar spine, offering the potential to detect more patients with abnormalities . In the full‐dose CT scan method, syndesmophyte volume was directly quantified and compared over time using a computer algorithm .…”

Section: Introductionmentioning

confidence: 99%

“…In the full‐dose CT scan method, syndesmophyte volume was directly quantified and compared over time using a computer algorithm . In the low‐dose CT method, a CT syndesmophyte score has been developed to measure the radiographic damage in the entire spine by human readers, with moderate interreader intraclass correlation coefficient for change score . Both CT methods have been shown to be more sensitive to change than the mSASSS , which makes it possible to detect a treatment effect in a clinical trial with fewer participants and/or a shorter study length.…”

Section: Introductionmentioning

confidence: 99%

“…In the low‐dose CT method, a CT syndesmophyte score has been developed to measure the radiographic damage in the entire spine by human readers, with moderate interreader intraclass correlation coefficient for change score . Both CT methods have been shown to be more sensitive to change than the mSASSS , which makes it possible to detect a treatment effect in a clinical trial with fewer participants and/or a shorter study length. Notably, the full‐dose CT scan method has a radiation exposure of 8 mSv per scan, which is comparable to 3 years of natural background radiation, and about one‐third of a positron emission tomography/CT scan, while the low‐dose CT has a radiation exposure of 4 mSv per scan.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Nonsteroidal Antiinflammatory Drugs as Potential Disease‐Modifying Medications in Axial Spondyloarthritis

Wang

Bathon

Ward

2020

Arthritis & Rheumatology

View full text Add to dashboard Cite

Nonsteroidal antiinflammatory drugs (NSAIDs) are the first‐line pharmacotherapy for patients with axial spondyloarthritis (SpA). In recent years, treatment options have expanded with the availability of biologic agents, including tumor necrosis factor inhibitors and interleukin‐17 inhibitors. However, a treatment strategy that clearly prevents syndesmophyte formation has not been established. Observational studies of patients with ankylosing spondylitis indicated potential disease‐modifying effects of NSAIDs, but two randomized trials came to different conclusions. More broadly, whether any of the currently available medications for axial SpA have an effect on spine radiographic progression, beyond symptom control, remains inconclusive. In this article, we will review clinical studies of the disease modification effects of NSAIDs and biologics in axial SpA; examine genetic, animal, and clinical evidence of the effects of NSAIDs on bone formation; and discuss how future studies may investigate the question of disease modification in axial SpA.

show abstract

Imaging Outcomes for Axial Spondyloarthritis and Sensitivity to Change: A Five‐Year Analysis of the DESIR Cohort

Sepriano

Smolen

Heijde

et al. 2022

Arthritis Care & Research

Self Cite

View full text Add to dashboard Cite

Objective To compare the sensitivity to change of different imaging scoring methods in patients with early axial spondyloarthritis (SpA). Methods Patients from the Devenir des Spondylarthropathies Indifferérenciées Récentes (DESIR) cohort fulfilling the Assessment of SpondyloArthritis international Society criteria for axial SpA were included. Radiographs and magnetic resonance imaging (MRI) of the sacroiliac (SI) joints and spine were obtained at baseline, 1, 2, and 5 years. Each image was scored by 2 or 3 readers in 3 separate reading waves. The rate of change of outcomes measuring inflammation of the spine and SI joints (e.g., Spondyloarthritis Research Consortium of Canada [SPARCC] score) and structural damage on MRI (e.g., ≥3 fatty lesions) and radiographs (e.g., modified New York grading) was assessed using multilevel generalized estimating equation models (taking all readers and waves into account). To allow comparisons across outcomes, rates were standardized (difference between the individual's value and the population mean divided by the SD). Results In total, 345 patients were included. Inflammation detected on MRI of the SI joints (MRI‐SI joints) (standardized rate range –0.278, –0.441) was more sensitive to change compared to spinal inflammation (range –0.030, –0.055). Structural damage in the SI joints showed a higher standardized rate of change on MRI‐SI joints (range 0.015, 0.274) compared to radiography of the SI joints (range 0.043, 0.126). MRI‐SI joints damage defined by ≥3 fatty lesions showed the highest sensitivity to change (0.274). Spinal structural damage slowly progressed over time with no meaningful difference between radiographic (range 0.037, 0.043) and MRI structural outcomes (range 0.008, 0.027). Conclusion Structural damage assessed in pelvic radiographs has low sensitivity to change, while fatty lesions detected on MRI‐SI joints are a promising alternative. In contrast, MRI of the spine is not better than radiography of the spine in detecting structural changes in patients with early axial SpA.

show abstract

Low-dose CT detects more progression of bone formation in comparison to conventional radiography in patients with ankylosing spondylitis: results from the SIAS cohort

Abstract: ldCT, covering the whole spine, detects more progression in the form of new and growing syndesmophytes in patients with AS compared with CR, which is limited to the cervical and lumbar spine. Most progression occurred in the thoracic spine.

Cited by 81 publications

References 19 publications

Clinical practice recommendations for the use of imaging in the diagnosis and management of axial spondyloarthritis in Taiwan

Clinical practice recommendations for the use of imaging in the diagnosis and management of axial spondyloarthritis in Taiwan

Nonsteroidal Antiinflammatory Drugs as Potential Disease‐Modifying Medications in Axial Spondyloarthritis

Imaging Outcomes for Axial Spondyloarthritis and Sensitivity to Change: A Five‐Year Analysis of the DESIR Cohort

Contact Info

Product

Resources

About