Comparison of OMERACT-RAMRIS scores and computer-aided dynamic magnetic resonance imaging findings of hand and wrist as a measure of activity in rheumatoid arthritis

The purpose of this study was to compare the value of conventional magnetic resonance imaging (MRI) finding of rheumatoid arthritis (RA) and computer-aided dynamic MRI measurements in predicting the activity of disease. The activity of the disease in 40 RA patients was evaluated by the disease activity score in 28 joints (DAS28). The conventional MRI of the wrists of all patients were scored for bone edema, synovitis and erosions, according to the criteria of RA-MRI scoring system (RAMRIS) developed by Outcome measures in rheumatology clinical trials (OMERACT) MR Imaging Group. Synovitis was also quantified by dynamic postcontrast MRI imaging using color coded maximum slope of increase maps and measurements of early enhancement rate (EER) and relative enhancement (RE). Twenty-two (55 %) patients with a score higher than 5.1 constituted the high disease activity group, 18 (45 %) patients with a score of 5.1 or less constituted moderate disease activity group. The dynamic MRI-EER score was the most significant parameter to differentiate between the groups (p = 0.001). Among OMERACT scores, only bone edema [p = 0.020 for wrist and p = 0.037 for metacarpophalangeal joints (MCP)] had a significant difference between the two groups. Dynamic MRI RE score and OMERACT scores for erosions and synovitis for both the wrist and MCP joints did not differ significantly between the two groups. Computer-aided dynamic MRI is a reliable, noninvasive method of evaluating the RA patients, which correlates with the DAS28 scores, at a higher significance than the OMERACT-RAMRIS scores.

[1]  C G Peterfy,et al.  MR imaging. , 1996, Bailliere's clinical rheumatology.

[2]  F. McQueen,et al.  A 1-year follow-up study of dynamic magnetic resonance imaging in early rheumatoid arthritis reveals synovitis to be increased in shared epitope-positive patients and predictive of erosions at 1 year. , 2000, Rheumatology.

[3]  A. Radjenovic,et al.  Regional variation and differential response to therapy for knee synovitis adjacent to the cartilage-pannus junction and suprapatellar pouch in inflammatory arthritis: implications for pathogenesis and treatment. , 2004, Arthritis and rheumatism.

[4]  K J Wolf,et al.  Rheumatoid arthritis: evaluation of hypervascular and fibrous pannus with dynamic MR imaging enhanced with Gd-DTPA. , 1990, Radiology.

[5]  M. Reiser,et al.  Gadolinium-DTPA in rheumatoid arthritis and related diseases: first results with dynamic magnetic resonance imaging , 2004, Skeletal Radiology.

[6]  Désirée van der Heijde,et al.  Plain X-rays in rheumatoid arthritis: overview of scoring methods, their reliability and applicability. , 1996 .

[7]  Paul Bird,et al.  OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Core set of MRI acquisitions, joint pathology definitions, and the OMERACT RA-MRI scoring system. , 2003, The Journal of rheumatology.

[8]  Michael J. Green,et al.  The relationship between synovitis and bone changes in early untreated rheumatoid arthritis: a controlled magnetic resonance imaging study. , 1999, Arthritis and rheumatism.

[9]  Neal Stewart,et al.  OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Exercise 3: an international multicenter reliability study using the RA-MRI Score. , 2003, The Journal of rheumatology.

[10]  H. Genant,et al.  Interreader agreement in the assessment of magnetic resonance images of rheumatoid arthritis wrist and finger joints--an international multicenter study. , 2001, The Journal of rheumatology.

[11]  Enzo Silvestri,et al.  Dynamic magnetic resonance of the wrist in psoriatic arthritis reveals imaging patterns similar to those of rheumatoid arthritis , 2005, Arthritis research & therapy.

[12]  M. A. van 't Hof,et al.  Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. , 1990, Annals of the rheumatic diseases.

[13]  Marcin Szkudlarek,et al.  New radiographic bone erosions in the wrists of patients with rheumatoid arthritis are detectable with magnetic resonance imaging a median of two years earlier. , 2003, Arthritis and rheumatism.

[14]  Paul Bird,et al.  OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Exercise 4: an international multicenter longitudinal study using the RA-MRI Score. , 2003, The Journal of rheumatology.

[15]  C Peterfy,et al.  An introduction to the EULAR–OMERACT rheumatoid arthritis MRI reference image atlas , 2005, Annals of the rheumatic diseases.

[16]  Enzo Silvestri,et al.  Dynamic gadolinium-enhanced magnetic resonance imaging of the wrist in patients with rheumatoid arthritis can discriminate active from inactive disease. , 2003, Arthritis and rheumatism.

[17]  K. Tamai,et al.  Dynamic magnetic resonance imaging for the evaluation of synovitis in patients with rheumatoid arthritis. , 1994, Arthritis and rheumatism.

[18]  Mary Corbett,et al.  Early rheumatoid disease , 1976 .

[19]  F. Mcqueen.  Magnetic resonance imaging in early inflammatory arthritis: what is its role? , 2000, Rheumatology.

[20]  O. Tervonen,et al.  Bone oedema predicts erosive progression on wrist MRI in early RA--a 2-yr observational MRI and NC scintigraphy study. , 2006, Rheumatology.

[21]  O. Tervonen,et al.  Contrast-enhanced dynamic and static MRI correlates with quantitative 99Tcm-labelled nanocolloid scintigraphy. Study of early rheumatoid arthritis patients. , 2004, Rheumatology.

[22]  H. Genant,et al.  The development of the EULAR–OMERACT rheumatoid arthritis MRI reference image atlas , 2005, Annals of the rheumatic diseases.

[23]  Tania Schink,et al.  Rheumatoid arthritis of the shoulder joint: comparison of conventional radiography, ultrasound, and dynamic contrast-enhanced magnetic resonance imaging. , 2003, Arthritis and rheumatism.

[24]  J J Anderson,et al.  The American college of rheumatology preliminary core set of disease activity measures for rheumatoid arthritis clinical trials , 1993 .

[25]  M Ostergaard,et al.  Magnetic resonance imaging-determined synovial membrane volume as a marker of disease activity and a predictor of progressive joint destruction in the wrists of patients with rheumatoid arthritis. , 1999, Arthritis and rheumatism.

[26]  R. Moots,et al.  MRI of rheumatoid arthritis image quantitation for the assessment of disease activity, progression and response to therapy. , 2008, Rheumatology.

[27]  M. Prevoo,et al.  Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. , 1995, Arthritis and rheumatism.

[28]  M. Corbett,et al.  Early rheumatoid disease. II. Patterns of joint involvement. , 1976, Annals of the rheumatic diseases.

[29]  J. Ridgway,et al.  Comparative assessment of leflunomide and methotrexate for the treatment of rheumatoid arthritis, by dynamic enhanced magnetic resonance imaging. , 2002, Arthritis and rheumatism.

[30]  O. Henriksen,et al.  Dynamic gadolinium-enhanced MR imaging in active and inactive immunoinflammatory gonarthritis. , 1994, Acta radiologica.

[31]  Michael J. Green,et al.  Elucidation of the relationship between synovitis and bone damage: a randomized magnetic resonance imaging study of individual joints in patients with early rheumatoid arthritis. , 2003, Arthritis and rheumatism.

[32]  A. Bjørnerud,et al.  Contrast-enhanced dynamic magnetic resonance imaging of finger joints in osteoarthritis and rheumatoid arthritis: an analysis based on pharmacokinetic modeling , 2006, Acta radiologica.

[33]  D. Blake,et al.  Quantitative assessment of the rheumatoid synovial microvascular bed by gadolinium-DTPA enhanced magnetic resonance imaging , 1998, Annals of the rheumatic diseases.

[34]  F. McQueen,et al.  Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals progression of erosions despite clinical improvement , 1999, Annals of the rheumatic diseases.

[35]  M Ostergaard,et al.  Quantification of synovistis by MRI: correlation between dynamic and static gadolinium-enhanced magnetic resonance imaging and microscopic and macroscopic signs of synovial inflammation. , 1998, Magnetic resonance imaging.

[36]  Paul Bird,et al.  Computerized measurement of magnetic resonance imaging erosion volumes in patients with rheumatoid arthritis: a comparison with existing magnetic resonance imaging scoring systems and standard clinical outcome measures. , 2003, Arthritis and rheumatism.

[37]  Neal Stewart,et al.  Bone edema scored on magnetic resonance imaging scans of the dominant carpus at presentation predicts radiographic joint damage of the hands and feet six years later in patients with rheumatoid arthritis. , 2003, Arthritis and rheumatism.

[38]  D. Blake,et al.  Quantification of rheumatoid synovitis by magnetic resonance imaging. , 1995, Arthritis and rheumatism.