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01-05-2015 | Musculoskeletal

Aiming for a simpler early arthritis MRI protocol: can Gd contrast administration be eliminated?

Authors: Wouter Stomp, Annemarie Krabben, Désirée van der Heijde, Tom W. J. Huizinga, Johan L. Bloem, Mikkel Østergaard, Annette H. M. van der Helm-van Mil, Monique Reijnierse

Published in: European Radiology | Issue 5/2015

Abstract

Purpose

To evaluate whether intravenous gadolinium (Gd) contrast administration can be eliminated when evaluating synovitis and tenosynovitis in early arthritis patients, thereby decreasing imaging time, cost, and invasiveness.

Materials and Methods

Wrist MRIs of 93 early arthritis patients were evaluated by two readers for synovitis of the radioulnar, radiocarpal, and intercarpal joints, according to the Rheumatoid Arthritis MRI Scoring method (RAMRIS), and for tenosynovitis in ten compartments. Scores of MRI images without Gd contrast enhancement were compared to scores obtained when evaluating all, including contrast-enhanced, MRI images as reference. Subsequently, a literature review and pooled analysis of data from the present and two previous studies were performed.

Results

At the individual joint/tendon level, sensitivity to detect synovitis without Gd contrast was 91 % and 72 % for the two readers, respectively, with a specificity of 51 % and 81 %. For tenosynovitis, the sensitivity was 67 % and 54 %, respectively, with a specificity of 87 % and 91 %. Pooled data analysis revealed an overall sensitivity of 81 % and specificity of 50 % for evaluation of synovitis. Variations in tenosynovitis scoring systems hindered pooled analyses.

Conclusion

Eliminating Gd contrast administration resulted in low specificity for synovitis and low sensitivity for tenosynovitis, indicating that Gd contrast administration remains essential for an optimal assessment.

Key Points

• Eliminating gadolinium contrast administration results in low specificity for synovitis

• For tenosynovitis, sensitivity is low without gadolinium contrast administration

• Gadolinium contrast administration remains essential for evaluating synovitis and tenosynovitis in early arthritis

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Title: Aiming for a simpler early arthritis MRI protocol: can Gd contrast administration be eliminated?
Authors: Wouter Stomp
Annemarie Krabben
Désirée van der Heijde
Tom W. J. Huizinga
Johan L. Bloem
Mikkel Østergaard
Annette H. M. van der Helm-van Mil
Monique Reijnierse
Publication date: 01-05-2015
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 5/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3522-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Aiming for a simpler early arthritis MRI protocol: can Gd contrast administration be eliminated?

Abstract

Purpose

Materials and Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusion

Key Points

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