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Salaffi F, Carotti M, Di Carlo M, Ceccarelli L, Farah S, Poliseno AC, Di Matteo A, Bandinelli F, Giovagnoni A. Magnetic Resonance Imaging (MRI)-Based Semi-Quantitative Methods for Rheumatoid Arthritis: From Scoring to Measurement. J Clin Med 2024; 13:4137. [PMID: 39064179 PMCID: PMC11277801 DOI: 10.3390/jcm13144137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/25/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the small joints of the hands and feet, characterized by pain, inflammation, and joint damage. In this context, magnetic resonance imaging (MRI) is useful to identify and monitor joint/tendon inflammation and the evolution of joint damage, playing a key role in treatment response evaluation, in addition to clinical measurements. Various methods to quantify joint inflammation and damage with MRI in RA have been developed, such as RA-MRI Score (RAMRIS), Early RA-MRI Score (ERAMRS), and Simplified RA-MRI Score (SAMIS). RAMRIS, introduced in 2002, offers an objective means to assess inflammation and damage via MRI in RA trials, encompassing findings such as synovitis, bone erosion, and edema/osteitis. Recently, an updated RAMRIS version was developed, which also includes the evaluation of joint space narrowing and tenosynovitis. The RAMRIS-5, which is a condensed RAMSIS version focusing on five hand joints only, has been proven to be a valuable resource for the semi-quantitative evaluation of RA joint damage, both in early and established disease. This narrative literature review will provide an overview of the MRI scoring systems that have been developed for the assessment of joint inflammation and structural damage in RA patients.
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Affiliation(s)
- Fausto Salaffi
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Carlo Urbani Hospital, Jesi, 60035 Ancona, Italy; (F.S.); (S.F.)
| | - Marina Carotti
- Department of Clinical, Special and Dental Sciences, Università Politecnica delle Marche, 60126 Ancona, Italy; (M.C.); (A.C.P.); (A.G.)
- Division of Radiology, Department of Radiological Sciences, University Hospital Azienda Ospedaliera Universitaria delle Marche, 60126 Ancona, Italy
| | - Marco Di Carlo
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Carlo Urbani Hospital, Jesi, 60035 Ancona, Italy; (F.S.); (S.F.)
| | - Luca Ceccarelli
- Oncohematologic and Emergency Radiology Unit, Department of Pediatric and Adult Cardio-Thoracic and Vascular, IRCCS Policlinico di Sant’Orsola, 40138 Bologna, Italy;
| | - Sonia Farah
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Carlo Urbani Hospital, Jesi, 60035 Ancona, Italy; (F.S.); (S.F.)
| | - Anna Claudia Poliseno
- Department of Clinical, Special and Dental Sciences, Università Politecnica delle Marche, 60126 Ancona, Italy; (M.C.); (A.C.P.); (A.G.)
- Division of Radiology, Department of Radiological Sciences, University Hospital Azienda Ospedaliera Universitaria delle Marche, 60126 Ancona, Italy
| | - Andrea Di Matteo
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UK;
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds Teaching Hospitals NHS Trust, Leeds LS9 7TF, UK
| | - Francesca Bandinelli
- Rheumatology Department, USL Tuscany Center, San Giovanni di Dio Hospital, 50143 Florence, Italy;
| | - Andrea Giovagnoni
- Department of Clinical, Special and Dental Sciences, Università Politecnica delle Marche, 60126 Ancona, Italy; (M.C.); (A.C.P.); (A.G.)
- Division of Radiology, Department of Radiological Sciences, University Hospital Azienda Ospedaliera Universitaria delle Marche, 60126 Ancona, Italy
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Ponsiglione A, McGuire W, Petralia G, Fennessy M, Benkert T, Ponsiglione AM, Padhani AR. Image quality of whole-body diffusion MR images comparing deep-learning accelerated and conventional sequences. Eur Radiol 2024:10.1007/s00330-024-10883-5. [PMID: 38960946 DOI: 10.1007/s00330-024-10883-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 04/20/2024] [Accepted: 04/29/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVES To compare the image quality of deep learning accelerated whole-body (WB) with conventional diffusion sequences. METHODS Fifty consecutive patients with bone marrow cancer underwent WB-MRI. Two experts compared axial b900 s/mm2 and the corresponding maximum intensity projections (MIP) of deep resolve boost (DRB) accelerated diffusion-weighted imaging (DWI) sequences (time of acquisition: 6:42 min) against conventional sequences (time of acquisition: 14 min). Readers assessed paired images for noise, artefacts, signal fat suppression, and lesion conspicuity using Likert scales, also expressing their overall subjective preference. Signal-to-noise and contrast-to-noise ratios (SNR and CNR) and the apparent diffusion coefficient (ADC) values of normal tissues and cancer lesions were statistically compared. RESULTS Overall, radiologists preferred either axial DRB b900 and/or corresponding MIP images in almost 80% of the patients, particularly in patients with a high body-mass index (BMI > 25 kg/m2). In qualitative assessments, axial DRB images were preferred (preferred/strongly preferred) in 56-100% of cases, whereas DRB MIP images were favoured in 52-96% of cases. DRB-SNR/CNR was higher in all normal tissues (p < 0.05). For cancer lesions, the DRB-SNR was higher (p < 0.001), but the CNR was not different. DRB-ADC values were significantly higher for the brain and psoas muscles, but not for cancer lesions (mean difference: + 53 µm2/s). Inter-class correlation coefficient analysis showed good to excellent agreement (95% CI 0.75-0.93). CONCLUSION DRB sequences produce higher-quality axial DWI, resulting in improved MIPs and significantly reduced acquisition times. However, differences in the ADC values of normal tissues need to be considered. CLINICAL RELEVANCE STATEMENT Deep learning accelerated diffusion sequences produce high-quality axial images and MIP at reduced acquisition times. This advancement could enable the increased adoption of Whole Body-MRI for the evaluation of patients with bone marrow cancer. KEY POINTS Deep learning reconstruction enables a more than 50% reduction in acquisition time for WB diffusion sequences. DRB images were preferred by radiologists in almost 80% of cases due to fewer artefacts, improved background signal suppression, higher signal-to-noise ratio, and increased lesion conspicuity in patients with higher body mass index. Cancer lesion diffusivity from DRB images was not different from conventional sequences.
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Affiliation(s)
- Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Will McGuire
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - Giuseppe Petralia
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Radiology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Marie Fennessy
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - Thomas Benkert
- MR Application Predevelopment, Siemens Healthineers AG, Erlangen, Germany
| | - Alfonso Maria Ponsiglione
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy
| | - Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, United Kingdom.
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Blondiaux E. Prevalence and causes of artifacts on whole-body MRI in pediatric patients. Diagn Interv Imaging 2023; 104:91-92. [PMID: 36414507 DOI: 10.1016/j.diii.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 11/21/2022]
Affiliation(s)
- Eléonore Blondiaux
- Department of Pediatric Radiology, Trousseau Hospital, AP-HP, 75012 Paris, France; Sorbonne Université, Biomedical Imaging Laboratory, INSERM, CNRS, 75013 Paris, France.
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