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Geijer M, Inci F, Solidakis N, Szaro P, Al-Amiry B. The development of musculoskeletal radiology for 100 years as presented in the pages of Acta Radiologica. Acta Radiol 2021; 62:1460-1472. [PMID: 34664508 PMCID: PMC8647486 DOI: 10.1177/02841851211050866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/16/2021] [Indexed: 11/23/2022]
Abstract
During the last 100 years, musculoskeletal radiology has developed from bone-only radiography performed by everyone to a dedicated subspecialty, still secure in its origins in radiography but having expanded into all modalities of imaging. Like other subspecialties in radiology, it has become heavily dependent on cross-sectional and functional imaging, and musculoskeletal interventions play an important role in tumor diagnosis and treatment and in joint diseases. All these developments are reflected in the pages in Acta Radiologica, as shown in this review.
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Affiliation(s)
- Mats Geijer
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, 70712University of Gothenburg, Gothenburg, Sweden
- Department of Radiology, Region Västra Götaland, 56749Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Fatih Inci
- Department of Radiology, Region Västra Götaland, 56749Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Nektarios Solidakis
- Department of Radiology, Region Västra Götaland, 56749Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pawel Szaro
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, 70712University of Gothenburg, Gothenburg, Sweden
- Department of Radiology, Region Västra Götaland, 56749Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bariq Al-Amiry
- Department of Clinical Science, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
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Studeny T, Kratzer W, Schmidberger J, Graeter T, Barth TFE, Hillenbrand A. Analysis of vascularization in thyroid gland nodes with superb microvascular imaging (SMI) and CD34 expression histology: a pilot study. BMC Med Imaging 2021; 21:159. [PMID: 34717558 PMCID: PMC8557585 DOI: 10.1186/s12880-021-00690-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 10/19/2021] [Indexed: 11/28/2022] Open
Abstract
Background The Doppler sonography technique known as "superb microvascular imaging" (SMI) is advancing sonographic micro vascularization imaging in various disciplines. In this study, we aimed to determine whether SMI could reliably reproduce the blood flow in thyroid nodes and whether malignancy could be diagnosed, based on vascularization properties. Immunhistochemical staining by CD34 and SMI where used to determine the vascularization of nodes in terms of quantified vascularization parameters gained by computational evaluation. Methods We used image analysis programs to investigate whether the quantitative value for vascularization strength in the thyroid node, measured with SMI, was correlated with the actual degree of vascularization, determined microscopically. We included 16 patients that underwent thyroid resections. We prepared thyroid gland tissue slices for immunohistochemistry and labelled endothelial cells with CD34 to visualize blood vessels microscopically. We used image analysis programs, ImageJ, to quantify SMI Doppler sonographic measurements and CellProfiler to quantify CD34 expression in histological sections. We evaluated the numeric values for diagnostic value in node differentiation. Furthermore, we compared these values to check for correlations. Results Among the 16 nodes studied, three harboured malignant tumours (18.75%): two papillary and one follicular carcinoma. Among the 13 benign lesions (81.25%), four harboured follicular adenomas. Malignant and benign nodes were not significantly different in sonographic (0.88 ± 0.89 vs. 1.13 ± 0.19; p = 0.2790) or immunohistochemical measurements of vascularization strength (0.05 ± 0.05 vs. 0.08 ± 0.06; p = 0.2260). Conclusion We found a positive, significant correlation (r = 0.55588; p = 0.0254) between SMI (quantitative values for vascularization strength) and immunohistochemistry (CD34 staining) evaluations of thyroid nodes.
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Affiliation(s)
- Thomas Studeny
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Wolfgang Kratzer
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
| | - Julian Schmidberger
- Department of Internal Medicine I, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Tilmann Graeter
- Department of Diagnostic and Interventional Radiology, Ulm University Hospital, Albert-Einstein-Alee 23, 89081, Ulm, Germany
| | - Thomas F E Barth
- Institute of Pathology, Ulm University Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Andreas Hillenbrand
- Department of General and Visceral Surgery, Ulm University Hospital, Albert-Einstein-Alee 23, 89081, Ulm, Germany
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Zufferey P, Courvoisier DS, Nissen MJ, Möller B, Brulhart L, Ziswiler HR, Tamborrini G, Ciurea A, D'Agostino MA, Finckh A. Discordances between clinical and ultrasound measurements of disease activity among RA patients followed in real life. Joint Bone Spine 2019; 87:57-62. [PMID: 31557525 DOI: 10.1016/j.jbspin.2019.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/11/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Measurements of disease activity, such as the clinical disease activity score (DAS28) or ultrasound (US) scores, often yield discordant results. This study's objectives were to determine the proportion of disagreements between the two assessment methods in patients with rheumatoid arthritis (RA) and to describe factors associated with discrepancy in assessment. METHODS All RA patients in the Swiss registry for inflammatory arthritides (SCQM) with at least one concomitant DAS28 and US score, were included. Disease activity was categorized as remission, low-to-moderate, and high, based on previously established cut-offs, for both the DAS28 and the US score. A longitudinal analysis was performed among patients who underwent at least two assessments. RESULTS Of 2369 assessments included (1091 patients), 1196 (50.4%) were discordant. The US score both over- and under-estimated disease activity compared to the DAS28 score (23.5% and 26.8% respectively). Clinical and demographic factors significantly associated with discordant results were the individual components of the DAS28 score when US was used as the reference and age, disease duration, and the swollen joint count when the DAS28 was used as the reference. The main US-related factor associated with discordance was the presence of US tenosynovitis. In the longitudinal analysis of 1081 patients, the proportion of disagreements remained essentially unchanged. CONCLUSION Rates of disagreement between clinical and US assessments of disease activity among RA patients are high and remain high during follow-up, even when the US assessors were aware of the clinical examination findings. Both clinical- and ultrasound- related factors were associated with discordances.
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Affiliation(s)
| | | | | | | | - Laure Brulhart
- Hôpital neuchatelois, La chaud de fonds 2300, Switzerland
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Fujimori M, Kamishima T, Narita A, Henmi M, Kato M, Sutherland K, Nishida M, Tanaka Y, Yutong L, Tanimura K, Atsumi T. Quantitative power Doppler signal assessment in the subchondral bone region of the metacarpophalangeal joint is an effective predictor of radiographic progression in the hand of rheumatoid arthritis: a pilot study. Rheumatol Int 2019; 39:1413-1421. [PMID: 31089859 DOI: 10.1007/s00296-019-04320-w] [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: 02/13/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022]
Abstract
Ultrasonography is useful for assessment of synovitis in the hand of rheumatoid arthritis (RA) patients. The aim of this study was to investigate the predictive value of the quantitative power Doppler (PD) signal assessment in the subchondral bone region of the metacarpophalangeal (MCP) joint in patients with RA showing radiographic progression of the hand by comparing with those of previously reported scoring systems. Twenty-two patients (20 women) with RA who underwent power Doppler ultrasonography (PDUS) of the bilateral one to five MCP joints at baseline were included in the study. Radiography of both hands was performed at baseline and at 1 year. PDUS of the synovial space was evaluated according to semi-quantitative scoring (0-3) and quantitative measurement (0-100%). The PD signal in the subchondral bone region was qualitatively (0, 1) and quantitatively (mm2) assessed. The performance of PDUS assessment was compared using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and the risk ratio (RR). As a predictor for radiographic progression, the quantitative PD signal assessment in the subchondral bone region (AUC = 0.842, p < 0.01) was equivalent to quantitative vascularity (AUC = 0.817, p < 0.05) and semi-quantitative scoring (AUC = 0.754, p < 0.05). As for the RR of the PD signal in the subchondral bone region for radiographic progression, the quantitative PD signal assessment was 5.40 (p < 0.01), whereas the qualitative PD signal assessment was 1.60 (p = 0.204). Quantitative PD signal assessment in the subchondral bone region can predict radiographic progression in the hand of RA patients.
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Affiliation(s)
- Motoshi Fujimori
- Graduate School of Health Sciences, Hokkaido University, North-12 West-5, Kita-ku, Sapporo, 060-0812, Japan
| | - Tamotsu Kamishima
- Faculty of Health Sciences, Hokkaido University, North-12 West-5, Kita-ku, Sapporo, 060-0812, Japan.
| | - Akihiro Narita
- Hokkaido Medical Center for Rheumatic Diseases, Kotoni 1-3-1-45, Nishi-ku, Sapporo, 063-0811, Japan
| | - Mihoko Henmi
- Hokkaido Medical Center for Rheumatic Diseases, Kotoni 1-3-1-45, Nishi-ku, Sapporo, 063-0811, Japan
| | - Masaru Kato
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North-15 West-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Kenneth Sutherland
- Global Station for Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, North-15 West-7, Kita-ku, Sapporo, 060-8638, Japan
| | - Mutsumi Nishida
- Division of Laboratory and Transfusion Medicine/Diagnostic Center for Sonography, Hokkaido University Hospital, North-14 West-5, Kita-ku, Sapporo, 060-8648, Japan
| | - Yuki Tanaka
- Graduate School of Health Sciences, Hokkaido University, North-12 West-5, Kita-ku, Sapporo, 060-0812, Japan
| | - Lu Yutong
- Graduate School of Health Sciences, Hokkaido University, North-12 West-5, Kita-ku, Sapporo, 060-0812, Japan
| | - Kazuhide Tanimura
- Hokkaido Medical Center for Rheumatic Diseases, Kotoni 1-3-1-45, Nishi-ku, Sapporo, 063-0811, Japan
| | - Tatsuya Atsumi
- Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North-15 West-7, Kita-ku, Sapporo, 060-8638, Japan
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Fujimori M, Kamishima T, Kato M, Seno Y, Sutherland K, Sugimori H, Nishida M, Atsumi T. Composite assessment of power Doppler ultrasonography and MRI in rheumatoid arthritis: a pilot study of predictive value in radiographic progression after one year. Br J Radiol 2018; 91:20170748. [PMID: 29565675 DOI: 10.1259/bjr.20170748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Power Doppler ultrasonography (PDUS) and MRI are independently useful to predict structural damage in patients with rheumatoid arthritis (RA). We hypothesize that there is a complementary relationship between these modalities. The aim of this study is, therefore, to investigate the usefulness of the predictive value of composite assessment of PDUS and contrast-enhanced MRI in radiographic outcomes in patients with RA. METHODS 20 patients (17 females and 3 males) with RA on disease-modifying antirheumatic drugs underwent PDUS and MRI of both hands at baseline. Radiography of the bilateral hands was performed at baseline and at 1 year. Articular synovitis on PDUS was evaluated according to quantitative measurement. Synovitis, bone marrow edema and bone erosion were scored according to the RA MRI scoring method. The changes of joint space narrowing and bone erosion on radiograph were assessed by the Sharp/van der Heijde method. We applied t-statistics to combine the assessment of quantitative PDUS with semiquantitative MRI. RESULTS Structural damage progression for radiography was not correlated with any evaluations for MRI, while it showed significant correlation with synovitis on PDUS (rs = 0.597, p = 0.005). The composite assessment of both modalities (synovitis for PDUS and bone marrow edema for MRI) was correlated with structural damage progression on radiograph (rs = 0.792, p < 0.0001). CONCLUSION Composite assessment of PDUS and MRI may have a stronger predictive value in radiographic progression than PDUS or MRI alone in RA. Advances in knowledge: Composite assessment of PDUS and MRI may be an effective predictor of structural damage in RA.
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Affiliation(s)
- Motoshi Fujimori
- 1 Master Course of Health Sciences, Graduate School of Health Sciences, Hokkaido University, Sapporo , Hokkaido , Japan
| | - Tamotsu Kamishima
- 2 Department of Biomedical Science and Engineering, Faculty of Health Sciences, Hokkaido University , Hokkaido, Sapporo , Japan
| | - Masaru Kato
- 3 Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo , Japan
| | - Yumika Seno
- 4 Department of Health Sciences,Hokkaido University , Sapporo, Hokkaido , Japan
| | - Kenneth Sutherland
- 5 Global Station for Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University , Sapporo, Hokkaido , Japan.,6 Division of Photonic Bioimaging, Faculty of Medicine Research Center for Cooperative Projects, Hokkaido University , Sapporo , Japan
| | - Hiroyuki Sugimori
- 2 Department of Biomedical Science and Engineering, Faculty of Health Sciences, Hokkaido University , Hokkaido, Sapporo , Japan
| | - Mutsumi Nishida
- 7 Division of Laboratory and Transfusion Medicine/Diagnostic Center for Sonography, Hokkaido University Hospital , Sapporo, Hokkaido , Japan
| | - Tatsuya Atsumi
- 3 Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo , Japan
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