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Xu Q, Xu XH, Liu ZZ, Zhu JB, Ding HH, Jin CC, Yan ZH. Efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation for synovial hyperplasia. Int J Hyperthermia 2024; 41:2328113. [PMID: 38964750 DOI: 10.1080/02656736.2024.2328113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/03/2024] [Indexed: 07/06/2024] Open
Abstract
PURPOSE This study aimed to investigate the efficacy and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) for the treatment of synovial hyperplasia in the knee joints of antigen-induced arthritis (AIA) model rabbits. METHODS Forty Japanese large-eared white rabbits were divided into AIA and control groups. After successful induction of the AIA model, the knee joints were randomly assigned to RFA and non-RFA groups. The RFA group underwent ultrasound-guided RFA to treat synovial hyperplasia in the knee joint. Dynamic observation of various detection indices was conducted to evaluate the safety and effectiveness of the RFA procedure. RESULTS Successful synovial ablation was achieved in the RFA group, with no intraoperative or perioperative mortality. Postoperative the circumference of the knee joint reached a peak before decreasing in the third week after surgery. The incidence and diameter of postoperative skin ulcers were not significantly different compared to the non-RFA group (p > .05). Anatomical examination revealed an intact intermuscular fascia around the ablated area in the RFA group. The ablated synovial tissue initially presented as a white mass, which subsequently liquefied into a milky white viscous fluid. Gross articular cartilage was observed, along with liquefied necrosis of the synovium on pathological histology and infiltration of inflammatory cells in the surrounding soft tissue. CONCLUSION The experimental results demonstrated that ultrasound-guided RFA of the knee in the treatment of synovial hyperplasia in AIA model animals was both effective and safe.
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Affiliation(s)
- Qi Xu
- Department of Ultrasound, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
| | - Xiao-Hui Xu
- Department of Medical and Health Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ze-Zheng Liu
- Department of Ultrasound, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
| | - Jian-Bi Zhu
- Department of Ultrasound, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
| | - Huan-Huan Ding
- Department of Ultrasound, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
| | - Chun-Chun Jin
- Department of Ultrasound, Third Affiliated Hospital of Shanghai University, Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, China
| | - Zhi-Han Yan
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou Key Laboratory of Structural and Functional Imaging, Wenzhou, China
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Liu H, Chen S, Huang C, Zheng Q, Ye Y, Ye Z, Lyu G. Longitudinal Changes in Knee Joint Synovial Vascularity in a Rabbit Model of Rheumatoid Arthritis: Quantification Using Power Doppler Ultrasound and Contrast-Enhanced Ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2430-2441. [PMID: 33958258 DOI: 10.1016/j.ultrasmedbio.2021.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 02/24/2021] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
We studied a rabbit model of rheumatoid arthritis (RA) to examine the time course of changes in synovial neovascularization based on quantitative power Doppler ultrasound and contrast-enhanced ultrasound (CEUS). Twenty-five male New Zealand rabbits were in the ovalbumin-induced arthritis (OIA) group, and 5 were in the control group. Both rear knee joints of all rabbits were examined using conventional US and CEUS over 16 weeks. The knee synoviums of OIA rabbits were sampled by US-guided biopsy, and expression of CD31 and vascular endothelial growth factor (VEGF) was determined by immunohistochemistry. The correlation of joint damage based on multimodal US with microvessel density (CD31 positivity) and VEGF expression at different times was analyzed. OIA rabbits had increased synovial expression of CD31 and VEGF from weeks 6 to 12 (p < 0.01). During the early stage of CEUS enhancement, "dot enhancement" was more common at weeks 6 and 8, and "stripe enhancement" was more common at weeks 12 and 16 (p < 0.05). There were significant positive correlations of synovial CD31 and VEGF expression with power Doppler image grade, CEUS grade and peak intensity (p < 0.05 for all). Thus, OIA rabbits mimicked early-stage RA at 6 to 8 weeks, middle-stage RA at 8 to 12 weeks and late-stage RA at 12 to 16 weeks. Power Doppler image grade, CEUS grade and peak intensity, especially when combined with CD31 expression data, accurately characterized the extent of synovial vascularization in a rabbit model of RA. Increased vascularity based on CEUS may have value for the early diagnosis of RA.
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Affiliation(s)
- Hui Liu
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Shuqiang Chen
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Chao Huang
- Department of Nuclear Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qing Zheng
- Department of Hematology and Rheumatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yuhong Ye
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhen Ye
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Guorong Lyu
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China; Department of Clinical Medicine, Quanzhou Medical College, Quanzhou, China.
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Gong Y, Huang Y, Su Y, He J, Chen S. Value of Contrast-Enhanced Ultrasonography in Evaluating Rheumatoid Arthritis: Preliminary Research Based on an Animal Model. Med Sci Monit 2021; 27:e931327. [PMID: 34172694 PMCID: PMC8243804 DOI: 10.12659/msm.931327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the effectiveness of grayscale ultrasound (GSUS), power Doppler imaging (PDI), and contrast-enhanced ultrasonography (CEUS) in early rheumatoid arthritis (RA) diagnosis through animal experiments. MATERIAL AND METHODS A rabbit RA model was constructed. The animals were randomly divided into 2 groups, namely, the RA model group and the control group. GSUS, PDI, and CEUS were performed in the model group during early RA and were compared with pathology of synovial biopsies. The consistency of 3 types of ultrasonography was evaluated in tandem with pathological grading. RESULTS 23 rabbits in the RA model group completed the experiment. GSUS showed that the synovial thickening of grades 1, 2 and 3 occurred in 12, 19, and 15 joints, respectively. The sensitivity, specificity, and accuracy of PDI in the diagnosis of knee joint synovitis in RA grades 1, 2, and 3 were 80.56% (29/36), 60.00% (6/10), and 76.09% (35/46), respectively, while those with CEUS were 94.44% (34/36), 90.00% (9/10), and 93.47% (43/46), respectively. The differences in diagnostic sensitivity, specificity, and accuracy of the 2 methods were statistically significant. Additionally, the thickness of the synovium measured with GSUS precontrast was greater than that of postcontrast. CONCLUSIONS RA evaluated with GSUS is often more hypertrophied than when evaluated with CEUS, while evaluation by PDI is less hypertrophied than that by CEUS. However, from a practical view point, GSUS and PDI are of sufficient practical value, except for in a few special cases.
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Affiliation(s)
- Yiran Gong
- Department of Ultrasonic Imaging, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Yinan Huang
- Department of Ultrasonic Imaging, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Yiming Su
- Department of Ultrasonic Imaging, First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China (mainland)
| | - Juxin He
- Department of Ultrasonic Imaging, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Shuqiang Chen
- Department of Ultrasonic Imaging, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
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Puentes-Osorio Y, Amariles P, Calleja MÁ, Merino V, Díaz-Coronado JC, Taborda D. Potential clinical biomarkers in rheumatoid arthritis with an omic approach. AUTOIMMUNITY HIGHLIGHTS 2021; 12:9. [PMID: 34059137 PMCID: PMC8165788 DOI: 10.1186/s13317-021-00152-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/18/2021] [Indexed: 12/29/2022]
Abstract
Objective To aid in the selection of the most suitable therapeutic option in patients with diagnosis of rheumatoid arthritis according to the phase of disease, through the review of articles that identify omics biological markers. Methods A systematic review in PubMed/Medline databases was performed. We searched articles from August 2014 to September 2019, in English and Spanish, filtered by title and full text; and using the terms "Biomarkers" AND “Rheumatoid arthritis". Results This article supplies an exhaustive review from research of objective measurement, omics biomarkers and how disease activity appraise decrease unpredictability in treatment determinations, and finally, economic, and clinical outcomes of treatment options by biomarkers’ potential influence. A total of 122 articles were included. Only 92 met the established criteria for review purposes and 17 relevant references about the topic were included as well. Therefore, it was possible to identify 196 potential clinical biomarkers: 22 non-omics, 20 epigenomics, 33 genomics, 21 transcriptomics, 78 proteomics, 4 glycomics, 1 lipidomics and 17 metabolomics. Conclusion A biomarker is a measurable indicator of some, biochemical, physiological, or morphological condition; evaluable at a molecular, biochemical, or cellular level. Biomarkers work as indicators of physiological or pathological processes, or as a result of a therapeutic management. In the last five years, new biomarkers have been identified, especially the omics, which are those that proceed from the investigation of genes (genomics), metabolites (metabolomics), and proteins (proteomics). These biomarkers contribute to the physician choosing the best therapeutic option in patients with rheumatoid arthritis.
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Liu H, Huang C, Chen S, Zheng Q, Ye Y, Ye Z, Lv G. Value of contrast-enhanced ultrasound for detection of synovial vascularity in experimental rheumatoid arthritis: an exploratory study. J Int Med Res 2019; 47:5740-5751. [PMID: 31547746 PMCID: PMC6862898 DOI: 10.1177/0300060519874159] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/15/2019] [Indexed: 12/27/2022] Open
Abstract
Objective This study aimed to examine the associations between contrast-enhanced ultrasound (CEUS) imaging and synovial hypervascularity and synovitis score in a rabbit model of antigen-induced arthritis (AIA), compared with power Doppler ultrasound (PDUS). Methods We investigated 50 knee joints in 25 AIA rabbits (AIA group), and 10 knee joints in five sham-injected rabbits (control group). PDUS and CEUS images were evaluated at the 8th week. Ultrasound-guided synovial biopsies were targeted in the area with hypervascularity, and synovial microvessel density (MVD) was evaluated by immunohistochemical staining of CD31. Results The PDUS score was significantly higher in the AIA group (2.61 ± 0.78) compared with the control group (0.50 ± 0.53). CEUS in the AIA group revealed a fast-in/slow-out pattern of contrast enhancement. MVD revealed by CD31+ vessel count and the synovitis score were significantly higher in the AIA group compared with the control group. In the AIA group, CEUS findings showed a better correlation with MVD revealed by CD31+ and synovitis score than PDUS findings. Conclusion CEUS is superior to PDUS for estimating synovial hypervascularity and hyperplasia in experimental rheumatoid arthritis.
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Affiliation(s)
- Hui Liu
- Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Chao Huang
- Department of Nuclear Medicine, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Shuqiang Chen
- Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Qing Zheng
- Department of Hematology and Rheumatology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yuhong Ye
- Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhen Ye
- Department of Ultrasound, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Guorong Lv
- Department of Ultrasound, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
- Department of Clinical Medicine, Quanzhou Medical College, Quanzhou, China
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Naredo E, Medina JP, Pérez-Baos S, Mediero A, Herrero-Beaumont G, Largo R. Validation of Musculoskeletal Ultrasound in the Assessment of Experimental Gout Synovitis. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1516-1524. [PMID: 29703511 DOI: 10.1016/j.ultrasmedbio.2018.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 06/08/2023]
Abstract
The objective of this study was to validate musculoskeletal ultrasound (US) in a rabbit model of acute gout. Acute gout was induced by intra-articular injection of monosodium urate (MSU) crystals in 10 rabbits; the 3 controls received vehicle. Rabbit knees were assessed by B-mode and power Doppler (PD) US 24 and 72 h after injections. After 72 h, all rabbits were euthanized. US discriminated between the MSU-injected and control groups with respect to the different inflammatory findings at both at 24 and 72 h and for MSU crystal-related findings after 24 h of injection. US synovial thickening, intra-synovial power Doppler signal and global joint distension significantly correlated with the synovial global histopathological score (r = 0.47, p = 0.0188), tissue vascularization measured by CD31 immunohistochemical-positive staining (r = 0.46, p = 0.0172) and tissue levels of interleukin-1β (r = 0.53, p = 0.0078), respectively. US is a valid method for assessment of synovial inflammation in experimental gouty arthritis in rabbits.
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Affiliation(s)
- Esperanza Naredo
- Bone and Joint Research Unit, Department of Rheumatology, Hospital Universitario Fundación Jiménez Díaz, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Juan Pablo Medina
- Bone and Joint Research Unit, Department of Rheumatology, Hospital Universitario Fundación Jiménez Díaz, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Sandra Pérez-Baos
- Bone and Joint Research Unit, Department of Rheumatology, Hospital Universitario Fundación Jiménez Díaz, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Aranzazu Mediero
- Bone and Joint Research Unit, Department of Rheumatology, Hospital Universitario Fundación Jiménez Díaz, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
| | - Gabriel Herrero-Beaumont
- Bone and Joint Research Unit, Department of Rheumatology, Hospital Universitario Fundación Jiménez Díaz, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain.
| | - Raquel Largo
- Bone and Joint Research Unit, Department of Rheumatology, Hospital Universitario Fundación Jiménez Díaz, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain
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