Spondyloarthritis research consortium of Canada magnetic resonance Imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis

W P Maksymowych, R D Inman, D Salonen, S S Dhillon, M Williams, M Stone, B Conner-Spady, J Palsat, R G W Lambert

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Abstract

Objective. To develop a feasible magnetic resonance imaging (MRI)-based scoring system for sacroiliac joint inflammation in patients with ankylosing spondylitis (AS) that requires minimal scan time, does not require contrast enhancement, evaluates lesions separately at each articular surface, and limits the number of sacroiliac images that are scored. Methods. A scoring method based on the assessment of increased signal denoting bone marrow edema on T2-weighted STIR sequences was used. MRI films were assessed blindly in random order at 2 sites by multiple readers. Intra- and interreader reliability was assessed by intraclass correlation coefficient (ICC); the 24-week response of patients with AS randomized to placebo: infliximab (3:8) was assessed by effect size and standardized response mean. The reliability and responsiveness of the scoring method were compared for STIR and gadolinium diethylenetriaminepentaacetic (GdDTPA)-enhanced MRI sequences. Results. We scanned 11 patients with AS with clinically active disease and 11 additional patients randomized to the trial of infliximab therapy. ICC for total sacroiliac joint STIR score ranged from 0.90 to 0.98 (P < 0.00001) and interobserver ICC for combined readers from the 2 sites was 0.84 (P < 0.0001). ICC for change scores was lower for STIR (ICC 0.53) than for Gd-DTPA-enhanced sequences (ICC 0.79). Responsiveness was poor, although fusion was evident in one-third of patients who received treatment (placebo:infliximab) and inflammation scores were low. Conclusion. The Spondyloarthritis Research Consortium of Canada MRI index is a feasible and reproducible index for measuring sacroiliac joint inflammation in patients with AS.
LanguageEnglish
Pages703-709
Number of pages7
JournalArthritis & Rheumatism
Volume53
Issue number5
DOIs
StatusPublished - 2005

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Sacroiliac Joint
Ankylosing Spondylitis
Canada
Magnetic Resonance Imaging
Inflammation
Research
Research Design
Placebos
Gadolinium DTPA
Gadolinium
Edema
Joints
Bone Marrow
Therapeutics
Infliximab

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Maksymowych, W. P., Inman, R. D., Salonen, D., Dhillon, S. S., Williams, M., Stone, M., ... Lambert, R. G. W. (2005). Spondyloarthritis research consortium of Canada magnetic resonance Imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis. DOI: 10.1002/art.21445

Spondyloarthritis research consortium of Canada magnetic resonance Imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis. / Maksymowych, W P; Inman, R D; Salonen, D; Dhillon, S S; Williams, M; Stone, M; Conner-Spady, B; Palsat, J; Lambert, R G W.

In: Arthritis & Rheumatism, Vol. 53, No. 5, 2005, p. 703-709.

Research output: Contribution to journalArticle

Maksymowych, WP, Inman, RD, Salonen, D, Dhillon, SS, Williams, M, Stone, M, Conner-Spady, B, Palsat, J & Lambert, RGW 2005, 'Spondyloarthritis research consortium of Canada magnetic resonance Imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis' Arthritis & Rheumatism, vol. 53, no. 5, pp. 703-709. DOI: 10.1002/art.21445
Maksymowych, W P ; Inman, R D ; Salonen, D ; Dhillon, S S ; Williams, M ; Stone, M ; Conner-Spady, B ; Palsat, J ; Lambert, R G W. / Spondyloarthritis research consortium of Canada magnetic resonance Imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis. In: Arthritis & Rheumatism. 2005 ; Vol. 53, No. 5. pp. 703-709
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abstract = "Objective. To develop a feasible magnetic resonance imaging (MRI)-based scoring system for sacroiliac joint inflammation in patients with ankylosing spondylitis (AS) that requires minimal scan time, does not require contrast enhancement, evaluates lesions separately at each articular surface, and limits the number of sacroiliac images that are scored. Methods. A scoring method based on the assessment of increased signal denoting bone marrow edema on T2-weighted STIR sequences was used. MRI films were assessed blindly in random order at 2 sites by multiple readers. Intra- and interreader reliability was assessed by intraclass correlation coefficient (ICC); the 24-week response of patients with AS randomized to placebo: infliximab (3:8) was assessed by effect size and standardized response mean. The reliability and responsiveness of the scoring method were compared for STIR and gadolinium diethylenetriaminepentaacetic (GdDTPA)-enhanced MRI sequences. Results. We scanned 11 patients with AS with clinically active disease and 11 additional patients randomized to the trial of infliximab therapy. ICC for total sacroiliac joint STIR score ranged from 0.90 to 0.98 (P < 0.00001) and interobserver ICC for combined readers from the 2 sites was 0.84 (P < 0.0001). ICC for change scores was lower for STIR (ICC 0.53) than for Gd-DTPA-enhanced sequences (ICC 0.79). Responsiveness was poor, although fusion was evident in one-third of patients who received treatment (placebo:infliximab) and inflammation scores were low. Conclusion. The Spondyloarthritis Research Consortium of Canada MRI index is a feasible and reproducible index for measuring sacroiliac joint inflammation in patients with AS.",
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AU - Maksymowych,W P

AU - Inman,R D

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AU - Dhillon,S S

AU - Williams,M

AU - Stone,M

AU - Conner-Spady,B

AU - Palsat,J

AU - Lambert,R G W

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N2 - Objective. To develop a feasible magnetic resonance imaging (MRI)-based scoring system for sacroiliac joint inflammation in patients with ankylosing spondylitis (AS) that requires minimal scan time, does not require contrast enhancement, evaluates lesions separately at each articular surface, and limits the number of sacroiliac images that are scored. Methods. A scoring method based on the assessment of increased signal denoting bone marrow edema on T2-weighted STIR sequences was used. MRI films were assessed blindly in random order at 2 sites by multiple readers. Intra- and interreader reliability was assessed by intraclass correlation coefficient (ICC); the 24-week response of patients with AS randomized to placebo: infliximab (3:8) was assessed by effect size and standardized response mean. The reliability and responsiveness of the scoring method were compared for STIR and gadolinium diethylenetriaminepentaacetic (GdDTPA)-enhanced MRI sequences. Results. We scanned 11 patients with AS with clinically active disease and 11 additional patients randomized to the trial of infliximab therapy. ICC for total sacroiliac joint STIR score ranged from 0.90 to 0.98 (P < 0.00001) and interobserver ICC for combined readers from the 2 sites was 0.84 (P < 0.0001). ICC for change scores was lower for STIR (ICC 0.53) than for Gd-DTPA-enhanced sequences (ICC 0.79). Responsiveness was poor, although fusion was evident in one-third of patients who received treatment (placebo:infliximab) and inflammation scores were low. Conclusion. The Spondyloarthritis Research Consortium of Canada MRI index is a feasible and reproducible index for measuring sacroiliac joint inflammation in patients with AS.

AB - Objective. To develop a feasible magnetic resonance imaging (MRI)-based scoring system for sacroiliac joint inflammation in patients with ankylosing spondylitis (AS) that requires minimal scan time, does not require contrast enhancement, evaluates lesions separately at each articular surface, and limits the number of sacroiliac images that are scored. Methods. A scoring method based on the assessment of increased signal denoting bone marrow edema on T2-weighted STIR sequences was used. MRI films were assessed blindly in random order at 2 sites by multiple readers. Intra- and interreader reliability was assessed by intraclass correlation coefficient (ICC); the 24-week response of patients with AS randomized to placebo: infliximab (3:8) was assessed by effect size and standardized response mean. The reliability and responsiveness of the scoring method were compared for STIR and gadolinium diethylenetriaminepentaacetic (GdDTPA)-enhanced MRI sequences. Results. We scanned 11 patients with AS with clinically active disease and 11 additional patients randomized to the trial of infliximab therapy. ICC for total sacroiliac joint STIR score ranged from 0.90 to 0.98 (P < 0.00001) and interobserver ICC for combined readers from the 2 sites was 0.84 (P < 0.0001). ICC for change scores was lower for STIR (ICC 0.53) than for Gd-DTPA-enhanced sequences (ICC 0.79). Responsiveness was poor, although fusion was evident in one-third of patients who received treatment (placebo:infliximab) and inflammation scores were low. Conclusion. The Spondyloarthritis Research Consortium of Canada MRI index is a feasible and reproducible index for measuring sacroiliac joint inflammation in patients with AS.

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