eprintid: 10177493 rev_number: 13 eprint_status: archive userid: 699 dir: disk0/10/17/74/93 datestamp: 2023-09-26 07:42:50 lastmod: 2024-02-16 10:48:15 status_changed: 2023-09-26 07:42:50 type: article metadata_visibility: show sword_depositor: 699 creators_name: Jones, Alexis creators_name: Bray, Timothy creators_name: Sakai, Naomi creators_name: Bainbridge, Alan creators_name: Ciurtin, Coziana creators_name: Hall-Craggs, Margaret title: Measuring response to treatment in axial spondyloarthritis using quantitative imaging biomarkers: a prospective observational cohort study ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 note: © The British Institute of Radiology This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 Unported License http://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted non-commercial reuse, provided the original author and source are credited. abstract: Objective: Objective assessments of disease activity and response to treatment in axial spondyloarthritis (axSpA) remain a challenge; quantitative imaging biomarkers (QIBs) of inflammation could enhance assessments of disease activity and therapeutic response. We aimed to determine the responsiveness of QIBs obtained from diffusion-weighted imaging (DW-MRI) and chemical shift-encoded MRI (CSE-MRI) using the partially automated Bone Edema and Adiposity Characterisation with Histograms (BEACH) software tool in axSpA patients undergoing biologic therapy. Methods: We conducted a prospective longitudinal cohort study, including 30 patients with axSpA undergoing biologic therapy. Patients were scanned before and after biologic therapy using conventional MRI, DWI and CSE-MRI at 3T. Apparent diffusion coefficient (ADC) and proton density fat fraction (PDFF) were assessed using the BEACH tool (https://github.com/TJPBray/BEACH), and conventional MR images were assessed using established visual scoring methods by expert radiologists. Responsiveness – the ability of the MRI measurements to capture changes in disease occurring as a result of biologic therapy – was assessed using the standardized response mean (SRM). Inter-reader reliability of the ADC and PDFF maps was assessed using Bland-Altman limits of agreement analysis and the intraclass correlation coefficient. Results: Responsiveness to therapy was moderate for ADC-based parameters (SRM 0.50) and comparable to established visual scoring methods for bone marrow oedema (SRM 0.53). Interobserver variability was lower for QIBs compared with conventional visual scores methods. Conclusions: QIBs measured using the BEACH tool are sensitive to changes in inflammation in axSpA following biologic therapy, with similar responsiveness and lower interobserver variability to visual scoring by expert radiologists. Advances in knowledge: QIBs measured using the partially automated BEACH tool offer an objective measure of response to biologic therapy in axSpA. date: 2023-12-01 date_type: published publisher: British Institute of Radiology official_url: https://doi.org/10.1259/bjr.20220530 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2090794 doi: 10.1259/bjr.20220530 lyricists_name: Bray, Timothy lyricists_id: TBRAY81 actors_name: Bray, Timothy actors_id: TBRAY81 actors_role: owner full_text_status: public publication: British Journal of Radiology volume: 96 number: 1152 issn: 0007-1285 citation: Jones, Alexis; Bray, Timothy; Sakai, Naomi; Bainbridge, Alan; Ciurtin, Coziana; Hall-Craggs, Margaret; (2023) Measuring response to treatment in axial spondyloarthritis using quantitative imaging biomarkers: a prospective observational cohort study. British Journal of Radiology , 96 (1152) 10.1259/bjr.20220530 <https://doi.org/10.1259/bjr.20220530>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10177493/1/Bray_bjr.20220530.pdf