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A diffusion-based quantification technique for assessment of sacroiliitis in adolescents with enthesitis-related arthritis

Vendhan, K; Bray, TJ; Atkinson, D; Punwani, S; Fisher, C; Sen, D; Ioannou, Y; (2016) A diffusion-based quantification technique for assessment of sacroiliitis in adolescents with enthesitis-related arthritis. British Journal of Radiology , 89 (1059) , Article 20150775. 10.1259/bjr.20150775. Green open access

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Abstract

OBJECTIVE: To investigate the use of a quantitative diffusion-weighted imaging (DWI) tool for measuring inflammation of the sacroiliac joints (SIJs) in enthesitis-related arthritis (ERA). METHODS: A retrospective study was performed with institutional review board approval. Subjects were adolescents who had undergone MRI of the SIJs since January 2010. 10 patients with a clinical diagnosis of ERA and 10 controls with a clinical diagnosis of mechanical back pain were assessed. Axial T1 weighted, short tau inversion recovery (STIR) and DWI (b-values 0, 50, 100, 300 and 600 mm(2) s(-1)) images were acquired. Apparent diffusion coefficient (ADC) maps were generated using a monoexponential fit. On each of four slices, two to three linear regions-of-interest were placed on each joint. Normalized ADC (nADC) values were defined as joint ADC divided by a reference ADC derived from normal sacral bone. STIR images were scored using a modification of an established technique. The correlation between nADC values and STIR scores was evaluated using Spearman's rank correlation. RESULTS: Mean nADC values were significantly higher in cases than in controls (p = 0.0015). There was a strong correlation between STIR scores and nADC values (R = 0.85). CONCLUSION: ADC values are significantly increased in inflamed SIJs compared with controls. There is a good correlation between this diffusion-based method and STIR scores of inflammation. ADVANCES IN KNOWLEDGE: We have described and provisionally validated a method for quantifying the severity of inflammation in the SIJs in ERA using ADC measurements. This method is quick, is reproducible and could potentially be automated.

Type: Article
Title: A diffusion-based quantification technique for assessment of sacroiliitis in adolescents with enthesitis-related arthritis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1259/bjr.20150775
Publisher version: http://dx.doi.org/10.1259/bjr.20150775
Language: English
Additional information: This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Keywords: Adolescent, Adult, Arthritis, Juvenile, Child, Diffusion Magnetic Resonance Imaging, Female, Humans, Image Enhancement, Male, Reproducibility of Results, Retrospective Studies, Sacroiliac Joint, Sacroiliitis, Sensitivity and Specificity, Severity of Illness Index, Young Adult
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Metabolism and Experi Therapeutics
URI: https://discovery.ucl.ac.uk/id/eprint/1475472
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