title: Reliability of different Doppler ultrasound quantification methods and devices in the assessment of therapeutic response in arthritis.
abstract: OBJECTIVE
  To evaluate the metric qualities of power Doppler ultrasound (PDUS) for different quantification methods and devices in the assessment of arthritis during anti-inflammatory treatment.
  
  
  METHODS
  Twenty-four patients with active arthritis and first-time treatment with the TNF-alpha inhibitor adalimumab underwent sequential clinical, laboratory and US examination at baseline, weeks 2, 6 and 12. 2D and 3D PDUS was performed by two independent investigators. The images and movies were scored from 0 to 3 and the amount of colour pixels and voxels was calculated. In addition, the resistance index of a synovial artery was measured. Thirteen patients were examined with a second US machine.
  
  
  RESULTS
  Treatment response was already observed at week 2 with a significant reduction of 2D (P < 0.01) and 3D scores (P < 0.001). A moderate correlation to 28-joint disease activity score was found for 3D voxel count (r(s) = 0.35, P < 0.001). Interobserver agreement was kappa or ICC >or= 0.8 for all methods except the resistance index (ICC = 0.60). Intermachine agreement was kappa = 0.57 for 2D PDUS score.
  
  
  CONCLUSIONS
  The study demonstrates good to excellent interobserver and moderate intermachine reliability of different PDUS assessment methods in a longitudinal open-label study.
authors.affiliation: Department of Rheumatology and Immunology, University of Giessen, Kerckhoff Klinik, Benekestr.2-8, 61231 Bad Nauheim, Germany. k.albrecht@kerckhoff-klinik.de
authors.forename: K
authors.initials: K
authors.lastname: Albrecht
authors.forename: K
authors.initials: K
authors.lastname: Grob
authors.forename: U
authors.initials: U
authors.lastname: Lange
authors.forename: U
authors.initials: U
authors.lastname: Müller-Ladner
authors.forename: J
authors.initials: J
authors.lastname: Strunk
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001168:Arthritis / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D013583:Synovial Membrane / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D018608:Ultrasonography, Doppler / Q000379:methods; D014955:Wrist Joint / Q000000981:diagnostic imaging
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab