title: Measuring bone erosion and edema in rheumatoid arthritis: a comparison of manual segmentation and RAMRIS methods.
abstract: OBJECTIVE
  To investigate the reliability, feasibility, and validity of a computer-assisted manual segmentation (outlining) technique for measuring magnetic resonance imaging (MRI) bone erosion and edema at the wrist in rheumatoid arthritis (RA).
  
  
  METHODS
  The 3T MRI scans were obtained in 22 RA patients (<2 years). Bone erosion and edema volumes were scored by two readers using outlining and were compared with RAMRIS scores.
  
  
  RESULTS
  Using outlining, intraobserver reliability for erosions and edema was high: intraclass correlation coefficients (ICCs) = 0.994 (0.991, 0.997) and 0.996 (0.994, 0.998), respectively (Reader 1). Interobserver reliability was high for bone erosion (ICC [90% confidence interval, CI] = 0.80 [0.64, 0.92]) and comparable to RAMRIS scoring (ICC 0.78 [0.64, 0.92]), but was only moderate for bone edema (0.46 [0.00, 0.96]), compared with RAMRIS (ICC = 0.84 [0.73, 0.94]). The methods were highly correlated for erosion scores, r = 0.90, 0.82 (Readers 1 and 2) and moderately correlated for edema, r = 0.57, 0.87.
  
  
  CONCLUSIONS
  Segmentation (outlining) can be used to measure the volume of MRI bone erosion and edema at the wrist in RA patients. When compared with RAMRIS scoring, outlining had similar reliability for quantifying erosions but reliability was lower for bone edema, possibly reflecting difficulty delineating the borders of affected bone.
authors.affiliation: Department of Rheumatology, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand. f.mcqueen@auckland.ac.nz
authors.forename: Angela R
authors.initials: AR
authors.lastname: Crowley
authors.forename: Jing
authors.initials: J
authors.lastname: Dong
authors.forename: Alex
authors.initials: A
authors.lastname: McHaffie
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Clarke
authors.forename: Quentin
authors.initials: Q
authors.lastname: Reeves
authors.forename: Megan
authors.initials: M
authors.lastname: Williams
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Robinson
authors.forename: Nicola
authors.initials: N
authors.lastname: Dalbeth
authors.forename: Fiona M
authors.initials: FM
authors.lastname: McQueen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis*; D001185:Artificial Intelligence; D004487:Edema / Q000175:diagnosis* / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010014:Osteolysis / Q000175:diagnosis* / Q000209:etiology; D010363:Pattern Recognition, Automated / Q000379:methods*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014955:Wrist Joint / Q000473:pathology