title: Synovitis and bone inflammation in early rheumatoid arthritis: high-resolution multi-pinhole SPECT versus MRI.
abstract: OBJECTIVE
  We aimed to assess the relationship between bone inflammation in multi-pinhole single-photon emission computed tomography (MPH-SPECT) and synovitis detected by magnetic resonance imaging (MRI) in early rheumatoid arthritis patients.
  
  
  METHODS
  MPH-SPECT with technetium dicarboxypropanedisphosphonate (Tc-99mDPD) and 3 Tesla MRI were performed in 10 early rheumatoid arthritis patients. Eighty finger joint sites were assessed for increased osteoblastic activity using visual and region-of-interest (ROI) analysis. Presence of joint inflammation in MRI was investigated using the subscores of the rheumatoid arthritis MRI score.
  
  
  RESULTS
  Tc-99mDPD uptake was increased in 38 (47.5%) and 22 (27.5%) joint sites as determined by visual and ROI analysis, respectively. A total of 32 (84.2%) sites with increased bone metabolism showed a normal MRI bone signal. The MPH-SPECT uptake ratio was elevated only in the subgroup with severe synovitis (P < 0.001).
  
  
  CONCLUSIONS
  In early rheumatoid arthritis, molecular imaging with MPH-SPECT detects higher rates of inflammatory bone involvement compared to MRI. Our preliminary data suggest that osteitis is related to severe synovitis.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Univ Dusseldorf, Medical Faculty, Dusseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Buchbender
authors.forename: Benedikt
authors.initials: B
authors.lastname: Ostendorf
authors.forename: Katalin
authors.initials: K
authors.lastname: Mattes-György
authors.forename: Falk
authors.initials: F
authors.lastname: Miese
authors.forename: Hans-Joerg
authors.initials: HJ
authors.lastname: Wittsack
authors.forename: Michael
authors.initials: M
authors.lastname: Quentin
authors.forename: Christof
authors.initials: C
authors.lastname: Specker
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Hans-Wilhelm
authors.initials: HW
authors.lastname: Müller
authors.forename: Axel
authors.initials: A
authors.lastname: Scherer
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging* / Q000473:pathology*; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010000:Osteitis / Q000175:diagnosis* / Q000209:etiology; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D013585:Synovitis / Q000175:diagnosis* / Q000209:etiology; D017556:Technetium Compounds; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D005682:Gadolinium