title: Correlation of structural abnormalities of the wrist and metacarpophalangeal joints evaluated by high-resolution peripheral quantitative computed tomography, 3 Tesla magnetic resonance imaging and conventional radiographs in rheumatoid arthritis.
abstract: OBJECTIVE
  In rheumatoid arthritis (RA) hands, we applied high-resolution peripheral quantitative computed tomography (HR-pQCT) and 3 Tesla (3 T) magnetic resonance imaging (MRI), which are new methods for erosion detection and bone marrow edema (BME) quantification. We compared the erosion measurements between these techniques with conventional radiographs (CR) in order to examine their significance for evaluating structural abnormalities.
  
  
  METHODS
  In 16 RA patients, HR-pQCT of metacarpophalangeal and wrist joints, 3 T MRI of wrist joints, as well as CR in both hands and feet were performed. Ten patients had 1-year follow-up CR. CRs were graded according to the modified Sharp score (MSS). Bone erosions were evaluated in HR-pQCT and MRI. BME pattern was quantified from MRI for volume, signal change and total burden.
  
  
  RESULTS
  The erosion detection sensitivity of MRI was 85.7% and CR was 60.9% when HR-pQCT was considered as a reference method. The smallest dimensions of erosion detected by HR-pQCT, MRI and CR were 0.09, 0.14 and 0.66 cm, respectively. Baseline total MSS was correlated with HR-pQCT erosion measures, MRI erosion measures and MRI BME volume (P < 0.05). The mean difference between baseline and 1-year follow-up MSS (delta MSS) was 1.2. A trend was observed toward a correlation between delta MSS and MRI BME volume and burden.
  
  
  CONCLUSIONS
  This study demonstrates that HR-pQCT detects more and smaller bone erosions compared to MRI and CR. In addition, 3 T MRI can provide quantitative measurement of BME. Combination of HR-pQCT and MRI modalities may provide powerful tools to evaluate joint inflammation and bone damage in RA.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.|Division of Rheumatology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, South Korea.
authors.forename: Chan Hee
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.|Department of Radiology, Thammasat University, Pathumthani, Thailand.
authors.forename: Waraporn
authors.initials: W
authors.lastname: Srikhum
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Burghardt
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.|Department of Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Warapat
authors.initials: W
authors.lastname: Virayavanich
authors.affiliation: Department of Medicine, University of California, San Francisco, California, USA.|Division of Rheumatology, San Francisco General Hospital, San Francisco, California, USA.
authors.forename: John B
authors.initials: JB
authors.lastname: Imboden
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Link
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging*; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging; D018450:Disease Progression; D004487:Edema / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014955:Wrist Joint / Q000000981:diagnostic imaging*
keywords: 3 Tesla magnetic resonance imaging; conventional radiograph; erosion; high-resolution peripheral quantitative computed tomography; rheumatoid arthritis