title: Computer-aided and manual quantifications of MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss in rheumatoid arthritis of the wrist.
abstract: OBJECTIVE
  To investigate the reliability and validity of computer-aided automated and manual quantification as well as semiquantitative analysis for MRI synovitis, bone marrow edema-like lesions, erosion and cartilage loss of the wrist in rheumatoid arthritis (RA) compared to the OMERACT-RAMRIS.
  
  
  METHODS
  Wrist MRI was performed at 3 T in 16 patients with RA. Synovial volume and perfusion, bone marrow edema-like lesion (BMEL) volume, signal intensity and perfusion, and erosion dimensions were measured manually and using an in-house-developed automated software algorithm; findings were correlated with the OMERAC-RAMRIS gradings. In addition, a semiquantitative MRI cartilage loss score system was developed. Intraclass correlation coefficients (ICCs) were used to test the reproducibility of these quantitative and semiquantitative techniques. Spearman correlation coefficients were calculated between lesion quantifications and RAMRIS and between the MRI cartilage score and radiographic Sharp van der Heijde joint space narrowing scores.
  
  
  RESULTS
  The intra- and interobserver ICCs were excellent for synovial, BMEL and erosion quantifications and cartilage loss grading (all >0.89). The synovial volume, BMEL volume and signal intensity, and erosion dimensions were significantly correlated with the corresponding RAMRIS (r = 0.727 to 0.900, p < 0.05). Synovial perfusion parameter maximum enhancement (Emax) was significantly correlated with synovitis RAMRIS (r = 0.798). BMEL perfusion parameters were not correlated with the RAMRIS BME score. Cartilage loss gradings from MRI were significantly correlated with the Sharp joint space narrowing scores (r = 0.635, p = 0.008).
  
  
  CONCLUSIONS
  The computer-aided, manual and semiquantitative methods presented in this study can be used to evaluate MRI pathologies in RA with excellent reproducibility. Significant correlations with standard RAMRIS were found in the measurements using these methods.
authors.affiliation: Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China, frankyang119@126.com.
authors.forename: Haitao
authors.initials: H
authors.lastname: Yang
authors.forename: Julien
authors.initials: J
authors.lastname: Rivoire
authors.forename: Michael
authors.initials: M
authors.lastname: Hoppe
authors.forename: Waraporn
authors.initials: W
authors.lastname: Srikhum
authors.forename: John
authors.initials: J
authors.lastname: Imboden
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Link
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Li
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications / Q000473:pathology*; D001853:Bone Marrow / Q000473:pathology*; D002356:Cartilage / Q000473:pathology*; D004487:Edema / Q000473:pathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D013585:Synovitis / Q000150:complications / Q000473:pathology*; D014955:Wrist Joint / Q000473:pathology*