title: Computer-Aided Assessment of Spinal Inflammation on Magnetic Resonance Images in Patients With Spondyloarthritis.
abstract: OBJECTIVE
  To evaluate a computer-aided approach to the assessment of spinal inflammation on magnetic resonance imaging (MRI) in spondyloarthritis as compared to visual assessment.
  
  
  METHODS
  Following institutional ethics approval, 32 patients (mean ± SD age 35.3 ± 10.2 years) with active ankylosing spondylitis underwent treatment with methotrexate and infliximab for 30 weeks. Spinal MRI examination (T1-weighted, T2-weighted fat-suppressed, and postcontrast T1-weighted fat-suppressed sagittal sequences using a 1.5T MRI system) was performed at baseline and at 30 weeks. Following manual identification of the vertebral corners, vertebral body segmentation was performed using a deformable model that automatically isolated the 4 vertebral corner areas, allowing automatic measurement of the relative mean corner intensity of each vertebral corner before and after treatment. Quantitative computer-aided assessment of spinal inflammation was compared with a semiquantitative visual assessment of spinal inflammation (the Berlin method).
  
  
  RESULTS
  Computer-aided quantification was quick and highly reliable, and it identified increases in vertebral corner edema or enhancement that were significantly decreased following treatment (P < 0.5). For computer-aided analysis, there was excellent inter- and intrarater correlation of both corner edema and enhancement (intraclass correlation coefficients [ICCs] >0.99), and the correlations were better than those for visual analysis (ICCs 0.83-0.96). For computer-aided analysis, the standardized response mean was 1.67 for corner edema and 1.64 for enhancement, as compared to 1.20 and 1.18, respectively, for visual analysis. Computer-aided quantification of MRI data correlated better (r = 0.50-0.53, P < 0.01) with clinical features of spinal disease activity pre- and posttreatment than did visual analysis of spinal inflammation (r = 0.37-0.43, P > 0.02).
  
  
  CONCLUSIONS
  Computer-aided assessment of spinal inflammation in spondyloarthritis is quick, reliable, and sensitive and correlates better with clinical disease activity than does visual assessment by the Berlin method.
authors: Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors: James F
authors: JF
authors: Griffith
authors: Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors: Defeng
authors: D
authors: Wang
authors: Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors: Lin
authors: L
authors: Shi
authors: Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors: David K W
authors: DK
authors: Yeung
authors: Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors: Ryan
authors: R
authors: Lee
authors: Chinese University of Hong Kong, Shatin, Hong Kong, China.
authors: Tam Lai
authors: TL
authors: Shan
mesh_terms: D000328:Adult; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013131:Spine / Q000473:pathology*; D025241:Spondylarthritis / Q000175:diagnosis / Q000473:pathology*