title: Use of Tomosynthesis for Detection of Bone Erosions of the Foot in Patients With Established Rheumatoid Arthritis: Comparison With Radiography and CT.
abstract: OBJECTIVE
  The purpose of this study was to compare tomosynthesis with radiography for the detection of bone erosions of the foot in patients with established rheumatoid arthritis (RA) using MDCT as a reference standard.
  
  
  METHODS
  Eighteen consecutive patients with established RA were included. Each patient underwent radiography, tomosynthesis, and CT examinations of the feet on the same day. Two radiologists independently determined the number of bone erosions and the Sharp-van der Heijde score with each of the three imaging modalities.
  
  
  RESULTS
  On a total of 216 joints from 18 patients, 216 bone erosions were detected on CT, 215 on tomosynthesis, and 181 with radiography. The mean (± SD) Sharp-van der Heijde score was equivalent for tomosynthesis (18.8 ± 16.8) and CT (19.8 ± 18.5) but was statistically lower for radiography (16.4 ± 18.0) (p = 0.030). The respective overall sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for tomosynthesis were 80%, 75%, 78%, 76%, and 80%, whereas the respective corresponding values for radiography were 66%, 81%, 74%, 77%, and 71%. The radiation burden of tomosynthesis was almost equivalent to that of radiography.
  
  
  CONCLUSIONS
  Tomosynthesis has a higher sensitivity than radiography to detect bone erosions of the foot in patients with established RA and imparts an almost equivalent radiation burden.
authors.affiliation: 1 Department of Diagnostic Imaging, University of Liège, Domaine du Sart Tilman, Bât. 35 4000-B Liège, Belgium.
authors.forename: Paolo
authors.initials: P
authors.lastname: Simoni
authors.affiliation: 1 Department of Diagnostic Imaging, University of Liège, Domaine du Sart Tilman, Bât. 35 4000-B Liège, Belgium.
authors.forename: Laurent
authors.initials: L
authors.lastname: Gérard
authors.affiliation: 2 Department of Rheumatology, University of Liège, Liège, Belgium.
authors.forename: Marie-Joëlle
authors.initials: MJ
authors.lastname: Kaiser
authors.affiliation: 2 Department of Rheumatology, University of Liège, Liège, Belgium.
authors.forename: Clio
authors.initials: C
authors.lastname: Ribbens
authors.affiliation: 2 Department of Rheumatology, University of Liège, Liège, Belgium.
authors.forename: Charline
authors.initials: C
authors.lastname: Rinkin
authors.affiliation: 2 Department of Rheumatology, University of Liège, Liège, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Malaise
authors.affiliation: 2 Department of Rheumatology, University of Liège, Liège, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Malaise
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
keywords: arthritis; foot; image enhancement methods; radiography; rheumatoid; tomosynthesis