Quantification of bone lesions in rheumatoid arthritis by MRI multispectral tissue class transition analysis

Recent advances in the development of disease-modifying antirheumatic drugs (DMARDs) bring hope for a treatment that will provide inhibition of the structural damage associated with the disease. DMARD development presents great challenges for the validation of structural surrogate markers to evaluate the performance of these new therapies in clinical trials, where they will likely be compared with active controls. These challenges are being addressed in part by the medical imaging community by developing quantitative measures of RA disease progression for evaluation of new treatments during clinical trials. Recently, a novel multispectral (MS) MRI analysis method was presented to quantify temporal changes in bone lesions observed in the hands of RA patients. This technique employs image registration and MS analysis to identify MS tissue class transitions between serial MRI exams. This review will examine the use of MS class transition analysis as a means to quantify changes in bone lesions in the hands and wrists of patients with RA.