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Improved wrist pannus volume measurement from contrast-enhanced MRI in rheumatoid arthritis using shuffle transform
Emily Xanthopoulos1, Charles E Hutchinson, Judith E Adams
1Imaging Science and Biomedical Engineering, University of Manchester, Manchester M13 9PT, UK.
Background:
Contrast-enhanced MRI is of value in assessing rheumatoid pannus in the hand, but the images are not always easy to quantitate.
Objective:
To develop and evaluate an improved measurement of volume of enhancing pannus (VEP) in the hand in human rheumatoid arthritis (RA).
Methods:
MR images of the hand and wrist were obtained for 14 patients with RA at 0, 1 and 13 weeks. Volume of enhancing pannus was measured on images created by subtracting precontrast T1-weighted images from contrast-enhanced T1-weighted images using a shuffle transformation technique. Maximum intensity projection (MIP) and 3D volume rendering of the images were used as a guide to identify the pannus and any contrast-enhanced veins.
Result:
Visualisation of pannus was much improved following the shuffle transform. Between 0 weeks and 1 week, the mean value of the within-subject coefficient of variation (CoV) was 0.13 and the estimated total CoV was 0.15. There was no evidence of significant increased variability within the 13-week interval for the complete sample of patients.
Conclusion:
Volume of enhancing pannus can be measured reproducibly in the rheumatoid hand using 3D contrast-enhanced MRI and shuffle transform.
Insights
This study presents a reproducible method for measuring rheumatoid pannus in the hand using 3D contrast-enhanced MRI and shuffle transformation. This improved technique enhances visualization and quantitation of rheumatoid arthritis (RA) disease activity.
Area of Science:
- Rheumatology
- Radiology
- Medical Imaging
Background:
- Contrast-enhanced MRI aids in assessing rheumatoid pannus in the hand.
- Quantifying rheumatoid pannus from MRI images presents challenges.
Purpose of the Study:
- To develop and assess an improved method for measuring the volume of enhancing pannus (VEP) in the hands of rheumatoid arthritis (RA) patients.
- Enhance the quantitation of rheumatoid pannus in RA hands.
Main Methods:
- MR images of the hand and wrist were acquired from 14 RA patients over 13 weeks.
- Volume of enhancing pannus (VEP) was calculated by subtracting precontrast from contrast-enhanced T1-weighted images.
- Shuffle transformation technique, Maximum Intensity Projection (MIP), and 3D volume rendering were employed for pannus identification.
Main Results:
- The shuffle transform significantly improved pannus visualization.
- The within-subject coefficient of variation (CoV) was 0.13 between 0 and 1 week, with an estimated total CoV of 0.15.
- No significant increase in variability was observed over the 13-week study period.
Conclusions:
- 3D contrast-enhanced MRI combined with shuffle transform allows for reproducible measurement of VEP in rheumatoid hands.
- This technique offers a reliable method for monitoring RA disease activity in the hand.
