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Updated: Dec 16, 2025
Author Spotlight: Enhancing Rheumatoid Arthritis Research Through HR-pQCT Imaging Analysis
Published on: October 6, 2023
Perfusion in hand arthritis on dynamic contrast-enhanced computed tomography: a randomized prospective study using
Sevtap Tugce Ulas1, Kay Geert Hermann1, Marcus R Makowski1
1Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt - Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.
Insights
Dynamic contrast-enhanced CT (DCE-CT) shows comparable performance to DCE-MRI for detecting arthritis in the hand. DCE-CT is a viable alternative when MRI is unavailable or contraindicated.
Area of Science:
- Radiology
- Medical Imaging
- Rheumatology
Background:
- Rheumatoid arthritis (RA) diagnosis and monitoring rely on imaging.
- Dynamic contrast-enhanced MRI (DCE-MRI) is a standard reference for assessing joint inflammation.
- Limitations of MRI include availability and contraindications.
Purpose of the Study:
- To evaluate dynamic contrast-enhanced CT (DCE-CT) performance in detecting and quantifying perfusion parameters in hand arthritis.
- To compare DCE-CT with DCE-MRI for assessing synovitis in rheumatoid arthritis.
Main Methods:
- 36 patients with suspected RA underwent both DCE-CT and DCE-MRI of the hand.
- Perfusion parameters (MTT, TTP, rBV, rBF) were calculated using four decomposition techniques.
- Region of interest (ROI) analysis and statistical comparisons were performed.
Main Results:
- DCE-CT and DCE-MRI yielded similar perfusion parameters with small effect sizes.
- DCE-CT differentiated inflamed from non-inflamed joints based on rBF and rBV.
- DCE-CT showed a tendency to underestimate parameters in severe inflammation.
Conclusions:
- DCE-CT is a promising imaging technique for arthritis detection and assessment.
- DCE-CT serves as a suitable alternative to DCE-MRI when MRI is not feasible.
- Further research may optimize DCE-CT for severe inflammatory conditions.
Objective:
To evaluate the performance of dynamic contrast-enhanced CT (DCE-CT) in detecting and quantitatively assessing perfusion parameters in patients with arthritis of the hand compared with dynamic contrast-enhanced MRI (DCE-MRI) as a standard of reference.
Materials And Methods:
In this IRB-approved randomized prospective single-centre study, 36 consecutive patients with suspected rheumatoid arthritis underwent DCE-CT (320-row, tube voltage 80 kVp, tube current 8.25 mAs) and DCE-MRI (1.5 T) of the hand. Perfusion maps were calculated separately for mean transit time (MTT), time to peak (TTP), relative blood volume (rBV), and relative blood flow (rBF) using four different decomposition techniques. Region of interest (ROI) analysis was performed in metacarpophalangeal joints II-V and in the wrist. Pairs of perfusion parameters in DCE-CT and DCE-MRI were compared using a two-tailed t test for paired samples and interpreted for effect size (Cohen's d). According to the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) scoring results, differentiation of synovitis-positive and synovitis-negative joints with both modalities was assessed with the independent t test.
Results:
The two modalities yielded similar perfusion parameters. Identified differences had small effects (d 0.01-0.4). DCE-CT additionally differentiates inflamed and noninflamed joints based on rBF and rBV but tends to underestimate these parameters in severe inflammation. The total dose-length product (DLP) was 48 mGy*cm with an estimated effective dose of 0.038 mSv.
Conclusion:
DCE-CT is a promising imaging technique in arthritis. In patients with a contraindication to MRI or when MRI is not available, DCE-CT is a suitable alternative to detect and assess arthritis.
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