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Juvenile Dermatomyositis Magnetic Resonance Imaging Score (JIS) does not correlate with criteria for clinically

Kapil Gargh1, Eslam Al-Abadi2,3, Samantha Low4

  • 1Childhood Arthritis and Rheumatic Diseases Unit, Birmingham Women's and Children's Hospital NHS Foundation Trust, Steelhouse Lane, Birmingham, B4 6NH, West Midlands, UK.

Rheumatology International
|November 19, 2021
PubMed

Insights

The Juvenile Dermatomyositis Imaging Score (JIS) correlates with physician treatment decisions, unlike the PRINTO criteria for clinically inactive disease (CID). MRI findings are crucial for assessing JDM activity and guiding treatment escalation.

Area of Science:

  • Pediatric Rheumatology
  • Medical Imaging
  • Disease Activity Assessment

Background:

  • Current criteria for clinically inactive disease (CID) in Juvenile Dermatomyositis (JDM) do not incorporate Magnetic Resonance Imaging (MRI) findings.
  • The use of MRI and standardized scoring tools for JDM is increasing.
  • There is a need to evaluate the role of MRI in assessing JDM disease activity.

Purpose of the Study:

  • To assess the correlation between MRI scores (using the Juvenile Dermatomyositis Imaging Score - JIS) and clinically inactive disease (CID) criteria.
  • To evaluate the relationship between MRI findings and physician treatment decisions in JDM.
  • To determine if MRI can better predict treatment escalation than current clinical criteria.

Main Methods:

  • Retrospective analysis of MRIs from children with JDM over a 10-year period, scored using the JIS.
  • Collection of demographic, diagnosis, treatment, and core set measures data.
  • Statistical analysis to correlate JIS with CID categories and physician treatment decisions.

Main Results:

  • The JIS was not significantly associated with the CID category but showed a correlation with physician treatment decisions.
  • No significant association was found between clinical decisions and the CID category.
  • The JIS demonstrated good predictive ability for treatment escalation (AUC 0.80), with 78% sensitivity, specificity, and accuracy, outperforming CID criteria.

Conclusions:

  • Clinical criteria alone may be insufficient for accurately assessing JDM disease activity.
  • Physician treatment decisions align with MRI findings, suggesting MRI's utility in clinical practice.
  • Further multi-center prospective studies are required to validate these findings and establish MRI as a reliable biomarker for JDM activity.
Keywords:
BiomarkerJuvenile dermatomyositisMagnetic resonance imagingPaediatric rheumatology

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