Time-efficient MRI scoring system for axial spondyloarthritis: a feasibility study

Area of Science:

• Rheumatology
• Medical Imaging
• Clinical Research

Background:

• Axial spondyloarthritis (axSpA) requires reliable methods to monitor disease activity during treatment.
• The Spondyloarthritis Research Consortium of Canada (SPARCC) MRI score is a validated tool but can be time-consuming.
• Biological therapies have improved axSpA management, necessitating efficient assessment tools.

Purpose of the Study:

• To develop and assess the feasibility of a simplified SPARCC MRI score for axSpA.
• To compare the simplified score's performance against the original SPARCC score in patients on biological therapy.
• To evaluate the simplified score's reliability, sensitivity to change, and time efficiency.

Main Methods:

• A prospective feasibility study involving 60 axSpA patients receiving biological therapy.
• MRI of sacroiliac joints and spine at baseline and six months.
• Development of a simplified SPARCC score (three most affected slices/vertebrae) and comparison with the original score.
• Correlation with clinical indices and inflammatory markers; assessment of inter-reader agreement and sensitivity to change.

Main Results:

• Both simplified and original SPARCC scores showed significant improvement after six months of biological therapy (p < 0.001).
• The simplified score demonstrated strong correlations with disease activity markers, comparable to the original score.
• Inter-reader agreement was substantial to almost perfect for both scores, with the simplified spine score showing the highest agreement (κ=0.817-0.784).
• The simplified score significantly reduced assessment time (11 min vs. 37 min, p < 0.001).

Conclusions:

• The simplified SPARCC MRI score is a feasible and promising research tool for assessing axSpA disease activity.
• It offers improved inter-reader reliability and significantly reduced assessment time compared to the original score.
• Further validation is needed to confirm its broader clinical applicability and routine utility.