Utility of combined high-resolution bone SPECT and MRI for the identification of rheumatoid arthritis patients with high-risk for erosive progression |
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Authors: | Christian Buchbender,Philipp Sewerin,Katalin Mattes-Gyö rgy,Falk Miese,Hans-Joerg Wittsack,Christof Specker,Gerald Antoch,Hans-Wilhelm Mü ller,Matthias Schneider,Axel Scherer,Benedikt Ostendorf |
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Affiliation: | 1. Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany;2. Univ Dusseldorf, Medical Faculty, Department of Rheumatology, Moorenstr. 5, D-40225 Dusseldorf, Germany;3. Univ Dusseldorf, Medical Faculty, Department of Nuclear Medicine, Moorenstr. 5, D-40225 Dusseldorf, Germany;4. Department of Rheumatology & Clinical Immunology, Kliniken Essen-Sud, Propsteistrasse 2, D-45239 Essen, Germany |
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Abstract: | ObjectivesTo evaluate the utility of sequentially acquired, post hoc fused, magnetic resonance imaging (MRI) and multi-pinhole single photon emission computed tomography (MPH-SPECT) with technetium-99m-labeled disphosphonates (Tc99m-DPD) for the identification of finger joints with later erosive progression in early rheumatoid arthritis (ERA) patients.MethodsTen consecutive ERA patients prospectively underwent MPH-SPECT and MRI of metacarpophalangeal (MCP) joints prior to and after 6 months methotrexate therapy. Tc99m-DPD uptake was measured at proximal and distal MCP sites using regional analysis. The course of joint pathologies was scored according to the Rheumatoid Arthritis MRI Score (RAMRIS) criteria.ResultsThe frequency of increased Tc99m-DPD uptake, synovitis and bone marrow edemadecreased under MTX therapy; but the number of bone erosions increased. Joints with progressive and new erosions on follow-up had a higher baseline Tc99m-DPD uptake (2.64 ± 1.23 vs. 1.43 ± 0.91) (p = 0.02).ConclusionsJoints with erosive progression are characterized by an early increased Tc99m-DPD uptake, even in absence of MRI bone pathologies. Tc99m-DPD MPH-SPECT might thus be of additional value to morphological MRI for the identification of RA patients with a high risk for erosive progression. |
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Keywords: | Rheumatoid arthritis Single photon emission computertomography DPD bone scanning Magnetic resonance imaging Joint Erosion |
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