Diagnostic accuracy of high-resolution peripheral quantitative computed tomography and X-ray for classifying erosive rheumatoid arthritis

Rasmus Klose-Jensen; Josephine Therkildsen; Anne-Birgitte Garm Blavnsfeldt; Bente L Langdahl; Anna Zejden; Jesper Thygesen; Kresten Krarup Keller; Ellen-Margrethe Hauge

doi:10.1093/rheumatology/keab446

Diagnostic accuracy of high-resolution peripheral quantitative computed tomography and X-ray for classifying erosive rheumatoid arthritis

Rasmus Klose-Jensen^*, Josephine Therkildsen, Anne-Birgitte Garm Blavnsfeldt, Bente L Langdahl, Anna Zejden, Jesper Thygesen, Kresten Krarup Keller, Ellen-Margrethe Hauge

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

Objective: To investigate whether high-resolution peripheral quantitative CT (HR-pQCT) of two metacarpophalangeal (MCP) joints can more accurately classify patients as having erosive RA compared with conventional radiography (CR) of 44 joints in the hands, wrists and feet. Methods: In this single-centre cross-sectional study, patients with established RA (disease duration ≥5 years) were investigated by HR-pQCT and CR. The second and third MCP joints of the dominant hand were assessed for erosions by HR-pQCT. CR of the hands, wrists and feet were scored according to the Sharp-van der Heijde (SHS) method. Results: In total, 353 patients were included; 66 (18.7%) patients were classified as having non-erosive RA, and 287 (81.3%) had erosive RA by CR. The sensitivity and specificity (95% CI) of HR-pQCT for classifying patients as having erosive RA when standard CR of hands, wrists and feet was used as the reference was 89% (84, 92%) and 30% (20, 43%), respectively. Using HR-pQCT as the reference, the sensitivity and specificity of CR for classifying patients having erosive RA were 85% (80, 89%) and 38% (25, 52%), respectively. McNemar's χ2 test showed no significant difference between the sensitivities of patients classified as having erosive RA by HR-pQCT or by CR (2.14, P = 0.177). Conclusion: The diagnostic accuracy of HR-pQCT scanning of only two MCP joints and CR of 44 joints suggests the two modalities were comparable for classifying patients with established RA as having erosive disease. Clinical trial registration: ClinicalTrials.gov (NCT03429426).

Originalsprog	Engelsk
Tidsskrift	Rheumatology
Vol/bind	61
Nummer	3
Sider (fra-til)	963-973
Antal sider	11
ISSN	1462-0324
DOI	https://doi.org/10.1093/rheumatology/keab446
Status	Udgivet - mar. 2022

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10.1093/rheumatology/keab446

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@article{939ef77c593d4da1a9fde395467dc02a,

title = "Diagnostic accuracy of high-resolution peripheral quantitative computed tomography and X-ray for classifying erosive rheumatoid arthritis",

abstract = "Objective: To investigate whether high-resolution peripheral quantitative CT (HR-pQCT) of two metacarpophalangeal (MCP) joints can more accurately classify patients as having erosive RA compared with conventional radiography (CR) of 44 joints in the hands, wrists and feet. Methods: In this single-centre cross-sectional study, patients with established RA (disease duration ≥5 years) were investigated by HR-pQCT and CR. The second and third MCP joints of the dominant hand were assessed for erosions by HR-pQCT. CR of the hands, wrists and feet were scored according to the Sharp-van der Heijde (SHS) method. Results: In total, 353 patients were included; 66 (18.7%) patients were classified as having non-erosive RA, and 287 (81.3%) had erosive RA by CR. The sensitivity and specificity (95% CI) of HR-pQCT for classifying patients as having erosive RA when standard CR of hands, wrists and feet was used as the reference was 89% (84, 92%) and 30% (20, 43%), respectively. Using HR-pQCT as the reference, the sensitivity and specificity of CR for classifying patients having erosive RA were 85% (80, 89%) and 38% (25, 52%), respectively. McNemar's χ2 test showed no significant difference between the sensitivities of patients classified as having erosive RA by HR-pQCT or by CR (2.14, P = 0.177). Conclusion: The diagnostic accuracy of HR-pQCT scanning of only two MCP joints and CR of 44 joints suggests the two modalities were comparable for classifying patients with established RA as having erosive disease. Clinical trial registration: ClinicalTrials.gov (NCT03429426).",

keywords = "DAMAGE, HR-pQCT (high resolution-peripheral quantitative computed tomography), METACARPOPHALANGEAL JOINTS, MODIFYING ANTIRHEUMATIC DRUGS, PROGRESSION, QUALITY, QUANTIFICATION, RADIOGRAPHS, SUBJECT MOTION, Sharp, WRIST, conventional radiography, erosions, rheumatoid arthritis, van der Heijde",

author = "Rasmus Klose-Jensen and Josephine Therkildsen and Blavnsfeldt, {Anne-Birgitte Garm} and Langdahl, {Bente L} and Anna Zejden and Jesper Thygesen and Keller, {Kresten Krarup} and Ellen-Margrethe Hauge",

year = "2022",

month = mar,

doi = "10.1093/rheumatology/keab446",

language = "English",

volume = "61",

pages = "963--973",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "3",

}

Diagnostic accuracy of high-resolution peripheral quantitative computed tomography and X-ray for classifying erosive rheumatoid arthritis. / Klose-Jensen, Rasmus ; Therkildsen, Josephine ; Blavnsfeldt, Anne-Birgitte Garm et al.
I: Rheumatology, Bind 61, Nr. 3, 03.2022, s. 963-973.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Diagnostic accuracy of high-resolution peripheral quantitative computed tomography and X-ray for classifying erosive rheumatoid arthritis

AU - Klose-Jensen, Rasmus

AU - Therkildsen, Josephine

AU - Blavnsfeldt, Anne-Birgitte Garm

AU - Langdahl, Bente L

AU - Zejden, Anna

AU - Thygesen, Jesper

AU - Keller, Kresten Krarup

AU - Hauge, Ellen-Margrethe

PY - 2022/3

Y1 - 2022/3

N2 - Objective: To investigate whether high-resolution peripheral quantitative CT (HR-pQCT) of two metacarpophalangeal (MCP) joints can more accurately classify patients as having erosive RA compared with conventional radiography (CR) of 44 joints in the hands, wrists and feet. Methods: In this single-centre cross-sectional study, patients with established RA (disease duration ≥5 years) were investigated by HR-pQCT and CR. The second and third MCP joints of the dominant hand were assessed for erosions by HR-pQCT. CR of the hands, wrists and feet were scored according to the Sharp-van der Heijde (SHS) method. Results: In total, 353 patients were included; 66 (18.7%) patients were classified as having non-erosive RA, and 287 (81.3%) had erosive RA by CR. The sensitivity and specificity (95% CI) of HR-pQCT for classifying patients as having erosive RA when standard CR of hands, wrists and feet was used as the reference was 89% (84, 92%) and 30% (20, 43%), respectively. Using HR-pQCT as the reference, the sensitivity and specificity of CR for classifying patients having erosive RA were 85% (80, 89%) and 38% (25, 52%), respectively. McNemar's χ2 test showed no significant difference between the sensitivities of patients classified as having erosive RA by HR-pQCT or by CR (2.14, P = 0.177). Conclusion: The diagnostic accuracy of HR-pQCT scanning of only two MCP joints and CR of 44 joints suggests the two modalities were comparable for classifying patients with established RA as having erosive disease. Clinical trial registration: ClinicalTrials.gov (NCT03429426).

AB - Objective: To investigate whether high-resolution peripheral quantitative CT (HR-pQCT) of two metacarpophalangeal (MCP) joints can more accurately classify patients as having erosive RA compared with conventional radiography (CR) of 44 joints in the hands, wrists and feet. Methods: In this single-centre cross-sectional study, patients with established RA (disease duration ≥5 years) were investigated by HR-pQCT and CR. The second and third MCP joints of the dominant hand were assessed for erosions by HR-pQCT. CR of the hands, wrists and feet were scored according to the Sharp-van der Heijde (SHS) method. Results: In total, 353 patients were included; 66 (18.7%) patients were classified as having non-erosive RA, and 287 (81.3%) had erosive RA by CR. The sensitivity and specificity (95% CI) of HR-pQCT for classifying patients as having erosive RA when standard CR of hands, wrists and feet was used as the reference was 89% (84, 92%) and 30% (20, 43%), respectively. Using HR-pQCT as the reference, the sensitivity and specificity of CR for classifying patients having erosive RA were 85% (80, 89%) and 38% (25, 52%), respectively. McNemar's χ2 test showed no significant difference between the sensitivities of patients classified as having erosive RA by HR-pQCT or by CR (2.14, P = 0.177). Conclusion: The diagnostic accuracy of HR-pQCT scanning of only two MCP joints and CR of 44 joints suggests the two modalities were comparable for classifying patients with established RA as having erosive disease. Clinical trial registration: ClinicalTrials.gov (NCT03429426).

KW - DAMAGE

KW - HR-pQCT (high resolution-peripheral quantitative computed tomography)

KW - METACARPOPHALANGEAL JOINTS

KW - MODIFYING ANTIRHEUMATIC DRUGS

KW - PROGRESSION

KW - QUALITY

KW - QUANTIFICATION

KW - RADIOGRAPHS

KW - SUBJECT MOTION

KW - Sharp

KW - WRIST

KW - conventional radiography

KW - erosions

KW - rheumatoid arthritis

KW - van der Heijde

UR - http://www.scopus.com/inward/record.url?scp=85125553721&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/keab446

DO - 10.1093/rheumatology/keab446

M3 - Journal article

C2 - 34015091

SN - 1462-0324

VL - 61

SP - 963

EP - 973

JO - Rheumatology

JF - Rheumatology

IS - 3

ER -

Diagnostic accuracy of high-resolution peripheral quantitative computed tomography and X-ray for classifying erosive rheumatoid arthritis

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