Effect of radiographic disease severity in high-resolution quantitative computed tomography assessment of metacarpophalangeal joint erosion and cysts

Anne-Birgitte Blavnsfeldt; Rasmus Klose-Jensen; Jesper Thygesen; Philip Therkildsen; Bente Lomholt Langdahl; Kresten Krarup Keller; Ellen Margrethe Hauge

doi:10.1111/1756-185X.14020

Effect of radiographic disease severity in high-resolution quantitative computed tomography assessment of metacarpophalangeal joint erosion and cysts

Anne-Birgitte Blavnsfeldt^*, Rasmus Klose-Jensen, Jesper Thygesen, Philip Therkildsen, Bente Lomholt Langdahl, Kresten Krarup Keller, Ellen Margrethe Hauge

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

3 Citations (Scopus)

Abstract

Aim: Bone erosions are the hallmark of rheumatoid arthritis (RA). High-resolution peripheral quantitative computed tomography (HR-pQCT) enables 3-dimensional visualization of arthritic bone erosions at a high resolution. However, the degree of erosive disease could influence the reliability of HR-pQCT evaluation. We aim to assess the intra- and inter-reader variability of identification of erosions in the metacarpophalangeal (MCP) joints using HR-pQCT in healthy controls and patients with RA, stratified according to van der Heijde-modified Sharp Score (HSS) of radiographic erosions. Method: We analyzed HR-pQCT images from 78 patients with RA and 25 healthy controls. Patients were allocated to one of three groups of mild, moderate or severe disease according to HSS of MCP joints 2 and 3. Total HR-pQCT scans were analyzed twice in random order by three experienced readers, blinded to group distribution. The number of cortical interruptions and their classification as either erosions or cysts according to predefined criteria were recorded. Intraclass correlation coefficients (ICC) for cortical interruptions, erosions and cysts were calculated for each group using a 2-way random-effects model for inter-reader ICC and a 2-way mixed-effects model for intra-reader ICC. Results: The intra- and inter-reader ICC were good to moderate for cortical interruptions and moderate for erosions throughout disease severity groups. The ICCs for the identification of cysts decreased with increasing degree of erosive disease. Conclusion: The detection of cortical interruptions is only minimally affected by the degree of erosive damage, whereas the distinction between erosions and cysts is more complex in patients with extensive erosive disease.

Original language	English
Journal	International Journal of Rheumatic Diseases
Volume	24
Issue	1
Pages (from-to)	112-119
Number of pages	8
ISSN	1756-1841
DOIs	https://doi.org/10.1111/1756-185X.14020
Publication status	Published - Jan 2021

Keywords

Heijde-modified Sharp Score
bone erosions
cortical interruptions
cysts
high-resolution peripheral quantitative computed tomography
inter- and intra-reader reliability

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10.1111/1756-185X.14020

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Blavnsfeldt, A.-B., Klose-Jensen, R., Thygesen, J., Therkildsen, P., Langdahl, B. L., Keller, K. K., & Hauge, E. M. (2021). Effect of radiographic disease severity in high-resolution quantitative computed tomography assessment of metacarpophalangeal joint erosion and cysts. International Journal of Rheumatic Diseases, 24(1), 112-119. https://doi.org/10.1111/1756-185X.14020

@article{beee436d8c6842a290e1ad4fa7fe415a,

title = "Effect of radiographic disease severity in high-resolution quantitative computed tomography assessment of metacarpophalangeal joint erosion and cysts",

abstract = "Aim: Bone erosions are the hallmark of rheumatoid arthritis (RA). High-resolution peripheral quantitative computed tomography (HR-pQCT) enables 3-dimensional visualization of arthritic bone erosions at a high resolution. However, the degree of erosive disease could influence the reliability of HR-pQCT evaluation. We aim to assess the intra- and inter-reader variability of identification of erosions in the metacarpophalangeal (MCP) joints using HR-pQCT in healthy controls and patients with RA, stratified according to van der Heijde-modified Sharp Score (HSS) of radiographic erosions. Method: We analyzed HR-pQCT images from 78 patients with RA and 25 healthy controls. Patients were allocated to one of three groups of mild, moderate or severe disease according to HSS of MCP joints 2 and 3. Total HR-pQCT scans were analyzed twice in random order by three experienced readers, blinded to group distribution. The number of cortical interruptions and their classification as either erosions or cysts according to predefined criteria were recorded. Intraclass correlation coefficients (ICC) for cortical interruptions, erosions and cysts were calculated for each group using a 2-way random-effects model for inter-reader ICC and a 2-way mixed-effects model for intra-reader ICC. Results: The intra- and inter-reader ICC were good to moderate for cortical interruptions and moderate for erosions throughout disease severity groups. The ICCs for the identification of cysts decreased with increasing degree of erosive disease. Conclusion: The detection of cortical interruptions is only minimally affected by the degree of erosive damage, whereas the distinction between erosions and cysts is more complex in patients with extensive erosive disease.",

keywords = "Heijde-modified Sharp Score, bone erosions, cortical interruptions, cysts, high-resolution peripheral quantitative computed tomography, inter- and intra-reader reliability",

author = "Anne-Birgitte Blavnsfeldt and Rasmus Klose-Jensen and Jesper Thygesen and Philip Therkildsen and Langdahl, {Bente Lomholt} and Keller, {Kresten Krarup} and Hauge, {Ellen Margrethe}",

year = "2021",

month = jan,

doi = "10.1111/1756-185X.14020",

language = "English",

volume = "24",

pages = "112--119",

journal = "International Journal of Rheumatic Diseases",

issn = "1756-1841",

publisher = "John Wiley & Sons Inc.",

number = "1",

}

Blavnsfeldt, A-B , Klose-Jensen, R, Thygesen, J, Therkildsen, P, Langdahl, BL , Keller, KK & Hauge, EM 2021, 'Effect of radiographic disease severity in high-resolution quantitative computed tomography assessment of metacarpophalangeal joint erosion and cysts', International Journal of Rheumatic Diseases, vol. 24, no. 1, pp. 112-119. https://doi.org/10.1111/1756-185X.14020

Effect of radiographic disease severity in high-resolution quantitative computed tomography assessment of metacarpophalangeal joint erosion and cysts. / Blavnsfeldt, Anne-Birgitte ; Klose-Jensen, Rasmus; Thygesen, Jesper et al.
In: International Journal of Rheumatic Diseases, Vol. 24, No. 1, 01.2021, p. 112-119.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Effect of radiographic disease severity in high-resolution quantitative computed tomography assessment of metacarpophalangeal joint erosion and cysts

AU - Blavnsfeldt, Anne-Birgitte

AU - Klose-Jensen, Rasmus

AU - Thygesen, Jesper

AU - Therkildsen, Philip

AU - Langdahl, Bente Lomholt

AU - Keller, Kresten Krarup

AU - Hauge, Ellen Margrethe

PY - 2021/1

Y1 - 2021/1

N2 - Aim: Bone erosions are the hallmark of rheumatoid arthritis (RA). High-resolution peripheral quantitative computed tomography (HR-pQCT) enables 3-dimensional visualization of arthritic bone erosions at a high resolution. However, the degree of erosive disease could influence the reliability of HR-pQCT evaluation. We aim to assess the intra- and inter-reader variability of identification of erosions in the metacarpophalangeal (MCP) joints using HR-pQCT in healthy controls and patients with RA, stratified according to van der Heijde-modified Sharp Score (HSS) of radiographic erosions. Method: We analyzed HR-pQCT images from 78 patients with RA and 25 healthy controls. Patients were allocated to one of three groups of mild, moderate or severe disease according to HSS of MCP joints 2 and 3. Total HR-pQCT scans were analyzed twice in random order by three experienced readers, blinded to group distribution. The number of cortical interruptions and their classification as either erosions or cysts according to predefined criteria were recorded. Intraclass correlation coefficients (ICC) for cortical interruptions, erosions and cysts were calculated for each group using a 2-way random-effects model for inter-reader ICC and a 2-way mixed-effects model for intra-reader ICC. Results: The intra- and inter-reader ICC were good to moderate for cortical interruptions and moderate for erosions throughout disease severity groups. The ICCs for the identification of cysts decreased with increasing degree of erosive disease. Conclusion: The detection of cortical interruptions is only minimally affected by the degree of erosive damage, whereas the distinction between erosions and cysts is more complex in patients with extensive erosive disease.

AB - Aim: Bone erosions are the hallmark of rheumatoid arthritis (RA). High-resolution peripheral quantitative computed tomography (HR-pQCT) enables 3-dimensional visualization of arthritic bone erosions at a high resolution. However, the degree of erosive disease could influence the reliability of HR-pQCT evaluation. We aim to assess the intra- and inter-reader variability of identification of erosions in the metacarpophalangeal (MCP) joints using HR-pQCT in healthy controls and patients with RA, stratified according to van der Heijde-modified Sharp Score (HSS) of radiographic erosions. Method: We analyzed HR-pQCT images from 78 patients with RA and 25 healthy controls. Patients were allocated to one of three groups of mild, moderate or severe disease according to HSS of MCP joints 2 and 3. Total HR-pQCT scans were analyzed twice in random order by three experienced readers, blinded to group distribution. The number of cortical interruptions and their classification as either erosions or cysts according to predefined criteria were recorded. Intraclass correlation coefficients (ICC) for cortical interruptions, erosions and cysts were calculated for each group using a 2-way random-effects model for inter-reader ICC and a 2-way mixed-effects model for intra-reader ICC. Results: The intra- and inter-reader ICC were good to moderate for cortical interruptions and moderate for erosions throughout disease severity groups. The ICCs for the identification of cysts decreased with increasing degree of erosive disease. Conclusion: The detection of cortical interruptions is only minimally affected by the degree of erosive damage, whereas the distinction between erosions and cysts is more complex in patients with extensive erosive disease.

KW - Heijde-modified Sharp Score

KW - bone erosions

KW - cortical interruptions

KW - cysts

KW - high-resolution peripheral quantitative computed tomography

KW - inter- and intra-reader reliability

U2 - 10.1111/1756-185X.14020

DO - 10.1111/1756-185X.14020

M3 - Journal article

C2 - 33169933

SN - 1756-1841

VL - 24

SP - 112

EP - 119

JO - International Journal of Rheumatic Diseases

JF - International Journal of Rheumatic Diseases

IS - 1

ER -

Effect of radiographic disease severity in high-resolution quantitative computed tomography assessment of metacarpophalangeal joint erosion and cysts

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Keywords

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