Erosive Progression by High-Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography in Rheumatoid Arthritis

Josephine Therkildsen; Rasmus Klose Jensen; Mathias Hänel; Bente Lomholt Langdahl; Jesper Thygesen; Jesper Skovhus Thomsen; Sarah L. Manske; Kresten Krarup Keller; Ellen Margrethe Hauge

doi:10.1093/rheumatology/keae281

Erosive Progression by High-Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography in Rheumatoid Arthritis

Josephine Therkildsen, Rasmus Klose Jensen, Mathias Hänel, Bente Lomholt Langdahl, Jesper Thygesen, Jesper Skovhus Thomsen, Sarah L. Manske, Kresten Krarup Keller, Ellen Margrethe Hauge

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

2 Citations (Scopus)

Abstract

Objectives: To investigate the diagnostic accuracy of high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess erosive progression during 1 year compared with conventional radiography (CR) in rheumatoid arthritis (RA). Methods: This prospective study included 359 patients with RA (disease duration ≥5 years) between March 2018 and October 2020. HR-pQCT and CR were obtained at inclusion and after 1 year. Erosive assessment was performed at two metacarpophalangeal joints of the dominant hand using HR-pQCT, and progression was defined as an increase in erosion number ≥1 or an increase in erosive volume > least significant change. CR of hands, wrists and feet was evaluated using Sharp/van der Heijde scores and erosive progression was defined as a 1.1-point increase in erosion score according to the smallest detectable change. Results: In paired analyses (n ¼ 310), erosive progression was identified in 30 patients using CR and in 40 patients using HR-pQCT. In the 40 patients with erosive progression on HR-pQCT, progression was not identified by CR in 33 patients. Adding HR-pQCT to CR doubled the proportion of patients identified with progression from 30 (10%) to 63 (20%) patients. Using CR as the reference, the sensitivity of HR-pQCT for identifying erosive progression was 23.3% (95% CI: 9.9, 42.3%) and the specificity was 88.2% (95% CI: 83.8, 91.7%). Conclusion: A substantial proportion of patients with erosive progression are overlooked using CR only to monitor erosive progression. Adding high-resolution peripheral CT to CR doubles the proportion of patients who may benefit from individualized therapy targeting erosive progression in RA.

Original language	English
Article number	Online ahead of print.
Journal	Rheumatology
Volume	64
Issue	3
Pages (from-to)	1092-1101
Number of pages	10
ISSN	1462-0324
DOIs	https://doi.org/10.1093/rheumatology/keae281
Publication status	Published - 1 Mar 2025

Keywords

erosive progression
high-resolution peripheral quantitative computed tomography
radiography
rheumatoid arthritis

Access to Document

10.1093/rheumatology/keae281

Cite this

Therkildsen, J., Jensen, R. K., Hänel, M., Langdahl, B. L., Thygesen, J., Thomsen, J. S., Manske, S. L., Keller, K. K., & Hauge, E. M. (2025). Erosive Progression by High-Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography in Rheumatoid Arthritis. Rheumatology, 64(3), 1092-1101. Article Online ahead of print. https://doi.org/10.1093/rheumatology/keae281

@article{f35ff02d14c747649066a4caaa3060e2,

title = "Erosive Progression by High-Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography in Rheumatoid Arthritis",

abstract = "Objectives: To investigate the diagnostic accuracy of high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess erosive progression during 1 year compared with conventional radiography (CR) in rheumatoid arthritis (RA). Methods: This prospective study included 359 patients with RA (disease duration ≥5 years) between March 2018 and October 2020. HR-pQCT and CR were obtained at inclusion and after 1 year. Erosive assessment was performed at two metacarpophalangeal joints of the dominant hand using HR-pQCT, and progression was defined as an increase in erosion number ≥1 or an increase in erosive volume > least significant change. CR of hands, wrists and feet was evaluated using Sharp/van der Heijde scores and erosive progression was defined as a 1.1-point increase in erosion score according to the smallest detectable change. Results: In paired analyses (n ¼ 310), erosive progression was identified in 30 patients using CR and in 40 patients using HR-pQCT. In the 40 patients with erosive progression on HR-pQCT, progression was not identified by CR in 33 patients. Adding HR-pQCT to CR doubled the proportion of patients identified with progression from 30 (10%) to 63 (20%) patients. Using CR as the reference, the sensitivity of HR-pQCT for identifying erosive progression was 23.3% (95% CI: 9.9, 42.3%) and the specificity was 88.2% (95% CI: 83.8, 91.7%). Conclusion: A substantial proportion of patients with erosive progression are overlooked using CR only to monitor erosive progression. Adding high-resolution peripheral CT to CR doubles the proportion of patients who may benefit from individualized therapy targeting erosive progression in RA.",

keywords = "erosive progression, high-resolution peripheral quantitative computed tomography, radiography, rheumatoid arthritis",

author = "Josephine Therkildsen and Jensen, {Rasmus Klose} and Mathias H{\"a}nel and Langdahl, {Bente Lomholt} and Jesper Thygesen and Thomsen, {Jesper Skovhus} and Manske, {Sarah L.} and Keller, {Kresten Krarup} and Hauge, {Ellen Margrethe}",

year = "2025",

month = mar,

day = "1",

doi = "10.1093/rheumatology/keae281",

language = "English",

volume = "64",

pages = "1092--1101",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "3",

}

Therkildsen, J , Jensen, RK , Hänel, M , Langdahl, BL, Thygesen, J, Thomsen, JS, Manske, SL, Keller, KK & Hauge, EM 2025, 'Erosive Progression by High-Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography in Rheumatoid Arthritis', Rheumatology, vol. 64, no. 3, Online ahead of print., pp. 1092-1101. https://doi.org/10.1093/rheumatology/keae281

Erosive Progression by High-Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography in Rheumatoid Arthritis. / Therkildsen, Josephine ; Jensen, Rasmus Klose ; Hänel, Mathias et al.
In: Rheumatology, Vol. 64, No. 3, Online ahead of print., 01.03.2025, p. 1092-1101.

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

TY - JOUR

T1 - Erosive Progression by High-Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography in Rheumatoid Arthritis

AU - Therkildsen, Josephine

AU - Jensen, Rasmus Klose

AU - Hänel, Mathias

AU - Langdahl, Bente Lomholt

AU - Thygesen, Jesper

AU - Thomsen, Jesper Skovhus

AU - Manske, Sarah L.

AU - Keller, Kresten Krarup

AU - Hauge, Ellen Margrethe

PY - 2025/3/1

Y1 - 2025/3/1

N2 - Objectives: To investigate the diagnostic accuracy of high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess erosive progression during 1 year compared with conventional radiography (CR) in rheumatoid arthritis (RA). Methods: This prospective study included 359 patients with RA (disease duration ≥5 years) between March 2018 and October 2020. HR-pQCT and CR were obtained at inclusion and after 1 year. Erosive assessment was performed at two metacarpophalangeal joints of the dominant hand using HR-pQCT, and progression was defined as an increase in erosion number ≥1 or an increase in erosive volume > least significant change. CR of hands, wrists and feet was evaluated using Sharp/van der Heijde scores and erosive progression was defined as a 1.1-point increase in erosion score according to the smallest detectable change. Results: In paired analyses (n ¼ 310), erosive progression was identified in 30 patients using CR and in 40 patients using HR-pQCT. In the 40 patients with erosive progression on HR-pQCT, progression was not identified by CR in 33 patients. Adding HR-pQCT to CR doubled the proportion of patients identified with progression from 30 (10%) to 63 (20%) patients. Using CR as the reference, the sensitivity of HR-pQCT for identifying erosive progression was 23.3% (95% CI: 9.9, 42.3%) and the specificity was 88.2% (95% CI: 83.8, 91.7%). Conclusion: A substantial proportion of patients with erosive progression are overlooked using CR only to monitor erosive progression. Adding high-resolution peripheral CT to CR doubles the proportion of patients who may benefit from individualized therapy targeting erosive progression in RA.

AB - Objectives: To investigate the diagnostic accuracy of high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess erosive progression during 1 year compared with conventional radiography (CR) in rheumatoid arthritis (RA). Methods: This prospective study included 359 patients with RA (disease duration ≥5 years) between March 2018 and October 2020. HR-pQCT and CR were obtained at inclusion and after 1 year. Erosive assessment was performed at two metacarpophalangeal joints of the dominant hand using HR-pQCT, and progression was defined as an increase in erosion number ≥1 or an increase in erosive volume > least significant change. CR of hands, wrists and feet was evaluated using Sharp/van der Heijde scores and erosive progression was defined as a 1.1-point increase in erosion score according to the smallest detectable change. Results: In paired analyses (n ¼ 310), erosive progression was identified in 30 patients using CR and in 40 patients using HR-pQCT. In the 40 patients with erosive progression on HR-pQCT, progression was not identified by CR in 33 patients. Adding HR-pQCT to CR doubled the proportion of patients identified with progression from 30 (10%) to 63 (20%) patients. Using CR as the reference, the sensitivity of HR-pQCT for identifying erosive progression was 23.3% (95% CI: 9.9, 42.3%) and the specificity was 88.2% (95% CI: 83.8, 91.7%). Conclusion: A substantial proportion of patients with erosive progression are overlooked using CR only to monitor erosive progression. Adding high-resolution peripheral CT to CR doubles the proportion of patients who may benefit from individualized therapy targeting erosive progression in RA.

KW - erosive progression

KW - high-resolution peripheral quantitative computed tomography

KW - radiography

KW - rheumatoid arthritis

UR - http://www.scopus.com/inward/record.url?scp=86000183046&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/keae281

DO - 10.1093/rheumatology/keae281

M3 - Journal article

C2 - 38749001

SN - 1462-0324

VL - 64

SP - 1092

EP - 1101

JO - Rheumatology

JF - Rheumatology

IS - 3

M1 - Online ahead of print.

ER -

Erosive Progression by High-Resolution Peripheral Quantitative Computed Tomography and Conventional Radiography in Rheumatoid Arthritis

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this