Definition for Rheumatoid Arthritis Erosions Imaged with High Resolution Peripheral Quantitative Computed Tomography and Interreader Reliability for Detection and Measurement

被引:63
作者
Barnabe, Cheryl [1 ,2 ]
Toepfer, Dominique [3 ]
Marotte, Hubert [4 ,5 ]
Hauge, Ellen-Margrethe [6 ,7 ]
Scharmga, Andrea [8 ]
Kocijan, Roland [9 ]
Kraus, Sebastian [10 ,11 ]
Boutroy, Stephanie [12 ]
Schett, Georg [10 ]
Keller, Kresten Krarup [6 ]
de Jong, Joost [8 ]
Stok, Kathryn S. [13 ]
Finzel, Stephanie [10 ,14 ]
机构
[1] Univ Calgary, Dept Med, Calgary, AB, Canada
[2] Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada
[3] Univ Erlangen Nurnberg, Inst Med Phys, Erlangen, Germany
[4] Univ Hosp St Etienne, Inst Natl Sante & Rech Med, St Etienne, France
[5] Univ Hosp St Etienne, Rheumatol Dept, St Etienne, France
[6] Aarhus Univ Hosp, Dept Rheumatol, Aarhus, Denmark
[7] Aarhus Univ, Dept Clin Med, Aarhus, Denmark
[8] Maastricht Univ, Dept Rheumatol, Med Ctr, Maastricht, Netherlands
[9] Med Univ Vienna, St Vincent Hospital Med Dept 2, VINFORCE Study Grp, Acad Teaching Hosp, Vienna, Austria
[10] Univ Erlangen Nurnberg, Dept Internal Med Rheumatol & Immunol 3, Erlangen, Germany
[11] Kantonsspital Baden, Baden, Switzerland
[12] Hop Edouard Herriot Kresten, INSERM, Lyon, France
[13] Swiss Fed Inst Technol, Zurich, Switzerland
[14] Univ Med Ctr Freiburg, Dept Rheumatol & Clin Immunol, Freiburg, Germany
关键词
RHEUMATOID ARTHRITIS; EROSIONS; HR-PQCT; JOINT SPACE WIDTH; BONE EROSIONS; METACARPOPHALANGEAL JOINTS; WRIST; QUANTIFICATION; CLASSIFICATION; CRITERIA; REPAIR; HAND;
D O I
10.3899/jrheum.160648
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. High-resolution peripheral quantitative computed tomography (HR-pQCT) sensitively detects erosions in rheumatoid arthritis (RA); however, nonpathological cortical bone disruptions are potentially misclassified as erosive. Our objectives were to set and test a definition for pathologic cortical bone disruptions in RA and to standardize reference landmarks for measuring erosion size. Methods. HR-pQCT images of metacarpophalangeal joints of RA and control subjects were used in an iterative process to achieve consensus on the definition and reference landmarks. Independent readers (n = 11) applied the definition to score 58 joints and measure pathologic erosions in 2 perpendicular multiplanar reformations for their maximum width and depth. Interreader reliability for erosion detection and variability in measurements between readers [root mean square coefficient of variation (RMSCV), intraclass correlation (ICC)] were calculated. Results. Pathologic erosions were defined as cortical breaks extending over a minimum of 2 consecutive slices in perpendicular planes, with underlying trabecular bone loss and a nonlinear shape. Interreader agreement for classifying pathologic erosions was 90.2%, whereas variability for width and depth erosion assessment was observed (RMSCV perpendicular width 12.3%, axial width 20.6%, perpendicular depth 24.0%, axial depth 22.2%; ICC perpendicular width 0.206, axial width 0.665, axial depth 0.871, perpendicular depth 0.783). Mean erosion width was 1.84 mm (range 0.16-8.90) and mean depth was 1.86 mm (range 0.30-8.00). Conclusion. We propose a new definition for erosions visualized with HR-pQCT imaging. Interreader reliability for erosion detection is good, but further refinement of selection of landmarks for erosion size measurement, or automated volumetric methods, will be pursued.
引用
收藏
页码:1935 / 1940
页数:6
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