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Perfusion in hand arthritis on dynamic contrast-enhanced computed tomography: a randomized prospective study using MRI as a standard of reference.
Skeletal Radiol. 2020 Jun 30 [Online ahead of print]SR

Abstract

OBJECTIVE

To evaluate the performance of dynamic contrast-enhanced CT (DCE-CT) in detecting and quantitatively assessing perfusion parameters in patients with arthritis of the hand compared with dynamic contrast-enhanced MRI (DCE-MRI) as a standard of reference.

MATERIALS AND METHODS

In this IRB-approved randomized prospective single-centre study, 36 consecutive patients with suspected rheumatoid arthritis underwent DCE-CT (320-row, tube voltage 80 kVp, tube current 8.25 mAs) and DCE-MRI (1.5 T) of the hand. Perfusion maps were calculated separately for mean transit time (MTT), time to peak (TTP), relative blood volume (rBV), and relative blood flow (rBF) using four different decomposition techniques. Region of interest (ROI) analysis was performed in metacarpophalangeal joints II-V and in the wrist. Pairs of perfusion parameters in DCE-CT and DCE-MRI were compared using a two-tailed t test for paired samples and interpreted for effect size (Cohen's d). According to the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) scoring results, differentiation of synovitis-positive and synovitis-negative joints with both modalities was assessed with the independent t test.

RESULTS

The two modalities yielded similar perfusion parameters. Identified differences had small effects (d 0.01-0.4). DCE-CT additionally differentiates inflamed and noninflamed joints based on rBF and rBV but tends to underestimate these parameters in severe inflammation. The total dose-length product (DLP) was 48 mGy*cm with an estimated effective dose of 0.038 mSv.

CONCLUSION

DCE-CT is a promising imaging technique in arthritis. In patients with a contraindication to MRI or when MRI is not available, DCE-CT is a suitable alternative to detect and assess arthritis.

Authors+Show Affiliations

Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt - Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt - Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt - Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.Department of Rheumatology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt - Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.Department of Rheumatology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Humboldt - Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt - Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.Department of Radiology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt - Universität zu Berlin, Freie Universität Berlin, Berlin, Germany. torsten.diekhoff@charite.de.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32607803

Citation

Ulas, Sevtap Tugce, et al. "Perfusion in Hand Arthritis On Dynamic Contrast-enhanced Computed Tomography: a Randomized Prospective Study Using MRI as a Standard of Reference." Skeletal Radiology, 2020.
Ulas ST, Hermann KG, Makowski MR, et al. Perfusion in hand arthritis on dynamic contrast-enhanced computed tomography: a randomized prospective study using MRI as a standard of reference. Skeletal Radiol. 2020.
Ulas, S. T., Hermann, K. G., Makowski, M. R., Biesen, R., Proft, F., Schilling, R., & Diekhoff, T. (2020). Perfusion in hand arthritis on dynamic contrast-enhanced computed tomography: a randomized prospective study using MRI as a standard of reference. Skeletal Radiology. https://doi.org/10.1007/s00256-020-03526-5
Ulas ST, et al. Perfusion in Hand Arthritis On Dynamic Contrast-enhanced Computed Tomography: a Randomized Prospective Study Using MRI as a Standard of Reference. Skeletal Radiol. 2020 Jun 30; PubMed PMID: 32607803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perfusion in hand arthritis on dynamic contrast-enhanced computed tomography: a randomized prospective study using MRI as a standard of reference. AU - Ulas,Sevtap Tugce, AU - Hermann,Kay Geert, AU - Makowski,Marcus R, AU - Biesen,Robert, AU - Proft,Fabian, AU - Schilling,Ralph, AU - Diekhoff,Torsten, Y1 - 2020/06/30/ PY - 2020/04/01/received PY - 2020/06/18/accepted PY - 2020/06/15/revised PY - 2020/7/2/entrez KW - Arthritis, rheumatoid KW - Computed tomography KW - Magnetic resonance imaging KW - Perfusion imaging KW - Synovitis JF - Skeletal radiology JO - Skeletal Radiol. N2 - OBJECTIVE: To evaluate the performance of dynamic contrast-enhanced CT (DCE-CT) in detecting and quantitatively assessing perfusion parameters in patients with arthritis of the hand compared with dynamic contrast-enhanced MRI (DCE-MRI) as a standard of reference. MATERIALS AND METHODS: In this IRB-approved randomized prospective single-centre study, 36 consecutive patients with suspected rheumatoid arthritis underwent DCE-CT (320-row, tube voltage 80 kVp, tube current 8.25 mAs) and DCE-MRI (1.5 T) of the hand. Perfusion maps were calculated separately for mean transit time (MTT), time to peak (TTP), relative blood volume (rBV), and relative blood flow (rBF) using four different decomposition techniques. Region of interest (ROI) analysis was performed in metacarpophalangeal joints II-V and in the wrist. Pairs of perfusion parameters in DCE-CT and DCE-MRI were compared using a two-tailed t test for paired samples and interpreted for effect size (Cohen's d). According to the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) scoring results, differentiation of synovitis-positive and synovitis-negative joints with both modalities was assessed with the independent t test. RESULTS: The two modalities yielded similar perfusion parameters. Identified differences had small effects (d 0.01-0.4). DCE-CT additionally differentiates inflamed and noninflamed joints based on rBF and rBV but tends to underestimate these parameters in severe inflammation. The total dose-length product (DLP) was 48 mGy*cm with an estimated effective dose of 0.038 mSv. CONCLUSION: DCE-CT is a promising imaging technique in arthritis. In patients with a contraindication to MRI or when MRI is not available, DCE-CT is a suitable alternative to detect and assess arthritis. SN - 1432-2161 UR - https://www.unboundmedicine.com/medline/citation/32607803/Perfusion_in_hand_arthritis_on_dynamic_contrast-enhanced_computed_tomography:_a_randomized_prospective_study_using_MRI_as_a_standard_of_reference L2 - https://doi.org/10.1007/s00256-020-03526-5 DB - PRIME DP - Unbound Medicine ER -
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