Utility of combined high-resolution bone SPECT and MRI for the identification of rheumatoid arthritis patients with high-risk for erosive progression

Abstract Objectives To evaluate the utility of sequentially acquired, post hoc fused, magnetic resonance imaging (MRI) and multi-pinhole single photon emission computed tomography (MPH-SPECT) with technetium-99m-labeled disphosphonates (Tc99m-DPD) for the identification of finger joints with later e...

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Bibliographic Details
Published in:European journal of radiology 2013-02, Vol.82 (2), p.374-379
Main Authors: Buchbender, Christian, Sewerin, Philipp, Mattes-György, Katalin, Miese, Falk, Wittsack, Hans-Joerg, Specker, Christof, Antoch, Gerald, Müller, Hans-Wilhelm, Schneider, Matthias, Scherer, Axel, Ostendorf, Benedikt
Format: Article
Language:English
Subjects:
Adult
Aged
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - diagnosis
Diphosphonates
DPD bone scanning
Erosion
Female
Humans
Joint
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Middle Aged
Organotechnetium Compounds
Osteolysis - complications
Osteolysis - diagnosis
Radiology
Radiopharmaceuticals
Reproducibility of Results
Rheumatoid arthritis
Sensitivity and Specificity
Single photon emission computertomography
Subtraction Technique
Tomography, Emission-Computed, Single-Photon - methods
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Summary:Abstract Objectives To evaluate the utility of sequentially acquired, post hoc fused, magnetic resonance imaging (MRI) and multi-pinhole single photon emission computed tomography (MPH-SPECT) with technetium-99m-labeled disphosphonates (Tc99m-DPD) for the identification of finger joints with later erosive progression in early rheumatoid arthritis (ERA) patients. Methods Ten consecutive ERA patients prospectively underwent MPH-SPECT and MRI of metacarpophalangeal (MCP) joints prior to and after 6 months methotrexate therapy. Tc99m-DPD uptake was measured at proximal and distal MCP sites using regional analysis. The course of joint pathologies was scored according to the Rheumatoid Arthritis MRI Score (RAMRIS) criteria. Results The frequency of increased Tc99m-DPD uptake, synovitis and bone marrow edemadecreased under MTX therapy; but the number of bone erosions increased. Joints with progressive and new erosions on follow-up had a higher baseline Tc99m-DPD uptake (2.64 ± 1.23 vs. 1.43 ± 0.91) ( p = 0.02). Conclusions Joints with erosive progression are characterized by an early increased Tc99m-DPD uptake, even in absence of MRI bone pathologies. Tc99m-DPD MPH-SPECT might thus be of additional value to morphological MRI for the identification of RA patients with a high risk for erosive progression.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2012.10.011