Radiologic imaging is crucial for diagnosing and monitoring rheumatic inflammatory diseases. Particularly the emerging approach of precision medicine has increased the interest in quantitative imaging. Extensive research has shown that ultrasound allows a quantification of direct signs such as bone erosions and synovial thickness. Dual-energy X-ray absorptiometry and high-resolution peripheral quantitative computed tomography (CT) contribute to the quantitative assessment of secondary signs such as osteoporosis or lean mass loss. Magnetic resonance imaging (MRI), using different techniques and sequences, permits in-depth evaluations. For instance, the perfusion of the inflamed synovium can be quantified by dynamic contrast-enhanced imaging or diffusion-weighted imaging, and cartilage injury can be assessed by mapping (T1ρ, T2). Furthermore, the increased metabolic activity characterizing the inflammatory response can be reliably assessed by hybrid imaging (positron emission tomography [PET]/CT, PET/MRI). Finally, advances in intelligent systems are pushing forward quantitative imaging. Complex mathematical algorithms of lesions’ segmentation and advanced pattern recognition are showing promising results.
Auto-Immune & Inflammatory
Multimodal Imaging of the Distal Interphalangealjoint Synovio-entheseal Complex in Psoriatic Arthritis (MIDAS): a Cross-sectional Study on the Diagnostic Accuracy of Different Imaging Modalities Comparing Psoriatic Arthritis to Psoriasis and Osteoarthritis
Precision Medicine and Artificial Intelligence – The Perfect Fit for Autoimmunity
Quantitative Imaging in Inflammatory Arthritis: Between Tradition and Innovation.
Role of Artificial Intelligence in Assessment of Peripheral Joint MRI in Inflammatory Arthritis: A Systematic Review and Meta-analysis
The Role of Advanced MRI in the Development of Treat-to-Target Therapeutic Strategies, Patient Stratification and Phenotyping in Rheumatoid Arthritis
18F-FDG PET/CT Imaging of Extranodal Rosai-Dorfman Disease with Hepatopancreatic Involvement – A Pictorial and Literature Review
Perfusion in Bone Marrow Lesions Assessed on DCE-MRI and its Association with Pain in Knee Osteoarthritis: A Cross-Sectional Study
The Impact of a Significant Weight Loss on Inflammation Assessed on DCE-MRI and Static MRI in Knee Osteoarthritis: A Prospective Cohort Study
The Effects of Weight Loss on Imaging Outcomes in Osteoarthritis of the Hip or Knee in People who are Overweight or Obese: A Systematic Review
Copyright © 2019 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Osteoarthritis Cartilage. 2020 Jan;28(1):10-21. doi: 10.1016/j.joca.2019.10.013. Epub 2019 Nov 26.
Abstract
OBJECTIVE:
To evaluate the structural effects of weight loss on hip or knee osteoarthritis (OA) and to summarize which structural joint pathologies have been examined and the evidence for the outcome measurement instruments applied.
DESIGN:
Based on a pre-specified protocol (available: PROSPERO CRD42017065263), we conducted a systematic search of the bibliographic databases, Medline, Embase and Web of Science identifying longitudinal articles reporting the effects of weight loss on structural imaging outcomes in OA of the hip or knee in people who are overweight or obese.
RESULTS:
From 1625 potentially eligible records, 14 articles (from 6 cohorts) were included. 2 cohorts were derived from RCTs. Evaluated pathologies were: articular cartilage (n = 7), joint space width (n = 3), bone marrow lesions (n = 5), synovitis (n = 2), effusion (n = 1), meniscus (n = 3), bone marrow density (n = 1) and infrapatellar fat pad (IPFP; n = 2). Cartilage showed conflicting results when evaluating cartilage thickness by direct thickness measurements. Compositional dGEMRIC and T2 mapping measures in early knee OA showed trends towards reduced cartilage degeneration. Joint space width on conventional radiographs showed no change. Weight loss reduced the size of the IPFP. Synovitis and effusion were not affected. Following weight loss DXA showed bone loss at the hip.
CONCLUSION:
We did not find consistent evidence of the effects of weight loss on OA structural pathology in people who are overweight or obese. There is a need to achieve consensus on which structural pathologies and measurements to apply in weight loss and OA research.