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Musculoskeletal Imaging CRO

Musculoskeletal Imaging In Clinical Trials

As a specialist imaging CRO for musculoskeletal trials, we deliver standardized imaging assessments using established scoring systems, subspecialist MSK readers and robust DXA harmonization, including site-level calibration and phantom-based quality control where required.

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Years of Imaging Expertise!

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Clinical Trials Supported

Global

Site & Investigator Network

Compliance & Certificates

SOC 2 TYPE II

HHS-Seal

GDPR

FDA 21 CFR Part 11

ISO 13485

What our musculoskeletal imaging team does

Imaging endpoints in musculoskeletal trials

In musculoskeletal trials, the reliability of imaging endpoints depends on consistent image acquisition and standardized application of the relevant scoring methodology. Semi-quantitative systems such as RAMRIS, PsAMRIS, MOAKS and SPARCC require experienced readers, structured training and robust quality control to minimize variability in image interpretation.

DXA introduces an additional harmonization challenge. Differences between scanner manufacturers and systems can affect the comparability of measurements, making appropriate calibration, cross-site standardization and quality control essential when data are collected across multiple sites or hardware platforms.

IAG has extensive experience in musculoskeletal imaging methodology, including DCE-MRI of small joints and computer-aided quantification of synovitis and bone marrow oedema. We deliver standardized, centrally read imaging endpoints and quantitative MRI biomarkers across global studies.

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What our musculoskeletal imaging team does

Musculoskeletal Imaging Capabilities

BICR design, acquisition guidelines and reader concordance testing for validated MSK scoring systems plus cross-site DXA harmonization and computer-aided synovitis quantification.

DXA harmonization

Expertise in cross-site standardization of Hologic and GE systems, including phantom-based calibration and quality control where required.

Computer-aided synovitis quantification

DCE-MRI of small joints with quantification correlated to RAMRIS and histology

Global trial delivery

End-to-end imaging support for bone health, osteoporosis and musculoskeletal studies across global sites, including experience in China.

Study Phases

How Image Analysis Group Supports Musculoskeletal Trials

Scoring methodology, DXA harmonization and central review scaled to your stage of development.

Collect & Hold

Prospective or retrospective collection and secure archival of radiographs, MRI and DXA ready for scoring when your analysis plan is set.

Collect & Hold

Early Phase Trials

Sequence harmonization, DCE-MRI setup and quantitative synovitis analysis to establish a measurable inflammation signal.

Early Phase Trials

Late Phase Trials

Concordance-tested MSK readers applying RAMRIS, PsAMRIS or MOAKS at scale, with DXA standardized across Hologic and GE systems.

Late Phase Trials

RWE & AI Studies

Submission-ready structural and quantitative datasets, TFLs and reader variability analyses.

RWE & AI Studies

The experts behind your reads.

Musculoskeletal Imaging Experts

Internationally recognised MSK radiologists and rheumatology investigators who define scoring methodology, run reader training and oversee quantitative assessment of inflammation and structural damage.

Prof. Mikael Boesen Therapeutic Area Lead — IAG Scientific Advisory Board Musculoskeletal

Dr. John A. Carrino Scientific Advisor — Musculoskeletal Imaging Expert Musculoskeletal

Prof. Henning Bliddal Scientific Advisor — GLP-1, Osteoarthritis and Pain Musculoskeletal

Prof. Philip J. Mease Scientific Advisor — Psoriatic Arthritis, Spondyloarthritis, Rheumatoid Arthritis, Fibromyalgia, Lupus Autoimmune

Scoring systems, measures and modalities we work in.

Musculoskeletal Scoring Systems and Quantitative Measures.

RAMRIS, PsAMRIS, SPARCC, mSASSS, BASRI, MOAKS, WORMS, Kellgren–Lawrence and OARSI Atlas, with DEMRIQ, Trabecular Bone Score, Genant grading and DXA-derived BMD measures.

Criterion

Applies to

RAMRIS

Rheumatoid arthritis MRI assessment

PsAMRIS

MRI assessment of sacroiliac joint and spinal inflammation

mSASSS

Radiographic structural damage assessment

BASRI

Radiographic assessment of ankylosing spondylitis

MOAKS

Semi-quantitative MRI assessment

WORMS

Whole-organ MRI assessment

Kellgren–Lawrence grading

Radiographic OA grading

OARSI Atlas

Radiographic OA feature assessment

DEMRIQ

Dynamic contrast-enhanced MRI quantification

Musculoskeletal Indications We Support

Indications We Cover

Inflammatory and degenerative joint disease, axial spondyloarthritis, bone health and orthopedic and spine programs — with the scoring system selected per indication.

Bone Health

Multi-vendor DXA is the central risk in bone trials — scanner differences can be mistaken for treatment effect. We harmonize Hologic and GE systems with phantom-based calibration and QC, and deliver BMD, Trabecular Bone Score, Genant vertebral fracture grading and QCT measures.

Orthopedic and Spine Imaging

Device and surgical studies need reproducible structural assessment despite implant artefact. We define positioning, projection and sequence requirements in the charter and centralize review for consistent longitudinal comparison.

Osteoarthritis

OA progression is slow, so acquisition consistency and reader calibration determine whether change is detectable. We apply MOAKS and WORMS semi-quantitative MRI scoring with Kellgren–Lawrence and OARSI Atlas radiographic grading, standardized across sites and timepoints.

Ankylosing Spondylitis

Axial SpA trials need both inflammation and structural damage measures. We deliver SPARCC scoring of sacroiliac and spinal inflammation alongside mSASSS and BASRI radiographic assessment, with acquisition standardized across sites.

Rheumatoid Arthritis

RAMRIS scoring of synovitis, bone marrow oedema and erosion depends entirely on reader calibration. We run structured reader training and concordance testing before study reads, and offer quantitative DCE-MRI and computer-aided synovitis measurement for objective inflammation endpoints.

Psoriatic Arthritis

PsA involves joints, entheses and dactylitis, so scoring must cover more than synovium. We apply PsAMRIS with harmonized small-joint MRI acquisition and readers qualified across the full range of PsA features.

One Platform Behind Every MSK Read

Why Sponsors Choose IAG

DYNAMIKA™ delivers validated MSK scoring at scale — RAMRIS, PsAMRIS and MOAKS applied by concordance-tested readers, with DXA harmonized across Hologic and GE systems and every action auditable.<br />

Centralized, secure data collection

DYNAMIKA™ unifies global imaging into a single cloud-native environment — GxP-validated, SOC 2 Type II and 21 CFR Part 11 compliant.

Real-time visibility and oversight

24/7 access to imaging status for every stakeholder, with site and reader performance tracked as the study runs.

Quality control and automated anonymization

Automated checks on receipt produce de-identified, QC-passed datasets before any read begins.

Consistent, standardized reads

Protocol-driven central reviews deliver consistent, reproducible assessments using validated scoring systems appropriate to the indication, including RAMRIS, PsAMRIS and MOAKS, with DXA harmonization across Hologic and GE systems where required.

Musculoskeletal

Reader management and audit trails

Subspecialist musculoskeletal radiologists are qualified against the relevant scoring methodology, with reader training and concordance testing completed before study reads begin. Reader assignment, blinding and adjudication workflows—including 2+1 models where required—are managed in-platform with a complete audit trail.