Ultrasound assessment of synovial pathologic features in rheumatoid arthritis using comprehensive multiplane images of the second metacarpophalangeal joint

Kei Ikeda, Yohei Seto, Akihiro Narita, Atsushi Kawakami, Yutaka Kawahito, Hiromu Ito, Isao Matsushita, Shigeru Ohno, Keiichiro Nishida, Takeshi Suzuki, Atsushi Kaneko, Michihiro Ogasawara, Jun Fukae, Mihoko Henmi, Takayuki Sumida, Tamotsu Kamishima, Takao Koike

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: The aim of this pilot study was to provide groundwork that could be utilized to optimize the global ultrasound (US) assessment of the whole joint for synovial pathologic features in patients with rheumatoid arthritis (RA). Methods: US images of the second metacarpophalangeal joint in 8 predefined imaging planes, comprising regions that comprehensively capture the synovial pathologic features of the whole joint, were obtained from 30 patients with RA. Twelve experienced sonographers evaluated these images at the level of both the individual image and the whole joint, using a visual analog scale (VAS) to assess pathologic severity. Interrater reproducibility of the VAS scores was evaluated with intraclass correlation coefficients (ICCs), and factors that independently influenced the global assessment of the whole joint were identified using multiple linear regression analysis. Results: A total of 14,276 VAS scores were analyzed. Interrater reproducibility of any eligible VAS assessment of synovial pathologic features was good (ICC 0.65). US assessment of synovial pathologic features in joints with mild inflammation was less reproducible than that in joints with severe inflammation. Although the most severely affected region in a joint did not always represent the average pathologic severity among the 8 regions, global assessment of the whole joint strongly correlated with assessment of the most severely affected region (P <0.001). Importantly, the standard, midline imaging plane was not the most influential plane on the global assessment of the whole joint. Assessment of synovial fluid accumulation was not reproducible (ICCs 0.20-0.42) and did not substantiallyinfluence the global assessment of synovial inflammation (β =0.06). Conclusion: The results of this study provide a unique data set that could be utilized to optimize the global US assessment of synovial pathologic features of the whole joint in patients with RA.

Original languageEnglish
Pages (from-to)523-532
Number of pages10
JournalArthritis and Rheumatology
Volume66
Issue number3
DOIs
Publication statusPublished - 2014

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Metacarpophalangeal Joint
Rheumatoid Arthritis
Joints
Visual Analog Scale
Inflammation
Synovial Fluid
Linear Models
Regression Analysis

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Rheumatology

Cite this

Ultrasound assessment of synovial pathologic features in rheumatoid arthritis using comprehensive multiplane images of the second metacarpophalangeal joint. / Ikeda, Kei; Seto, Yohei; Narita, Akihiro; Kawakami, Atsushi; Kawahito, Yutaka; Ito, Hiromu; Matsushita, Isao; Ohno, Shigeru; Nishida, Keiichiro; Suzuki, Takeshi; Kaneko, Atsushi; Ogasawara, Michihiro; Fukae, Jun; Henmi, Mihoko; Sumida, Takayuki; Kamishima, Tamotsu; Koike, Takao.

In: Arthritis and Rheumatology, Vol. 66, No. 3, 2014, p. 523-532.

Research output: Contribution to journalArticle

Ikeda, K, Seto, Y, Narita, A, Kawakami, A, Kawahito, Y, Ito, H, Matsushita, I, Ohno, S, Nishida, K, Suzuki, T, Kaneko, A, Ogasawara, M, Fukae, J, Henmi, M, Sumida, T, Kamishima, T & Koike, T 2014, 'Ultrasound assessment of synovial pathologic features in rheumatoid arthritis using comprehensive multiplane images of the second metacarpophalangeal joint', Arthritis and Rheumatology, vol. 66, no. 3, pp. 523-532. https://doi.org/10.1002/art.38280
Ikeda, Kei ; Seto, Yohei ; Narita, Akihiro ; Kawakami, Atsushi ; Kawahito, Yutaka ; Ito, Hiromu ; Matsushita, Isao ; Ohno, Shigeru ; Nishida, Keiichiro ; Suzuki, Takeshi ; Kaneko, Atsushi ; Ogasawara, Michihiro ; Fukae, Jun ; Henmi, Mihoko ; Sumida, Takayuki ; Kamishima, Tamotsu ; Koike, Takao. / Ultrasound assessment of synovial pathologic features in rheumatoid arthritis using comprehensive multiplane images of the second metacarpophalangeal joint. In: Arthritis and Rheumatology. 2014 ; Vol. 66, No. 3. pp. 523-532.
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abstract = "Objective: The aim of this pilot study was to provide groundwork that could be utilized to optimize the global ultrasound (US) assessment of the whole joint for synovial pathologic features in patients with rheumatoid arthritis (RA). Methods: US images of the second metacarpophalangeal joint in 8 predefined imaging planes, comprising regions that comprehensively capture the synovial pathologic features of the whole joint, were obtained from 30 patients with RA. Twelve experienced sonographers evaluated these images at the level of both the individual image and the whole joint, using a visual analog scale (VAS) to assess pathologic severity. Interrater reproducibility of the VAS scores was evaluated with intraclass correlation coefficients (ICCs), and factors that independently influenced the global assessment of the whole joint were identified using multiple linear regression analysis. Results: A total of 14,276 VAS scores were analyzed. Interrater reproducibility of any eligible VAS assessment of synovial pathologic features was good (ICC 0.65). US assessment of synovial pathologic features in joints with mild inflammation was less reproducible than that in joints with severe inflammation. Although the most severely affected region in a joint did not always represent the average pathologic severity among the 8 regions, global assessment of the whole joint strongly correlated with assessment of the most severely affected region (P <0.001). Importantly, the standard, midline imaging plane was not the most influential plane on the global assessment of the whole joint. Assessment of synovial fluid accumulation was not reproducible (ICCs 0.20-0.42) and did not substantiallyinfluence the global assessment of synovial inflammation (β =0.06). Conclusion: The results of this study provide a unique data set that could be utilized to optimize the global US assessment of synovial pathologic features of the whole joint in patients with RA.",
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T1 - Ultrasound assessment of synovial pathologic features in rheumatoid arthritis using comprehensive multiplane images of the second metacarpophalangeal joint

AU - Ikeda, Kei

AU - Seto, Yohei

AU - Narita, Akihiro

AU - Kawakami, Atsushi

AU - Kawahito, Yutaka

AU - Ito, Hiromu

AU - Matsushita, Isao

AU - Ohno, Shigeru

AU - Nishida, Keiichiro

AU - Suzuki, Takeshi

AU - Kaneko, Atsushi

AU - Ogasawara, Michihiro

AU - Fukae, Jun

AU - Henmi, Mihoko

AU - Sumida, Takayuki

AU - Kamishima, Tamotsu

AU - Koike, Takao

PY - 2014

Y1 - 2014

N2 - Objective: The aim of this pilot study was to provide groundwork that could be utilized to optimize the global ultrasound (US) assessment of the whole joint for synovial pathologic features in patients with rheumatoid arthritis (RA). Methods: US images of the second metacarpophalangeal joint in 8 predefined imaging planes, comprising regions that comprehensively capture the synovial pathologic features of the whole joint, were obtained from 30 patients with RA. Twelve experienced sonographers evaluated these images at the level of both the individual image and the whole joint, using a visual analog scale (VAS) to assess pathologic severity. Interrater reproducibility of the VAS scores was evaluated with intraclass correlation coefficients (ICCs), and factors that independently influenced the global assessment of the whole joint were identified using multiple linear regression analysis. Results: A total of 14,276 VAS scores were analyzed. Interrater reproducibility of any eligible VAS assessment of synovial pathologic features was good (ICC 0.65). US assessment of synovial pathologic features in joints with mild inflammation was less reproducible than that in joints with severe inflammation. Although the most severely affected region in a joint did not always represent the average pathologic severity among the 8 regions, global assessment of the whole joint strongly correlated with assessment of the most severely affected region (P <0.001). Importantly, the standard, midline imaging plane was not the most influential plane on the global assessment of the whole joint. Assessment of synovial fluid accumulation was not reproducible (ICCs 0.20-0.42) and did not substantiallyinfluence the global assessment of synovial inflammation (β =0.06). Conclusion: The results of this study provide a unique data set that could be utilized to optimize the global US assessment of synovial pathologic features of the whole joint in patients with RA.

AB - Objective: The aim of this pilot study was to provide groundwork that could be utilized to optimize the global ultrasound (US) assessment of the whole joint for synovial pathologic features in patients with rheumatoid arthritis (RA). Methods: US images of the second metacarpophalangeal joint in 8 predefined imaging planes, comprising regions that comprehensively capture the synovial pathologic features of the whole joint, were obtained from 30 patients with RA. Twelve experienced sonographers evaluated these images at the level of both the individual image and the whole joint, using a visual analog scale (VAS) to assess pathologic severity. Interrater reproducibility of the VAS scores was evaluated with intraclass correlation coefficients (ICCs), and factors that independently influenced the global assessment of the whole joint were identified using multiple linear regression analysis. Results: A total of 14,276 VAS scores were analyzed. Interrater reproducibility of any eligible VAS assessment of synovial pathologic features was good (ICC 0.65). US assessment of synovial pathologic features in joints with mild inflammation was less reproducible than that in joints with severe inflammation. Although the most severely affected region in a joint did not always represent the average pathologic severity among the 8 regions, global assessment of the whole joint strongly correlated with assessment of the most severely affected region (P <0.001). Importantly, the standard, midline imaging plane was not the most influential plane on the global assessment of the whole joint. Assessment of synovial fluid accumulation was not reproducible (ICCs 0.20-0.42) and did not substantiallyinfluence the global assessment of synovial inflammation (β =0.06). Conclusion: The results of this study provide a unique data set that could be utilized to optimize the global US assessment of synovial pathologic features of the whole joint in patients with RA.

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