Title:Value of Magnetic Resonance T1 Mapping in Evaluating the Early Response to
Treatment for Rheumatoid Arthritis
Volume: 20
Author(s): Yi Dai, Wenzhao Yuan, Yidi Chen, Qiaoqing Lan, Fang Qin, Hao Ding, Huiting Zhang, Yiwu Lei and Liling Long*
Affiliation:
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, Guangxi - 530021, China
Keywords:
Magnetic resonance imaging, Rheumatoid arthritis, T1 mapping, Bone marrow edema, RAMRIS, BME.
Abstract:
Background:
Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) is usually used for the semi-quantitative evaluation of joint changes in
Rheumatoid Arthritis (RA). However, this method cannot evaluate early changes in bone marrow edema (BME).
Objective:
To determine whether T1 mapping of wrist BME predicts early treatment response in RA.
Methods:
This study prospectively enrolled 48 RA patients administered oral anti-rheumatic drugs. MRI of the most severely affected wrist was performed
before and after 4 (48 patients) and 8 weeks of treatment (38 patients). Mean T1 values of BME in the lunate, triangular, and capitate bones;
RAMRIS for each wrist; Erythrocyte-Sedimentation Rate (ESR); and 28-joint Disease Activity Score (DAS28)-ESR score were analyzed. Patients
were divided into responders (4 weeks, 30 patients; 8 weeks, 32 patients) and non-responders (4 weeks, 18 patients; 8 weeks, 6 patients), according
to EULAR response criteria. Receiver operating characteristic (ROC) curves were used to evaluate the efficacy of T1 values.
Results:
ESR and DAS28-ESR were not correlated with T1 value and RAMRIS at each examination (P > 0.05). Changes in T1 value and DAS28-ESR
relative to the baseline were moderately positively correlated with each other at 4 and 8 weeks (r = 0.555 and 0.527, respectively; P < 0.05). At 4
weeks, the change and rate of change in T1 value significantly differed between responders and non-responders (-85.63 vs. -19.92 ms; -12.89% vs.
-2.81%; P < 0.05). The optimal threshold of the rate of change in T1 value at 4 weeks for predicting treatment response was -5.32% (area under the
ROC curve, 0.833; sensitivity, 0.900; specificity, 0.667).
Conclusion:
T1 mapping provides a new imaging method for monitoring RA lesions; changes in wrist BME T1 values reflect early treatment response.
