To Contrast or Not to Contrast? On the Role of Contrast Enhancement in Hand MRI Studies of Patients with Rheumatoid Arthritis
Miriam Frenken,
Gesa Rübsam,
Alexander Mewes,
Karl Ludger Radke,
Lien Li,
Lena M. Wilms,
Sven Nebelung,
Daniel B. Abrar,
Philipp Sewerin
Affiliations
Miriam Frenken
Institute of Diagnostic and Interventional Radiology, University Hospital of Düsseldorf, Moorenstraße 5, 40225 Dusseldorf, Germany
Gesa Rübsam
Department and Hiller Research Unit of Rheumatology, Heinrich Heine University Düsseldorf, UKD, Moorenstrasse 5, 40225 Düsseldorf, Germany
Alexander Mewes
Institute of Diagnostic and Interventional Radiology, University Hospital of Düsseldorf, Moorenstraße 5, 40225 Dusseldorf, Germany
Karl Ludger Radke
Institute of Diagnostic and Interventional Radiology, University Hospital of Düsseldorf, Moorenstraße 5, 40225 Dusseldorf, Germany
Lien Li
Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 Munich, Germany
Lena M. Wilms
Institute of Diagnostic and Interventional Radiology, University Hospital of Düsseldorf, Moorenstraße 5, 40225 Dusseldorf, Germany
Sven Nebelung
Institute of Diagnostic and Interventional Radiology, University Hospital of Düsseldorf, Moorenstraße 5, 40225 Dusseldorf, Germany
Daniel B. Abrar
Institute of Diagnostic and Interventional Radiology, University Hospital of Düsseldorf, Moorenstraße 5, 40225 Dusseldorf, Germany
Philipp Sewerin
Department and Hiller Research Unit of Rheumatology, Heinrich Heine University Düsseldorf, UKD, Moorenstrasse 5, 40225 Düsseldorf, Germany
Currently, clinical indications for the application of gadolinium-based contrast agents (GBCA) in magnetic resonance imaging (MRI) are increasingly being questioned. Consequently, this study aimed to evaluate the additional diagnostic value of contrast enhancement in MRI of the hand in patients with rheumatoid arthritis (RA). Thirty-one patients with RA (mean age, 50 ± 14 years (range, 18–72 years)) underwent morphologic MRI scans on a clinical 3 T scanner. MRI studies were analyzed based on (1) the Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) and (2) the GBCA-free RAMRIS version, termed RAMRIS Sine-Gadolinium-For-Experts (RAMRIS-SAFE), in which synovitis and tenosynovitis were assessed using the short-tau inversion-recovery sequence instead of the post-contrast T1-weighted sequence. The synovitis subscores in terms of Spearman’s ρ, as based on RAMRIS and RAMRIS-SAFE, were almost perfect (ρ = 0.937; p ρ = 0.380 p = 0.035). Correlation between the total RAMRIS and RAMRIS-SAFE was also almost perfect (ρ = 0.976; p κ was high (0.963 ≤ κ ≤ 0.925). In conclusion, RAMRIS-SAFE as the GBCA-free version of the well-established RAMRIS is a patient-friendly and resource-efficient alternative for assessing disease-related joint changes in RA. As patients with RA are subject to repetitive GBCA applications, non-contrast imaging protocols should be considered.
