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Original Research

Synovitis in Patients with Early Inflammatory Arthritis Monitored with Quantitative Analysis of Dynamic Contrast-enhanced Optical Imaging and MR Imaging

Published Online:Jan 1 2014https://doi.org/10.1148/radiol.13130039

Abstract

Our data show that quantitative measurements of dynamic indocyanine green–enhanced optical imaging allow for therapeutic monitoring of synovitis in the hands of patients with early inflammatory arthritis.

Purpose

To evaluate quantitative perfusion measurements of dynamic indocyanine green (ICG)–enhanced optical imaging for monitoring synovitis in the hands of patients with inflammatory arthritis compared with dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging and clinical outcome.

Materials and Methods

This study was approved by the ethics committee at the institution. Individual joints (n = 840) in the hands and wrists of 28 patients (14 women; mean age, 53.3 years) with inflammatory arthritis were examined at three different time points: before start of therapy and 12 and 24 weeks after start of therapy or therapy escalation. Treatment response was assessed by using clinical measures (simple disease activity index [SDAI]), ICG-enhanced optical imaging, and DCE MR imaging. Dynamic images were obtained for optical imaging and DCE MR imaging. The rate of early enhancement (REE) of the perfusion curves of each joint was calculated by using in-house developed software. Correlation coefficients were estimated to evaluate the associations of changes of imaging parameters and SDAI change.

Results

Quantitative perfusion measurements with optical imaging and MR imaging correctly identified patients who responded (n = 18) and did not respond to therapy (n = 10), as determined by SDAI. The difference of REE after 24 weeks of treatment compared with baseline in responders was significantly reduced in optical imaging and MR imaging (optical imaging: mean, −21.5%; MR imaging: mean, −41.0%; P < .001 for both), while in nonresponders it was increased (optical imaging: mean, 10.8%; P = .075; MR imaging: mean, 8.7%; P = .03). The REE of optical imaging significantly correlated with MR imaging (ρ = 0.80; P < .001) and SDAI (ρ = 0.61; P < .001).

Conclusion

Quantitative analysis of contrast-enhanced optical imaging allows for potential therapeutic monitoring of synovitis in patients with inflammatory arthritis.

© RSNA, 2013

Online supplemental material is available for this article.

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Article History

Received January 6, 2013; revision requested March 13; revision received April 17; accepted May 9; final version accepted May 15.
Published online: Jan 2014
Published in print: Jan 2014