Abstract
BackgroundOngoing arthritis in children with juvenile idiopathic arthritis (JIA) can result in cartilage damage.ObjectiveTo study the feasibility and repeatability of T1ρ for assessing knee cartilage in JIA and also to describe T1ρ values and study correlation between T1ρ and conventional MRI scores for disease activity.Materials and methodsThirteen children with JIA or suspected JIA underwent 3-tesla (T) knee MRI that included conventional sequences and a T1ρ sequence. Segmentation of knee cartilage was carried out on T1ρ images. We used intraclass correlation coefficient to study the repeatability of segmentation in a subset of five children. We used the juvenile arthritis MRI scoring system to discriminate inflamed from non-inflamed knees. The Mann-Whitney U and Spearman correlation compared T1ρ between children with and without arthritis on MRI and correlated T1ρ with the juvenile arthritis MRI score.ResultsAll children successfully completed the MRI examination. No images were excluded because of poor quality. Repeatability of T1ρ measurement had an intraclass correlation coefficient (ICC) of 0.99 (P<0.001). We observed no structural cartilage damage and found no differences in T1ρ between children with (n=7) and without (n=6) inflamed knees (37.8 ms vs. 31.7 ms, P=0.20). However, we observed a moderate correlation between T1ρ values and the juvenile arthritis MRI synovitis score (r=0.59, P=0.04).ConclusionThis pilot study suggests that T1ρ is a feasible and repeatable quantitative imaging technique in children. T1ρ values were associated with the juvenile arthritis MRI synovitis score.
Highlights
Juvenile idiopathic arthritis is the most common rheumatic disease in childhood [1]
We observed a moderate correlation between T1ρ values and the juvenile arthritis magnetic resonance imaging (MRI) synovitis score (r=0.59, P=0.04)
The primary aim of this pilot study was to evaluate feasibility of T1ρ knee cartilage imaging in children with juvenile idiopathic arthritis; secondarily we studied repeatability of T1ρ values derived by manual cartilage segmentation
Summary
Juvenile idiopathic arthritis is the most common rheumatic disease in childhood [1]. Cartilage can be damaged by the autoimmune-mediated inflammation that originates in the synovial membrane. Damage to the cartilage matrix is characterized by loss of proteoglycan and collagen, as demonstrated in studies focusing on rheumatoid arthritis [5,6,7,8,9]. This microstructural damage is important to recognize because intensification of anti-rheumatic treatment might prevent irreversible cartilage damage. Current imaging techniques, such as radiography, US imaging and conventional MRI, can detect structural bone damage and synovial inflammation but cannot detect microstructural damage to cartilage [10]. Ongoing arthritis in children with juvenile idiopathic arthritis (JIA) can result in cartilage damage
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