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Wang H, Ou Y, Fang W, Ambalathankandy P, Goto N, Ota G, Okino T, Fukae J, Sutherland K, Ikebe M, Kamishima T. A deep registration method for accurate quantification of joint space narrowing progression in rheumatoid arthritis. Comput Med Imaging Graph 2023; 108:102273. [PMID: 37531811 DOI: 10.1016/j.compmedimag.2023.102273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/15/2023] [Accepted: 07/15/2023] [Indexed: 08/04/2023]
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease that leads to progressive articular destruction and severe disability. Joint space narrowing (JSN) has been regarded as an important indicator for RA progression and has received significant attention. Radiology plays a crucial role in the diagnosis and monitoring of RA through the assessment of joint space. A new framework for monitoring joint space by quantifying joint space narrowing (JSN) progression through image registration in radiographic images has emerged as a promising research direction. This framework offers the advantage of high accuracy; however, challenges still exist in reducing mismatches and improving reliability. In this work, we utilize a deep intra-subject rigid registration network to automatically quantify JSN progression in the early stages of RA. In our experiments, the mean-square error of the Euclidean distance between the moving and fixed images was 0.0031, the standard deviation was 0.0661 mm and the mismatching rate was 0.48%. Our method achieves sub-pixel level accuracy, surpassing manual measurements significantly. The proposed method is robust to noise, rotation and scaling of joints. Moreover, it provides misalignment visualization, which can assist radiologists and rheumatologists in assessing the reliability of quantification, exhibiting potential for future clinical applications. As a result, we are optimistic that our proposed method will make a significant contribution to the automatic quantification of JSN progression in RA. Code is available at https://github.com/pokeblow/Deep-Registration-QJSN-Finger.git.
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Affiliation(s)
- Haolin Wang
- Graduate School of Health Sciences, Hokkaido University, Sapporo, 060-0812, Hokkaido, Japan
| | - Yafei Ou
- Research Center For Integrated Quantum Electronics, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan; Graduate School of Information Science and Technology, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan.
| | - Wanxuan Fang
- Graduate School of Health Sciences, Hokkaido University, Sapporo, 060-0812, Hokkaido, Japan
| | - Prasoon Ambalathankandy
- Research Center For Integrated Quantum Electronics, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan; Graduate School of Information Science and Technology, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan
| | - Naoto Goto
- Research Center For Integrated Quantum Electronics, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan; Graduate School of Information Science and Technology, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan
| | - Gen Ota
- Research Center For Integrated Quantum Electronics, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan; Graduate School of Information Science and Technology, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan
| | - Taichi Okino
- Department of Radiological Technology, Sapporo City General Hospital, Sapporo, 060-8604, Hokkaido, Japan
| | - Jun Fukae
- Kuriyama Red Cross Hospital, Yubari, 069-1513, Hokkaido, Japan
| | - Kenneth Sutherland
- Global Center for Biomedical Science and Engineering, Hokkaido University, Sapporo, 060-8638, Hokkaido, Japan
| | - Masayuki Ikebe
- Research Center For Integrated Quantum Electronics, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan; Graduate School of Information Science and Technology, Hokkaido University, Sapporo, 060-0813, Hokkaido, Japan
| | - Tamotsu Kamishima
- Faculty of Health Sciences, Hokkaido University, Sapporo, 060-0812, Hokkaido, Japan
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Pfeil A, Oelzner P, Hoffmann T, Renz DM, Wolf G, Böttcher J. Sind röntgenologische Scoring-Methoden als Parameter zur
Verlaufsbeurteilung der rheumatoiden Arthritis noch
zeitgemäß? AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1394-0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungDie radiologische Progression beschreibt das Ausmaß der
Gelenkzerstörung im Verlauf einer rheumatoiden Arthritis. Zur
Quantifizierung der radiologischen Progression werden Scoring-Methoden
(z. B. van der Heijde Modifikation des Sharp-Score) eingesetzt. In
verschiedenen Studien zu biologischen- bzw. target-synthetischen Disease
Modifying Anti-Rheumatic Drugs gelang nur unzureichend eine Differenzierung
der radiologischen Progression. Zudem finden die Scores oft keinen
routinemäßigen Einsatz in der klinischen
Entscheidungsfindung. Durch die computerbasierte Analyse von
Handröntgenaufnahmen ist eine valide Quantifizierung der
radiologischen Progression und die zuverlässige Bewertung von
Therapieeffekten möglich. Somit stellen die computerbasierten
Methoden eine vielversprechende Alternative in der Quantifizierung der
radiologischen Progression dar.
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Affiliation(s)
- Alexander Pfeil
- Klinik für Innere Medizin III, Universitätsklinikum
Jena, Jena, Deutschland
| | - Peter Oelzner
- Klinik für Innere Medizin III, Universitätsklinikum
Jena, Jena, Deutschland
| | - Tobias Hoffmann
- Klinik für Innere Medizin III, Universitätsklinikum
Jena, Jena, Deutschland
| | - Diane M. Renz
- Institut für Diagnostische und Interventionelle Radiologie,
Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Gunter Wolf
- Klinik für Innere Medizin III, Universitätsklinikum
Jena, Jena, Deutschland
| | - Joachim Böttcher
- Medizinische Fakultät, Friedrich-Schiller-Universität
Jena, Jena, Deutschland
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Pfeil A, Nussbaum A, Renz DM, Hoffmann T, Malich A, Franz M, Oelzner P, Wolf G, Böttcher J. Radiographic remission in rheumatoid arthritis quantified by computer-aided joint space analysis (CASJA): a post hoc analysis of the RAPID 1 trial. Arthritis Res Ther 2020; 22:229. [PMID: 33023661 PMCID: PMC7541323 DOI: 10.1186/s13075-020-02322-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/17/2020] [Indexed: 11/20/2022] Open
Abstract
Background The reduction of finger joint space width (JSW) in patients with rheumatoid arthritis (RA) is strongly associated with joint destruction. Treatment with certolizumab pegol (CZP), a PEGylated anti-TNF, has been proven to be effective in RA patients. The computer-aided joint space analysis (CAJSA) provides the semiautomated measurement of joint space width at the metacarpal-phalangeal joints (MCP) based on hand radiographs. The aim of this post hoc analysis of the RAPID 1 trial was to quantify MCP joint space distance (JSD-MCP) measured by CAJSA between baseline and week 52 in RA patients treated with certolizumab pegol (CZP) plus methotrexate (MTX) compared with MTX/placebo. Methods Three hundred twenty-eight patients were included in the post hoc analysis and received placebo plus MTX, CZP 200 mg plus MTX and CZP 400 mg plus MTX. All patients underwent X-rays of the hand at baseline and week 52 as well as assessment of finger joint space narrowing of the MCP using CAJSA (Version 1.3.6; Sectra; Sweden). The joint space width (JSW) was expressed as mean joint space distance of the MCP joints I to V (JSD-MCPtotal). Results The MTX group showed a significant reduction of joint space of − 4.8% (JSD-MCPtotal), whereas in patients treated with CZP 200 mg/MTX and CZP 400 mg/MTX a non-significant change (JSD-MCPtotal + 0.6%) was observed. Over 52 weeks, participants with DAS28 remission (DAS28 ≤ 2.6) exhibited a significant joint space increase of + 3.3% (CZP 200 mg plus MTX) and + 3.9% (CZP pegol 400 mg plus MTX). Conclusion CZP plus MTX did not reduce JSD-MCPtotal estimated by CAJSA compared with MTX/placebo. Furthermore, clinical remission (DAS28 ≤ 2.6) in patients treated with CZP plus MTX was associated with an increasing JSD, indicating radiographic remission in RA.
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Affiliation(s)
- Alexander Pfeil
- Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Anica Nussbaum
- Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Diane M Renz
- Institute of Diagnostic and Interventional Radiology, Department of Pediatric Radiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Tobias Hoffmann
- Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Ansgar Malich
- Institute of Diagnostic Radiology, Suedharz-Hospital Nordhausen, Dr. Robert-Koch-Straße 38, 99734, Nordhausen, Germany
| | - Marcus Franz
- Department of Internal Medicine I, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Peter Oelzner
- Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Gunter Wolf
- Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
| | - Joachim Böttcher
- Faculty of Medicine, Jena University Hospital - Friedrich Schiller, University Jena, Am Klinikum 1, 07747, Jena, Germany.,Institute of Diagnostic and Interventional Radiology, Jena University Hospital - Friedrich Schiller, University Jena, Am Klinikum 1, 07747, Jena, Germany
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Zhu J, Li B, Qiu L, Liu H, Zhang M, Wang Y, Wang P, Jiao D, Chen T, Liu X, Cui L, Shan Y, Luo B, Lin N, Hua X, Hu Z, Hu Y, Tu B, Zheng Y, Chen S, Xu S, Mao J, Liu W, Xiang M, Li J, Chen J, Tang Y, Chen S, He Y, Dai T, Zhang S, Zhang Y, Fang M, Hao S, Lin X, He X, Bao B, Xi Z, Peng X, Zhang Q, Du G. A measurement method of knee joint space width by ultrasound: a large multicenter study. Quant Imaging Med Surg 2020; 10:979-987. [PMID: 32489922 PMCID: PMC7242315 DOI: 10.21037/qims-20-373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/09/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Although plain radiology is the primary method for assessing joint space width (JSW), it has poor sensitivity to change over time in regards to determining longitudinal progression. We, therefore, developed a new ultrasound (US) measurement method of knee JSW and aimed to provide a monitoring method for the change of JSW in the future. METHODS A multicenter study was promoted by the Professional Committee of Musculoskeletal Ultrasound, the Ultrasound Society, and the Chinese Medical Doctor Association. US study of knee specimens determined the landmarks for ultrasonic measurement of knee JSW. The US of 1,272 participants from 27 centers was performed to discuss the feasibility and possible influencing factors of knee JSW. The landmarks for US measurement of knee JS, the inflection point of medial femoral epicondyle and the proximal end of the tibia, were determined. RESULTS The mean knee JSW1 (medial knee JSW) was 8.57±1.95 mm in females and 9.52±2.31 mm in males. The mean knee JSW2 (the near medial knee JSW) was 9.07±2.24 mm in females and 10.17±2.35 mm in males. The JSW values of males were significantly higher than those of females, with a statistical difference. JSW values were negatively correlated with age and body mass index (BMI) to different degrees and positively correlated with height. CONCLUSIONS The novel US measurement method can be used to measure knee JSW.
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Affiliation(s)
- Jiaan Zhu
- Department of Ultrasound, Peking University People’s Hospital, Beijing 100044, China
| | - Bing Li
- Department of Ultrasound, Peking University People’s Hospital, Beijing 100044, China
| | - Li Qiu
- Department of Ultrasound, Sichuan University West China Hospital, Chengdu 610041, China
| | - Hongmei Liu
- Department of Ultrasound, Guangdong Second Provincial General Hospital, Guangzhou 510317, China
| | - Mi Zhang
- Department of Ultrasound, Peking University People’s Hospital, Beijing 100044, China
| | - Yuexiang Wang
- Department of Ultrasound, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Ping Wang
- Department of Ultrasound, Third Affiliated Hospital of Southern Medical University, Guangzhou 510000, China
| | - Dan Jiao
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - Tao Chen
- Department of Ultrasound, Beijing Jishuitan Hospital, Beijing 100009, China
| | - Xueling Liu
- Department of Ultrasound, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning 530023, China
| | - Ligang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Yong Shan
- Department of Ultrasound, The Second Hospital of Anhui Medical University, Hefei 230601, China
| | - Baoming Luo
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Ning Lin
- Department of Ultrasound, Fujian Provincial Hospital, Fuzhou 350001, China
| | - Xing Hua
- Department of Ultrasound, The First Hospital Affiliated to Army Medical University (Southwest Hospital), Chongqing 400038, China
| | - Zhenlong Hu
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated First People’s Hospital, Shanghai 210620, China
| | - Yue Hu
- Department of Ultrasound, Peking University People’s Hospital, Beijing 100044, China
| | - Bin Tu
- Department of Ultrasound, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, China
| | - Yuanyi Zheng
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
| | - Shuqiang Chen
- Department of Ultrasound, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Shiliang Xu
- Department of Ultrasound, Haikou People’s Hospital, Haikou 570208, China
| | - Jianying Mao
- Department of Ultrasound, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 200052, China
| | - Weiyong Liu
- Department of Ultrasound, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230036, China
| | - Minghui Xiang
- Department of Ultrasound, Central Hospital Affiliated to Shenyang Medical College, Shenyang 110027, China
| | - Jia Li
- Department of Ultrasound, Zhongda Hospital Southeast University, Nanjing 210009, China
| | - Jian Chen
- Department of Ultrasound, Yan’an Hospital of Kunming City, Kunming 650051, China
| | - Yuanjiao Tang
- Department of Ultrasound, Sichuan University West China Hospital, Chengdu 610041, China
| | - Siming Chen
- Department of Ultrasound, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Yanni He
- Department of Ultrasound, Guangdong Second Provincial General Hospital, Guangzhou 510317, China
| | - Ting Dai
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun 130033, China
| | - Shumin Zhang
- Department of Ultrasound, Beijing Jishuitan Hospital, Beijing 100009, China
| | - Yuanyuan Zhang
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - Mingdi Fang
- Department of Ultrasound, The Second Hospital of Anhui Medical University, Hefei 230601, China
| | - Shaoyun Hao
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Xiaoyan Lin
- Department of Ultrasound, Fujian Provincial Hospital, Fuzhou 350001, China
| | - Xiuzhen He
- Department of Ultrasound, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, China
| | - Bo Bao
- Department of Ultrasound, Haikou People’s Hospital, Haikou 570208, China
| | - Zhanguo Xi
- Department of Ultrasound, Luoyang Orthopedic-Traumatological Hospital of Henan Province, Luoyang 471000, China
| | - Xiaojing Peng
- Department of Ultrasound, Jiangsu Province Hospital, Nanjing 210029, China
| | - Qunxia Zhang
- Department of Ultrasound, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400065, China
| | - Guoqing Du
- Department of Ultrasound, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China
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Inhibition of periarticular bone loss is associated with clinical remission and ACR70-Response in rheumatoid arthritis. Rheumatol Int 2018; 39:637-645. [PMID: 30569216 DOI: 10.1007/s00296-018-4226-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/11/2018] [Indexed: 12/29/2022]
Abstract
The aim of this study, based on a post hoc analysis of the data set used in the RAPID 1 trial, focuses on the associations between metacarpal bone mineral density, as estimated by digital X-ray radiogrammetry (DXR), and clinical remission as well as ACR70-Response in rheumatoid arthritis (RA) patients treated with certolizumab pegol (CZP). The trial evaluates a total of 345 RA patients treated with methotrexate versus CZP 200 mg versus CZP 400 mg. All patients underwent X-rays of the hand at baseline and week 52 as well as computerized calculations of bone mineral density (BMD) by DXR. Clinical remission was defined as DAS28 < 2.6. ACR70-Response was also evaluated. The radiological assessment of disease progression was estimated using the modified total Sharp Score. The mean difference for DAS28 was observed for patients treated with CZP 400 mg (median: - 3.53, minimum: - 6.77; maximum: + 0.48) and CZP 200 mg (median: - 3.13, minimum: - 6.37; maximum: - 0.52) compared to the methotrexate group (median - 2.41, minimum: - 4.76; maximum: + 0.31). The DXR-BMD showed a minor bone loss for the treatment groups undergoing therapy with CZP 200 mg (median: - 0.009 g/cm2, minimum: - 0.059 g/cm2; maximum: + 0.095 g/cm2) and CZP 400 mg (median: - 0.008 g/cm2, minimum: - 0.064 g/cm2; maximum: + 0.080 g/cm2). The methotrexate group presented an advanced periarticular metacarpal bone loss as measured by DXR-BMD (median: - 0.024 g/cm2, minimum: - 0.102 g/cm2; maximum: + 0.057 g/cm2). In the case of clinical remission and ACR70-Response, no significant change of the DXR-BMD was observed for both CZP groups. The study highlights that patients treated with CZP show a less accentuated periarticular bone loss as estimated by DXR in comparison to patients with methotrexate plus placebo. In addition, patients with clinical remission and ACR70-Response revealed no periarticular demineralisation.
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Yue J, Wu D, Tam LS. The role of imaging in early diagnosis and prevention of joint damage in inflammatory arthritis. Expert Rev Clin Immunol 2018; 14:499-511. [PMID: 29754519 DOI: 10.1080/1744666x.2018.1476849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
INTRODUCTION Inflammatory arthritis is characterized by chronic inflammation in the synovium, associated with degradation of cartilage and erosion of juxta-articular bone. The bone loss and joint destruction mediated by aberrant immunological responses resulting in proinflammatory cytokine release and various immune cell activation are known as osteoimmunology. Areas covered: A structured literature search including Medline and PubMed, Cochrane meta-analyses and abstracts of international congresses was performed to review joint damage in inflammatory arthritis in terms of pathogenesis, novel imaging assessment, and prevention. Expert commentary: Deeper understanding of the integration of the skeletal and immune as well as inflammatory system is paving the way to prevent bone loss and bone destruction in inflammatory arthritis. With the availability of various imaging modalities such as ultrasound, magnetic resonance imaging (MRI) and high-resolution peripheral quantitative computed tomography (HR-pQCT), we are now able to detect early joint damage, early diagnosis of inflammatory arthritis, monitor the progression or even ascertain whether the inflammatory process is effectively suppressed to allow repair of joint damage by novel therapeutic agents.
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Affiliation(s)
- Jiang Yue
- a Department of Medicine & Therapeutics , The Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin , Hong Kong
| | - Dongze Wu
- a Department of Medicine & Therapeutics , The Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin , Hong Kong
| | - Lai-Shan Tam
- a Department of Medicine & Therapeutics , The Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin , Hong Kong
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