Whole-body MRI Quantification for Assessment of Bone Lesions in Chronic Nonbacterial Osteomyelitis Patients Treated With Pamidronate: A Prevalence, Reproducibility, and Responsiveness Study
| Autor: | Lillian Lim, Andrea S. Doria, Jyoti Panwar, Ronald M. Laxer, Jennifer Stimec, Mirkamal Tolend, Shirley M. L. Tse |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Immunology Whole body mri Pamidronate Lesion 03 medical and health sciences 0302 clinical medicine Rheumatology Prevalence Immunology and Allergy Medicine Humans Whole Body Imaging 030212 general & internal medicine Child Retrospective Studies 030203 arthritis & rheumatology Reproducibility medicine.diagnostic_test business.industry Osteomyelitis Soft tissue Reproducibility of Results Magnetic resonance imaging medicine.disease Response to treatment Magnetic Resonance Imaging Bone lesion Radiology medicine.symptom business |
| Zdroj: | The Journal of rheumatology. 48(5) |
| ISSN: | 0315-162X |
| Popis: | ObjectiveThe purpose of this study was (1) to assess the interreader reliability in detecting and scoring the inflammatory bone lesions in pediatric patients with chronic nonbacterial osteomyelitis (CNO) by using whole-body magnetic resonance imaging (WB-MRI), and (2) to evaluate the responsiveness of the MRI-detected CNO lesions to pamidronate therapy.MethodsEighty-eight WB-MRI examinations were independently reviewed and scored by 2 radiologists blinded to clinical details in 32 retrospectively enrolled pediatric patients with CNO. Inflammatory bone lesions, soft tissue abnormality, and bony structural changes were scored before and after pamidronate therapy. Lesion responsiveness was calculated by using standardized response mean and interreader reliability was assessed by k statistics.ResultsThere was good to excellent interreader agreement for the detection and quantification of bone lesions. After the first cycle of pamidronate in all 32 patients, 96 of the 279 lesions (34%; after excluding 108 lesions of hand and feet) resolved, whereas in a subset of 11 patients with 2 or more cycles, 76% of lesions resolved after the second cycle. Twenty-one (7.5%) lesions worsened and 46 (16.4%) new lesions developed after 1 cycle in all 32 patients. In these 11 patients, the number of worsened lesions reduced to 2 (2%) and new lesions to 14 (14.9%) after the second cycle as detected on MRI. Vertebral lesions had the highest response to treatment.ConclusionWB-MRI is a reliable tool for objective quantification and assessment of response to treatment of pediatric CNO bone lesions and could be used to monitor disease activity for clinical and research purposes. |
| Databáze: | OpenAIRE |
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