Diagnostic and Interventional Radiology
Musculoskeletal Imaging - Original Article

Synovitis and bone inflammation in early rheumatoid arthritis: high-resolution multi-pinhole SPECT versus MRI

1.

Department of Diagnostic and Interventional Radiology, Univ Dusseldorf, Medical Faculty, Dusseldorf, Germany

2.

Department of Rheumatology, Univ Dusseldorf, Medical Faculty, Dusseldorf, Germany

3.

Department Nuclear Medicine, Univ Dusseldorf, Medical Faculty, Dusseldorf, Germany

4.

Department of Rheumatology & Clinical Immunology, Kliniken Essen-Sued, Essen, Germany

5.

Department of Diagnostic and Interventional Radiology, University Dusseldorf, School of Medicine, Düsseldorf, Germany

Diagn Interv Radiol 2013; 19: 20-24
DOI: 10.4261/1305-3825.DIR.5922-12.1
Read: 532 Downloads: 252 Published: 03 September 2019

Abstract

PURPOSE We aimed to assess the relationship between bone inflammation in multi-pinhole single-photon emission computed tomography (MPH-SPECT) and synovitis detected by magnetic resonance imaging (MRI) in early rheumatoid arthritis patients. 

 

MATERIALS AND METHODS 
MPH-SPECT with technetium dicarboxypropanedisphosphonate (Tc-99mDPD) and 3 Tesla MRI were performed in 10 early rheumatoid arthritis patients. Eighty finger joint sites were assessed for increased osteoblastic activity using visual and region-of-interest (ROI) analysis. Presence of joint inflammation in MRI was investigated using the subscores of the rheumatoid arthritis MRI score. 

 

RESULTS 
Tc-99mDPD uptake was increased in 38 (47.5%) and 22 (27.5%) joint sites as determined by visual and ROI analysis, respectively. A total of 32 (84.2%) sites with increased bone metabolism showed a normal MRI bone signal. The MPHSPECT uptake ratio was elevated only in the subgroup with severe synovitis (P < 0.001). 

 

CONCLUSION 
In early rheumatoid arthritis, molecular imaging with MPHSPECT detects higher rates of inflammatory bone involvement compared to MRI. Our preliminary data suggest that osteitis is related to severe synovitis.

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