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Measurement of cartilage volumes in rheumatoid arthritis using MRI

¹ Department of Medical Physics & Bioengineering, Bristol General Hospital, Guinea Street, Bristol BS1 6SY, ² Rheumatology Unit, University of Bristol Division of Medicine, Bristol Royal Infirmary, Bristol BS2 8HW, ³ Division of Imaging Sciences and Biomedical Imaging, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, ⁴ MRC Health Services Research, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, ⁵ Respiratory and Inflammation Research, ⁶ Enabling Science Technology and Information, AstraZeneca, Alderley Park, Macclesfield, Cheshire SK10 4TG and ⁷ Department of Clinical Radiology, Bristol Royal Infirmary, Bristol BS2 8HW, UK

MRI is a valuable imaging modality for assessment of the articular cartilage in rheumatoid arthritis (RA) and is potentially of use in monitoring disease progression and response to therapy. In this study, we investigated the sources of error in volume measurements obtained by segmentation of MR images of knee cartilage in patients with RA and followed cartilage volume in a group of RA patients for 12 months. 23 RA patient volunteers were recruited for knee imaging. Six subjects were imaged at baseline only, six were imaged at baseline and again within an hour in the same imaging session, six subjects were imaged at baseline and 7 days, and 17 subjects were imaged at baseline, 4±2 months and 12 months. Imaging was performed at 1.0 T using a three-dimensional spoiled gradient-echo sequence with fat-suppression. Manual image segmentation was performed once or twice on the lateral tibial, medial tibial, patellar and femoral compartment by either one or two segmenters. Coefficients of variation (CoV) for repeated volume measurement of total cartilage were 2.2% (same segmenter, same scan), 5.2% (different segmenter, same scan), 4.9% (same segmenter, different scan, same session), and 4.4% (same segmenter, different scan, different session). Over the 12 month duration of the study there was no significant change in total cartilage volume, nor were there significant changes in volume in any individual compartment. This measurement technique is reproducible, but any net change in cartilage volume over 1 year is very small.

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