New Publications: Dynamic gadolinium-enhanced magnetic resonance imaging allows accurate assessment of the synovial inflammatory activity in rheumatoid arthritis knee joints: a comparison with synovial histology

Posted online on January 30, 2012

MB Axelsen1, M Stoltenberg2, RP Poggenborg1, O Kubassova3, M Boesen4,5, H Bliddal4, K Hørslev-Petersen6, LG Hanson7,8, M Østergaard1

1Department of Rheumatology, Copenhagen University Hospital at Glostrup, Glostrup, Denmark
2Department of Rheumatology, Copenhagen University Hospital at Køge, Køge , Denmark
3Image Analysis Ltd, Leeds, UK
4The Parker Institute, Copenhagen University Hospital at Frederiksberg, Frederiksberg, Denmark
5Department of Radiology, Copenhagen University Hospital at Frederiksberg, Frederiksberg, Denmark
6King Christian X Hospital for Rheumatic Diseases, Graasten, Graasten, Denmark
7Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital at Hvidovre, Hvidovre , Denmark
8Department of Electrical Engineering, Technical University of Denmark, Lyngby, Denmark
Mette Bjørndal Axelsen, Department of Rheumatology RM, Copenhagen University Hospital at Glostrup, Nordre Ringvej 57, DK-2600 Glostrup, Denmark.

Objective:

To determine whether dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) evaluated using semi-automatic image processing software can accurately assess synovial inflammation in rheumatoid arthritis (RA) knee joints.

Methods:

In 17 RA patients undergoing knee surgery, the average grade of histological synovial inflammation was determined from four biopsies obtained during surgery. A preoperative series of T1-weighted dynamic fast low-angle shot (FLASH) MR images was obtained. Parameters characterizing contrast uptake dynamics, including the initial rate of enhancement (IRE), were generated by the software in three different areas: (I) the entire slice (Whole slice); (II) a manually outlined region of interest (ROI) drawn quickly around the joint, omitting large artefacts such as blood vessels (Quick ROI); and (III) a manually outlined ROI following the synovial capsule of the knee joint (Precise ROI). Intra- and inter-reader agreement was assessed using the intra-class correlation coefficient (ICC). 

Results:

The IRE from the Quick ROI and the Precise ROI revealed high correlations to the grade of histological inflammation (Spearman’s correlation coefficient (rho) = 0.70, p = 0.001 and rho = 0.74, p = 0.001, respectively). Intra- and inter-reader ICCs were very high (0.93–1.00). No Whole slice parameters were correlated to histology.

Conclusion:

DCE-MRI provides fast and accurate assessment of synovial inflammation in RA patients. Manual outlining of the joint to omit large artefacts is necessary.

Read More: http://informahealthcare.com/doi/abs/10.3109/03009742.2011.608375

 



Dynamika 4.4.2 is now available

Release of Dynamika 4.4.2

We are pleased to announce the release of Dynamika 4.4.2, which has even more features to enhance your workflow, speed up reading of MRI and reduce a possibility of human error. Please contact sales@imageanalysis.org.uk to receive a free evaluation licence.



Recruiting Scientific Software Engineer and PA to CEO – fascinating projects, start ASAP

Image Analysis is looking for ambitious, talented new team members. We are currently recruiting for a Scientific Software Engineer and a Personal Assistant for our amazing CEO.

For more information Click Here



CASE OF THE WEEK:

MRI parameters for prediction of multiple sclerosis diagnosis in children with acute CNS demyelination: a prospective national cohort study (Verhey etal 2011)

The Lancet Neurology, Volume 10, Issue 12, Pages 1065 – 1073, December 2011

doi:10.1016/S1474-4422(11)70250-2

Published Online: 07 November 2011

A study in Canada has yielded two MRI perameters, which when identified concurrently, predict the onset of pediatric MS with an accuracy of approximately 90%

The study created a standardised scoring method and applied it to MRI scans from a national prospective incidence cohort of children with CNS demyelination and found that the combination of one or more T1-weighted hypointense lesions and one or more T2-weighted periventricular lesions after an incident demyelinating event is highly predictive of a later diagnosis of MS.

This study builds on work conducted by McDonald 2010 (Annals of Neurology, March 2011, Vol. 69:2, pp 292-302) which highlights the importance of periventricular and contrast-enhancing lesions, but differs in that, ‘we see MRI evidence of established or chronic disease already at the first attack in the pediatric population, and that’s mainly through the T1-hypointense lesions,” says lead investigator Leonard Verhey, who is interested to see if similar results will be found in adults

The presence of either one or more T1-weighted hypointense lesions (hazard ratio 20·6, 95% CI 5·46—78·0) or one or more periventricular lesions (3·34, 1·27—8·83) was associated with an increased likelihood of MS diagnosis with a sensitivity 84%, specificity of 93%, positive predictive value of 76% and a negative predictive value of 96%. The risk for MS diagnosis was highest when both parameters were present (34·27, 16·69—70·38).

The team will continue to follow the children, in a longitudinal study. The ability to identify children with MS promptly will enhance timely access to care and will be important for future clinical trials in paediatric MS. The study shows the potential diagnostic power of MRI in this field. This study was conducted without advanced visualisation software and found evidence of chronic disease after the first attack, suggesting that these indicators may be precursors to the diseases onset. Using advanced visualisation tools and pre-emptive scanning shows the potential to increase diagnoses and provide an opportunity for prophylactic treatment.

For more information on how our advanced visualisation platform could help your study please contact our team.



Dr Kubassova is selected to attend EC Innovation Conference 2011

As a finalist for the prestigious European Commission ‘Woman Innovators Award’, Image Analysis’ founder and CEO Dr Olga Kubassova has been invited to attend the EC Innovation Union’s ‘Innovation Conference 2011’. This conference, which will take place in Brussels, includes various debates, Master Classes, Round Tables, and lectures with exclusive key note speakers including an eminent Nobel Prize Laureate on why science matters and from some of the world’s leading authorities on the economic and social aspect of innovation.

The event will explore the broader strategic and social implications of sustainable innovation and allow delegates to interact and receive valuable feedback from world renowned key opinion leaders and stakeholders from the fields of science, healthcare, government and business. It is an exciting opportunity to both; promote Image Analysis as a world leader in the field of advanced visualisation of medical images, and to learn from some of the most respected and successful business innovators in the world.

If you would like to find out more about the European Innovation Union please click here.



IA Well Recieved in Poland

IA’s Bart Kozinski presented at the Polish ‘Rheumatoid hand’ conference on the 19th of November alongside Dr. Agnieszka Warczyńska. Bart’s presentation, ‘Dynamic Contrast Enhanced MRI examination in rheumatoid hand’, and our stand at the conference were very well received and we are looking forward to working with our Polish counterparts, not only in the field of Rheumatology but also in MSK, Oncology and Neurology.

If you would like to download a Polish translation of our brochure click here.



IA’s Dr Kubassova featured in Saturday’s Financial Times

Image Analysis Ltd’s Dr Olga Kubassova was featured in the Financial Times article ‘IP boost for students’ on Saturday 29th October. To view the article Click Here

The article cites IA’s success as an example of why universities should be more open with their Intellectual Property (IP) and be more proactive in encouraging students to be entrepreneurial.



Watch EULAR 2011 interviews

Watch key members of the IA team being interviewed at EULAR 2011. ‘Videos are produced by ISEMIR, Rheumatology, Best Practices in Imaging.’

Treat to Target: MRI and US use in rheumatology with Norman Gaylis, President of International Society of Rheumatology

Cost effective therapy for MSK patients vs. Imaging, with Prof. P. Taylor (Kennedy Institute of Rheumatology, Oxford, UK),

Quantification of Inflammation with MRI, with Mikael Boesen, MD, PhD, Head of MRI Research, the Parker Institute, Copenhagen, Denmark

Usage of extremity MRI in routine practice, with Prof. Marco Cimmino, Genoa, Italy

Usage of Advanced Software for Quantification of MRI in clinical routine, research and Randomised Clinical trials, with Dr. Olga Kubassova, CEO of Image Analysis, United Kingdom.



IA’s MD Dr Olga Kubassova nominated for prestigious EC Award!

IA’s MD, Dr Olga Kubassova, has been nominated for the Prestigious ‘EU Woman Innovators’ Awards, presented by the European Comission. Olga will present to the European Comission and be interviewed by a panel tomorrow. To be nominated for such a coveted international award is an achievement in itself, we will keep you posted as soon as we here any news.



IA Chairman chairs debate on ‘NHS Information Revolution: using information to improve quality’ at the King’s Fund London

Image Analysis’ Chairman Jeremy Nettle chaired a debate on ‘NHS Information Revolution: using information to improve quality’ at the King’s Fund London last week amongst the topics being discussed were:

· NICE quality standards and the Commissioning Outcomes Framework: a work in progress – Fergus Macbeth, Director of the Centre for Clinical Practice, NICE

· Meeting the information needs of clinical commissioning groups – Ailsa Claire OBE, Director of Commissioning Development, NHS Yorkshire and the Humber and Lead on Commissioning Intelligence for CCGs, Department of Health

· BCS: enabling an NHS Information Revolution – Justin Whatling, Vice Chair Strategy and Policy, BCS Health

To view biographies of all those involved follow this link