In-office MRI vs. radiography in detecting changes in erosions after one year of infliximab therapy

Norman B. Gaylis, Steven D. Needell, Daniel Rudensky

This article has been published by the Japan College of Rheumatology in April 2007, Mod Rheumatol 17, pages 273 – 278. This study was led by Dr. Norman B. Gaylis, Dr. Steven D. Needell and Dr. Daniel Rudensky.

ABSTRACT

The objective of this study was to compare stan­dard hand radiographs with in-office 0.2 T magnetic reso­nance imaging(MRI) in monitoring response to therapy in patients with rheumatoid arthritis(RA) who were receiving infliximab, to evaluate the frequency and location of ero­sions, and to determine if there were differences in outcome based on disease duration at baseline. Patients who satisfied the American College of Rheumatology criteria for RA and were receiving infliximab therapy were evaluated with a baseline and 1-year follow-up MRI. Magnetic resonance images were interpreted by two blinded, board-certified radiologists. Bone erosions were identified as well – defined defects extending through the cortical margin. The mean age of the 48 patients was 58.5 years. The median infliximab dosage was 4mg/kg. Baseline data showed that 41 patients had abnormal MRls. The mean time between the baseline and follow-up MRI examinations was 10.5 months. Follow-­up MRI revealed regression in 11 patients. Thirty-one patients had both MRIs and radiographs. Magnetic reso­nance imaging was approximately twice as sensitive as radiography in detecting erosions at baseline. In-office MRI was useful in monitoring disease response after the initiation of infliximab treatment. Magnetic resonance imaging is poten­tially a very valuable diagnostic tool and prognostic indica­tor for use in patients with RA.

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