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Optical spectral transmission may detect joint inflammation in patients with RA
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Use of a noninvasive optical spectral transmission device may detect joint inflammation in patients with rheumatoid arthritis, according to results of this pilot study.
Researchers recruited 59 patients with rheumatoid arthritis (RA) and 10 participants with noninflammatory, undifferentiated arthralgia. Twenty patients had a Disease Activity Score in 28 joints (DAS28) of 2.6 or less, 29 patients had a DAS28 of 2.6 to 5.1 and 13 patients had a DAS28 of greater than 5.1.
Clinical assessment included an ultrasound and optical spectral transmission (OST) examination of the wrists and hands in all patients and MRI examination in patients with a DAS28 of 2.6 or less. Ultrasound was performed by one examiner blinded to study details with a MyLab 60 system equipped with an 18.6 MHz linear array transducer.
A rheumatology nurse used a full-hand prototype, multi-joint OST device to examine hands. Both hands were inserted into pressure cuffs to allow LED lights at wavelengths of 660 nm and 810 nm to illuminate the joints. A charge-coupled device camera continuously recorded images of the dorsal side of the hand at a minimum frame rate of six images per second. Measurements were completed in 90 seconds and included measurements at a cuff inflation of 5 mm Hg, 50 mm Hg and deflation. A reviewer blinded to patient details analyzed the images. A 1.5-Tesla MRI device was used to obtain coronal and transversal T1-weighted turbo spin images and coronal T2-weighted turbo spin images.
An internally validated algorithm was developed to detect joint inflammation with OST using ultrasound as a reference and multiple regression analysis. The maximum gray scale and power Doppler scores for synovitis and tenosynovitis were dependent variables, and normalized joint parameters were independent variables. The performance of OST was compared with clinical examination, DAS28, ultrasound and MRI using receiver-operating curve analysis at the patient level and at the joint level with synovitis on ultrasound as a reference.
Moderate agreement between OST and clinical assessments, ultrasound and MRI was observed. Researchers also found a higher correlation between OST and ultrasound compared with clinical assessment. Correlation to MRI was similar to clinical assessment, but the researchers noted challenges in the assessment of patients with remission or low disease activity. – by Shirley Pulawski
Disclosures: van Onna reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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