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Proton density fat fraction (PDFF) maps aid fat metaplasia evaluation in the sacroiliac joints in additional to T1WI : improved diagnostic accuracy in axial spondyloarthritis

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Abstract
Purpose: To evaluate the added value of qualitative and quantitative fat metaplasia analysis using proton-density fat fraction (PDFF) map in additional to T1-weighted imaging (T1WI) of the sacroiliac joints (SIJ) for diagnosis of axial spondyloarthritis (axSpA).Method: Patients aged 18-45 years with axSpA were enrolled. Non-SpA patients and healthy volunteers were included as controls. All participants underwent 3.0T MRI of the SIJs including semi-coronal T1WI and semi-coronal chemical-shift encoded MRI sequence for generating PDFF map. Each joint was divided into four quadrants for analysis. Two independent readers scored fat metaplasia on T1WI alone or with additional PDFF map and measured PDFF values in different reading sessions. Using clinical diagnosis as the reference, diagnostic accuracy of visual scores and PDFF measurements was evaluated by area under the receiver operating charac-teristic curve (AUC). Inter-reader agreement was evaluated by the intra-class correlation coefficient (ICC).Results: Forty-nine patients with axSpA and thirty-six controls were included. Qualitative fat metaplasia scores using additional PDFF map performed better than using T1WI alone (AUC: Reader 1, 0.847 vs 0.795, p = 0.082; Reader 2, 0.785 vs 0.719, p = 0.048). AUCs of quantitative analysis using number of quadrants with PDFF value >= 75 % were higher than qualitative analysis using T1WI alone (Reader 1, 0.863 vs 0.795, p = 0.046; Reader 2, 0.823 vs 0.785, p = 0.011). ICCs were 0.854 to 0.922 for qualitative analysis and 0.935 for quantitative analysis.Conclusions: Additional PDFF map can increase the diagnostic accuracy for axSpA by qualitative and quantitative fat metaplasia analysis, in comparison to using T1WI alone.
Keywords
Radiology, Nuclear Medicine and imaging, General Medicine, Fat fraction, Bone marrow, Magnetic resonance imaging, Sacroiliac joint, Spondyloarthritis

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MLA
Chen, Min, et al. “Proton Density Fat Fraction (PDFF) Maps Aid Fat Metaplasia Evaluation in the Sacroiliac Joints in Additional to T1WI : Improved Diagnostic Accuracy in Axial Spondyloarthritis.” EUROPEAN JOURNAL OF RADIOLOGY, vol. 157, 2022, doi:10.1016/j.ejrad.2022.110569.
APA
Chen, M., Yu, K., Hu, X., Van Den Berghe, T., Qi, Y., Jin, B., … Cheng, G. (2022). Proton density fat fraction (PDFF) maps aid fat metaplasia evaluation in the sacroiliac joints in additional to T1WI : improved diagnostic accuracy in axial spondyloarthritis. EUROPEAN JOURNAL OF RADIOLOGY, 157. https://doi.org/10.1016/j.ejrad.2022.110569
Chicago author-date
Chen, Min, Keyan Yu, Xuehan Hu, Thomas Van Den Berghe, Yulong Qi, Bin Jin, Xin Liu, and Guanxun Cheng. 2022. “Proton Density Fat Fraction (PDFF) Maps Aid Fat Metaplasia Evaluation in the Sacroiliac Joints in Additional to T1WI : Improved Diagnostic Accuracy in Axial Spondyloarthritis.” EUROPEAN JOURNAL OF RADIOLOGY 157. https://doi.org/10.1016/j.ejrad.2022.110569.
Chicago author-date (all authors)
Chen, Min, Keyan Yu, Xuehan Hu, Thomas Van Den Berghe, Yulong Qi, Bin Jin, Xin Liu, and Guanxun Cheng. 2022. “Proton Density Fat Fraction (PDFF) Maps Aid Fat Metaplasia Evaluation in the Sacroiliac Joints in Additional to T1WI : Improved Diagnostic Accuracy in Axial Spondyloarthritis.” EUROPEAN JOURNAL OF RADIOLOGY 157. doi:10.1016/j.ejrad.2022.110569.
Vancouver
1.
Chen M, Yu K, Hu X, Van Den Berghe T, Qi Y, Jin B, et al. Proton density fat fraction (PDFF) maps aid fat metaplasia evaluation in the sacroiliac joints in additional to T1WI : improved diagnostic accuracy in axial spondyloarthritis. EUROPEAN JOURNAL OF RADIOLOGY. 2022;157.
IEEE
[1]
M. Chen et al., “Proton density fat fraction (PDFF) maps aid fat metaplasia evaluation in the sacroiliac joints in additional to T1WI : improved diagnostic accuracy in axial spondyloarthritis,” EUROPEAN JOURNAL OF RADIOLOGY, vol. 157, 2022.
@article{8770761,
  abstract     = {{Purpose: To evaluate the added value of qualitative and quantitative fat metaplasia analysis using proton-density fat fraction (PDFF) map in additional to T1-weighted imaging (T1WI) of the sacroiliac joints (SIJ) for diagnosis of axial spondyloarthritis (axSpA).Method: Patients aged 18-45 years with axSpA were enrolled. Non-SpA patients and healthy volunteers were included as controls. All participants underwent 3.0T MRI of the SIJs including semi-coronal T1WI and semi-coronal chemical-shift encoded MRI sequence for generating PDFF map. Each joint was divided into four quadrants for analysis. Two independent readers scored fat metaplasia on T1WI alone or with additional PDFF map and measured PDFF values in different reading sessions. Using clinical diagnosis as the reference, diagnostic accuracy of visual scores and PDFF measurements was evaluated by area under the receiver operating charac-teristic curve (AUC). Inter-reader agreement was evaluated by the intra-class correlation coefficient (ICC).Results: Forty-nine patients with axSpA and thirty-six controls were included. Qualitative fat metaplasia scores using additional PDFF map performed better than using T1WI alone (AUC: Reader 1, 0.847 vs 0.795, p = 0.082; Reader 2, 0.785 vs 0.719, p = 0.048). AUCs of quantitative analysis using number of quadrants with PDFF value >= 75 % were higher than qualitative analysis using T1WI alone (Reader 1, 0.863 vs 0.795, p = 0.046; Reader 2, 0.823 vs 0.785, p = 0.011). ICCs were 0.854 to 0.922 for qualitative analysis and 0.935 for quantitative analysis.Conclusions: Additional PDFF map can increase the diagnostic accuracy for axSpA by qualitative and quantitative fat metaplasia analysis, in comparison to using T1WI alone.}},
  articleno    = {{110569}},
  author       = {{Chen, Min and Yu, Keyan and Hu, Xuehan and Van Den Berghe, Thomas and Qi, Yulong and Jin, Bin and Liu, Xin and Cheng, Guanxun}},
  issn         = {{0720-048X}},
  journal      = {{EUROPEAN JOURNAL OF RADIOLOGY}},
  keywords     = {{Radiology,Nuclear Medicine and imaging,General Medicine,Fat fraction,Bone marrow,Magnetic resonance imaging,Sacroiliac joint,Spondyloarthritis}},
  language     = {{eng}},
  pages        = {{7}},
  title        = {{Proton density fat fraction (PDFF) maps aid fat metaplasia evaluation in the sacroiliac joints in additional to T1WI : improved diagnostic accuracy in axial spondyloarthritis}},
  url          = {{http://doi.org/10.1016/j.ejrad.2022.110569}},
  volume       = {{157}},
  year         = {{2022}},
}

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