Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging
Objectives Radiography and MRI of the sacroiliac joints (SIJ) are relevant for the diagnosis and classification of patients with axial spondyloarthritis (axSpA). This study aimed to evaluate the impact of clinical information (CI) on the accuracy of imaging interpretation.Methods Out of 109 patients...
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BMJ Publishing Group
2024-04-01
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Series: | RMD Open |
Online Access: | https://rmdopen.bmj.com/content/10/2/e004044.full |
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author | Jürgen Braun Denis Poddubnyy Torsten Diekhoff Fabian Proft Mikhail Protopopov Valeria Rios Rodriguez Murat Torgutalp Judith Rademacher Dominik Deppe Katharina Ziegeler Tim Pohlner |
author_facet | Jürgen Braun Denis Poddubnyy Torsten Diekhoff Fabian Proft Mikhail Protopopov Valeria Rios Rodriguez Murat Torgutalp Judith Rademacher Dominik Deppe Katharina Ziegeler Tim Pohlner |
author_sort | Jürgen Braun |
collection | DOAJ |
description | Objectives Radiography and MRI of the sacroiliac joints (SIJ) are relevant for the diagnosis and classification of patients with axial spondyloarthritis (axSpA). This study aimed to evaluate the impact of clinical information (CI) on the accuracy of imaging interpretation.Methods Out of 109 patients referred because of suspicion of axSpA with complete imaging sets (radiographs and MRI of SIJ), 61 were diagnosed with axSpA (56%). Images were independently evaluated by three radiologists in four consecutive reading campaigns: radiographs and radiographs+MRI without and with CI including demographic data, SpA features, physical activity and pregnancy. Radiographs were scored according to the modified New York criteria, and MRIs for inflammatory and structural changes compatible with axSpA (yes/no). The clinical diagnosis was taken as reference standard. The compatibility of imaging findings with a diagnosis of axSpA (precision) before and after the provision of CI and radiologists’ confidence with their findings (0–10) were evaluated.Results The precision of radiographs evaluation without versus with CI increased from 70% to 78% (p=0.008), and for radiographs+MRI from 81% to 82% (p=1.0), respectively. For CR alone, the sensitivity and specificity of radiologic findings were 51% and 94% without and 60% and 100% with CI, while, for radiographs+MRI, they were 74% and 90% vs 71% and 98%, respectively. The diagnostic confidence of radiologists increased from 5.2±1.9 to 6.0±1.7 with CI for radiographs, and from 6.7±1.6 to 7.2±1.6 for radiographs+MRI, respectively.Conclusion The precision, specificity and diagnostic confidence of radiologic evaluation increased when CI was provided. |
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language | English |
last_indexed | 2024-04-24T13:05:25Z |
publishDate | 2024-04-01 |
publisher | BMJ Publishing Group |
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series | RMD Open |
spelling | doaj.art-a135ac2a123748e9953558beac86137d2024-04-05T08:25:09ZengBMJ Publishing GroupRMD Open2056-59332024-04-0110210.1136/rmdopen-2023-004044Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imagingJürgen Braun0Denis Poddubnyy1Torsten Diekhoff2Fabian Proft3Mikhail Protopopov4Valeria Rios Rodriguez5Murat Torgutalp6Judith Rademacher7Dominik Deppe8Katharina Ziegeler9Tim Pohlner10Ruhr University Bochum, Bochum, Nordrhein-Westfalen, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin, Berlin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Gastroenterology, Infectious Diseases and Rheumatology (including Clinical Nutrition), Charité-Universitätsmedizin Berlin, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitatsmedizin Berlin Campus Benjamin Franklin, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Radiology, Charité Universitätsmedizin Berlin Campus Charité Mitte, Berlin, GermanyDepartment of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité Universitätsmedizin Berlin, Berlin, GermanyObjectives Radiography and MRI of the sacroiliac joints (SIJ) are relevant for the diagnosis and classification of patients with axial spondyloarthritis (axSpA). This study aimed to evaluate the impact of clinical information (CI) on the accuracy of imaging interpretation.Methods Out of 109 patients referred because of suspicion of axSpA with complete imaging sets (radiographs and MRI of SIJ), 61 were diagnosed with axSpA (56%). Images were independently evaluated by three radiologists in four consecutive reading campaigns: radiographs and radiographs+MRI without and with CI including demographic data, SpA features, physical activity and pregnancy. Radiographs were scored according to the modified New York criteria, and MRIs for inflammatory and structural changes compatible with axSpA (yes/no). The clinical diagnosis was taken as reference standard. The compatibility of imaging findings with a diagnosis of axSpA (precision) before and after the provision of CI and radiologists’ confidence with their findings (0–10) were evaluated.Results The precision of radiographs evaluation without versus with CI increased from 70% to 78% (p=0.008), and for radiographs+MRI from 81% to 82% (p=1.0), respectively. For CR alone, the sensitivity and specificity of radiologic findings were 51% and 94% without and 60% and 100% with CI, while, for radiographs+MRI, they were 74% and 90% vs 71% and 98%, respectively. The diagnostic confidence of radiologists increased from 5.2±1.9 to 6.0±1.7 with CI for radiographs, and from 6.7±1.6 to 7.2±1.6 for radiographs+MRI, respectively.Conclusion The precision, specificity and diagnostic confidence of radiologic evaluation increased when CI was provided.https://rmdopen.bmj.com/content/10/2/e004044.full |
spellingShingle | Jürgen Braun Denis Poddubnyy Torsten Diekhoff Fabian Proft Mikhail Protopopov Valeria Rios Rodriguez Murat Torgutalp Judith Rademacher Dominik Deppe Katharina Ziegeler Tim Pohlner Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging RMD Open |
title | Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging |
title_full | Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging |
title_fullStr | Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging |
title_full_unstemmed | Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging |
title_short | Diagnostic accuracy in axial spondyloarthritis: a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging |
title_sort | diagnostic accuracy in axial spondyloarthritis a systematic evaluation of the role of clinical information in the interpretation of sacroiliac joint imaging |
url | https://rmdopen.bmj.com/content/10/2/e004044.full |
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