Canada-Denmark MRI scoring system of the spine in patients with axial spondyloarthritis: Updated definitions, scoring rules and inter-reader reliability in a multiple reader setting

Simon Krabbe*, Mikkel Østergaard, Susanne J. Pedersen, Ulrich Weber, Georg Kröber, Walter Makysmowych, Robert G.W. Lambert

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

27 Downloads (Pure)

Abstract

Objective: To validate the Canada-Denmark (CANDEN) MRI scoring system for the spine in axial spondyloarthritis with updated lesion definitions.

Methods: Lesion definitions in the CANDEN system were updated and illustrated by a consensus set of reference images. Sagittal spine MRIs of 40 patients with axial spondyloarthritis obtained at baseline and at week 52 after initiation of treatment with the tumour necrosis factor inhibitor golimumab were evaluated in unknown chronology by seven readers blinded to all other data.

Results: CANDEN MRI spine inflammation score had very good reliability for status scores (single-measure intraclass correlation coefficient (ICC) of 21 reader pairs median of 0.91 (IQR 0.88-0.92)) and change scores (ICC 0.88 (0.86-0.92)). CANDEN MRI spine fat score had good to very good reliability for status scores (ICC 0.79 (0.75-0.86)) and moderate to good reliability for detecting change (ICC 0.59 (0.46-0.73)). CANDEN MRI spine bone erosion score and CANDEN MRI spine new bone formation score had slight to moderate reliability for status scores (ICC 0.38 (0.32-0.52) and 0.39 (0.27-0.49), respectively).

Conclusion: The CANDEN MRI spine scoring system allows a comprehensive evaluation of inflammation, fat, bone erosion and new bone formation of the spine in patients with axial spondyloarthritis. It demonstrated very good reliability for detecting change in inflammation, moderate to good reliability for detecting change in fat, and slight to moderate reliability for detecting bone erosions and new bone formation. Studies with longer follow-up or patients with more advanced spinal involvement may be needed to reliably detect change in bone erosion and new bone formation scores.

Trial registration number: NCT02011386.

Original languageEnglish
Article numbere001057
JournalRMD Open
Volume5
Issue number2
Number of pages10
ISSN2056-5933
DOIs
Publication statusPublished - 13. Oct 2019

Fingerprint

Denmark
Osteogenesis
Fats
Chronology
Osteitis
Tumor Necrosis Factor-alpha

Keywords

  • magnetic resonance imaging
  • outcomes research
  • spondyloarthritis

Cite this

Krabbe, Simon ; Østergaard, Mikkel ; Pedersen, Susanne J. ; Weber, Ulrich ; Kröber, Georg ; Makysmowych, Walter ; Lambert, Robert G.W. / Canada-Denmark MRI scoring system of the spine in patients with axial spondyloarthritis : Updated definitions, scoring rules and inter-reader reliability in a multiple reader setting. In: RMD Open. 2019 ; Vol. 5, No. 2.
@article{626179547f46445282f983aaa9fbd8a8,
title = "Canada-Denmark MRI scoring system of the spine in patients with axial spondyloarthritis: Updated definitions, scoring rules and inter-reader reliability in a multiple reader setting",
abstract = "Objective: To validate the Canada-Denmark (CANDEN) MRI scoring system for the spine in axial spondyloarthritis with updated lesion definitions.Methods: Lesion definitions in the CANDEN system were updated and illustrated by a consensus set of reference images. Sagittal spine MRIs of 40 patients with axial spondyloarthritis obtained at baseline and at week 52 after initiation of treatment with the tumour necrosis factor inhibitor golimumab were evaluated in unknown chronology by seven readers blinded to all other data.Results: CANDEN MRI spine inflammation score had very good reliability for status scores (single-measure intraclass correlation coefficient (ICC) of 21 reader pairs median of 0.91 (IQR 0.88-0.92)) and change scores (ICC 0.88 (0.86-0.92)). CANDEN MRI spine fat score had good to very good reliability for status scores (ICC 0.79 (0.75-0.86)) and moderate to good reliability for detecting change (ICC 0.59 (0.46-0.73)). CANDEN MRI spine bone erosion score and CANDEN MRI spine new bone formation score had slight to moderate reliability for status scores (ICC 0.38 (0.32-0.52) and 0.39 (0.27-0.49), respectively).Conclusion: The CANDEN MRI spine scoring system allows a comprehensive evaluation of inflammation, fat, bone erosion and new bone formation of the spine in patients with axial spondyloarthritis. It demonstrated very good reliability for detecting change in inflammation, moderate to good reliability for detecting change in fat, and slight to moderate reliability for detecting bone erosions and new bone formation. Studies with longer follow-up or patients with more advanced spinal involvement may be needed to reliably detect change in bone erosion and new bone formation scores.Trial registration number: NCT02011386.",
keywords = "magnetic resonance imaging, outcomes research, spondyloarthritis",
author = "Simon Krabbe and Mikkel {\O}stergaard and Pedersen, {Susanne J.} and Ulrich Weber and Georg Kr{\"o}ber and Walter Makysmowych and Lambert, {Robert G.W.}",
year = "2019",
month = "10",
day = "13",
doi = "10.1136/rmdopen-2019-001057",
language = "English",
volume = "5",
journal = "RMD Open",
issn = "2056-5933",
publisher = "BMJ Group",
number = "2",

}

Canada-Denmark MRI scoring system of the spine in patients with axial spondyloarthritis : Updated definitions, scoring rules and inter-reader reliability in a multiple reader setting. / Krabbe, Simon; Østergaard, Mikkel; Pedersen, Susanne J.; Weber, Ulrich; Kröber, Georg; Makysmowych, Walter; Lambert, Robert G.W.

In: RMD Open, Vol. 5, No. 2, e001057, 13.10.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Canada-Denmark MRI scoring system of the spine in patients with axial spondyloarthritis

T2 - Updated definitions, scoring rules and inter-reader reliability in a multiple reader setting

AU - Krabbe, Simon

AU - Østergaard, Mikkel

AU - Pedersen, Susanne J.

AU - Weber, Ulrich

AU - Kröber, Georg

AU - Makysmowych, Walter

AU - Lambert, Robert G.W.

PY - 2019/10/13

Y1 - 2019/10/13

N2 - Objective: To validate the Canada-Denmark (CANDEN) MRI scoring system for the spine in axial spondyloarthritis with updated lesion definitions.Methods: Lesion definitions in the CANDEN system were updated and illustrated by a consensus set of reference images. Sagittal spine MRIs of 40 patients with axial spondyloarthritis obtained at baseline and at week 52 after initiation of treatment with the tumour necrosis factor inhibitor golimumab were evaluated in unknown chronology by seven readers blinded to all other data.Results: CANDEN MRI spine inflammation score had very good reliability for status scores (single-measure intraclass correlation coefficient (ICC) of 21 reader pairs median of 0.91 (IQR 0.88-0.92)) and change scores (ICC 0.88 (0.86-0.92)). CANDEN MRI spine fat score had good to very good reliability for status scores (ICC 0.79 (0.75-0.86)) and moderate to good reliability for detecting change (ICC 0.59 (0.46-0.73)). CANDEN MRI spine bone erosion score and CANDEN MRI spine new bone formation score had slight to moderate reliability for status scores (ICC 0.38 (0.32-0.52) and 0.39 (0.27-0.49), respectively).Conclusion: The CANDEN MRI spine scoring system allows a comprehensive evaluation of inflammation, fat, bone erosion and new bone formation of the spine in patients with axial spondyloarthritis. It demonstrated very good reliability for detecting change in inflammation, moderate to good reliability for detecting change in fat, and slight to moderate reliability for detecting bone erosions and new bone formation. Studies with longer follow-up or patients with more advanced spinal involvement may be needed to reliably detect change in bone erosion and new bone formation scores.Trial registration number: NCT02011386.

AB - Objective: To validate the Canada-Denmark (CANDEN) MRI scoring system for the spine in axial spondyloarthritis with updated lesion definitions.Methods: Lesion definitions in the CANDEN system were updated and illustrated by a consensus set of reference images. Sagittal spine MRIs of 40 patients with axial spondyloarthritis obtained at baseline and at week 52 after initiation of treatment with the tumour necrosis factor inhibitor golimumab were evaluated in unknown chronology by seven readers blinded to all other data.Results: CANDEN MRI spine inflammation score had very good reliability for status scores (single-measure intraclass correlation coefficient (ICC) of 21 reader pairs median of 0.91 (IQR 0.88-0.92)) and change scores (ICC 0.88 (0.86-0.92)). CANDEN MRI spine fat score had good to very good reliability for status scores (ICC 0.79 (0.75-0.86)) and moderate to good reliability for detecting change (ICC 0.59 (0.46-0.73)). CANDEN MRI spine bone erosion score and CANDEN MRI spine new bone formation score had slight to moderate reliability for status scores (ICC 0.38 (0.32-0.52) and 0.39 (0.27-0.49), respectively).Conclusion: The CANDEN MRI spine scoring system allows a comprehensive evaluation of inflammation, fat, bone erosion and new bone formation of the spine in patients with axial spondyloarthritis. It demonstrated very good reliability for detecting change in inflammation, moderate to good reliability for detecting change in fat, and slight to moderate reliability for detecting bone erosions and new bone formation. Studies with longer follow-up or patients with more advanced spinal involvement may be needed to reliably detect change in bone erosion and new bone formation scores.Trial registration number: NCT02011386.

KW - magnetic resonance imaging

KW - outcomes research

KW - spondyloarthritis

U2 - 10.1136/rmdopen-2019-001057

DO - 10.1136/rmdopen-2019-001057

M3 - Journal article

C2 - 31673422

AN - SCOPUS:85073594119

VL - 5

JO - RMD Open

JF - RMD Open

SN - 2056-5933

IS - 2

M1 - e001057

ER -