Skip to main content

Main menu

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • 50th Volume Reprints
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • JRheum Supplements
  • Services

User menu

  • My Cart
  • Log In

Search

  • Advanced search
The Journal of Rheumatology
  • JRheum Supplements
  • Services
  • My Cart
  • Log In
The Journal of Rheumatology

Advanced Search

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • 50th Volume Reprints
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • Follow Jrheum on BlueSky
  • Follow jrheum on Twitter
  • Visit jrheum on Facebook
  • Follow jrheum on LinkedIn
  • Follow jrheum on YouTube
  • Follow jrheum on Instagram
  • Follow jrheum on RSS
Research ArticleOMERACT 2016 — International Consensus Conference on Outcome Measures in Rheumatology, Whistler, British Columbia, Canada, May 2016

The SPECTRA Collaboration OMERACT Special Interest Group: Current Research and Future Directions

Kathryn S. Stok, Stephanie Finzel, Andrew J. Burghardt, Philip G. Conaghan and Cheryl Barnabe for the SPECTRA Collaboration
The Journal of Rheumatology December 2017, 44 (12) 1911-1915; DOI: https://doi.org/10.3899/jrheum.161197
Kathryn S. Stok
From the Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK; Departments of Medicine and Community Health Sciences, University of Calgary; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.
K.S. Stok, PhD, Senior Lecturer, Institute for Biomechanics, ETH Zurich, and Department of Biomedical Engineering, University of Melbourne; S. Finzel, MD, Senior Attending Physician, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg; A.J. Burghardt, BS, Research Specialist, Department of Radiology and Biomedical Imaging, University of California; P.G. Conaghan, MD, PhD, Professor, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre; C. Barnabe, MD, MSc, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, and McCaig Institute for Bone and Joint Health, University of Calgary.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: kstok@unimelb.edu.au
Stephanie Finzel
From the Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK; Departments of Medicine and Community Health Sciences, University of Calgary; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.
K.S. Stok, PhD, Senior Lecturer, Institute for Biomechanics, ETH Zurich, and Department of Biomedical Engineering, University of Melbourne; S. Finzel, MD, Senior Attending Physician, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg; A.J. Burghardt, BS, Research Specialist, Department of Radiology and Biomedical Imaging, University of California; P.G. Conaghan, MD, PhD, Professor, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre; C. Barnabe, MD, MSc, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, and McCaig Institute for Bone and Joint Health, University of Calgary.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Andrew J. Burghardt
From the Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK; Departments of Medicine and Community Health Sciences, University of Calgary; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.
K.S. Stok, PhD, Senior Lecturer, Institute for Biomechanics, ETH Zurich, and Department of Biomedical Engineering, University of Melbourne; S. Finzel, MD, Senior Attending Physician, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg; A.J. Burghardt, BS, Research Specialist, Department of Radiology and Biomedical Imaging, University of California; P.G. Conaghan, MD, PhD, Professor, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre; C. Barnabe, MD, MSc, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, and McCaig Institute for Bone and Joint Health, University of Calgary.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Philip G. Conaghan
From the Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK; Departments of Medicine and Community Health Sciences, University of Calgary; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.
K.S. Stok, PhD, Senior Lecturer, Institute for Biomechanics, ETH Zurich, and Department of Biomedical Engineering, University of Melbourne; S. Finzel, MD, Senior Attending Physician, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg; A.J. Burghardt, BS, Research Specialist, Department of Radiology and Biomedical Imaging, University of California; P.G. Conaghan, MD, PhD, Professor, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre; C. Barnabe, MD, MSc, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, and McCaig Institute for Bone and Joint Health, University of Calgary.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Cheryl Barnabe
From the Institute for Biomechanics, ETH Zurich, Zurich, Switzerland; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia; Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and UK National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK; Departments of Medicine and Community Health Sciences, University of Calgary; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada.
K.S. Stok, PhD, Senior Lecturer, Institute for Biomechanics, ETH Zurich, and Department of Biomedical Engineering, University of Melbourne; S. Finzel, MD, Senior Attending Physician, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg; A.J. Burghardt, BS, Research Specialist, Department of Radiology and Biomedical Imaging, University of California; P.G. Conaghan, MD, PhD, Professor, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre; C. Barnabe, MD, MSc, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary, and McCaig Institute for Bone and Joint Health, University of Calgary.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • References
  • PDF
PreviousNext
Loading

Abstract

Objective. High-resolution peripheral quantitative computed tomography (HR-pQCT) has the potential to improve radiographic progression determination in clinical trials and longitudinal observational studies. The goal of this work was to describe the current state of research presented at Outcome Measures in Rheumatology (OMERACT) 2016 and ensuing future directions outlined during discussion among attendees.

Methods. At OMERACT 2016, SPECTRA (Study grouP for xtrEme-Computed Tomography in Rheumatoid Arthritis) introduced efforts to (1) validate the HR-pQCT according to OMERACT guidelines, focusing on rheumatoid arthritis (RA), and (2) find alternatives for automated joint space width (JSW) analysis. The Special Interest Group (SIG) was presented to patient research partners, physicians/researchers, and SIG leaders followed by a 40-min discussion on future directions.

Results. A consensus definition for RA erosion using HR-pQCT was demonstrated through a systematic literature review and a Delphi exercise. Histopathology and perfusion studies were presented that analyzed the true characteristics of cortical breaks in HR-pQCT images, and to provide criterion validity. Results indicate that readers were able to discriminate between erosion and small vascular channels. Moderate reliability (ICC 0.206–0.871) of direct erosion size measures was shown, which improved (> 0.9) only when experienced readers were considered. Quantification of erosion size was presented for scoring, direct measurement, and volumetric approaches, as well as a reliability exercise for direct measurement. Three methods for JSW measurement were compared, all indicating excellent reproducibility with differences at the extremes (i.e., near-zero and joint edge thickness).

Conclusion. Initial reports on HR-pQCT are promising; however, to consider its use in clinical trials and longitudinal observational studies, it is imperative to assess the responsiveness of erosion measurement quantification.

Key Indexing Terms:
  • RADIOGRAPHIC COMPUTED TOMOGRAPHY
  • 3-D IMAGING
  • RHEUMATOID ARTHRITIS
  • METACARPOPHALANGEAL JOINT
  • OMERACT

Radiographic progression is a key outcome in randomized controlled trials for inflammatory arthritis. Unfortunately, the power of this assessment is limited in the early diagnosis and treat-to-target paradigm in rheumatoid arthritis (RA), with most patients demonstrating little baseline joint damage or progression during trials. This is compounded with early timing of rescue therapies and limited exposure durations. In observational studies, plain radiography is the most feasible method for assessing damage progression, but only provides a 2-dimensional evaluation of a 3-D surface, resulting in errors related to positioning and overlapping bony interfaces. Current radiographic scoring schemes are based on ordinal scoring of joint space width (JSW) and erosions, predisposing results to floor and ceiling effects, and significant progression is required to reach the incremental worsening threshold to detect score progression. For these reasons, diagnostic imaging biomarkers with higher sensitivity to change, such as high-resolution peripheral quantitative computed tomography (HR-pQCT), could improve radiographic progression determination in clinical trials and longitudinal observational studies, as well as adding new outcomes for detection of preerosive bony changes1, quantification of joint space narrowing (JSN), and assessment of bone densitometry and microarchitecture2.

HR-pQCT is a relatively new imaging modality for quantitative evaluation of cortical and trabecular bone mineral density and bone microstructure, typically at the distal radius and tibia3,4. Quantitative measurements obtained with HR-pQCT are well established as biomarkers and outcome measures in osteoporosis research5. HR-pQCT uses a very low irradiation dose (< 5 µSv to image a 1-cm region of interest) and is approved by the US Food and Drug Administration. There are 70–75 sites worldwide, distributed on all continents, using either 82 µm or 60 µm isotropic resolution technology (SCANCO Medical AG). Advantages of HR-pQCT adoption in peripheral small joint imaging include high resolution and detection of periarticular bone damage such as erosions, cysts, JSN, and bone proliferations in inflammatory and degenerative disease not visualized sensitively with other imaging technologies such as plain radiography, ultrasound, and magnetic resonance imaging (MRI)6,7.

Pilot studies in inflammatory arthritis conditions demonstrated that scanning protocols were well tolerated by patients with active inflammation and those with chronic joint changes. Because motion artifact is a concern in image acquisition, scanning protocols were developed, along with position holders to stabilize the area of interest. Patient positioning and image acquisition take 5–10 min compared to other imaging modalities such as conventional computed tomography (10–15 min) or MRI (20–45 min). Costs for 1 measurement by HR-pQCT vary between countries, but are comparable to a standard bone densitometry (dual-energy x-ray absorptiometry) scan.

From this early pilot work, independent laboratories began to test the application of HR-pQCT for imaging peripheral joints. Some initial publications described visible pathological manifestations6, while others compared findings at different stages of RA8,9, as well as different types of inflammatory arthritis, degenerative arthritis, and normal states10,11. Since then, 44 individual studies using HR-pQCT for arthritis assessment have been published or presented as abstracts12, and led to the involvement of the SPECTRA (Study grouP for xtrEme-Computed Tomography in Rheumatoid Arthritis) collaboration in the formal Outcome Measures in Rheumatology (OMERACT) validation process. The collaboration is a global network of rheumatologists, clinicians, epidemiologists, engineers, radiologists, fellows, students, physicists, pediatricians, and industry partners. The inaugural SPECTRA meeting in Calgary, Alberta, Canada in 2011 focused on standardizing image acquisition across centers13. Since then, membership has grown to 20 investigative sites from 5 continents, demonstrating clear interest in applying this technology in arthritis assessment for clinical research. The principal aims of SPECTRA are to (1) investigate HR-pQCT for arthritis assessment in clinical trials, (2) validate HR-pQCT as a new imaging modality in clinical trials using OMERACT’s incremental validation process, and (3) harmonize SPECTRA’s global efforts for efficiency.

SPECTRA adheres to the OMERACT filter 1.0 incremental validation process — truth, feasibility, discrimination; and filter 2.0 — pathophysiological manifestations14. The goal has been to target evaluation for findings sensitive to change in biologically relevant intervals not identified by current imaging techniques, and to improve the correlation of imaging findings to function, which is significantly delayed with existing technologies. The aim of our work is to describe the current state of research as presented at OMERACT 2016 and the ensuing future directions outlined during the discussion among attendees.

MATERIALS AND METHODS

At OMERACT 2016 in Whistler, British Columbia, Canada in May 2016, SPECTRA introduced HR-pQCT as a new imaging modality for outcome measures in clinical trials and longitudinal observational studies in a Special Interest Group (SIG). The collaboration’s current research in validating HR-pQCT according to OMERACT guidelines was presented, focusing on the definition and evaluation of erosion in RA, and an automated algorithm for JSW analysis.

The SIG was presented to patient research partners, physicians/researchers, and SIG leaders at OMERACT 2016. Following a 20-min presentation, a 40-min discussion on important next steps and future directions was moderated by 2 SIG leaders, with the other 2 SIG leaders collecting minutes.

RESULTS

The SPECTRA SIG at OMERACT 2016 was attended by 2 patient research partners, 16 physicians/researchers, and 4 SIG leaders.

Pathophysiological manifestations visible with HR-pQCT

Table 112,14,15,16,17,18 shows current and ongoing research efforts presented at the SIG, as well as future research directions allowing conformity to OMERACT guidelines.

View this table:
  • View inline
  • View popup
Table 1.

Pathophysiological manifestations visible with HR-pQCT. The state of current and future research goals of SPECTRA within the OMERACT guidelines.

Definition and evaluation of erosions in RA

A consensus definition for RA erosions visualized by HR-pQCT was deemed an essential first step toward development of measurement frameworks. A systematic literature review was presented, and identified multiple approaches for defining erosion in HR-pQCT images8,19,20,21. These are consistent in that a cortical break must be present, and was expanded to assert that the break must be visible over multiple slices and in multiple planes. Erosion shape definition was also important15, and differentiation between erosions and vessel channels was deemed necessary (Figure 1).

Figure 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 1.

HR-pQCT image of the metacarpophalangeal head, transverse view. Arrows indicate examples of (A) an erosion and (B) a vessel channel. HR-pQCT: high-resolution peripheral quantitative computed tomography.

Eleven readers reviewed the definition and performed 2 scoring exercises to further refine it. A final scoring exercise on 58 joints gave 90% agreement on erosion presence, κ 0.52 (95% CI 0.37–0.63) for all readers (of varying experience), and for experienced readers, κ 0.7616. Experienced readers were those with more than 5 years’ experience. These results were presented to 11 separate investigators and a Delphi exercise was performed. Results indicated 100% acceptance of the proposed definition.

A histopathology study was presented, which analyzed the true characteristics of cortical breaks in HR-pQCT (criterion validity), and provides anatomic data supporting the SPECTRA definition. A perfusion study with barium sulphate was presented, which correlates linear cortical channels with penetrating blood vessels22. These data confirm the SPECTRA definition of erosion and that HR-pQCT can distinguish bone erosion from small vascular channels, a critical distinction for discrimination between healthy controls and individuals with early RA who exhibit both physiologic vascular channels and small bone erosions22.

Multiple approaches to measure erosion have been identified17, using a semiquantitative score, a direct measurement from 2-dimensional images, or volumetric approximation. Given that volumetric methods are not widely available, results from direct measurement were presented. Consensus was reached on a standard approach, which was tested for reliability in the RELEX-1 reading exercise. Moderate reliability was obtained [perpendicular width root mean square coefficient of variance (RMSCV) 12.3%, ICC 0.206; axial width RMSCV 20.6%, ICC 0.665; perpendicular depth RMSCV 24.0%, ICC 0.783; axial depth RMSCV 22.2%, ICC 0.871]16. ICC increased to > 0.9 for experienced readers only. Plans were described for a second study investigating responsiveness of the direct measurement approach (RELEX-2), as well as automated quantitative strategies consistent with the SPECTRA definition.

Ways to measure JSW

JSW is an indirect measure of arthritis disease activity. A systematic literature review was presented that identified published approaches to joint space measurement18,19,23. Specifically, 3 techniques for high-throughput, robust, reproducible, fully automated, quantitative 3-D measurements of JSW from HR-pQCT–derived data have been published18,19,23.

To standardize JSW measurement among the SPECTRA consortium, a study has been performed to reach consensus on one method; either 1 of the 3 published or a hybrid. The methods were compared to test JSW measurement reliability (1) across a spectrum of RA disease (early to late), (2) in scan/rescan (including re-positioning), and (3) for the same joints measured on the 2 HR-pQCT devices available commercially (XtremeCT and XtremeCT II, Scanco Medical AG). Results indicate excellent reproducibility, with all 3 methods able to discriminate JSW across a spectrum of disease, and mean and minimum JSW estimates comparable between them. This comparison revealed that maximum JSW estimates were significantly different between the 3 methods, while minimum JSW reliability was sensitive to scan/rescan errors, particularly in joints with substantial narrowing because of differences in handling zones with zero or near-zero thickness (Figure 2). There was no difference in JSW when measured using the 2 models of HR-pQCT.

Figure 2.
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 2.

(A) and (B) show 2 examples of HR-pQCT images of the MCP II joint at different stages of arthritis disease, and (C) and (D) their corresponding joint space masks. Colors indicate where each of the 3 algorithms (1, 2, 3) had full (white), partial (orange, purple, green), or no agreement (yellow, red, blue) in defining the joint space mask volume. Joint space volume for (A) was 90 mm3, 94 mm3, and 70 mm3, and (B) was 106 mm3, 114 mm3, 87 mm3 for algorithms 1, 2, and 3, respectively. HR-pQCT: high-resolution peripheral quantitative computed tomography; MCP: metacarpophalangeal.

DISCUSSION

SIG discussion and future research directions

Following presentation of our current research, future research directions were discussed. A consensus emerged that it is now imperative to perform a longitudinal study assessing the responsiveness of erosion measurement quantification, in which one scoring method (direct measurement or automated measurement) must be selected that gives reliable estimates of change over time and with treatment. If a manual method is selected, calibration of readers is required. Consequently, identification of disease-specific cutoffs in erosion and JSW metrics, compared to normal findings in healthy controls, is necessary.

Further, it was recommended that performance of the HR-pQCT be tested for detecting and quantifying pathological manifestations in comparison to other modalities (e.g., ultrasound, MRI)15,17, as well as other rheumatological diseases (e.g., osteoarthritis, psoriasis, and psoriatic arthritis), and crystal arthropathies. Translation of the methods to other sites of interest, for example the wrist23 or metatarsophalangeal joints, would also aid in increasing sensitivity to detect activity in site-specific diseases.

APPENDIX 1

List of study collaborators. SPECTRA: Steven K. Boyd (Calgary, Canada); Liam Martin (Calgary, Canada); Susan G. Barr (Calgary, Canada); Lynne Feehan (Vancouver, Canada); Mira van Veenendaal (Toronto, Canada); Angela Cheung (Toronto, Canada); Rae Yeung (Toronto, Canada); Georg Schett (Erlangen, Germany); Nikolay Tzaribachev (Bad Bramstedt, Germany); Klaus Engelke (Erlangen, Germany); Xiaojuan Li (San Francisco, USA); Valentina Pedoia (San Francisco, USA); Yebin Jiang (Michigan, USA); Karen Troy (Worcester, USA); Josh Baker (Pennsylvania, USA); Joop van den Bergh (Maastricht, The Netherlands); Piet Geusens (Maastricht, The Netherlands); Bert van Rietbergen (Eindhoven, The Netherlands); Paul Willems (Maastricht, The Netherlands); Joost de Jong (Maastricht, The Netherlands); Astrid van Tubergen (Maastricht, The Netherlands); Hubert Marotte (Saint-Etienne, France); Roland Chapurlat (Lyon, France); Stephanie Boutroy (Lyon, France); Denis Jullien (Lyon, France); Eric Lespessailles (Orleans, France); Nada Ibrahim (Orleans, France); Kristian Stengaard-Pedersen (Aarhus, Denmark); Kresten Keller (Aarhus, Denmark); Ellen-Margrethe Hauge (Aarhus, Denmark); Roland Kocijan (Vienna, Austria); Christian Dejaco (Graz, Austria); Nicolas Vilayphiou (Zurich, Switzerland); Sebastian Kraus (Baden, Switzerland); Rosa Pereira (Sao Paulo, Brasil); Camille Figueiredo (Sao Paulo, Brasil); Osvaldo Daniel Messina (Buenos Aires, Argentina); Ling Qin (Hong Kong, China); Lai-Shan Tam (Hong Kong, China).

Footnotes

  • PGC is supported in part by the NIHR Leeds Biomedical Research Centre.

  • Accepted for publication June 3, 2017.

REFERENCES

  1. 1.↵
    1. Geusens PP,
    2. Finzel S
    . Imaging: bone erosions in rheumatoid arthritis: better to see more? Nat Rev Rheumatol 2013;9:385–6.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Paccou J,
    2. Edwards M,
    3. Moss C,
    4. Dennison E,
    5. Cooper C
    . High-resolution imaging of bone and joint architecture in rheumatoid arthritis. Br Med Bull 2014;112:107–18.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Mueller TL,
    2. Stauber M,
    3. Kohler T,
    4. Eckstein F,
    5. Muller R,
    6. van Lenthe GH
    . Non-invasive bone competence analysis by high-resolution pQCT: an in vitro reproducibility study on structural and mechanical properties at the human radius. Bone 2009;44:364–71.
    OpenUrlCrossRefPubMed
  4. 4.↵
    1. Krug R,
    2. Burghardt AJ,
    3. Majumdar S,
    4. Link TM
    . High-resolution imaging techniques for the assessment of osteoporosis. Radiol Clin North Am 2010;48:601–21.
    OpenUrlCrossRefPubMed
  5. 5.↵
    1. Cheung AM,
    2. Adachi JD,
    3. Hanley DA,
    4. Kendler DL,
    5. Davison KS,
    6. Josse R,
    7. et al.
    High-resolution peripheral quantitative computed tomography for the assessment of bone strength and structure: a review by the Canadian Bone Strength Working Group. Curr Osteoporos Rep 2013;11:136–46.
    OpenUrlCrossRefPubMed
  6. 6.↵
    1. Stach CM,
    2. Bäuerle M,
    3. Englbrecht M,
    4. Kronke G,
    5. Engelke K,
    6. Manger B,
    7. et al.
    Periarticular bone structure in rheumatoid arthritis patients and healthy individuals assessed by high-resolution computed tomography. Arthritis Rheum 2010;62:330–9.
    OpenUrlPubMed
  7. 7.↵
    1. Finzel S,
    2. Kraus S,
    3. Schmidt S,
    4. Hueber A,
    5. Rech J,
    6. Engelke K,
    7. et al.
    Bone anabolic changes progress in psoriatic arthritis patients despite treatment with methotrexate or tumour necrosis factor inhibitors. Ann Rheum Dis 2013;72:1176–81.
    OpenUrlAbstract/FREE Full Text
  8. 8.↵
    1. Fouque-Aubert A,
    2. Boutroy S,
    3. Marotte H,
    4. Vilayphiou N,
    5. Bacchetta J,
    6. Miossec P,
    7. et al.
    Assessment of hand bone loss in rheumatoid arthritis by high-resolution peripheral quantitative CT. Ann Rheum Dis 2010;69:1671–6.
    OpenUrlAbstract/FREE Full Text
  9. 9.↵
    1. Zhu TY,
    2. Griffith JF,
    3. Qin L,
    4. Hung VW,
    5. Fong TN,
    6. Au SK,
    7. et al.
    Alterations of bone density, microstructure, and strength of the distal radius in male patients with rheumatoid arthritis: a case-control study with HR-pQCT. J Bone Miner Res 2014;29:2118–29.
    OpenUrlCrossRefPubMed
  10. 10.↵
    1. Finzel S,
    2. Sahinbegovic E,
    3. Kocijan R,
    4. Engelke K,
    5. Englbrecht M,
    6. Schett G
    . Inflammatory bone spur formation in psoriatic arthritis is different from bone spur formation in hand osteoarthritis. Arthritis Rheumatol 2014;66:2968–75.
    OpenUrl
  11. 11.↵
    1. Goldhahn J,
    2. Stok K,
    3. Mueller TL,
    4. Müller R,
    5. Kolling C
    . Imaging of finger micro-architecture with high-resolution pQCT for monitoring of erosive destructions and implant anchorage. Swiss Med Wkly 2010;140:44.
    OpenUrlPubMed
  12. 12.↵
    1. Nagaraj S,
    2. Finzel S,
    3. Stok KS,
    4. Barnabe C;
    5. SPECTRA Collaboration
    . High-resolution peripheral quantitative computed tomography imaging in the assessment of periarticular bone of metacarpophalangeal and wrist joints. J Rheumatol 2016;43:1921–34.
    OpenUrlAbstract/FREE Full Text
  13. 13.↵
    1. Barnabe C,
    2. Feehan L;
    3. SPECTRA (Study GrouP for XTrEme-CT in RA)
    . High-resolution peripheral quantitative computed tomography imaging protocol for metacarpophalangeal joints in inflammatory arthritis: the SPECTRA collaboration. J Rheumatol 2012;39:1494–5.
    OpenUrlFREE Full Text
  14. 14.↵
    1. Boers M,
    2. Kirwan JR,
    3. Gossec L,
    4. Conaghan PG,
    5. D’Agostino MA,
    6. Bingham CO 3rd,
    7. et al.
    How to choose core outcome measurement sets for clinical trials: OMERACT 11 approves filter 2.0. J Rheumatol 2014;41:1025–30.
    OpenUrlAbstract/FREE Full Text
  15. 15.↵
    1. Finzel S,
    2. Ohrndorf S,
    3. Englbrecht M,
    4. Stach C,
    5. Messerschmidt J,
    6. Schett G,
    7. et al.
    A detailed comparative study of high-resolution ultrasound and micro-computed tomography for detection of arthritic bone erosions. Arthritis Rheum 2011;63:1231–6.
    OpenUrlCrossRefPubMed
  16. 16.↵
    1. Barnabe C,
    2. Toepfer D,
    3. Marotte H,
    4. Hauge EM,
    5. Scharmga A,
    6. Kocijan R,
    7. et al;
    8. SPECTRA Collaboration
    . Definition for rheumatoid arthritis erosions imaged with high resolution peripheral quantitative computed tomography and interreader reliability for detection and measurement. J Rheumatol 2016;43:1935–40.
    OpenUrlAbstract/FREE Full Text
  17. 17.↵
    1. Srikhum W,
    2. Virayavanich W,
    3. Burghardt AJ,
    4. Yu A,
    5. Link TM,
    6. Imboden JB,
    7. et al.
    Quantitative and semiquantitative bone erosion assessment on high-resolution peripheral quantitative computed tomography in rheumatoid arthritis. J Rheumatol 2013;40:408–16.
    OpenUrlAbstract/FREE Full Text
  18. 18.↵
    1. Boutroy S,
    2. Hirschenhahn E,
    3. Youssof E,
    4. Locrelle H,
    5. Thomas T,
    6. Chapurlat R,
    7. et al.
    Importance of hand positioning in 3D joint space morphology assessment. Arthritis Rheum 2013;65:S840.
    OpenUrl
  19. 19.↵
    1. Barnabe C,
    2. Szabo E,
    3. Martin L,
    4. Boyd SK,
    5. Barr SG
    . Quantification of small joint space width, periarticular bone microstructure and erosions using high-resolution peripheral quantitative computed tomography in rheumatoid arthritis. Clin Exp Rheumatol 2013;31:243–50.
    OpenUrlPubMed
  20. 20.↵
    1. Yang H,
    2. Yu A,
    3. Burghardt AJ,
    4. Virayavanich W,
    5. Link TM,
    6. Imboden JB,
    7. et al.
    Quantitative characterization of metacarpal and radial bone in rheumatoid arthritis using high resolution- peripheral quantitative computed tomography. Int J Rheum Dis 2017;20:353–62.
    OpenUrl
  21. 21.↵
    1. Zhu Y,
    2. Griffith JF,
    3. Qin L,
    4. Hung VW,
    5. Fong TN,
    6. Au SK,
    7. et al.
    SAT0095 Periarticular bone loss in female patients with rheumatoid arthritis: a case-control study using HR-PQCT. Ann Rheum Dis 2013;72 Suppl 3:A611.
    OpenUrlAbstract/FREE Full Text
  22. 22.↵
    1. Boutroy S,
    2. Chapurlat R,
    3. Vanden-Bossche A,
    4. Locrelle H,
    5. Thomas T,
    6. Marotte H
    . Erosion or vascular channel? Arthritis Rheumatol 2015;67:2956.
    OpenUrl
  23. 23.↵
    1. Burghardt AJ,
    2. Lee CH,
    3. Kuo D,
    4. Majumdar S,
    5. Imboden JB,
    6. Link TM,
    7. et al.
    Quantitative in vivo HR-pQCT imaging of 3D wrist and metacarpophalangeal joint space width in rheumatoid arthritis. Ann Biomed Eng 2013;41:2553–64.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

The Journal of Rheumatology
Vol. 44, Issue 12
1 Dec 2017
  • Table of Contents
  • Table of Contents (PDF)
  • Index by Author
  • Editorial Board (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about The Journal of Rheumatology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
The SPECTRA Collaboration OMERACT Special Interest Group: Current Research and Future Directions
(Your Name) has forwarded a page to you from The Journal of Rheumatology
(Your Name) thought you would like to see this page from the The Journal of Rheumatology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
The SPECTRA Collaboration OMERACT Special Interest Group: Current Research and Future Directions
Kathryn S. Stok, Stephanie Finzel, Andrew J. Burghardt, Philip G. Conaghan, Cheryl Barnabe
The Journal of Rheumatology Dec 2017, 44 (12) 1911-1915; DOI: 10.3899/jrheum.161197

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

 Request Permissions

Share
The SPECTRA Collaboration OMERACT Special Interest Group: Current Research and Future Directions
Kathryn S. Stok, Stephanie Finzel, Andrew J. Burghardt, Philip G. Conaghan, Cheryl Barnabe
The Journal of Rheumatology Dec 2017, 44 (12) 1911-1915; DOI: 10.3899/jrheum.161197
del.icio.us logo Twitter logo Facebook logo  logo Mendeley logo
  • Tweet Widget
  •  logo
Bookmark this article

Jump to section

  • Article
    • Abstract
    • MATERIALS AND METHODS
    • RESULTS
    • DISCUSSION
    • APPENDIX 1
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • References
  • PDF

Keywords

RADIOGRAPHIC COMPUTED TOMOGRAPHY
3-D IMAGING
RHEUMATOID ARTHRITIS
METACARPOPHALANGEAL JOINT
OMERACT

Related Articles

Cited By...

More in this TOC Section

OMERACT 2016 — International Consensus Conference on Outcome Measures in Rheumatology, Whistler, British Columbia, Canada, May 2016

  • Evidence for Updating the Core Domain Set of Outcome Measures for Juvenile Idiopathic Arthritis: Report from a Special Interest Group at OMERACT 2016
  • Defining Flare in Osteoarthritis of the Hip and Knee: A Systematic Literature Review — OMERACT Virtual Special Interest Group
Show more OMERACT 2016 — International Consensus Conference on Outcome Measures in Rheumatology, Whistler, British Columbia, Canada, May 2016

Special Interest Groups, Part 2

  • Evidence for Updating the Core Domain Set of Outcome Measures for Juvenile Idiopathic Arthritis: Report from a Special Interest Group at OMERACT 2016
  • Defining Flare in Osteoarthritis of the Hip and Knee: A Systematic Literature Review — OMERACT Virtual Special Interest Group
  • Stiffness Is the Cardinal Symptom of Inflammatory Musculoskeletal Diseases, Yet Still Variably Measured: Report from the OMERACT 2016 Stiffness Special Interest Group
Show more Special Interest Groups, Part 2

Similar Articles

Keywords

  • RADIOGRAPHIC COMPUTED TOMOGRAPHY
  • 3-D IMAGING
  • rheumatoid arthritis
  • metacarpophalangeal joint
  • OMERACT

Content

  • First Release
  • Current
  • Archives
  • Collections
  • Audiovisual Rheum
  • COVID-19 and Rheumatology

Resources

  • Guide for Authors
  • Submit Manuscript
  • Author Payment
  • Reviewers
  • Advertisers
  • Classified Ads
  • Reprints and Translations
  • Permissions
  • Meetings
  • FAQ
  • Policies

Subscribers

  • Subscription Information
  • Purchase Subscription
  • Your Account
  • Terms and Conditions

More

  • About Us
  • Contact Us
  • My Alerts
  • My Folders
  • Privacy/GDPR Policy
  • RSS Feeds
The Journal of Rheumatology
The content of this site is intended for health care professionals.
Copyright © 2025 by The Journal of Rheumatology Publishing Co. Ltd.
Print ISSN: 0315-162X; Online ISSN: 1499-2752
Powered by HighWire