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  1. Article ; Online: OMERACT validation of a deep learning algorithm for automated absolute quantification of knee joint effusion versus manual semi-quantitative assessment.

    Felfeliyan, Banafshe / Wichuk, Stephanie / Hareendranathan, Abhilash R / Lambert, Robert G / Maksymowych, Walter P / Jaremko, Jacob

    Seminars in arthritis and rheumatism

    2024  Volume 66, Page(s) 152420

    Abstract: Objective: To begin evaluating deep learning (DL)-automated quantification of knee joint effusion-synovitis via the OMERACT filter.: Methods: A DL algorithm previously trained on Osteoarthritis Initiative (OAI) knee MRI automatically quantified ... ...

    Abstract Objective: To begin evaluating deep learning (DL)-automated quantification of knee joint effusion-synovitis via the OMERACT filter.
    Methods: A DL algorithm previously trained on Osteoarthritis Initiative (OAI) knee MRI automatically quantified effusion volume in MRI of 53 OAI subjects, which were also scored semi-quantitatively via KIMRISS and MOAKS by 2-6 readers.
    Results: DL-measured knee effusion correlated significantly with experts' assessments (Kendall's tau 0.34-0.43) CONCLUSION: The close correlation of automated DL knee joint effusion quantification to KIMRISS manual semi-quantitative scoring demonstrated its criterion validity. Further assessments of discrimination and truth vs. clinical outcomes are still needed to fully satisfy OMERACT filter requirements.
    Language English
    Publishing date 2024-02-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 120247-9
    ISSN 1532-866X ; 0049-0172
    ISSN (online) 1532-866X
    ISSN 0049-0172
    DOI 10.1016/j.semarthrit.2024.152420
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  2. Article ; Online: Future of Low-Dose Computed Tomography and Dual-Energy Computed Tomography in Axial Spondyloarthritis.

    Diekhoff, Torsten / Hermann, Kay Geert A / Lambert, Robert G

    Current rheumatology reports

    2022  Volume 24, Issue 6, Page(s) 198–205

    Abstract: Purpose of review: Recent technical advances in computed tomography (CT) such as low-dose CT and dual-energy techniques open new applications for this imaging modality in clinical practice and for research purposes. This article will discuss the latest ... ...

    Abstract Purpose of review: Recent technical advances in computed tomography (CT) such as low-dose CT and dual-energy techniques open new applications for this imaging modality in clinical practice and for research purposes. This article will discuss the latest innovations and give a perspective on future developments.
    Recent findings: Low-dose CT has increasingly been used for assessing structural changes at the sacroiliac joints and the spine. It has developed into a method with similar or even lower radiation exposure than radiography while outperforming radiography for lesion detection. Despite being incompatible with low-dose scanning, some studies have shown that dual-energy CT can provide additional information that is otherwise only assessable with magnetic resonance imaging (MRI). However, it is unclear whether this additional information is reliable enough and if it would justify the additional radiation exposure, i.e. whether the performance of dual-energy CT is close enough to MRI to replace it in clinical practice. While the role of dual-energy CT in patients with axial spondyloarthritis remains to be established, low-dose CT has developed to an appropriate modality that should replace radiography in many circumstances and might supplement MRI.
    MeSH term(s) Axial Spondyloarthritis ; Humans ; Magnetic Resonance Imaging/methods ; Radiography ; Sacroiliac Joint/diagnostic imaging ; Sacroiliitis/diagnostic imaging ; Spondylarthritis/diagnostic imaging ; Spondylarthritis/pathology ; Tomography, X-Ray Computed/methods
    Language English
    Publishing date 2022-04-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057357-1
    ISSN 1534-6307 ; 1523-3774
    ISSN (online) 1534-6307
    ISSN 1523-3774
    DOI 10.1007/s11926-022-01075-5
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  3. Article: Drs. Lambert and Maksymowych reply.

    Lambert, Robert G / Maksymowych, Walter P

    The Journal of rheumatology

    2019  Volume 46, Issue 5, Page(s) 542

    MeSH term(s) Humans ; Magnetic Resonance Spectroscopy ; Spondylitis, Ankylosing
    Language English
    Publishing date 2019-04-30
    Publishing country Canada
    Document type Journal Article ; Comment
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.181215
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  4. Article ; Online: Low-dose computed tomography for axial spondyloarthritis: update on use and limitations.

    Lambert, Robert G W / Hermann, Kay Geert A / Diekhoff, Torsten

    Current opinion in rheumatology

    2021  Volume 33, Issue 4, Page(s) 326–332

    Abstract: Purpose of review: Recent developments in low-dose computed tomography (ldCT) have greatly reduced radiation exposure levels. This article reviews what a ldCT is and its use and limitations for imaging axial spondyloarthritis.: Recent findings: ... ...

    Abstract Purpose of review: Recent developments in low-dose computed tomography (ldCT) have greatly reduced radiation exposure levels. This article reviews what a ldCT is and its use and limitations for imaging axial spondyloarthritis.
    Recent findings: Detection of structural damage in bone with CT is far superior to radiography and ldCT of the sacroiliac joints (SIJ) can now be done at radiation exposure levels equivalent to, or even less than, conventional radiography. ldCT should be considered a 'first-choice' test for arthritis imaging, and wherever available, SIJ ldCT may completely replace conventional radiography. Radiation exposure in the spine with ldCT is lower than conventional CT. However, it is unclear whether the additional information regarding structural damage changes in the spine provided by ldCT will alter patient management sufficiently often to merit switching from spinal radiography to ldCT in routine clinical practice. In addition, ldCT cannot assess osteitis disease activity for which MRI remains the best test.
    Summary: ldCT of the sacroiliac joints (SIJ) can be done at radiation exposure levels equivalent to, or less than, radiography and ldCT may completely replace SIJ radiography. However, the role of spinal ldCT for spondyloarthritis is not clear and MRI is far superior for detecting disease activity.
    MeSH term(s) Humans ; Magnetic Resonance Imaging ; Radiography ; Sacroiliac Joint/diagnostic imaging ; Spine/diagnostic imaging ; Spondylarthritis/diagnostic imaging ; Tomography, X-Ray Computed
    Language English
    Publishing date 2021-04-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1045317-9
    ISSN 1531-6963 ; 1040-8711
    ISSN (online) 1531-6963
    ISSN 1040-8711
    DOI 10.1097/BOR.0000000000000803
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  5. Article: Diffusion-weighted Imaging in Axial Spondyloarthritis: A Measure of Effusion or Does It Elicit Confusion?

    Lambert, Robert G / Maksymowych, Walter P

    The Journal of rheumatology

    2018  Volume 45, Issue 6, Page(s) 729–730

    MeSH term(s) Diffusion Magnetic Resonance Imaging ; Exudates and Transudates ; Humans ; Magnetic Resonance Spectroscopy ; Spondylarthritis ; Spondylitis, Ankylosing
    Language English
    Publishing date 2018-06-01
    Publishing country Canada
    Document type Editorial ; Comment
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.171479
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  6. Article ; Online: Spondyloarthritis: Low-dose CT for spondyloarthritis - a brilliant new chapter?

    Maksymowych, Walter P / Lambert, Robert G

    Nature reviews. Rheumatology

    2018  Volume 14, Issue 3, Page(s) 130–131

    MeSH term(s) Cohort Studies ; Humans ; Spondylarthritis ; Spondylarthropathies ; Spondylitis, Ankylosing ; Tomography, X-Ray Computed
    Language English
    Publishing date 2018-01-25
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2491532-4
    ISSN 1759-4804 ; 1759-4790
    ISSN (online) 1759-4804
    ISSN 1759-4790
    DOI 10.1038/nrrheum.2018.4
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  7. Article ; Online: Imaging in Axial Spondyloarthritis: What is Relevant for Diagnosis in Daily Practice?

    Weber, Ulrich / Jurik, Anne Grethe / Lambert, Robert G W / Maksymowych, Walter P

    Current rheumatology reports

    2021  Volume 23, Issue 8, Page(s) 66

    Abstract: Purpose of review: To explore how imaging may assist diagnosing axial spondyloarthritis in rheumatology practice.: Recent findings: A diagnosis of axial spondyloarthritis is based on pattern recognition by synthesizing clinical, laboratory, and ... ...

    Abstract Purpose of review: To explore how imaging may assist diagnosing axial spondyloarthritis in rheumatology practice.
    Recent findings: A diagnosis of axial spondyloarthritis is based on pattern recognition by synthesizing clinical, laboratory, and imaging findings. In health care settings providing low threshold access to advanced imaging, sacroiliac joint MRI is the preferred imaging modality in clinically suspected axial spondyloarthritis. In daily routine, the optimum protocol to assess suspected inflammatory back pain combines sacroiliac joint and spine MRI fitting a 30-min slot. Contextual assessment of concomitant structural and active MRI lesions is key to enhance diagnostic utility. In women with postpartum back pain suggestive of axial spondyloarthritis, recent reports advocate waiting 6-12 months after delivery before acquiring sacroiliac joint MRI. Major unmet needs are consistent MRI protocols, standardized training modules on how to evaluate axial MRI, and timely dissemination of imaging advances into mainstream practice both in rheumatology and in radiology. In rheumatology practice, MRI has become indispensable to help diagnose early axial spondyloarthritis. However, major gaps in training and knowledge transfer to daily care need to be closed.
    MeSH term(s) Female ; Humans ; Magnetic Resonance Imaging ; Pain ; Radiography ; Sacroiliac Joint/diagnostic imaging ; Spondylarthritis/diagnostic imaging
    Language English
    Publishing date 2021-07-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057357-1
    ISSN 1534-6307 ; 1523-3774
    ISSN (online) 1534-6307
    ISSN 1523-3774
    DOI 10.1007/s11926-021-01030-w
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  8. Article ; Online: Improving the design of RCTs in non-radiographic axial spondyloarthritis.

    Maksymowych, Walter P / Lambert, Robert G W / Caplan, Liron / van den Bosch, Filip E / Østergaard, Mikkel

    Nature reviews. Rheumatology

    2022  Volume 18, Issue 8, Page(s) 481–489

    Abstract: Concerns have been raised that randomized placebo-controlled trials (RCTs) in non-radiographic axial spondyloarthritis (nr-axSpA) might be failing to identify patients that best show differences in clinical response rates between those receiving active ... ...

    Abstract Concerns have been raised that randomized placebo-controlled trials (RCTs) in non-radiographic axial spondyloarthritis (nr-axSpA) might be failing to identify patients that best show differences in clinical response rates between those receiving active drug and those receiving placebo therapies; in addition, some studies might even be showing spurious differences in responses to TNF and IL-17 inhibitor therapies. In particular, the most recent phase III RCTs in nr-axSpA have reported variable and generally lower response rates than observed in phase III trials of patients with ankylosing spondylitis and in trials conducted a decade ago in patients with early axSpA who were selected on the basis of axial inflammation evident on MRI scans. We argue that these observations at least partly reflect an RCT design that does not take full advantage of MRI to select patients who are responsive to therapy because the current MRI-based inclusion criteria cannot identify patients with axSpA with sufficient specificity. We propose that future studies should be designed using revised patient inclusion criteria based on expanded MRI evaluation and the application of data-driven definitions of a positive MRI for inflammatory and structural lesions typical of axSpA reported in an international multicentre analysis of MRI scans from the Assessment of SpondyloArthritis International Society (ASAS) classification cohort.
    MeSH term(s) Humans ; Magnetic Resonance Imaging ; Non-Radiographic Axial Spondyloarthritis/diagnostic imaging ; Non-Radiographic Axial Spondyloarthritis/drug therapy ; Patient Selection ; Randomized Controlled Trials as Topic/methods ; Research Design/standards
    Language English
    Publishing date 2022-05-13
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2491532-4
    ISSN 1759-4804 ; 1759-4790
    ISSN (online) 1759-4804
    ISSN 1759-4790
    DOI 10.1038/s41584-022-00789-1
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  9. Article ; Online: Erosions on T1-Weighted Magnetic Resonance Imaging Versus Radiography of Sacroiliac Joints in Recent-Onset Axial Spondyloarthritis: 2-Year Data (EMBARK Trial and DESIR Cohort).

    Maksymowych, Walter P / Claudepierre, Pascal / de Hooge, Manouk / Lambert, Robert G / Landewé, Robert / Molto, Anna / van der Heijde, Désirée / Bukowski, Jack F / Jones, Heather / Pedersen, Ron / Szumski, Annette / Vlahos, Bonnie / Dougados, Maxime

    The Journal of rheumatology

    2024  Volume 51, Issue 5, Page(s) 462–471

    Abstract: Objective: (1) To compare the capacity to detect sacroiliac joint (SIJ) erosions and baseline-to-week 104 change in erosions between magnetic resonance imaging (MRI) and radiographs in recent-onset axial spondyloarthritis (axSpA); and (2) to compare ... ...

    Abstract Objective: (1) To compare the capacity to detect sacroiliac joint (SIJ) erosions and baseline-to-week 104 change in erosions between magnetic resonance imaging (MRI) and radiographs in recent-onset axial spondyloarthritis (axSpA); and (2) to compare treatment-discriminatory capacities of MRI and radiographic scores for erosion detection in patients receiving etanercept in the Effect of Etanercept on Symptoms and Objective Inflammation in Nonradiographic axSpA (EMBARK) trial vs controls in the DESIR (
    Methods: Anonymized SIJ MRI and radiographs were assessed at patient and joint surface levels. Three readers evaluated MRI; 3 different readers evaluated radiographs. Final scores for comparison of radiographs and MRI for detection of erosions were assigned based on agreement of ≥ 2 of 3 readers' assessments.
    Results: At baseline, discordance in erosion detection between imaging methods was more frequent for MRI erosions in the absence of radiographic erosions (48/224 [21.4%] patients) than for radiographic erosions in the absence of MRI erosions (14/224 [6.3%] patients;
    Conclusion: In recent-onset axSpA, SIJ erosions and erosion change were observed more frequently on MRI than radiography. The significance of interval improvement of MRI erosions warrants further research. [ClinicalTrials.gov: NCT01258738, NCT01648907].
    MeSH term(s) Humans ; Sacroiliac Joint/diagnostic imaging ; Sacroiliac Joint/pathology ; Magnetic Resonance Imaging/methods ; Adult ; Female ; Male ; Axial Spondyloarthritis/diagnostic imaging ; Axial Spondyloarthritis/drug therapy ; Etanercept/therapeutic use ; Radiography ; Antirheumatic Agents/therapeutic use ; Treatment Outcome ; Severity of Illness Index ; Middle Aged
    Chemical Substances Etanercept (OP401G7OJC) ; Antirheumatic Agents
    Language English
    Publishing date 2024-05-01
    Publishing country Canada
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Comparative Study
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.2023-0906
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  10. Article: Magnetic resonance imaging of vertebral erosion in spondyloarthritis.

    Lambert, Robert G W

    The Journal of rheumatology

    2013  Volume 40, Issue 11, Page(s) 1791–1793

    MeSH term(s) Antirheumatic Agents/therapeutic use ; Female ; Humans ; Inflammation/drug therapy ; Male ; Spine/pathology ; Spondylitis, Ankylosing/drug therapy ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
    Chemical Substances Antirheumatic Agents ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2013-11
    Publishing country Canada
    Document type Comment ; Editorial
    ZDB-ID 194928-7
    ISSN 1499-2752 ; 0315-162X
    ISSN (online) 1499-2752
    ISSN 0315-162X
    DOI 10.3899/jrheum.130972
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