Toward Developing a Semiquantitative Whole Body-MRI Scoring for Juvenile Idiopathic Arthritis: Critical Appraisal of the State of the Art, Challenges, and Opportunities

Jyoti Panwar; Hiten Patel; Mirkamal Tolend; Jonathan Akikusa; Nele Herregods; Kerri Highmore; Emilio J Inarejos Clemente; Lennart Jans; Jacob Lester Jaremko; Thekla von Kalle; Eva Kirkhus; Arthur B Meyers; Marion A van Rossum; Dax G Rumsey; Jennifer Stimec; Shirley M Tse; Marinka Twilt; Nikolay Tzaribachev; Andrea S Doria

doi:10.1016/j.acra.2020.01.022

Toward Developing a Semiquantitative Whole Body-MRI Scoring for Juvenile Idiopathic Arthritis: Critical Appraisal of the State of the Art, Challenges, and Opportunities

Acad Radiol. 2021 Feb;28(2):271-286. doi: 10.1016/j.acra.2020.01.022. Epub 2020 Mar 3.

Authors

Jyoti Panwar¹, Hiten Patel², Mirkamal Tolend³, Jonathan Akikusa⁴, Nele Herregods⁵, Kerri Highmore⁶, Emilio J Inarejos Clemente⁷, Lennart Jans⁵, Jacob Lester Jaremko⁸, Thekla von Kalle⁹, Eva Kirkhus¹⁰, Arthur B Meyers¹¹, Marion A van Rossum¹², Dax G Rumsey¹³, Jennifer Stimec³, Shirley M Tse¹⁴, Marinka Twilt¹⁵, Nikolay Tzaribachev¹⁶, Andrea S Doria¹⁷

Affiliations

¹ Department of Radiology, Christian Medical College and Hospital, Vellore, India; Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
² Department of Radiology, Birmingham Children's Hospital, Birmingham, United Kingdom.
³ Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
⁴ Department of Radiology, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.
⁵ Department of Radiology, Ghent University, Ghent, Belgium.
⁶ Department of Radiology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
⁷ Department of Radiology, Hospital Sant Joan de Deu, Barcelona, Spain.
⁸ Department of Radiology, University of Alberta, Edmonton, Alberta, Canada.
⁹ RadiologischesInstitut, Olga hospital Klinikum, Stuttgart, Germany.
¹⁰ Department of Radiology, Oslo University Hospital, Oslo, Norway.
¹¹ Department of Radiology, Nemours Children's Hospital, Orlando, Florida, United States.
¹² Amsterdam Rheumatology and immunology Center, Reade, and Emma Children's Hospital Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
¹³ Division of Rheumatology, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada.
¹⁴ Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁵ Department of Pediatrics, Division of rheumatology, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
¹⁶ Pediatric Rheumatology Research Institute, Bad Bramstedt, Germany.
¹⁷ Department of Diagnostic Imaging, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, ON, Canada. Electronic address: andrea.doria@sickkids.ca.

PMID: 32139304
DOI: 10.1016/j.acra.2020.01.022

Abstract

With powerful new therapies available for management of juvenile idiopathic arthritis (JIA), early diagnosis leading to appropriate treatment may prevent long-term structural joint damage. Although magnetic resonance imaging (MRI) is typically used to assess individual body parts, indications for whole body (WB) MRI are increasing. Its utility as a diagnostic and monitoring tool has already been widely investigated in adult rheumatology patients, but less so in pediatric rheumatologic patients. This paper is a comprehensive review of scoring systems and a proposal for the conceptual development of a WB-MRI scoring system for the evaluation of JIA. In this review we identify, summarize, and critically appraise the available literature on the use of WB-MRI in inflammatory arthritis, addressing relevant considerations on components of a classification system that can lead to the development of a future pediatric WB-MRI scoring system for use in children with JIA. We also discuss advantages and challenges of developing such a WB-MRI scoring system for assessment of JIA and outline next steps toward the conceptual development of this scoring system.

Keywords: Children; Contrast agent; Growing joints; Juvenile idiopathic arthritis; Magnetic resonance imaging; Scoring systems; Whole body.

Publication types

Review

MeSH terms

Arthritis, Juvenile* / diagnostic imaging
Child
Human Body
Humans
Magnetic Resonance Imaging
Whole Body Imaging