Validation of assessment methods for the apparent diffusion coefficient in a clinical trial of axial spondyloarthritis patients treated with golimumab. (2020)

• Record Type: Journal Article
• Authors: Møller, Jakob M.; Østergaard, Mikkel; Thomsen, Henrik S.; Krabbe, Simon; Sørensen, Inge J.; Jensen, Bente; Madsen, Ole Rintek; Klarlund, Mette; Pedersen, Susanne J.
• Is Part Of: European journal of radiology open. Volume 7(2020)
• Publication Date: 2020
• Subjects: Apparent diffusion coefficient -- Diffusion weighted -- Magnetic resonance imaging -- Region-of-interest -- Spondyloarthritis; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2020.100285
• Languages: English
• ISSNs: 2352-0477

Abstract

Abstract: Purpose: To compare three region-of-interest (ROI) settings in the assessment of ADC in a clinical trial, and to evaluate the effectiveness of ADC in assessing therapy-induced changes and predicting clinical outcomes. Methods: In a 52-week clinical trial involving patients with axial spondyloarthritis, mean sacroiliac joint (SIJ) ADC measurements using structured, lesion-based, and index-lesion ROI-settings were assessed at baseline and weeks 4, 16, and 52. Variation among the three ROI-settings, correlations with Spondyloarthritis Research Consortium of Canada (SPARCC)-bone marrow edema (BME) SIJ inflammation indices, standardized response means (SRMs), and effectiveness in predicting clinical outcomes were analyzed. Results: Forty of the 53 patients had at least one assessable SIJ lesion on ADC at baseline. The mean of the structured ROI ADC (ADCstruc ) was 230 μmm 2 /s (standard deviation [SD] = 120). This was significantly lower ( p < 0.01) than the means of the lesion-based ROI ADC (ADClesion = 420 μmm 2 /s, SD = 210) and index-lesion ROI ADC (ADCindex = 471 μmm 2 /s, SD = 278), which did not differ. ADC correlated with SPARCC-BME scores at baseline ( p < 0.01) as did changes over time in ADC- and SPARCC-BME ( p < 0.05). At all follow-up time points, responsiveness was high for ADClesion (SRM > 0.92) and ADCindex (SRM > 0.87) while moderate for ADCstruc (SRM:0.54-0.67). Baseline ADC and changes in ADC did not predict clinical outcomes. Conclusions: Lesion-based and index-lesion ROI ADC could both be used to evaluate the effectiveness of tumor necrosis factor inhibitor therapy. None of the methods could predict clinical outcomes.