Standardized reporting of spine and sacroiliac joints in axial spondyloarthritis MRI: from the ESSR-Arthritis Subcommittee

期刊论文
发表日期：

2024年7月19日

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Winston J. Rennie,
Anne Cotten,
Anne Grethe Jurik,
Frederic Lecouvet,
Lennart Jans,
Patrick Omoumi,
Filippo Del Grande,
Danoob Dalili,
Alberto Bazzocchi,
Fabio Becce,
Dennis K. Bielecki,
Mikael Boesen,
Torsten Diekhoff,
Andrew Grainger,
Giuseppe Guglielmi,
Robert Hemke,
Kay Geert A. Hermann,
Nele Herregods,
Amanda Isaac,
Gordana Ivanac,
Franz Kainberger,
Andrea Klauser,
Salvatore Marsico,
Vasco Mascarenhas,
Philip O’Connor,
Edwin Oei,
Vittorio Pansini,
Olympia Papakonstantinou,
Anna Zejden,
Monique Reijnierse,
Andrea B. Rosskopf,
Amit Shah,
Iwona Sudol-Szopinska,
Frederiek Laloo,
Chiara Giraudo

摘要

Objectives

Apply a modified Delphi-based approach and produce a practical, radiology-specific set of definitions for interpretation and standardization of the multiple MRI findings in axial spondyloarthritis (ax-SpA), specifically to aid the general radiologist with a musculoskeletal interest, working with gold standard basic MRI protocols.

Materials and methods

We report the results of a modified Delphi-based consensus of 35 experts from 13 countries in the Arthritis Subcommittee of the European Society of Musculoskeletal Radiology (ESSR). Seventeen definitions were created (i.e., nine for the spine and eight for the sacroiliac joint) and two Delphi rounds were conducted on an electronic database, collated and revised by the project leader with agreement. Group leads were appointed for each definition following the first round. Final definitions included only those that reached a consensus > 80%; if > 50% agreed on exclusion consensus, definitions were excluded. Final results have been shared during the Arthritis meeting at the Annual ESSR Congress.

Results

Fourteen definitions, eight for the spine and six for the sacroiliac joint were agreed for standardized reporting. Andersson’s, anterior corner sclerotic and costovertebral joint inflammatory lesions of the spine, with active and non-active erosions, and fat metaplasia of the sacroiliac joint reaching the highest consensus (≥ 95%). More than 50% of the experts agreed to exclude joint space inflammation in the sacroiliac joint and tissue backfill. Syndesmophytes reached 76% agreement.

Conclusions

Agreed definitions by expert radiologists using a modified Delphi process, should allow standardized actionable radiology reports and clarity in reporting terminology of ax-SpA.

Clinical relevance statement

The proposed definitions will support reporting from musculoskeletal and general radiologists working with gold-standard basic MRI, improve confidence in lesion assessment, and standardize terminology to provide actionable reports on MRI in patients with ax-SpA.

Key Points

Experts applied a modified Delphi method to optimize the definitions of MRI findings of ax-SpA.

After two Delphi rounds and one in-person meeting, fourteen definitions reached the agreement threshold.

These consensus-based definitions will aid in actionable reporting specifically for the general radiologist with a musculoskeletal interest.