Advanced MRI in inflammatory arthritis

This thesis describes the application of advanced imaging tools in patients with inflammatory joint diseases. The first part describes the first steps in the evaluation of time-intensity curve (TIC)-shape analysis as a new post-processing technique for dynamic contrast material enhanced-magnetic resonance imaging (DCE-MRI) scans in patients with inflammatory joint diseases. We provided evidence for the technical feasibility and good reproducibility of DCE-MRI combined with TIC-shape analysis in arthritis patients, especially in inter-scanner comparisons. We also demonstrated the close relationship of TIC-shape analysis and outcomes of pharmacokinetic modeling (PKM). Combining these facts, we can confidently suggest that TIC-shape analysis should be the preferred method for post-processing DCE-MRI data in arthritis patients, especially in multicenter studies.
The second part encompasses various (DCE-)MRI studies that focus on understanding the preclinical and early phases of arthritis and on whether these advanced imaging techniques can be helpful in the early differentiation of inflammatory joint diseases and the predicting of outcomes. We showed the potential role of (DCE-)MRI (combined with TIC-shape analysis) in understanding disease pathophysiology, establishing diagnosis and predicting disease outcome. Whether the technique will become of significant value in the early differentiation of disease is still difficult to predict. More research on this topic is therefore needed.