Performance of the ASAS-proposed Cut-offs for Positive MRI Typical of Axial Spondyloarthritis for Discriminating Axial Involvement in Patients with Psoriatic Arthritis
Background: Unlike axial spondyloarthritis (axSpA), no classification criteria are currently available for axial psoriatic arthritis (axPsA). This study aimed to evaluate the performance of the proposed cut-offs from the Assessment of Spondyloarthritis International Society (ASAS) data-driven defini...
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| Format: | Article |
| Language: | English |
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World Scientific Publishing
2024-01-01
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| Series: | Journal of Clinical Rheumatology and Immunology |
| Online Access: | https://www.worldscientific.com/doi/10.1142/S2661341724740237 |
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| author | Xianfeng Yan Isaac T Cheng Jacqueline So Ho So Ryan Ka Lok Lee James Francis Griffith Lai-Shan Tam |
| author_facet | Xianfeng Yan Isaac T Cheng Jacqueline So Ho So Ryan Ka Lok Lee James Francis Griffith Lai-Shan Tam |
| author_sort | Xianfeng Yan |
| collection | DOAJ |
| description | Background: Unlike axial spondyloarthritis (axSpA), no classification criteria are currently available for axial psoriatic arthritis (axPsA). This study aimed to evaluate the performance of the proposed cut-offs from the Assessment of Spondyloarthritis International Society (ASAS) data-driven definitions for active and structural magnetic resonance imaging (MRI) lesions typical of axSpA in distinguishing axial involvement in patients with psoriatic arthritis (PsA). Methods: Seventy-two consecutive PsA patients (67% male, aged 45± 14 years) meeting the CASPAR classification criteria, regardless of the presence of back pain, were included. All patients underwent radiography of the pelvis and spine, as well as sacroiliac joint (SIJ) MRI, while 52 (72%) of 72 patients also underwent whole-spine MRI. The final diagnosis of axPsA was ascertained by two experienced rheumatologists. One rheumatologist with expertise in imaging and one trained reader evaluated the radiography and MRI images. Results: AxPsA was diagnosed in 27/72 (38%) patients. The proposed cut-offs for active sacroiliitis demonstrated high specificity (95.6%) but relatively low sensitivity (51.9%) in distinguishing patients with and without axPsA. When structural lesions of the SIJ were included in addition to active lesions, the sensitivity significantly improved (96.3% vs. 51.9%) with a modest decrease in specificity (86.7% vs. 95.6%). Incorporating MRI spine lesions (using the proposed cut-offs for positive spine MRI from the SPACE cohort) alongside SIJ lesions did not further change sensitivity or specificity compared with assessing SIJ alone. Conclusion: The ASAS-proposed cut-offs for identifying active and structural lesions of SIJ demonstrated satisfactory performance in discriminating axial involvement in PsA patients. |
| format | Article |
| id | doaj-art-e936213fdf904faba21dd92c47fb3452 |
| institution | Kabale University |
| issn | 2661-3417 2661-3425 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | World Scientific Publishing |
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| series | Journal of Clinical Rheumatology and Immunology |
| spelling | doaj-art-e936213fdf904faba21dd92c47fb34522024-11-12T08:27:23ZengWorld Scientific PublishingJournal of Clinical Rheumatology and Immunology2661-34172661-34252024-01-0124supp01262710.1142/S2661341724740237Performance of the ASAS-proposed Cut-offs for Positive MRI Typical of Axial Spondyloarthritis for Discriminating Axial Involvement in Patients with Psoriatic ArthritisXianfeng Yan0Isaac T Cheng1Jacqueline So2Ho So3Ryan Ka Lok Lee4James Francis Griffith5Lai-Shan Tam6Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SARDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SARDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SARDepartment of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SARDepartment of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SARDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SARDepartment of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SARBackground: Unlike axial spondyloarthritis (axSpA), no classification criteria are currently available for axial psoriatic arthritis (axPsA). This study aimed to evaluate the performance of the proposed cut-offs from the Assessment of Spondyloarthritis International Society (ASAS) data-driven definitions for active and structural magnetic resonance imaging (MRI) lesions typical of axSpA in distinguishing axial involvement in patients with psoriatic arthritis (PsA). Methods: Seventy-two consecutive PsA patients (67% male, aged 45± 14 years) meeting the CASPAR classification criteria, regardless of the presence of back pain, were included. All patients underwent radiography of the pelvis and spine, as well as sacroiliac joint (SIJ) MRI, while 52 (72%) of 72 patients also underwent whole-spine MRI. The final diagnosis of axPsA was ascertained by two experienced rheumatologists. One rheumatologist with expertise in imaging and one trained reader evaluated the radiography and MRI images. Results: AxPsA was diagnosed in 27/72 (38%) patients. The proposed cut-offs for active sacroiliitis demonstrated high specificity (95.6%) but relatively low sensitivity (51.9%) in distinguishing patients with and without axPsA. When structural lesions of the SIJ were included in addition to active lesions, the sensitivity significantly improved (96.3% vs. 51.9%) with a modest decrease in specificity (86.7% vs. 95.6%). Incorporating MRI spine lesions (using the proposed cut-offs for positive spine MRI from the SPACE cohort) alongside SIJ lesions did not further change sensitivity or specificity compared with assessing SIJ alone. Conclusion: The ASAS-proposed cut-offs for identifying active and structural lesions of SIJ demonstrated satisfactory performance in discriminating axial involvement in PsA patients.https://www.worldscientific.com/doi/10.1142/S2661341724740237 |
| spellingShingle | Xianfeng Yan Isaac T Cheng Jacqueline So Ho So Ryan Ka Lok Lee James Francis Griffith Lai-Shan Tam Performance of the ASAS-proposed Cut-offs for Positive MRI Typical of Axial Spondyloarthritis for Discriminating Axial Involvement in Patients with Psoriatic Arthritis Journal of Clinical Rheumatology and Immunology |
| title | Performance of the ASAS-proposed Cut-offs for Positive MRI Typical of Axial Spondyloarthritis for Discriminating Axial Involvement in Patients with Psoriatic Arthritis |
| title_full | Performance of the ASAS-proposed Cut-offs for Positive MRI Typical of Axial Spondyloarthritis for Discriminating Axial Involvement in Patients with Psoriatic Arthritis |
| title_fullStr | Performance of the ASAS-proposed Cut-offs for Positive MRI Typical of Axial Spondyloarthritis for Discriminating Axial Involvement in Patients with Psoriatic Arthritis |
| title_full_unstemmed | Performance of the ASAS-proposed Cut-offs for Positive MRI Typical of Axial Spondyloarthritis for Discriminating Axial Involvement in Patients with Psoriatic Arthritis |
| title_short | Performance of the ASAS-proposed Cut-offs for Positive MRI Typical of Axial Spondyloarthritis for Discriminating Axial Involvement in Patients with Psoriatic Arthritis |
| title_sort | performance of the asas proposed cut offs for positive mri typical of axial spondyloarthritis for discriminating axial involvement in patients with psoriatic arthritis |
| url | https://www.worldscientific.com/doi/10.1142/S2661341724740237 |
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