European Radiology

, Volume 27, Issue 6, pp 2391–2399 | Cite as

Whole-body MRI in patients with Non-bacterial Osteitis: Radiological findings and correlation with clinical data

  • A. P. Arnoldi
  • C. L. Schlett
  • H. Douis
  • L. L. Geyer
  • A. M. Voit
  • F. Bleisteiner
  • A. F. Jansson
  • S. Weckbach
Magnetic Resonance

Abstract

Objectives

To correlate clinical findings of Non-bacterial Osteitis (NBO) with whole-body MRI (WB-MRI) findings and determine a radiologic index for NBO (RINBO) which allows standardized reporting of WB-MRI.

Methods and materials

In a prospective study, 40 patients with diagnosis of NBO underwent clinical examination and WB-MRI in which STIR- and T1- weighted images were assessed for NBO-typical lesions. Parameters of interest for RINBO were: number of radiologically active lesions (RAL), size of the patients’ maximum RAL presence of extramedullary and spinal involvement. Results were tested for statistical agreement of clinical and MR-based lesion detection. RINBO was tested for correlation with clinical activity.

Results

62/95 clinically/radiologically active lesions were found in 30/33 patients. In 45 % of the cohort, more active lesions were detected by WB-MRI than by clinical examination. RINBO was a significant predictor for the presence of clinically active lesions.

Conclusion

WB-MRI is a powerful diagnostic tool for patients with NBO which can reveal asymptomatic disease activity. With RINBO a standardized evaluation approach is proposed which helps assessing radiologic disease burden and predicts clinical disease activity.

Key Points

Whole body MRI is a powerful diagnostic tool for patients with non-bacterial Osteitis.

Whole body MRI can reveal asymptomatic disease activity.

The radiologic index RINBO offers a standardized evaluation approach.

Keywords

Whole body imaging Magnetic resonance imaging Non-bacterial Osteitis CRMO Activity score 

Abbreviations

NBO

Non-bacterial Osteitis

CRMO

Chronic Recurrent Multifocal Osteomyelitis

WB-MRI

Whole Body Magnetic Resonance Imaging

RINBO

Radiologic index for Non-bacterial Osteitis

LMU

Ludwig-Maximilians-University

CAL

Clinically active lesions

VAS

Visual analogue scale

CRP

C-reactive protein

ESR

Erythrocyte sedimentation rate

STIR

Short tau inversion recovery

DWI

Diffusion weighted Imaging

RAL

Radiologically active lesions

RNAL

Radiologically not active lesions

SI

Signal intensity

POI

Parameter of interest

lpp

Lesions per patient

AUC

Area under the curve

Notes

Acknowledgments

The scientific guarantor of this publication is PD Dr. Annette Jansson. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have been previously reported in: Voit AM, Arnoldi AP, Douis H et al (2015) Whole-body Magnetic Resonance Imaging in Chronic Recurrent Multifocal Osteomyelitis: Clinical Longterm Assessment May Underestimate Activity. J Rheumatol 42:1455-1462. Methodology: prospective, diagnostic study, performed at one institution.

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • A. P. Arnoldi
    • 1
  • C. L. Schlett
    • 2
  • H. Douis
    • 3
  • L. L. Geyer
    • 1
  • A. M. Voit
    • 4
  • F. Bleisteiner
    • 4
  • A. F. Jansson
    • 4
  • S. Weckbach
    • 2
  1. 1.Institute for Clinical Radiology, Ludwig-Maximilians-University HospitalMunichGermany
  2. 2.Diagnostic and Interventional RadiologyUniversity Hospital HeidelbergHeidelbergGermany
  3. 3.Department of RadiologyUniversity Hospital BirminghamBirminghamUnited Kingdom
  4. 4.Department of Rheumatology & ImmunologyDr. von Hauner Children’s Hospital, Ludwig-Maximilians-UniversityMunichGermany

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