Optical imaging (HandScan) can identify ultrasound remission in rheumatoid arthritis

Charline Rinkin; Olivier Malaise; Florane Chauveheid; Caroline Gerard; Laurence Seidel; Michel Malaise; Clio Ribbens

doi:10.1186/s12891-024-07472-4

Optical imaging (HandScan) can identify ultrasound remission in rheumatoid arthritis

BMC Musculoskelet Disord. 2024 May 7;25(1):361. doi: 10.1186/s12891-024-07472-4.

Authors

Charline Rinkin^#¹, Olivier Malaise^#², Florane Chauveheid¹, Caroline Gerard¹, Laurence Seidel³, Michel Malaise¹, Clio Ribbens¹

Affiliations

¹ Rheumatology department, University Hospital of Liège, Liège, Belgium.
² Rheumatology department, University Hospital of Liège, Liège, Belgium. olivier.malaise@chuliege.be.
³ Biostatistics and research method center (B-STAT), University Hospital of Liège, Liège, Belgium.

^# Contributed equally.

Abstract

Background: Identifying remission is of high importance in rheumatoid arthritis (RA) because remission is associated with less structural progression. We investigated the efficacy of a new optical imaging device, HandScan, to identify RA remission, as defined by ultrasound (US).

Methods: 61 RA patients were included. Disease activity was evaluated by clinical assessment and US, using gray-scale (GS) and Power Doppler (PD). HandScan determined unitary optical spectral transmission (OST) values for wrists, metacarpophalangeal and proximal interphalangeal joints. At the patient level, three composite HandScan (HS) scores were calculated: total HS score; disease activity score OST (DAS-OST) and DAS-OST without patient global assessment (PtGA). Using ROC curves, we determined HS cut-offs to identify US-defined remission.

Results: At the joint level, unitary OST values significantly correlated with GS synovitis [odds ratio (OR) 2.43, p < 0.0001] and PD positivity (OR 3.72, p = 0.0002 ). At the patient level, total HS score and DAS-OST were significantly associated with all gray-scale US (GSUS) and power doppler US (PDUS) parameters evaluated (synovitis number and grade, synovial thickness, PD grade) (p < 0.05). The cut-off to identify US-defined remission at the joint level was of 0.92, giving an 81% sensitivity and a 96% positive predictive value (PPV). At the patient level, ROC-curves failed to identify a robust cut-off for the total HS score, but did identify a cut-off (3.68) for DAS-OST to identify US-defined remission, but with lower sensitivity (75%), specificity (56%) and PPV (67%).

Conclusions: HandScan is a non-invasive optical imaging technique providing OST values that correlate with GSUS and PDUS parameters. In addition, HandScan is able to reliably identify US-defined remission in RA at the joint level, with a good sensitivity and high PPV. At the patient level, HandScan DAS-OST can also determine US remission (while total HS score failed to do so), but with lower performance.

Keywords: Optical spectral transmission; Remission; Rheumatoid arthritis; Ultrasonography.

MeSH terms

Adult
Aged
Arthritis, Rheumatoid* / diagnostic imaging
Female
Humans
Male
Middle Aged
Optical Imaging / methods
Remission Induction*
Severity of Illness Index
Ultrasonography, Doppler* / methods