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Frank Gohlke - One of the best experts on this subject based on the ideXlab platform.
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Synovial tissue of the hip at power Doppler US: correlation between Vascularity and power Doppler US signal.
Radiology, 2002Co-Authors: M. Walther, Harry Harms, V. Krenn, S. Radke, S. Kirschner, Frank GohlkeAbstract:PURPOSE: To correlate power Doppler ultrasonographic (US) findings of the Vascularity of synovial tissue of the hip joint with the results of histopathologic examination of the same tissue to assess the value of power Doppler US in the visualization of synovitis. MATERIALS AND METHODS: The hip joints of 24 patients with osteoarthritis (n = 15) or rheumatoid arthritis (n = 9) of the hip joint were examined with US before arthroplasty. The Vascularity of the synovial membrane was classified qualitatively by using power Doppler US. During surgery, a section of the synovial tissue examined at power Doppler US preoperatively was resected. The Vascularity of the tissue specimen was investigated and graded qualitatively by a pathologist who was not aware of the US findings. Visual qualitative grading was controlled by means of analysis of the US images and histopathologic specimens with a digital image evaluation system. Correlations between power Doppler US and histopathologic examination findings were calculat...
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correlation of power doppler sonography with Vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis
Arthritis & Rheumatism, 2001Co-Authors: M. Walther, Harry Harms, V. Krenn, S. Radke, Trutzpeter Faehndrich, Frank GohlkeAbstract:Objective To examine the significance of power Doppler sonography (PDS) in the diagnosis of synovial hypertrophy of the knee joint by verifying and comparing the PDS findings with histopathologic findings of synovial membrane Vascularity. Methods The knee joints of 23 patients who were undergoing arthroplasty of the knee joint because of osteoarthritis or rheumatoid arthritis were examined with ultrasound before arthroplasty. The Vascularity of the synovial membrane was classified semiquantitatively using PDS. A sample of synovial tissue was obtained during the arthroplasty, and the Vascularity of the synovial tissue was evaluated by immunohistochemistry (factor VIII) and was graded qualitatively by a pathologist who was unaware of the PDS findings. The visual qualitative grading by the examiner was controlled by analyzing PDS images and histologic samples using a digital image evaluation system. Results The correlation between the qualitative PDS results and the qualitative grading of the Vascularity by the pathologist was 0.89 by Spearman's ρ (P < 0.01). The Pearson correlation coefficient between the digital analysis of the PDS images and the digital analysis of the tissue sections was 0.81 (P < 0.01). Digital image analysis and qualitative grading by the examiner had a correlation of 0.89 by Spearman's ρ (P < 0.01) for the PDS images. The correlation between the qualitative estimation of Vascularity by the pathologist and the digital image analysis was 0.88 by Spearman's ρ (P < 0.01). Conclusion In the present study, PDS proved to be a reliable diagnostic method for qualitative grading of the Vascularity of the synovial tissue. In clinical practice, PDS allows further differentiation of the hypertrophic synovium.
M. Walther - One of the best experts on this subject based on the ideXlab platform.
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Synovial tissue of the hip at power Doppler US: correlation between Vascularity and power Doppler US signal.
Radiology, 2002Co-Authors: M. Walther, Harry Harms, V. Krenn, S. Radke, S. Kirschner, Frank GohlkeAbstract:PURPOSE: To correlate power Doppler ultrasonographic (US) findings of the Vascularity of synovial tissue of the hip joint with the results of histopathologic examination of the same tissue to assess the value of power Doppler US in the visualization of synovitis. MATERIALS AND METHODS: The hip joints of 24 patients with osteoarthritis (n = 15) or rheumatoid arthritis (n = 9) of the hip joint were examined with US before arthroplasty. The Vascularity of the synovial membrane was classified qualitatively by using power Doppler US. During surgery, a section of the synovial tissue examined at power Doppler US preoperatively was resected. The Vascularity of the tissue specimen was investigated and graded qualitatively by a pathologist who was not aware of the US findings. Visual qualitative grading was controlled by means of analysis of the US images and histopathologic specimens with a digital image evaluation system. Correlations between power Doppler US and histopathologic examination findings were calculat...
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correlation of power doppler sonography with Vascularity of the synovial tissue of the knee joint in patients with osteoarthritis and rheumatoid arthritis
Arthritis & Rheumatism, 2001Co-Authors: M. Walther, Harry Harms, V. Krenn, S. Radke, Trutzpeter Faehndrich, Frank GohlkeAbstract:Objective To examine the significance of power Doppler sonography (PDS) in the diagnosis of synovial hypertrophy of the knee joint by verifying and comparing the PDS findings with histopathologic findings of synovial membrane Vascularity. Methods The knee joints of 23 patients who were undergoing arthroplasty of the knee joint because of osteoarthritis or rheumatoid arthritis were examined with ultrasound before arthroplasty. The Vascularity of the synovial membrane was classified semiquantitatively using PDS. A sample of synovial tissue was obtained during the arthroplasty, and the Vascularity of the synovial tissue was evaluated by immunohistochemistry (factor VIII) and was graded qualitatively by a pathologist who was unaware of the PDS findings. The visual qualitative grading by the examiner was controlled by analyzing PDS images and histologic samples using a digital image evaluation system. Results The correlation between the qualitative PDS results and the qualitative grading of the Vascularity by the pathologist was 0.89 by Spearman's ρ (P < 0.01). The Pearson correlation coefficient between the digital analysis of the PDS images and the digital analysis of the tissue sections was 0.81 (P < 0.01). Digital image analysis and qualitative grading by the examiner had a correlation of 0.89 by Spearman's ρ (P < 0.01) for the PDS images. The correlation between the qualitative estimation of Vascularity by the pathologist and the digital image analysis was 0.88 by Spearman's ρ (P < 0.01). Conclusion In the present study, PDS proved to be a reliable diagnostic method for qualitative grading of the Vascularity of the synovial tissue. In clinical practice, PDS allows further differentiation of the hypertrophic synovium.
Megumi Matsuhashi - One of the best experts on this subject based on the ideXlab platform.
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positive synovial Vascularity in patients with low disease activity indicates smouldering inflammation leading to joint damage in rheumatoid arthritis time integrated joint inflammation estimated by synovial Vascularity in each finger joint
Rheumatology, 2013Co-Authors: Jun Fukae, Masato Isobe, Akemi Kitano, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Akio Mitsuzaki, Masato Shimizu, Kazuhide Tanimura, Megumi MatsuhashiAbstract:Objective. To investigate the relationship between synovial Vascularity and joint damage progression in each finger joint of patients with RA under low disease activity during treatment with biologic agents. Methods. We studied 310 MCP and 310 PIP joints of 31 patients with active RA who were administered adalimumab (ADA) or tocilizumab (TCZ). Patients were examined with clinical and laboratory assessments. Power Doppler sonography was performed at baseline and at weeks 8, 20 and 40. Synovial Vascularity was evaluated according to quantitative measurement. Hand and foot radiography was performed at baseline and at week 50. Results. Composite scores of the DAS with 28 joints and the Simplified Disease Activity Index (SDAI) were significantly decreased from baseline to week 8, being sustained at a low level by biologic agents during the observational period. MCP and PIP joints with positive synovial Vascularity after week 8 showed more subsequent joint damage progression than joints without synovial Vascularity throughout the follow-up. The changes in radiographic progression in these joints were independent of the sum of synovial Vascularity from baseline to week 40 or the occasional occurrence of positive synovial Vascularity. Conclusion. Smouldering inflammation reflected by positive synovial Vascularity under low disease activity was linked to joint damage. The damage progressed irrespective of the severity of positive synovial Vascularity. Even with a favourable overall therapeutic response, monitoring of synovial Vascularity has the potential to provide useful joint information to tailor treatment strategies. Trial registration. University Hospital Medical Information Network Clinical Trials Registry; http://www. umin.ac.jp/ctr/; UMIN000004476.
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radiographic prognosis of finger joint damage predicted by early alteration in synovial Vascularity in patients with rheumatoid arthritis potential utility of power doppler sonography in clinical practice
Arthritis Care and Research, 2011Co-Authors: Jun Fukae, Masato Isobe, Akemi Kitano, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Akio Mitsuzaki, Masato Shimizu, Kazuhide Tanimura, Megumi MatsuhashiAbstract:Objective To investigate the relationship between synovial Vascularity and progression of structural bone damage in each finger joint in patients with rheumatoid arthritis (RA) and to demonstrate synovial Vascularity as a potential therapeutic marker. Methods We studied 250 metacarpophalangeal (MCP) and 250 proximal interphalangeal (PIP) joints of 25 patients with active RA who were administered adalimumab or tocilizumab. Patients were examined with clinical and laboratory assessments. Power Doppler sonography was performed at baseline and at the fourth and eighth weeks. Synovial Vascularity was evaluated according to quantitative measurement. Hand and foot radiography was performed at baseline and the twentieth week. Results Clinical indices such as the 28-joint Disease Activity Score, the Clinical Disease Activity Index, and the Simplified Disease Activity Index were significantly decreased by biologic agents. The MCP and PIP joints with no response in synovial Vascularity between baseline and the eighth week (Vascularity improvement of ≤70% at the eighth week) showed a higher risk of radiographic progression compared with responsive joints (Vascularity improvement of >70% at the eighth week; relative risk 2.33–9). Radiographic progression at the twentieth week was significantly lower in responsive joints than in nonresponsive joints. Conclusion The improvement of synovial Vascularity following treatment with biologic agents led to suppression of radiographic progression of RA in each finger joint. The alteration in synovial Vascularity numerically reflected therapeutic efficacy. Using Vascularity as a marker to determine the most suitable therapeutic approach would be beneficial for patients with active RA.
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change of synovial Vascularity in a single finger joint assessed by power doppler sonography correlated with radiographic change in rheumatoid arthritis comparative study of a novel quantitative score with a semiquantitative score
Arthritis Care and Research, 2010Co-Authors: Jun Fukae, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Masato Shimizu, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Tatsuya Atsumi, Takao KoikeAbstract:OBJECTIVE: To investigate the relationship between synovial Vascularity assessed by quantitative power Doppler sonography (PDS) and progression of structural bone damage in a single finger joint in patients with rheumatoid arthritis (RA). METHODS: We studied 190 metacarpophalangeal (MCP) joints and 190 proximal interphalangeal (PIP) joints of 19 patients with active RA who had initial treatment with disease-modifying antirheumatic drugs (DMARDs). Patients were examined by clinical and laboratory assessments throughout the study. Hand and foot radiography was performed at baseline and the twentieth week. Magnetic resonance imaging (MRI) was performed at baseline. PDS was performed at baseline and the eighth week. Synovial Vascularity was evaluated according to both quantitative and semiquantitative methods. RESULTS: Quantitative PDS was significantly correlated with the enhancement rate of MRI in each single finger joint. Comparing quantitative synovial Vascularity and radiographic change in single MCP or PIP joints, the level of Vascularity at baseline showed a significant positive correlation with radiographic progression at the twentieth week. The change of Vascularity in response to DMARDs, defined as the percentage change in Vascularity by the eighth week from baseline, was inversely correlated with radiographic progression in each MCP joint. The quantitative PDS method was more useful than the semiquantitative method for the evaluation of synovial Vascularity in a single finger joint. CONCLUSION: The change of synovial Vascularity in a single finger joint determined by quantitative PDS could numerically predict its radiographic progression. Using Vascularity as a guide to consider a therapeutic approach would have benefits for patients with active RA.
Roberto M Lang - One of the best experts on this subject based on the ideXlab platform.
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differential diagnosis of cardiac masses using contrast echocardiographic perfusion imaging
Journal of the American College of Cardiology, 2004Co-Authors: James N Kirkpatrick, Tiffany Wong, James Bednarz, Kirk T Spencer, Lissa Sugeng, Parker R Ward, Jeanne M Decara, Lynn Weinert, Thomas Krausz, Roberto M LangAbstract:Abstract Objectives We investigated the usefulness of echocardiographic contrast perfusion imaging in differentiating cardiac masses. Background Two-dimensional echocardiography is the primary diagnostic modality for cardiac masses. However, differentiation between the different types of cardiac masses may be difficult at times. We hypothesized that echocardiographic contrast perfusion imaging would differentiate the neo-vascularization of malignancies from the aVascularity of thrombi and the sparse Vascularity of stromal tumors. Methods Sixteen patients with cardiac masses underwent power-modulation imaging after echocardiographic intravenous contrast administration. Pixel intensities in the mass and an adjacent section of myocardium were analyzed visually and by dedicated software. All masses had a pathologic diagnosis or resolved after anticoagulation. In a subset of patients, video-intensity curves of contrast replenishment in the mass and myocardium over time were generated. The post-impulse steady-state pixel intensity (A) and initial rate of contrast replenishment after impulse (β) were compared with an index of blood vessel area on pathology. Results In seven of 16 patients, contrast enhancement resulted in greater pixel intensity in the mass than in the adjacent myocardium. All of these masses were classified pathologically as malignant (n = 6) or benign and vascular (n = 1). Nine masses demonstrated decreased pixel intensity, compared with the myocardium, and were diagnosed pathologically as myxomas (n = 2) or thrombi (n = 5), or they resolved with anticoagulation (n = 2). For the subset of patients, β correlated with the vessel area index (r = 0.60). Conclusions Echocardiographic contrast perfusion imaging aids in the differentiation of cardiac masses. Compared with the adjacent myocardium, malignant and vascular tumors hyper-enhanced, whereas stromal tumors and thrombi hypo-enhanced.
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differential diagnosis of cardiac masses using contrast echocardiographic perfusion imaging
Journal of the American College of Cardiology, 2004Co-Authors: James N Kirkpatrick, Tiffany Wong, James Bednarz, Kirk T Spencer, Lissa Sugeng, Parker R Ward, Jeanne M Decara, Lynn Weinert, Thomas Krausz, Roberto M LangAbstract:Abstract Objectives We investigated the usefulness of echocardiographic contrast perfusion imaging in differentiating cardiac masses. Background Two-dimensional echocardiography is the primary diagnostic modality for cardiac masses. However, differentiation between the different types of cardiac masses may be difficult at times. We hypothesized that echocardiographic contrast perfusion imaging would differentiate the neo-vascularization of malignancies from the aVascularity of thrombi and the sparse Vascularity of stromal tumors. Methods Sixteen patients with cardiac masses underwent power-modulation imaging after echocardiographic intravenous contrast administration. Pixel intensities in the mass and an adjacent section of myocardium were analyzed visually and by dedicated software. All masses had a pathologic diagnosis or resolved after anticoagulation. In a subset of patients, video-intensity curves of contrast replenishment in the mass and myocardium over time were generated. The post-impulse steady-state pixel intensity (A) and initial rate of contrast replenishment after impulse (β) were compared with an index of blood vessel area on pathology. Results In seven of 16 patients, contrast enhancement resulted in greater pixel intensity in the mass than in the adjacent myocardium. All of these masses were classified pathologically as malignant (n = 6) or benign and vascular (n = 1). Nine masses demonstrated decreased pixel intensity, compared with the myocardium, and were diagnosed pathologically as myxomas (n = 2) or thrombi (n = 5), or they resolved with anticoagulation (n = 2). For the subset of patients, β correlated with the vessel area index (r = 0.60). Conclusions Echocardiographic contrast perfusion imaging aids in the differentiation of cardiac masses. Compared with the adjacent myocardium, malignant and vascular tumors hyper-enhanced, whereas stromal tumors and thrombi hypo-enhanced.
Jun Fukae - One of the best experts on this subject based on the ideXlab platform.
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positive synovial Vascularity in patients with low disease activity indicates smouldering inflammation leading to joint damage in rheumatoid arthritis time integrated joint inflammation estimated by synovial Vascularity in each finger joint
Rheumatology, 2013Co-Authors: Jun Fukae, Masato Isobe, Akemi Kitano, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Akio Mitsuzaki, Masato Shimizu, Kazuhide Tanimura, Megumi MatsuhashiAbstract:Objective. To investigate the relationship between synovial Vascularity and joint damage progression in each finger joint of patients with RA under low disease activity during treatment with biologic agents. Methods. We studied 310 MCP and 310 PIP joints of 31 patients with active RA who were administered adalimumab (ADA) or tocilizumab (TCZ). Patients were examined with clinical and laboratory assessments. Power Doppler sonography was performed at baseline and at weeks 8, 20 and 40. Synovial Vascularity was evaluated according to quantitative measurement. Hand and foot radiography was performed at baseline and at week 50. Results. Composite scores of the DAS with 28 joints and the Simplified Disease Activity Index (SDAI) were significantly decreased from baseline to week 8, being sustained at a low level by biologic agents during the observational period. MCP and PIP joints with positive synovial Vascularity after week 8 showed more subsequent joint damage progression than joints without synovial Vascularity throughout the follow-up. The changes in radiographic progression in these joints were independent of the sum of synovial Vascularity from baseline to week 40 or the occasional occurrence of positive synovial Vascularity. Conclusion. Smouldering inflammation reflected by positive synovial Vascularity under low disease activity was linked to joint damage. The damage progressed irrespective of the severity of positive synovial Vascularity. Even with a favourable overall therapeutic response, monitoring of synovial Vascularity has the potential to provide useful joint information to tailor treatment strategies. Trial registration. University Hospital Medical Information Network Clinical Trials Registry; http://www. umin.ac.jp/ctr/; UMIN000004476.
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radiographic prognosis of finger joint damage predicted by early alteration in synovial Vascularity in patients with rheumatoid arthritis potential utility of power doppler sonography in clinical practice
Arthritis Care and Research, 2011Co-Authors: Jun Fukae, Masato Isobe, Akemi Kitano, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Akio Mitsuzaki, Masato Shimizu, Kazuhide Tanimura, Megumi MatsuhashiAbstract:Objective To investigate the relationship between synovial Vascularity and progression of structural bone damage in each finger joint in patients with rheumatoid arthritis (RA) and to demonstrate synovial Vascularity as a potential therapeutic marker. Methods We studied 250 metacarpophalangeal (MCP) and 250 proximal interphalangeal (PIP) joints of 25 patients with active RA who were administered adalimumab or tocilizumab. Patients were examined with clinical and laboratory assessments. Power Doppler sonography was performed at baseline and at the fourth and eighth weeks. Synovial Vascularity was evaluated according to quantitative measurement. Hand and foot radiography was performed at baseline and the twentieth week. Results Clinical indices such as the 28-joint Disease Activity Score, the Clinical Disease Activity Index, and the Simplified Disease Activity Index were significantly decreased by biologic agents. The MCP and PIP joints with no response in synovial Vascularity between baseline and the eighth week (Vascularity improvement of ≤70% at the eighth week) showed a higher risk of radiographic progression compared with responsive joints (Vascularity improvement of >70% at the eighth week; relative risk 2.33–9). Radiographic progression at the twentieth week was significantly lower in responsive joints than in nonresponsive joints. Conclusion The improvement of synovial Vascularity following treatment with biologic agents led to suppression of radiographic progression of RA in each finger joint. The alteration in synovial Vascularity numerically reflected therapeutic efficacy. Using Vascularity as a marker to determine the most suitable therapeutic approach would be beneficial for patients with active RA.
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change of synovial Vascularity in a single finger joint assessed by power doppler sonography correlated with radiographic change in rheumatoid arthritis comparative study of a novel quantitative score with a semiquantitative score
Arthritis Care and Research, 2010Co-Authors: Jun Fukae, Mihoko Henmi, Fumihiko Sakamoto, Akihiro Narita, Masato Shimizu, Kazuhide Tanimura, Megumi Matsuhashi, Tamotsu Kamishima, Tatsuya Atsumi, Takao KoikeAbstract:OBJECTIVE: To investigate the relationship between synovial Vascularity assessed by quantitative power Doppler sonography (PDS) and progression of structural bone damage in a single finger joint in patients with rheumatoid arthritis (RA). METHODS: We studied 190 metacarpophalangeal (MCP) joints and 190 proximal interphalangeal (PIP) joints of 19 patients with active RA who had initial treatment with disease-modifying antirheumatic drugs (DMARDs). Patients were examined by clinical and laboratory assessments throughout the study. Hand and foot radiography was performed at baseline and the twentieth week. Magnetic resonance imaging (MRI) was performed at baseline. PDS was performed at baseline and the eighth week. Synovial Vascularity was evaluated according to both quantitative and semiquantitative methods. RESULTS: Quantitative PDS was significantly correlated with the enhancement rate of MRI in each single finger joint. Comparing quantitative synovial Vascularity and radiographic change in single MCP or PIP joints, the level of Vascularity at baseline showed a significant positive correlation with radiographic progression at the twentieth week. The change of Vascularity in response to DMARDs, defined as the percentage change in Vascularity by the eighth week from baseline, was inversely correlated with radiographic progression in each MCP joint. The quantitative PDS method was more useful than the semiquantitative method for the evaluation of synovial Vascularity in a single finger joint. CONCLUSION: The change of synovial Vascularity in a single finger joint determined by quantitative PDS could numerically predict its radiographic progression. Using Vascularity as a guide to consider a therapeutic approach would have benefits for patients with active RA.