Publications by authors named "Diekhoff T"

Purpose: To examine whether incorporating anatomy-centred deep learning can improve generalisability and enable prediction of disease progression.

Methods: This retrospective multicentre study included conventional pelvic radiographs of four different patient cohorts focusing on axial spondyloarthritis collected at university and community hospitals. The first cohort, which consisted of 1483 radiographs, was split into training (n=1261) and validation (n=222) sets.

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Objectives: To examine the relationship between the quality of paraspinal muscles and pain intensity, duration, and quality of life in patients with chronic low back pain (cLBP).

Methods: Between January 2022 and December 2023, 119 individuals with no-back pain (no-BP) and 136 cLBP patients were enrolled. Both groups underwent health surveys and magnetic resonance imaging.

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Background: There is considerable practice variation in labelling, diagnosis and treatment of adults with sterile bone inflammation. We developed a expert consensus recommendations on the disease definition, diagnosis and treatment of this rare condition.

Methods: Systematic literature review and Grading of Recommendations, Assessment, Development and Evaluations-based appraisal of evidence, two Delphi surveys and three digital and in-person consensus meetings with a multidisciplinary expert panel and patient representatives.

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Background: Dual-energy computed tomography (DECT) is a noninvasive diagnostic tool for gouty arthritis. This study aimed to compare two postprocessing techniques for monosodium urate (MSU) detection: conventional two-material decomposition and material map-based decomposition.

Methods: A raster phantom and an ex vivo biophantom, embedded with four different MSU concentrations, were scanned in two high-end CT scanners.

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Article Synopsis
  • Recent advancements in computed tomography (CT), especially dual-energy CT (DECT), have significantly improved arthritis imaging, aiding in the diagnosis of conditions like gouty arthritis and monitoring structural changes.
  • Innovations such as low-dose CT and advanced reconstruction algorithms enhance image quality while minimizing radiation exposure, making CT safer and quicker for patients.
  • DECT's capability to differentiate between calcium and uric acid crystals, along with new techniques like four-dimensional CT for assessing joint dynamics, positions it as a vital tool for effective arthritis diagnosis and treatment monitoring.*
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Objectives: This study aims to establish expert consensus recommendations for clinical information on imaging requests in suspected/known axial spondyloarthritis (axSpA), focusing on enhancing diagnostic clarity and patient care through guidelines.

Materials And Methods: A specialised task force was formed, comprising 7 radiologists, 11 rheumatologists from the Assessment of Spondyloarthritis International Society (ASAS) and a patient representative. Using the Delphi method, two rounds of surveys were conducted among ASAS members.

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Background: A range of sacroiliac joint (SIJ) MRI protocols are used in clinical practice but not all were specifically designed for diagnostic ascertainment. This can be confusing and no standard diagnostic SIJ MRI protocol is currently accepted worldwide.

Objective: To develop a standardised MRI image acquisition protocol (IAP) for diagnostic ascertainment of sacroiliitis.

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Over the past decade, MRI has significantly advanced the diagnosis of rheumatic disease in both adults and juveniles. In this article, the authors present an update on MRI applications in rheumatology, based on a review of the most recent publications. New developments in adults related to, among others, axial spondyloarthritis, peripheral arthritis, and the whole body-MRI (WB-MRI) are presented.

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Objectives: Apply a modified Delphi-based approach and produce a practical, radiology-specific set of definitions for interpretation and standardization of the multiple MRI findings in axial spondyloarthritis (ax-SpA), specifically to aid the general radiologist with a musculoskeletal interest, working with gold standard basic MRI protocols.

Materials And Methods: We report the results of a modified Delphi-based consensus of 35 experts from 13 countries in the Arthritis Subcommittee of the European Society of Musculoskeletal Radiology (ESSR). Seventeen definitions were created (i.

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  • This study investigates how virtual noncontrast (VNC) images from dual-energy computed tomography (DECT) can improve the detection of monosodium urate crystals (MSU), which are indicative of gouty tophi, especially when high concentrations of iodinated contrast media (ICM) are used.
  • Using various phantoms with different ICM and MSU concentrations, the research compared the effectiveness of VNC images against standard DECT images in identifying MSU.
  • Results showed that VNC significantly enhances MSU detection when ICM levels are high, suggesting that VNC could effectively aid in diagnosing gout without needing traditional noncontrast image acquisitions.
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Whereas previous projects attempted to standardize imaging in patients with axial spondyloarthritis (axSpA), few studies have been published about the need for specific details regarding the image acquisition and lesions that may be less familiar to general radiologists. This work reports consensus recommendations developed by the Assessment of SpondyloArthritis International Society (ASAS) that aim to standardize the imaging reports in patients suspected of having or with known axSpA. A task force consisting of radiologists and rheumatologists from ASAS and one patient representative formulated two surveys that were completed by ASAS members.

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  • The knee is frequently affected by inflammatory arthritis, including crystal-induced and autoimmune types, leading to various patterns of joint damage over time.
  • Different types of arthritis have distinct causes, resulting in different imaging results, with some causing rapid joint destruction and others taking years to show damage.
  • Traditional imaging methods, like X-rays and MRIs, are crucial for diagnosis, but new techniques like dual-energy CT and hybrid imaging are enhancing how we diagnose and understand these knee conditions.
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  • The study assessed how clinical information affects the accuracy of radiography and MRI interpretations for diagnosing axial spondyloarthritis (axSpA).
  • The analysis included 109 patients, with results showing higher precision for radiographs when clinical data was presented (70% to 78%).
  • Overall, providing clinical information improved radiologists' confidence and diagnostic precision, indicating its importance in interpreting imaging results.
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Sacroiliitis is commonly seen in patients with axial spondyloarthritis, in whom timely diagnosis and treatment are crucial to prevent irreversible structural damage. Imaging has a prominent place in the diagnostic process and several new imaging techniques have been examined for this purpose. We present a summary of updated evidence-based practice recommendations for imaging of sacroiliitis.

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  • Reliable interpretation of imaging findings is crucial for diagnosing axial spondyloarthritis (axSpA), and this study explored how experience level affects diagnostic accuracy using X-ray (XR), MRI, and CT.
  • The study analyzed 163 low back pain patients, dividing nine blinded readers into three experience groups to assess their ability to identify axSpA through imaging.
  • Results indicated that the most experienced readers performed best overall, especially with MRI, while CT and MRI were more effective for less experienced readers, highlighting that MRI requires more skill and experience for accurate diagnosis.
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  • Conventional MRI has limitations in quantifying bone marrow lesions in axial spondyloarthritis due to variable signal intensities.
  • This study involved 62 patients undergoing both CT and MRI, with T1 mapping used to differentiate types of bone marrow lesions, including sclerosis, osteitis, and fat lesions.
  • T1 mapping showed significant differences in relaxation times for these lesions, achieving high accuracy in distinguishing them, but more development is needed to enhance the technique for mixed lesions before it can be used in clinical practice.
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Background: The Computed Tomography Syndesmophyte Score (CTSS) was developed as a reliable and sensitive tool to assess syndesmophytes in low-dose CT images of the entire spine in patients with axial spondyloarthritis (axSpA). The original paper provided sparce examples of the CTSS grades.

Objectives: Provide an atlas tailored to assist readers in understanding and employing the CTSS method.

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Objective: To evaluate progression from nonradiographic (nr-) to radiographic axial spondyloarthritis (r-axSpA) over 5 years in patients with recently diagnosed (≤1 year) axSpA fulfilling the Assessment of SpondyloArthritis international Society (ASAS) classification criteria.

Methods: A prospsective, observational study (Patients with Axial Spondyloarthritis: Multi-Country Registry of Clinical Characteristics) was conducted in rheumatology practices in 29 countries. Baseline and follow-up radiographs of sacroiliac joints were centrally evaluated by three readers according to the grading system of the modified New York criteria for patients initially classified as nr-axSpA.

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  • The study aimed to explore computed tomography-based thermography (CTT) for predicting ablation zones during microwave ablation (MWA) in a porcine liver model.
  • CTT effectively visualized ablation zones, showing a significant correlation between CT attenuation values and temperature changes, implying that the technique can be used to accurately assess treatment areas.
  • The findings suggest that CTT could be beneficial in clinical settings to improve patient outcomes and potentially reduce the risk of local cancer recurrence.
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Magnetic resonance imaging (MRI) has emerged as a valuable tool for early detection and of axial spondyloarthritis (axSpA). A standardized imaging acquisition protocol, aligned with the current state-of-the-art, is crucial to obtain MRI scans that meet the diagnostic quality requirements. It is important to note that certain lesions, particularly bone marrow edema (BME), can be induced by mechanical stress or be a manifestation of another non-inflammatory disorder and may mimic the characteristic findings of axSpA on MRI.

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Sacroiliitis is characterised by active and structural changes of the joint. While the Assessment of Spondyloarthritis international Society (ASAS) classification criteria stress the importance of bone marrow inflammation, recent reports suggest that osteitis can occur in various diseases, mechanical conditions and healthy individuals. Thus, structural lesions such as joint surface erosion and ankylosis are important factors for differential diagnosis.

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Article Synopsis
  • Axial spondyloarthritis (axSpA) is a chronic inflammatory condition that primarily affects the spine and sacroiliac joints, with imaging techniques like MRI and X-rays being critical for diagnosis and monitoring.
  • New bone formation is a key indicator of advanced axSpA, occurring in various spinal areas and SIJs, highlighting the disease's progression.
  • Different imaging modalities have unique strengths and weaknesses in detecting structural changes, making it essential to choose the right method for effective diagnosis and patient management.
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  • The study investigates how sex-specific differences affect the diagnosis of axial spondyloarthritis (axSpA) in women compared to men, which may lead to delays in diagnosis.
  • A total of 526 patients were analyzed for MRI findings related to axSpA, focusing on lesions like bone marrow edema and fat metaplasia.
  • Results showed that while active inflammatory lesions had similar diagnostic performance in both sexes, structural markers were less reliable in women, increasing the chances of false positives.
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  • The study aimed to assess how self-reported diagnostic confidence (DC) correlates with diagnostic accuracy in imaging for axial spondyloarthritis (axSpA) using X-rays, CT, and MRI.
  • Results showed that higher DC scores corresponded with accurate axSpA diagnoses across all imaging modalities, indicating a significant difference in scores for correct versus incorrect assessments.
  • The findings support the inclusion of self-reported DC in radiological reports to enhance the reliability of diagnoses in axSpA imaging.
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