Low-dose CT scanning improves assessment of ankylosing spondylitis patients

June 15, 2017

The results of a study presented today at the Annual European Congress of Rheumatology (EULAR) 2017 showed that low dose computed tomography (LD-CT) is more sensitive than conventional radiographs (X-rays) in the monitoring of disease progression in patients with Ankylosing Spondylitis (AS).

LD-CT, using a newly developed scoring method for assessing bone formation in AS patients, had previously been shown to be reliable and sensitive, with good consistency between different individuals interpreting the images.

In this latest study, designed to further validate LD-CT, a comparison of its ability to demonstrate the formation of new bony growths (known as syndesmophytes ) and / or an increase in size of these syndesmophytes, showed that LD-CT consistently detected more AS patients with these signs of than conventional X-rays.

"Standard dose computed tomography is a sensitive method for assessing structural changes in the spine in patients with AS," said lead author Dr. Anoek de Koning from the Leiden University Medical Centre, Leiden, Netherlands. "However, its clinical utility has been limited due to its use of relatively high doses of ionising radiation."

"Our findings support the use of LD-CT as a sensitive method for the assessment of new or growing syndesmophytes in future clinical research without exposing patients to high doses of radiation," she concluded.

Comparing the percentage of patients with newly formed syndesmophytes, growth of existing syndesmophytes and the combination of both, scored by two separate investigators and as a consensus score, LD-CT detected more patients with progression in all comparisons. This was especially apparent where there was a higher number of new or growing syndesmophytes per patient.

With the strictest comparison of the consensus score for both LD-CT and X-rays, 30% of the patients showed bony proliferation (newly formed and growth) at 3 or more sites on LD-CT, compared with only 6% on conventional X-rays.

Patients were recruited from the SIAS (Sensitive Imaging of Axial Spondyloarthritis) cohort from Leiden, the Netherlands and Herne, Germany. 50 AS patients were included based on modified New York criteria , the presence of one or more syndesmophytes on either the cervical and / or lumbar spine seen on X-ray, and one or more inflammatory lesions on an MRI of their whole spine.

Each of these patients had conventional X-rays of the lateral cervical and lumbar spine and LD-CT of the entire spine at baseline and two years. Two investigators independently assessed the images in separate sessions. Images were paired per patient, blinded to time order, patient information, and the result of the other imaging technique.

For LD-CT, syndesmophytes were scored in the coronal and sagittal planes for all ''quadrants' per view, thus scoring 8 ''quadrants' per vertebral unit. The formation of new syndesmophytes, growth of existing syndesmophytes and the combination of both was calculated per quadrant. Syndesmophytes were scored as absent (score 0), <50% of the intervertebral disc height (IVDH) (score 1), ?50% of the IVDH but no bridging (score 2) or as bridging the IVDH (score 3).2 Consensus about each of these outcomes was defined by agreement of both readers on the same vertebral level. Data were compared per reader and for the consensus score.

AS is a painful, progressive and disabling form of arthritis caused by chronic inflammation in the . Prevalence of AS varies globally, and is estimated at 23.8 per 10,000 in Europe and 31.9 per 10,000 in North America.

Explore further: Biomarkers may predict the progression of spinal damage in patients with ankylosing spondylitis

Related Stories

Biomarkers may predict the progression of spinal damage in patients with ankylosing spondylitis

June 6, 2012
A new study presented today at EULAR 2012, the Annual Congress of the European League Against Rheumatism, has identified five biomarkers that may predict the progression of structural damage in the spine of patients with ...

Combination of NSAIDs and TNF-inhibitors shows benefit for ankylosing spondylitis

November 13, 2016
A combination of nonsteroidal anti-inflammatory drugs and TNF-inhibitors may help slow down spine damage in ankylosing spondylitis, according to new research findings presented this week at the American College of Rheumatology ...

Post-op cervical fusion X-rays may be superfluous

August 13, 2013
(HealthDay)—X-rays taken during postoperative visits following cervical fusion surgery are rarely of value when history and exam are normal, according to a study published in the July issue of The Spine Journal.

Survey assesses patients' expectations after spine surgery

October 29, 2013
(HealthDay)—A new survey has been developed and validated for assessing patients' expectations of lumbar spine surgery, according to a report published in the Oct. 2 issue of The Journal of Bone & Joint Surgery.

Treatment of hips beneficial in patients with low back pain

February 6, 2017
(HealthDay)—For individuals presenting with a primary complaint of mechanical low back pain (LBP), prescriptive treatment of the hips seems beneficial in addition to treatment of the lumbar spine, according to a study published ...

Recommended for you

Exploring how herpes simplex virus changes when passed between family members

October 22, 2017
A new study explores how herpes simplex virus might change when passed from one individual to another, information that may prove useful in future development of therapeutics and vaccines. This rare glimpse into a transmission ...

Pneumonia vaccine under development provides 'most comprehensive coverage' to date, alleviates antimicrobial concerns

October 20, 2017
In 2004, pneumonia killed more than 2 million children worldwide, according to the World Health Organization. By 2015, the number was less than 1 million.

Newly discovered viral marker could help predict flu severity in infected patients

October 20, 2017
Flu viruses contain defective genetic material that may activate the immune system in infected patients, and new research published in PLOS Pathogens suggests that lower levels of these molecules could increase flu severity.

H7N9 influenza is both lethal and transmissible in animal model for flu

October 19, 2017
In 2013, an influenza virus that had never before been detected began circulating among poultry in China. It caused several waves of human infection and in late 2016, the number of people to become sick from the H7N9 virus ...

Flu simulations suggest pandemics more likely in spring, early summer

October 19, 2017
New statistical simulations suggest that Northern Hemisphere flu pandemics are most likely to emerge in late spring or early summer at the tail end of the normal flu season, according to a new study published in PLOS Computational ...

New insights into herpes virus could inform vaccine development

October 18, 2017
A team of scientists has discovered new insights into the mechanisms of Epstein-Barr virus (EBV) infection, as well as two antibodies that block the virus' entry into cells. The findings, published in Proceedings of the National ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.