Graduate School of Health Sciences, Hokkaido University, North 12 West 5, Kita-ku, Sapporo, 060-0812, Japan.
Faculty of Health Sciences, Hokkaido University, North 12 West 5, Kita-ku, Sapporo, 060-0812, Japan.
J Digit Imaging. 2017 Oct;30(5):648-656. doi: 10.1007/s10278-017-9970-9.
We have developed a refined computer-based method to detect joint space narrowing (JSN) progression with the joint space narrowing progression index (JSNPI) by superimposing sequential hand radiographs. The purpose of this study is to assess the validity of a computer-based method using images obtained from multiple institutions in rheumatoid arthritis (RA) patients. Sequential hand radiographs of 42 patients (37 females and 5 males) with RA from two institutions were analyzed by a computer-based method and visual scoring systems as a standard of reference. The JSNPI above the smallest detectable difference (SDD) defined JSN progression on the joint level. The sensitivity and specificity of the computer-based method for JSN progression was calculated using the SDD and a receiver operating characteristic (ROC) curve. Out of 314 metacarpophalangeal joints, 34 joints progressed based on the SDD, while 11 joints widened. Twenty-one joints progressed in the computer-based method, 11 joints in the scoring systems, and 13 joints in both methods. Based on the SDD, we found lower sensitivity and higher specificity with 54.2 and 92.8%, respectively. At the most discriminant cutoff point according to the ROC curve, the sensitivity and specificity was 70.8 and 81.7%, respectively. The proposed computer-based method provides quantitative measurement of JSN progression using sequential hand radiographs and may be a useful tool in follow-up assessment of joint damage in RA patients.
我们开发了一种改良的基于计算机的方法，通过叠加连续的手部 X 光片来检测关节间隙狭窄（JSN）进展，并使用关节间隙狭窄进展指数（JSNPI）进行定量评估。本研究旨在评估一种基于计算机的方法在来自两个机构的类风湿关节炎（RA）患者的图像中的有效性。对来自两个机构的 42 名 RA 患者（37 名女性和 5 名男性）的连续手部 X 光片进行了计算机方法和视觉评分系统的分析，作为参考标准。在关节水平上，超过最小可检测差异（SDD）的 JSNPI 定义了 JSN 进展。使用 SDD 和接收器操作特征（ROC）曲线计算了计算机方法对 JSN 进展的敏感性和特异性。在 314 个掌指关节中，根据 SDD，有 34 个关节进展，而 11 个关节变宽。在计算机方法中，有 21 个关节进展，在评分系统中有 11 个关节进展，在两种方法中有 13 个关节进展。根据 SDD，我们发现敏感性为 54.2%，特异性为 92.8%，分别较低和较高。在根据 ROC 曲线确定的最具鉴别力的截止点，敏感性和特异性分别为 70.8%和 81.7%。该研究提出的基于计算机的方法使用连续手部 X 光片提供了 JSN 进展的定量测量，可能是 RA 患者关节损伤随访评估的有用工具。
