From the Department of Radiology and Diagnostic Imaging, University of Alberta; Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Division of Medicine, University of New South Wales, New South Wales, Australia; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK; Department of Radiology, Balgrist University Hospital, Zurich, Switzerland.
Jacob Jaremko is the Capital Health Chair in Diagnostic Imaging at the University of Alberta; funds for this position derive from an endowment directed toward musculoskeletal imaging research.
J Rheumatol. 2017 Nov;44(11):1713-1717. doi: 10.3899/jrheum.161101. Epub 2017 Jul 1.
To assess reliability and feasibility of using a Web-based interface and interactive online calibration tool for magnetic resonance imaging (MRI) scoring of bone marrow lesions (BML) in osteoarthritis (OA), applied to the Hip MR Inflammation Scoring System (HIMRISS).
Seven readers new to HIMRISS (3 radiologists, 4 rheumatologists) scored coronal short-tau inversion recovery MRI from a hip OA observational study obtained pre- and 8-week poststeroid injection (n = 40 × 2 scans × 2 hips = 160 hips). By crossover design, Group B (4 readers) scored 20 patients (40 hips) using conventional spreadsheet-based methods and then another 20 using a Web-based interface and an online real-time iterative calibration (RETIC) training module. Group A (3 readers) reversed the order, scoring the first 20 subjects by the new method and the final 20 conventionally. Outcomes included ICC and reader survey.
Interobserver reliability for BML status was high by both spreadsheet and Web-based methods (0.84-0.90), regardless of the order in which scoring was performed. Reliability of change scores was moderate and improved with training. Improvement was greater in readers who began with the spreadsheet method and then used the Web-based method than in those who began with the Web-based method, especially at the acetabulum. Readers found Web-based/RETIC scoring more user-friendly and nearly 50% faster than traditional spreadsheet methods.
HIMRISS offers reliable BML scoring in OA, whether by conventional spreadsheet-based scoring or by a Web-based interface with interactive feedback. The new method allowed faster readings, provided a consistent training environment that helped inexperienced readers achieve reliability equivalent to that of conventional methods, and was preferred by the readers.
评估基于网络的界面和交互式在线校准工具在骨关节炎（OA）骨髓病变（BML）磁共振成像（MRI）评分中的可靠性和可行性，应用于髋关节 MRI 炎症评分系统（HIMRISS）。
7 名新接触 HIMRISS 的读者（3 名放射科医生，4 名风湿病学家）对来自髋关节 OA 观察性研究的冠状位短 tau 反转恢复 MRI 进行评分，这些 MRI 在类固醇注射前和 8 周后获得（n=40×2 次扫描×2 个髋关节=160 个髋关节）。采用交叉设计，B 组（4 名读者）使用传统的基于电子表格的方法对 20 名患者（40 个髋关节）进行评分，然后使用基于网络的界面和在线实时迭代校准（RETIC）培训模块对另外 20 名患者进行评分。A 组（3 名读者）则颠倒顺序，先用新方法对前 20 名患者进行评分，最后 20 名患者则用传统方法进行评分。结果包括 ICC 和读者调查。
无论是使用电子表格方法还是基于网络的方法，BML 状态的观察者间可靠性均较高（0.84-0.90），而与评分顺序无关。变化评分的可靠性为中等，且随培训而提高。从电子表格方法开始然后使用基于网络的方法的读者的改善程度大于从基于网络的方法开始的读者，尤其是在髋臼处。读者发现基于网络的/RETIC 评分比传统的电子表格方法更易用，速度快近 50%。
无论是通过传统的基于电子表格的评分还是通过具有交互式反馈的基于网络的界面，HIMRISS 都能可靠地对 OA 中的 BML 进行评分。新方法允许更快的阅读，提供了一致的培训环境，帮助缺乏经验的读者达到与传统方法相当的可靠性，并且受到了读者的青睐。
