Artificial intelligence in detecting early RA.

To prevent chronicity of Rheumatoid Arthritis (RA) by early treatment, detecting inflammatory signs in an early phase is essential. Since Magnetic Resonance Imaging (MRI) of the wrist, hand and foot can detect inflammation before it is clinically detectable, this modality may play an important role in achieving very early diagnoses. By collecting large amounts of MRI data from healthy controls and patients with arthralgia suspicious for progression to RA, patterns can be studied that are most specific for early development of RA. Furthermore, MRI can be used as outcome parameter for randomized placebo-controlled trials on early RA treatment, by detecting subtle changes in image intensities originating from natural progression or treatment effects. Very large amounts of MRI data, however, make manual quantification impractical and the coarse scale used in visual scoring systems (i.e. whole values between 0 and 3) limits its sensitivity to detect changes that are likely to be very subtle in such an early phase. In recent years, advances in artificial intelligence and especially 'deep learning' in interpreting medical images have shown that -in specific areas- a computerized analysis can outperform human observers. Therefore, research has been initiated into applying these artificial intelligence techniques to the quantification of early RA from MRI data. In this paper, an overview is given on the background and history of artificial intelligence, with a special focus on recent developments in 'deep learning', and how these techniques could be applied to detect subtle inflammatory changes in MRI data.