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Abstract #1440

Fat Fraction Thresholds for Defining Bone Marrow Edema and Fat Metaplasia in Spondyloarthritis: More Objective than ‘A Tiny Bit of White’

Timothy J P Bray1,2, Alan Bainbridge3, Corinne Fisher2, Debajit Sen2, and Margaret A Hall-Craggs1,2

1Centre for Medical Imaging, University College London, London, United Kingdom, 2Arthritis Research UK Centre for Adolescent Rheumatology, University College London, London, United Kingdom, 3Department of Medical Physics, University College London Hospitals, London, United Kingdom

MRI is now widely used to diagnose spondyloarthritis, but existing methods for image analysis rely on qualitative visual analysis by radiologists, and suffer from poor reproducibility between observers. Here, we show that proton density fat fraction (PDFF) measurements can be used as an objective, quantitative alternative to visual analysis. Using receiver operating characteristic (ROC) analysis, we find that PDFF measurements enable accurate separation of bone marrow edema (active inflammation) and fat metaplasia (structural damage) from normal marrow. The described approach is more objective than looking for 'a tiny bit of white' on fat-suppressed images, which is the current clinical standard.

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