MRI is increasingly used to identify and monitor inflammation in patients with inflammatory diseases involving the skeleton, such as spondyloarthritis. However, conventional image interpretation by radiologists provides only indirect information about the inflammatory process and lacks reproducibility. Here, we describe a partially-automated multiparametric MRI tool for quantifying and characterising both active and chronic inflammation in spondyloarthritis, relying on histographic analysis of apparent diffusion coefficient (ADC) and proton density fat fraction (PDFF) maps. We show that histographic analysis improves performance compared to simple averaging, and, further, that ADC and PDFF provide distinct, complementary information regarding active inflammation and structural damage respectively.
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