Using Advanced Medical Imaging to Study Bone and Joint Changes in Rheumatoid Arthritis

dc.contributor.advisorManske, Sarah Lynn
dc.contributor.authorBrunet, Scott Cameron
dc.contributor.committeememberBarnabé, Cheryl Carmelle Marie
dc.contributor.committeememberSalat, Peter
dc.date2019-11
dc.date.accessioned2019-06-20T14:51:40Z
dc.date.available2019-06-20T14:51:40Z
dc.date.issued2019-06-18
dc.description.abstractInflammatory processes in rheumatoid arthritis (RA) lead to the damage of joints which results in functional decline. Medical imaging plays an important role in evaluating the onset and progression of RA. High resolution peripheral quantitative computed tomography (HR-pQCT) permits 3-dimensional visualization of the bony microarchitecture allowing for improved erosion detection, joint space width, and bone microstructure measurements. The purpose of this research was to use HR-pQCT and other advanced imaging techniques to visualize and quantify bone changes in the metacarpophalangeal (MCP) joints in RA patients. First, the reproducibility of a semi-automated erosion segmentation program was assessed using intra-rater and scan-rescan measurements on a cohort of early RA participants. HR-pQCT was used to assess possible erosion healing in participants’ initiating a new biologic therapy. We observed that the majority of participants maintained stable joints space, bone mineral density, and erosion volume over a 9-month follow-up period, but 17% of the joints showed a significant decrease in total erosion volume suggesting potential erosion healing. Finally, the impact of subclinical inflammation on bone damage progression for patients in clinical remission was assessed using a combination of HR-pQCT and Magnetic Resonance Imaging (MRI). All 9 of the participants assessed in this study had evidence of subclinical inflammation on MRI, but there was no progression of joint damage seen on HR-pQCT. One participant had a significant decrease in erosion volume. An image registration algorithm, applied for the first time for MCP joints, was used to successfully localize areas of inflammation as seen on MRI with bone damage seen on HR-pQCT. It is demonstrated that even with a sensitive measure of bone damage, healing and progression can be difficult to visualize and quantify due to the heterogeneity of the disease. However, applying other imaging modalities that can provide information on inflammation, as displayed in this thesis, could allow us to gain further insight on the individual characteristics that lead to bone change. The imaging findings and techniques described in this thesis will provide a novel insight into the progression of bone damage in RA to help evaluate current treatment targets and improve patient outcomes in future research.en_US
dc.identifier.citationBrunet, S. C. (2019). Using Advanced Medical Imaging to Study Bone and Joint Changes in Rheumatoid Arthritis (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/36645
dc.identifier.urihttp://hdl.handle.net/1880/110509
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectRheumatoid Arthritisen_US
dc.subjectHigh Resolution peripheral Quantitative Computed Tomography (HR-pQCT)en_US
dc.subjectMagnetic Resonance Imaging (MRI)en_US
dc.subject.classificationBiophysics--Medicalen_US
dc.subject.classificationRadiologyen_US
dc.subject.classificationEngineeringen_US
dc.subject.classificationEngineering--Biomedicalen_US
dc.titleUsing Advanced Medical Imaging to Study Bone and Joint Changes in Rheumatoid Arthritisen_US
dc.typemaster thesisen_US
thesis.degree.disciplineEngineering – Biomedicalen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameMaster of Science (MSc)en_US
ucalgary.item.requestcopytrue
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