Workshop

The workshop proposal "Medical Imaging in Rheumatology" has been approved and included within the ICIAP 2015 Conference program.

The workshop is intended to provide an overview on advanced and innovative medical-imaging applications, for the early diagnosis and therapeutic control of rheumatic musculo-skeletal diseases.

Rheumatic musculo-skeletal diseases have an increasing impact on society and on health care costs, and their spread is raising, due to the increasing average age of the population. Such diseases are among the most common chronic conditions affecting the European population and the industrialized countries. Among the European population, the 22% of adults has presented problems with muscles, bones and joints for prolonged periods; for the 32% of them these symptoms have limited the activities of daily living (Health in Europe Eurobarometer report 2007).

To date, the diagnostic process is based on conventional radiology, in order to highlight bone erosion, which is, however, the final effect of the disease. Other imaging modalities, aiming at identifying perfusion characteristics in inflammatory joint diseases, are recently receiving increasing attention. Encouraging results have already been obtained by analyzing ultrasound and MRI acquisition modalities.

Through the analysis of Magnetic Resonance Imaging (MRI) erosive change due to Rheumatoid Arthritis (RA) can be detected with higher sensitivity than by using conventional radiography, particularly in the early stages of the disease. In addition, MRI allows direct visualization and assessment of synovitis, the primary lesion in RA, and of bone oedema, a probable forerunner of bone erosions. Dynamic Contrast-Enhanced MRI (DCE-MRI) has proved to be a promising tool for assessing the early inflammatory response to treatment, potentially even before volume changes. Advanced and innovative imaging techniques, used within appropriate image processing tools, seem to be a highly sensitive solution for monitoring the early inflammatory treatment response in patients with RA.

Conventionally, radiological and CT data are analyzed using Region Of Interest- (ROI-) based techniques, where very small ROIs are placed in the most information-bearing regions, as perceived by an observer. The latest methods of image processing and structural analysis of the regions of interest are leading the way in the reconstruction, 3D visualization, and automatic or semi-automatic quantitative evaluations. Such techniques can be applied for the analysis of data acquired by using the modern imaging modalities: they will allow to take full advantage of the rich information stored in the data.

At the time being, clinical experts need to perform quantitative or semi-quantitative analysis. Indeed, structural joint damage, a major outcome in rheumatoid arthritis (RA), has traditionally been measured by scoring methods applied to radiological images. Novel scoring systems have recently been proposed, such as the OMERACT rheumatoid arthritis scoring system (RAMRIS), which are based on MRI acquisitions. Hence, novel imaging modalities have a major potential as an outcome measure in RA clinical trials. Nevertheless, standardized, validated, and feasible processing, analysis, and assessment systems are currently still required.

The goal of this workshop is to enhance the use of alternative techniques such as MRI and US, which can even be used in a combined manner. The workshop will focus on the development of appropriate techniques for data analysis and 2D/3D visualization, in order to increase and improve the information available to the doctor during the diagnostic process and follow-up. The results of the research can also be verified through the presentation of experimental demonstrators and database collections of case studies that can be used as a reference for training and validation session.

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