A recent study funded by the National Institutes of Health has highlighted the potential of ultrashort echo time (UTE) magnetic resonance imaging (MRI) techniques for the quantitative evaluation of entheses and tendons in patients with psoriatic arthritis (PsA). The University of California, San Diego (UCSD) led the investigation, which demonstrated that using MRI T1 and magnetization transfer (MT) modeling could aid in the early detection and management of PsA. The UTE-MT modeling technique was found to be effective in detecting increased entheses among those with PsA and distinguishing them from asymptomatic volunteers.
The investigators focused on evaluating the macromolecular proton fraction (MMF) of the Achilles tendon as the primary outcome of interest. Scans were performed on a clinical scanner using UTE-T1 and UTE-MT modeling sequences. The study included 26 patients with PsA and 27 asymptomatic volunteers. Results showed that UTE-T1 values in the entheses and tendons were significantly greater in the PsA group compared to the asymptomatic group. Additionally, MMF values were significantly reduced in the entheses and tendons of PsA patients.
However, the study has some limitations to consider, including a small number of patients, an older age profile of PsA patients compared to asymptomatic volunteers, and the inability to identify and exclude patients who may have been undergoing treatment for PsA. Despite these limitations, the study highlights the potential of UTE-T1 and UTE-MT modeling for the quantitative evaluation of entheses and tendons in patients with PsA.
In conclusion, the use of UTE-MRI techniques shows promise in the early detection and management of PsA. Further research and larger studies are needed to validate the findings and determine the full potential of this imaging modality in the assessment of PsA.
– Moazamian D, Athertya JS, Dwek S, et al. Achilles tendon and enthesis assessment using ultrashort echo time magnetic resonance imaging (UTE-MRI) T1 and magnetization transfer (MT) modeling in psoriatic arthritis [published online ahead of print, 2023 Sep 23]. NMR Biomed. 2023;e5040.
– Mathew AJ, Coates LC, Danda D, Conaghan PG. Psoriatic arthritis: lessons from imaging studies and implications for therapy. Expert Rev Clin Immunol. 2017;13(2):133-142.