Non-EPI-DWI for Detection, Disease Monitoring, and Clinical Decision-Making in Thyroid Eye Disease.


Journal

AJNR. American journal of neuroradiology
ISSN: 1936-959X
Titre abrégé: AJNR Am J Neuroradiol
Pays: United States
ID NLM: 8003708

Informations de publication

Date de publication:
08 2020
Historique:
received: 13 10 2019
accepted: 16 05 2020
entrez: 16 8 2020
pubmed: 17 8 2020
medline: 29 12 2020
Statut: ppublish

Résumé

The Clinical Activity Score is widely used to grade activity of thyroid eye disease and guide treatment decisions, but as a subjective measurement and being confined to the anterior orbit, it has limitations. Non-EPI-DWI of the extraocular muscles may offer advantages as a functional imaging technique with reduced skull base artifacts, but the correlation with the Clinical Activity Score and patient outcome is unknown. Our aim was to establish the correlation between the Clinical Activity Score and non-EPI-DWI and to describe the additional value provided by adjunctive non-EPI-DWI in making clinical decisions. This was a retrospective longitudinal study of 31 patients seen in a multidisciplinary thyroid eye disease clinic during 5 years who had at least 1 ophthalmic and endocrine assessment including the Clinical Activity Score and a non-EPI-DWI ADC calculation. The Spearman rank correlation coefficient was used to determine the relationship between the Clinical Activity Score and non-EPI-DWI. A patient flow chart was constructed to evaluate clinical decision-making, and receiver operating characteristics were generated. From 60 non-EPI-DWI scans, 368 extraocular muscles were selected for analysis. There was a significant positive correlation between the Clinical Activity Score and ADC ( The non-EPI-DWI correlated well with the Clinical Activity Score in our patients and was a useful adjunct to the Clinical Activity Score in making clinical decisions, especially in patients with intermediate activity and severity of thyroid eye disease.

Sections du résumé

BACKGROUND AND PURPOSE
The Clinical Activity Score is widely used to grade activity of thyroid eye disease and guide treatment decisions, but as a subjective measurement and being confined to the anterior orbit, it has limitations. Non-EPI-DWI of the extraocular muscles may offer advantages as a functional imaging technique with reduced skull base artifacts, but the correlation with the Clinical Activity Score and patient outcome is unknown. Our aim was to establish the correlation between the Clinical Activity Score and non-EPI-DWI and to describe the additional value provided by adjunctive non-EPI-DWI in making clinical decisions.
MATERIALS AND METHODS
This was a retrospective longitudinal study of 31 patients seen in a multidisciplinary thyroid eye disease clinic during 5 years who had at least 1 ophthalmic and endocrine assessment including the Clinical Activity Score and a non-EPI-DWI ADC calculation. The Spearman rank correlation coefficient was used to determine the relationship between the Clinical Activity Score and non-EPI-DWI. A patient flow chart was constructed to evaluate clinical decision-making, and receiver operating characteristics were generated.
RESULTS
From 60 non-EPI-DWI scans, 368 extraocular muscles were selected for analysis. There was a significant positive correlation between the Clinical Activity Score and ADC (
CONCLUSIONS
The non-EPI-DWI correlated well with the Clinical Activity Score in our patients and was a useful adjunct to the Clinical Activity Score in making clinical decisions, especially in patients with intermediate activity and severity of thyroid eye disease.

Identifiants

pubmed: 32796099
pii: 41/8/1466
doi: 10.3174/ajnr.A6664
pmc: PMC7658861
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1466-1472

Informations de copyright

© 2020 by American Journal of Neuroradiology.

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Auteurs

C Feeney (C)

From the Eye Department (C.F., V.L., F.R., S.N.), Central Middlesex Hospital, London, UK.
Imperial Centre for Endocrinology (C.F.), North West Thames, UK.

R K Lingam (RK)

Department of Radiology (R.K.L.), Northwick Park & Central Middlesex Hospital, London Northwest University Healthcare National Health Service Trust, London, UK.

V Lee (V)

From the Eye Department (C.F., V.L., F.R., S.N.), Central Middlesex Hospital, London, UK v.lee@imperial.ac.uk vickie.lee@nhs.net.

F Rahman (F)

From the Eye Department (C.F., V.L., F.R., S.N.), Central Middlesex Hospital, London, UK.

S Nagendran (S)

From the Eye Department (C.F., V.L., F.R., S.N.), Central Middlesex Hospital, London, UK.

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Classifications MeSH