Rheumatology Advance Access originally published online on August 2, 2008
Rheumatology 2008 47(10):1521-1526; doi:10.1093/rheumatology/ken318
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Reliability of different Doppler ultrasound quantification methods and devices in the assessment of therapeutic response in arthritis
1Department of Rheumatology and Immunology, University of Giessen, Kerckhoff Klinik, Bad Nauheim, Germany.
Correspondence to: K. Albrecht, Department of Rheumatology and Immunology, University of Giessen, Kerckhoff Klinik, Benekestr.2-8, 61231 Bad Nauheim, Germany. E-mail: k.albrecht{at}kerckhoff-klinik.de
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Abstract |
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Objective. To evaluate the metric qualities of power Doppler ultrasound (PDUS) for different quantification methods and devices in the assessment of arthritis during anti-inflammatory treatment
Methods. Twenty-four patients with active arthritis and first-time treatment with the TNF-
inhibitor adalimumab underwent sequential clinical, laboratory and US examination at baseline, weeks 2, 6 and 12. 2D and 3D PDUS was performed by two independent investigators. The images and movies were scored from 0 to 3 and the amount of colour pixels and voxels was calculated. In addition, the resistance index of a synovial artery was measured. Thirteen patients were examined with a second US machine.
Results. Treatment response was already observed at week 2 with a significant reduction of 2D (P < 0.01) and 3D scores (P < 0.001). A moderate correlation to 28-joint disease activity score was found for 3D voxel count (rs = 0.35, P < 0.001). Interobserver agreement was 
or ICC 
0.8 for all methods except the resistance index (ICC = 0.60). Intermachine agreement was = 0.57 for 2D PDUS score.
Conclusions. The study demonstrates good to excellent interobserver and moderate intermachine reliability of different PDUS assessment methods in a longitudinal open-label study.
KEY WORDS: Power Doppler, Ultrasonography, 3D, Arthritis, Wrist
Submitted 11 April 2008;
revised version accepted 7 July 2008.
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