061. UTILITY OF HIGH DEFINITION MRI IN MONITORING DISEASE ACTIVITY IN TAKAYASU ARTERITIS
Notice bibliographique
Résumé
Background: Takayasu’s arteritis (TAK), is a rare large-vessel arteritis typically seen in young females. TAK can cause chronic structural damage such as stenosis and aneurysms, leading to significant morbidity and mortality, even in the absence of symptoms and elevations in acute phase reactants (APR). Currently, there is no gold standard for assessing disease activity in TAK. Given that CTA can pose significant radiation risk to young females, there has been an increased interest in using MRI, which can provide better soft tissue characterization without ionizing radiation exposure. Most studies have investigated the utility of 1.5T MRI in TAK; however, it remains unclear whether this image modality accurately predicts disease progression. We undertook a prospective observational study looking at the utility of high definition 3T MRI in the care of TAK patients to monitor disease activity. Methods: A prospective study of TAK patients meeting ACR criteria was undertaken at St. Joseph’s Health Care (London, Canada). For each patient, baseline demographics, clinical information and clinical activity status were collected at baseline and every 3 to 6 months. MRI of the chest and abdomen was sequentially obtained on each patient 1 to 2 times over the course of follow-up using a 3T PET/MR (Biograph mMR (Siemens, Germany)) with contrast (Gadovist (Bayer, Germany)). Images were assessed by a radiologist blinded to clinical data. Data was collected and analyzed using MS Excel (v.2017). Results: A total of 7 patients were included with a mean age of 29 years (SD 19), mean disease duration of 73 months (SD 66) and mean follow-up of 19 months (SD17). 5/7 patients were on corticosteroids over the course of follow-up with an average dose of 14.9 mg (SD = 19); 3/7 received biologic therapies; 4/7 another immunosuppressant; 1/7 an anti-hypertensive, 2/7 lipid-lowering medications and 5/7 an anti-platelet drug. Figure 1 summarizes the relationship between MRI findings and clinical activity. Patients with findings of active disease on MRI had higher APR. However, patients with clinically inactive disease continued to have evidence of active disease on MRI. Two of these patients had worsening MRI findings on follow-up; one of them developed clinically active disease 3 months later resulting in drug escalation. Graphical representation of APR, Indian Takayasu Arteritis Score 2010 (ITAS) and clinical activity with MRI (active disease defined as wall edema with thickening, worse or new stenosis/ dilation: Active-stable = no change from baseline, Active-worse = new or worse lesions from baseline, Inactive = No evidence of activity), Clinical activity = global clinician evaluation (based on history, physical exam and APR). Conclusion: High definition MRI may detect early active disease and predict disease flare in TAK; however, using it as a routine clinical test needs further exploration. Disclosures: Academic Medical Organization of Southwestern Ontario Opportunities Fund.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».