Quantification of acute and chronic lesions on magnetic resonance imaging in patients with recurrent acute anterior uveitis: a proof of concept
Bibliographic record
Abstract
Introduction: Acute anterior uveitis is an inflammation of the middle layer of the eye and is related to human leukocyte antigen B27 (HLA-B27) and the concept of spondyloarthritis (SpA). Objectives: To assess the prevalence of definite SpA by combined T1W/STIR MRI (global MRI), to quantify acute and chronic lesions in SIJ using MRI in patients with rAAU with and without back symptoms, and to assess which MRI lesion-based criteria optimally reflect the global MRI designation of definite SpA. Methods: A total of 50 consecutive patients with rAAU without prior rheumatologic diagnosis were included in this cross-sectional study and were compared to 21 healthy volunteers. They were evaluated for the presence of inflammatory back pain and classified according to modified New York criteria (Nym), ASAS (Assessment on SpondyloArthritis International Society) for axial SpA (ax-SpA) and peripheral (p-SpA), as well as fibromyalgia. Patients underwent radiography (XR) and MRI of the SI according to ASAS recommendations. Both MRI and XR were evaluated independently by two rheumatologists, and the discrepant cases read by a radiologist. The identification and quantification of acute and chronic lesions were performed according to MORPHO/SPARCC (The Spondyloarthritis Research Consortium of Canada) group protocol. The following laboratory tests were also performed: antinuclear antibody (ANA), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C- reactive protein (CRP) and HLA-B27. Results: rAAU patients were classified as ax-SpA (Group 1, n=20) according to ASAS criteria (2009); non-specific back pain (Group 2, n=6) and asymptomatic (Group 3, n=24). The groups were similar regarding age, sex, ethnicity, age at onset of uveitis, current uveitis activity and duration of eye disease. HLA-B27 was positive in 48% of those with rAAU. Considering only group 3, nine (37.5%) patients had SIJ MRI and/or X-ray positive for axial SpA (5 MRI and x-ray, 1 MRI, 3 x-ray). MRI scans compatible with SpA in groups 1(n=12) and 3 (n=6) were similar regarding acute and chronic lesions analysed according to MORPHO. The best sensitivity/specificity criterion to define a positive global MRI assessment was bone marrow edema (BME) ? 3 (92%/94%). Conclusions: This is the first study evaluating SIJ MRI in patients with rAUU without back symptoms showing positive findings for sacroiliitis, confirming a uvea-axial spine link, and BME ? 3 as optimal for a positive MRI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".