Synovitis and Therapy Response in Inflammatory Arthritis With Contrast Enhanced Ultrasound
| Status: | Recruiting |
|---|---|
| Conditions: | Arthritis, Rheumatoid Arthritis |
| Therapuetic Areas: | Rheumatology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/17/2018 |
| Start Date: | August 31, 2016 |
| End Date: | August 2018 |
| Contact: | George R Matcuk, MD |
| Email: | matcuk@usc.edu |
| Phone: | 323-442-8721 |
Quantitative Assessment of Synovitis and Therapy Response in Inflammatory Arthritis With Contrast Enhanced Ultrasound
This study is about using contrast-enhanced ultrasound (CEUS) to assess the degree of
synovitis (joint inflammation) in patients with inflammatory arthritis, such as rheumatoid
arthritis, and whether it can be used for assessing a treatment response. The investigators
hope to learn whether contrast enhanced ultrasounds are better than regular imaging
techniques, such as MRI, when used to evaluate the response to disease modifying
anti-rheumatic drug (DMARD) therapy in inflammatory arthritis.
synovitis (joint inflammation) in patients with inflammatory arthritis, such as rheumatoid
arthritis, and whether it can be used for assessing a treatment response. The investigators
hope to learn whether contrast enhanced ultrasounds are better than regular imaging
techniques, such as MRI, when used to evaluate the response to disease modifying
anti-rheumatic drug (DMARD) therapy in inflammatory arthritis.
Inflammatory arthritis affects approximately 1% of the world population and can lead to
significant pain and disability. Although radiographs can identify characteristic patterns of
joint space narrowing and erosive changes, these findings are typically late findings and
represent irreversible damage. With the development of disease modifying anti-rheumatic drugs
(DMARDs), the goal is now to identify the pre-erosive inflammatory features and identify the
patients that progress further into severe functional debility if not treated immediately.
MRI with gadolinium enhancement is proven to be very effective in early detection of soft
tissue, bone erosions, synovitis, the integrity of ligaments, cartilage and bone marrow
edema. However, MRI is expensive, may be impractical for assessing multiple joints and has
relatively long examination time. Some patients may have claustrophobia and some may have
contraindications to gadolinium administration. The investigators overarching goal is to
determine whether the perfusion information provided by novel ultrasound based techniques
such as, contrast enhanced ultrasound and superb microvascular imaging, can be used for
assessment of treatment response to DMARD therapy for inflammatory arthritis. The recent
advances in evaluation of vascularity of the tumors using contrast ultrasound technique can
also be applied to rheumatological diseases. It is ideal to develop a sensitive imaging
technique that can be routinely available and is relatively cheap. Ultrasound is available
and has low cost and can be used for assessment of treatment response to DMARD therapy
significant pain and disability. Although radiographs can identify characteristic patterns of
joint space narrowing and erosive changes, these findings are typically late findings and
represent irreversible damage. With the development of disease modifying anti-rheumatic drugs
(DMARDs), the goal is now to identify the pre-erosive inflammatory features and identify the
patients that progress further into severe functional debility if not treated immediately.
MRI with gadolinium enhancement is proven to be very effective in early detection of soft
tissue, bone erosions, synovitis, the integrity of ligaments, cartilage and bone marrow
edema. However, MRI is expensive, may be impractical for assessing multiple joints and has
relatively long examination time. Some patients may have claustrophobia and some may have
contraindications to gadolinium administration. The investigators overarching goal is to
determine whether the perfusion information provided by novel ultrasound based techniques
such as, contrast enhanced ultrasound and superb microvascular imaging, can be used for
assessment of treatment response to DMARD therapy for inflammatory arthritis. The recent
advances in evaluation of vascularity of the tumors using contrast ultrasound technique can
also be applied to rheumatological diseases. It is ideal to develop a sensitive imaging
technique that can be routinely available and is relatively cheap. Ultrasound is available
and has low cost and can be used for assessment of treatment response to DMARD therapy
Inclusion Criteria:
- Patients (≥ 18 years of age) that meet diagnostic criteria for an inflammatory
arthritis.
- Clinical suspicion of active synovitis involving at least one target joint.
- Patients competent to sign study specific Informed Consent.
- Patients willing to comply with protocol requirements.
- Intent to treat with disease-modifying anti-rheumatic drugs (DMARDs).
Exclusion Criteria:
- Patients who are pregnant or less than 18 years of age.
- Patients who have a known cardiac shunt or pulmonary hypertension.
- Patients with any known hypersensitivity to perflutren or gadolinium contrast agents
or renal insufficiency (GFR < 30 mL/min).
- Patients who cannot consent for themselves.
We found this trial at
1
site
1441 Eastlake Avenue
Los Angeles, California 90033
Los Angeles, California 90033
Principal Investigator: George R Matcuk, MD
Phone: 213-422-3505
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