Table 1.
MRI diagnostic test performance in included studies*
| Reference | N | Mean Follow-up, months (range) |
RF positive (%) |
anti- CCP positive (%) |
Plain radiograph erosions (%) |
Quality Criteria Reported (%) |
MRI Definition of RA | Sensitivity | Specificity | PPV | NPV | LR+ | LR− |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sugimoto 1996 (29) | 27 | 2.7 (NR) | 37 | NR | 0 | 53 | presence of MRI synovitis† | 100% | 72.7% | 84.2% | 94.1% | 3.56 | 0.04 |
| Sugimoto 2000 (30)‡ | 48 | 25 (4–72) | 73 | NR | 0 | 69 | presence of bilateral MRI synovitis (periarticular enhancement) | 96.2% | 86.4% | 89.3% | 95.0% | 7.05 | 0.05 |
| Klarlund 2000 (20) | 13 | 12 | 49 | NR | 6 | 62.5 | presence of MRI tenosynovitis | 60.0% | 62.5% | 50.0% | 71.4% | 40.00 | 0.80 |
| presence of MRI bone erosions | 20.0% | 100.0% | 100.0% | 66.7% | 0.60 | 0.64 | |||||||
| Boutry 2005 (28) | 47 | 29 (4–73) | NR | NR | 0 | 88 | presence of OMERACT MRI synovitis | 100.0% | 0.0% | 59.6% | 50.0% | 1.01 | 0.68 |
| presence of OMERACT MRI bone erosions§ | 60.7–100.0% | 15.8–52.6% | 63.6–65.4% | 47.6–85.7% | 1.17–1.28 | 0.75–0.11 | |||||||
| presence of OMERACT MRI bone edema | 39.3–71.4% | 84.2–94.7% | 78.6–95.2% | 48.5–69.2% | 2.49–13.57 | 0.30–0.72 | |||||||
| Solau-Gervais (21) | 30 | 30.6 (12-NR) | 30 | NR | 0 | 88 | OMERACT RAMRIS erosion score > 15 | 70.0% | 64.0% | - | - | - | - |
| presence of MRI carpus or MCP erosions | 66.7–80.0% | 27.3–53.8% | 55.6–66.7% | 27.3–70.0% | 1.73 | 0.37 | |||||||
| Tamai 2006 (22) | 113 | 12 (NR) | 39 | 24 | NR | 63 | presence of ≥ 2 of anti-CCP or RF antibodies, MRI bone edema or MRI erosions, and symmetric MRI synovitis | 82.5% | 84.8% | 93.0% | 66.7% | 5.43 | 0.21 |
| Narvaez 2008 (23) | 40 | 20 (12–42) | 0 | 23 | 0 | 87 | presence of OMERACT MRI synovitis with MRI bone edema or MRI erosions | 100.0% | 77.8% | 93.9% | 93.3% | 4.43 | 0.02 |
| Duer 2008 (24) | 41 | 24 (NR) | 34 | NR | 0 | 73 | presence of MRI synovitis | 100.0% | 60.0% | 48.0% | 100.0% | 2.50 | 0.00 |
| presence of MRI erosions | 64.0% | 77.0% | 50.0% | 85.0% | 2.78 | 0.47 | |||||||
| presence of MRI synovitis or erosions | 100.0% | 50.0% | 42.0% | 100.0% | 2.00 | 0.00 | |||||||
| presence of MRI synovitis and erosions | 64.0% | 87.0% | 64.0% | 87.0% | 4.92 | 0.41 | |||||||
| Mori 2008 (26) | 21 | 27.4 (13–40) | 59 | 24 | NR | 71 | presence of MRI symmetrical synovitis** | 100.0% | 75.0% | 62.5% | 100.0% | 2.00 | 0.18 |
| Eshed 2009 (25) | 99 | 8†† (6–41) | 35 | 26 | 0 | 69 | presence of MRI flexor tenosynovitis | 60.3% | 73.2% | 76.1% | 56.6% | 2.25 | 0.54 |
| presence of MRI extensor tenosynovitis | 24.1% | 87.8% | 73.7% | 45.0% | 1.98 | 0.86 | |||||||
| presence of MRI MCP synovitis | 82.8% | 39.0% | 65.7% | 61.6% | 1.36 | 0.44 | |||||||
| presence of anti-CCP antibodies and MRI tenosynovitis | 78.9% | 73.0% | - | - | - | - | |||||||
| Tamai 2009 (27)‡‡ | 129 | > 12 (NR) | 43 | 36 | NR | 63 | presence of MRI symmetrical synovitis | 74.7% | 59.3% | 71.8% | 62.7% | 1.84 | 0.43 |
| presence of MRI bone edema | 41.3% | 90.7% | 86.1% | 52.7% | 4.44 | 0.65 | |||||||
| presence of MRI erosions | 29.3% | 90.7% | 81.5% | 48.0% | 3.15 | 0.78 | |||||||
| presence of anti-CCP antibodies and MRI bone edema | 50.7% | 100.0% | 100.0% | 59.3% | 31.97 | 0.71 |
All studies used 1987 ACR criteria as RA diagnostic gold standard; All characteristics represent baseline prevalence; anti-CCP positive = baseline prevalence of anti-cyclic citrullinated peptide antibodies; RF positive = baseline rheumatoid factor antibodies; PPV = Positive predictive value; NPV = Negative predictive value; LR+ = Likelihood Ratio Positive; LR− = Likelihood ratio Negative; NR = Not reported; MCP = metacarophalangeal;
Defined as periarticular enhancement
Patient population overlaps with Sugimoto et al, 1996
Represents range of values for considering wrist and MCP joints separately
Addition of the presence of RF and/or anti-CCP antibodies did not alter test performance
Standard deviation
Population overlaps with Tamai et al, 2006