Quantitative imaging of inflammatory disease: are we missing a trick?

The role of conventional qualitative MRI is well established in the management of spondyloarthritis for assessment of inflammation and structural damage. The identification of a ‘positive’ MRI is now an important component of diagnostic pathways in spondyloarthritis.1 The role of q uantitative MRI (QMRI) is less established but offers the potential for direct measurement of disease characteristics. This approach is yielding huge benefits in fields such as oncology and neurology, where quantifiable measurements can be used to identify, stage and monitor disease. Given the influence that radiological assessment of disease burden has on treatment decisions, we argue that a quantitative imaging approach should be rigorously explored as a tool for assessment of inflammation in musculoskeletal imaging.Typically for QMRI, a model is fitted to a series of images to yield maps of a defined physical characteristic of the tissue. Assessment can then take the form of …