qRAMRIS

Rheumatoid arthritis (RA) is a painful disease of the joints which affects significant numbers
of adults. Powerful drugs are available to treat the disease, however these drugs do have
limitations; they are typically expensive and require hospital care to administer. Development
of new drugs for RA is hampered by the clinical tools available to assess the progress of the
disease. Clinical trials are typically conducted using radiographs (X-rays) of the hand,
evaluated by experts. Radiographs are excellent at visualising bone damage, but this kind of
damage is now uncommon in RA. Magnetic resonance (MR) imaging, which can visualise
soft tissues and swelling are becoming common.
Typically MR images are also ‘read’ by experts; this method provides an improvement over
the reading of radiographs, but remains unable to discriminate the very small changes which
occur within clinical trials. Agreement between experts is poor, due to the difficulty in
assessing complex 3D images, and the semi-quantitative methodology is relatively insensitive
to change.
Imorphics has proved successful at accurately measuring musculoskeletal structures using
proprietary 3-dimensional statistical modelling using MR images. Imorphics recently
identified that this technology could be applied to the field of RA measurement, using models
of the whole of the hand, including bone, ligaments, tendons, cartilage, joint capsule and skin.
The POC project objectives are to technically demonstrate that MR images of an RA hand can
be consistently and automatically processed to provide accurate quantitative measurements.
Removing inconsistencies in clinical assessment will provide increased accuracy in both
treatment and clinical trials. Commercially, the effective measurement of small improvements
in RA management and treatment could result in quicker drug testing, lower overheads and
therefore reduced time to market.