{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:49:30Z","timestamp":1791560970740,"version":"4.3.4"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Insights Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Standard MR imaging (MRI) for rheumatoid arthritis (RA) patients comprises a post-contrast T1-fat-saturated (T1FS\u2009+\u2009C) sequence to detect wrist synovitis and tenosynovitis. This study investigates whether non-contrast sequences can provide similar information to post-contrast imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Seventy-seven RA patients (F\/M: \u00a064\/13; age: 61\u2009\u00b1\u200912 years) underwent MRI examination of the most symptomatic wrist on a 3.0-T system. Axial T1FS\u2009+\u2009C as well as proton-density imaging with fat-saturation (PDFS) and T2-weighted imaging with fat-saturation (T2FS) sequences were performed. Two radiologists independently scored synovitis and tenosynovitis severity on all sequences, using the rheumatoid arthritis magnetic resonance imaging scoring system (RAMRIS). Intra- and interclass correlation coefficients (ICCs) were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For synovitis severity scoring, PDFS was practically identical to T1FS\u2009+\u2009C, while T2FS overestimated synovitis severity by up to 19%. For synovitis severity, PDFS imaging correlated better with T1FS\u2009+\u2009C than T2FS imaging (ICC: Reader 1: 0.931 vs 0.897; Reader 2: 0.969 vs 0.948). For tenosynovitis severity, PDFS and T2FS both yielded higher tenosynovitis scores than T1FS\u2009+\u2009C (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Compared to T1FS\u2009+\u2009C imaging, PDFS overestimated tenosynovitis severity by up to 39%, while T2FS overestimated tenosynovitis severity by up to 54%. For tenosynovitis severity, PDFS imaging correlated better with T1FS\u2009+\u2009C than T2FS imaging (ICC: Reader 1: 0.856 vs 0.731; Reader 2: 0.808 vs 0.800).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PDFS imaging had good (for tenosynovitis) to excellent (for synovitis) intra- and inter-reader reliability and provides comparable scoring to T1FS\u2009+\u2009C imaging when evaluating synovitis severity, though it tends to overestimate tenosynovitis severity. PDFS imaging can reasonably replace contrast-enhanced imaging for assessing wrist synovitis in RA patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      Post-contrast imaging is recommended for evaluating synovitis and tenosynovitis in rheumatoid arthritis (RA) patients, though it involves higher cost, scan time, and discomfort.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      Proton-density imaging with fat-saturation (PDFS) imaging had good to excellent intra- and inter-reader reliability for evaluating synovitis and tenosynovitis in RA wrists. Compared to post-contrast T1-fat-saturated (T1FS\u2009+\u2009C) imaging, PDFS imaging provides comparable semi-quantitative synovitis severity grading but tends to overestimate tenosynovitis severity.\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Critical relevance statement<\/jats:italic>\n                      <\/jats:bold>\n                      Post-contrast imaging for synovitis and tenosynovitis in RA patients involves discomfort, a longer time, and cost. PDFS imaging has good reliability and compares well with post-contrast imaging. In RA wrists, compared to T1FS+C imaging, PDFS imaging provides comparative semi-quantitative synovitis severity grading but tends to overestimate tenosynovitis severity.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13244-026-02406-1","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:58:39Z","timestamp":1791557919000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Proton-density fat-saturated non-contrast MR imaging is comparable to post-contrast MR imaging for revealing wrist synovitis"],"prefix":"10.1186","volume":"17","author":[{"given":"Su","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5206-9382","authenticated-orcid":false,"given":"James Francis","family":"Griffith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Dourado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai Shan","family":"Tam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"2406_CR1","doi-asserted-by":"publisher","first-page":"vii36","DOI":"10.1093\/rheumatology\/kes329","volume":"51","author":"YK Tan","year":"2012","unstructured":"Tan YK, Ostergaard M, Conaghan PG (2012) Imaging tools in rheumatoid arthritis: ultrasound vs magnetic resonance imaging. 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This study was approved by the Clinical Research Ethics Committee of the Joint Chinese University of Hong Kong (CUHK) and the New Territories East Cluster (NTEC) (Ref. No: 2021.398). Participants gave informed consent to participate in the study before taking part.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"244"}}