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Peer-reviewedCC BY 4.0Frontiers in Immunology

Short echo time first-echo images of T2* mapping for detecting structural sacroiliac joint lesions in axial spondyloarthritis: a CT-referenced study

  • İdil Kurut Aysin1
  • Murat Yoğurtçu2
  • Atilla Hikmet Çilengir3
  • Hasan Kocaayan4
  • Ayten Özkan4
  • Özge Yoğurtçu4
  • Yiğit Atli4
  • Mustafa Özmen4
  • Dilek Solmaz4
  • Özgür Tosun5
  • Servet Akar4
5 affiliations
  1. 1Department of Rheumatology, Balıkesir Ataturk City Hospital
  2. 2Department of Radiology, Tire State Hospital
  3. 3Department of Radiology, Faculty of Medicine, Izmir Democracy University
  4. 4Department of Rheumatology, Izmir Katip Celebi University Ataturk Training and Research Hospital
  5. 5Department of Radiology, Izmir Katip Celebi University Ataturk Training and Research Hospital
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Abstract

Objective: To assess the CT-referenced diagnostic performance of short-echo time (TE) first-echo images derived from a T2* mapping acquisition for detecting sacroiliac joint (SIJ) structural lesions in patients evaluated for axial spondyloarthritis (axSpA), compared with conventional T1-weighted turbo spin-echo (T1-TSE) MRI.

Methods: In this study, 54 patients underwent SIJ CT and 3T MRI; 52 were included in the final analysis. MRI included T1-TSE and a T2* mapping acquisition; the first-echo magnitude images (TE = 4.36 ms) were used for structural assessment. Two blinded readers scored CT and MRI using the Berlin and SPARCC structural scoring systems. Patient-level sensitivity (SE), specificity (SP), and diagnostic accuracy (DA) were calculated using CT as the reference. Correlation with CT was assessed using Pearson’s r, and inter-rater agreement was evaluated (κ for Berlin binary positivity; ICC for continuous sum scores).

Results: Forty-three of 52 patients fulfilled ASAS 2009/2011 spondyloarthritis classification criteria. Compared with T1-TSE, short TE-T2* images showed higher diagnostic performance for erosions (SE 88.6% vs 51.4%; SP 70.6% vs 82.4%; DA 82.6% vs 61.7%) and sclerosis (SE 86.2% vs 34.5%; SP 95.7% vs 100%; DA 90.3% vs 62.4%), while both sequences achieved high accuracy for joint space changes (DA 98.2%; T2*: SE/SP 98%/100%; T1: 100%/66.7%). Agreement with CT was stronger for short TE-T2* than for T1-TSE for Berlin erosion and sclerosis sum scores (r=0.913 and 0.921 vs 0.646 and 0.758), with substantial reader agreement for erosion and sclerosis positivity (κ=0.805 and 0.731 vs 0.564 and 0.598).

Conclusion: Short TE first echo images from a T2* mapping acquisition provide an accessible, radiation-free, erosion-sensitive approach that demonstrates higher CT-referenced detection of erosions and sclerosis compared with conventional T1-TSE imaging, with strong CT agreement and robust inter-rater reliability.

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Cite

BibTeXRIS
BibTeX
@article{aysin2026short,
  title = {{Short echo time first-echo images of T2* mapping for detecting structural sacroiliac joint lesions in axial spondyloarthritis: a CT-referenced study}},
  author = {İdil Kurut Aysin and Murat Yoğurtçu and Atilla Hikmet Çilengir and Hasan Kocaayan and Ayten Özkan and Özge Yoğurtçu and Yiğit Atli and Mustafa Özmen and Dilek Solmaz and Özgür Tosun and Servet Akar},
  journal = {Frontiers in Immunology},
  year = {2026},
  month = oct,
  doi = {10.3389/fimmu.2026.1946946},
  url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1946946/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Short echo time first-echo images of T2* mapping for detecting structural sacroiliac joint lesions in axial spondyloarthritis: a CT-referenced study
AU  - İdil Kurut Aysin
AU  - Murat Yoğurtçu
AU  - Atilla Hikmet Çilengir
AU  - Hasan Kocaayan
AU  - Ayten Özkan
AU  - Özge Yoğurtçu
AU  - Yiğit Atli
AU  - Mustafa Özmen
AU  - Dilek Solmaz
AU  - Özgür Tosun
AU  - Servet Akar
PY  - 2026
DA  - 2026/10/22
JO  - Frontiers in Immunology
DO  - 10.3389/fimmu.2026.1946946
UR  - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1946946/full
AB  - Objective: To assess the CT-referenced diagnostic performance of short-echo time (TE) first-echo images derived from a T2* mapping acquisition for detecting sacroiliac joint (SIJ) structural lesions in patients evaluated for axial spondyloarthritis (axSpA), compared with conventional T1-weighted turbo spin-echo (T1-TSE) MRI.  Methods: In this study, 54 patients underwent SIJ CT and 3T MRI; 52 were included in the final analysis. MRI included T1-TSE and a T2* mapping acquisition; the first-echo magnitude images (TE = 4.36 ms) were used for structural assessment. Two blinded readers scored CT and MRI using the Berlin and SPARCC structural scoring systems. Patient-level sensitivity (SE), specificity (SP), and diagnostic accuracy (DA) were calculated using CT as the reference. Correlation with CT was assessed using Pearson’s r, and inter-rater agreement was evaluated (κ for Berlin binary positivity; ICC for continuous sum scores).  Results: Forty-three of 52 patients fulfilled ASAS 2009/2011 spondyloarthritis classification criteria. Compared with T1-TSE, short TE-T2* images showed higher diagnostic performance for erosions (SE 88.6% vs 51.4%; SP 70.6% vs 82.4%; DA 82.6% vs 61.7%) and sclerosis (SE 86.2% vs 34.5%; SP 95.7% vs 100%; DA 90.3% vs 62.4%), while both sequences achieved high accuracy for joint space changes (DA 98.2%; T2*: SE/SP 98%/100%; T1: 100%/66.7%). Agreement with CT was stronger for short TE-T2* than for T1-TSE for Berlin erosion and sclerosis sum scores (r=0.913 and 0.921 vs 0.646 and 0.758), with substantial reader agreement for erosion and sclerosis positivity (κ=0.805 and 0.731 vs 0.564 and 0.598).  Conclusion: Short TE first echo images from a T2* mapping acquisition provide an accessible, radiation-free, erosion-sensitive approach that demonstrates higher CT-referenced detection of erosions and sclerosis compared with conventional T1-TSE imaging, with strong CT agreement and robust inter-rater reliability.
SN  - 1664-3224
ER  -