@article{StumperBergerKlotscheetal.2025, author = {Stumper, Nele and Berger, J{\"o}rn and Klotsche, Jens and Gedat, Egbert and Hoff, Paula and Schmittat, Gabriela and Burmester, Gerd-R{\"u}diger and Kr{\"o}nke, Gerhard and Backhaus, Marina and Haugen, Ida Kristin and Ohrndorf, Sarah}, title = {To optimise the diagnostic process of rheumatic diseases affecting the hands using fluorescence optical imaging (FOI)}, series = {RMD Open}, volume = {11}, journal = {RMD Open}, number = {3}, publisher = {EULAR}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:526-opus4-20698}, year = {2025}, abstract = {Background Accurate and rapid diagnosis of rheumatic diseases is essential for further treatment decision. Different rheumatic diseases present characteristic patterns (image features) in fluorescence optical imaging (FOI). We developed an atlas of FOI image features and tested its ability to differentiate various rheumatic diseases. Methods FOI images from patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), connective tissue diseases (CTD) and osteoarthritis (OA) were analysed by two readers blinded for diagnosis and calibrated against each other, using the prima vista mode (PVM) and an automated 5-phase model. Twenty-six different reoccurring typical signal enhancement patterns (features) indicating inflamed joints, nail or skin were defined and all FOI images were scored accordingly. The feature frequency in each patient cohort and phase (PVM, 5-phase) was counted. Contingency tables were created with categorical variable counts and diagnosis using common formulae. Findings Four hundred thirty-eight patients with RA (n=117), PsA (n=110), CTD (n=121) and OA (n=90) were included. Once the data had been categorised, a two-step diagnostic pathway was developed: in the first step, OA was best distinguished from the other diseases with high specificity by five patterns (specificity >0.9, diagnostic OR between 2.34 and 8.24). In a second step, the remaining autoimmune diseases were differentiated from each other by a certain number of features (five for RA, 12 for PsA and four for CTD). Interpretation This was the first study to show that feature analysis in FOI helps to differentiate typical rheumatic diseases from each other, potentially simplifying and speeding up the diagnostic process. Therefore, FOI could be considered an additional component of a wider range of imaging techniques used in rheumatology.}, language = {en} } @article{GedatBergerKieseletal.2022, author = {Gedat, Egbert and Berger, J{\"o}rn and Kiesel, Denise and Failli, Vieri and Briel, Andreas and Welker, Pia}, title = {Features Found in Indocyanine Green-Based Fluorescence Optical Imaging of Inflammatory Diseases of the Hands}, series = {Diagnostics}, volume = {12}, journal = {Diagnostics}, number = {8}, publisher = {MDPI}, issn = {2075-4418}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:526-opus4-16359}, year = {2022}, abstract = {Rheumatologists in Europe and the USA increasingly rely on fluorescence optical imaging (FOI, Xiralite) for the diagnosis of inflammatory diseases. Those include rheumatoid arthritis, psoriatic arthritis, and osteoarthritis, among others. Indocyanine green (ICG)-based FOI allows visualization of impaired microcirculation caused by inflammation in both hands in one examination. Thousands of patients are now documented and most literature focuses on inflammatory arthritides, which affect synovial joints and their related structures, making it a powerful tool in the diagnostic process of early undifferentiated arthritis and rheumatoid arthritis. However, it has become gradually clear that this technique has the potential to go even further than that. FOI allows visualization of other types of tissues. This means that FOI can also support the diagnostic process of vasculopathies, myositis, collagenoses, and other connective tissue diseases. This work summarizes the most prominent imaging features found in FOI examinations of inflammatory diseases, outlines the underlying anatomical structures, and introduces a nomenclature for the features and, thus, supports the idea that this tool is a useful part of the imaging repertoire in rheumatology clinical practice, particularly where other imaging methods are not easily available.}, language = {en} } @article{RotheBergerWelkeretal.2023, author = {Rothe, Felix and Berger, J{\"o}rn and Welker, Pia and Fiebelkorn, Richard and Kupper, Stefan and Kiesel, Denise and Gedat, Egbert and Ohrndorf, Sarah}, title = {Fluorescence optical imaging feature selection with machine learning for differential diagnosis of selected rheumatic diseases}, series = {Frontiers in Medicine}, volume = {10}, journal = {Frontiers in Medicine}, publisher = {Frontiers}, issn = {2296-858X}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:526-opus4-17922}, year = {2023}, abstract = {Background and objective: Accurate and fast diagnosis of rheumatic diseases affecting the hands is essential for further treatment decisions. Fluorescence optical imaging (FOI) visualizes inflammation-induced impaired microcirculation by increasing signal intensity, resulting in different image features. This analysis aimed to find specific image features in FOI that might be important for accurately diagnosing different rheumatic diseases. Patients and methods: FOI images of the hands of patients with different types of rheumatic diseases, such as rheumatoid arthritis (RA), osteoarthritis (OA), and connective tissue diseases (CTD), were assessed in a reading of 20 different image features in three phases of the contrast agent dynamics, yielding 60 different features for each patient. The readings were analyzed for mutual differential diagnosis of the three diseases (One-vs-One) and each disease in all data (One-vs-Rest). In the first step, statistical tools and machine-learning-based methods were applied to reveal the importance rankings of the features, that is, to find features that contribute most to the model-based classification. In the second step machine learning with a stepwise increasing number of features was applied, sequentially adding at each step the most crucial remaining feature to extract a minimized subset that yields the highest diagnostic accuracy. Results: In total, n = 605 FOI of both hands were analyzed (n = 235 with RA, n = 229 with OA, and n = 141 with CTD). All classification problems showed maximum accuracy with a reduced set of image features. For RA-vs.-OA, five features were needed for high accuracy. For RA-vs.-CTD ten, OA-vs.-CTD sixteen, RA-vs.-Rest five, OA-vs.-Rest eleven, and CTD-vs-Rest fifteen, features were needed, respectively. For all problems, the final importance ranking of the features with respect to the contrast agent dynamics was determined. Conclusions: With the presented investigations, the set of features in FOI examinations relevant to the differential diagnosis of the selected rheumatic diseases could be remarkably reduced, providing helpful information for the physician.}, language = {en} }