• Jacob L Jaremko, Omar Azmat, Lambert Robert G W RGW From the Department of Radiology and Diagnostic Imaging, University of Alberta; Division of Rheumatology, Faculty of Medicine and Dentistry, Univer, Paul Bird, Ida K Haugen, Lennart Jans, Ulrich Weber, Naomi Winn, Veronika Zubler, and Walter P Maksymowych.
• From the Department of Radiology and Diagnostic Imaging, University of Alberta; Division of Rheumatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Division of Medicine, University of New South Wales, New South Wales, Australia; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium; King Christian 10th Hospital for Rheumatic Diseases, Gråsten; Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK; Department of Radiology, Balgrist University Hospital, Zurich, Switzerland. jjaremko@ualberta.ca.
• J Rheumatol. 2017 Nov 1; 44 (11): 1713-1717.

ObjectiveTo assess reliability and feasibility of using a Web-based interface and interactive online calibration tool for magnetic resonance imaging (MRI) scoring of bone marrow lesions (BML) in osteoarthritis (OA), applied to the Hip MR Inflammation Scoring System (HIMRISS).MethodsSeven readers new to HIMRISS (3 radiologists, 4 rheumatologists) scored coronal short-tau inversion recovery MRI from a hip OA observational study obtained pre- and 8-week poststeroid injection (n = 40 × 2 scans × 2 hips = 160 hips). By crossover design, Group B (4 readers) scored 20 patients (40 hips) using conventional spreadsheet-based methods and then another 20 using a Web-based interface and an online real-time iterative calibration (RETIC) training module. Group A (3 readers) reversed the order, scoring the first 20 subjects by the new method and the final 20 conventionally. Outcomes included ICC and reader survey.ResultsInterobserver reliability for BML status was high by both spreadsheet and Web-based methods (0.84-0.90), regardless of the order in which scoring was performed. Reliability of change scores was moderate and improved with training. Improvement was greater in readers who began with the spreadsheet method and then used the Web-based method than in those who began with the Web-based method, especially at the acetabulum. Readers found Web-based/RETIC scoring more user-friendly and nearly 50% faster than traditional spreadsheet methods.ConclusionHIMRISS offers reliable BML scoring in OA, whether by conventional spreadsheet-based scoring or by a Web-based interface with interactive feedback. The new method allowed faster readings, provided a consistent training environment that helped inexperienced readers achieve reliability equivalent to that of conventional methods, and was preferred by the readers.

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