ACR Convergence 2026: Do Not Miss – Imaging

Tuğba İzci Duran

Tuğba is a rheumatologist and Associate Professor from Türkiye. Her clinical and research interests include psoriatic arthritis, axial spondyloarthritis, musculoskeletal imaging, real-world evidence, patient-reported outcomes and cardiovascular comorbidities in inflammatory rheumatic diseases. She completed a Clinical Research Fellowship at Charité – Universitätsmedizin Berlin, gaining experience in international collaborative research. She is a member of the Young-GRAPPA Newsletter Subcommittee and serves as the EMEUNET Country Liaison for Türkiye and a member of its Country Liaison Sub-Committee, supporting international collaboration, education and engagement among early-career rheumatologists.

Poster 0757| Sunday, 08.11.2026 10:30
Poster Session: Imaging of Rheumatic Diseases Poster A
Presenting author: P. Mandl (Austria)
Title: EULAR Recommendations for the Use of Imaging in the Diagnosis and Management of Spondyloarthritis in Clinical Practice – 2025 Update

A 26-member EULAR task force reviewed 181 studies from 11,656 references to update imaging recommendations for SpA. The update introduces three overarching principles, revises nine recommendations and adds one. MRI replaces radiography as the first imaging modality for diagnosing axSpA. Peripheral joint radiographs may help predict structural progression in peripheral SpA. These recommendations offer a clinically relevant framework for choosing imaging in diagnosis, monitoring and prognosis.
Poster 0760| Sunday, 08.11.2026 10:30
Poster Session: Imaging of Rheumatic Diseases Poster A
Presenting author: H. Borrell (Spain)
Title: Lung ultrasound within a screening strategy for ruling out interstitial lung disease in rheumatoid arthritis

This single-centre study screened 441 patients with RA using a structured ILD algorithm. In the lung ultrasound subgroup (n=115), a threshold of ≥5 B-lines yielded 68% sensitivity, 82% specificity and 93% negative predictive value against HRCT. B-lines discriminated ILD better than pleural irregularities (AUC 0.754 versus 0.688). LUS may support triage within a screening pathway, but the limited sensitivity warrants caution when excluding ILD in patients with ongoing clinical suspicion.
Poster 1694| Monday, 09.11.2026 10:30
Poster Session: Imaging of Rheumatic Diseases Poster B
Presenting author: G. Ayan (Türkiye)
Title: Low-dose CT, MRI or Radiographs: Which Imaging Modality Best Captures Spinal Structural Progression in Axial Spondyloarthritis?

In 67 patients with axSpA from the SPACE cohort, blinded readers compared spinal structural progression on low-dose CT, MRI and radiographs. Low-dose CT showed the greatest sensitivity to change, with relative standardised rates of change of 2.33 for CTSS and 2.72 for syndesmophyte counts versus mSASSS. Absolute progression remained low across modalities. The findings support low-dose CT as a responsive research outcome, while radiation exposure and clinical utility require consideration before routine use.
Oral 1868| Monday, 09.11.2026 13:00
Abstract Session: Imaging of Rheumatic Diseases
Presenting author: A. Podolanczuk (USA)
Title: Use of Quantitative CT in the Real-World Evaluation of Progressive Pulmonary Fibrosis: The Retrospective Evaluation in the US of e-Lung in PPF (REVISE PPF) Multicenter Observational Study

This retrospective study evaluated quantitative CT in 509 patients across three specialist ILD centres. In patients with serial CT, the algorithm detected progression before clinical PPF diagnosis in 52–83%, with mean lead times of 8–28 months across centres. An increase ≥3% in the weighted reticulovascular score was associated with mortality (HR 6.92 and 5.86 in the analysed cohorts). Quantitative CT may aid earlier recognition and risk stratification, pending prospective evaluation of its clinical benefit.
Oral 1870| Monday, 09.11.2026 13:30
Abstract Session: Imaging of Rheumatic Diseases
Presenting author: F. Fagni (Germany)
Title: Development of a Deep Learning-Based Tool for Automated Assessment of Synovitis, Power-Doppler Activity, Erosions, and Osteophytes and Classification of Arthritis Using Ultrasound Imaging.

Researchers developed ultrasound models using 4,757 joint scans from 460 patients with inflammatory arthritis and patient-level cross-validation. Weighted AUCs were 0.79 for synovitis, 0.90 for power Doppler, 0.81 for erosions and 0.84 for osteophytes. Diagnostic classification achieved AUC 0.80 but balanced accuracy of 0.49. The study supports automated lesion assessment across heterogeneous acquisition settings. External validation is needed, and diagnostic classification remains less reliable than lesion assessment.
Oral 1872| Monday, 09.11.2026 14:00
Abstract Session: Imaging of Rheumatic Diseases
Presenting author: V. Devauchelle-Pensec (France)
Title: Head-to-head comparison of [⁶⁸Ga]Ga-FAPI-46 PET/CT and [¹⁸F]FDG PET/CT in patients with recent-onset or relapsing polymyalgia rheumatica and/or giant cell arteritis

This prospective pilot compared FAPI-46 and FDG PET/CT in 30 patients with recent-onset or relapsing PMR and/or GCA. Disease-related uptake appeared in 30/30 on FAPI versus 27/30 on FDG. FAPI identified more musculoskeletal sites in PMR (20.8 versus 13.8) and arterial segments in GCA (6.7 versus 4.7). Cranial involvement was detected in 66.7% versus 33.3% of nine GCA patients. Larger studies must establish specificity and the clinical significance of additional uptake.
Poster 2684| Tuesday, 10.11.2026 10:30
Poster Session: Imaging of Rheumatic Diseases Poster C
Presenting author: J. Narváez (Spain)
Title: 18F-FDG-PET/MR imaging in treated large-vessel vasculitis: distinguishing persistent vascular uptake from active mural inflammation

This prospective PET/MR study included 23 patients with treated large-vessel vasculitis: five with Takayasu arteritis and 18 with GCA. PET and MR agreed in 100% and 83.3%, respectively. Two GCA patients had positive PET but negative MR findings, suggesting that persistent metabolic uptake may not always reflect active mural inflammation. Hybrid imaging could help interpret discordant findings. The small cohort and absence of an independent activity reference limit conclusions about treatment decisions.

Leave a Reply