Magnetic resonance imaging for adult idiopathic inflammatory myopathies: A scoping review of protocols, grading systems and applications

Jessica A Day¹, Daniel Brito de Araújo², Mickael Essouma³, Edoardo Conticini⁴, Lisa G Rider⁵, Daren Gibson⁶, Adriana Maluf Elias⁷, Claudia Saad Magalhães⁸, Simone Appenzeller⁹, Adam Schiffenbauer⁵, Anneke J van der Koi¹⁰, Siamak Moghadam-Kia¹¹, Vitor Tavares Paula¹², Julio Brandão Guimarães¹³, Edoardo Marrani¹⁴, Andrea Schwarz Doria¹⁵, Samuel Katsuyuki Shinjo¹⁶; IMACS WBMRI in Myopathies Working Group

Affiliations

¹ The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Royal Melbourne Hospital, Melbourne, Victoria, Australia; The University of Melbourne, Melbourne, Victoria, Australia. Electronic address: day.j@wehi.edu.au.
² Internal Medicine Department, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, RS, Brazil.
³ Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Yaounde, Cameroon.
⁴ Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
⁵ Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD, United States.
⁶ Medical Imaging, Fiona Stanley Hospital, Murdoch, Australia.
⁷ Pediatric Rheumatology Unit, Children's Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
⁸ Pediatric Rheumatology Unit, Department of Pathology, Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, Brazil.
⁹ Department of Orthopedics, Rheumatology and Traumatology, University of Campinas, Campinas, SP, Brazil.
¹⁰ Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.
¹¹ Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
¹² Musculokeletal radiologist. Radiology Department, Children's Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, SP, Brazil.
¹³ Universidade Federal de São Paulo, EPM-UNIFESP, São Paulo, Brazil; Grupo Fleury Medicina e Saúde, São Paulo, Brazil.
¹⁴ Rheumatology Unit, ERN-ReCONNET Center, Meyer Children's Hospital IRCCS, Florence, Italy.
¹⁵ Department of Diagnostic & Interventional Radiology, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
¹⁶ Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.

PMID: 41330175
DOI: 10.1016/j.semarthrit.2025.152865

Free article

Magnetic resonance imaging for adult idiopathic inflammatory myopathies: A scoping review of protocols, grading systems and applications

Jessica A Day et al. Semin Arthritis Rheum. 2025 Dec.

Free article

. 2025 Dec:75:152865.

doi: 10.1016/j.semarthrit.2025.152865. Epub 2025 Nov 7.

Authors

Affiliations

¹ The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Royal Melbourne Hospital, Melbourne, Victoria, Australia; The University of Melbourne, Melbourne, Victoria, Australia. Electronic address: day.j@wehi.edu.au.
² Internal Medicine Department, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, RS, Brazil.
³ Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Yaounde, Cameroon.
⁴ Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
⁵ Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD, United States.
⁶ Medical Imaging, Fiona Stanley Hospital, Murdoch, Australia.
⁷ Pediatric Rheumatology Unit, Children's Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
⁸ Pediatric Rheumatology Unit, Department of Pathology, Botucatu Medical School, São Paulo State University, Botucatu, São Paulo, Brazil.
⁹ Department of Orthopedics, Rheumatology and Traumatology, University of Campinas, Campinas, SP, Brazil.
¹⁰ Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.
¹¹ Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
¹² Musculokeletal radiologist. Radiology Department, Children's Institute, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, SP, Brazil.
¹³ Universidade Federal de São Paulo, EPM-UNIFESP, São Paulo, Brazil; Grupo Fleury Medicina e Saúde, São Paulo, Brazil.
¹⁴ Rheumatology Unit, ERN-ReCONNET Center, Meyer Children's Hospital IRCCS, Florence, Italy.
¹⁵ Department of Diagnostic & Interventional Radiology, Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
¹⁶ Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.

PMID: 41330175
DOI: 10.1016/j.semarthrit.2025.152865

Erratum in

Erratum to "Magnetic resonance imaging for adult idiopathic inflammatory myopathies: a scoping review of protocols, grading systems and applications"[Seminars in Arthritis and Rheumatism Volume 75, (2025) 152865].
Day JA, de Araújo DB, Essouma M, Conticini E, Rider LG, Gibson D, Elias AM, Magalhães CS, Appenzeller S, Schiffenbauer A, van der Koi AJ, Moghadam-Kia S, Paula VT, Guimarães JB, Marrani E, Doria AS, Shinjo SK; IMACS WBMRI in Myopathies Working Group. Day JA, et al. Semin Arthritis Rheum. 2026 Feb;76:152899. doi: 10.1016/j.semarthrit.2025.152899. Epub 2025 Dec 31. Semin Arthritis Rheum. 2026. PMID: 41477958 No abstract available.

Abstract

Magnetic resonance imaging (MRI) has emerged as a key non-invasive tool for the evaluation of idiopathic inflammatory myopathies (IIM); however, heterogeneity in techniques, protocols, and grading systemics impedes standardization. This scoping review systematically examined the MRI techniques, protocols, and grading systems reported in the adult IIM literature. A systematic search of PubMed, EMBASE, and Cochrane databases was conducted from 2000 to 2024 using keywords related to IIM and MRI. Studies involving adults with IIM who underwent MRI were screened and reviewed for inclusion. Forty-nine studies were included in the analysis, 13 of which evaluated whole-body MRI and 36 evaluated dedicated body-part MRI, collectively reporting data from 2810 IIM patients. A wide range of imaging protocols was observed with variations in scanner type, field strength, sequence combinations, and anatomical coverage. Semi-quantitative visual grading was the most commonly used assessment method (31/49, 63.2 %), with binary scoring in 23/31 and software-assisted or automated techniques in 8/31. Six studies used descriptive analysis alone. Inter-rater agreement was reported in 15 studies, with variable reliability observed for both muscle edema (intraclass correlation coefficient [ICC] range: 0.78-1.00; kappa range: 0.30-1.00) and replacement of skeletal muscle by fat (ICC range: 0.77-0.97; kappa range: 0.54-0.93). Several studies have reported that WB-MRI patterns correlate with clinical measures of disease activity and can discriminate between myopathic diseases and IIM subtypes. In summary, despite the clinical utility of MRI for IIM, significant methodological variability remains. Future research should focus on standardizing protocols and grading systems to enhance the consistency and reliability of MRI assessments for IIM.

Keywords: Idiopathic inflammatory myopathies; MRI; Magnetic resonance imaging; Myositis.

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Conflict of interest statement

Declaration of competing interest Andrea Schwarz Doria reports a relationship with Baxalta-Shire that includes: funding grants. Andrea Schwarz Doria reports a relationship with Novo Nordisk that includes: funding grants. Andrea Schwarz Doria reports a relationship with Terry Fox Foundation that includes: funding grants. Andrea Schwarz Doria reports a relationship with PSI Foundation that includes:. Andrea Schwarz Doria reports a relationship with Society of Pediatric Radiology that includes: funding grants. Andrea Schwarz Doria reports a relationship with Garron Family Cancer Centre that includes:. Lisa G. Rider reports a relationship with National Institute of Environmental Health Sciences, National Institutes of Health (project ES101081) that includes: funding grants. Adam Schiffenbauer reports a relationship with National Institute of Environmental Health Sciences, National Institutes of Health (project ES101081) that includes: funding grants. Samuel Katsuyuki Shinjo reports a relationship with Faculdade de Medicina da USP that includes: funding grants. Jessica Day reports a relationship with The Royal Melbourne Hospital that includes: funding grants. Jessica Day reports a relationship with CSL Limited that includes: funding grants. Jessica Day reports a relationship with Nkarta Inc that includes: consulting or advisory. The authors received no financial support for the research, authorship, and/or publication of this study. This project was conducted as a working group of IMACS and reviewed by the IMACS Scientific Committee. IMACS is funded by the intramural research program of the National Institute of Environmental Health Sciences, National Institutes of Health (project ES101081). If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Magnetic resonance imaging for adult idiopathic inflammatory myopathies: A scoping review of protocols, grading systems and applications

Affiliations

Magnetic resonance imaging for adult idiopathic inflammatory myopathies: A scoping review of protocols, grading systems and applications

Authors

Affiliations

Erratum in

Abstract

Conflict of interest statement

Publication types

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LinkOut - more resources

Full Text Sources

Medical