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89 [95% CI 0.81-0.96] for structural lesions and 0.83 [95% CI 0.72-0.94] for inflammatory lesions. Notably, subgroup analysis of 26 patients with mSASSS=0 showed that fatty metaplasia on MRI were highly predictive of radiographic progression at 3years (AUC [95% CI] 0.87 [0.61-1.00]). Moreover, 3-year cumulative ESR and CRP values increased in proportion to the extent of inflammatory lesions on initial MRI. Initial MRI assessment of the whole spine may predict radiographic progression and subsequent systemic inflammatory burden in axSpA