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Long-term changes of magnetization transfer-derived measures from patients with relapsing-remitting and secondary
M A Rocca1, G Mastronardo, M Rodegher
1Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan, Italy.
Background And Purpose:
For cases of multiple sclerosis (MS), magnetization transfer (MT) imaging may provide more pathologically specific and accurate estimates of the disease process than does conventional imaging. In this study, we evaluated changes of the MT ratio (MTR) of newly enhancing lesions, the MTR of normal-appearing white matter (NAWM), the average lesion MTR, and the MT histogram-derived metrics during a 3-year follow-up period for patients with relapsing-remitting or secondary progressive MS.
Methods:
Dual-echo, conventional spin-echo, and MT images were obtained from seven patients with relapsing-remitting MS, seven patients with secondary progressive MS, and five age- and sex-matched control subjects at the time of study entry and 1, 13, and 37 months later.
Results:
Newly enhancing lesions in the patients with secondary progressive MS presented a more severe and significant MTR reduction during the follow-up period as compared with those in the relapsing-remitting group. In cases of secondary progressive MS, we also observed a significant reduction of the MTR values of the NAWM and a trend toward reduction of average lesion MTR values. The patients with MS had mean percentage changes of MT histogram-derived measures that were approximately two to 10 times higher than those of the control subjects.
Conclusion:
This preliminary 3-year follow-up study shows that newly enhancing lesions and NAWM in patients with secondary progressive MS have significantly lower MTR values than do those in patients with relapsing-remitting MS. It also shows that the tissue damage that remains after enhancement ceases is more severe in secondary progressive disease.
Insights
Magnetization transfer imaging (MTI) reveals significant differences in multiple sclerosis (MS) progression. Secondary progressive MS shows greater MTR reduction in lesions and normal-appearing white matter (NAWM) compared to relapsing-remitting MS.
Area of Science:
- Neuroimaging
- Radiology
- Medical Physics
Background:
- Multiple sclerosis (MS) diagnosis and monitoring can benefit from advanced imaging techniques.
- Magnetization transfer (MT) imaging offers potentially more specific pathological insights than conventional MRI.
- Assessing disease progression in MS requires sensitive biomarkers.
Purpose of the Study:
- To evaluate Magnetization Transfer Ratio (MTR) changes in newly enhancing lesions and normal-appearing white matter (NAWM) over 3 years in MS patients.
- To compare MTR metrics between relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) during disease progression.
- To analyze MT histogram-derived metrics for detecting subtle tissue changes in MS.
Main Methods:
- Longitudinal study involving 3-year follow-up of 14 MS patients (7 RRMS, 7 SPMS) and 5 controls.
- Acquisition of dual-echo, conventional spin-echo, and MT images at multiple time points.
- Quantitative analysis of MTR in lesions, NAWM, and MT histogram parameters.
Main Results:
- SPMS patients exhibited significantly greater MTR reduction in newly enhancing lesions compared to RRMS patients.
- SPMS showed significant MTR reduction in NAWM and a trend for reduced average lesion MTR.
- MT histogram metrics demonstrated 2-10 times greater changes in MS patients versus controls.
Conclusions:
- Newly enhancing lesions and NAWM have lower MTR in SPMS, indicating more severe tissue damage.
- MT imaging effectively differentiates disease severity and progression between RRMS and SPMS.
- Persistent tissue damage after lesion enhancement cessation is more pronounced in SPMS.