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Quantitative FLAIR MRI in Amyotrophic Lateral Sclerosis.
Jeremy Fabes1, Lucy Matthews2, Nicola Filippini3
1Centre for Functional Magnetic Resonance Imaging of the Brain, Oxford University, John Radcliffe Hospital, West Wing Level 6, Oxford OX3 9DU, UK.
Academic Radiology
|June 3, 2017
Summary
Quantitative fluid-attenuated inversion recovery (FLAIR) MRI intensity in the corticospinal tract (CST) shows promise for diagnosing amyotrophic lateral sclerosis (ALS). This method offers potential for disease monitoring and stratification across ALS phenotypes.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- T2-weighted MRI visual assessment of corticospinal tract (CST) hyperintensity has limited sensitivity for amyotrophic lateral sclerosis (ALS) diagnosis.
- A quantitative approach using FLAIR MRI may improve diagnostic accuracy and disease monitoring in ALS.
- Exploring FLAIR MRI intensity across diverse ALS phenotypes is crucial for understanding its clinical utility.
Purpose of the Study:
- To investigate the quantitative FLAIR MRI intensity in the CST and corpus callosum in patients with various ALS phenotypes.
- To compare FLAIR MRI intensity between ALS patient subgroups and healthy controls.
- To assess the longitudinal changes in FLAIR MRI intensity and its correlation with clinical outcomes.
Main Methods:
- 3 Tesla MRI scans were acquired for 33 classical ALS patients, 10 with flail arm presentation, 6 with primary lateral sclerosis, and 21 healthy controls.
- Quantitative FLAIR MRI intensity was measured in the CST and corpus callosum.
- Longitudinal analysis was performed on a subset of patients, and correlations with executive function and ALS Functional Rating Scale (ALSFRS) scores were examined.
Main Results:
- Mean FLAIR intensity was significantly higher in ALS patient groups compared to controls.
- Cerebral peduncle FLAIR intensity demonstrated the strongest ability to classify ALS subgroups.
- FLAIR intensity showed a longitudinal increase, and the rate of change in the CST correlated with the decline in executive function and ALSFRS scores.
Conclusions:
- Quantitative FLAIR MRI provides valuable, quantifiable information for ALS.
- FLAIR MRI has potential for diagnostic, patient stratification, and disease monitoring applications in ALS.
- This imaging technique may aid in understanding disease progression and treatment response in ALS.
