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Conventional and synthetic MRI in multiple sclerosis: a comparative study.

Wolfgang Krauss1,2, Martin Gunnarsson3,4, Margareta Nilsson5

  • 1Department of Radiology, Faculty of Medicine and Health, Örebro University, SE-701 85, Örebro, Sweden. Wolfgang.krauss@regionorebrolan.se.

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Summary

Synthetic MRI shows promise for assessing multiple sclerosis (MS) lesion dissemination, potentially shortening exam times. While conventional MRI offers slightly higher inter- and intra-observer agreement, synthetic MRI demonstrates comparable lesion detection capabilities.

Keywords:
Inter- and intra-observer agreementMagnetic resonance imagingMultiple sclerosisQuantitative MRISynthetic MRI

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Area of Science:

  • Radiology
  • Neuroimaging
  • Medical Physics

Background:

  • Multiple sclerosis (MS) diagnosis and monitoring rely heavily on Magnetic Resonance Imaging (MRI).
  • Conventional MRI sequences can be time-consuming.
  • Synthetic MRI offers a potential alternative for faster image acquisition and reconstruction.

Purpose of the Study:

  • To compare the diagnostic performance of synthetic MRI versus conventional MRI in assessing lesion load in patients with MS.
  • To evaluate inter- and intra-observer agreement for both imaging techniques.
  • To determine if synthetic MRI can be a viable tool for MS assessment.

Main Methods:

  • Prospective acquisition of synthetic and conventional MRI images in 52 MS patients.
  • Quantitative MRI (qMRI) used to measure proton density and relaxation times (T1, T2).
  • Calculation of synthetic T1W, T2W, and FLAIR images based on qMRI parameters.
  • Blind, independent, and randomized review of images by two radiologists to document and categorize lesions.
  • Evaluation of agreement using kappa statistic.

Main Results:

  • No significant difference in lesion detection between synthetic and conventional MRI across anatomical regions or image types.
  • Inter- and intra-observer agreement was generally higher for conventional MRI, though not significantly different in specific regions or image types.
  • Combined reports on lesion load and contrast-enhancing lesions showed no significant difference between the two methods.

Conclusions:

  • Synthetic MRI holds potential for assessing MS dissemination in space (DIS).
  • Synthetic MRI may contribute to reduced examination times in MS patient assessment.
  • While conventional MRI shows slightly better inter- and intra-observer agreement, synthetic MRI offers a comparable alternative for lesion assessment.