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Updated: Jan 4, 2026
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Is It Possible to Discriminate Active MS Lesions with Diffusion Weighted Imaging?
Sena Unal1, Elif Peker1, Seyda Erdogan2
1Department of Radiology, Ankara University School of Medicine, Ankara, Turkey.
Objective:
Patients with multiple sclerosis (MS) are at a risk of gadolinium deposition because of multiple control imaging. Therefore, it is important to determine biomarkers that can differentiate active and chronic lesions without using contrast agent. This study aimed to assess mean apparent diffusion coefficient (ADC) values and signal intensities (SI) on diffusion weighted imaging (DWI) values of active and nonactive lesions.
Materials And Methods:
We included 25 patients in this study. We measured mean ADC values and SI on DWI of the randomly selected active and nonactive lesions and normal appearing white matter (NAWM) for all patients with MS. SI on DWI and ADC values were normalized to the SI of the CSF. We compared all of the measurements between active and nonactive lesions, active lesions and NAWM, and nonactive lesions and NAWM. SI on DWI and mean ADC values of normal healthy white matter (NHWM) of control group were measured. A comparison was made between NHWM and NAWM.
Results:
For patients with active lesions, the mean nADC value was 0.35±0.06 for active lesions and 0.30±0.07 for nonactive lesions (p>0.050). The mean nDWI-SI value was 3.69±0.68 for active lesions was 3.39±0.68 for nonactive lesions (p<0.050). When patients with and without active lesions were compared, both nDWI values and nADC values for active and nonactive lesions were statistically insignificant (p>0.050).
Discussion:
In MS lesions, diffusion alternations can be quantitatively evaluated with ADC mapping. Lesions seen in patients with MS have higher mean ADC values than NAWM and NHWM.
Insights
Gadolinium deposition is a concern in multiple sclerosis (MS) imaging. This study explored diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values to differentiate active and non-active MS lesions without contrast agents.
Area of Science:
- Neuroimaging
- Radiology
- Biomarkers
Background:
- Gadolinium deposition from repeated MRI contrast enhances risks in multiple sclerosis (MS) patients.
- Identifying active versus chronic MS lesions without contrast is crucial for patient management.
- Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping offer potential non-contrast biomarkers.
Purpose of the Study:
- To evaluate the efficacy of mean apparent diffusion coefficient (ADC) values and signal intensities (SI) on DWI in distinguishing active from non-active MS lesions.
- To assess if DWI and ADC values can serve as biomarkers for MS lesion activity without contrast administration.
Main Methods:
- 25 MS patients were included in the study.
- Mean ADC and normalized DWI SI values were measured for active lesions, non-active lesions, and normal-appearing white matter (NAWM).
- Measurements were compared between lesion types and with normal white matter (NWM) from both MS patients and a control group.
Main Results:
- A statistically significant difference was observed in normalized DWI SI between active and non-active lesions (p<0.050).
- No statistically significant difference was found in normalized ADC values between active and non-active lesions (p>0.050).
- MS lesions exhibited higher mean ADC values compared to NAWM and normal healthy white matter (NHWM).
Conclusions:
- Diffusion alterations in MS lesions can be quantitatively assessed using ADC mapping.
- ADC mapping shows potential for characterizing MS lesions, with higher ADC values in lesions compared to normal white matter.
- Further research may refine DWI/ADC parameters for differentiating active MS lesions without contrast agents.
