Manganese-Enhanced MRI in Patients with Multiple Sclerosis

Area of Science:

• Neuroimaging
• Radiology
• Contrast Agents

Background:

• Cellular uptake of manganese ions as MRI contrast agents can highlight disease processes.
• Mangafodipir, a manganese chelate, is approved for liver lesion imaging.

Purpose of the Study:

• To explore the enhancement profile of manganese in multiple sclerosis (MS) patients.
• Investigate manganese as a potential contrast agent for MS lesion detection.

Main Methods:

• A case series of 6 adult MS patients was studied.
• Patients underwent baseline MRI with gadolinium, followed by mangafodipir injection.
• Post-injection scans were performed at variable time points.

Main Results:

• Ten out of fourteen new MS lesions showed manganese enhancement with varying characteristics.
• Manganese enhancement was observed in lesions forming days after injection, persisting for weeks.
• Some lesions displayed diffuse manganese enhancement larger than gadolinium enhancement or T2-FLAIR abnormalities.

Conclusions:

• This study demonstrates the first use of a manganese-based contrast agent for enhancing MS lesions.
• Manganese contrast agents exhibit a distinct temporal and spatial enhancement profile compared to gadolinium.
• Further research is needed to elucidate manganese uptake mechanisms and cell specificity in MS lesions.