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Iron Rims as an Imaging Biomarker in MS: A Systematic Mapping Review
Amjad I AlTokhis1,2, Abdulmajeed M AlOtaibi1,3, Ghadah A Felmban1,3
1School of Medicine, University of Nottingham, Nottingham, UK/Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK.
Background:
Multiple sclerosis (MS) is an autoimmune, inflammatory, demyelinating and degenerative disease of the central nervous system (CNS). To date, there is no definitive imaging biomarker for diagnosing MS. The current diagnostic criteria are mainly based on clinical relapses supported by the presence of white matter lesions (WMLs) on MRI. However, misdiagnosis of MS is still a significant clinical problem. The paramagnetic, iron rims (IRs) around white matter lesions have been proposed to be an imaging biomarker in MS. This study aimed to carry out a systematic mapping review to explore the detection of iron rim lesions (IRLs), on clinical MR scans, and describe the characteristics of IRLs presence in MS versus other MS-mimic disorders.
Methods:
Publications from 2001 on IRs lesions were reviewed in three databases: PubMed, Web of Science and Embase. From the initial result set 718 publications, a final total of 38 papers were selected.
Results:
The study revealed an increasing interest in iron/paramagnetic rims lesions studies. IRs were more frequently found in periventricular regions and appear to be absent in MS-mimics. Conclusions IR is proposed as a promising imaging biomarker for MS.
Insights
Iron rims (IRs) on MRI may be a promising biomarker for multiple sclerosis (MS). These IRs are often found in MS but not in MS-mimic disorders, aiding diagnosis.
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- Multiple sclerosis (MS) is a CNS disease with no definitive imaging biomarker.
- Current MS diagnosis relies on clinical relapses and MRI white matter lesions (WMLs), leading to misdiagnosis.
- Paramagnetic iron rims (IRs) around WMLs are proposed as a potential MS imaging biomarker.
Purpose of the Study:
- To systematically review the detection of iron rim lesions (IRLs) on clinical MRI scans.
- To describe the characteristics of IRLs in MS compared to MS-mimic disorders.
Main Methods:
- Systematic mapping review of publications from 2001 onwards.
- Searches conducted in PubMed, Web of Science, and Embase databases.
- 38 relevant papers selected from an initial 718 publications.
Main Results:
- Growing research interest in iron/paramagnetic rim lesions.
- IRs are more frequently detected in periventricular regions in MS.
- IRs appear to be absent in conditions mimicking MS.
Conclusions:
- Iron rims (IRs) show promise as an imaging biomarker for MS diagnosis.
- Further research into IRLs could improve diagnostic accuracy for MS.
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