Quantitative MRI adds to neuropsychiatric lupus diagnostics

Area of Science:

• Neuroimaging
• Rheumatology
• Neurology

Background:

• Diagnosing neuropsychiatric manifestations in Systemic Lupus Erythematosus (SLE) is challenging.
• Brain white matter lesions (WML) are common in SLE patients but their diagnostic utility is unclear.

Purpose of the Study:

• To assess if quantitative measurements of WML, including count, volume, and distribution, can aid in diagnosing neuropsychiatric Systemic Lupus Erythematosus (NPSLE).

Main Methods:

• Acquired brain MRI scans (dual-echo and 3D T1-weighted) from 32 SLE patients and 32 controls using a 3T scanner.
• Quantified T2-hyperintense lesion volume (T2LV) and number (T2LN) using semi-automatic segmentation.
• Classified NPSLE using established criteria and recorded clinical data, including the SLE International Collaborating Clinics/ACR damage index (SDI).

Main Results:

• SLE patients exhibited higher T2LV and T2LN compared to healthy controls and NPSLE patients had higher T2LV and T2LN than other SLE patients.
• WML distribution was prominent in the splenium of the corpus callosum, superior longitudinal fasciculus, and corona radiata.
• T2LV and T2LN correlated with SLE duration and age; T2LV also correlated with SDI. Specific thresholds for T2LV and T2LN improved NPSLE classification.

Conclusions:

• Quantitative analysis of brain white matter lesions (WML) provides valuable diagnostic information for NPSLE.
• WML burden is significantly associated with NPSLE diagnosis and disease characteristics.