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Quantitative susceptibility-weighted imaging in predicting disease activity in multiple sclerosis
Selvadasan Vinayagamani1, Sekar Sabarish1, Sruthi S Nair2
1Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India.
Purpose:
Repeated use of Gadolinium (Gd) contrast for multiple sclerosis (MS) imaging leads to Gd deposition in brain. We aimed to study the utility of phase values by susceptibility weighted imaging (SWI) to assess the iron content in MS lesions to differentiate active and inactive lesions.
Methods:
MS persons who underwent MRI were grouped into group 1 with active lesions and group 2 with inactive lesions based on the presence or absence of contrast enhancing lesions. Phase values of lesions (PL) and contralateral normal white matter (PN) were calculated using the SPIN software by drawing ROI. Subtracted phase values (PS = PL - PN) and iron content (PS/3) of the lesions were calculated in both groups.
Results:
We analyzed 69 enhancing lesions from 22 patients (group 1) and 84 non-enhancing lesions from 29 patients (group 2). Mean-subtracted phase values and iron content corrected for voxels in ROI were significantly lower in enhancing lesions compared to non-enhancing lesions (p < 0.001). A cut-off value 2.8 μg/g for iron content showed area under the curve of 0.909 with good sensitivity.
Conclusion:
Quantification of iron content using SWI phase values holds promise as a biomarker to differentiate active from inactive lesions of MS.
Insights
Susceptibility weighted imaging (SWI) phase values can quantify iron content in multiple sclerosis (MS) lesions. This method effectively differentiates active from inactive MS lesions, aiding in disease assessment.
Area of Science:
- Neuroimaging
- Radiology
- Biomarker Discovery
Background:
- Gadolinium (Gd) contrast agents used in multiple sclerosis (MS) imaging can lead to brain deposition.
- Differentiating active from inactive MS lesions is crucial for effective disease management and treatment strategies.
Purpose of the Study:
- To evaluate the utility of susceptibility weighted imaging (SWI) phase values for assessing iron content within MS lesions.
- To determine if iron content can distinguish between active and inactive MS lesions.
Main Methods:
- Patients with MS were categorized into active (contrast-enhancing) and inactive (non-enhancing) lesion groups.
- Region of Interest (ROI) based phase values of lesions (PL) and normal white matter (PN) were calculated using SPIN software.
- Subtracted phase values (PS) and estimated iron content (PS/3) were computed for lesion analysis.
Main Results:
- Analysis included 69 enhancing lesions (22 patients) and 84 non-enhancing lesions (29 patients).
- Significantly lower mean-subtracted phase values and iron content were observed in active (enhancing) lesions compared to inactive (non-enhancing) lesions (p < 0.001).
- An iron content cut-off of 2.8 μg/g demonstrated high diagnostic performance (AUC=0.909) for differentiating lesion types.
Conclusions:
- Quantification of iron content via SWI phase values shows potential as a reliable biomarker.
- This technique can effectively differentiate active from inactive MS lesions.
- SWI phase analysis offers a promising non-invasive method for MS lesion characterization.
