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Updated: Aug 30, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Evaluation of white matter microstructure in pediatric onset multiple sclerosis with diffusion compartment imaging
Fedel Machado-Rivas1, Camilo Jaimes1, Benoit Scherrer1
1Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Insights
Pediatric-onset multiple sclerosis (POMS) shows significant white matter changes. A novel Diffusion Compartment Imaging (DCI) model reveals subtle microstructural alterations in normal-appearing white matter not seen with standard Diffusion Tensor Imaging (DTI).
Area of Science:
- Neuroimaging
- Neurology
- Medical Physics
Background:
- Pediatric-onset multiple sclerosis (POMS) exhibits accelerated axonal damage compared to adult forms.
- Understanding white matter (WM) microstructural changes is crucial for POMS management.
Purpose of the Study:
- To characterize WM microstructural changes in POMS using a Diffusion Compartment Imaging (DCI) model.
- To compare the sensitivity of DCI with standard Diffusion Tensor Imaging (DTI) in detecting these changes.
Main Methods:
- Recruited 11 POMS patients and 11 healthy controls for 3 Tesla MRI.
- Utilized a novel DCI model (DIAMOND) and Diffusion Tensor Imaging (DTI) to analyze white matter microstructure.
- Quantified compartmental axial diffusivity, radial diffusivity (cRD), mean diffusivity (cMD), and compartmental fractional anisotropy (cFA) in lesions and normal-appearing white matter (NAWM).
Main Results:
- DCI revealed higher cRD and cMD, and lower cFA and heterogeneity index in POMS lesions compared to contralateral NAWM.
- DTI analysis showed similar trends.
- Whole-brain NAWM in POMS patients demonstrated elevated cRD and cMD, and reduced cFA compared to controls.
Conclusions:
- The DCI model accurately characterizes white matter lesions in POMS.
- DCI detects incipient microstructural changes in NAWM that may be missed by DTI.
Background And Purpose:
Pediatric-onset multiple sclerosis (POMS) shows earlier axonal involvement and greater axonal loss than in adults. We aim to characterize the white matter (WM) microstructural changes in POMS using a diffusion compartment imaging (DCI) model and compare it to standard diffusion tensor imaging (DTI).
Methods:
Eleven patients (2 males, mean age 18.8 ± 3.9 years) with a diagnosis of relapsing and remitting POMS (mean age at disease onset 13.8 ± 2.9 years, mean duration 5.1 ± 1.9 years) and healthy controls (8 males, mean age 26.4 ± 6.5 years) were recruited and imaged at 3 T. A 90-gradient set Cube and Sphere acquisition and a novel DCI model known as DIstribution of Anisotropic MicrOstructural eNvironments with Diffusion-weighted imaging (DIAMOND) were used to calculate a single anisotropic compartment, an isotropic compartment, and a free diffusion compartment. Lesions and contralateral normal-appearing white matter (NAWM) in patients and whole brain WM for controls were labeled.
Results:
Eleven patients and 11 controls were recruited. When comparing lesions and contralateral NAWM in patients using DCI, compartmental axial diffusivity, radial diffusivity (cRD), and mean diffusivity (cMD) were higher in lesions. Conversely, compartmental fractional anisotropy (cFA) and heterogeneity index were lower in lesions. An analysis of DTI equivalents showed the same trends. In whole-brain NAWM of patients compared to controls, cRD and cMD were higher and cFA was lower in patients.
Conclusion:
Lesions in POMS can be accurately characterized by a DCI model. Incipient changes in NAWM seen in DCI may not be readily observable by DTI.
