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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
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Improving the Detection of Myelin Integrity in Multiple Sclerosis Using Selective Inversion Recovery for MRI With

Ahmad A Toubasi1, Dhairya A Lakhani1,2, Gary Cutter3

  • 1Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Journal of Magnetic Resonance Imaging : JMRI
|December 10, 2024
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Summary
This summary is machine-generated.

Selective inversion recovery quantitative magnetization transfer (SIR-qMT)-derived macromolecular to free water pool size ratio (PSR) is more accurate than diffusion tensor imaging (DTI)-derived radial diffusivity (RD) for detecting tissue injury in multiple sclerosis (MS). PSR offers superior accuracy and effect size for assessing myelin integrity.

Keywords:
diffusion tensor imagingmultiple sclerosismyelinselective inversion recovery quantitative magnetization transfer imaging

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Area of Science:

  • Neuroimaging
  • Biomarkers
  • Multiple Sclerosis Research

Background:

  • Selective inversion recovery quantitative magnetization transfer (SIR-qMT) and diffusion tensor imaging (DTI) offer potential metrics for assessing myelin integrity in multiple sclerosis (MS).
  • Macromolecular to free water pool size ratio (PSR) from SIR-qMT and radial diffusivity (RD) from DTI are key metrics under investigation.
  • Establishing the accuracy of PSR and RD in identifying MS-related tissue injury is crucial for clinical translation.

Purpose of the Study:

  • To compare the diagnostic accuracy and Cohen's effect size (ES) of PSR and RD.
  • To evaluate the ability of PSR and RD to detect and quantify tissue injury in early MS patients.
  • To determine which metric, PSR or RD, is superior for assessing MS pathology.

Main Methods:

  • A cross-sectional prospective study involving 43 newly diagnosed MS patients and 18 healthy controls (HCs).
  • 3-Tesla MRI scans were acquired using T1-weighted, T2-weighted fluid-attenuated inversion recovery (FLAIR), DTI, and SIR-qMT sequences.
  • Regions of interest (ROIs) were defined in T2-lesions, chronic black holes (cBHs), normal-appearing white matter (NAWM) proximal and distant to lesions, and normal white matter (NWM) in HCs. Receiver operating characteristic curves and paired t tests were used for analysis.

Main Results:

  • PSR values significantly differed across all comparisons between MS lesions/NAWM and NWM in HCs.
  • RD values also differed significantly, except when comparing cBHs to T2-lesions (P = 0.051).
  • PSR demonstrated significantly higher accuracy and a larger effect size than RD in differentiating T2-lesions and cBHs from various white matter regions.

Conclusions:

  • Macromolecular to free water pool size ratio (PSR) derived from SIR-qMT exhibits superior accuracy and effect size compared to radial diffusivity (RD) from DTI.
  • PSR is a more effective metric for detecting and quantifying tissue injury in multiple sclerosis (MS).
  • These findings support the clinical utility of PSR as a sensitive biomarker for MS-related white matter damage.