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Updated: May 29, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Reliability of paramagnetic rim lesion detection at 1.5T MRI in multiple sclerosis patients
Maria Sofia Martire1,2, Lucia Moiola3, Pietro Maggi4,5
1Neurology Unit, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Background:
Paramagnetic rim lesions (PRL) are valuable for diagnosing and prognosing multiple sclerosis (MS) and detectable at 7T and 3T MRI. For translation into clinical practice, it is essential assessing their visibility on 1.5T clinical scanners.
Objective:
To evaluate the reliability of detecting PRL using commercially available susceptibility-weighted imaging (SWI) at 1.5 versus 3T MRI.
Methods:
SWI images were obtained in 20 people with MS at 1.5T and 3T MRI, with an average scan interval of 1.1 years. Only stable, non-enhancing lesions visible on both scans were analyzed. PRL at 3T were identified by two expert raters using NAIMS PRL criteria and used as a reference. Four raters, blinded to 3T results, assessed PRL at 1.5T. Discrepancies were resolved by consensus.
Results:
PRL were identified in 16 of 20 patients. At 3T, 95 PRL were identified by consensus (mean 5 PRL per patient, range 0-30). Blinded to 3T scans, 82% of PRL were visible at 1.5T (78 of 95 PRL). Interrater reliability was "almost perfect" for both 1.5 and 3T scans. Raters accurately classified all patients as having ⩾1PRL or not at 1.5T.
Conclusion:
The majority of PRL are detectable at 1.5T without significantly reducing the specificity of PRL identification or increasing the detection of pseudo-PRL. This may facilitate their clinical use in MS diagnosis and prognosis.
Insights
Paramagnetic rim lesions (PRL) are reliably detectable on 1.5T MRI scans, similar to 3T scans. This finding supports the clinical use of PRL for multiple sclerosis (MS) diagnosis and prognosis.
Area of Science:
- Radiology
- Neuroimaging
- Magnetic Resonance Imaging (MRI)
Background:
- Paramagnetic rim lesions (PRL) are crucial biomarkers for multiple sclerosis (MS) diagnosis and prognosis.
- PRL are currently detectable using 7T and 3T MRI, but their visibility on standard 1.5T scanners needs evaluation for clinical translation.
Purpose of the Study:
- To assess the reliability of detecting PRL using commercially available susceptibility-weighted imaging (SWI) at 1.5T compared to 3T MRI.
- To determine if 1.5T MRI can be effectively used for identifying PRL in clinical practice.
Main Methods:
- SWI images were acquired from 20 individuals with MS at both 1.5T and 3T MRI.
- Lesions identified at 3T by expert raters using NAIMS criteria served as the reference standard.
- Four blinded raters assessed PRL visibility at 1.5T, with discrepancies resolved by consensus.
Main Results:
- Paramagnetic rim lesions (PRL) were identified in 16 out of 20 patients.
- 82% of PRL detected at 3T were also visible at 1.5T (78 out of 95 PRL).
- Interrater reliability was "almost perfect" for both 1.5T and 3T scans, and patients were accurately classified regarding the presence of PRL.
Conclusions:
- The majority of PRL are detectable at 1.5T MRI.
- Detection of PRL at 1.5T does not significantly reduce specificity or increase pseudo-PRL detection.
- This supports the potential for wider clinical application of PRL in MS diagnosis and prognosis using 1.5T scanners.
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