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Gadolinium enhanced MRI predicts clinical and MRI disease activity in relapsing-remitting multiple sclerosis
T Koudriavtseva1, A J Thompson, M Fiorelli
1Department of Neurological Sciences, University of Rome La Sapienza, Italy.
Abstract:
The aim of the study was to evaluate the predictive power of baseline gadolinium (Gd) enhanced MRI in relation to subsequent clinical and MRI activity. Sixty eight patients with clinically definite relapsing-remitting multiple sclerosis had a baseline Gd enhanced MRI and were followed up clinically and by monthly Gd enhanced MRI for six months. The occurrence of relapses during the follow up period was predicted by the presence of at least one enhancing lesion on the baseline MRI (P < 0.05). The number and volume of enhancing lesions at baseline were significantly associated with both enhancing lesions observed during the follow up period (P < 0.0001) and the accumulation of abnormality on T2 weighted images (P < 0.0001). Moreover, the presence of three or more enhancing lesions at baseline scan was consistently associated with the development of permanent abnormalities on T2 weighted images six months later. The study suggests that the number and volume of Gd enhancing lesions at a single examination are strong short term predictors of subsequent clinical and MRI activity.
Insights
Baseline gadolinium-enhanced MRI scans can predict future disease activity in multiple sclerosis. The number and volume of enhancing lesions at baseline strongly correlate with subsequent clinical relapses and MRI changes.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Multiple Sclerosis (MS) is a chronic neurological disease.
- Relapsing-remitting MS (RRMS) is the most common form.
- Predicting disease activity is crucial for management.
Purpose of the Study:
- To assess the predictive value of baseline gadolinium-enhanced MRI in RRMS.
- To correlate baseline MRI findings with subsequent clinical and MRI activity.
Main Methods:
- Sixty-eight RRMS patients underwent baseline gadolinium-enhanced MRI.
- Patients were followed clinically and with monthly enhanced MRIs for six months.
Main Results:
- Presence of at least one baseline enhancing lesion predicted relapses (P < 0.05).
- Baseline lesion number/volume correlated with follow-up enhancing lesions and T2 abnormalities (P < 0.0001).
- Three or more baseline lesions predicted permanent T2 abnormalities at six months.
Conclusions:
- Baseline gadolinium-enhanced MRI is a strong short-term predictor of MS activity.
- Quantitative MRI metrics predict clinical and radiological disease progression.