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The influence of slice orientation on brain MRI lesion load measurement in multiple sclerosis
M Rovaris1, M P Sormani, M A Rocca
1MS Biosignal Analysis Center, Department of Neurology, IRCCS Ospedale San Raffaele, University of Milan, Italy.
Abstract:
This study aimed at evaluating the influence of a different slice orientation on brain magnetic resonance imaging (MRI) lesion load in multiple sclerosis (MS). Fifteen MS patients were scanned obtaining both axial and sagittal conventional spin echo (24 slices; TR 2400, TE 30/80) brain MRI. The total lesion load (TLL) was assessed twice for each scan, using a semi-automated local thresholding technique and the same marked hardcopies. The mean TLL was 22734 mm3 for axial and 22003 mm3 for sagittal scans. The mean intra-observer coefficient of variation (COV) was 4.65% for the axial acquisitions and 4.52% for the sagittal acquisitions. This difference was not statistically significant (one-way ANOVA, P > 0.1). The lesion load was significantly higher from axial MRI as compared to the intra-observer variability (two-way ANOVA, P=0.01), but the fluctuations around this average difference between axial and sagittal scan TLL were significantly large (test for interaction, P < 0.001). Our data indicate that the use of sagittal conventional MRI scans does not seem to be worthwhile for the quantitative assessment of lesion load in MS patients.
Insights
Slice orientation impacts multiple sclerosis (MS) brain lesion load measurement. Sagittal magnetic resonance imaging (MRI) scans are not recommended for accurate lesion quantification in MS patients.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Multiple sclerosis (MS) is a chronic neurological disease.
- Accurate lesion load measurement is crucial for MS management.
- Brain magnetic resonance imaging (MRI) is the primary tool for MS lesion detection.
Purpose of the Study:
- To evaluate the effect of slice orientation (axial vs. sagittal) on brain lesion load quantification in MS patients.
- To determine if sagittal MRI scans offer advantages over axial scans for MS lesion assessment.
Main Methods:
- Fifteen MS patients underwent brain MRI using both axial and sagittal conventional spin echo sequences.
- Total lesion load (TLL) was assessed using a semi-automated local thresholding technique.
- Intra-observer variability was calculated using the coefficient of variation (COV).
Main Results:
- Mean TLL was slightly higher for axial (22734 mm3) than sagittal (22003 mm3) scans.
- No statistically significant difference in intra-observer COV between axial (4.65%) and sagittal (4.52%) acquisitions.
- Lesion load from axial MRI was significantly higher than intra-observer variability, with large fluctuations between axial and sagittal TLL.
Conclusions:
- Sagittal conventional MRI scans do not appear beneficial for quantitative lesion load assessment in MS.
- Axial MRI may provide a more sensitive, albeit variable, measure of MS lesion load compared to sagittal.
- Further research may be needed to optimize MRI protocols for MS lesion quantification.