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MR outcome parameters in multiple sclerosis: comparison of surface-based thresholding segmentation and magnetization
J H van Waesberghe1, M A van Buchem, M Filippi
1Department of Radiology, MR Center for MS Research, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Background And Purposes:
MR imaging is now widely used to monitor disease progression in patients with multiple sclerosis (MS). The purpose of this study was to explore the relationship between disability status and existing and new MR parameters in MS patients.
Methods:
Forty-one patients with clinically definitive MS were studied. MR imaging included T2- and T1-weighted imaging as well as gradient-echo imaging with and without magnetization transfer contrast. We used surface-based thresholding segmentation techniques to obtain T2 and T1 lesion load, T1/T2 ratio, and several magnetization transfer ratio (MTR) lesion load parameters. MTR histographic analysis included measurements of absolute peak height (aHp), relative peak height (rHp), MTR of the peak (MTRp), mean MTR (MTRm), and MTR25, MTR50, and MTR75, relating to the integrals of the histogram at 25%, 50%, and 75%, respectively, of the total area under the curve. All MR parameters were correlated with Expanded Disability Status Scale (EDSS) score, disease duration, and patient's age.
Results:
Using surface-based thresholding segmentation techniques, we found relatively low correlations with EDSS. T1 lesion load and T1/T2 ratios correlated most strongly. Regarding MTR histographic parameters, EDSS correlated best with rHp but only weakly with others. Similar correlations were found with disease duration, but not with age.
Conclusion:
The best MR correlations with disability were several MTR histographic parameters. Our findings may favor the use of these MR parameters over T2 lesion load to monitor disease progression in patients with MS, findings that should be explored further in longitudinal studies.
Insights
Magnetization transfer ratio (MTR) histogram parameters show the strongest correlation with disability in multiple sclerosis (MS) patients. These advanced MR imaging metrics may offer superior monitoring of MS disease progression compared to traditional T2 lesion load.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- Magnetic Resonance (MR) imaging is crucial for monitoring multiple sclerosis (MS) progression.
- Existing MR parameters have shown varying degrees of correlation with patient disability.
Purpose of the Study:
- To investigate the relationship between disability status and novel MR imaging parameters in MS patients.
- To compare the correlation strength of different MR metrics with Expanded Disability Status Scale (EDSS) scores.
Main Methods:
- Studied 41 patients with clinically definitive MS using T2- and T1-weighted, and gradient-echo MR imaging with magnetization transfer contrast.
- Employed surface-based thresholding for T2/T1 lesion load and MTR lesion load.
- Conducted MTR histogram analysis, measuring parameters like peak height and mean MTR, and correlated these with EDSS, disease duration, and age.
Main Results:
- T1 lesion load and T1/T2 ratios showed the strongest correlation with EDSS among traditional metrics.
- Magnetization transfer ratio (MTR) histogram parameters, particularly relative peak height (rHp), demonstrated the best correlation with EDSS.
- Similar correlations were observed with disease duration, but not with patient age.
Conclusions:
- Several MTR histogram parameters exhibit superior correlation with disability in MS patients compared to T2 lesion load.
- These MTR histogram metrics may be more effective for monitoring MS disease progression.
- Further longitudinal studies are recommended to validate these findings.