Brain MRI Lesion Load at 1.5T and 3T versus Clinical Status in Multiple Sclerosis

Stankiewicz, James; Glanz, Bonnie I.; Healy, Brian C.; Arora, Ashish; Neema, Mohit; Benedict, Ralph H. B.; Guss, Zachary D.; Tauhid, Shahamat; Buckle, Guy J.; Houtchens, Maria K.; Khoury, Samia J.; Weiner, Howard L.; Guttmann, Charles R.G.; Bakshi, Rohit

doi:10.1111/j.1552-6569.2009.00449.x

Cited by 111 publications

(103 citation statements)

References 51 publications

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“…High field strengths provide superior image quality through increased signal intensity. The clinical superiority of 3T over 1.5T has been demonstrated in multiple sclerosis 75,76 and, in animal models, in brain tumor imaging. [77][78][79] Case study experience supports superior CNS lesion grading and monitoring with 3T versus 1.5T (Fig 7).…”

Section: Protocol Sequence and Equipment Optimizationmentioning

confidence: 99%

MR Imaging of Neoplastic Central Nervous System Lesions: Review and Recommendations for Current Practice

Essig¹,

Anzalone²,

Combs³

et al. 2011

AJNR Am J Neuroradiol

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SUMMARY: MR imaging is the preferred technique for the diagnosis, treatment planning, and monitoring of patients with neoplastic CNS lesions. Conventional MR imaging, with gadolinium-based contrast enhancement, is increasingly combined with advanced, functional MR imaging techniques to offer morphologic, metabolic, and physiologic information. This article provides updated recommendations to neuroradiologists, neuro-oncologists, neurosurgeons, and radiation oncologists on the practical applications of MR imaging of neoplastic CNS lesions in adults, with particular focus on gliomas, based on a review of the clinical trial evidence and personal experiences shared at a recent international meeting of experts in neuroradiology, neuro-oncology, neurosurgery, and radio-oncology.ABBREVIATIONS: ADC ϭ apparent diffusion coefficient; CBV ϭ cerebral blood volume; CNS ϭ central nervous system; DCE ϭ dynamic contrast-enhanced; DSC ϭ dynamic susceptibility contrast; DTI ϭ diffusion tensor imaging; DWI ϭ diffusion-weighted imaging; FLAIR ϭ fluid-attenuated inversion recovery; FSE ϭ fast spin-echo; GFR ϭ glomerular filtration rate; GRE ϭ gradient recalled-echo; K trans ϭ volume transfer coefficient; MRS ϭ MR spectroscopy; PET ϭ positronemission tomography; PWI ϭ perfusion-weighted imaging; rCBV ϭ relative cerebral blood volume; TSE ϭ turbo spin-echo N eoplastic CNS lesions are a heterogeneous group of diseases with a variable outcome that reflects the precision of diagnosis and the delivery of optimal and specific treatment. CNS imaging has a pivotal role in directing management decisions.The goals and requirements for CNS imaging are multiple and include the establishment of a diagnosis and differential diagnosis, with accurate lesion grading for characterization of tumor biology. Imaging is an essential part of the decisionmaking process for therapy and later for planning of surgical or radiotherapeutic interventions. In the case of neurosurgery, neuroimaging can precisely define the location and accurately delineate the lesion and its relationship to eloquent gray-and white-matter structures, before intervention. In radiation therapy, imaging can define and demarcate margins for therapy planning. Imaging is mandatory after therapeutic intervention for monitoring disease and possible side effects.MR imaging is the standard technique for visualizing and characterizing neoplastic CNS lesions, with superior sensitivity compared with alternative modalities.1-4 Diagnosis and treatment planning are routinely based on conventional MR imaging, such as T2-weighted imaging, FLAIR, and T1 unenhanced FSE or GRE. Following contrast-enhanced T1-weighted imaging, sequences including 3D GRE or 2D TSE or FSE are used routinely for assessment of brain tumors. Through enhancing tissue relaxation, gadolinium-based contrast media improve the sensitivity and specificity of conventional and perfusion-weighted MR imaging examinations, with the capability to identify lesions not visible on unenhanced MR imaging and to provide additional information o...

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Section: Protocol Sequence and Equipment Optimizationmentioning

confidence: 99%

MR Imaging of Neoplastic Central Nervous System Lesions: Review and Recommendations for Current Practice

Essig¹,

Anzalone²,

Combs³

et al. 2011

AJNR Am J Neuroradiol

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“…[2][3][4][5][6] Recent advances in imaging, including 3T 3D volumetric T2 FLAIR sequences, allow better resolution of small demyelinating lesions, resulting in better clinicoradiologic correlation. 7,8 Despite advances in imaging techniques, conventional side-by-side comparison (CSSC) is often subject to a reader's expertise. 9 The sensitivity of detecting new lesions is also likely to be reduced when the section number is increased and scan planes are un-matched; however, to our knowledge, this reduction has not yet been investigated.…”

mentioning

confidence: 99%

Improving Multiple Sclerosis Plaque Detection Using a Semiautomated Assistive Approach

Heerden

Rawlinson

Zhang

et al. 2015

AJNR Am J Neuroradiol

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“…Furthermore, brain volume may vary based on pathophysiological factors, including recent start of immunomodulatory therapy, acute inflammation, hydration status, time of day, tobacco use, genetics, and comorbid conditions (Rocca et al., 2017). As MRI technology evolves and increasingly precise high‐field (e.g., 3T) magnets proliferate in clinical practice, there remains an ongoing need for critical evaluation of the sensitivity and validity of postprocessing software pipelines (Chu et al., 2016; Stankiewicz et al., 2011). …”

Section: Introductionmentioning

confidence: 99%

Whole‐brain atrophy assessed by proportional‐ versus registration‐based pipelines from 3TMRIin multiple sclerosis

et al. 2018

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Background and PurposeWhole‐brain atrophy is a standard outcome measure in multiple sclerosis (MS) clinical trials as assessed by various software tools. The effect of processing method on the validity of such data obtained from high‐resolution 3T MRI is not known. We compared two commonly used methods of quantifying whole‐brain atrophy.MethodsThree‐dimensional T1‐weighted and FLAIR images were obtained at 3T in MS (n = 61) and normal control (NC, n = 30) groups. Whole‐brain atrophy was assessed by two automated pipelines: (a) SPM8 to derive brain parenchymal fraction (BPF, proportional‐based method); (b) SIENAX to derive normalized brain parenchymal volume (BPV, registration method). We assessed agreement between BPF and BPV, as well their relationship to Expanded Disability Status Scale (EDSS) score, timed 25‐foot walk (T25FW), cognition, and cerebral T2 (FLAIR) lesion volume (T2LV).ResultsBrain parenchymal fraction and BPV showed only partial agreement (r = 0.73) in the MS group, and r = 0.28 in NC. Both methods showed atrophy in MS versus NC (BPF p < 0.01, BPV p < 0.05). Within MS group comparisons, BPF (p < 0.05) but not BPV (p > 0.05) correlated with EDSS score. BPV (p = 0.03) but not BPF (p = 0.08) correlated with T25FW. Both metrics correlated with T2LV (p < 0.05) and cognitive subscales. BPF (p < 0.05) but not BPV (p > 0.05) showed lower brain volume in cognitively impaired (n = 23) versus cognitively preserved (n = 38) patients. However, direct comparisons of BPF and BPV sensitivities to atrophy and clinical correlations were not statistically significant.ConclusionWhole‐brain atrophy metrics may not be interchangeable between proportional‐ and registration‐based automated pipelines from 3T MRI in patients with MS.

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Brain MRI Lesion Load at 1.5T and 3T versus Clinical Status in Multiple Sclerosis

Cited by 111 publications

References 51 publications

MR Imaging of Neoplastic Central Nervous System Lesions: Review and Recommendations for Current Practice

MR Imaging of Neoplastic Central Nervous System Lesions: Review and Recommendations for Current Practice

Improving Multiple Sclerosis Plaque Detection Using a Semiautomated Assistive Approach

Whole‐brain atrophy assessed by proportional‐ versus registration‐based pipelines from 3TMRIin multiple sclerosis

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