Multisite reliability and repeatability of an advanced brain MRI protocol

Schwartz, Daniel L.; Tagge, Ian J.; Powers, Katherine; Ahn, Sinyeob; Bakshi, Rohit; Calabresi, Peter A.; Constable, R. Todd; Grinstead, John; Henry, Roland G.; Nair, Govind; Papinutto, Nico; Pelletier, Daniel; Shinohara, Russell T.; Oh, Jiwon; Reich, Daniel S.; Sicotte, Nancy L.; Rooney, William D.; Cooperative, Naims

doi:10.1002/jmri.26652

Cited by 33 publications

(54 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In conclusion, our prospective multicenter study shows that the CVS can accurately predict an MS diagnosis in diagnostically difficult cases using 3T clinical scanners. Multisite availability of an optimized MRI sequence, 33 such as FLAIR* imaging, is required to promote the larger multicenter clinical studies needed to confirm the value of introducing this promising imaging biomarker into everyday clinical practice.…”

Section: Discussionmentioning

confidence: 99%

The “central vein sign” in patients with diagnostic “red flags” for multiple sclerosis: A prospective multicenter 3T study

et al. 2019

View full text Add to dashboard Cite

Background: The central vein sign (CVS) has been shown to help in the differential diagnosis of multiple sclerosis (MS), but most prior studies are retrospective. Objectives: To prospectively assess the diagnostic predictive value of the CVS in diagnostically difficult cases. Methods: In this prospective multicenter study, 51 patients with suspected MS who had clinical, imaging, or laboratory “red flags” (i.e. features atypical for MS) underwent 3T fluid-attenuated inversion recovery (FLAIR*) magnetic resonance imaging (MRI) for CVS assessment. After the diagnostic work-up, expert clinicians blinded to the results of the CVS assessment came to a clinical diagnosis. The value of the CVS to prospectively predict an MS diagnosis was assessed. Results: Of the 39 patients who received a clinical diagnosis by the end of the study, 27 had MS and 12 received a non-MS diagnosis that included systemic lupus erythematosus, sarcoidosis, migraine, Sjögren disease, SPG4-spastic-paraparesis, neuromyelitis optica, and Susac syndrome. The percentage of perivenular lesions was higher in MS (median = 86%) compared to non-MS (median = 21%; p < 0.0001) patients. A 40% perivenular lesion cutoff was associated with 97% accuracy and a 96% positive/100% negative predictive value. Conclusion: The CVS detected on 3T FLAIR* images can accurately predict an MS diagnosis in patients suspected to have MS, but with atypical clinical, laboratory, and imaging features.

show abstract

Section: Discussionmentioning

confidence: 99%

The “central vein sign” in patients with diagnostic “red flags” for multiple sclerosis: A prospective multicenter 3T study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Nevertheless, in order to be reliably employed in the clinical routine, qMRI must undergo both technical and biological/clinical validation [96]. Technical validation in qMRI entails testing for accuracy, repeatability and reproducibility of the underlying physical measurement, both over time and across sites [72,97]. Technical tolerances related to hardware components should be first identified and then quantified through physical phantoms, by following the available standardized procedures or guidelines and recommendations [71,[98][99][100][101].…”

Section: Quantitative Imagingmentioning

confidence: 99%

Medical physics challenges in clinical MR-guided radiotherapy

et al. 2020

View full text Add to dashboard Cite

The integration of magnetic resonance imaging (MRI) for guidance in external beam radiotherapy has faced significant research and development efforts in recent years. The current availability of linear accelerators with an embedded MRI unit, providing volumetric imaging at excellent soft tissue contrast, is expected to provide novel possibilities in the implementation of image-guided adaptive radiotherapy (IGART) protocols. This study reviews open medical physics issues in MR-guided radiotherapy (MRgRT) implementation, with a focus on current approaches and on the potential for innovation in IGART. Daily imaging in MRgRT provides the ability to visualize the static anatomy, to capture internal tumor motion and to extract quantitative image features for treatment verification and monitoring. Those capabilities enable the use of treatment adaptation, with potential benefits in terms of personalized medicine. The use of online MRI requires dedicated efforts to perform accurate dose measurements and calculations, due to the presence of magnetic fields. Likewise, MRgRT requires dedicated quality assurance (QA) protocols for safe clinical implementation. Reaction to anatomical changes in MRgRT, as visualized on daily images, demands for treatment adaptation concepts, with stringent requirements in terms of fast and accurate validation before the treatment fraction can be delivered. This entails specific challenges in terms of treatment workflow optimization, QA, and verification of the expected delivered dose while the patient is in treatment position. Those challenges require specialized medical physics developments towards the aim of fully exploiting MRI capabilities. Conversely, the use of MRgRT allows for higher confidence in tumor targeting and organs-at-risk (OAR) sparing. The systematic use of MRgRT brings the possibility of leveraging IGART methods for the optimization of tumor targeting and quantitative treatment verification. Although several challenges exist, the intrinsic benefits of MRgRT will provide a deeper understanding of dose delivery effects on an individual basis, with the potential for further treatment personalization.

show abstract

“…This latter point is especially of importance, as it remains to be elucidated if acute time-varying factors, such as exposure the day or week before, would impact various MRI outcomes. For example, reliability differences in MRI estimates within the same individuals (62) may suggest macrostructural changes detected by MRI may be better suited for detecting effects of chronic exposure, whereas functional metrics may be more sensitive to acute conditions. Future studies should consider these strengths and weaknesses of each technique depending on their specific question(s) in relation to how air pollution may impact the brain during development.…”

Section: Discussionmentioning

confidence: 99%

Outdoor Air Pollution and Brain Structure and Function From Across Childhood to Young Adulthood: A Methodological Review of Brain MRI Studies

Herting

Younan

Campbell

et al. 2019

Front. Public Health

View full text Add to dashboard Cite

Outdoor air pollution has been recognized as a novel environmental neurotoxin. Studies have begun to use brain Magnetic Resonance Imaging (MRI) to investigate how air pollution may adversely impact developing brains. A systematic review was conducted to evaluate and synthesize the reported evidence from MRI studies on how early-life exposure to outdoor air pollution affects neurodevelopment. Using PubMed and Web of Knowledge, we conducted a systematic search, followed by structural review of original articles with individual-level exposure data and that met other inclusion criteria. Six studies were identified, each sampled from 3 cohorts of children in Spain, The Netherlands, and the United States. All studies included a one-time assessment of brain MRI when children were 6–12 years old. Air pollutants from traffic and/or regional sources, including polycyclic aromatic hydrocarbons (PAHs), nitrogen dioxide, elemental carbon, particulate matter (<2.5 or <10 μm), and copper, were estimated prenatally (n = 1), during childhood (n = 3), or both (n = 2), using personal monitoring and urinary biomarkers (n = 1), air sampling at schools (n = 4), or a land-use regression (LUR) modeling based on residences (n = 2). Associations between exposure and brain were noted, including: smaller white matter surface area (n = 1) and microstructure (n = 1); region-specific patterns of cortical thinness (n = 1) and smaller volumes and/or less density within the caudate (n = 3); altered resting-state functional connectivity (n = 2) and brain activity to sensory stimuli (n = 1). Preliminary findings suggest that outdoor air pollutants may impact MRI brain structure and function, but limitations highlight that the design of future air pollution-neuroimaging studies needs to incorporate a developmental neurosciences perspective, considering the exposure timing, age of study population, and the most appropriate neurodevelopmental milestones.

show abstract

Multisite reliability and repeatability of an advanced brain MRI protocol

Cited by 33 publications

References 33 publications

The “central vein sign” in patients with diagnostic “red flags” for multiple sclerosis: A prospective multicenter 3T study

The “central vein sign” in patients with diagnostic “red flags” for multiple sclerosis: A prospective multicenter 3T study

Medical physics challenges in clinical MR-guided radiotherapy

Outdoor Air Pollution and Brain Structure and Function From Across Childhood to Young Adulthood: A Methodological Review of Brain MRI Studies

Contact Info

Product

Resources

About