Focal cortical lesion detection in multiple sclerosis: 3 tesla DIR versus 7 tesla FLASH-T2*

Background: Neuroinflammation with microglia activation is thought to be closely related to cortical multiple sclerosis (MS) lesion pathogenesis. Objective: Using 11C-PBR28 and 7 Tesla (7T) imaging, we assessed in 9 relapsing–remitting multiple sclerosis (RRMS) and 10 secondary progressive multiple sclerosis (SPMS) patients the following: (1) microglia activation in lesioned and normal-appearing cortex, (2) cortical lesion inflammatory profiles, and (3) the relationship between neuroinflammation and cortical integrity. Methods: Mean 11C-PBR28 uptake was measured in focal cortical lesions, cortical areas with 7T quantitative T2* (q-T2*) abnormalities, and normal-appearing cortex. The relative difference in cortical 11C-PBR28 uptake between patients and 14 controls was used to classify cortical lesions as either active or inactive. Disease burden was investigated according to cortical lesion inflammatory profiles. The relation between q-T2* and 11C-PBR28 uptake along the cortex was assessed. Results: 11C-PBR28 uptake was abnormally high in cortical lesions in RRMS and SPMS; in SPMS, tracer uptake was significantly increased also in normal-appearing cortex. 11C-PBR28 uptake and q-T2* correlated positively in many cortical areas, negatively in some regions. Patients with high cortical lesion inflammation had worse clinical outcome and higher intracortical lesion burden than patients with low inflammation. Conclusion: 11C-PBR28 and 7T imaging reveal distinct profiles of cortical inflammation in MS, which are related to disease burden.

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Quantitative 7-Tesla Imaging of Cortical Myelin Changes in Early Multiple Sclerosis

Frontiers in Neurology ◽

10.3389/fneur.2021.714820 ◽

2021 ◽

Vol 12 ◽

Author(s):

Valeria Barletta ◽

Elena Herranz ◽

Constantina A. Treaba ◽

Ambica Mehndiratta ◽

Russell Ouellette ◽

...

Keyword(s):

Multiple Sclerosis ◽

Quantitative Mri ◽

7 Tesla ◽

Cortical Lesion ◽

Healthy Controls ◽

Cortical Lesions ◽

Lesion Analysis ◽

Cortical Map ◽

The Brain

Cortical demyelination occurs early in multiple sclerosis (MS) and relates to disease outcome. The brain cortex has endogenous propensity for remyelination as proven from histopathology study. In this study, we aimed at characterizing cortical microstructural abnormalities related to myelin content by applying a novel quantitative MRI technique in early MS. A combined myelin estimation (CME) cortical map was obtained from quantitative 7-Tesla (7T) T2* and T1 acquisitions in 25 patients with early MS and 19 healthy volunteers. Cortical lesions in MS patients were classified based on their myelin content by comparison with CME values in healthy controls as demyelinated, partially demyelinated, or non-demyelinated. At follow-up, we registered changes in cortical lesions as increased, decreased, or stable CME. Vertex-wise analysis compared cortical CME in the normal-appearing cortex in 25 MS patients vs. 19 healthy controls at baseline and investigated longitudinal changes at 1 year in 10 MS patients. Measurements from the neurite orientation dispersion and density imaging (NODDI) diffusion model were obtained to account for cortical neurite/dendrite loss at baseline and follow-up. Finally, CME maps were correlated with clinical metrics. CME was overall low in cortical lesions (p = 0.03) and several normal-appearing cortical areas (p < 0.05) in the absence of NODDI abnormalities. Individual cortical lesion analysis revealed, however, heterogeneous CME patterns from extensive to partial or absent demyelination. At follow-up, CME overall decreased in cortical lesions and non-lesioned cortex, with few areas showing an increase (p < 0.05). Cortical CME maps correlated with processing speed in several areas across the cortex. In conclusion, CME allows detection of cortical microstructural changes related to coexisting demyelination and remyelination since the early phases of MS, and shows to be more sensitive than NODDI and relates to cognitive performance.

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3 Tesla and 7 Tesla MRI of multiple sclerosis cortical lesions

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.22115 ◽

2010 ◽

Vol 32 (4) ◽

pp. 971-977 ◽

Cited By ~ 79

Author(s):

Emma C. Tallantyre ◽

Paul S. Morgan ◽

Jennifer E. Dixon ◽

Ali Al-Radaideh ◽

Matthew J. Brookes ◽

...

Keyword(s):

Multiple Sclerosis ◽

3 Tesla ◽

7 Tesla ◽

Cortical Lesions ◽

7 Tesla Mri

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7 Tesla 3D-MP-FLAIR and 3D-MP-DIR: Lesion Detection in Multiple Sclerosis

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-0030-1268258 ◽

2010 ◽

Vol 182 (12) ◽

Author(s):

WL de Graaf ◽

F Visser ◽

MP Wattjes ◽

JJ Zwanenburg ◽

PJW Pouwels ◽

...

Keyword(s):

Multiple Sclerosis ◽

Lesion Detection ◽

7 Tesla

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Reliability of cortical lesion detection on double inversion recovery MRI applying the MAGNIMS-Criteria in multiple sclerosis patients within a 16-months period

PLoS ONE ◽

10.1371/journal.pone.0172923 ◽

2017 ◽

Vol 12 (2) ◽

pp. e0172923 ◽

Cited By ~ 6

Author(s):

Tobias Djamsched Faizy ◽

Christian Thaler ◽

Tim Ceyrowski ◽

Gabriel Broocks ◽

Natascha Treffler ◽

...

Keyword(s):

Multiple Sclerosis ◽

Lesion Detection ◽

Inversion Recovery ◽

Double Inversion Recovery ◽

Cortical Lesion ◽

Multiple Sclerosis Patients

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Does high-field MR imaging improve cortical lesion detection in multiple sclerosis?

Journal of Neurology ◽

10.1007/s00415-008-0620-5 ◽

2008 ◽

Vol 255 (2) ◽

pp. 183-191 ◽

Cited By ~ 49

Author(s):

J. J. G. Geurts ◽

E. L. A. Blezer ◽

H. Vrenken ◽

A. van der Toorn ◽

J. A. Castelijns ◽

...

Keyword(s):

Multiple Sclerosis ◽

Mr Imaging ◽

High Field ◽

Lesion Detection ◽

Cortical Lesion ◽

High Field Mr

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Imaging cortical multiple sclerosis lesions with ultra-high field MRI

10.1101/2021.06.25.21259363 ◽

2021 ◽

Author(s):

Mads Alexander Just Madsen ◽

Vanessa Wiggermann ◽

Stephan Bramow ◽

Jeppe Romme Christensen ◽

Finn Sellebjerg ◽

...

Keyword(s):

Multiple Sclerosis ◽

High Field ◽

Lesion Detection ◽

Cortical Lesion ◽

Type I ◽

Type Ii ◽

Cortical Lesions ◽

Ultra High Field ◽

Type Iv

Background: Cortical lesions are abundant in multiple sclerosis (MS), yet difficult to visualize in vivo. Ultra- high field (UHF) MRI at 7T and above provides technological advances suited to optimize the detection of cortical lesions in MS. Purpose: To provide a narrative and quantitative systematic review of the literature on UHF MRI of cortical lesions in MS. Methods: A systematic search of all literature on UHF MRI of cortical lesions in MS published before September 2020. Quantitative outcome measures included cortical lesion numbers reported using 3T and 7T MRI and between 7T MRI sequences, along with sensitivity of UHF MRI towards cortical lesions verified by histopathology. Results: 7T MRI detected on average 52±26% (mean±95% confidence interval) more cortical lesions than the best performing image contrast at 3T, with the largest increase in type II-IV intracortical lesion detection. Across all studies, the mean cortical lesion number was 17±6/patient. In progressive MS cohorts, approximately four times more cortical lesions were reported than in CIS/early RRMS, and RRMS. Superiority of one MRI sequence over another could not be established from available data. Post- mortem lesion detection with UHF MRI agreed only modestly with pathological examinations. Mean pro- and retrospective sensitivity was 33±6% and 71±10%, respectively, with the highest sensitivity towards type I and type IV lesions. Conclusion: UHF MRI improves cortical lesion detection in MS considerably compared to 3T MRI, particularly for type II-IV lesions. Despite modest sensitivity, 7T MRI is still capable of visualizing all aspects of cortical lesion pathology and could potentially aid clinicians in diagnosing and monitoring MS, and progressive MS in particular. However, standardization of acquisition and segmentation protocols is needed.

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Gray matter network reorganization in multiple sclerosis from 7‐Tesla and 3‐Tesla MRI data

Annals of Clinical and Translational Neurology ◽

10.1002/acn3.51029 ◽

2020 ◽

Vol 7 (4) ◽

pp. 543-553

Author(s):

Gabriel Gonzalez‐Escamilla ◽

Dumitru Ciolac ◽

Silvia De Santis ◽

Angela Radetz ◽

Vinzenz Fleischer ◽

...

Keyword(s):

Multiple Sclerosis ◽

Gray Matter ◽

3 Tesla ◽

7 Tesla ◽

3 Tesla Mri ◽

Gray Matter Network

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Thalamic lesions in multiple sclerosis by 7T MRI: Clinical implications and relationship to cortical pathology

Multiple Sclerosis Journal ◽

10.1177/1352458514558134 ◽

2015 ◽

Vol 21 (9) ◽

pp. 1139-1150 ◽

Cited By ~ 34

Author(s):

Daniel M Harrison ◽

Jiwon Oh ◽

Snehashis Roy ◽

Emily T Wood ◽

Anna Whetstone ◽

...

Keyword(s):

Multiple Sclerosis ◽

White Matter ◽

Gray Matter ◽

Demographic Data ◽

Clinical Information ◽

7 Tesla ◽

Cortical Lesion ◽

Thalamic Lesion ◽

Cortical Lesions ◽

Thalamic Lesions

Objective: Pathology in both cortex and deep gray matter contribute to disability in multiple sclerosis (MS). We used the increased signal-to-noise ratio of 7-tesla (7T) MRI to visualize small lesions within the thalamus and to relate this to clinical information and cortical lesions. Methods: We obtained 7T MRI scans on 34 MS cases and 15 healthy volunteers. Thalamic lesion number and volume were related to demographic data, clinical disability measures, and lesions in cortical gray matter. Results: Thalamic lesions were found in 24/34 of MS cases. Two lesion subtypes were noted: discrete, ovoid lesions, and more diffuse lesional areas lining the periventricular surface. The number of thalamic lesions was greater in progressive MS compared to relapsing–remitting (mean ±SD, 10.7 ±0.7 vs. 3.0 ±0.7, respectively, p < 0.001). Thalamic lesion burden (count and volume) correlated with EDSS score and measures of cortical lesion burden, but not with white matter lesion burden or white matter volume. Conclusions: Using 7T MRI allows identification of thalamic lesions in MS, which are associated with disability, progressive disease, and cortical lesions. Thalamic lesion analysis may be a simpler, more rapid estimate of overall gray matter lesion burden in MS.

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