Quantitative susceptibility mapping captures chronic multiple sclerosis rim lesions with greater myelin damage: Comparison with high-pass filtered phase MRI

Background Chronic active MS lesions with paramagnetic rim can be identified by high-pass filtered (HPF) phase imaging or quantitative susceptibility mapping (QSM). Purpose The objective was to compare the ability of HPF and QSM to identify MS lesions with greater myelin damage and to distinguish MS patients with increased clinical disability. Material and Methods Eighty-six patients were scanned with gradient echo sequence for lesion rim detection and FAST-T2 sequence for myelin water fraction (MWF) mapping. Chronic lesions were classified based on the presence/absence of rim on HPF and QSM images (HPF rim+/QSM rim+, HPF rim+/QSM rim-, HPF rim-/QSM rim+, HPF rim-/QSM rim-). A lesion-level linear mixed-effects model with MWF as outcome was used to compare myelin damage among the lesion groups. A multivariate patient-level linear regression model was fit to establish the association between Expanded Disease Status Scale (EDSS) and the number of rim lesions (zero vs. one or more). Results Of 2229 lesions, 96 (8.8%) were HPF rim+/QSM rim+, 211 (9.5%) were HPF rim+/QSM rim-, and the remainder had no rim. Adjusting for other factors, HPF rim+/QSM rim+ lesions had on average significantly lower MWF than both HPF rim+/QSM rim- (p<0.001) and HPF rim-/QSM rim- (p<0.001) lesions, while the MWF difference between HPF rim+/QSM rim- and HPF rim-/QSM rim- lesions was not statistically significant (p=0.309). Having at least one QSM rim+ lesion was associated with an increase in EDSS compared to having no QSM rim+ lesions, holding all other factors constant (p=0.026). The relationship between having one or more HPF rim+ lesions vs. having no HPF rim+ lesions and EDSS was not statistically significant. Conclusion QSM identifies chronic MS lesions with paramagnetic rim that on average have greater myelin damage. QSM may be a valuable tool for studying the impact of rim lesions on clinical disability in MS.

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Combining Quantitative Susceptibility Mapping with Automatic Zero Reference (QSM0) and Myelin Water Fraction Imaging to Quantify Iron-Related Myelin Damage in Chronic Active MS Lesions

American Journal of Neuroradiology ◽

10.3174/ajnr.a5482 ◽

2017 ◽

Vol 39 (2) ◽

pp. 303-310 ◽

Cited By ~ 8

Author(s):

Y. Yao ◽

T.D. Nguyen ◽

S. Pandya ◽

Y. Zhang ◽

S. Hurtado Rúa ◽

...

Keyword(s):

Susceptibility Mapping ◽

Quantitative Susceptibility Mapping ◽

Water Fraction ◽

Myelin Water Fraction ◽

Zero Reference ◽

Myelin Damage

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A comparison of phase imaging and quantitative susceptibility mapping in the imaging of multiple sclerosis lesions at ultrahigh field

Magnetic Resonance Materials in Physics Biology and Medicine ◽

10.1007/s10334-016-0560-5 ◽

2016 ◽

Vol 29 (3) ◽

pp. 543-557 ◽

Cited By ~ 21

Author(s):

Matthew John Cronin ◽

Samuel Wharton ◽

Ali Al-Radaideh ◽

Cris Constantinescu ◽

Nikos Evangelou ◽

...

Keyword(s):

Multiple Sclerosis ◽

Susceptibility Mapping ◽

Phase Imaging ◽

Quantitative Susceptibility Mapping ◽

Ultrahigh Field

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Multiple sclerosis lesion geometry in quantitative susceptibility mapping (QSM) and phase imaging

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.24745 ◽

2014 ◽

Vol 42 (1) ◽

pp. 224-229 ◽

Cited By ~ 26

Author(s):

Sarah Eskreis-Winkler ◽

Kofi Deh ◽

Ajay Gupta ◽

Tian Liu ◽

Cynthia Wisnieff ◽

...

Keyword(s):

Multiple Sclerosis ◽

Susceptibility Mapping ◽

Multiple Sclerosis Lesion ◽

Phase Imaging ◽

Quantitative Susceptibility Mapping

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The impact of white matter fiber orientation in single-acquisition quantitative susceptibility mapping

NMR in Biomedicine ◽

10.1002/nbm.3798 ◽

2017 ◽

Vol 30 (11) ◽

pp. e3798 ◽

Cited By ~ 13

Author(s):

Marta Lancione ◽

Michela Tosetti ◽

Graziella Donatelli ◽

Mirco Cosottini ◽

Mauro Costagli

Keyword(s):

White Matter ◽

Fiber Orientation ◽

Susceptibility Mapping ◽

Quantitative Susceptibility Mapping ◽

The Impact

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Disease Correlates of Rim Lesions on Quantitative Susceptibility Mapping in Multiple Sclerosis

10.21203/rs.3.rs-1041443/v1 ◽

2021 ◽

Author(s):

Melanie Marcille ◽

Sandra Hurtado Rúa ◽

Charles Tyshkov ◽

Abhishek Jaywant ◽

Joseph Comunale ◽

...

Keyword(s):

Multiple Sclerosis ◽

Regression Model ◽

Verbal Learning ◽

Susceptibility Mapping ◽

California Verbal Learning Test ◽

Quantitative Susceptibility Mapping ◽

Cognitive Assessments ◽

Learning Test ◽

Multiple Sclerosis Patients ◽

The Impact

Abstract Quantitative susceptibility mapping (QSM), an imaging technique sensitive to brain iron, has been used to detect paramagnetic rims of iron-laden active microglia and macrophages in a subset of multiple sclerosis (MS) lesions, known as rim+ lesions, and are consistent with chronic active lesions. Because of their potential impact on disease progression and tissue damage, investigating the influence of rim+ lesions on disability and neurodegeneration is critical to establish the impact of these lesions on the disease course. This study aimed to explore the relationship between chronic active rim+ lesions, identified as having a hyperintense rim on QSM, and both clinical disability and imaging measures of neurodegeneration in patients with MS. The patient cohort was composed of 159 relapsing-remitting multiple sclerosis patients. The Expanded Disability Status Scale (EDSS) and Brief International Cognitive Assessment for Multiple Sclerosis, which includes both the Symbol Digit Modalities Test and California Verbal Learning Test-II, were used to assess clinical disability. Cortical thickness and thalamic volume were evaluated as imaging measures of neurodegeneration. A total of 4,469 MS lesions were identified, of which 171 QSM rim+ (3.8%) lesions were identified among 57 patients (35.8%). In a multivariate regression model, as the overall total lesion burden increased, patients with at least one rim+ lesion on QSM performed worse on both physical disability and cognitive assessments, specifically the Symbol Digit Modalities Test (p=0.010), California Verbal Learning Test-II (p=0.030), and EDSS (p=0.001). In a separate univariate regression model, controlling for age (p<0.001), having at least one rim+ lesion was related to more cortical thinning (p= 0.03) in younger patients (< 45 years). Lower thalamic volume was associated with older patients (p=0.038) and larger total lesion burden (p<0.001); however, the association did not remain significant with rim+ lesions (p=0.10). Our findings demonstrate a novel observation that chronic active lesions, as identified on QSM, modify the impact of lesion burden on clinical disability in MS patients. These results support further exploration of rim+ lesions for therapeutic targeting in MS to reduce disability and subsequent neurodegeneration.

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