Imaging cortical multiple sclerosis lesions with ultra-high field MRI
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Imaging cortical multiple sclerosis lesions with ultra-high field MRI. / Madsen, Mads A.J.; Wiggermann, Vanessa; Bramow, Stephan; Christensen, Jeppe Romme; Sellebjerg, Finn; Siebner, Hartwig R.
In: NeuroImage: Clinical, Vol. 32, 102847, 2021.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Imaging cortical multiple sclerosis lesions with ultra-high field MRI
AU - Madsen, Mads A.J.
AU - Wiggermann, Vanessa
AU - Bramow, Stephan
AU - Christensen, Jeppe Romme
AU - Sellebjerg, Finn
AU - Siebner, Hartwig R.
N1 - Publisher Copyright: © 2021 The Author(s)
PY - 2021
Y1 - 2021
N2 - Background: Cortical lesions are abundant in multiple sclerosis (MS), yet difficult to visualize in vivo. Ultra-high field (UHF) MRI at 7 T 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 3 T and 7 T MRI and between 7 T MRI sequences, along with sensitivity of UHF MRI towards cortical lesions verified by histopathology. Results: 7 T MRI detected on average 52 ± 26% (mean ± 95% confidence interval) more cortical lesions than the best performing image contrast at 3 T, with the largest increase in type II-IV intracortical lesion detection. Across all studies, the mean cortical lesion number was 17 ± 6 per patient. In progressive MS cohorts, approximately four times more cortical lesions were reported than in CIS/early RRMS, and RRMS. Yet, there was no difference in lesion type ratio between these MS subtypes. Furthermore, 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 3 T MRI, particularly for type II-IV lesions. Despite modest sensitivity, 7 T 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.
AB - Background: Cortical lesions are abundant in multiple sclerosis (MS), yet difficult to visualize in vivo. Ultra-high field (UHF) MRI at 7 T 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 3 T and 7 T MRI and between 7 T MRI sequences, along with sensitivity of UHF MRI towards cortical lesions verified by histopathology. Results: 7 T MRI detected on average 52 ± 26% (mean ± 95% confidence interval) more cortical lesions than the best performing image contrast at 3 T, with the largest increase in type II-IV intracortical lesion detection. Across all studies, the mean cortical lesion number was 17 ± 6 per patient. In progressive MS cohorts, approximately four times more cortical lesions were reported than in CIS/early RRMS, and RRMS. Yet, there was no difference in lesion type ratio between these MS subtypes. Furthermore, 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 3 T MRI, particularly for type II-IV lesions. Despite modest sensitivity, 7 T 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.
KW - 7T MRI
KW - Cortical lesions
KW - Multiple sclerosis
KW - Systematic review
KW - Ultra-high field MRI
U2 - 10.1016/j.nicl.2021.102847
DO - 10.1016/j.nicl.2021.102847
M3 - Journal article
C2 - 34653837
AN - SCOPUS:85116907016
VL - 32
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
SN - 2213-1582
M1 - 102847
ER -
ID: 288201544