Inversion Recovery Ultrashort TE MR Imaging of Myelin is Significantly Correlated with Disability in Patients with Multiple Sclerosis

Jang, Hyungseok; Ma, Yajun; Chang, Eric Y.; Dehkordy, Soudabeh Fazeli; Lee, Roland R.; Lombardi, Alecio; Bydder, Graeme M.; Corey–Bloom, Jody; Du, Jiang

doi:10.3174/ajnr.a7006

Cited by 14 publications

(13 citation statements)

References 33 publications

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“…With the introduction of UTE MRI sequences, which have 100–1000 times shorter echo times than conventional sequences, myelin and its specific changes of demyelination and remyelination can potentially be visualized directly ( Horch et al, 2011 ; Wilhelm et al, 2012 ; Du et al, 2014a ; Boucneau et al, 2018 ; Jang et al, 2021 ; Mueller et al, 2022 ). The 3D IR-UTE Cones sequence allows high-contrast volumetric myelin imaging in MS patients.…”

Section: Discussionmentioning

confidence: 99%

“…With rapidly increasing developments in the field of MRI, it is favorable to establish sequences that allow direct visualization of myelin. As myelin has very short T2* values of less than 1 msec ( Horch et al, 2011 ; Wilhelm et al, 2012 ; Du et al, 2014a ; Boucneau et al, 2018 ; Ma et al, 2020a , b ; Jang et al, 2021 ; Mueller et al, 2022 ), the changes seen on clinical T1- or T2-weighted images are not specific to myelin, as they only depict longer T2 components. With the introduction of ultrashort echo time (UTE) MRI sequences, which have 100–1000 times shorter echo times than conventional sequences, myelin can potentially be visualized directly ( Horch et al, 2011 ; Wilhelm et al, 2012 ; Ma et al, 2020b ).…”

Section: Introductionmentioning

confidence: 99%

“…In MS disease pathology, demyelination and remyelination mainly occur in parallel within the same lesion ( Filippi et al, 2019 ). Many studies investigated correlations between pathological changes on MRI and disability in patients with Jang et al (2021) found a moderate correlation between the IR-UTE signal in the normal-appearing white matter (NAWM) and the EDSS ( Jang et al, 2021 ). Other authors showed that correlations could also be found on standard clinical MRI sequences.…”

Section: Introductionmentioning

confidence: 99%

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The signal intensity variation of multiple sclerosis (MS) lesions on magnetic resonance imaging (MRI) as a potential biomarker for patients’ disability: A feasibility study

et al. 2023

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IntroductionAlthough many lesion-based MRI biomarkers in multiple sclerosis (MS) patients were investigated, none of the previous studies dealt with the signal intensity variations (SIVs) of MS lesions. In this study, the SIVs of MS lesions on direct myelin imaging and standard clinical sequences as possible MRI biomarkers for disability in MS patients were assessed.MethodsTwenty seven MS patients were included in this prospective study. IR-UTE, FLAIR, and MPRAGE sequences were employed on a 3T scanner. Regions of interest (ROIs) were manually drawn within the MS lesions, and the cerebrospinal fluid (CSF) and signal intensity ratios (SIR) were calculated from the derived values. Variations coefficients were determined from the standard deviations (Coeff 1) and the absolute differences (Coeff 2) of the SIRs. Disability grade was assessed by the expanded disability status scale (EDSS). Cortical/gray matter, subcortical, infratentorial, and spinal lesions were excluded.ResultsThe mean diameter of the lesions was 7.8 ± 1.97 mm, while the mean EDSS score was 4.5 ± 1.73. We found moderate correlations between the EDSS and Coeff 1 and 2 on IR-UTE and MPRAGE images. Accordingly, Pearson’s correlations on IR-UTE were R = 0.51 (p = 0.007) and R = 0.49 (p = 0.01) for Coeff 1 and 2, respectively. For MPRAGE, Pearson’s correlations were R = 0.5 (p = 0.008) and R = 0.48 (p = 0.012) for Coeff 1 and 2, respectively. For FLAIR, only poor correlations could be found.ConclusionThe SIVs of MS lesions on IR-UTE and MPRAGE images, assessed by Coeff 1 and 2, could be used as novel potential MRI biomarkers for patients’ disability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The signal intensity variation of multiple sclerosis (MS) lesions on magnetic resonance imaging (MRI) as a potential biomarker for patients’ disability: A feasibility study

et al. 2023

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“…14 While conventional MRI sequences are highly effective in detecting focal macroscopic brain tissue abnormalities, they may not correlate well with patients' neurologic deficits. 15,16 Correlations between a patient's clinical status and white matter (WM) lesion load remain modest; however, there is a stronger correlation between GM lesions, especially cortical lesions (CLs), and disease burden and brain atrophy. CLs are more difficult to visualize than WM lesions because of the lower myelin content in the cortex.…”

Section: Msmentioning

confidence: 99%

Autoimmune diseases of the brain, imaging and clinical review

et al. 2021

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There is an extensive spectrum of autoimmune entities that can involve the central nervous system, which has expanded with the emergence of new imaging modalities and several clinicopathologic entities. Clinical presentation is usually non-specific, and imaging has a critical role in the workup of these diseases. Immune-mediated diseases of the brain are not common in daily practice for radiologists and, except for a few of them such as multiple sclerosis, there is a vague understanding about differentiating them from each other based on the radiological findings. In this review, we aim to provide a practical diagnostic approach based on the unique radiological findings for each disease. We hope our diagnostic approach will help radiologists expand their basic understanding of the discussed disease entities and narrow the differential diagnosis in specific clinical scenarios. An understanding of unique imaging features of these disorders, along with laboratory evaluation, may enable clinicians to decrease the need for tissue biopsy.

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“…UTE MRI achieves significantly shortened TEs (on the order of microseconds) that can capture rapidly decaying signal from tissues with short T 2 relaxation times by utilizing a short radiofrequency (RF) pulse and rapid center-out non-Cartesian encoding schemes. UTE MRI has been evaluated in many preclinical applications and shown its efficacy in the imaging of short T 2 tissues such as tendon ( 10 ), ligament ( 11 ), meniscus ( 12 ), bone ( 13 ), the osteochondral junction ( 14 , 15 ), and myelin lipid ( 16 , 17 ). Advanced, quantitative UTE techniques based on different MRI-based parameters have also been investigated to provide more sensitive assessment.…”

Section: Introductionmentioning

confidence: 99%

Detection of iron oxide nanoparticle (IONP)-labeled stem cells using quantitative ultrashort echo time imaging: a feasibility study

Athertya¹,

Akers²,

Sedaghat³

et al. 2023

Quant Imaging Med Surg

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Background: In this study, we investigated the feasibility of quantitative ultrashort echo time (qUTE) magnetic resonance (MR) imaging techniques in the detection and quantification of iron oxide nanoparticle (IONP)-labeled stem cells.Methods: A stem cell phantom containing multiple layers of unlabeled or labeled stem cells with different densities was prepared. The phantom was imaged with quantitative UTE (qUTE) MR techniques [i.e., UTE-T 1 mapping, UTE-T 2 * mapping, and UTE-based quantitative susceptibility mapping (UTE-QSM)] as well as with a clinical T 2 mapping sequence on a 3T clinical MR system. For T 1 mapping, a variable flip angle (VFA) method based on actual flip angle imaging (AFI) technique was utilized. For T 2 * mapping and UTE-QSM, multiple images with variable, interleaved echo times including UTE images and gradient recalled echo (GRE) images were used. For UTE-QSM, the phase information from the multi-echo images was utilized and processed using a QSM framework based on the morphology-enabled dipole inversion (MEDI) algorithm. The qUTE techniques were also evaluated in an ex vivo experiment with a mouse injected with IONP-labeled stem cells.Results: In the phantom experiment, the parameters estimated with qUTE techniques showed high linearity with respect to the density of IONP-labeled stem cells (R 2 >0.99), while the clinical T 2 parameter showed impaired linearity (R 2 =0.87). In the ex vivo mouse experiment, UTE-T 2 * mapping and UTE-QSM showed feasibility in the detection of injected stem cells with high contrast, whereas UTE-T 1 and UTE-T 2 * showed limited detection. Overall, UTE-QSM demonstrated the best contrast of all, with other methods being subjected more to a confounding factor due to different magnetic susceptibilities of various types of neighboring tissues, which creates inhomogeneous contrast that behaves similar to IONP. Conclusions:In this study, we evaluated the feasibility of a series of qUTE imaging techniques as well as conventional T 2 mapping for the detection of IONP-labeled stem cells in vitro and ex vivo. UTE-QSM performed superior amongst other qUTE techniques as well as conventional T 2 mapping in detecting stem cells with high contrast.

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Inversion Recovery Ultrashort TE MR Imaging of Myelin is Significantly Correlated with Disability in Patients with Multiple Sclerosis

Cited by 14 publications

References 33 publications

The signal intensity variation of multiple sclerosis (MS) lesions on magnetic resonance imaging (MRI) as a potential biomarker for patients’ disability: A feasibility study

The signal intensity variation of multiple sclerosis (MS) lesions on magnetic resonance imaging (MRI) as a potential biomarker for patients’ disability: A feasibility study

Autoimmune diseases of the brain, imaging and clinical review

Detection of iron oxide nanoparticle (IONP)-labeled stem cells using quantitative ultrashort echo time imaging: a feasibility study

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