A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-Weighted White Matter to Gray Matter Signal Intensity Ratio

Martín, Allan; Leener, Benjamin De; Cohen‐Adad, Julien; Cadotte, David W.; Kalsi-Ryan, Sukhvinder; Lange, Stefan; Tetreault, Lindsay; Nouri, Aria; Crawley, Adrian; Mikulis, David J.; Ginsberg, Howard J.; Fehlings, Michael G.

doi:10.3174/ajnr.a5162

Cited by 67 publications

(62 citation statements)

References 40 publications

(64 reference statements)

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“…8,27-31 T2*WI WM/GM demonstrated low intersubject and test-retest variability, which are favorable statistical properties because they make it more likely that a subject with pathology will show abnormal results (confirmed by encouraging results reported in a companion article 20 ). CSA showed greater intersubject variation than other metrics, though this improved slightly following normalization with cervical cord length.…”

Section: Summary Of Findingssupporting

confidence: 51%

“…20 We propose a multiparametric approach to cervical SC quantitative MR imaging with clinically feasible methods, including acceptable acquisition times, standard hardware/pulse sequences, and automated image analysis. Our protocol yields 4 measures of SC tissue injury (CSA, FA, MT ratio [MTR], and T2*WI WM/GM), for which this study establishes normative values in numerous ROIs.…”

mentioning

confidence: 99%

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Clinically Feasible Microstructural MRI to Quantify Cervical Spinal Cord Tissue Injury Using DTI, MT, and T2*-Weighted Imaging: Assessment of Normative Data and Reliability

Martín¹,

Leener

Cohen‐Adad

et al. 2017

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: DTI, magnetization transfer, T2*-weighted imaging, and cross-sectional area can quantify aspects of spinal cord microstructure. However, clinical adoption remains elusive due to complex acquisitions, cumbersome analysis, limited reliability, and wide ranges of normal values. We propose a simple multiparametric protocol with automated analysis and report normative data, analysis of confounding variables, and reliability.

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Section: Summary Of Findingssupporting

confidence: 51%

mentioning

confidence: 99%

Clinically Feasible Microstructural MRI to Quantify Cervical Spinal Cord Tissue Injury Using DTI, MT, and T2*-Weighted Imaging: Assessment of Normative Data and Reliability

Martín¹,

Leener

Cohen‐Adad

et al. 2017

AJNR Am J Neuroradiol

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“…22 Voxel size = 0.5 × 0.5 × 5mm 3 , FOV = 180 × 180mm 2 , TR = 500 milliseconds, effective TE = 22 milliseconds, flip angle = 30 ; 7 slices were acquired. A sagittal 3-dimensional (3D) T2-weighted fast spin-echo "SPACE" sequence was used for vertebral level identification with slab selective excitation, voxel size = 0.8 × 0.8 × 0.8mm 3 , field of view (FOV) = 256 × 256mm 2 , 72 sagittal slices, repetition time (TR) = 1,500 milliseconds, echo time (TE) = 131 milliseconds, acceleration factor R = 2.…”

Section: Cervical Sc Acquisition Protocolmentioning

confidence: 99%

“…Images were first visually inspected for incidental findings and underwent quality control. 22 DTI images were coregistered to the MNI-Poly-AMU template. The sagittal 3D T2-weighted volume was automatically segmented using PropSeg 30 and nonlinearly registered to the MNI-Poly-AMU template 31 to provide automated vertebral labeling for each subject's scan.…”

Section: Sc Mri Data Processingmentioning

confidence: 99%

“…[14][15][16][17][18] Recent studies indicate that widespread cortical and subcortical abnormalities can be detected in asymptomatic C9orf72 carriers younger than 40 years. In recent years, spinal imaging has seen momentous developments, and the combination of novel biomarkers 22 and analysis pipelines 23 allows the quantitative characterization of disease-associated gray and WM profiles, captures progressive changes, and may have a role in diagnostic applications. 20 Cervical SC magnetic resonance spectroscopy in asymptomatic SOD1 carriers reveals a similar neurometabolic profile compared to symptomatic ALS patients, namely reduced N-acetylaspartate (NAA)/Cr and NAA/Myo ratios.…”

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Presymptomatic spinal cord pathology in c9orf72 mutation carriers: A longitudinal neuroimaging study

Querin

Bede

Mendili

et al. 2019

Annals of Neurology

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Objective: C9orf72 hexanucleotide repeats expansions account for almost half of familial amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) cases. Recent imaging studies in asymptomatic C9orf72 carriers have demonstrated cerebral white (WM) and gray matter (GM) degeneration before the age of 40 years. The objective of this study was to characterize cervical spinal cord (SC) changes in asymptomatic C9orf72 hexanucleotide carriers. Methods: Seventy-two asymptomatic individuals were enrolled in a prospective study of first-degree relatives of ALS and FTD patients carrying the c9orf72 hexanucleotide expansion. Forty of them carried the pathogenic mutation (C9 + ). Each subject underwent quantitative cervical cord imaging. Structural GM and WM metrics and diffusivity parameters were evaluated at baseline and 18 months later. Data were analyzed in C9 + and C9 − subgroups, and C9 + subjects were further stratified by age. Results: At baseline, significant WM atrophy was detected at each cervical vertebral level in C9 + subjects older than 40 years without associated changes in GM and diffusion tensor imaging parameters. At 18-month follow-up, WM atrophy was accompanied by significant corticospinal tract (CST) fractional anisotropy (FA) reductions. Intriguingly, asymptomatic C9 + subjects older than 40 years with family history of ALS (as opposed to FTD) also exhibited significant CST FA reduction at baseline. View this article online at wileyonlinelibrary.com.Additional supporting information can be found in the online version of this article.

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Utility of Advanced DWI in the Detection of Spinal Cord Microstructural Alterations and Assessment of Neurologic Function in Cervical Spondylotic Myelopathy Patients

Zhang

Ouyang

Liu

et al. 2021

Magnetic Resonance Imaging

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Background Diffusion‐weighted imaging (DWI) can quantify the microstructural changes in the spinal cord. It might be a substitute for T2 increased signal intensity (ISI) for cervical spondylotic myelopathy (CSM) evaluation and prognosis. Purpose The purpose of the study is to investigate the relationship between DWI metrics and neurologic function of patients with CSM. Study Type Retrospective. Population Forty‐eight patients with CSM (18.8% females) and 36 healthy controls (HCs, 25.0% females). Field Strength/Sequence 3 T; spin‐echo echo‐planar imaging‐DWI; turbo spin‐echo T1/T2; multi‐echo gradient echo T2*. Assessment For patients, conventional MRI indicators (presence and grades of T2 ISI), DWI indicators (neurite orientation dispersion and density imaging [NODDI]‐derived isotropic volume fraction [ISOVF], intracellular volume fraction, and orientation dispersion index [ODI], diffusion tensor imaging [DTI]‐derived fractional anisotropy [FA] and mean diffusivity [MD], and diffusion kurtosis imaging [DKI]‐derived FA, MD, and mean kurtosis), clinical conditions, and modified Japanese Orthopaedic Association (mJOA) were recorded before the surgery. Neurologic function improvement was measured by the 3‐month follow‐up recovery rate (RR). For HCs, DWI, and mJOA were measured as baseline comparison. Statistical Tests Continuous (categorical) variables were compared between patients and HCs using Student's t‐tests or Mann–Whitney U tests (chi‐square or Fisher exact tests). The relationships between DWI metrics/conventional MRI findings, and the pre‐operative mJOA/RR were assessed using correlation and multivariate analysis. P < 0.05 was considered statistically significant. Results Among patients, grades of T2 ISI were not correlated with pre‐surgical mJOA/RR (P = 0.717 and 0.175, respectively). NODDI ODI correlated with pre‐operative mJOA (r = −0.31). DTI FA, DKI FA, and NODDI ISOVF were correlated with the recovery rate (r = 0.31, 0.41, and −0.34, respectively). In multivariate analysis, NODDI ODI (DTI FA, DKI FA, NODDI ISOVF) significantly contributed to the pre‐operative mJOA (RR) after adjusting for age. Data Conclusion DTI FA, DKI FA, and NODDI ISOVF are predictors for prognosis in patients with CSM. NODDI ODI can be used to evaluate CSM severity. Level of Evidence 3 Technical Efficacy Stage 5

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A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-Weighted White Matter to Gray Matter Signal Intensity Ratio

Cited by 67 publications

References 40 publications

Clinically Feasible Microstructural MRI to Quantify Cervical Spinal Cord Tissue Injury Using DTI, MT, and T2*-Weighted Imaging: Assessment of Normative Data and Reliability

Clinically Feasible Microstructural MRI to Quantify Cervical Spinal Cord Tissue Injury Using DTI, MT, and T2*-Weighted Imaging: Assessment of Normative Data and Reliability

Presymptomatic spinal cord pathology in c9orf72 mutation carriers: A longitudinal neuroimaging study

Utility of Advanced DWI in the Detection of Spinal Cord Microstructural Alterations and Assessment of Neurologic Function in Cervical Spondylotic Myelopathy Patients

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