Consensus recommendations for MS cortical lesion scoring using double inversion recovery MRI

Geurts, Jeroen J. G.; Roosendaal, Stefan D.; Calabrese, Massimiliano; Ciccarelli, Olga; Agosta, Federica; Chard, Declan; Gass, Achim; Huerga, Elena Charro; Moraal, Bastiaan; Pareto, Deborah; Rocca, Maria A.; Wattjes, Mike P.; Yousry, Tarek; Uitdehaag, B. M. J.; Barkhof, Frederik

doi:10.1212/wnl.0b013e31820a0cc4

Cited by 258 publications

(275 citation statements)

References 20 publications

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“…29,30 Conventional-strength MRI (#3T) is relatively insensitive in detecting subpial demyelination and almost exclusively identifies leukocortical (type I) lesions. 8,31 Alternatively, optimized T2* sequences at 7T MRI demonstrate the ability to detect all neuropathologically defined CL types in vivo with similar frequency, and ex vivo validation has shown excellent retrospective sensitivity of 93% for cortical demyelination at 7T. 9,28 Among our cohort, several measures of cognitive performance were significantly associated with global WMLV and type I CL counts.…”

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confidence: 76%

Contribution of cortical lesion subtypes at 7T MRI to physical and cognitive performance in MS

et al. 2013

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Objectives: Evaluate cross-sectionally the contribution of focal cortical lesion (CL) subtypes at ultra-high-field MRI and traditional MRI metrics of brain damage to neurologic disability and cognitive performance in a heterogeneous multiple sclerosis (MS) cohort.Methods: Thirty-four patients with early or established disease including clinically isolated syndrome, relapsing-remitting MS, and secondary progressive MS were scanned on a human 7-tesla (7T) (Siemens) scanner to acquire fast low-angle shot (FLASH) T2*-weighted images for characterization of white matter and deep gray matter lesion volume, and CL types. Patients also underwent anatomical 3T MRI for cortical thickness estimation, and neuropsychological testing within 1 week of the 7T scan. Twenty-seven patient scans were acceptable for further analysis. Neurologic disability was measured using the Expanded Disability Status Scale.Results: Type III-IV CLs had the strongest relationship to physical disability (r 5 0.670, p , 0.0001).White matter lesion volume and type I CLs are each significantly associated with 6 of 11 neuropsychological test variables. Type III-IV CLs significantly correlate with 4 of 11 neuropsychological test variables whereas type II CLs, deep gray matter lesion volume, and cortical thickness metrics are less frequently associated with cognitive performance. Cognitive dysfunction is a common but frequently overlooked clinical manifestation of multiple sclerosis (MS). 1 Frequently affected cognitive domains include executive function, processing speed, and memory. 2 Cognitive impairment in MS deleteriously affects social and vocational activities, may result in unemployment, and appears to lead to an increased vulnerability to psychiatric illness. 3 Despite the impact of cognitive dysfunction in MS, our understanding of its pathophysiology is limited. Conclusions: Leukocortical (type I) and subpial (III-IV) CLs identified on 7T FLASH-T2Conventional and quantitative MRI have identified potential biomarkers and better defined the pathophysiology of cognitive dysfunction in MS. 4 To date, global rather than regional metrics of cortical atrophy and cortical lesion (CL) volume using double inversion recovery (DIR) sequences at 3 tesla (3T) better account for the variance seen in cognitive performance in MS-supplanting conventional white matter (WM) MRI metrics. 5,6 These findings are not entirely unexpected because MS neuropathology has highlighted the cortex as a major location of demyelination. 7 Although 3T DIR is an innovative improvement over conventional imaging

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confidence: 76%

Contribution of cortical lesion subtypes at 7T MRI to physical and cognitive performance in MS

et al. 2013

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“…Regions of interest (ROIs) were determined according to the Aparc atlas as implemented in FreeSurfer,33 and corresponded to the available tissue blocks from the 5 left hemispheric ROIs of the inferior frontal gyrus, superior frontal gyrus, anterior cingulate gyrus, inferior parietal gyrus, and superior temporal gyrus. Tissue blocks were excluded if they contained macroscopic MS lesions or MS lesions visible in the double inversion recovery sequence 34. Hence, only normal‐appearing GM was sampled as part of the standardized autopsy procedure.…”

Section: Methodsmentioning

confidence: 99%

Cortical pathology in multiple sclerosis detected by the T1/T2‐weighted ratio from routine magnetic resonance imaging

Righart

Biberacher

Jonkman

et al. 2017

Annals of Neurology

105

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ObjectiveIn multiple sclerosis, neuropathological studies have shown widespread changes in the cerebral cortex. In vivo imaging is critical, because the histopathological substrate of most measurements is unknown.MethodsUsing a novel magnetic resonance imaging analysis technique, based on the ratio of T1‐ and T2‐weighted signal intensities, we studied the cerebral cortex of a large cohort of patients in early stages of multiple sclerosis. A total of 168 patients with clinically isolated syndrome or relapsing–remitting multiple sclerosis (Expanded Disability Status Scale: median = 1, range = 0–3.5) and 80 age‐ and sex‐matched healthy controls were investigated. We also searched for the histopathological substrate of the T1/T2‐weighted ratio by combining postmortem imaging and histopathology in 9 multiple sclerosis brain donors.ResultsPatients showed lower T1/T2‐weighted ratio values in parietal and occipital areas. The 4 most significant clusters appeared in the medial occipital and posterior cingulate cortex (each left and right). The decrease of the T1/T2‐weighted ratio in the posterior cingulate was related to performance in attention. Analysis of the T1/T2‐weighted ratio values of postmortem imaging yielded a strong correlation with dendrite density but none of the other parameters including myelin.InterpretationThe T1/T2‐weighted ratio decreases in early stages of multiple sclerosis in a widespread manner, with a preponderance of posterior areas and with a contribution to attentional performance; it seems to reflect dendrite pathology. As the method is broadly available and applicable to available clinical scans, we believe that it is a promising candidate for studying and monitoring cortical pathology or therapeutic effects in multiple sclerosis. Ann Neurol 2017;82:519–529

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“…[121][122][123][124][125][126] Several MRI techniques, including double inversion recovery and phase sensitive inversion recovery, have been used to detect, score and interpret cortical grey matter lesions, but these applica tions lack standardization. [127][128][129] Advanced, quanti tative imaging techniques may also acquire a central role for evaluating the course of MS pathology in the near future. Standardization of these methods, particularly in multicentre settings, will be a challenge.…”

Section: Future Perspectivesmentioning

confidence: 99%

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

2015

Nat Rev Neurol

394

132

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Consensus recommendations for MS cortical lesion scoring using double inversion recovery MRI

Cited by 258 publications

References 20 publications

Contribution of cortical lesion subtypes at 7T MRI to physical and cognitive performance in MS

Contribution of cortical lesion subtypes at 7T MRI to physical and cognitive performance in MS

Cortical pathology in multiple sclerosis detected by the T1/T2‐weighted ratio from routine magnetic resonance imaging

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

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