Exploration of New Contrasts, Targets, and MR Imaging and Spectroscopy Techniques for Neuromuscular Disease – A Workshop Report of Working Group 3 of the Biomedicine and Molecular Biosciences COST Action BM1304 MYO-MRI

Abstract

Neuromuscular diseases are characterized by progressive muscle degeneration and muscle weakness resulting in functional disabilities. While each of these diseases is individually rare, they are common as a group, and a large majority lacks effective treatment with fully market approved drugs. Magnetic resonance imaging and spectroscopy techniques (MRI and MRS) are showing increasing promise as an outcome measure in clinical trials for these diseases. In 2013, the European Union funded the COST (co-operation in science and technology) action BM1304 called MYO-MRI ( www.myo-mri.eu ), with the overall aim to advance novel MRI and MRS techniques for both diagnosis and quantitative monitoring of neuromuscular diseases through sharing of expertise and data, joint development of protocols, opportunities for young researchers and creation of an online atlas of muscle MRI and MRS . In this report, the topics that were discussed in the framework of working group 3, which had the objective to: Explore new contrasts, new targets and new imaging techniques for NMD are described. The report is written by the scientists who attended the meetings and presented their data. An overview is given on the different contrasts that MRI can generate and their application, clinical needs and desired readouts, and emerging methods.

Fat–water separation by fast metabolite cycling magnetic resonance spectroscopic imaging at 3 T: A method to generate separate quantitative distribution maps of musculoskeletal lipid components

“…A summary of the latest MRI/S methods for neuromuscular disease monitoring has recently been published . Within this publication, the importance of advancing quantitative MR‐based fat‐mapping techniques was emphasized.…”

Musculoskeletal fat imaging and quantification by high-resolution metabolite cycling magnetic resonance spectroscopic imaging at 3 T: A fast method to generate separate distribution maps of lipid components

“…A summary of the latest MRI/S methods for neuromuscular disease monitoring has been recently published. 66 Within this publication, the importance of advancing fat quantification techniques was emphasized. We think that our proposed technique would help the field by providing a different approach to assess fat infiltration diseases.…”

Quantitative MR-Bildgebung zur Charakterisierung der Skelettmuskulatur

“…Ein neues Gebiet der Muskelbildgebung ist Natrium-MRT ( 23 Na-MRT), ein Verfahren zur Bestimmung der Salzkonzentration eines Gewebes. Mit Natrium-MRT kann daher die starke Erhöhung der Salzkonzentration, die durch die Vergrößerung des extrazellulären Volumens infolge einer Muskeldegeneration verursacht wird, quantifiziert werden [5]. Zusätzlich kann eine Erhöhung intrazellulären Natriums, die mit einem Verlust von Muskelfunktion einhergeht, visualisiert werden [97].…”

“…However, a more precise characterization of muscle quality should remedy this shortcoming. Appropriate methods are available with CT and MRI, but these must now be used in studies on age-related muscle degeneration, in intervention studies and in studies on fracture risk assessment Einleitung Neben der traditionellen Rolle der Bildgebung für Diagnose und Verlaufskontrolle von neuromuskulären Muskelerkrankungen [1][2][3][4][5] ist die Bestimmung von ‚Muskelqualität' auch bei Herz-, Lungen-und Nierenerkrankungen, bei Kachexie und Sarkopenie und bei Fehlernährung, Inaktivität, Verbrennungen und Unfällen relevant [6]. Darüber hinaus werden zunehmend vor allem altersassoziierte chronisch entzündliche Prozesse als eine Ursache von Muskelverfettung betrachtet [7][8][9][10].…”