Phase White Matter Signal Abnormalities in Patients with Clinically Isolated Syndrome and Other Neurologic Disorders

Hagemeier, Jesper; Heininen-Brown, Mari; Gabelić, Tereza; Guttuso, Thomas; Silvestri, Nicholas J.; Lichter, David; Fugoso, L.E.; Bergsland, Niels; Carl, Ellen; Geurts, Jeroen J. G.; Weinstock‐Guttman, Bianca; Zivadinov, Robert

doi:10.3174/ajnr.a3969

Cited by 11 publications

(10 citation statements)

References 37 publications

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“…60 White matter signal abnormalities on SWI also tend to be more predictive of conversion to clinically definite MS than are T2 lesions, and venocentric and hypointense rim lesions are specific findings that are useful for differentiating patients with CIS or MS from those with other neurological disorders. 42,48,61 Future studies should investigate whether these findings further improve the specificity of MRI diagnosis of MS.…”

Section: Differential Diagnosis Via Detection Of Iron and Veinsmentioning

confidence: 99%

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

et al. 2015

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| The clinical use of MRI in patients with multiple sclerosis (MS) has advanced markedly over the past few years. Technical improvements and continuously emerging data from clinical trials and observational studies have contributed to the enhanced performance of this tool for achieving a prompt diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal experience of the members of the MAGNIMS (Magnetic Resonance Imaging in MS) network. We address the indications, timing, coverage, reporting and interpretation of MRI studies in patients with suspected MS. Our recommendations are intended to help radiologists and neurologists standardize and optimize the use of MRI in clinical practice for the diagnosis of MS.

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Section: Differential Diagnosis Via Detection Of Iron and Veinsmentioning

confidence: 99%

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

et al. 2015

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“…In a recent study in patients with clinically isolated syndrome who converted to clinically definite MS within a 3-year follow-up period versus those who did not, converters had significantly (p = 0.008) more phase lesions, but not T2WM or T1WM lesions; although the phase contrast could have been influenced by demyelination or other factors, the predictive value of phase lesions could imply a role in early disease pathology [Hagemeier et al 2014]. These findings are in line with observations that phase contrast observed in MS WM lesions is dynamic and may be visible at early disease onset [Yablonskiy et al 2012;Chen et al 2014].…”

Section: Discussionmentioning

confidence: 99%

“…An overview of the SWI processing, lesion analysis method, and reproducibility results used in the present study is discussed elsewhere [Hagemeier et al 2012b[Hagemeier et al , 2014. Each subject's images and WM lesion maps were coregistered with functional MRI of the brain's linear image registration tool (FLIRT) using 6 degrees of freedom (rigid body) [Jenkinson and Smith, 2011].…”

Section: Mri Assessmentsmentioning

confidence: 99%

“…Classification of phase WM lesions was performed using a manual region-of-interest approach that was previously shown to be reproducible [Hagemeier et al 2012b[Hagemeier et al , 2014. WM lesions were identified separately on T2/PD/FLAIR, T1WI, and SWI-filtered phase maps in a blinded manner without a priori knowledge of where the WM lesions were located with respect to the other modality.…”

Section: Mri Assessmentsmentioning

confidence: 99%

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A pilot, longitudinal, 24-week study to evaluate the effect of interferon beta-1a subcutaneous on changes in susceptibility-weighted imaging-filtered phase assessment of lesions and subcortical deep-gray matter in relapsing–remitting multiple sclerosis

Zivadinov

Dwyer

Marković-Pleše

et al. 2015

Ther Adv Neurol Disord

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Background: Studies have shown a relationship between increased iron content and clinical progression, cognitive impairment, and brain atrophy in patients with multiple sclerosis. Altered phase, as determined by susceptibility-weighted imaging (SWI), can potentially capture iron content changes. Objective: The objective of this study was to investigate phase changes in white matter (WM) lesions and subcortical deep-gray matter (SDGM) of patients with relapsing-remitting (RR) MS treated with interferon beta-1a administered subcutaneously versus untreated healthy controls (HCs). Methods: We conducted a 24-week, nonrandomized, open-label pilot study of 23 patients with RRMS receiving interferon beta-1a administered subcutaneously and 15 HCs. Patients were imaged on a 3T scanner at baseline, 12, and 24 weeks; changes in phase behavior in WM lesions and regional SDGM [mean phase of low-phase voxels (MP-LPV)], and in SDGM volumes, were measured. Between-and within-group changes were tested using nonparametric statistics adjusted for multiple comparisons. Results: The number (p = 0.003) and volume (p < 0.001) of phase WM lesions both significantly decreased among RRMS patients over 24 weeks. At baseline, MP-LPV was lower (suggestive of greater iron content) in total SDGM among RRMS patients versus HCs (p = 0.002). Week 24 MP-LPV changes from baseline were not significantly different between groups in total SDGM or any region except the putamen (−0.0025 radians in RRMS patients versus 0.0035 radians in HCs; p = 0.041). Conclusions: Over 24 weeks, phase lesions were reduced significantly in the RRMS group. These preliminary results suggest that SWI-filtered phase may become a useful tool for monitoring RRMS disease activity.

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“…Phase white matter (WM) lesions were classified using a manual region-of-interest approach previously shown to be reproducible (Hagemeier et al, , 2014. Image analyses were carried out by a single operator who was blinded to clinical status.…”

Section: Data Collectionmentioning

confidence: 99%

Associations between changes in ferritin levels and susceptibility-weighted imaging filtered phase in patients with relapsing–remitting multiple sclerosis over 24 weeks of therapy with subcutaneous interferon beta-1a three times weekly

Dwyer¹,

Zivadinov²,

Marković-Pleše³

et al. 2015

Journal of Neuroimmunology

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Subanalysis of a pilot study (NCT01085318) assessed correlations between serum ferritin and imaging assessments in relapsing-remitting multiple sclerosis patients (n = 23) receiving 44 μg interferon beta-1a subcutaneously three times weekly. At baseline, 12, and 24 weeks, mean ferritin was 75, 127 (p < 0.001 vs baseline), and 101 (p=0.020 vs baseline) ng/mL. No relationship between ferritin and susceptibility-weighted imaging (SWI)-filtered phase of subcortical deep gray matter was found. Increasing ferritin correlated with decreasing lesion numbers on both fluid attenuated inversion recovery and SWI phase at 12 weeks (r = -0.62; p = 0.003; n = 21), and with decreasing gadolinium-enhancing lesion volume at 24 weeks (r = -0.71; p = 0.050; n = 8).

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Phase White Matter Signal Abnormalities in Patients with Clinically Isolated Syndrome and Other Neurologic Disorders

Cited by 11 publications

References 37 publications

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

A pilot, longitudinal, 24-week study to evaluate the effect of interferon beta-1a subcutaneous on changes in susceptibility-weighted imaging-filtered phase assessment of lesions and subcortical deep-gray matter in relapsing–remitting multiple sclerosis

Associations between changes in ferritin levels and susceptibility-weighted imaging filtered phase in patients with relapsing–remitting multiple sclerosis over 24 weeks of therapy with subcutaneous interferon beta-1a three times weekly

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