Quantitative volumetric magnetization transfer analysis in multiple sclerosis: Estimation of macroscopic and microscopic disease burden

Buchem, Mark A. van; McGowan, Joseph C.; Kolson, Dennis L.; Polansky, Marcia; Grossman, Robert I.

doi:10.1002/mrm.1910360420

Cited by 200 publications

(142 citation statements)

References 23 publications

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“…The presence, number, and size of the white matter lesions in both NPSLE groups are shown in Table 1 In SLE patients with neurologic or psychiatric symptoms or with evidence of cognitive decline, conventional qualitative MRI often detects either no abnormalities or abnormalities that do not provide an explanation for the central nervous system symptoms (2-4). Since in patients with diseases affecting the brain, abnormalities are often not confined to areas that are abnormal on conventional qualitative MRI, quantitative methods have been developed to assess global disease burden, such as MTR histogram analysis (15). It has been demonstrated that MTR histogram analysis is more sensitive to the presence of disease in the brain than is conventional MRI and that it is able to detect abnormalities in brain tissue that appear normal on conventional MRI (16)(17)(18).…”

Section: Resultsmentioning

confidence: 99%

Association of global brain damage and clinical functioning in neuropsychiatric systemic lupus erythematosus

Bosma¹,

Middelkoop²,

Rood³

et al. 2002

Arthritis & Rheumatism

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Objective. To investigate the relationship between quantitative estimates of global brain damage based on magnetization transfer imaging (MTI) and cerebral functioning, as measured by neurologic, psychiatric, and cognitive assessments, as well as disease duration in patients with a history of neuropsychiatric systemic lupus erythematosus (NPSLE).Methods. In patients with systemic lupus erythematosus (SLE), neurologic, psychiatric, and psychological symptoms often occur. The frequency of nervous system involvement has been reported to range from 11% to 60% (1). Infection, drug side effects, hypertension, or metabolic derangements, as well as an intrinsic brain manifestation of SLE (i.e., neuropsychiatric SLE [NPSLE]), can cause such symptoms. The uncertain pathogenesis and the wide variety of manifestations of NPSLE complicate the development of a uniform diagnostic decision-making protocol and a uniform method of monitoring a patient with this type of SLE. Findings of routine brain imaging studies are often unremarkable in patients with NPSLE, or the studies reveal abnormalities, such as cerebral atrophy and white matter hyperintensities (on magnetic resonance imaging [MRI]), that can also be found in SLE patients without neuropsychiatric symptoms. Furthermore, no correlation has thus far been demonstrated between quantitative measures of such nonspecific abnormalities and measures of brain function (2-5).Recently, magnetization transfer ratio (MTR) histogram analysis, a quantitative MRI technique based on magnetization transfer imaging (MTI), was applied in patients with primary NPSLE but without abnormalities on MRI that could account for the clinical picture. With this technique, cerebral abnormalities were identified in these patients (6,7). Such abnormalities were found in SLE patients who had had episodes of neuropsychiatric symptoms in the past (chronic NPSLE) as well as in patients who were experiencing an active phase of neuropsychiatric symptoms (active NPSLE) (6,7). The

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Section: Resultsmentioning

confidence: 99%

Association of global brain damage and clinical functioning in neuropsychiatric systemic lupus erythematosus

Bosma¹,

Middelkoop²,

Rood³

et al. 2002

Arthritis & Rheumatism

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“…MS lesions also have lower MTR values (typically 20 pu in this image dataset) and, therefore, the threshold selected was such that voxels in visible lesions were not removed by this process. Other workers [1]- [5] have used thresholds in a similar manner; we chose this after experimentation, selecting an aggressive value to reduce partial volume effects with CSF.…”

Section: ) Thresholdingmentioning

confidence: 99%

“…MTR, thus, provides a reproducible, quantitative measure of brain tissue structures and their modification by pathological change, which in MS occurs not only in visible lesions but also in the normal appearing tissues. There have been numerous recent studies which have used histogram analysis to study the global MTR characteristics of brain tissue [1]- [8].…”

mentioning

confidence: 99%

“…Various descriptive measures have previously been used to describe the MTR histogram and to measure change; these include histogram peak height, peak location (i.e., mode), average MTR value (i.e., mean), 25th percentile, 50th percentile, and 75th percentile values [1]- [6]. These measures have been used for two purposes: to separate controls from MS subgroups (or to separate subgroups) using simple students t-tests, and to correlate with [expanded disability status scale (EDSS); a measure of disability in MS] [9].…”

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confidence: 99%

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Classification of disease subgroup and correlation with disease severity using magnetic resonance imaging whole-brain histograms: application to magnetization transfer ratios and multiple sclerosis

Dehmeshki

Barker

Tofts

2002

IEEE Trans. Med. Imaging

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Abstract-This paper presents a new approach to characterize subtle diffuse changes in multiple sclerosis (MS) using histograms derived from magnetization transfer ratio (MTR) images. Two major parts dominate our histogram analysis; 1) Classification of MTR histograms into control and MS subgroups; 2) Correlation with current disability, as measured by the EDSS scale (a measure of disease severity). Two data reduction schemes are used to reduce the complexity of the analysis: linear discriminant analysis (LDA) and principal component analysis (PCA). LDA is better for the classification of MTR histograms as it takes into account the between-class variation. By using LDA, the space of MTR histograms is transformed to the optimal discriminant space for a nearest mean classifier. In contrast, PCA is useful for correlation with current disability as it takes into account the variation within each subgroup in its process. A multiple regression analysis is used to evaluate the multiple correlation of those principal components with the degree of disability in MS. This is the first application of such classification and correlation techniques to magnetic resonance imaging histogram data. Our MTR histogram analysis approach give improved classification success and improved correlation compared with methods that use traditional histogram features such as peak height and peak location.Index Terms-Histogram analysis, linear discriminant analysis, multiple sclerosis, principal component analysis.

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“…MTI is emerging as a sensitive method to detect disease activity and monitor disease progression in MS. Early studies using MTR in an animal model 127 and in patients with MS 128,129 showed that decreased MTR was present and most likely reflected demyelination and axonal loss. However, reduced MTR is generally nonspecific and may be influenced by edema, gliosis, and inflammation.…”

Section: Magnetization Transfer Imagingmentioning

confidence: 99%

Imaging of multiple sclerosis: Role in neurotherapeutics

Bakshi¹,

Minagar²,

Jaisani³

et al. 2005

Neurotherapeutics

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Summary:Magnetic resonance imaging (MRI) plays an everexpanding role in the evaluation of multiple sclerosis (MS). This includes its sensitivity for the diagnosis of the disease and its role in identifying patients at high risk for conversion to MS after a first presentation with selected clinically isolated syndromes. In addition, MRI is a key tool in providing primary therapeutic outcome measures for phase I/II trials and secondary outcome measures in phase III trials. The utility of MRI stems from its sensitivity to longitudinal changes including those in overt lesions and, with advanced MRI techniques, in areas affected by diffuse occult disease (the so-called normalappearing brain tissue). However, all current MRI methodology suffers from limited specificity for the underlying histopathology. Conventional MRI techniques, including lesion detection and measurement of atrophy from T1-or T2-weighted images, have been the mainstay for monitoring disease activity in clinical trials, in which the use of gadolinium with T1-weighted images adds additional sensitivity and specificity for areas of acute inflammation. Advanced imaging methods including magnetization transfer, fluid attenuated inversion recovery, diffusion, magnetic resonance spectroscopy, functional MRI, and nuclear imaging techniques have added to our understanding of the pathogenesis of MS and may provide methods to monitor therapies more sensitively in the future. However, these advanced methods are limited by their cost, availability, complexity, and lack of validation. In this article, we review the role of conventional and advanced imaging techniques with an emphasis on neurotherapeutics.

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Quantitative volumetric magnetization transfer analysis in multiple sclerosis: Estimation of macroscopic and microscopic disease burden

Cited by 200 publications

References 23 publications

Association of global brain damage and clinical functioning in neuropsychiatric systemic lupus erythematosus

Association of global brain damage and clinical functioning in neuropsychiatric systemic lupus erythematosus

Classification of disease subgroup and correlation with disease severity using magnetic resonance imaging whole-brain histograms: application to magnetization transfer ratios and multiple sclerosis

Imaging of multiple sclerosis: Role in neurotherapeutics

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