The Role of High‐Frequency MRI Monitoring in the Detection of Brain Atrophy in Multiple Sclerosis

Uher, Tomáš; Krásenský, Jan; Sobíšek, Lukáš; Seidl, Zdeněk; Bergsland, Niels; Dwyer, Michael G.; Havrdová, Eva; Zivadinov, Robert; Horáková, Dana; Vaněčková, Manuela

doi:10.1111/jon.12505

Cited by 4 publications

(5 citation statements)

References 27 publications

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“…Finally, there was a significant aging interaction effect on increase in the PLVVC between HI and MS patients, which was not observed for the annualized PBVC. For all analyses, the results were similar for annualized (between first MRI and MRF) and annualized cumulative (including all serial MRI time points used in the analyses) rates of PLVVC and PBVC, in line with the findings from the previous study showing that serial MRI monitoring may only slightly improve the precision of brain atrophy measurement in individual subjects …”

Section: Discussionsupporting

confidence: 85%

Aging and Brain Atrophy in Multiple Sclerosis

Ghione

Bergsland

Dwyer

et al. 2019

Journal of Neuroimaging

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BACKGROUND AND PURPOSE: Brain atrophy accelerates at the age of 60 in healthy individuals (HI) and at disease onset in multiple sclerosis (MS) patients. Whether there is an exacerbating effect of aging superimposed on MS-related brain atrophy is unknown. We estimated the aging effect on lateral ventricular volume (LVV) and whole brain volume (WBV) changes in MS patients. METHODS: 1,982 MS patients (mean follow-up: 4.8 years) and 351 HI (mean follow-up: of 3.1 years), aged from 20 to 79 years old (yo), were collected retrospectively. Percent LVV change (PLVVC) and percent brain volume change (PBVC) on 1.5T and 3T MRI scanners (median of 3.9 scans per subject) were calculated. These were determined between all-time points and subjects were divided in six-decade age groups. MRI differences between age groups were calculated using analysis of covariance (ANCOVA). RESULTS: Compared to HI, at first MRI, MS patients had significantly increased LVV in the age groups: 30-39 yo, 40-49 yo, 50-59 yo, 60-69 yo (all P < .0001), and 70-79 yo (P = .029), and decreased WBV in the age groups: 20-29 yo (P = .024), 30-39 yo (P = .031), 40-49 yo, and 50-59 yo (all P < .0001). Annualized PLVVC was significantly different between the age groups 20-59 and 60-79 yo in MS patients (P = .005) and HI (P < .0001), as was for PBVC in MS patients (P = .001), but not for HI (P = .521). There was a significant aging interaction effect in the annualized PLVVC (P = .001) between HI and MS patients, which was not observed for the annualized PBVC (P = .380). CONCLUSIONS: Development of brain atrophy manifests progressively in MS patients, and occurs with a different pattern, as compared to aging HI. PLVVC increased across age in HI as compared to MS, while PBVC decreased across ages in both HI and MS.

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Section: Discussionsupporting

confidence: 85%

Aging and Brain Atrophy in Multiple Sclerosis

Ghione

Bergsland

Dwyer

et al. 2019

Journal of Neuroimaging

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“…Many research groups are trying to address these issues by: (a) collecting MRI brain volumetric data from normal participants and MS patients using standardized protocols; (b) continuing to develop/improve methods to reduce measurement error; and (c) developing predictive models based on cross-sectional WBV measures. 47,48 The use of high frequency MRI monitoring, over both 12- and 24-month periods and using a segmentation-based analysis method (ScanView, an in-house developed software from Charles University, Prague, Czech Republic), was recently explored by Uher et al 49 It was concluded that high-frequency MRI performed over 12- and 24-month timeframes, may have a considerable effect on improving the precision of pathological BVL identification in individual patients. 49 However, the frequency of MRI acquisition required to gain optimal results (2-monthly MRI scans) would be impractical in a real-world clinical setting.…”

Section: Discussionmentioning

confidence: 99%

“…47,48 The use of high frequency MRI monitoring, over both 12- and 24-month periods and using a segmentation-based analysis method (ScanView, an in-house developed software from Charles University, Prague, Czech Republic), was recently explored by Uher et al 49 It was concluded that high-frequency MRI performed over 12- and 24-month timeframes, may have a considerable effect on improving the precision of pathological BVL identification in individual patients. 49 However, the frequency of MRI acquisition required to gain optimal results (2-monthly MRI scans) would be impractical in a real-world clinical setting. The statistical association, consistency and agreement between the techniques used to measure absolute WBV in this study were excellent but were less impressive when normalized WBV measurements were compared.…”

Section: Discussionmentioning

confidence: 99%

Comparing longitudinal brain atrophy measurement techniques in a real-world multiple sclerosis clinical practice cohort: towards clinical integration?

Beadnall

Wang

Hecke

et al. 2019

Ther Adv Neurol Disord

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Background:Whole brain atrophy (WBA) estimates in multiple sclerosis (MS) correlate more robustly with clinical disability than traditional, lesion-based metrics. We compare Structural Image Evaluation using Normalisation of Atrophy (SIENA) with the icobrain longitudinal pipeline (icobrain long), for assessment of longitudinal WBA in MS patients.Methods:Magnetic resonance imaging (MRI) scan pairs [1.05 (±0.15) year separation] from 102 MS patients were acquired on the same 3T scanner. Three-dimensional (3D) T1-weighted and two-dimensional (2D)/3D fluid-attenuated inversion-recovery sequences were analysed. Percentage brain volume change (PBVC) measurements were calculated using SIENA and icobrain long. Statistical correlation, agreement and consistency between methods was evaluated; MRI brain volumetric and clinical data were compared. The proportion of the cohort with annualized brain volume loss (aBVL) rates ⩾ 0.4%, ⩾0.8% and ⩾0.94% were calculated. No evidence of disease activity (NEDA) 3 and NEDA 4 were also determined.Results:Mean annualized PBVC was −0.59 (±0.65)% and −0.64 (±0.73)% as measured by icobrain long and SIENA. icobrain long and SIENA-measured annualized PBVC correlated strongly, r = 0.805 (p < 0.001), and the agreement [intraclass correlation coefficient (ICC) 0.800] and consistency (ICC 0.801) were excellent. Weak correlations were found between MRI metrics and Expanded Disability Status Scale scores. Over half the cohort had aBVL ⩾ 0.4%, approximately a third ⩾0.8%, and aBVL was ⩾0.94% in 28.43% and 23.53% using SIENA and icobrain long, respectively. NEDA 3 was achieved in 35.29%, and NEDA 4 in 15.69% and 16.67% of the cohort, using SIENA and icobrain long to derive PBVC, respectively.Discussion:icobrain long quantified longitudinal WBA with a strong level of statistical agreement and consistency compared to SIENA in this real-world MS population. Utility of WBA measures in individuals remains challenging, but show promise as biomarkers of neurodegeneration in MS clinical practice. Optimization of MRI analysis algorithms/techniques are needed to allow reliable use in individuals. Increased levels of automation will enable more rapid clinical translation.

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“…1 Unfortunately, a relatively high variability of brain atrophy measures renders challenging its application in individual MS patients. [2][3][4][5][6][7][8] Although MS is typically associated with accelerated brain volume loss, [3][4][5] there are cases where brain volume increase (BVI) appears to occur, particularly over short-time periods. 9 As consequence, apparent BVI may complicate the interpretation of brain volume change measurements in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

“…Assessment of brain atrophy in individual multiple sclerosis (MS) patients could facilitate the identification of those with or without risk of disease progression 1 . Unfortunately, a relatively high variability of brain atrophy measures renders challenging its application in individual MS patients 2–8 . Although MS is typically associated with accelerated brain volume loss, 3–5 there are cases where brain volume increase (BVI) appears to occur, particularly over short‐time periods 9 .…”

Section: Introductionmentioning

confidence: 99%

Interpretation of Brain Volume Increase in Multiple Sclerosis

Uher

Bergsland

Krásenský

et al. 2020

Journal of Neuroimaging

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BACKGROUND AND PURPOSE: A high variability of brain MRI volume change measurement renders challenging its interpretation in multiple sclerosis (MS). Occurrence and clinical relevance of observed apparent brain volume increase (BVI) in MS patients have not been investigated yet. The objective was to quantify the prevalence and factors associated with BVI. METHODS: We examined 366 MS patients (2,317 scans) and 44 controls (132 scans). Volumetric analysis of brain volume changes was performed by SIENA and ScanView. BVI was defined as brain volume change >0%. We compared characteristics of patients with and without BVI. RESULTS: BVI was found in 26.3% (from 1,951) longitudinal scans (SIENA). If BVI occurred, a probability that BVI will be repeated consecutively more than or equal to two times was 15.9%. The repeated BVI was associated with clinical disease activity in 50% of cases. BVI was associated with shorter time and lower T2 lesion volume increase between two MRI scans, and higher normalized brain volume (all P < .0001). A proportion of scans with BVI was higher when analyzed by ScanView (35.3%) and in controls (36.4% by SIENA). CONCLUSIONS: BVI occurs in a great proportion of MR scans over short-term follow-up and is not associated with disease stabilization. Although BVI can be caused by several factors, the results indicate that measurement error may contribute to BVI in the majority of cases. Clinicians should be aware of the frequent occurrence of apparent BVI, interpret brain volume changes in MS patients with great caution, and use methods with precise quantification of brain volume changes.

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The Role of High‐Frequency MRI Monitoring in the Detection of Brain Atrophy in Multiple Sclerosis

Abstract: High-frequency MRI monitoring may have a considerable effect on improving the precision of precisely identifying pathological BVL in individual patients. However, limitations in translation to clinical practice remain.

Cited by 4 publications

References 27 publications

Aging and Brain Atrophy in Multiple Sclerosis

Aging and Brain Atrophy in Multiple Sclerosis

Comparing longitudinal brain atrophy measurement techniques in a real-world multiple sclerosis clinical practice cohort: towards clinical integration?

Interpretation of Brain Volume Increase in Multiple Sclerosis

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