An ultra-high field study of cerebellar pathology in early relapsing-remitting multiple sclerosis using MP2RAGE

Fartaria, Mario Joao, O'Brien, Kieran, Sorega, Alexandra, Bonnier, Guillaume, Roche, Alexis, Falkovskiy, Pavel, Krueger, Gunnar, Kober, Tobias, Bach Cuadra, Meritxell and Granziera, Cristina (2017) An ultra-high field study of cerebellar pathology in early relapsing-remitting multiple sclerosis using MP2RAGE. Investigative Radiology, 52 5: 265-273. doi:10.1097/RLI.0000000000000338


Author Fartaria, Mario Joao
O'Brien, Kieran
Sorega, Alexandra
Bonnier, Guillaume
Roche, Alexis
Falkovskiy, Pavel
Krueger, Gunnar
Kober, Tobias
Bach Cuadra, Meritxell
Granziera, Cristina
Title An ultra-high field study of cerebellar pathology in early relapsing-remitting multiple sclerosis using MP2RAGE
Journal name Investigative Radiology   Check publisher's open access policy
ISSN 1536-0210
0020-9996
Publication date 2017-05-01
Sub-type Article (original research)
DOI 10.1097/RLI.0000000000000338
Open Access Status Not yet assessed
Volume 52
Issue 5
Start page 265
End page 273
Total pages 9
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Subject 2741 Radiology Nuclear Medicine and imaging
Abstract Objectives: The aim of this study was to study focal cerebellar pathology in early stages of multiple sclerosis (MS) using ultra-high-field magnetization-prepared 2 inversion-contrast rapid gradient-echo (7T MP2RAGE). Materials and Methods: Twenty early-stage relapsing-remitting MS patients underwent an MP2RAGE acquisition at 7 T magnetic resonance imaging (MRI) (images acquired at 2 different resolutions: 0.58 × 0.58 × 0.58 mm, 7T-0.58, and 0.75 × 0.75 × 0.90 mm, 7T-0.75) and 3 T MRI (1.0 × 1.0 × 1.2 mm, 3T-1.0). Total cerebellar lesion load and volume and mean cerebellar lesion volume were compared across images using a Wilcoxon signed-rank test. Mean T1 relaxation times in lesions and normal-appearing tissue as well as contrast-to-noise ratio (CNR) measurements were also compared using a Wilcoxon signed-rank test. A multivariate analysis was applied to assess the contribution of MRI metrics to clinical performance in MS patients. Results: Both 7T-0.58 and 7T-0.75 MP2RAGE showed significantly higher lesion load compared with 3T-1.0 MP2RAGE (P < 0.001). Plaques that were judged as leukocortical in 7T-0.75 and 3T-1.0 MP2RAGEs were instead identified as WM lesions in 7T-0.58 MP2RAGE. Cortical lesion CNR was significantly higher in MP2RAGEs at 7 T than at 3 T. Total lesion load as well as total and mean lesion volume obtained at both 7 T and 3 T MP2RAGE significantly predicted attention (P < 0.05, adjusted R = 0.5), verbal fluency (P < 0.01, adjusted R = 0.6), and motor performance (P = 0.01, adjusted R = 0.7). Conclusions: This study demonstrates the value of 7 T MP2RAGE to study the cerebellum in early MS patients. 7T-0.58 MP2RAGE provides a more accurate anatomical description of white and gray matter pathology compared with 7T-0.75 and 3T-1.0 MP2RAGE, likely due to the improved spatial resolution, lower partial volume effects, and higher CNR.
Formatted abstract
Objectives: The aim of this study was to study focal cerebellar pathology in early stages of multiple sclerosis (MS) using ultra-high-field magnetization-prepared 2 inversion-contrast rapid gradient-echo (7T MP2RAGE).

Materials and Methods: Twenty early-stage relapsing-remitting MS patients underwent an MP2RAGE acquisition at 7 T magnetic resonance imaging (MRI) (images acquired at 2 different resolutions: 0.58 × 0.58 × 0.58 mm3, 7T-0.58, and 0.75 × 0.75 × 0.90 mm3, 7T-0.75) and 3 T MRI (1.0 × 1.0 × 1.2 mm3, 3T-1.0). Total cerebellar lesion load and volume and mean cerebellar lesion volume were compared across images using a Wilcoxon signed-rank test. Mean T1 relaxation times in lesions and normal-appearing tissue as well as contrast-to-noise ratio (CNR) measurements were also compared using a Wilcoxon signed-rank test. A multivariate analysis was applied to assess the contribution of MRI metrics to clinical performance in MS patients.

Results: Both 7T-0.58 and 7T-0.75 MP2RAGE showed significantly higher lesion load compared with 3T-1.0 MP2RAGE (P < 0.001). Plaques that were judged as leukocortical in 7T-0.75 and 3T-1.0 MP2RAGEs were instead identified as WM lesions in 7T-0.58 MP2RAGE. Cortical lesion CNR was significantly higher in MP2RAGEs at 7 T than at 3 T. Total lesion load as well as total and mean lesion volume obtained at both 7 T and 3 T MP2RAGE significantly predicted attention (P < 0.05, adjusted R2 = 0.5), verbal fluency (P < 0.01, adjusted R2 = 0.6), and motor performance (P = 0.01, adjusted R2 = 0.7).

Conclusions: This study demonstrates the value of 7 T MP2RAGE to study the cerebellum in early MS patients. 7T-0.58 MP2RAGE provides a more accurate anatomical description of white and gray matter pathology compared with 7T-0.75 and 3T-1.0 MP2RAGE, likely due to the improved spatial resolution, lower partial volume effects, and higher CNR.
Keyword Cerebellar pathology
Cerebellum lesions
High-field MRI
Multiple sclerosis
Ultra-high-field MRI
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Centre for Advanced Imaging Publications
 
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