Contributions
Abstract: P1603
Type: LB Poster
Abstract Category: Late Breaking News
Background: Determining the origin of structural anomalies originating from in situ demyelination or non-specific white matter (NSWM) disease due to aging, migraine headaches, or small vessel disease is limited by traditional 2-dimensional, forced perspective, views of brain lesions. The objective of this study was to describe the 3-dimensional (3D) geometric shapes and surface characteristics of multiple sclerosis (MS) lesions, in comparison to other etiologies, utilizing 3D MRI techniques, maximum intensity projection images, 3D mesh software, and 3D printing, allowing for the physical palpation and proper inspection of brain lesions.
Methods: Standardized 3-Tesla 3D brain MRI studies were performed on enrolled MS and NSWM patients. Focal supratentorial lesions were identified, manually segmented, and stereolithography files generated. All lesions were 3D printed at actual size and also enlarged with acrylonitrile butadiene styrene at 200µm. Three healthcare providers who were blinded to all clinical and radiological data rated primary and secondary characteristics. Regression models adjusting for age, disease duration, and individual patient effects were applied to assess lesion characteristics between patient groups.
Results: A total of 1,001 lesions were analyzed (710 (MS), 291 (NSWM)) from thirty patients (19 with a confirmed diagnosis of multiple sclerosis (11 F; median age=33.6 years, range: 26.9-54.5), median disease duration= 2.2 years (0.4-19.4)), 11 with verified NSWM disease without MS (11 F; median age=55.0 years, range: 27.9-66.2). Lesions from MS versus NSWM patients demonstrated a higher percentage of asymmetry (75.9% versus 43%; OR: 4.39 [2.37-8.12]; p< 0.001), were more highly associated with complex surface morphologies (65.9% versus 27.8%; OR: 2.3 [1.74-3.05]; p< 0.001), and were described as being multi-lobular (7.9% versus 0.3%, p< 0.001), elongated (12.8% versus 2.4%, p< 0.001), and containing a protrusion (3.6% versus 0%, p=0.02). Three-dimensional shape and surface features supportive of NSWM were clearly identified in subjects with MS, providing evidence for the coexistence of MS and non-MS lesion phenotypes.
Interpretation: Distinct 3D geometric shapes and surface characteristics appear to differentiate lesions resulting from MS and NSWM disease. These data may provide new insights related to the biology of conditions yielding MRI anomalies along with providing new approaches to diagnosis and clinical surveillance.
Disclosure:
Mr. Newton: nothing to disclose.
Ms. Wright: nothing to disclose.
Ms. Winkler: nothing to disclose.
Dr. M. Takahashi: nothing to disclose.
Dr. I. Dimitrov: nothing to disclose.
Dr. M. P. Sormani received lecture fees from Teva, Merck Serono, Biogen, Novartis, and Genzyme and consulting fees from Merck Serono, Biogen, Teva, Genzyme, Roche, and Novartis.
Dr. M. Pinho: nothing to disclose.
Dr. D. T. Okuda received lecture fees from Acorda Therapeutics, Genzyme, and TEVA
Neuroscience, consulting and advisory board fees from EMD Serono, Genentech, Genzyme, Novartis and TEVA Neuroscience, and research support from Biogen.
Abstract: P1603
Type: LB Poster
Abstract Category: Late Breaking News
Background: Determining the origin of structural anomalies originating from in situ demyelination or non-specific white matter (NSWM) disease due to aging, migraine headaches, or small vessel disease is limited by traditional 2-dimensional, forced perspective, views of brain lesions. The objective of this study was to describe the 3-dimensional (3D) geometric shapes and surface characteristics of multiple sclerosis (MS) lesions, in comparison to other etiologies, utilizing 3D MRI techniques, maximum intensity projection images, 3D mesh software, and 3D printing, allowing for the physical palpation and proper inspection of brain lesions.
Methods: Standardized 3-Tesla 3D brain MRI studies were performed on enrolled MS and NSWM patients. Focal supratentorial lesions were identified, manually segmented, and stereolithography files generated. All lesions were 3D printed at actual size and also enlarged with acrylonitrile butadiene styrene at 200µm. Three healthcare providers who were blinded to all clinical and radiological data rated primary and secondary characteristics. Regression models adjusting for age, disease duration, and individual patient effects were applied to assess lesion characteristics between patient groups.
Results: A total of 1,001 lesions were analyzed (710 (MS), 291 (NSWM)) from thirty patients (19 with a confirmed diagnosis of multiple sclerosis (11 F; median age=33.6 years, range: 26.9-54.5), median disease duration= 2.2 years (0.4-19.4)), 11 with verified NSWM disease without MS (11 F; median age=55.0 years, range: 27.9-66.2). Lesions from MS versus NSWM patients demonstrated a higher percentage of asymmetry (75.9% versus 43%; OR: 4.39 [2.37-8.12]; p< 0.001), were more highly associated with complex surface morphologies (65.9% versus 27.8%; OR: 2.3 [1.74-3.05]; p< 0.001), and were described as being multi-lobular (7.9% versus 0.3%, p< 0.001), elongated (12.8% versus 2.4%, p< 0.001), and containing a protrusion (3.6% versus 0%, p=0.02). Three-dimensional shape and surface features supportive of NSWM were clearly identified in subjects with MS, providing evidence for the coexistence of MS and non-MS lesion phenotypes.
Interpretation: Distinct 3D geometric shapes and surface characteristics appear to differentiate lesions resulting from MS and NSWM disease. These data may provide new insights related to the biology of conditions yielding MRI anomalies along with providing new approaches to diagnosis and clinical surveillance.
Disclosure:
Mr. Newton: nothing to disclose.
Ms. Wright: nothing to disclose.
Ms. Winkler: nothing to disclose.
Dr. M. Takahashi: nothing to disclose.
Dr. I. Dimitrov: nothing to disclose.
Dr. M. P. Sormani received lecture fees from Teva, Merck Serono, Biogen, Novartis, and Genzyme and consulting fees from Merck Serono, Biogen, Teva, Genzyme, Roche, and Novartis.
Dr. M. Pinho: nothing to disclose.
Dr. D. T. Okuda received lecture fees from Acorda Therapeutics, Genzyme, and TEVA
Neuroscience, consulting and advisory board fees from EMD Serono, Genentech, Genzyme, Novartis and TEVA Neuroscience, and research support from Biogen.