Contributions
Abstract: 75
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background and purpose: To compare the sensitivity in the detection of spinal cord (SC) lesions of different sagittal sequences [short T1 inversion recovery (STIR), T2 and proton density (PD)-weighted, and combined T2-STIR sequences] acquired at 3.0T, in patients presenting with a clinically isolated syndrome (CIS).
Materials and methods: MRI of the whole SC of 84 patients presenting with a CIS (age 34.7+7.4 years; 66.7% females; 17.9% with a SC syndrome) were retrospectively analyzed by two independent observers (O1, O2). Presence of SC lesions was evaluated on sagittal STIR, T2, PD and combined T2-STIR sequences. The reference standard (RS) was obtained by a third experienced neuroradiologist using all sequences available, in order to calculate a definitive lesion counts. Sensitivity, specificity and interobserver agreement were assessed for each sequence.
Results: A total of 84 image sets, which included all four type of images, were analyzed. The RS detected 107 lesions, and 35.7% patients with at least one SC lesion. In the independent analysis, the total lesion count was 84 (O1) and 128 (O2) on STIR, 103 (O1) and 90 (O2) on T2-STIR, 75 (O1) and 97 (O2) on PD, and 71 (O1) and 78 (O2) on T2. The percentage of patients with at least one SC lesion was 31% (O1) and 59.5% (O2) on STIR; 45.2% (O1) and 46.4% (O2) on T2-STIR images; 34.5% (O1) and 50% (O2) on PD; while 36.9% (O1) and 41.7% (O2) on T2 images.
Sensitivity for detecting lesions by observers was 72.0% (O1) and 72.0% (O2) for STIR; 72.0% (O1) and 60.8% (O2) for T2-STIR; 51.4% (O1) and 60.8% (O2) for PD, and 54.2% (O1) and 57.0% (O2) for T2.
Sensitivity and specificity for detecting patients with at least one SC lesion were 83.3% and 98.2% (O1) and 96.7% and 61.1% (O2) for STIR; 96.7% and 83.3% (O1) and 90% and 77.8% (O2) for T2-STIR; 80.0%, and 90.7% (O1) and 93.3% and 74.1% (O2) for PD; and 76.7% and 85.2% (O1) and 80.0% and 79.6% (O2) for T2.
The interobserver (O1, O2) agreement (weighted kappa value) for detecting patients with at least one SC lesion was moderate to good: 0.423 (STIR), 0.502 (T2), 0.69 (PD), and 0.64 (T2-STIR).
Conclusions: Highest sensitivity for detecting SC lesions and patients with at least one SC lesion, was achieved with STIR and combined T2-STIR images, although the first sequence showed only a moderate level of interobserver agreement. The combination of STIR, T2 and combined T2-STIR images is probably the best strategy for detecting SC lesions in CIS patients.
Disclosure: Annalaura Salerno has nothing to disclose
Julian Gutièrrez has nothing to disclose
Cristina Auger has received speaking honoraria from Biogen, Stendhal and Novartis
Elena Huerga has nothing to disclose
F Xavier Aymerich has nothing to disclose
Juan Francisco Corral has nothing to disclose
Manel Alberich has nothing to disclose
Mar Tintoré has received compensation for consulting services and speaking honoraria from Bayer Schering Pharma, Merck-Serono, Biogen-Idec, Teva Pharmaceuticals, Sanofi-Aventis, Novartis, Almirall, Genzyme, and Roche.
Georgina Arrambide has received compensation for consulting services from Biogen-Idec and research support from Novartis.
Xavier Montalban has received speaking honoraria and travel expenses for participation in scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past years with Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Receptos, Roche, Sanofi-Genzyme and Teva Pharmaceutical
Alex Rovira serves on scientific advisory boards for Biogen Idec, Novartis, Genzyme, and OLEA Medical, has received speaker honoraria from Bayer, Genzyme, Sanofi-Aventis, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd, OLEA Medical, Stendhal, Novartis and Biogen Idec, and has research agreements with Siemens AG.
Abstract: 75
Type: Oral
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background and purpose: To compare the sensitivity in the detection of spinal cord (SC) lesions of different sagittal sequences [short T1 inversion recovery (STIR), T2 and proton density (PD)-weighted, and combined T2-STIR sequences] acquired at 3.0T, in patients presenting with a clinically isolated syndrome (CIS).
Materials and methods: MRI of the whole SC of 84 patients presenting with a CIS (age 34.7+7.4 years; 66.7% females; 17.9% with a SC syndrome) were retrospectively analyzed by two independent observers (O1, O2). Presence of SC lesions was evaluated on sagittal STIR, T2, PD and combined T2-STIR sequences. The reference standard (RS) was obtained by a third experienced neuroradiologist using all sequences available, in order to calculate a definitive lesion counts. Sensitivity, specificity and interobserver agreement were assessed for each sequence.
Results: A total of 84 image sets, which included all four type of images, were analyzed. The RS detected 107 lesions, and 35.7% patients with at least one SC lesion. In the independent analysis, the total lesion count was 84 (O1) and 128 (O2) on STIR, 103 (O1) and 90 (O2) on T2-STIR, 75 (O1) and 97 (O2) on PD, and 71 (O1) and 78 (O2) on T2. The percentage of patients with at least one SC lesion was 31% (O1) and 59.5% (O2) on STIR; 45.2% (O1) and 46.4% (O2) on T2-STIR images; 34.5% (O1) and 50% (O2) on PD; while 36.9% (O1) and 41.7% (O2) on T2 images.
Sensitivity for detecting lesions by observers was 72.0% (O1) and 72.0% (O2) for STIR; 72.0% (O1) and 60.8% (O2) for T2-STIR; 51.4% (O1) and 60.8% (O2) for PD, and 54.2% (O1) and 57.0% (O2) for T2.
Sensitivity and specificity for detecting patients with at least one SC lesion were 83.3% and 98.2% (O1) and 96.7% and 61.1% (O2) for STIR; 96.7% and 83.3% (O1) and 90% and 77.8% (O2) for T2-STIR; 80.0%, and 90.7% (O1) and 93.3% and 74.1% (O2) for PD; and 76.7% and 85.2% (O1) and 80.0% and 79.6% (O2) for T2.
The interobserver (O1, O2) agreement (weighted kappa value) for detecting patients with at least one SC lesion was moderate to good: 0.423 (STIR), 0.502 (T2), 0.69 (PD), and 0.64 (T2-STIR).
Conclusions: Highest sensitivity for detecting SC lesions and patients with at least one SC lesion, was achieved with STIR and combined T2-STIR images, although the first sequence showed only a moderate level of interobserver agreement. The combination of STIR, T2 and combined T2-STIR images is probably the best strategy for detecting SC lesions in CIS patients.
Disclosure: Annalaura Salerno has nothing to disclose
Julian Gutièrrez has nothing to disclose
Cristina Auger has received speaking honoraria from Biogen, Stendhal and Novartis
Elena Huerga has nothing to disclose
F Xavier Aymerich has nothing to disclose
Juan Francisco Corral has nothing to disclose
Manel Alberich has nothing to disclose
Mar Tintoré has received compensation for consulting services and speaking honoraria from Bayer Schering Pharma, Merck-Serono, Biogen-Idec, Teva Pharmaceuticals, Sanofi-Aventis, Novartis, Almirall, Genzyme, and Roche.
Georgina Arrambide has received compensation for consulting services from Biogen-Idec and research support from Novartis.
Xavier Montalban has received speaking honoraria and travel expenses for participation in scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past years with Almirall, Bayer, Biogen, Genzyme, Merck, Novartis, Receptos, Roche, Sanofi-Genzyme and Teva Pharmaceutical
Alex Rovira serves on scientific advisory boards for Biogen Idec, Novartis, Genzyme, and OLEA Medical, has received speaker honoraria from Bayer, Genzyme, Sanofi-Aventis, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd, OLEA Medical, Stendhal, Novartis and Biogen Idec, and has research agreements with Siemens AG.