Contributions
Abstract: EP1559
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Purpose: Evaluate the location of lesion evolution for different MS clinical phenotypes using MSmetrix.
Materials and methods: Longitudinal MRI follow-up of 12 clinically isolated syndrome (CIS), 30 relapsing remitting (RR), 17 primary progressive (PP) and 28 secondary progressive (SP) MS patients was conducted using a 1.5 Tesla MR system (Sonata Siemens). For each patient, two time points at least 2 years apart were selected in order to estimate medium-term lesion evolution.
MSmetrix employs T1-weighted and FLAIR images at two time points to estimate brain tissue and lesion segmentations and volumetry, as well as volume changes in time. Moreover, the lesions are classified according to brain location. Volumes of new or enlarging lesions classified by MSmetrix as juxtacortical lesions, periventricular lesions or deep white matter lesions, were compared between the four patient groups (CIS, RR, PP and SP).
Results: CIS patients showed the largest volume of new lesions (i.e., lesions not touching any older lesion), with an average volume of only 0.1 ml in each of the three locations (juxtacortical, periventricular, deep white matter). PP and SP patients had on average lower new lesion volumes (< 0.06 ml), with almost no new lesions in the periventricular region. This was compensated by large volumes for lesion enlargement, especially in the periventricular region. Although all groups show lesion enlargement mostly in the periventricular regions compared to other regions, some significant differences between groups were observed: PP patients showed the most enlargement in the periventricular region (median 3.8 ml), significantly higher than for CIS and RR, but comparable to the SP group. The RR group showed more enlargement of deep white matter lesions compared to the other groups, with a median of 0.1 ml. There were no significant differences between clinical groups in the volumes of enlarged juxtacortical lesions (median value 0.05 ml for all groups).
Conclusion: MSmetrix found a location-dependent evolution of new and enlarging lesions for different MS clinical phenotypes. Some of the findings can be explained by disease duration: more advanced MS forms (PP and SP patients) show significant enlargement of existing periventricular lesions instead of new lesion formation. Compared to other groups, RR patients had more enlargement of the deep white matter lesions, and for CIS patients there seemed to be no location prevalence in the appearance of new lesions.
Disclosure: Diana M. Sima, Saurabh Jain, Eloy Roura, Anke Maertens, Dirk Smeets, Wim Van Hecke are employed by icometrix.
Dominique Sappey-Marinier: nothing to disclose.
Françoise Durand-Dubief has received consultancy fees, speaker fees, research grants (non-personal) or honoraria from Biogen, Genzyme-Sanofi, Medday, Merck-Serono, Novartis, Roche and Teva.
Abstract: EP1559
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Purpose: Evaluate the location of lesion evolution for different MS clinical phenotypes using MSmetrix.
Materials and methods: Longitudinal MRI follow-up of 12 clinically isolated syndrome (CIS), 30 relapsing remitting (RR), 17 primary progressive (PP) and 28 secondary progressive (SP) MS patients was conducted using a 1.5 Tesla MR system (Sonata Siemens). For each patient, two time points at least 2 years apart were selected in order to estimate medium-term lesion evolution.
MSmetrix employs T1-weighted and FLAIR images at two time points to estimate brain tissue and lesion segmentations and volumetry, as well as volume changes in time. Moreover, the lesions are classified according to brain location. Volumes of new or enlarging lesions classified by MSmetrix as juxtacortical lesions, periventricular lesions or deep white matter lesions, were compared between the four patient groups (CIS, RR, PP and SP).
Results: CIS patients showed the largest volume of new lesions (i.e., lesions not touching any older lesion), with an average volume of only 0.1 ml in each of the three locations (juxtacortical, periventricular, deep white matter). PP and SP patients had on average lower new lesion volumes (< 0.06 ml), with almost no new lesions in the periventricular region. This was compensated by large volumes for lesion enlargement, especially in the periventricular region. Although all groups show lesion enlargement mostly in the periventricular regions compared to other regions, some significant differences between groups were observed: PP patients showed the most enlargement in the periventricular region (median 3.8 ml), significantly higher than for CIS and RR, but comparable to the SP group. The RR group showed more enlargement of deep white matter lesions compared to the other groups, with a median of 0.1 ml. There were no significant differences between clinical groups in the volumes of enlarged juxtacortical lesions (median value 0.05 ml for all groups).
Conclusion: MSmetrix found a location-dependent evolution of new and enlarging lesions for different MS clinical phenotypes. Some of the findings can be explained by disease duration: more advanced MS forms (PP and SP patients) show significant enlargement of existing periventricular lesions instead of new lesion formation. Compared to other groups, RR patients had more enlargement of the deep white matter lesions, and for CIS patients there seemed to be no location prevalence in the appearance of new lesions.
Disclosure: Diana M. Sima, Saurabh Jain, Eloy Roura, Anke Maertens, Dirk Smeets, Wim Van Hecke are employed by icometrix.
Dominique Sappey-Marinier: nothing to disclose.
Françoise Durand-Dubief has received consultancy fees, speaker fees, research grants (non-personal) or honoraria from Biogen, Genzyme-Sanofi, Medday, Merck-Serono, Novartis, Roche and Teva.