Contributions
Abstract: EP1745
Type: ePoster
Abstract Category: Therapy - disease modifying - 29 Risk management for disease modifying treatments
Background: Brain magnetic resonance imaging (MRI) plays a crucial role in the diagnosis and follow-up of natalizumab-associated progressive multifocal leukoencephalopathy (NTZ-PML) patients. Recent studies have demonstrated that PML lesions may show a low signal intensity (LSI) rim or band along the grey-white matter junction on susceptibility weighted imaging (SWI) or T2*-weighted imaging (T2*WI), which is likely caused by iron accumulation in macrophages in the lower layers of the cortex.
Objective:
To investigate whether the presence of a LSI rim on SWI or T2*WI is a reproducible finding in patients from a multi-center, real-world, and heterogeneous, dataset of local and referred NTZ-PML patients.
Methods: Patients were collected from the ongoing Dutch-Belgian NTZ-PML cohort and included in the study if a MRI with SWI or T2*WI sequence was available after the diagnosis of PML. The image acquisition was not standardized and based on local scanning protocols. Two raters in consensus scored the presence of a LSI rim, its location and whether it was located in, or adjacent to, a PML lesion.
Results: Of the 30 screened patients, 8 patients were included. A total of 10 MRIs (five different MR scanners; three 1.5T and two 3.0T) with SWI (n = 7) and/or T2*WI (n = 7) were available. The MRIs were performed at the acute PML stage (n = 2), PML- immune reconstitution inflammatory syndrome (IRIS) stage (n = 2), and chronic/follow-up stage (n=6).
In 7 of the 8 patients a LSI rim was visible (7 out of 10 MRIs): 2 in the acute PML stage and 5 at the chronic stage. The LSI rims were observed in the left frontal lobe (n = 3), right frontal lobe (n = 4), or left occipital lobe (n = 1), and all were in or adjacent to a PML lesion.
Conclusion: We show that the presence of a LSI rim was observed in, or adjacent to, a PML lesion in 7 out of 8 patients tested. This suggests that SWI and T2*WI may add to the diagnosis and follow-up of PML without being influenced by differences in image acquisition.
Disclosure: MTW does not report any potential conflict of interest.
JK has received consultancy fees from Merck-Serono, Teva, Biogen, Genzyme and Novartis.
MPW has received consultancy fees from Biogen, Roche, and Novartis.
Abstract: EP1745
Type: ePoster
Abstract Category: Therapy - disease modifying - 29 Risk management for disease modifying treatments
Background: Brain magnetic resonance imaging (MRI) plays a crucial role in the diagnosis and follow-up of natalizumab-associated progressive multifocal leukoencephalopathy (NTZ-PML) patients. Recent studies have demonstrated that PML lesions may show a low signal intensity (LSI) rim or band along the grey-white matter junction on susceptibility weighted imaging (SWI) or T2*-weighted imaging (T2*WI), which is likely caused by iron accumulation in macrophages in the lower layers of the cortex.
Objective:
To investigate whether the presence of a LSI rim on SWI or T2*WI is a reproducible finding in patients from a multi-center, real-world, and heterogeneous, dataset of local and referred NTZ-PML patients.
Methods: Patients were collected from the ongoing Dutch-Belgian NTZ-PML cohort and included in the study if a MRI with SWI or T2*WI sequence was available after the diagnosis of PML. The image acquisition was not standardized and based on local scanning protocols. Two raters in consensus scored the presence of a LSI rim, its location and whether it was located in, or adjacent to, a PML lesion.
Results: Of the 30 screened patients, 8 patients were included. A total of 10 MRIs (five different MR scanners; three 1.5T and two 3.0T) with SWI (n = 7) and/or T2*WI (n = 7) were available. The MRIs were performed at the acute PML stage (n = 2), PML- immune reconstitution inflammatory syndrome (IRIS) stage (n = 2), and chronic/follow-up stage (n=6).
In 7 of the 8 patients a LSI rim was visible (7 out of 10 MRIs): 2 in the acute PML stage and 5 at the chronic stage. The LSI rims were observed in the left frontal lobe (n = 3), right frontal lobe (n = 4), or left occipital lobe (n = 1), and all were in or adjacent to a PML lesion.
Conclusion: We show that the presence of a LSI rim was observed in, or adjacent to, a PML lesion in 7 out of 8 patients tested. This suggests that SWI and T2*WI may add to the diagnosis and follow-up of PML without being influenced by differences in image acquisition.
Disclosure: MTW does not report any potential conflict of interest.
JK has received consultancy fees from Merck-Serono, Teva, Biogen, Genzyme and Novartis.
MPW has received consultancy fees from Biogen, Roche, and Novartis.