Contributions
Abstract: P480
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: B-cell lymphoid aggregates have been implicated in meningeal inflammation, cortical grey matter demyelination, and disability progression in multiple sclerosis (MS) (1). Gadolinium-enhanced 3D-FLAIR (Gd-3D-FLAIR) MRI has been shown to identify foci of leptomeningeal enhancement (LME) in MS (2), thought to be an imaging biomarker for leptomeningeal inflammation. However, there has been considerable variability in the rate of LME detection by different investigators.
Objectives: To determine if MRI scanner variability can cause different rates of LME detection by different investigators.
Aims: To add to the knowledge base of LME as a biomarker of meningeal inflammation in MS, in the hope of identifying disease modifying therapies that can attenuate meningeal inflammation.
Methods: A phantom was made containing vials of increasing concentrations of Gd from 0.01 to 3.0 mmol, as previously described by Mathews et al, 1999 (3). The phantom was placed over the forehead of one volunteer, and scanned using 3D-FLAIR on all imaging platforms available. Signal intensity was normalized by dividing by thalamic signal, and concentration-intensity curves were generated and compared by scanner type, including type of FLAIR and field strength. The effects of various surface coil intensity correction algorithms and fat suppression were also assessed.
Results: Scanners using CUBE FLAIR showed notably higher signal intensity compared to scanners using SPACE FLAIR. When using CUBE, 3T produced a moderate increase in signal intensity over 1.5T, whereas there was no difference between 1.5T and 3T when using SPACE.
Conclusions: There appears to be different sensitivity in signal detection by 3D-FLAIR between different scanners. Controlling for scanner variability will be essential in future studies of LME.
References:
1. Howell OW, Reeves CA, Nicholas R, et al. Meningeal inflammation is widespread and linked to cortical pathology in multiple sclerosis. Brain 2011; 134:2755-2771.
2. Absinta M, Vuolo L, Rao A, et al. Gadolinium-based MRI characterization of leptomeningeal inflammation in multiple sclerosis. Neurology 2015; 85:18-28.
3. Mathews VP, Caldemeyer KS, Lowe MJ, et al. Brain: gadolinium-enhanced fast fluid-attenuated inversion-recovery MR imaging. Radiology 1999; 211:257-263.
Disclosure: Dr. Titelbaum has no disclosures
Dr. Engisch has no disclosures
Dr. Schwartz has no relevant disclosures
Dr. Napoli has no relevant disclosures
Dr. Sloane has no relevant disclosures
Dr. Katz has no relevant disclosures
Dr. Lathi has no relevant disclosures
Abstract: P480
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: B-cell lymphoid aggregates have been implicated in meningeal inflammation, cortical grey matter demyelination, and disability progression in multiple sclerosis (MS) (1). Gadolinium-enhanced 3D-FLAIR (Gd-3D-FLAIR) MRI has been shown to identify foci of leptomeningeal enhancement (LME) in MS (2), thought to be an imaging biomarker for leptomeningeal inflammation. However, there has been considerable variability in the rate of LME detection by different investigators.
Objectives: To determine if MRI scanner variability can cause different rates of LME detection by different investigators.
Aims: To add to the knowledge base of LME as a biomarker of meningeal inflammation in MS, in the hope of identifying disease modifying therapies that can attenuate meningeal inflammation.
Methods: A phantom was made containing vials of increasing concentrations of Gd from 0.01 to 3.0 mmol, as previously described by Mathews et al, 1999 (3). The phantom was placed over the forehead of one volunteer, and scanned using 3D-FLAIR on all imaging platforms available. Signal intensity was normalized by dividing by thalamic signal, and concentration-intensity curves were generated and compared by scanner type, including type of FLAIR and field strength. The effects of various surface coil intensity correction algorithms and fat suppression were also assessed.
Results: Scanners using CUBE FLAIR showed notably higher signal intensity compared to scanners using SPACE FLAIR. When using CUBE, 3T produced a moderate increase in signal intensity over 1.5T, whereas there was no difference between 1.5T and 3T when using SPACE.
Conclusions: There appears to be different sensitivity in signal detection by 3D-FLAIR between different scanners. Controlling for scanner variability will be essential in future studies of LME.
References:
1. Howell OW, Reeves CA, Nicholas R, et al. Meningeal inflammation is widespread and linked to cortical pathology in multiple sclerosis. Brain 2011; 134:2755-2771.
2. Absinta M, Vuolo L, Rao A, et al. Gadolinium-based MRI characterization of leptomeningeal inflammation in multiple sclerosis. Neurology 2015; 85:18-28.
3. Mathews VP, Caldemeyer KS, Lowe MJ, et al. Brain: gadolinium-enhanced fast fluid-attenuated inversion-recovery MR imaging. Radiology 1999; 211:257-263.
Disclosure: Dr. Titelbaum has no disclosures
Dr. Engisch has no disclosures
Dr. Schwartz has no relevant disclosures
Dr. Napoli has no relevant disclosures
Dr. Sloane has no relevant disclosures
Dr. Katz has no relevant disclosures
Dr. Lathi has no relevant disclosures