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Alexandra Lipka¹, Wolfgang Bogner¹, Assunta Dal-Bianco², Gilbert Hangel^1,3, Paulus Rommer², Bernhard Strasser¹, Stanislav Motyka¹, Lukas Hingerl¹, Thomas Berger², Fritz Leutmezer², Stephan Gruber¹, Siegfried Trattnig^1,4, and Eva Niess^1
1Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, High Field MR Centre, Vienna, Austria, ²Medical University of Vienna, Department of Neurology, Vienna, Austria, ³Medical University of Vienna, Department of Neurosurgery, Vienna, Austria, ⁴Karl Landsteiner Institute for Clinical Molecular MRI in Musculoskeletal System, Vienna, Austria

Keywords: Multiple Sclerosis, Multiple Sclerosis

Besides clinical examination, conventional T1/T2-weighted magnetic resonance imaging (cMRI) is the method of choice for diagnosis and treatment monitoring of Multiple Sclerosis (MS). In contrast to cMRI, which - in MS - can only depict the severity of irreversible tissue damage and is not able to explain underlying pathological processes, MR Spectroscopic Imaging (MRSI) can detect pathologies on a biochemical level, while Susceptibility Weighted Imaging (SWI) provides information about iron deposition. In 31 relapsing-remitting (RRMS) patients, we investigate - via ultra-high resolution FID-MRSI at 7T - metabolic characteristics of different types of iron accumulation and the metabolic distribution within lesions and their vicinity. 

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Alessandra S. Caporale^1,2, Antonio M. Chiarelli^1,2, Emma Biondetti^1,2, Alessandro Villani^1,2, Ilona Lipp³, Valentina Tomassini^1,2,4,5, and Richard G. Wise^1,2,5
1Department of Neurosciences, Imaging and Clinical Sciences, 'G. d'Annunzio University' of Chieti-Pescara, Chieti, Italy, ²Institute for Advanced Biomedical Technologies (ITAB), 'G. d'Annunzio University' of Chieti-Pescara, Chieti, Italy, ³Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany, ⁴MS Centre, Department of Clinical Neurology, ‘SS. Annunziata’ University Hospital, Chieti, Italy, ⁵Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, United Kingdom

Keywords: Multiple Sclerosis, White Matter, normal appearing white matter, neurodegeneration, cognitive impairment

In 99 relapsing-remitting multiple sclerosis (MS) patients and 25 healthy controls we quantified cerebral free water fraction (FWF) and investigated its relationship with lesion burden and information processing speed, measured with Symbol Digit Modalities Test (SDMT). FWF was obtained from the mcDESPOT method, fitting a three-compartment relaxation model to spoiled-gradient-echo and balanced-SSFP signals with varying flip angles. MS patients showed higher FWF than controls, in the lesioned tissue and in normal appearing white matter (NAWM). In NAWM and perilesional tissue, FWF correlated with lesion load. FWF spatial heterogeneity increased with worsening SDMT performance in regions involved in MS-related cognitive impairment.

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Jinhee Jang¹, Hyeong-Geol Shin^2,3, Minjun Kim⁴, Hyebin Lee¹, and Woojun Kim^5
1Radiology, Seoul St. Mary's Hospital, Seoul, Korea, Republic of, ²Radiology, Johns Hopkins University, Baltimore, MD, United States, ³F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States, ⁴Electrical and Computer Engineering, Seoul National University, Seoul, Korea, Republic of, ⁵Neurology, Seoul St. Mary's Hospital, Seoul, Korea, Republic of

Keywords: Multiple Sclerosis, Quantitative Susceptibility mapping

While χ-separation gives unique and valuable information, requirement of R2 limited its clinical application. This study assessed the clinical feasibility of two R2*-based magnetic source separation. From 24 MR scans of MS subjects, four sets of magnetic source separation maps were generated; (1) χ-separation (originally proposed method), (2) χ-separation* (exploiting R2*), (3) χ-sepnet (DL-based), and (4) χ-sepnet* (DL-based, utilizing R2*). χ-separation* and χ-sepnet* showed good agreement to χ-separation and χ-sepnet in MS lesions and the brain. However, there are small but consistent biases in each method, which are important caveats for R2*-based χ-separation. These biases were relatively smaller in χ-sepnet*.

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Kelley M. Swanberg¹, Hetty Prinsen², Daniel Pelletier^2,3, and Christoph Juchem^1,2,4,5
1Biomedical Engineering, Columbia University, New York, NY, United States, ²Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, United States, ³Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA, United States, ⁴Neurology, Yale University School of Medicine, New Haven, CT, United States, ⁵Radiology, Columbia University Irving Medical Center, New York, NY, United States

Keywords: Multiple Sclerosis, Spectroscopy, dimethyl fumarate, glutathione, oxidative stress

Multiple sclerosis (MS) is an autoimmune disease that damages the central nervous system. Oxidative stress, thought to play a role in MS-related pathophysiology, can be modulated in the cell by endogenous antioxidants such as glutathione (GSH), hypothesized to participate in the therapeutic effect of MS disease-modifying therapy dimethyl fumarate. We used proton magnetic resonance spectroscopy (¹H MRS) to measure in vivo cortical glutathione concentrations in individuals with relapsing-remitting multiple sclerosis (RR-MS) before and during 12 months of dimethyl fumarate therapy and observed a significant positive effect of time on prefrontal cortex glutathione. No such change was shown in healthy controls. 

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Tomoko Maekawa¹, Masaaki Hori^1,2, Katsutoshi Murata³, Kouhei Kamiya^1,2, Christina Andica^1,4, Akifumi Hagiwara¹, Shohei Fujita^1,5, Koji Kamagata¹, Akihiko Wada¹, and Shigeki Aoki^1
1Juntendo University School of Medicine, Tokyo, Japan, ²Toho University Omori Medical Center, Tokyo, Japan, ³Siemens Healthcare K.K., Tokyo, Japan, ⁴Faculty of Health Data Science, Juntendo University, Chiba, Japan, ⁵The University of Tokyo, Tokyo, Japan

Keywords: Multiple Sclerosis, Diffusion/other diffusion imaging techniques, Microstructure

The purpose of our study was to investigate the utility of changes in diffusivity between short and long diffusion time in evaluating acute and chronic plaques of multiple sclerosis. Chronic plaques showed weak diffusion time-dependence with diffusion times between 6.5 ms and 35.2 ms. The differences in diffusion time-dependence were attributed to the internal structure of plaques. DWI with a short diffusion time may provide additional information about the microstructure of MS plaques.

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Mert Şişman^1,2, Thanh D. Nguyen², Alexey V. Dimov², Melanie Marcille ³, Pascal Spincemaille², Susan A. Gauthier³, and Yi Wang^2,4
1Electrical and Computer Engineering, Cornell University, Ithaca, NY, United States, ²Department of Radiology, Weill Cornell Medicine, New York, NY, United States, ³Department of Neurology, Weill Cornell Medicine, New York, NY, United States, ⁴Biomedical Engineering, Cornell University, Ithaca, NY, United States

Keywords: Multiple Sclerosis, White Matter

Monitoring myelin content quantitatively is important in the study of Multiple Sclerosis (MS). Here, a novel approach is proposed to estimate myelin volume fraction (MVF) of MS lesions from routine multi-echo gradient echo (mGRE) using biophysical modeling of the myelin sheaths. The obtained MVF values correlated significantly with the myelin water fraction (MWF) values obtained in the same lesions using conventional multicomponent T2 relaxometry. Moreover, the change in MVF values in newly enhancing lesions over the first year also correlated significantly with the change in MWF values over the same period.

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Samira Mchinda^1,2,3, Arnaud Le Troter^1,2, Sarah Demortière⁴, Nilser Laines Medina^1,2,3, Lauriane PINI^1,2, Jean Pelletier^1,2,4, Bertrand Audoin^1,2,4, and Virginie Callot^1,2,3
1Aix Marseille Univ, CNRS, CRMBM, Marseille, France, ²APHM, Hôpital Universitaire Timone, CEMEREM, Marseille, France, ³iLab-Spine, International Associated Laboratory, Montreal, Canada, Marseille, France, ⁴APHM, Hôpital Universitaire Timone, Département de Neurologie, Marseille, France

Keywords: Multiple Sclerosis, Spinal Cord, z-score maps

Manual segmentation, considered as ground truth, remains time consuming and operator dependent. In this work, a strategy to identify and potentially segment individual cervical spinal cord lesions based on z-score maps(ZM) from 3T quantitative T₁-MP2RAGE(T_1q) imaging is proposed. All manually segmented lesions could be visually identified in ZM with a lower threshold(LT) of 2. Conversely, Sixty-nine% of the lesions could be isolated automatically using LT=3 and analyzing the characteristics of the ZM clusters in combination with ZM gradient maps. Four patients (/4) without lesions, and 21/23 controls showed no significant cluster.

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Benjamin Charles Musall¹, Yanyu Yang², Arash Kamali¹, John A Lincoln³, Vi Ly², Xi Luo², Ponnada A Narayana¹, Refaat E Gabr¹, and Khader M Hasan^1
1Diagnostic and Interventional Imaging, UTHealth McGovern Medical School, Houston, TX, United States, ²Department of Biostatistics and Data Science, University of Texas School of Public Health, Houston, TX, United States, ³Department of Neurology, UTHealth McGovern Medical School, Houston, TX, United States

Keywords: Multiple Sclerosis, Quantitative Imaging

Quantitative T2 of diffusely-abnormal white matter (DAWM), assessed at baseline in a population of 800 patients with relapsing-remitting MS with U-Net segmentation and T2 mapping, is distinct and intermediate to T2-hyperintense focal lesions and normal-appearing white matter (NAWM).

Yujing Li^1,2, Tingli Yang³, Min Li³, Rui Wang³, Xinying Ren³, Diaohan Xiong³, Kai Ai⁴, and Jing Zhang^3
1Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, China, ²Second Clinical School, Lanzhou University, Lanzhou, China, ³Lanzhou University Second Hospital, Lanzhou, China, ⁴Philips Healthcare, Xi’an, China

Keywords: Multiple Sclerosis, Gray Matter

This study investigated the shape changes in the subcortical structure of patients with multiple sclerosis (PwMS) and how they are associated with MS-related fatigue. Surface-based vertex analysis was performed on 25 fatigued RRMS (F-MS), 25 non-fatigued RRMS (NF-MS), and 40 healthy controls (HCs). Compared to HCs, PwMS showed regional shape contractions in the areas of bilateral thalamus. The morphological changes in the bilateral thalamus occur only on the side closest to the ventricles. Compared to the NF-MS subgroup, F-MS patients showed regional surface atrophy in the areas of left caudate nucleus, which was negatively correlated with the severity of fatigue.

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Elena Grosso¹, Carmen Tur^2,3, Alberto Calvi², Sara Collorone², Francesco Grussu^2,4, Marco Battiston², Ferran Prados Carrasco^2,5,6, Baris Kanber^2,5, Rebecca Samson², Egidio D'Angelo^1,7, Claudia AM Gandini Wheeler-Kingshott^1,2,7, and Fulvia Palesi^1
1Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy, ²NMR Research Unit, Department of Neuroinflammation, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology, University College London (UCL), London, United Kingdom, ³Neurology-Neuroimmunology Department Multiple Sclerosis Centre of Catalonia (Cemcat), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain, ⁴Radiomics Group, Vall d’Hebron Institute of Oncology, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain, ⁵Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London, United Kingdom, ⁶E-Health Center, Universitat Oberta de Catalunya, Barcelona, Spain, ⁷Brain Connectivity Centre Research Unit, IRCCS Mondino Foundation, Pavia, Italy

Keywords: Multiple Sclerosis, Diffusion/other diffusion imaging techniques, personalised-NODDI

Neurite Orientation Dispersion and Density Imaging (NODDI) is a multi-compartmental model for microstructure characterization utilising diffusion-weighted MRI. Here, a recently proposed personalized-NODDI (pNODDI) modelling technique was used to assess microstructural alterations in a cohort of Multiple Sclerosis (MS) patients. Our findings showed that pNODDI metrics were sensitive to MS pathology and could discriminate between healthy controls and MS. Furthermore, pNODDI metrics of key brain regions increased the discriminative power between the two groups. Overall, pNODDI provides a personalized and clinically feasible model for microstructure, increasing sensitivity to pathological alterations. 

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Ratthaporn Boonsuth^1,2, Marco Battiston¹, Rebecca S. Samson¹, Alberto Calvi^1,3, Claudia A. M. Gandini Wheeler-Kingshott^1,4,5, and Marios C. Yiannakas^1
1NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom, ²Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand, ³Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases; Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain, ⁴Brain Connectivity Research Centre, IRCCS Mondino Foundation, Pavia, Italy, ⁵Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy

Keywords: Multiple Sclerosis, Quantitative Imaging, Nerves, Multimodal, Neurography

The peripheral nervous system is not routinely examined objectively in multiple sclerosis (MS), despite evidence from neuropathology that demonstrates its implication. In this pilot in vivo study, the sciatic nerve was examined using multi-shell diffusion-weighted imaging, quantitative magnetisation transfer and T1 relaxometry to investigate whether pathological neural tissue damage could be detected in people with relapsing-remitting MS as compared to healthy controls.   

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Eva A. Krijnen^1,2, Albulena Bajrami^1,3, Tommy A.A. Broeders¹, Samantha Noteboom¹, Piet M. Bouman¹, Frederik Barkhof^4,5, Bernard M.J. Uitdehaag⁶, Eric C. Klawiter², Ismail Koubiyr¹, and Menno M. Schoonheim^1
1MS Center Amsterdam, Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, Netherlands, ²Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States, ³Multiple Sclerosis Specialist Center, Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy, ⁴MS Center Amsterdam, Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, Netherlands, ⁵Institutes of Neurology and Healthcare Engineering, University College London, London, United Kingdom, ⁶MS Center Amsterdam, Neurology, Amsterdam Neuroscience, Amsterdam UMC location VUmc, Amsterdam, Netherlands

Keywords: Multiple Sclerosis, Gray Matter, Diffusion/Other Diffusion Imaging Techniques

Cognitive functioning in people with multiple sclerosis (MS) is strongly related to cortical lesions (CLs), although the severity of demyelination remains difficult to assess in-vivo. In addition, how the pathological microstructural changes in normal-appearing gray matter relate to cognition also remains unclear. This study assessed how microstructural integrity (based on diffusion MRI) in CLs and normal-appearing cortex relates to cognition in MS. Microstructural integrity changes were most evident in cognitively-impaired MS, especially in the normal-appearing cortex. Regionally, damage was especially related to cognition within cognitive functional networks such as the ventral attention network.

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Agnese Tamanti¹, Annalisa Colombi¹, Angela Peloso¹, Nicola Serafin¹, Valentina Camera¹, Francesca Benedetta Pizzini², Marco Castellaro³, and Massimiliano Calabrese^2
1Department of Neurosciences, Biomedicine and Movement sciences, University of Verona, Verona, Italy, ²Neuroradiology Unit, Department of Diagnostics and Pathology, University of Verona, Verona, Italy, ³Department of Information Engineering, University of Padova, Padova, Italy

Keywords: Multiple Sclerosis, Multi-Contrast, paramagnetic rim lesions

Chronic active lesions have been recently investigated in multiple sclerosis (MS) and associated with the detection of paramagnetic rims on susceptibility-based MRI images (filtered phase and quantitative susceptibility mapping). Quantitative MRI approaches have the potential to reveal the degree of tissue damage in paramagnetic rim lesions. In this study a significant increase in T2* relaxation time and Quantitative Susceptibility Mapping (QSM) as well as a decrease in Magnetization Transfer Ratio (MTR) and Magnetization Transfer Saturation (MTSat) was revealed in PRL+ lesions compared to PRL-, thus supporting the use of these MRI metrics to detect tissue damage associated with chronic activity.

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Catherine M. Medeiros¹, Kay C. Igwe^1,2, Hetty Prinsen³, Abhinav V. Kurada¹, Kelley M. Swanberg^1,3, and Christoph Juchem^1,3,4,5
1Biomedical Engineering, Columbia University School of Engineering and Applied Science, New York, NY, United States, ²Neurology, Columbia University Irving Medical Center, New York, NY, United States, ³Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, United States, ⁴Neurology, Yale University School of Medicine, New Haven, CT, United States, ⁵Radiology, Columbia University Irving Medical Center, New York, NY, United States

Keywords: Multiple Sclerosis, Segmentation, Quantification, Water Referencing

A current standard practice in proton magnetic resonance spectroscopy (¹H-MRS) uses water as an internal reference for absolute metabolite quantification. We investigate how apparent metabolite concentrations might be affected by tissue-level changes, specifically multiple sclerosis lesions, via water versus creatine referencing in voxels considered normal-appearing at time of scan. Our results suggest that multiple possible routes of confound by hidden lesions on metabolite quantification in even normal-appearing tissue should be considered when applying internal water referencing to ¹H-MRS studies in cohorts with multiple sclerosis.

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Sreekanth Madhusoodhanan Nair¹, Jin Jin², Fei Han³, Brian Renner¹, Elaina Gombos¹, Ke Cheng Liu⁴, Sunil Patil⁵, John A Derbyshire⁶, Ken Sakaie⁷, Emmanuel Obusez⁷, Jonathan Lee⁷, Mark Elliott⁸, Russell T Shinohara⁹, Matthew K Schindler¹⁰, Jae W Song⁸, Michel Bilello⁸, Marwa Kaisey¹, Omar Al-Louzi¹, Nader Binesh¹¹, Marcel Maya¹¹, Javier Galvan¹¹, Hui Han¹², Debiao Li¹², Andrew Solomon¹³, Daniel S Reich¹⁴, Nancy L Sicotte¹, Mark Lowe⁷, Daniel Ontaneda¹⁵, and Pascal Sati^1,12
1Department of Neurology, Cedars Sinai Medical Center, Los Angeles, CA, United States, ²Siemens Healthcare Pty Ltd, Brisbane, Australia, ³Siemens Medical Solutions, Los Angeles, CA, United States, ⁴Siemens Medical Solutions, Malvern, PA, United States, ⁵Siemens Medical Solutions, Baltimore, MD, United States, ⁶Functional MRI Facility, National Institute of Mental Health, Bethesda, MD, United States, ⁷Imaging Institute, Cleveland Clinic, Cleveland, OH, United States, ⁸Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States, ⁹Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States, ¹⁰Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States, ¹¹Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CO, United States, ¹²Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ¹³Larner College of Medicine, The University of Vermont, Burlington, VT, United States, ¹⁴Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, CA, United States, ¹⁵Mellen Center, Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States

Keywords: Multiple Sclerosis, Data Analysis, Parallel Imaging

High-resolution T2*-weighted brain imaging using 3D echo planar imaging (3D-EPI) at 3T allows detection of new biomarkers of neurological disorders, such as the central vein sign in multiple sclerosis. However, current 3D-EPI scan times are suboptimal for a widespread implementation in hospitals and private imaging centers. In this study, we evaluated the feasibility of combining 3D-EPI acquisition with different CAIPIRINHA undersampling patterns. A significant reduction in scan time (up to 70% reduction) was achieved without any obvious aliasing artifacts, confirming the feasibility of ultra-fast, high-resolution T2* brain imaging for future clinical applications at 3T.

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Matthias Weigel^1,2,3, Peter Dechent⁴, Riccardo Galbusera^1,2, Erik Bahn⁵, Ludwig Kappos^1,2, Wolfgang Brück⁵, Christine Stadelmann⁵, and Cristina Granziera^1,2
1Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland, ²Neurological Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland, ³Division of Radiological Physics, Dept. of Radiology, University Hospital Basel, Basel, Switzerland, ⁴MR-Research in Neurosciences, Department of Cognitive Neurology, University Medical Center Göttingen, Göttingen, Germany, ⁵Institute of Neuropathology, University Medical Center Göttingen, Göttingen, Germany

Keywords: Multiple Sclerosis, Ex-Vivo Applications

Ex Vivo MRI of the entire human brain facilitates new and fascinating insights into cerebral and cerebellar morphology and pathology. One key factor for achieving ultra-high spatial resolutions is a signal- and time-efficient MRI sequence, particularly, at 3T field strength. Though counterintuitive at first notion, we suggest a “slow” balanced steady-state free precession (bSSFP) approach with phase-cycling and very low receiver bandwidth (“LoBa-bSSFP”) as a highly signal- and time-efficient scheme for ex vivo acquisitions. LoBa-bSSFP can support spatial resolutions as high as 98-microns isotropic for covering the entire cerebellum on a common 3T MR system.

Sarah Schlaeger¹, Mark Mühlau², Guillaume Gilbert³, Irene Vavasour⁴, Thomas Amthor⁵, Mariya Doneva⁵, Aurore Menegaux¹, Markus Lauerer², Viola Pongratz², Claus Zimmer¹, Benedikt Wiestler¹, Christine Preibisch^1,2, Jan Kirschke¹, and Ronja C. Berg^1,2
1Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany, ²Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany, ³MR Clinical Science, Philips Healthcare, Mississauga, ON, Canada, ⁴Department of Radiology, University of British Columbia, Vancouver, BC, Canada, ⁵Philips Research Europe, Hamburg, Germany

Keywords: Multiple Sclerosis, Brain

Quantitative MRI in patients with multiple sclerosis (MS) allows for the objective identification of even subtle pathological changes in lesional, perilesional, NAGM, and NAWM tissue. Routine clinical scan protocols need to be tailored to the most diagnostically relevant MR biomarkers, however, to date only a few studies have investigated the particular diagnostic sensitivity of different MR biomarkers to different structural alterations of brain tissue affected by MS. Therefore, we studied 13 MS patients and 14 healthy controls using multiparametric, quantitative MR: we evaluated and compared the ability of nine different MR biomarkers to detect and characterize MS pathology.

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Junghwa Kang¹, Jeongmin Yim², Jinhee Jang³, and Yoonho Nam^1
1Department of Biomedical engineering, Hankuk University of Foreign Studies, Yongin, Korea, Republic of, ²College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of, ³Department of Radiology, Seoul St. Mary's Hospital, Seoul, Korea, Republic of

Keywords: Multiple Sclerosis, Multiple Sclerosis, longitudinal MR, new lesion

Measurement of new lesions in longitudinal images is crucial in the evaluation of MS but is laborious and time-consuming. In this study, wWe investigate the effect of subtraction images between two time point FLAIR images on new MS lesion segmentation in longitudinal FLAIR images. The results showed that our method with combination of longitudinal FLAIR images and their subtraction images together helps to improve the accuracy of segmentation of new MS lesion.

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Irene Margaret Vavasour¹, Connor Keane², Poljanka Johnson³, Joshua Lee², Adelia Adelia², Jiwon Oh⁴, Anthony Traboulsee², and Shannon Kolind^1,2,5
1Radiology, University of British Columbia, Vancouver, BC, Canada, ²Medicine, University of British Columbia, Vancouver, BC, Canada, ³Neuroscience, University of British Columbia, Vancouver, BC, Canada, ⁴Medicine, University of Toronto, Toronto, ON, Canada, ⁵Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada

Keywords: Multiple Sclerosis, Relaxometry, radiologically isolated syndrome, normal-appearing, myelin water fraction, myelin heterogeneity index white matter, motor function

Regional myelin water fraction (MWF) in radiologically isolated syndrome (RIS) white matter were compared to relapsing-remitting (RR) and primary-progressive (PP) multiple sclerosis (MS). Results showed myelin damage in some white matter regions of RIS. Early myelin damage in RIS may be associated with subclinical ambulatory dysfunction. Manual dexterity correlated with myelin content in the cortical spinal tract and corpus callosum in PPMS whereas it correlated with myelin heterogeneity in RRMS. These findings suggest that myelin changes in critical white matter tracts have differing impact in gross and fine motor function in RIS and MS subtypes.