Restriction Spectrum Imaging in Multiple Sclerosis

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Presentation transcript:

Restriction Spectrum Imaging in Multiple Sclerosis Piotr Sowa, MD Dep. of Radiology and Nuclear Medicine / Oslo University Hospital Institute of Clinical Medicine / University of Oslo, Norway

Background RSI = Restriction Spectrum Imaging Newly introduced MRI diffusion-based sequence DWI & DTI extension RSI separates signal from cylindrical and spherical structures Promising results in neurooncology Not used in multiple sclerosis (MS) before

Background

Background RSI enables calculation of several diffusion parameters describing the tissue microstructure: fast apparent diffusion coefficient (fADC) slow apparent diffusion coefficient (sADC) fractional anisotropy (FA) restricted fractional anisotropy (rFA) cellularity neurite density (ND) extracellular water fraction (EWF) free water fraction (FWF) The aim of the study was to evaluate the association between diffusion parameters derived from RSI and neurological disability in MS patients.

Materials & methods 80 MS-patients in different stages of the disease diagnosed according to the 2010 McDonald criteria, 2012-13 mean age 40.2±10.4 (range 20–67) years, 63 (79%) females 77 relapsing remitting (RR) MS, 1 clinical isolated syndrome (CIS), 2 primary progressive (PP) MS Neurological disability as measured with expanded disability status scale (EDSS) collected retrospectively from electronic hospital record Patients were grouped according to their disability: minimal (EDSS<2.5), n=28 low (EDSS of 2.5-3), n=41 substantial (EDSS >3), n=11

Materials & methods Binary masks were created of: white matter (WM), with Freesurfer software white matter lesions (WML), with MIPAV software Parameters were extracted from the whole volume of WML and whole volume of normal appearing white matter (NAWM) Group analysis and correlation with EDSS were performed

Results fADC sADC FA rFA ND Cellularity EWF FWF in WML (grey) NAWM (white)

Results / conclusions Parameter that differentiated best between disability subgroups was sADC in WML (ANOVA: F=5.5, η2=0.13, p=0.006) Parameter that correlated best with disability was ND in NAWM (ϱ=-0.38, p=0.011). in NAWM (not in lesions) Processes in NAWM are important for disability in MS RSI can help in solving the clinico-radiological paradox Diffusion parameters derived from RSI are promising imaging biomarkers in MS

Thank you! P. Sowa, H. F. Harbo, N. S. White, E. G. Celius, H. Bartsch, P. Berg-Hansen, S. M. Moen, L. T. Westlye, O. A. Andreassen, Anders S. Dale, Mona K. Beyer Oslo University Hospital, University of Oslo, University of California San Diego, Oslo and Akershus University College of Applied Sciences