
Abstract Background and objectives In multiple sclerosis (MS), slowly expanding lesions were shown to be associated with worse disability and prognosis. Their timely detection from cross-sectional data at early disease stages could be clinically relevant to inform treatment planning. Here, we propose to use multiparametric, quantitative MRI to allow a better cross-sectional characterization of lesions with different longitudinal phenotypes. Methods We analysed T1 and T2 relaxometry maps from a longitudinal cohort of MS patients. Lesions were classified as enlarging, shrinking, new or stable based on their longitudinal volumetric change using a newly developed automated technique. Voxelwise deviations were computed as z-scores by comparing individual patient data to T1, T2 and T2/T1 normative values from healthy subjects. We studied the distribution of microstructural properties inside lesions and within perilesional tissue. Results and conclusions Stable lesions exhibited the highest T1 and T2 z-scores in lesion tissue, while the lowest values were observed for new lesions. Shrinking lesions presented the highest T1 z-scores in the first perilesional ring while enlarging lesions showed the highest T2 z-scores in the same region. Finally, a classification model was trained to predict the longitudinal lesion type based on microstructural metrics and feature importance was assessed. Z-scores estimated in lesion and perilesional tissue from T1, T2 and T2/T1 quantitative maps carry discriminative and complementary information to classify longitudinal lesion phenotypes, hence suggesting that multiparametric MRI approaches are essential for a better understanding of the pathophysiological mechanisms underlying disease activity in MS lesions.
Male, Adult, Multiple Sclerosis, 610 Medicine & health, Lesion subtyping, Multiple Sclerosis/diagnostic imaging/pathology, Multiple sclerosis, Enlarging lesions, Brain/diagnostic imaging/pathology, Humans, Longitudinal Studies, Multiparametric Magnetic Resonance Imaging, Original Communication, Cross, Brain, Quantitative MRI, Middle Aged, Magnetic Resonance Imaging, Sectional Studies, 2728 Neurology (clinical), Phenotype, Cross-Sectional Studies, 2808 Neurology, Humans; Male; Female; Adult; Longitudinal Studies; Multiple Sclerosis/diagnostic imaging; Multiple Sclerosis/pathology; Phenotype; Middle Aged; Brain/diagnostic imaging; Brain/pathology; Multiparametric Magnetic Resonance Imaging; Disease Progression; Cross-Sectional Studies; Magnetic Resonance Imaging; Enlarging lesions; Lesion subtyping; Multiple sclerosis; Quantitative MRI; Relaxometry, Disease Progression, 10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center, Female, Relaxometry
Male, Adult, Multiple Sclerosis, 610 Medicine & health, Lesion subtyping, Multiple Sclerosis/diagnostic imaging/pathology, Multiple sclerosis, Enlarging lesions, Brain/diagnostic imaging/pathology, Humans, Longitudinal Studies, Multiparametric Magnetic Resonance Imaging, Original Communication, Cross, Brain, Quantitative MRI, Middle Aged, Magnetic Resonance Imaging, Sectional Studies, 2728 Neurology (clinical), Phenotype, Cross-Sectional Studies, 2808 Neurology, Humans; Male; Female; Adult; Longitudinal Studies; Multiple Sclerosis/diagnostic imaging; Multiple Sclerosis/pathology; Phenotype; Middle Aged; Brain/diagnostic imaging; Brain/pathology; Multiparametric Magnetic Resonance Imaging; Disease Progression; Cross-Sectional Studies; Magnetic Resonance Imaging; Enlarging lesions; Lesion subtyping; Multiple sclerosis; Quantitative MRI; Relaxometry, Disease Progression, 10046 Balgrist University Hospital, Swiss Spinal Cord Injury Center, Female, Relaxometry
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