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Journal of Neurology
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Serveur académique lausannois
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https://dx.doi.org/10.5167/uzh...
Other literature type . 2024
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Microstructural characterization of multiple sclerosis lesion phenotypes using multiparametric longitudinal analysis

Authors: Veronica Ravano; Michaela Andelova; Gian Franco Piredda; Stefan Sommer; Samuele Caneschi; Lucia Roccaro; Jan Krasensky; +11 Authors

Microstructural characterization of multiple sclerosis lesion phenotypes using multiparametric longitudinal analysis

Abstract

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.

Keywords

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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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
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hybrid