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Lin Y, Chan KH, Mak HKF, Yau KX, Cao P. Quantitative myelin water assessment for multiple sclerosis using multi-inversion magnetic resonance fingerprinting. Med Phys 2024. [PMID: 39388122 DOI: 10.1002/mp.17461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 09/05/2024] [Accepted: 09/27/2024] [Indexed: 10/15/2024] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a demyelination disease. Myelin water is a biomarker of myelin and thus myelin water imaging is a vital tool to provide insight into the demyelination process. PURPOSE This study aimed to characterize the multiple compartments including myelin water fraction (MWF), gray matter (GM) cellular water, white matter (WM) cellular water, and cerebrospinal fluid (CSF) using multiple inversion recovery (mIR) magnetic resonance fingerprinting (MRF) on a clinical MS cohort. METHODS The Phantom experiment was conducted with tubes containing different WM and GM concentrations extracted from pig brains. For the in-vivo experiment, 23 healthy control (HC) volunteers and 18 MS patients were recruited for this study. The experiments were performed using a clinical 3T MRI. A multi-slice, fast imaging with a steady-state precession (FISP) based mIR MRF protocol was used to obtain the MWF measurements, with 6 min of scan time for each volunteer. The quantification was based on the iterative non-negative least squares (NNLS) with reweighting. The brain compartments quantified were myelin water, WM cellular water, GM cellular water, and CSF. A radiologist with 6 years of experience labeled the MS lesions on FLAIR, MPRAGE, and MWF. Statistical analysis was performed by applying unpaired and paired student's t-tests to compare the MWF results in different groups and in normal-appearing white matter (NAWM) and MS lesions. RESULTS The phantom result demonstrated the ability to detect MWF with various myelin concentrations. The maps derived from mIR MRF, including MWF, WM cellular water, GM cellular water, and CSF were consistent with the anatomical structures observed in FLAIR and MPRAGE. The MWF values in the NAWM of MS patients were significantly different from those in HC, with values of 0.32 ± 0.025 and 0.25 ± 0.036, respectively. Additionally, the MWF values in WM lesions were significantly smaller than in NAWM at 0.034 ± 0.036. CONCLUSION The mIR-MRF technique, using multi-compartment analysis, can simultaneously generate maps of MWF, WM cellular water, GM cellular water, and CSF with sufficient brain coverage and in a reasonably short scan time. The MWF map might provide insights into the demyelination associated with MS.
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Affiliation(s)
- Yingying Lin
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
| | - Koon-Ho Chan
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Henry Ka-Fung Mak
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
| | | | - Peng Cao
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong, China
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Bontempi P, Marangoni S, Cazzoletti L, Bajrami A, Giometto B, Farace P, Rozzanigo U. Very-long T2-weighted imaging of the non-lesional brain tissue in multiple sclerosis patients. NMR IN BIOMEDICINE 2024:e5235. [PMID: 39086258 DOI: 10.1002/nbm.5235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 07/15/2024] [Accepted: 07/21/2024] [Indexed: 08/02/2024]
Abstract
The purpose of this study is to demonstrate that T2-weighted imaging with very long echo time (TE > 300 ms) can provide relevant information in neurodegenerative/inflammatory disorder. Twenty patients affected by relapsing-remitting multiple sclerosis with stable disease course underwent 1.5 T 3D FLAIR, 3D T1-weighted, and a multi-echo sequence with 32 echoes (TE = 10-320 ms). Focal lesions (FL) were identified on FLAIR. T1-images were processed to segment deep gray matter (dGM), white matter (WM), FL sub-volumes with T1 hypo-intensity (T1FL), and dGM volumes (atrophy). Clinical-radiological parameters included Expanded Disability Status Scale (EDSS), disease duration, patient age, T1FL, and dGM atrophy. Correlation analysis was performed between the mean signal intensity (SI) computed on the non-lesional dGM and WM at different TE versus the clinical-radiological parameters. Multivariable linear regressions were fitted to the data to assess the association between the dependent variable EDSS and the independent variables obtained by T1FL lesion load and the mean SI of dGM and WM at the different TE. A clear trend is observed, with a systematic strengthening of the significance of the correlation at longer TE for all the relationships with the clinical-radiological parameters, becoming significant (p < 0.05) for EDSS, T1FL volumes, and dGM atrophy. Multivariable linear regressions show that at shorter TE, the SI of the T2-weighted sequences is not relevant for describing the EDSS variability while the T1FL volumes are relevant, and vice versa, at very-long TEs (around 300 ms); the SI of the T2-weighted sequences significantly (p < 0.05) describes the EDSS variability. By very long TE, the SI primarily originates from water with a T2 longer than 250 ms and/or free water, which may be arising from the perivascular space (PVS). Very-long T2-weighting might detect dilated PVS and represent an unexplored MR approach in neurofluid imaging of neurodegenerative/inflammatory diseases.
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Affiliation(s)
- Pietro Bontempi
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | | | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | | | - Paolo Farace
- Medical Physics Department, Hospital of Trento, Trento, Italy
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Lee J, Ji S, Oh SH. So You Want to Image Myelin Using MRI: Magnetic Susceptibility Source Separation for Myelin Imaging. Magn Reson Med Sci 2024; 23:291-306. [PMID: 38644201 PMCID: PMC11234950 DOI: 10.2463/mrms.rev.2024-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/19/2024] [Indexed: 04/23/2024] Open
Abstract
In MRI, researchers have long endeavored to effectively visualize myelin distribution in the brain, a pursuit with significant implications for both scientific research and clinical applications. Over time, various methods such as myelin water imaging, magnetization transfer imaging, and relaxometric imaging have been developed, each carrying distinct advantages and limitations. Recently, an innovative technique named as magnetic susceptibility source separation has emerged, introducing a novel surrogate biomarker for myelin in the form of a diamagnetic susceptibility map. This paper comprehensively reviews this cutting-edge method, providing the fundamental concepts of magnetic susceptibility, susceptibility imaging, and the validation of the diamagnetic susceptibility map as a myelin biomarker that indirectly measures myelin content. Additionally, the paper explores essential aspects of data acquisition and processing, offering practical insights for readers. A comparison with established myelin imaging methods is also presented, and both current and prospective clinical and scientific applications are discussed to provide a holistic understanding of the technique. This work aims to serve as a foundational resource for newcomers entering this dynamic and rapidly expanding field.
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Affiliation(s)
- Jongho Lee
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
| | - Sooyeon Ji
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
| | - Se-Hong Oh
- Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Korea
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Buch S, Subramanian K, Chen T, Chen Y, Larvie M, Bernitsas E, Haacke EM. Characterization of white matter lesions in multiple sclerosis using proton density and T1-relaxation measures. Magn Reson Imaging 2024; 106:110-118. [PMID: 38145698 DOI: 10.1016/j.mri.2023.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/18/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE Although lesion dissemination in time is a defining characteristic of multiple sclerosis (MS), there is a limited understanding of lesion heterogeneity. Currently, conventional sequences such as fluid attenuated inversion recovery (FLAIR) and T1-weighted (T1W) data are used to assess MS lesions qualitatively. Estimating water content could provide a measure of local tissue rarefaction, or reduced tissue density, resulting from chronic inflammation. Our goal was to utilize the proton spin density (PD), derived from a rapid, multi-contrast STAGE (strategically acquired gradient echo) protocol to characterize white matter (WM) lesions seen on T2W, FLAIR and T1W data. MATERIALS AND METHODS Twenty (20) subjects with relapsing-remitting MS were scanned at 3 T using T1W, T2-weighted, FLAIR and strategically acquired gradient echo (STAGE) sequences. PD and T1 maps were derived from the STAGE data. Disease severity scores, including Extended Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC), were correlated with total, high PD and high T1 lesion volumes. A probability map of high PD regions and all lesions across all subjects was generated. Five perilesional normal appearing WM (NAWM) bands surrounding the lesions were generated to compare the median PD and T1 values in each band with the lesional values and the global WM. RESULTS T1W intensity was negatively correlated with PD as expected (R = -0.87, p < 0.01, R2 = 0.756) and the FLAIR signal was suppressed for high PD volumes within the lesions, roughly for PD ≥ 0.85. The threshold for high PD and T1 regions was set to 0.909 and 1953.6 ms, respectively. High PD regions showed a high probability of occurrence near the boundary of the lateral ventricles. EDSS score and nine-hole peg test (dominant and non-dominant hand) were significantly correlated with the total lesion volume and the volumes of high PD and T1 regions (p < 0.05). There was a significant difference in PD/T1 values between the high PD/T1 regions within the lesions and the remaining lesional tissue (p < 0.001). In addition, the PD values of the first NAWM perilesional band directly adjacent to the lesional boundary displayed a significant difference (p < 0.05) compared to the global WM. CONCLUSION Lesions with high PD and T1s had the highest probability of occurrence at the boundary of the lateral ventricles and likely represent chronic lesions with significant local tissue rarefaction. Moreover, the perilesional NAWM exhibited subtly increasing PD and T1 values from the NAWM up to the lesion boundary. Unlike on the T1 maps, the perilesional band adjacent to the lesion boundary possessed a significantly higher PD value than the global WM PD values. This shows that PD maps were sensitive to the subtle changes in NAWM surrounding the lesions.
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Affiliation(s)
- Sagar Buch
- Department of Neurology, Wayne State University, Detroit, MI, USA
| | | | - Teresa Chen
- College of Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, MI, USA
| | - Mykol Larvie
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | | | - E Mark Haacke
- Department of Neurology, Wayne State University, Detroit, MI, USA; Department of Radiology, Wayne State University, Detroit, MI, USA.
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Motegi H, Kufukihara K, Kitagawa S, Sekiguchi K, Hata J, Fujiwara H, Jinzaki M, Okano H, Nakamura M, Iguchi Y, Nakahara J. Non-lesional white matter changes depicted by q-space diffusional MRI correlate with clinical disabilities in multiple sclerosis. J Neurol Sci 2024; 456:122851. [PMID: 38181653 DOI: 10.1016/j.jns.2023.122851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/20/2023] [Accepted: 12/17/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND We previously developed an optimized q-space diffusional MRI technique (normalized leptokurtic diffusion [NLD] map) to delineate the demyelinated lesions of multiple sclerosis (MS) patients. Herein, we evaluated the utility of NLD maps to discern the white matter abnormalities in normal-appearing white matter (NAWM) and the abnormalities' possible associations with physical and cognitive disabilities in MS. METHODS We conducted a retrospective observational study of MS patients treated at our hospital (Jan. 2012 to Dec. 2022). Clinical and MRI data were collected; Processing Speed Test (PST) data were obtained when possible. For a quantitative analysis of the NLD maps, we calculated the NLD index as GVROI/GVREF, where GV is a mean grayscale value in the regions of interest (ROIs) and the reference area (REF; cerebrospinal fluid). RESULTS One hundred-one individuals with MS were included. The lower corpus callosum and non-lesional WM NLD index were associated with worse Expanded Disability Status Scale (EDSS) and PST scores. The NLD indexes in the corpus callosum (p < 0.0001) and non-lesional white matter (p < 0.0001) were significantly reduced in progressive MS compared to relapsing-remitting MS. We categorized MS severity as moderate/severe (EDSS score ≥ 4 points) and mild (EDSS score < 4 points). The NLD indexes in the corpus callosum (p < 0.0001) and non-lesional white matter (p < 0.0001) were significantly lower in the moderate/severe MS group compared to the mild MS group. CONCLUSION The NLD map revealed abnormalities in the non-lesional white matter, providing valuable insights for evaluating manifestations in MS patients.
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Affiliation(s)
- Haruhiko Motegi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan; Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Kenji Kufukihara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan; Department of Neurology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
| | - Satoshi Kitagawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Koji Sekiguchi
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
| | - Junichi Hata
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan; Department of Physiology, Keio University School of Medicine, Tokyo, Japan; Laboratory for Marmoset Neural Architecture, RIKEN Center for Brain Science, Wako, Japan.
| | - Hirokazu Fujiwara
- Center of Preventive Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
| | - Hideyuki Okano
- Department of Physiology, Keio University School of Medicine, Tokyo, Japan; Laboratory for Marmoset Neural Architecture, RIKEN Center for Brain Science, Wako, Japan.
| | - Masaya Nakamura
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
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Stellingwerff MD, Al-Saady ML, Chan KS, Dvorak A, Marques JP, Kolind S, Roosendaal SD, Wolf NI, Barkhof F, van der Knaap MS, Pouwels PJW. Applicability of multiple quantitative magnetic resonance methods in genetic brain white matter disorders. J Neuroimaging 2024; 34:61-77. [PMID: 37925602 DOI: 10.1111/jon.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/29/2023] [Accepted: 10/20/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Magnetic resonance imaging (MRI) measures of tissue microstructure are important for monitoring brain white matter (WM) disorders like leukodystrophies and multiple sclerosis. They should be sensitive to underlying pathological changes. Three whole-brain isotropic quantitative methods were applied and compared within a cohort of controls and leukodystrophy patients: two novel myelin water imaging (MWI) techniques (multi-compartment relaxometry diffusion-informed MWI: MCR-DIMWI, and multi-echo T2 relaxation imaging with compressed sensing: METRICS) and neurite orientation dispersion and density imaging (NODDI). METHODS For 9 patients with different leukodystrophies (age range 0.4-62.4 years) and 15 control subjects (2.3-61.3 years), T1-weighted MRI, fluid-attenuated inversion recovery, multi-echo gradient echo with variable flip angles, METRICS, and multi-shell diffusion-weighted imaging were acquired on 3 Tesla. MCR-DIMWI, METRICS, NODDI, and quality control measures were extracted to evaluate differences between patients and controls in WM and deep gray matter (GM) regions of interest (ROIs). Pearson correlations, effect size calculations, and multi-level analyses were performed. RESULTS MCR-DIMWI and METRICS-derived myelin water fractions (MWFs) were lower and relaxation times were higher in patients than in controls. Effect sizes of MWF values and relaxation times were large for both techniques. Differences between patients and controls were more pronounced in WM ROIs than in deep GM. MCR-DIMWI-MWFs were more homogeneous within ROIs and more bilaterally symmetrical than METRICS-MWFs. The neurite density index was more sensitive in detecting differences between patients and controls than fractional anisotropy. Most measures obtained from MCR-DIMWI, METRICS, NODDI, and diffusion tensor imaging correlated strongly with each other. CONCLUSION This proof-of-concept study shows that MCR-DIMWI, METRICS, and NODDI are sensitive techniques to detect changes in tissue microstructure in WM disorders.
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Affiliation(s)
- Menno D Stellingwerff
- Department of Child Neurology, Amsterdam Leukodystrophy Center, Emma Children's Hospital, Cellular & Molecular Mechanisms, Amsterdam University Medical Centers, and Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, Netherlands
| | - Murtadha L Al-Saady
- Department of Child Neurology, Amsterdam Leukodystrophy Center, Emma Children's Hospital, Cellular & Molecular Mechanisms, Amsterdam University Medical Centers, and Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, Netherlands
| | - Kwok-Shing Chan
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Adam Dvorak
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - José P Marques
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Shannon Kolind
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stefan D Roosendaal
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, and Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Nicole I Wolf
- Department of Child Neurology, Amsterdam Leukodystrophy Center, Emma Children's Hospital, Cellular & Molecular Mechanisms, Amsterdam University Medical Centers, and Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, and Amsterdam Neuroscience, Amsterdam, Netherlands
- Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Marjo S van der Knaap
- Department of Child Neurology, Amsterdam Leukodystrophy Center, Emma Children's Hospital, Cellular & Molecular Mechanisms, Amsterdam University Medical Centers, and Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, Netherlands
| | - Petra J W Pouwels
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, and Amsterdam Neuroscience, Amsterdam, Netherlands
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Bontempi P, Rozzanigo U, Marangoni S, Fogazzi E, Ravanelli D, Cazzoletti L, Giometto B, Farace P. Non-lesional white matter in relapsing-remitting multiple sclerosis assessed by multicomponent T2 relaxation. Brain Behav 2023; 13:e3334. [PMID: 38041516 PMCID: PMC10726908 DOI: 10.1002/brb3.3334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 12/03/2023] Open
Abstract
INTRODUCTION The purpose of the study is to investigate, by T2 relaxation, non-lesional white matter (WM) in relapsing-remitting (RR) multiple sclerosis (MS). METHODS Twenty stable RR MS patients underwent 1.5T Magnetic Resonance Imaging (MRI) with 3D Fluid-Attenuated Inversion-Recovery (FLAIR), 3D-T1-weighted, and T2-relaxation multi-echo sequences. The Lesion Segmentation Tool processed FLAIR images to identify focal lesions (FLs), whereas T1 images were segmented to identify WM and FL sub-volumes with T1 hypo-intensity. Non-lesional WM was obtained as the segmented WM, excluding FL volumes. The multi-echo sequence allowed decomposition into myelin water, intra-extracellular water, and free water (Fw), which were evaluated on the segmented non-lesional WM. Correlation analysis was performed between the non-lesional WM relaxation parameters and Expanded Disability Status Scale (EDSS), disease duration, patient age, and T1 hypo-intense FL volumes. RESULTS The T1 hypo-intense FL volumes correlated with EDSS. On the non-lesional WM, the median Fw correlated with EDSS, disease duration, age, and T1 hypo-intense FL volumes. Bivariate EDSS correlation of FL volumes and WM T2-relaxation parameters did not improve significance. CONCLUSION T2 relaxation allowed identifying subtle WM alterations, which significantly correlated with EDSS, disease duration, and age but do not seem to be EDSS-predictors independent from FL sub-volumes in stable RR patients. Particularly, the increase in the Fw component is suggestive of an uninvestigated prodromal phenomenon in brain degeneration.
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Affiliation(s)
- Pietro Bontempi
- Department of Engineering for Innovation MedicineUniversity of VeronaVeronaItaly
| | - Umberto Rozzanigo
- Neuro‐radiology Unit, Hospital of TrentoAzienda Provinciale per i Servizi Sanitari (APSS)TrentoItaly
| | - Sabrina Marangoni
- Neurology Unit, Hospital of TrentoAzienda Provinciale per i Servizi Sanitari (APSS)TrentoItaly
| | - Elena Fogazzi
- Physics departmentUniversity of TrentoPovoTrentoItaly
| | - Daniele Ravanelli
- Medical Physics Department, Hospital of TrentoAzienda Provinciale per i Servizi Sanitari (APSS)TrentoItaly
| | - Lucia Cazzoletti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly
| | - Bruno Giometto
- Neurology Unit, Hospital of TrentoAzienda Provinciale per i Servizi Sanitari (APSS)TrentoItaly
| | - Paolo Farace
- Medical Physics Department, Hospital of TrentoAzienda Provinciale per i Servizi Sanitari (APSS)TrentoItaly
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Martin P, Hagberg GE, Schultz T, Harzer K, Klose U, Bender B, Nägele T, Scheffler K, Krägeloh-Mann I, Groeschel S. T2-Pseudonormalization and Microstructural Characterization in Advanced Stages of Late-infantile Metachromatic Leukodystrophy. Clin Neuroradiol 2021; 31:969-980. [PMID: 33226437 PMCID: PMC8648649 DOI: 10.1007/s00062-020-00975-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/27/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE T2-weighted signal hyperintensities in white matter (WM) are a diagnostic finding in brain magnetic resonance imaging (MRI) of patients with metachromatic leukodystrophy (MLD). In our systematic investigation of the evolution of T2-hyperintensities in patients with the late-infantile form, we describe and characterize T2-pseudonormalization in the advanced stage of the natural disease course. METHODS The volume of T2-hyperintensities was quantified in 34 MRIs of 27 children with late-infantile MLD (median age 2.25 years, range 0.5-5.2 years). In three children with the most advanced clinical course (age >4 years) and for whom the T2-pseudonormalization was the most pronounced, WM microstructure was investigated using a multimodal MRI protocol, including diffusion-weighted imaging, MR spectroscopy (MRS), myelin water fraction (MWF), magnetization transfer ratio (MTR), T1-mapping and quantitative susceptibility mapping. RESULTS T2-hyperintensities in cerebral WM returned to normal in large areas of 3 patients in the advanced disease stage. Multimodal assessment of WM microstructure in areas with T2-pseudonormalization revealed highly decreased values for NAA, neurite density, isotropic water, mean and radial kurtosis, MWF and MTR, as well as increased radial diffusivity. CONCLUSION In late-infantile MLD patients, we found T2-pseudonormalization in WM tissue with highly abnormal microstructure characterizing the most advanced disease stage. Pathological hallmarks might be a loss of myelin, but also neuronal loss as well as increased tissue density due to gliosis and accumulated storage material. These results suggest that a multimodal MRI protocol using more specific microstructural parameters than T2-weighted sequences should be used when evaluating the effect of treatment trials in MLD.
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Affiliation(s)
- Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
| | - Gisela E Hagberg
- High Field Magnetic Resonance, Max-Planck Institute for Biological Cybernetics, Tübingen, Germany
- Biomedical Magnetic Resonance, University Hospital, Tübingen, Germany
| | - Thomas Schultz
- B-IT and Institute of Computer Science, University of Bonn, Bonn, Germany
| | - Klaus Harzer
- Department of Neuropediatrics, University Children's Hospital, Tübingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Thomas Nägele
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Klaus Scheffler
- High Field Magnetic Resonance, Max-Planck Institute for Biological Cybernetics, Tübingen, Germany
- Biomedical Magnetic Resonance, University Hospital, Tübingen, Germany
| | | | - Samuel Groeschel
- Department of Neuropediatrics, University Children's Hospital, Tübingen, Germany
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Assessing the differential sensitivities of wave-CAIPI ViSTa myelin water fraction and magnetization transfer saturation for efficiently quantifying tissue damage in MS. Mult Scler Relat Disord 2021; 56:103309. [PMID: 34688179 DOI: 10.1016/j.msard.2021.103309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 09/21/2021] [Accepted: 10/02/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Wave-CAIPI Visualization of Short Transverse relaxation time component (ViSTa) is a recently developed, short-T1-sensitized MRI method for fast quantification of myelin water fraction (MWF) in the human brain. It represents a promising technique for the evaluation of subtle, early signals of demyelination in the cerebral white matter of multiple sclerosis (MS) patients. Currently however, few studies exist that robustly assess the utility of ViSTa MWF measures of myelin compared to more conventional MRI measures of myelin in the brain of MS patients. Moreover, there are no previous studies evaluating the sensitivity of ViSTa MWF for the non-invasive detection of subtle tissue damage in both normal-appearing white matter (NAWM) and white matter lesions of MS patients. As a result, a central purpose of this study was to systematically evaluate the relationship between myelin sensitivity of T1-based ViSTa MWF mapping and a more generally recognized metric, Magnetization Transfer Saturation (MTsat), in healthy control and MS brain white matter. METHODS ViSTa MWF and MTsat values were evaluated in automatically-classified normal appearing white matter (NAWM), white matter (WM) lesion tissue, cortical gray matter, and deep gray matter of 29 MS patients and 10 healthy controls using 3T MRI. MWF and MT sat were also assessed in a tract-specific manner using the Johns Hopkins University WM atlas. MRI-derived measures of cerebral myelin content were uniquely compared by employing non-normal distribution-specific measures of median, interquartile range and skewness. Separate analyses of variance were applied to test tissue-specific differences in MTsat and ViSTa MWF distribution metrics. Non-parametric tests were utilized when appropriate. All tests were corrected for multiple comparisons using the False Discovery Rate method at the level, α=0.05. RESULTS Differences in whole NAWM MS tissue damage were detected with a higher effect size when using ViSTa MWF (q = 0.0008; ƞ2 = 0.34) compared to MTsat (q = 0.02; ƞ2= 0.24). We also observed that, as a possible measure of WM pathology, ViSTa-derived NAWM MWF voxel distributions of MS subjects were consistently skewed towards lower MWF values, while MTsat voxel distributions showed reduced skewness values. We further identified tract-specific reductions in mean ViSTa MWF of MS patients compared to controls that were not observed with MTsat. However, MTsat (q = 1.4 × 10-21; ƞ2 = 0.88) displayed higher effect sizes when differentiating NAWM and MS lesion tissue. Using regression analysis at the group level, we identified a linear relationship between MTsat and ViSTa MWF in NAWM (R2 = 0.46; p = 7.8 × 10-4) lesions (R2 = 0.30; p = 0.004), and with all tissue types combined (R2 = 0.71; p = 8.4 × 10-45). The linear relationship was also observed in most of the WM tracts we investigated. ViSTa MWF in NAWM of MS patients correlated with both disease duration (p = 0.02; R2 = 0.27) and WM lesion volume (p = 0.002; R2 = 0.34). CONCLUSION Because ViSTa MWF and MTsat metrics exhibit differential sensitivities to tissue damage in MS white matter, they can be collected in combination to provide an efficient, comprehensive measure of myelin water and macromolecular pool proton signals. These complementary measures may offer a more sensitive, non-invasive biopsy of early precursor signals in NAWM that occur prior to lesion formation. They may also aid in monitoring the efficacy of remyelination therapies.
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Rzepiński Ł, Kucharczuk J, Maciejek Z, Grzybowski A, Parisi V. Spectral-Domain Optical Coherence Tomography Assessment in Treatment-Naïve Patients with Clinically Isolated Syndrome and Different Multiple Sclerosis Types: Findings and Relationship with the Disability Status. J Clin Med 2021; 10:jcm10132892. [PMID: 34209692 PMCID: PMC8268329 DOI: 10.3390/jcm10132892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 01/08/2023] Open
Abstract
This study evaluates the peripapillary retinal nerve fiber layer (pRNFL) thickness and total macular volume (TMV) using spectral-domain optical coherence tomography in treatment naïve patients with the clinically isolated syndrome (CIS) and different multiple sclerosis (MS) types. A total of 126 patients (15 CIS, 65 relapsing-remitting MS, 14 secondary progressive MS, 11 primary progressive MS, 21 benign MS) with or without optic neuritis (ON) history and 63 healthy age-similar controls were assessed. Concerning controls' eyes, pRNFL thickness was significantly reduced in CIS-ON eyes (p < 0.01), while both TMV and pRNFL thickness was decreased in all MS eyes regardless of ON history (p < 0.01). Significant differences in pRNFL thickness and TMV between MS variants were observed for non-ON eyes (p < 0.01), with the lowest values in benign and secondary progressive disease type, respectively. The pRNFL thickness was inversely correlated with Expanded Disability Status Scale (EDSS) score in non-ON subgroups (p < 0.01), whereas TMV was inversely correlated with EDSS score in both ON and non-ON subgroups (p < 0.01). Concluding, pRNFL thinning confirms optic nerve damage in CIS-ON eyes and appears to be disproportionately high with respect to the disability status of benign MS patients. The values of TMV and pRNFL in non-ON eyes significantly correspond to MS course heterogeneity and patients' disability than in ON eyes.
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Affiliation(s)
- Łukasz Rzepiński
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Powstańców Warszawy 5, 85-681 Bydgoszcz, Poland;
- Neurology Department, Sanitas—Neurology Outpatient Clinic, Dworcowa 110, 85-010 Bydgoszcz, Poland
- Correspondence:
| | - Jan Kucharczuk
- Department of Ophthalmology, 10th Military Research Hospital and Polyclinic, Powstańców Warszawy 5, 85-681 Bydgoszcz, Poland;
| | - Zdzisław Maciejek
- Department of Neurology, 10th Military Research Hospital and Polyclinic, Powstańców Warszawy 5, 85-681 Bydgoszcz, Poland;
- Neurology Department, Sanitas—Neurology Outpatient Clinic, Dworcowa 110, 85-010 Bydgoszcz, Poland
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Żołnierska 18, 10-561 Olsztyn, Poland;
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Mickiewicza 24/3B, 60-836 Poznan, Poland
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11
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Manning AP, MacKay AL, Michal CA. Understanding aqueous and non-aqueous proton T 1 relaxation in brain. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2021; 323:106909. [PMID: 33453678 DOI: 10.1016/j.jmr.2020.106909] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/17/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
A full picture of longitudinal relaxation in complex heterogeneous environments like white matter brain tissue remains elusive. In tissue, successive approximations, from the solvation layer model to the two pool model, have highlighted how longitudinal magnetization evolution depends on both inter-compartmental exchange and spin-lattice relaxation. In white matter, however, these models fail to capture the behaviour of the two distinct aqueous pools, myelin water and intra/extra-cellular water. A challenge with testing more comprehensive multi-pool models lies in directly observing all pools, both aqueous and non-aqueous. In this work, we advance these efforts by integrating three main experimental and analytical elements: direct observation of the longitudinal relaxation of both the aqueous and the non-aqueous protons in white matter, a wide range of different initial conditions, and application of an analysis pipeline which includes lineshape, CPMG, and fitting of a four pool model. An eigenvector interpretation of the four pool model highlights how longitudinal relaxation in white matter depends on initial conditions. We find that a single set of model parameters is able to describe the entire range of relaxation behaviour observed in all the separable aqueous and non-aqueous pools in experiments involving six different initial conditions. Understanding of the nature and connectedness of the tissue components is crucial in the design and interpretation of many MRI measurements, especially those based on magnetization transfer and longitudinal relaxation. In particular, the dependency of relaxation behaviour on initial conditions is likely the basis for understanding method-dependent discrepancies in in vivo T1.
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Affiliation(s)
- Alan P Manning
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada
| | - Alex L MacKay
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada; Department of Radiology, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Carl A Michal
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada.
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12
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Measures of Thalamic Integrity are Associated with Cognitive Functioning in Fingolimod-treated Multiple Sclerosis Patients. Mult Scler Relat Disord 2020; 47:102635. [PMID: 33260053 DOI: 10.1016/j.msard.2020.102635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/25/2020] [Accepted: 11/18/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Cognitive impairment is common in relapsing-remitting multiple sclerosis (RRMS) and multiple domains are affected, including information processing speed, episodic memory, and executive function. Damage to the thalamus appears to be related to cognitive functioning in MS. Fingolimod is a disease-modifying therapy for RRMS, which has been shown to have a protective effect on thalamic volume. OBJECTIVE To determine the relationship between cognitive measures and the thalamus in fingolimod-treated RRMS patients and healthy controls using ultra high-field magnetic resonance imaging (MRI). METHODS Fingolimod-treated RRMS and healthy participants were recruited from a single center to undergo neuropsychological testing and 7 tesla MRI. These assessments were performed at baseline, 6 months, and 12 months. The neuropsychological testing included the Brief Visuospatial Memory Test-Revised (BVMTR), the Symbol Digit Modalities Test (SDMT), the Selective Reminding Test (SRT), and the Delis-Kaplan Executive Function System (DKEFS). MRI metrics included thalamic volume, thalamic myelin density, thalamic axon density, T2 lesion volume, brain parenchymal fraction, and cortical thickness. Mixed-effects linear regression was used to determine the relationship between MRI parameters and neuropsychological test performance over time. Rates of change in patients and controls were compared using two-sample t-tests. RESULTS We enrolled 15 RRMS patients and 5 healthy controls. Controls performed better than patients at baseline, but this difference was only significant for the letter fluency subtest of the DKEFS and for long-term storage as assessed by the SRT. Thalamic volume and thalamic myelin density were significantly associated with visuospatial (BVMTR) and verbal memory (SRT). Thalamic volume alone was also associated with inhibitory control (Color word interference subtest of the DKEFS) and cognitive flexibility (Number letter switching subtest of the DKEFS), whereas thalamic myelin density alone was associated with semantic knowledge (Verbal fluency subtest of the DKEFS). There were no significant changes in the rates of change in neurometric test performance or MRI metrics between patients and controls from baseline to 6 months and baseline to 12 months. CONCLUSIONS Thalamic injury is associated with cognitive performance in several domains. Fingolimod-treated RRMS patients evolved similarly to healthy controls over one year with regards to neuropsychological test performance and changes on MRI.
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13
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Doucette J, Kames C, Rauscher A. DECAES - DEcomposition and Component Analysis of Exponential Signals. Z Med Phys 2020; 30:271-278. [PMID: 32451148 DOI: 10.1016/j.zemedi.2020.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/17/2020] [Accepted: 04/14/2020] [Indexed: 12/12/2022]
Abstract
Combinations of multiple exponentially decaying signals are found across many disciplines of science. Decomposition of these multi-exponential signals into their individual components provides insight into the various contributors to the signal. Magnetic resonance images, for instance, can be acquired with multiple gradient or spin echoes to provide voxel by voxel multi-exponential T2* or T2 decays, respectively. With their millions of voxels, these images make the task of decomposition into individual exponentials computationally challenging. Current implementations take several hours, which is prohibitively long in many settings, such as on-scanner calculation for clinical applications. Here, we present a fast approach for the decomposition of multi-exponential signals. The method is applied to multi echo spin echo MRI scans and computes myelin water maps of the whole brain in under 2min, and luminal water maps of the prostate in under 1min.
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Affiliation(s)
- Jonathan Doucette
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, V6T 1Z1 Vancouver, BC, Canada; UBC MRI Research Centre, 2221 Wesbrook Mall, V6T 2B5 Vancouver, BC, Canada.
| | - Christian Kames
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, V6T 1Z1 Vancouver, BC, Canada; UBC MRI Research Centre, 2221 Wesbrook Mall, V6T 2B5 Vancouver, BC, Canada
| | - Alexander Rauscher
- Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, V6T 1Z1 Vancouver, BC, Canada; UBC MRI Research Centre, 2221 Wesbrook Mall, V6T 2B5 Vancouver, BC, Canada; Department of Radiology, University of British Columbia, 2775 Laurel Street, V5Z 1M9 Vancouver, BC, Canada; Department of Pediatrics, Faculty of Medicine, University of British Columbia, 4480 Oak Street, BC Children's Hospital, V6H 3V4 Vancouver, BC, Canada
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14
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Wolfe T, Hoffman K, Hogan MK, Salazar B, Tang X, Chaboub L, Quini CC, Lu ZL, Horner PJ. Quantification of Myelinated Nerve Fraction and Degeneration in Spinal Cord Neuropil by SHIFT MRI. J Magn Reson Imaging 2020; 53:1162-1174. [PMID: 33098256 DOI: 10.1002/jmri.27397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Neurodegeneration is a complex cellular process linked to prompt changes in myelin integrity and gradual neuron loss. Current imaging techniques offer estimations of myelin volumes in lesions/remyelinated areas but are limited to detect subtle injury. PURPOSE To investigate whether measurements detected by a signal hierarchically isolated as a function of time-to-echo (SHIFT) MRI technique can determine changes in myelin integrity and fiber axolemma. STUDY TYPE Prospective animal model. ANIMAL MODEL Surgically demyelinated spinal cord (SC) injury model in rodents (n = 6). FIELD STRENGTH/SEQUENCE Gradient-echo spin-echo at 3T. ASSESSMENT Multicompartment T2 relaxations were computed by SHIFT MRI in 75-microns-resolution images of the SC injury penumbra region 2 weeks post-trauma. G-ratio and axolemma delamination were assessed by transmission electron microscopy (TEM) in intact and injured samples. SC myelinated nerve fraction was computed by SHIFT MRI prospectively and assessed histologically. STATISTICAL TESTS Relations between SHIFT-isolated T2 -components and TEM measurements were studied using linear regression and t-tests. Pearson's correlation and significance were computed to determine the SHIFT's sensitivity to detect myelinated fibers ratio in gray matter. Regularized least-squares-based ranking analysis was employed to determine SHIFT MRI's ability to discern intact and injured myelinated nerves. RESULTS Biexponential signals isolated by SHIFT MRI for intact vs. lesion penumbra exhibited changes in T2 , shifting from intermediate components (25 ± 2 msec) to long (43 ± 11 msec) in white matter, and similarly in gray matter regions-of-interest (31 ± 2 to 46 ± 16 msec). These changes correlated highly with TEM g-ratio and axon delamination measurements (P < 0.05). Changes in short T2 components were observed but not statistically significant (8.5 ± 0.5 to 7 ± 3 msec, P = 0.445, and 4.0 ± 0.9 to 7 ± 3 msec, P = 0.075, respectively). SHIFT MRI's ability to detect myelinated fibers within gray matter was confirmed (P < 0.001). DATA CONCLUSION Changes detected by SHIFT MRI are associated with abnormal intermembrane spaces formed upon mild injury, directly correlated with early neuro integrity loss. Level of Evidence 1 Technical Efficacy Stage 2.
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Affiliation(s)
- Tatiana Wolfe
- Center for Neuroregneration, Department of Neurosurgery, Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Kristopher Hoffman
- Center for Neuroregneration, Department of Neurosurgery, Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Matthew K Hogan
- Center for Neuroregneration, Department of Neurosurgery, Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Betsy Salazar
- Center for Neuroregneration, Department of Neurosurgery, Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Xiufeng Tang
- Center for Neuroregneration, Department of Neurosurgery, Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Lesley Chaboub
- Center for Neuroregneration, Department of Neurosurgery, Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA
| | - Caio C Quini
- Department of Biological Physics, Universidade Estadual Paulista UNESP, Botucatu, Sao Paulo, Brazil
| | - Zhong-Lin Lu
- Division of Arts and Sciences, NYU Shanghai, Shanghai, China, NYU-ECNU Institute of Cognitive Neuroscience at NYU Shanghai, Shanghai, China, Center for Neural Science and Department of Psychology, New York University, New York, USA
| | - Philip J Horner
- Center for Neuroregneration, Department of Neurosurgery, Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas, USA
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15
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Birkl C, Doucette J, Fan M, Hernández-Torres E, Rauscher A. Myelin water imaging depends on white matter fiber orientation in the human brain. Magn Reson Med 2020; 85:2221-2231. [PMID: 33017486 PMCID: PMC7821018 DOI: 10.1002/mrm.28543] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/13/2020] [Accepted: 09/14/2020] [Indexed: 12/14/2022]
Abstract
Purpose The multi‐exponential T2 decay of the MRI signal from cerebral white matter can be separated into short T2 components related to myelin water and long T2 components related to intracellular and extracellular water. In this study, we investigated to what degree the apparent myelin water fraction (MWF) depends on the angle between white matter fibers and the main magnetic field. Methods Maps of the apparent MWF were acquired using multi‐echo Carr‐Purcell‐Meiboom‐Gill and gradient‐echo spin‐echo sequences. The Carr‐Purcell‐Meiboom‐Gill sequence was acquired with a TR of 1073 ms, 1500 ms, and 2000 ms. The fiber orientation was mapped with DTI. By angle‐wise pooling the voxels across the brain’s white matter, orientation‐dependent apparent MWF curves were generated. Results We found that the apparent MWF varied between 25% and 35% across different fiber orientations. Furthermore, the selection of the TR influences the apparent MWF. Conclusion White matter fiber orientation induces a strong systematic bias on the estimation of the apparent MWF. This finding has implications for future research and the interpretation of MWI results in previously published studies.
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Affiliation(s)
- Christoph Birkl
- UBC MRI Research Center, University of British Columbia, Vancouver, Canada.,Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria.,Department of Neurology, Medical University of Graz, Graz, Austria
| | - Jonathan Doucette
- UBC MRI Research Center, University of British Columbia, Vancouver, Canada.,Department of Physics & Astronomy, University of British Columbia, Vancouver, Canada
| | - Michael Fan
- UBC MRI Research Center, University of British Columbia, Vancouver, Canada.,Texas Oncology, Dallas, Texas, USA
| | - Enedino Hernández-Torres
- UBC MRI Research Center, University of British Columbia, Vancouver, Canada.,Department of Medicine (Division of Neurology), University of British Columbia, Vancouver, Canada
| | - Alexander Rauscher
- UBC MRI Research Center, University of British Columbia, Vancouver, Canada.,Department of Physics & Astronomy, University of British Columbia, Vancouver, Canada.,Department of Pediatrics (Division of Neurology), University of British Columbia, Vancouver, Canada
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16
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Lee J, Hyun JW, Lee J, Choi EJ, Shin HG, Min K, Nam Y, Kim HJ, Oh SH. So You Want to Image Myelin Using MRI: An Overview and Practical Guide for Myelin Water Imaging. J Magn Reson Imaging 2020; 53:360-373. [PMID: 32009271 DOI: 10.1002/jmri.27059] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/01/2020] [Accepted: 01/02/2020] [Indexed: 12/22/2022] Open
Abstract
Myelin water imaging (MWI) is an MRI imaging biomarker for myelin. This method can generate an in vivo whole-brain myelin water fraction map in approximately 10 minutes. It has been applied in various applications including neurodegenerative disease, neurodevelopmental, and neuroplasticity studies. In this review we start with a brief introduction of myelin biology and discuss the contributions of myelin in conventional MRI contrasts. Then the MRI properties of myelin water and four different MWI methods, which are categorized as T2 -, T2 *-, T1 -, and steady-state-based MWI, are summarized. After that, we cover more practical issues such as availability, interpretation, and validation of these methods. To illustrate the utility of MWI as a clinical research tool, MWI studies for two diseases, multiple sclerosis and neuromyelitis optica, are introduced. Additional topics about imaging myelin in gray matter and non-MWI methods for myelin imaging are also included. Although technical and physiological limitations exist, MWI is a potent surrogate biomarker of myelin that carries valuable and useful information of myelin. Evidence Level: 5 Technical Efficacy: 1 J. MAGN. RESON. IMAGING 2021;53:360-373.
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Affiliation(s)
- Jongho Lee
- Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
| | - Jae-Won Hyun
- Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
| | - Jieun Lee
- Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
| | - Eun-Jung Choi
- Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
| | - Hyeong-Geol Shin
- Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
| | - Kyeongseon Min
- Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
| | - Yoonho Nam
- Department of Radiology, Seoul Saint Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Ho Jin Kim
- Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
| | - Se-Hong Oh
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Gyeonggi-do, Korea.,Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
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17
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Lee J, Lee D, Choi JY, Shin D, Shin H, Lee J. Artificial neural network for myelin water imaging. Magn Reson Med 2019; 83:1875-1883. [DOI: 10.1002/mrm.28038] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/19/2019] [Accepted: 09/20/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Jieun Lee
- Laboratory for Imaging Science and Technology Department of Electrical and Computer Engineering Seoul National University Seoul Republic of Korea
| | - Doohee Lee
- Laboratory for Imaging Science and Technology Department of Electrical and Computer Engineering Seoul National University Seoul Republic of Korea
| | - Joon Yul Choi
- Laboratory for Imaging Science and Technology Department of Electrical and Computer Engineering Seoul National University Seoul Republic of Korea
- Cleveland Clinic, Epilepsy Center Neurological Institute Cleveland Ohio
| | - Dongmyung Shin
- Laboratory for Imaging Science and Technology Department of Electrical and Computer Engineering Seoul National University Seoul Republic of Korea
| | - Hyeong‐Geol Shin
- Laboratory for Imaging Science and Technology Department of Electrical and Computer Engineering Seoul National University Seoul Republic of Korea
| | - Jongho Lee
- Laboratory for Imaging Science and Technology Department of Electrical and Computer Engineering Seoul National University Seoul Republic of Korea
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18
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Chu ML, Chien CP, Wu WC, Chung HW. Gradient- and spin-echo (GRASE) MR imaging: a long-existing technology that may find wide applications in modern era. Quant Imaging Med Surg 2019; 9:1477-1484. [PMID: 31667134 DOI: 10.21037/qims.2019.09.13] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Mei-Lan Chu
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.,Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan
| | - Cheng-Ping Chien
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan.,Department of Radiology, Taipei Beitou Health Management Hospital, Taipei, Taiwan
| | - Wen-Chau Wu
- Institute of Medical Device and Imaging, National Taiwan University, Taipei, Taiwan
| | - Hsiao-Wen Chung
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
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19
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Myelin water imaging of moderate to severe diffuse traumatic brain injury. NEUROIMAGE-CLINICAL 2019; 22:101785. [PMID: 30927603 PMCID: PMC6444291 DOI: 10.1016/j.nicl.2019.101785] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 03/08/2019] [Accepted: 03/16/2019] [Indexed: 11/24/2022]
Abstract
Traumatic axonal injury (TAI), a signature injury of traumatic brain injury (TBI), is increasingly known to involve myelin damage. The objective of this study was to demonstrate the clinical relevance of myelin water imaging (MWI) by first quantifying changes in myelin water after TAI and then correlating those changes with measures of injury severity and neurocognitive performance. Scanning was performed at 3 months post-injury in 22 adults with moderate to severe diffuse TBI and 30 demographically matched healthy controls using direct visualization of short transverse component (ViSTa) MWI. Fractional anisotropy (FA) and radial diffusivity (RD) were also obtained using diffusion tensor imaging. Duration of post-traumatic amnesia (PTA) and cognitive processing speed measured by the Processing Speed Index (PSI) from Wechsler Adult Intelligence Scale-IV, were assessed. A between-group comparison using Tract-Based Spatial Statistics revealed that there was a widespread reduction of apparent myelin water fraction (aMWF) in TBI, consistent with neuropathology involving TAI. The group difference map of aMWF yielded topography that was different from FA and RD. Importantly, aMWF demonstrated significant associations with PTA (r = −0.564, p = .006) and PSI (r = 0.452, p = .035). In conclusion, reduced myelin water, quantified by ViSTa MWI, is prevalent in moderate-to-severe diffuse TBI and could serve as a potential biomarker for injury severity and prediction of clinical outcomes. Apparent myelin water fraction (aMWF) was reduced after diffuse TBI. aMWF predicted processing speed in patients with diffuse TBI. Both aMWF and DTI metrics were significantly correlated with injury severity. aMWF showed only moderate correlations with DTI metrics.
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20
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Lee LE, Ljungberg E, Shin D, Figley CR, Vavasour IM, Rauscher A, Cohen-Adad J, Li DKB, Traboulsee AL, MacKay AL, Lee J, Kolind SH. Inter-Vendor Reproducibility of Myelin Water Imaging Using a 3D Gradient and Spin Echo Sequence. Front Neurosci 2018; 12:854. [PMID: 30519158 PMCID: PMC6258882 DOI: 10.3389/fnins.2018.00854] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/01/2018] [Indexed: 01/22/2023] Open
Abstract
Myelin water imaging can be achieved using multicomponent T2 relaxation analysis to quantify in vivo measurement of myelin content, termed the myelin water fraction (MWF). Therefore, myelin water imaging can be a valuable tool to better understand the underlying white matter pathology in demyelinating diseases, such as multiple sclerosis. To apply myelin water imaging in multisite studies and clinical applications, it must be acquired in a clinically feasible scan time (less than 15 min) and be reproducible across sites and scanner vendors. Here, we assessed the reproducibility of MWF measurements in regional and global white matter in 10 healthy human brains across two sites with two different 3 T magnetic resonance imaging scanner vendors (Philips and Siemens), using a 32-echo gradient and spin echo (GRASE) sequence. A strong correlation was found between the MWF measurements in the global white matter (Pearson's r = 0.91; p < 0.001) for all participants across the two sites. The mean intersite MWF coefficient of variation across participants was 2.77% in the global white matter and ranged from 4.47% (splenium of the corpus callosum) to 17.89% (genu of the corpus callosum) in white matter regions of interest. Bland-Altman analysis showed a good agreement in MWF measurements between the two sites with small bias of 0.002. Overall, MWF estimates were in good agreement across the two sites and scanner vendors. Our findings support the use of quantitative multi-echo T2 relaxation metrics, such as the MWF, in multicenter studies and clinical trials to gain deeper understanding about the pathological processes resulting from the underlying disease progression in neurodegenerative diseases.
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Affiliation(s)
- Lisa Eunyoung Lee
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Emil Ljungberg
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Dongmyung Shin
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, South Korea
| | - Chase R Figley
- Department of Radiology, University of Manitoba, Winnipeg, MB, Canada
| | - Irene M Vavasour
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada
| | - Alexander Rauscher
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada.,Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada.,Department of Physics and Astronomy, The University of British Columbia, Vancouver, BC, Canada
| | - Julien Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada.,Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada
| | - David K B Li
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada
| | - Anthony L Traboulsee
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Alex L MacKay
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada.,Department of Physics and Astronomy, The University of British Columbia, Vancouver, BC, Canada
| | - Jongho Lee
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, South Korea
| | - Shannon H Kolind
- Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.,Department of Radiology, The University of British Columbia, Vancouver, BC, Canada.,Department of Physics and Astronomy, The University of British Columbia, Vancouver, BC, Canada
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