Quantitative magnetic resonance imaging towards clinical application in multiple sclerosis

Cristina Granziera; Jens Wuerfel; Frederik Barkhof; Massimiliano Calabrese; Nicola De Stefano; Christian Enzinger; Nikos Evangelou; Massimo Filippi; Jeroen J G Geurts; Daniel S Reich; Maria A Rocca; Stefan Ropele; Àlex Rovira; Pascal Sati; Ahmed T Toosy; Hugo Vrenken; Claudia A M Gandini Wheeler-Kingshott; Ludwig Kappos; MAGNIMS Study Group

doi:10.1093/brain/awab029

Quantitative magnetic resonance imaging towards clinical application in multiple sclerosis

Brain. 2021 Jun 22;144(5):1296-1311. doi: 10.1093/brain/awab029.

Authors

Cristina Granziera^{1

2}, Jens Wuerfel^{3

4}, Frederik Barkhof^{5

6}, Massimiliano Calabrese⁷, Nicola De Stefano⁸, Christian Enzinger⁹, Nikos Evangelou¹⁰, Massimo Filippi^{11

12}, Jeroen J G Geurts¹³, Daniel S Reich¹⁴, Maria A Rocca¹¹, Stefan Ropele¹⁵, Àlex Rovira¹⁶, Pascal Sati^{14

17}, Ahmed T Toosy¹⁸, Hugo Vrenken⁵, Claudia A M Gandini Wheeler-Kingshott^{18

19

20}, Ludwig Kappos^{1

2}; MAGNIMS Study Group

Collaborators

MAGNIMS Study Group:
F Barkhof, N de Stefano, J Sastre-Garriga, O Ciccarelli, C Enzinger, M Filippi, Claudio Gasperini, L Kappos, J Palace, H Vrenken, À Rovira, M A Rocca, T Yousry

Affiliations

¹ Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.
² Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.
³ Medical Image Analysis Center, Basel, Switzerland.
⁴ Quantitative Biomedical Imaging Group (qbig), Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
⁵ Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, multiple sclerosis Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands.
⁶ UCL Institutes of Healthcare Engineering and Neurology, London, UK.
⁷ Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
⁸ Neurology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
⁹ Department of Neurology and Division of Neuroradiology, Medical University of Graz, Graz, Austria.
¹⁰ Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
¹¹ Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
¹² Vita-Salute San Raffaele University, Milan, Italy.
¹³ Department of Anatomy and Neurosciences, multiple sclerosis Center Amsterdam, Neuroscience Amsterdam, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands.
¹⁴ Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Bethesda, MD, USA.
¹⁵ Neuroimaging Research Unit, Department of Neurology, Medical University of Graz, Graz, Austria.
¹⁶ Section of Neuroradiology (Department of Radiology), Vall d'Hebron University Hospital and Research Institute, Barcelona, Spain.
¹⁷ Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
¹⁸ Queen Square multiple sclerosis Centre, Department of Neuroinflammation, Queen Square Institute of Neurology, University College London, London, UK.
¹⁹ Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
²⁰ Brain MRI 3T Research Centre, IRCCS Mondino Foundation, Pavia, Italy.

Abstract

Quantitative MRI provides biophysical measures of the microstructural integrity of the CNS, which can be compared across CNS regions, patients, and centres. In patients with multiple sclerosis, quantitative MRI techniques such as relaxometry, myelin imaging, magnetization transfer, diffusion MRI, quantitative susceptibility mapping, and perfusion MRI, complement conventional MRI techniques by providing insight into disease mechanisms. These include: (i) presence and extent of diffuse damage in CNS tissue outside lesions (normal-appearing tissue); (ii) heterogeneity of damage and repair in focal lesions; and (iii) specific damage to CNS tissue components. This review summarizes recent technical advances in quantitative MRI, existing pathological validation of quantitative MRI techniques, and emerging applications of quantitative MRI to patients with multiple sclerosis in both research and clinical settings. The current level of clinical maturity of each quantitative MRI technique, especially regarding its integration into clinical routine, is discussed. We aim to provide a better understanding of how quantitative MRI may help clinical practice by improving stratification of patients with multiple sclerosis, and assessment of disease progression, and evaluation of treatment response.

Keywords: imaging; multiple sclerosis; quantitative MRI.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Brain / diagnostic imaging*
Brain / pathology
Humans
Magnetic Resonance Imaging / methods*
Multiple Sclerosis / diagnostic imaging*
Neuroimaging / methods*
Spinal Cord / diagnostic imaging*
Spinal Cord / pathology

Grants and funding

MR/S026088/1/MRC_/Medical Research Council/United Kingdom