Quantitative magnetic resonance imaging towards clinical application in multiple sclerosis

Author:

Granziera Cristina12ORCID,Wuerfel Jens34,Barkhof Frederik56,Calabrese Massimiliano7,De Stefano Nicola8,Enzinger Christian9,Evangelou Nikos10,Filippi Massimo1112ORCID,Geurts Jeroen J G13,Reich Daniel S14,Rocca Maria A11ORCID,Ropele Stefan15,Rovira Àlex16,Sati Pascal1417,Toosy Ahmed T18ORCID,Vrenken Hugo5,Gandini Wheeler-Kingshott Claudia A M181920,Kappos Ludwig12,Barkhof F,de Stefano N,Sastre-Garriga J,Ciccarelli O,Enzinger C,Filippi M,Gasperini Claudio,Kappos L,Palace J,Vrenken H,Rovira À,Rocca M A,Yousry T,

Affiliation:

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

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.

Funder

Swiss National Science Foundation

EUROSTAR

HORIZON2020

National Institute for Health Research biomedical research center

EU Horizon2020 research and innovation

Intramural Research Program of National Institute of Neurological Disorders and Stroke

National Institutes of Health

Medical Research Council

Austrian Science Foundation

Dutch multiple sclerosis Research Foundation

ZonMW

HealthHolland

Publisher

Oxford University Press (OUP)

Subject

Clinical Neurology

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