MRI Atrophy Measures May ID Patients Progressing to MS
Development of thalamic, central atrophy tied to conversion to CDMS over two years
WEDNESDAY, April 24 (HealthDay News) -- Use of magnetic resonance imaging (MRI) biomarkers may identify patients who are at high risk for conversion from clinically isolated syndrome (CIS) to clinically definite multiple sclerosis (CDMS), according to a study published online April 23 in Radiology.
Robert Zivadinov, M.D., Ph.D., from the State University of New York at Buffalo, and colleagues treated 216 CIS patients with 30 µg of intramuscular interferon β1a once a week. At baseline, six months, one year, and two years, patients were assessed with MRI. MRI-based progression measures included cumulative number and volume of contrast agent-enhanced (CE) new and enlarged T2 lesions, and changes in whole-brain, tissue-specific global, and regional gray matter volumes.
The researchers found that during the study period 92 of 216 patients (42.6 percent) converted to CDMS; 122 (56.5 percent) CIS patients fulfilled McDonald 2005 criteria and 153 (70.8 percent) fulfilled McDonald 2010 criteria for MRI dissemination in time and space. The mean annual relapse rate was 0.46, and 3.1 months was the mean time to first relapse. Development of CDMS was significantly associated with the lateral ventricle volume, accumulation of CE, new total T2 and new enlarging T2 lesions increase, and thalamic and whole-brain volume decrease. MRI variables significantly associated with the development of CDMS included decrease in thalamic volumes and increase in lateral ventricle volumes.
"Measurement of thalamic atrophy and increase in ventricular size in CIS is associated with CDMS development and should be used in addition to the assessment of new T2 and CE lesions," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
Abstract (http://radiology.rsna.org/content/early/2013/04/11/radiol.13122424.abstract )Full Text (subscription or payment may be required) (http://radiology.rsna.org/content/early/2013/04/11/radiol.13122424.full )