MRI Technique Tracks MS Progression More Effectively

Scientists have developed a more efficient way to track multiple sclerosis (MS) in its earliest stages, according to research published online ahead of print in Radiology.

Researchers from the University of Western Ontario Robarts Research Institute tested 25 patients with relapsing-remitting MS or clinically isolated syndrome (CIS) using the Quantitative Susceptibility (QS) Magnetic Resonance Imaging (MRI). In general, half of patients diagnosed with CIS will later be diagnosed with MS. The process, which was designed by researchers to be able to be reproduced in any hospital, used a standard Siemens 3T MRI. The study also scanned 15 age- and sex-matched control subjects.

The investigators found that brain and spine lesions in MS patients visualized with normal MRI tended to appear and disappear over time, though QS analysis found in all patients common areas of damage that correlated well with the Extended Disability Status Score (EDSS). The EDSS is a standard tool used to track MS progression, as well as time since CIS and MS diagnoses and age.

Compared to control subjects, QS “aided identification of significant, voxel-level increases in iron deposition in subcortical gray matter (GM) of patients with MS,” the authors wrote.

“When you do conventional MRIs on these patients you see lesions in the brain very clearly, but the number or volume of their lesions do not correlate with the patients’ disabilities,” Ravi Menon, PhD, the leader of the study, said in a press release. “This paradox has been recognized since the MRI was introduced to clinical practice in the early ’80s, and yet this is the only imaging tool we have for assessing MS. Our research provides a quantitative tool using a relatively conventional imaging sequence but with novel analysis. This tool shows that there is considerable damage occurring in common areas of all patients in both the white matter and in the deep brain structures — the gray matter. Those quantitative measures – what we call quantitative susceptibility, correlate with disease symptoms.”

The research team believes if QS testing is started early enough, it could have diagnostic and prognostic implications, because there are drugs currently available to slow the progression of MS.

“Significantly, in white matter, even where we see no lesions whatsoever, we’re able to measure damage in the same area of all patients using QS mapping,” Menon said. “So even at the very earliest stages of the disease when the disability score is very low, or when the person hasn’t yet been diagnosed with MS, there’s already significant damage.”