Abstract Details

Title Timing of MRI Cervical Spine and Finding Asymptomatic T2 Hyperintensities in Multiple Sclerosis Patients

Topic Multiple Sclerosis

Presentation(s) S26 - MS and CNS Inflammatory Disease: Clinical Considerations II (1:11 PM-1:22 PM)

Poster/Presentation
Number 002

Background Brain MRI is one of the most important tools for monitoring disease activity in MS patients. While spinal cord imaging is useful for establishing an MS diagnosis, it is unclear whether there is utility in repeating cervical spine imaging as part of routine surveillance for subclinical disease activity

Objective

To determine how frequently follow-up magnetic resonance imaging (MRI) cervical (C) spine in multiple sclerosis (MS) patients reveals asymptomatic T2 hyperintense lesions

Design/Methods A query was generated in EPIC slicer dicer software. Patients aged 18-65 years who were diagnosed with relapsing remitting MS and were see at the Johns Hopkins MS Center from 2014-2018 with an MRI C spine were included in the query

Results 1739 patients were identified from the initial query; 100 patients have been phenotyped in detail to date. Of these, 87 were female, mean age was 25.7(SD=2.7) years, and 57% were Caucasian, 28% were African American and 12% were Asian. The mean disease duration was 3.9 (SD=2.5) years with a mean Expanded Disability Status Scale score of 1.2(SD=1.1). Cervical spine imaging for routine surveillance (no suspected cord relapse) was performed in 43 patients at year 1, 53 patients at year 2, 34 patients at year 3, and 16 at year 4. Of these, the corresponding numbers (percentages) of people incidental lesions discovered were 7 (16%) at year 1, 3 (6%) at year 2, 3 (9%) at year 3, and 2 (13%) at year 4

Conclusions The utility of cervical spine MRI in surveying otherwise asymptomatic people with MS for new lesions is unclear. Our preliminary data suggest a reasonable proportion of patients evaluated to data had asymptomatic lesions. Since cord activity may confer a worse long-term prognosis but, at the same time, MRI is expensive and time-intensive for patients, evaluating its usefulness in monitoring MS patients for breakthrough disease is imperative

Authors/Disclosures
Muhammad Taimur A. Malik, MD PRESENTER	Dr. Malik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genetech . Dr. Malik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jansen . Dr. Malik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD serono. The institution of Dr. Malik has received research support from National MS Society .
Peter A. Calabresi, MD, FAAN (Johns Hopkins University)	Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Calabresi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Idorsia. An immediate family member of Dr. Calabresi has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MyMD. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Myelin Repair Foundation. The institution of Dr. Calabresi has received research support from Genentech. Dr. Calabresi has received publishing royalties from a publication relating to health care. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Grant reveiwer with Myelin Repair Foundation. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker for CME with NYAS. Dr. Calabresi has received personal compensation in the range of $500-$4,999 for serving as a Speaker with Academic CME.
	No disclosure on file
Ellen M. Mowry, MD, FAAN (Johns Hopkins University)	Dr. Mowry has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BeCareLink, LLC. The institution of Dr. Mowry has received research support from Biogen. The institution of Dr. Mowry has received research support from Genentech. Dr. Mowry has received publishing royalties from a publication relating to health care.

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