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Abstract Details

Restricted diffusion and fiber fraction are two important parameters for identifying subtypes of multiple sclerosis using diffusion basis spectrum imaging
Multiple Sclerosis
S31 - MS and CNS Inflammatory Disease: Imaging (4:25 PM-4:36 PM)
006

MS is a disease with profound heterogeneity pathologically, clinically, and radiologically. Clinically-defined subtypes of MS do not capture the known pathological heterogeneity. Imaging biomarkers capable of differentiating and quantifying the underlying heterogeneous pathologies can provide important insights into the disease spectrum in MS. DBSI models diffusion-weighted MRI signals as a combination of discrete anisotropic diffusion tensors (representing the integrity of axon fibers and myelin), and a spectrum of isotropic diffusion tensors (reflecting the extra-axonal environment associated with inflammation and tissue loss).

 

To differentiate pathologically meaningful subtypes of multiple sclerosis (MS) using a novel diffusion imaging method called diffusion basis spectrum imaging (DBSI).

 

Fifty-five MS patients with pre-identified clinically-defined disease subtype of relapsing-remitting MS (RRMS, n=22), secondary-progressive MS (SPMS, n=16), and primary-progressive MS (PPMS, n=17) underwent brain DBSI. Two sets of regions of interests (ROIs) were defined for each patient including white matter lesions, and normal appearing corpus callosum (excluding lesions). DBSI-derived metrics (radial diffusivity, axial diffusivity, fiber fraction, restricted isotropic fraction, hindered non-restricted isotropic fraction, and free non-restricted isotropic fraction) were included in recursive partitioning analysis to identify the most homogenous subgroups based on their clinically-defined subtype.

 

For the white matter brain lesions, and for normal appearing corpus callosum, the most important metrics for identifying MS subgroups were restricted isotropic fraction and fiber fraction. Total lesion volume did not improve classification. DBSI metrics classified 60-64% of MS patients into their clinically-defined subtypes using a single scan and without including any clinical or demographic characteristics.

 

DBSI-derived restricted fraction (reflecting isotropic diffusion within cells), and fiber fraction (apparent axonal content) capture some of the differences between patients having different pre-determined clinically-defined MS subtypes. DBSI might be a promising tool for noninvasively capturing the pathological heterogeneity that is characteristic of people with MS.

 

Authors/Disclosures
Afsaneh Shirani, MD
PRESENTER
Dr. Shirani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Robert T. Naismith, MD, FAAN (Washington University) Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bristol Myers Squib. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Naismith has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Genzyme. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celltrion. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD Serono. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sandoz. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astoria. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Impaact-Bio. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kyverna. Dr. Naismith has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Horizon. Dr. Naismith has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch.
No disclosure on file
No disclosure on file
Anne H. Cross, MD, FAAN (Washington University School of Medicine) Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech / F. Hoffman la Roche. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TG Therapeutics. Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb . Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octave. Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Cross has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Cross has received personal compensation in the range of $5,000-$9,999 for serving as an officer or member of the Board of Directors for Consortium of MS Centers. Dr. Cross has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. The institution of Dr. Cross has received research support from Genentech. Dr. Cross has received intellectual property interests from a discovery or technology relating to health care.