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Atrophied Brain Lesion Volume: A New Imaging Biomarker in Multiple Sclerosis.
J Neuroimaging 2018; 28(5):490-495JN

Abstract

BACKGROUND AND PURPOSE

Lesion accrual in multiple sclerosis (MS) is an important and clinically relevant measure, used extensively as an imaging trial endpoint. However, lesions may also shrink or disappear entirely due to atrophy. Although generally ignored or treated as a nuisance, this phenomenon may actually be an important stand-alone imaging biomarker. Therefore, we investigated the rate of brain lesion loss due to atrophy (atrophied lesion volume) in MS subtypes compared to baseline lesion volume and to new and enlarging lesion volumes, and evaluated the independent predictive value of this phenomenon for clinical disability.

METHODS

A total of 192 patients (18 clinically isolated syndrome, 126 relapsing-remitting MS, and 48 progressive) received 3T magnetic resonance imaging at baseline and 5 years. Lesions were quantified at baseline, and new/enlarging lesion volumes were calculated over the study interval. Atrophied lesion volume was calculated by combining baseline lesion masks with follow-up SIENAX-derived cerebrospinal fluid partial volume maps. Measures were compared between disease subgroups, and correlations with disability change (Expanded Disability Status Scale [EDSS]) were evaluated. Hierarchical regression was employed to determine the unique additive value of atrophied lesion volume.

RESULTS

Atrophied lesion volume was different between MS subtypes (P = .02), and exceeded new lesion volume accumulation in progressive MS (298.1 vs. 75.5 mm3 ). Atrophied lesion volume was the only significant correlate of EDSS change (r = .192 relapsing, r = .317 progressive, P < .05), and explained significant additional variance when controlling for brain atrophy and new/enlarging lesion volume (R2 .092 vs. .045, P = .003).

CONCLUSION

Atrophied lesion volume is a unique and clinically relevant imaging marker in MS, with particular promise in progressive MS.

Authors+Show Affiliations

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY.Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY.Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY.Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY.Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY.Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29856910

Citation

Dwyer, Michael G., et al. "Atrophied Brain Lesion Volume: a New Imaging Biomarker in Multiple Sclerosis." Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging, vol. 28, no. 5, 2018, pp. 490-495.
Dwyer MG, Bergsland N, Ramasamy DP, et al. Atrophied Brain Lesion Volume: A New Imaging Biomarker in Multiple Sclerosis. J Neuroimaging. 2018;28(5):490-495.
Dwyer, M. G., Bergsland, N., Ramasamy, D. P., Jakimovski, D., Weinstock-Guttman, B., & Zivadinov, R. (2018). Atrophied Brain Lesion Volume: A New Imaging Biomarker in Multiple Sclerosis. Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging, 28(5), pp. 490-495. doi:10.1111/jon.12527.
Dwyer MG, et al. Atrophied Brain Lesion Volume: a New Imaging Biomarker in Multiple Sclerosis. J Neuroimaging. 2018;28(5):490-495. PubMed PMID: 29856910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atrophied Brain Lesion Volume: A New Imaging Biomarker in Multiple Sclerosis. AU - Dwyer,Michael G, AU - Bergsland,Niels, AU - Ramasamy,Deepa P, AU - Jakimovski,Dejan, AU - Weinstock-Guttman,Bianca, AU - Zivadinov,Robert, Y1 - 2018/06/01/ PY - 2018/03/18/received PY - 2018/05/09/revised PY - 2018/05/10/accepted PY - 2018/6/2/pubmed PY - 2019/11/14/medline PY - 2018/6/2/entrez KW - Multiple sclerosis KW - atrophy KW - biomarker KW - lesions SP - 490 EP - 495 JF - Journal of neuroimaging : official journal of the American Society of Neuroimaging JO - J Neuroimaging VL - 28 IS - 5 N2 - BACKGROUND AND PURPOSE: Lesion accrual in multiple sclerosis (MS) is an important and clinically relevant measure, used extensively as an imaging trial endpoint. However, lesions may also shrink or disappear entirely due to atrophy. Although generally ignored or treated as a nuisance, this phenomenon may actually be an important stand-alone imaging biomarker. Therefore, we investigated the rate of brain lesion loss due to atrophy (atrophied lesion volume) in MS subtypes compared to baseline lesion volume and to new and enlarging lesion volumes, and evaluated the independent predictive value of this phenomenon for clinical disability. METHODS: A total of 192 patients (18 clinically isolated syndrome, 126 relapsing-remitting MS, and 48 progressive) received 3T magnetic resonance imaging at baseline and 5 years. Lesions were quantified at baseline, and new/enlarging lesion volumes were calculated over the study interval. Atrophied lesion volume was calculated by combining baseline lesion masks with follow-up SIENAX-derived cerebrospinal fluid partial volume maps. Measures were compared between disease subgroups, and correlations with disability change (Expanded Disability Status Scale [EDSS]) were evaluated. Hierarchical regression was employed to determine the unique additive value of atrophied lesion volume. RESULTS: Atrophied lesion volume was different between MS subtypes (P = .02), and exceeded new lesion volume accumulation in progressive MS (298.1 vs. 75.5 mm3 ). Atrophied lesion volume was the only significant correlate of EDSS change (r = .192 relapsing, r = .317 progressive, P < .05), and explained significant additional variance when controlling for brain atrophy and new/enlarging lesion volume (R2 .092 vs. .045, P = .003). CONCLUSION: Atrophied lesion volume is a unique and clinically relevant imaging marker in MS, with particular promise in progressive MS. SN - 1552-6569 UR - https://www.unboundmedicine.com/medline/citation/29856910/Atrophied_Brain_Lesion_Volume:_A_New_Imaging_Biomarker_in_Multiple_Sclerosis_ L2 - https://doi.org/10.1111/jon.12527 DB - PRIME DP - Unbound Medicine ER -