Abstract Details

Title Architectural Development of Acute MS Lesions at 7T Phase Contrast

Topic MS and Related Diseases

Presentation(s) S21 - (-)

Poster/Presentation
Number 005

Objective

Background Magnetic susceptibility is an intrinsic property of tissue determined by molecular composition. Myelin, iron, deoxyhemoglobin, free radicals-all relevant in MS pathogenesis-influence local tissue susceptibility and can affect the magnitude and phase of the gradient-echo (GRE) MRI signal. Previous studies have shown heterogeneous patterns of magnitude and phase contrast in chronic lesions.

Design/Methods Nine active MS patients were studied at 7T. Pre-Gad, high-resolution T2*w GRE scans, T1w GRE scans before/after Gad injection, and dynamic contrast-enhanced (DCE) T1w GRE scans during/after Gad administration were acquired. Phase and magnitude features and DCE pattern were determined for acute and selected chronic lesions. When possible, one-year follow-up (FU) 7T MRI was performed.

Results We detected 26 Gad-enhancing lesions; 3 were too small to analyze reliably. Eight had a centripetal DCE pattern, 8 centrifugal, and 1 transitional; 6 were not captured on DCE. Most lesions were visible on phase (100%) and magnitude (86%). There was a hypointense rim on phase (78%) and, more rarely, magnitude images (17%); this was more common in centripetal lesions, where the rim clearly colocalized with blood-brain-barrier (BBB) opening. A sample of 36 chronic lesions, selected for the presence of a hypointense phase rim, showed a thicker and darker rim on phase and, frequently, on magnitude (67% of chronic vs. 17% of acute lesions). For acute lesions, one-year FU showed completely altered phase patterns.

Conclusions Phase contrast patterns are highly sensitive to tissue changes in acute MS lesions and differ from the patterns seen in chronic lesions. In centripetally enhancing lesions, the hypointense phase rim reflects the expanding inflammatory edge and may directly correspond to inflammatory byproducts and sequelae of BBB opening.

Authors/Disclosures
Martina Absinta, MD PRESENTER	Dr. Absinta has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Absinta has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abata Therapeutics. The institution of Dr. Absinta has received research support from International MS Alliance. The institution of Dr. Absinta has received research support from FRRB Early Career Award. The institution of Dr. Absinta has received research support from Cariplo Foundation.
	No disclosure on file
Maria Gaitan, MD	Dr. Gaitan has nothing to disclose.
Pietro Maggi, MD, PhD (CHUV Service de neurologie)	No disclosure on file
Irene Cortese, MD	Dr. Cortese has stock in Keires, AG. Dr. Cortese has stock in Nouscom, AG. Dr. Cortese has stock in PDC*line Pharma.
Merrilee Needham, MD	Dr. Needham has received personal compensation in the range of $500-$4,999 for serving as a Consultant for teva. Dr. Needham has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for abcuro. Dr. Needham has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for sanofi aventis.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Daniel Reich, MD, PhD (National Institutes of Health, Neuroimmunology Branch, NINDS)	Dr. Reich has received research support from NIH. The institution of Dr. Reich has received research support from Adelson Medical Research Foundation. The institution of Dr. Reich has received research support from Sanofi. The institution of Dr. Reich has received research support from Abata Therapeutics. The institution of Dr. Reich has received research support from National Multiple Sclerosis Society. Dr. Reich has received intellectual property interests from a discovery or technology relating to health care. Dr. Reich has received personal compensation in the range of $5,000-$9,999 for serving as a CME Faculty with PeerView. Dr. Reich has received personal compensation in the range of $5,000-$9,999 for serving as a CME Faculty with Integrity. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a CME Faculty with Letters and Sciences. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a CME Faculty with Academic CME. Dr. Reich has a non-compensated relationship as a Advisor with Sanofi that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Board of Directors with ACTRIMS that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Abata Therapeutics that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with University of Basel RC2NB that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Multiple Sclerosis Society of Canada that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Tuscan Doctorate in Neuroscience that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Editorial Board with Multiple Sclerosis Journal that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Biohaven that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Sana that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Merck KGaA EMD Serono that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Bristol-Meyers Squibb that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with ChemoCentryx that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator, Advisor with Hyperfine that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Imaginab that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Perceptive that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Annexon that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator, Advisor with Philips that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Siemens that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Novartis that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Calico Life Sciences that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Cognito Therapeutics that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Sudo that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Allumis that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with BioCentury that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Regeneron that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Eli Lilly that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with SetPoint that is relevant to AAN interests or activities.

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