Abstract Details

Title The Use of a Short Acquisition Magnetization Transfer Ratio (MTR) Sequence in a Multicenter Clinical Trial of Siponimod (BAF312) in Relapsing-Remitting Multiple Sclerosis

Topic MS and Related Diseases

Presentation(s) P07 - (-)

Poster/Presentation
Number 115

Objective

Background BACKGROUND: MTR is used in MS studies to evaluate tissue integrity in patients. MTR in normal appearing white matter (NAWM) is higher than in active MS lesions, in which inflammation and demyelination occur. Post-lesion MTR may recover towards normal values as inflammatory edema resolves and remyelination occurs. Commonly, MTR is based on spoiled gradient recalled echo (SPGR) sequences, taking more than 20 minutes to perform; however, balanced steady-state free precession (bSSFP) MTR, which takes approximately one-quarter of the time, would reduce scanning time for patients.

Design/Methods DESIGN/METHODS: Patients (n = 7) across four radiological centers who were participating in a clinical trial of the sphingosine 1-phosphate receptor modulator, siponimod (BAF312), were scanned monthly for 6 months using a protocol including pre- and post-gadolinium (Gd)-enhancing T1 magnetic resonance imaging and bSSFP MTR. MTR was not estimated at all time points (? 20 lesions were assessed at lesion onset; three lesions were assessed 4 months after onset). A neuroradiologist analyzed T1 images to identify Gd-enhancing lesions. MTR and T1-Gd sequences were co-registered to allow measurement of MTR in lesions of interest.

Results RESULTS: The average MTR rapidly decreased from 40.8% (standard deviation [SD]: 5.2%) in the month before lesion onset to 36.6% (SD: 4.2%) upon lesion onset. No significant increase occurred after lesion onset in this small cohort. Measurements outside the lesion were stable; mean MTR in grey matter was 31.5% (SD: 0.98%) and NAWM 42.7% (SD: 0.77%), with low variation among patients.

Conclusions CONCLUSIONS: To our knowledge, this is the first use of bSSFP MTR in a multicenter trial. bSSFP MTR successfully detected changes associated with inflammatory lesion appearance similar to previous observations from longer MTR sequences.

Authors/Disclosures
PRESENTER	No disclosure on file
David K. Li, MD (University of British Columbia)	Dr. Li has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Li has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Biogen. Dr. Li has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Academy of Health Care Learning. Dr. Li has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Sanofi-Genzyme. Dr. Li has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Consortium of MS Centers.
	No disclosure on file
Rohit Sood, MD, PhD (Parexel International)	No disclosure on file
Thomas P. Bleck, MD, FAAN (Northwestern University Department of Neurology)	Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Marinus Pharmaceuticals. Dr. Bleck has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for iECURE. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Acasti. Dr. Bleck has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Society of Critical Care Medicine. Dr. Bleck has received research support from NIH.
	No disclosure on file
	No disclosure on file
Erik Wallstroem, MD, PhD (Sanofi)	Dr. Wallstroem has received personal compensation for serving as an employee of Sanofi. Dr. Wallstroem has stock in Sanofi. Dr. Wallstroem has received intellectual property interests from a discovery or technology relating to health care.

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