Abstract Details

Title Diffusion Tensor Imaging Reveals Greater Microstructure Damage in Multiple Sclerosis Lesions that Shrink into Cerebrospinal Fluid (Atrophied Lesion Volume)

Topic Multiple Sclerosis

Presentation(s) S45 - Multiple Sclerosis: Imaging (4:06 PM-4:18 PM)

Poster/Presentation
Number 004

Objective To determine whether T2 lesions that go on to become atrophied lesions over time in multiple sclerosis (MS) patients are characterized by differences in their underlying microstructure, as characterized by diffusion tensor imaging (DTI), and its bi-tensor extension.

Background Atrophied lesion volume is a recently proposed imaging marker in MS reflecting the shrinkage of lesional tissue into cerebrospinal fluid (CSF). The measure has been shown to be very sensitive to the progression of MS and conversion to a secondary-progressive disease course. A previous study showed that only 13% of the areas that eventually become atrophied lesions over 5-year follow-up, were represented by chronic black holes at baseline. Therefore, the underlying tissue properties of areas that eventually become atrophied lesions remain poorly understood.

Design/Methods 141 MS patients underwent 3T MRI at baseline and again after 5.4 years with a protocol that included a 3D T1, FLAIR and diffusion-weighted imaging acquisitions. Atrophied T2 lesion volume was calculated by overlaying baseline T2 lesion masks on follow-up CSF maps. Standard DTI measures, including mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were calculated as were free water (FW)-corrected DTI measures along with FW itself. DTI-derived measures were calculated within baseline lesional voxels that went on to become areas of atrophied lesion volume at follow-up. Paired t-tests were compared these values with corresponding tissue that remained lesional.

Results WM lesions at baseline that went on to be classified as atrophied LV at follow-up were characterized by significantly worse diffusivity characteristics for all investigated metrics (< .001 for all measures except for FW-corrected AD, p=.012). The largest effect size was seen for FW (d=2.46) followed by conventional RD (d=2.21) and conventional MD (d=2.13).

Conclusions Lesions that eventually shrink into CSF are characterized by more extensive microstructural damage compared to those that do not.

Authors/Disclosures
Niels Bergsland (Buffalo Neuroimaging Analysis Center / State University of New York At Buffalo) PRESENTER	Prof. Bergsland has nothing to disclose.
Michael G. Dwyer III, MD, PhD (Buffalo Neurological Analysis Center)	Dr. Dwyer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Dwyer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Keystone Heart, Ltd. Dr. Dwyer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. The institution of Dr. Dwyer has received research support from Novartis. The institution of Dr. Dwyer has received research support from Keystone Heart, Ltd. The institution of Dr. Dwyer has received research support from Bristol Myers Squibb. The institution of Dr. Dwyer has received research support from Roche.
Dejan Jakimovski, MD, PhD (Buffalo Neuroimaging Analysis Center, University at Buffalo)	Dr. Jakimovski has nothing to disclose.
Bianca Weinstock-Guttman, MD (Department of Neurology, University At Buffalo)	Dr. Weinstock-Guttman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme &Sanofi. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving as a Reviewer with NIH.
Robert Zivadinov, MD, PhD, FAAN (Buffalo Neuroimaging Analysis Center)	The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Omnicuris. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Myrobalan. Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Zivadinov has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.

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