Abstract Details

Title T1 and T2 Mapping Improves Correlation of Disability and Brain Atrophy Beyond Lesional Measures in Patients with Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (11:45 AM-12:45 PM)

Poster/Presentation
Number 1-015

Objective To assess the incremental predictive value for disability, measured by Expanded Disability Status Scale (EDSS) and normalized brain volume (nBV), of evaluating pathology in normal-appearing white matter (NAWM) using mapping of T1 and T2 Z-scores (T1M, T2M) along with T2 lesion volume (T2LV) in patients with multiple sclerosis (pwMS).

Background T2LV is typically used to quantify the radiological disease burden of pwMS, but other pathophysiological processes occurring in NAWM remain underexplored.

Design/Methods In this cross-sectional observational study, we investigated 140 pwMS (74% relapsing-remitting and 26% progressive; mean disease duration: 9.4±9.2 years; 70.1% females; median EDSS: 2.8). All examinations were performed on a single 3T MRI scanner (MAGNETOM Skyra, Siemens Healthineers, Forchheim, Germany). The protocol included 3D MPRAGE, FLAIR, MP2RAGE, and 2D GRAPPATINI research application sequences for T2M. T1 and T2 deviations from reference values from 92 healthy controls were estimated using Z-score-derived metrics computed for each individual patient’s NAWM. NBV and T2LV were derived from MPRAGE and FLAIR, respectively, using research applications. PwMS were stratified into four groups based on medians of T2LV and T1M/T2M Z-scores. Kruskal-Wallis was used to compare differences between the subgroups.

Results We found differences between the groups (EDSS: p<0.001, e2 = 0.150 in T1M; p<0.001, e2=0.161 in T2M; BV: p<0.001, e2=0.218 in T1M; p<0.001, e2=0.315 in T2M). Patients with high T1M/T2M Z-scores and high T2LV exhibited the lowest nBV compared to other subgroups. Patients with high T2LV and high T1M/T2M Z-scores had lower nBV compared to patients with high T2LV but low T1M/T2M Z-scores (p<0.05 and p<0.001, respectively).

Conclusions The combination of T1 and T2 mapping with T2LV correlated to brain atrophy in pwMS. These findings may inform future research, supporting the potential use of T1M and T2M as complementary MRI markers in routine practice for a more comprehensive assessment of disease burden.

Authors/Disclosures
Manuela Vaneckova PRESENTER	Manuela Vaneckova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis . Manuela Vaneckova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Manuela Vaneckova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Manuela Vaneckova has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. The institution of Manuela Vaneckova has received research support from Czech Ministry of Health project—grants NU 22-04-00193 . Manuela Vaneckova has received research support from Czech Ministry of Health project - RVO VFN 64165 . Manuela Vaneckova has received personal compensation in the range of $500-$4,999 for serving as a principal investigator with Czech Ministry of Health project—grants NU 22-04-00193 .
Matej Kudrna, MSC	Mr. Kudrna has nothing to disclose.
Veronica Ravano, PhD	Mrs. Ravano has received personal compensation for serving as an employee of Siemens Healthineers. Mrs. Ravano has stock in Siemens Healthineers. Mrs. Ravano has received intellectual property interests from a discovery or technology relating to health care.
Václav Čapek, PhD	Dr. Capek has nothing to disclose.
Jiri Lindner, MD	Mr. Lindner has nothing to disclose.
Dominika Stastna, MD, PhD (General University Hospital in Prague)	Dr. Stastna has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Stastna has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Stastna has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Stastna has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Stastna has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck. Dr. Stastna has received publishing royalties from a publication relating to health care.
Michaela Andelova	The institution of Michaela Andelova has received research support from Novartis. The institution of Michaela Andelova has received research support from Janssen.
Dana Horakova	Dana Horakova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dana Horakova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dana Horakova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dana Horakova has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck.
Gian Franco Piredda, PhD	Dr. Piredda has received personal compensation for serving as an employee of Siemens Healthineers. Dr. Piredda has stock in Siemens Healthineers. Dr. Piredda has received intellectual property interests from a discovery or technology relating to health care.
Tom Hilbert, PhD	Dr. Hilbert has received personal compensation for serving as an employee of Siemens Healthineers.
Jonathan A. Disselhorst, PhD	Mr. Disselhorst has received personal compensation for serving as an employee of Siemens Healthineers International AG. Mr. Disselhorst has stock in Siemens Healthineers.
Bénédicte Maréchal, PhD	Dr. Maréchal has received personal compensation for serving as an employee of Siemens Healthineers International AG.
Tobias Kober, PhD	Dr. Kober has received personal compensation for serving as an employee of Siemens Healthineers. Dr. Kober has stock in Siemens Healthineers. Dr. Kober has received intellectual property interests from a discovery or technology relating to health care.
Tomas Uher	Tomas Uher has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Tomas Uher has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol myers. Tomas Uher has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Tomas Uher has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. The institution of Tomas Uher has received research support from Novartis.

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