News | Magnetic Resonance Imaging (MRI) | November 13, 2019

7T MRI Offers New Insights Into Multiple Sclerosis

Investigators use powerful imaging technology to reveal that a potential MRI marker of brain inflammation is common among patients with early MS and may be a sign of gray matter injury

An image on Brigham and Women's Hospital's 7T MRI system

An image on Brigham and Women's Hospital's 7T MRI system. Image courtesy of Brigham and Women's Hospital

November 13, 2019 — Increased immune system activity along the surface of the brain, or meningeal inflammation, may be important for understanding how multiple sclerosis (MS) progresses from the most common and earliest form of the disease known as relapsing remitting MS (RRMS) to a secondary progressive form. The meninges are a thin, protective tissue that covers the brain and spinal cord. One proposed way to more easily see evidence of inflammation at the meninges is by finding leptomeningeal enhancement (LME) on magnetic resonance imaging (MRI) scans. This can appear early in the course of the disease and increases as the disease progresses, yet the most commonly available MRI technology — 3 Tesla (3T) — gives a limited view of this proposed marker. Investigators from Brigham and Women's Hospital have completed a new study using 7 Tesla (7T) MRI — a far more powerful imaging technology — to further examine LME in MS patients. With this new powerful tool, they have found that this proposed marker of brain inflammation in MS patients is more common than previously reported and is tied to lesions in the gray matter regions of the brain. The team's findings are published in the Multiple Sclerosis Journal.

"The 7T MRI scanner affords us new ways of viewing areas of damage in neurologic diseases such as MS that were not well seen using 3T MRI; it's capturing nuances that we would otherwise miss," said corresponding author Jonathan Zurawski, M.D., a neurologist at the Brigham. "The 7T scanner reveals markers or signatures that were poorly characterized or overlooked and may allow us to better understand the disease process and ultimately better treat MS patients. As a clinician, I often hear from patients that they feel worse, even though the MRI may appear stable. I've always thought that there is probably more to the story of that patient; 7T MRI is helping us fill in those details."

The Brigham's 7T MRI unit arrived at the hospital in 2017 and became the second in the country to be approved for clinical use. Since that time, it has been fully integrated into the MRI program at the Brigham. In addition to providing cutting-edge patient care, Brigham investigators are using the 7T to advance research and discovery.

To conduct their study, Zurawski and colleagues enrolled 30 participants with RRMS and 15 heathy control subjects. All participants underwent detailed 7T MRI scans to look for signs of LME and gray matter lesions.

The team found that two-thirds (20/30) of MS subjects had LME compared to only one of the 15 healthy people (6.7 percent), a tenfold increase. (Previous studies of patients with progressive MS using 3T MRI found signs of LME in only 20 to 50 percent of subjects.) MS patients with LME also had a four-to-five-fold increase in cortical lesions and thalamic lesions, telltale signs of gray matter injury seen in MS. Interestingly, these signs were independent of white matter lesions, which are the traditional marker of MS.

The team chose to study patients with RRMS to help address a gap in the current understanding of the disease. They note that their study was limited by its small sample size. While they cannot yet address how treatment of LME may affect disease progression, and whether their findings may apply to patients with the progressive form of the disease, plans are underway to continue following the patients in this study over time to see how LME and gray matter lesions may change over months and years. The team has also expanded the study's size to include more patients in the future.

"Gray matter injury is an important part of MS, which may be a key factor leading to disease progression," said Zurawski. "Our hope is that by finding new markers of this progression, it opens up the opportunity for developing treatments that can prevent progression before lesions become widespread."

For more information: brighamandwomens.org

Related Content

Iodine-based CT contrast ready for scanning with a Canon Aquilion One 320-slice CT system at Northwestern Medicine Central DuPage Hospital in the Chicago suburbs.
News | Radiology Imaging | January 22, 2020
January 22, 2020 — The risk of administering modern...
Virtual reality during chemotherapy has been shown to improve breast cancer patients’ quality of life during the most stressful treatments
News | Virtual and Augmented Reality | January 21, 2020
January 21, 2020 — Virtual reality during chemotherapy has been shown to improve...
This is a lung X-ray reviewed automatically by artificial intelligence (AI) to identify a collapsed lung (pneumothorax) in the color coded area. This AI app from Lunit is awaiting final FDA review and in planned to be integrated into several vendors' mobile digital radiography (DR) systems. Fujifilm showed this software integrated as a work-in-progress into its mobile X-ray system at RSNA 2019. GE Healthcare has its own version of this software for its mobile r=ray systems that gained FDA in 2019.   #RSNA #

This is a lung X-ray reviewed automatically by artificial intelligence (AI) to identify a collapsed lung (pneumothorax) in the color coded area. This AI app from Lunit is awaiting final FDA review and in planned to be integrated into several vendors' mobile digital radiography (DR) systems. Fujifilm showed this software integrated as a work-in-progress into its mobile X-ray system at RSNA 2019. GE Healthcare has its own version of this software for its mobile r=ray systems that gained FDA in 2019.

Feature | RSNA | January 20, 2020 | Dave Fornell, Editor
Here are images of some of the newest new medical imaging technologies displayed on the expo floor at the ...
Researchers at Karolinska Institutet in Sweden and Tampere University in Finland have developed a method based on artificial intelligence (AI) for histopathological diagnosis and grading of prostate cancer

From left: Peter Ström, Martin Eklund, Kimmo Kartasalo, Henrik Olsson och Lars Egevad, researchers at Karolinska Institutet in Sweden. Photo courtesy of Stefan Zimmerman

News | Prostate Cancer | January 20, 2020
January 20, 2020 — Researchers at Karolinska Institutet in Sweden and...
Gadolinium based contrast dye in brain MRI

Gadolinium contrast agents (GBCAs) are partly retained in the brain, raising safety concerns, as seen in this MRI.

News | Contrast Media | January 17, 2020
January 17, 2020 — Bracco Diagnostics Inc., the U.
Carestream’s X-ray digital tomosynthesis functionality creates three-dimensional datasets from digital radiography (DR) that can be scrolled through similar to computed tomography (CT) imaging. It received 510(k) clearance from the U.S. Food and Drug Administration (FDA) in January 2020. Digital tomosynthesis uses a single sweep of X-ray exposures and streamlines operator workflow by separating the process of DT exposure acquisition from image volume formation.
News | Digital Radiography (DR) | January 15, 2020
January 15, 2020 — Carestream’s X-ray digital tomosynthesis (DT) functionality, which creates three-dimensional datas
Imaging Technology News (ITN) has been acquired by Wainscot Media
News | Imaging Technology News - ITN | January 14, 2020
January 14, 2020 — Park Ridge, N.J.-based publisher Wainscot Medi...
Videos | RSNA | January 13, 2020
ITN Editor Dave Fornell takes a tour of some of the most innovative new medical imaging technologies displayed on the
Professor Samer Ezziddin, M.D., from Saarland University/Saarland University Hospital.

Professor Samer Ezziddin, M.D., from Saarland University/Saarland University Hospital. Image courtesy of Saarland University/Thorsten Mohr

 

News | Prostate Cancer | January 13, 2020
January 13, 2020 — When a non-scientist tries to imagine a scientist, the image that often arises is one of a somewha