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Standardization of T1w/T2w ratio improves detection of tissue damage in multiple sclerosis

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Item Type:Article
Title:Standardization of T1w/T2w ratio improves detection of tissue damage in multiple sclerosis
Creators Name:Cooper, G. and Finke, C. and Chien, C. and Brandt, A.U. and Asseyer, S. and Ruprecht, K. and Bellmann-Strobl, J. and Paul, F. and Scheel, M.
Abstract:Normal appearing white matter (NAWM) damage develops early in multiple sclerosis (MS) and continues in the absence of new lesions. The ratio of T1w and T2w (T1w/T2w ratio), a measure of white matter integrity, has previously shown reduced intensity values in MS NAWM. We evaluate the validity of a standardized T1w/T2w ratio (sT1w/T2w ratio) in MS and whether this method is sensitive in detecting MS-related differences in NAWM. T1w and T2w scans were acquired at 3 Tesla in 47 patients with relapsing-remitting MS and 47 matched controls (HC). T1w/T2w and sT1w/T2w ratios were then calculated. We compared between-group variability between T1w/T2w and sT1w/T2w ratio in HC and MS and assessed for group differences. We also evaluated the relationship between the T1w/T2w and sT1w/T2w ratios and clinically relevant variables. Compared to the classic T1w/T2w ratio, the between-subject variability in sT1w/T2w ratio showed a significant reduction in MS patients (p < 0.001) and HC (p < 0.001). However, only sT1w/T2w ratio values were reduced in patients compared to HC (p < 0.001). The sT1w/T2w ratio intensity values were significantly influenced by age, T2 lesion volume and group status (MS vs. HC) (adjusted R(2) = 0.30, p < 0.001). We demonstrate the validity of the sT1w/T2w ratio in MS and that it is more sensitive to MS-related differences in NAWM compared to T1w/T2w ratio. The sT1w/T2w ratio shows promise as an easily-implemented measure of NAWM in MS using readily available scans and simple post-processing methods.
Keywords:Magnetic Resonance Imaging Techniques, Multiple Sclerosis, Normal Appearing White Matter, T1w/T2w Ratio, Relapsing-Remitting
Source:Frontiers in Neurology
Publisher:Frontiers Media SA
Page Range:334
Date:April 2019
Official Publication:https://doi.org/10.3389/fneur.2019.00334
PubMed:View item in PubMed

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