Measurement of Corpus Callosum and Comparison of MRI Techniques for Monitoring of Multiple Sclerosis

Czech version

Authors: M. Vaněčková ¹; J. Krásenský ¹; D. Horáková ²; M. Mašek ¹; Andrea Burgetová ¹ ; E. Havrdová ²; Z. Seidl ¹
Authors‘ workplace: 1. LF UK a VFN v Praze Oddělení MR, Radiodiagnostická klinika ¹; 1. LF UK a VFN v Praze Neurologická klinika a Centrum klinických neurověd ²
Published in: Cesk Slov Neurol N 2012; 75/108(6): 742-747
Category: Short Communication

Overview

Aim:
To compare contemporary MRI measures for prediction of future clinical disability in multiple sclerosis patients (MS) by analysis of our MRI data (brain atrophy, T2 lesion volume, T1 lesion volume and corpus callosum atrophy).

Methods:
Long-term (seven years) longitudinal MRI data of 178 patients were analyzed in the same protocol: FLAIR and T1WI 3D. Using an originally developed software named ScanViewCZ (developed at our MR unit), lesion load was measured automatically from FLAIR sequence (T2 lesion volume), the brain atrophy, brain parenchymal fraction and T1 lesion volume were assed from T1W 3D sequence. Measurement of corpus callosum atrophy: area of the central slice in sagittal reconstruction of T1 W 3D was determined automatically by the originally developed software. Clinical disability was assessed with Expanded Disability Status Scale (EDSS). Patients were divided into two groups: clinically stable and those with sustained progression over seven years.

Results:
Statistically significant correlation of future sustained disability progression (as characterized by EDSS score) was found in association with brain atrophy and corpus callosum atrophy. Correlation with lesion load was low. Using the corpus callosum MRI, clinically stable patients were statistically significantly (p = 0.0024) different from patients with sustained progression as soon as within the first year.

Conclusions:
This retrospective study shows that monitoring of the corpus callosum atrophy is the most useful for stratification of patients into “stable” and “sustained progression” groups.

Key words:
multiple sclerosis – magnetic resonance imaging – corpus callosum – monitoring

Sources

1. Vaněčková M, Seidl Z. Roztroušená skleróza mozkomíšní a magnetická rezonance: současnost a nové trendy. Cesk Slov Neurol N 2008; 71/104(6): 664–672.

2. Ge Y. Multiple sclerosis: the role of MR imaging. AJNR Am J Neuroradiol 2006; 27(6): 1165–1176.

3. Miller DH, Grossman RI, Reingold SC, McFarland HF. The role of magnetic resonance techniques in understanding and managing multiple sclerosis. Brain 1998; 121 (Pt 1): 3–24.

4. Filippi M, Grossman RI. MRI techniques to monitor MS evolution: the present and the future. Neurology 2002; 58(8): 1147–1153.

5. Barkhof F. The clinico-radiological paradox in multiple sclerosis revisited. Curr Opin Neurol 2002; 15(3): 239–245.

6. Horakova D, Dwyer MG, Havrdova E, Cox JL, Dolezal O, Bergsland A et al. Gray matter atrophy and disability progression in patients with early relapsing-remitting multiple sclerosis: a 5-year longitudinal study. J Neurol Sci 2009; 282(1–2): 112–119.

7. Miller DH, Barkhof F, Frank JA, Parker GJ, Thompson AJ. Measurement of atrophy in multiple sclerosis: pathological basis, methodological aspects and clinical relevance. Brain 2002; 125 (Pt 8): 1676–1695.

8. Rudick RA, Fisher E, Lee JC, Simon J, Jacobs L. Use of the brain parenchymal fraction to measure whole brain atrophy in relapsing-remitting MS. Neurology 1999; 53(8): 1698–1704.

9. Smith SM, Zhang Y, Jenkinson M, Chen J, Matthews PM, Federico A et al. Accurate, robust, and automated longitudinal and cross-sectional brain change analysis. Neuroimage 2002; 17(1): 479–489.

10. van den Elskamp IJ, Knol DL, Vrenken H, Karas G, Meijerman A, Filippi M et al. Lesional magnetization transfer ratio: a feasible outcome for remyelinating treatment trials in multiple sclerosis. Mult Scler 2010; 16(6): 660–669.

11. Rovaris M, Gass A, Bammer R, Hickman SJ, Ciccarelli O, Miller DH et al. Diffusion MRI in multiple sclerosis. Neurology 2005; 65(10): 1526–1532.

12. Burgetová A, Seidl Z, Vaněčková M, Krásenský J, Horáková D. Magnetická rezonanční relaxometrie u roztroušené sklerózy – měření T2 relaxačního času v centrální šedé hmotě. Cesk Slov Neurol N 2010; 73/106(1): 26–31.

13. Vaněčková M, Seidl Z, Krásenský J, Horáková D, Havrdová E, Němcová J et al. Naše zkušenosti s MR monitorací pacientů s roztroušenou sklerózou v klinické praxi. Cesk Slov Neurol N 2010; 73/106(4): 716–720.

14. Evangelou N, Konz D, Esiri MM, Smith S, Palace J, Matthews PM. Regional axonal loss in the corpus callosum correlates with cerebral white matter lesion volume and distribution in multiple sclerosis. Brain 2000; 123 (Pt 9): 1845–1849.

15. Gean-Marton AD, Vezina LG, Marton KI, Stimac GK, Peyster RG, Taveras JM et al. Abnormal corpus callosum: a sensitive and specific indicator of multiple sclerosis. Radiology 1991; 180(1): 215–221.

16. Barkhof FJ, Elton M, Lindeboom J, Tas MW, Schmidt WF, Hommes OR et al. Functional correlates of callosal atrophy in relapsing-remitting multiple sclerosis patients. A preliminary MRI study. J Neurol 1998; 245(3): 153–158.

17. Coombs BD, Best A, Brown MS, Miller DE, Corboy J, Baier M et al. Multiple sclerosis pathology in the normal and abnormal appearing white matter of the corpus callosum by diffusion tensor imaging. Mult Scler 2004; 10(4): 392–397.

18. Yaldizli O, Atefy R, Gass A, Sturm D, Glassl S, Tettenborn B et al. Corpus callosum index and long-term disability in multiple sclerosis patients. J Neurol 2010; 257(8): 1256–1264.

19. Sampat MP, Berger AM, Healy BC, Hildenbrand P, Vass J, Meier DS et al. Regional white matter atrophy – based classification of multiple sclerosis in cross--sectional and longitudinal data. AJNR Am J Neuroradiol 2009; 30(9): 1731–1739.

20. Havrdova E, Zivadinov R, Krasensky J, Dwyer MG, Novakova I, Dolezal O et al. Randomized study of interferon beta-1a, low-dose azathioprine, and low--dose corticosteroids in multiple sclerosis. Mult Scler 2009; 15(8): 965–976.

21. Vaněčková M, Seidl Z, Krásenský J, Obenberger J, Havrdová E, Viták T et al. Sledování objemu ložisek u roztroušené sklerózy mozkomíšní (tzv. lesion load) v obraze magnetické rezonance. Cesk Slov Neurol N 2002; 65/98(3): 175–179.

22. Vaneckova M, Seidl Z, Krasensky J, Havrdova E, Horakova D, Dolezal O et al. Patients‘ stratification and correlation of brain magnetic resonance imaging parameters with disability progression in multiple sclerosis. Eur Neurol 2009; 61(5): 278–284.

23. Lin F, Yu C, Liu Y, Li K, Lei H. Diffusion tensor group tractography of the corpus callosum in clinically isolated syndrome. AJNR Am J Neuroradiol 2011; 32(1): 92–98.

24. Vaneckova M, Kalincik T, Krasensky J, Horakova D, Havrdova E, Hrebikova T, Seidl Z. Corpus Callosum Atrophy: a Simple Predictor of Multiple Sclerosis Progression (Longitudinal 9-year Study), Eur Neurol 2012; 68: 23–27.

25. Figueira FF, Santos VS, Figueira GM, Silva AC. Corpus callosum index: a practical method for long--term follow-up in multiple sclerosis. Arq Neuropsiquiatr 2007; 65(4A): 931–935.

26. Ozturk A, Smith SA, Gordon-Lipkin EM, Harrison DM, Shiee N, Pham DL et al. MRI of the corpus callosum in multiple sclerosis: association with disability. Mult Scler 2010; 16(2): 166–177.