Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2025
Reliability of Central Vein Sign Imaging With 3T FLAIR* in a Multicenter Study.
СтатьяМногоцентровое исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Martin Melissa Lynne, Cao Quy, Luskin Elaina, Renner Brian, Daboul Lynn, O'Donnell Carly M, Rodrigues Paulo, Derbyshire John, Azevedo Christina J, Bar-Or Amit, Caverzasi Eduardo, Calabresi Peter, Cree Bruce A C, Freeman Léorah, Henry Roland G, Longbrake Erin E, Oh Jiwon, Papinutto Nico, Pelletier Daniel, Prchkovska Vesna, Ramos Marc, Samudralwar Rohini D, Schindler Matthew K, Sotirchos Elias S, Sicotte Nancy L, Solomon Andrew J, Reich Daniel S, Ontaneda Daniel, Shinohara Russell T, Sati Pascal
Аннотация
BACKGROUND AND PURPOSE: The central vein sign (CVS) is a diagnostic imaging biomarker for multiple sclerosis (MS). FLAIR* is a combined MRI contrast that provides high conspicuity for CVS at 3 Tesla (3T), enabling its sensitive and accurate detection in clinical settings. This study evaluated whether CVS conspicuity of 3T FLAIR* is reliable across imaging sites and MRI vendors and whether gadolinium (Gd) contrast increases CVS conspicuity.
METHODS: A cross-sectional, multicenter study recruited adults referred for possible diagnosis of MS at 10 sites. FLAIR* contrast was generated using high-resolution T2*-weighted (acquired pre- and post-injection of Gd) and T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) brain images at 3T from two MRI vendors. Lesions and veins were segmented to compute lesion-to-vein contrast-to-noise ratio (CNRlesion-to-vein), a quantitative measure of CVS conspicuity. CNRlesion-to-vein measures for pre- and post-Gd FLAIR* were compared across sites and vendors.
RESULTS: Eighty-seven participants from nine sites were included in the analysis. There was no significant difference in mean CNRlesion-to-vein between sites for pre-Gd (p-value = 0.07) or post-Gd (p-value = 0.27) FLAIR*. There were also no significant differences between vendors for pre-Gd (p-value = 0.10) or post-Gd (p-value = 0.31) FLAIR*. Patient-level pairwise differences in CNRlesion-to-vein between pre-Gd and post-Gd FLAIR* revealed a significant increase for post-Gd FLAIR* (p-value < 0.001).
CONCLUSIONS: CVS conspicuity on 3T FLAIR* is consistent across imaging sites and MRI vendors. Moreover, Gd-based contrast agent significantly improved CVS conspicuity on 3T FLAIR*. These findings support the implementation of FLAIR* in clinical settings for MS.
METHODS: A cross-sectional, multicenter study recruited adults referred for possible diagnosis of MS at 10 sites. FLAIR* contrast was generated using high-resolution T2*-weighted (acquired pre- and post-injection of Gd) and T2-weighted fluid-attenuated inversion recovery (T2-FLAIR) brain images at 3T from two MRI vendors. Lesions and veins were segmented to compute lesion-to-vein contrast-to-noise ratio (CNRlesion-to-vein), a quantitative measure of CVS conspicuity. CNRlesion-to-vein measures for pre- and post-Gd FLAIR* were compared across sites and vendors.
RESULTS: Eighty-seven participants from nine sites were included in the analysis. There was no significant difference in mean CNRlesion-to-vein between sites for pre-Gd (p-value = 0.07) or post-Gd (p-value = 0.27) FLAIR*. There were also no significant differences between vendors for pre-Gd (p-value = 0.10) or post-Gd (p-value = 0.31) FLAIR*. Patient-level pairwise differences in CNRlesion-to-vein between pre-Gd and post-Gd FLAIR* revealed a significant increase for post-Gd FLAIR* (p-value < 0.001).
CONCLUSIONS: CVS conspicuity on 3T FLAIR* is consistent across imaging sites and MRI vendors. Moreover, Gd-based contrast agent significantly improved CVS conspicuity on 3T FLAIR*. These findings support the implementation of FLAIR* in clinical settings for MS.