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BRAIN

The Effect of Corticosteroid Medication on Quantitative MR Parameters of the Brain

Stefan C.A. Steensa, Gerda M. Steup-Beekmanb, Gerlof P.Th. Bosmaa, Faiza Admiraal-Behloulc, Hans Olofsenc, Joost Doornbosa, Tom W.J. Huizingab and Mark A. van Buchema

a Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
b Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands
c Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands

Address correspondence to Stefan C.A. Steens, MD, Department of Radiology, C2-S, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands

BACKGROUND AND PURPOSE: Quantitative MR imaging techniques such as magnetization transfer imaging (MTI), diffusion-weighted imaging (DWI), and MR spectroscopy are promising diagnostic tools for use with patients with diffuse brain diseases such as neuropsychiatric systemic lupus erythematosus (NPSLE). Such patients are often on corticosteroid (CS) treatment. Presently, it is unknown whether CSs per se influence quantitative MR imaging measurements. The aim of this study was to evaluate the effect of low-dose oral CSs on MTI, DWI, and MR spectroscopy parameters of the brain.

METHODS: Twenty-seven rheumatoid arthritis (RA) patients with and without CS medication and 15 healthy controls were subjected to conventional MR imaging, whole-brain MTI and DWI, and single-voxel MR spectroscopy. Oral CSs were used by 13 of the RA patients. Univariate analyses with age as a covariate were performed on MTI, DWI, and MR spectroscopy parameters between RA patients with and without CSs and healthy controls. Pearson correlations were calculated between all imaging parameters and duration of disease, duration of CS use, and CS dosage.

RESULTS: No significant differences between the groups of subjects or significant correlations with clinical parameters were found for MTI, DWI and MR spectroscopy parameters.

CONCLUSION: In this study, we found no evidence for an effect of low-dose oral CSs on whole-brain MTI and DWI histogram parameters and single-voxel MR spectroscopy measurements of the brain. The results of this study demonstrate that it is unlikely that MTI, DWI, and MR spectroscopy parameters reported in NPSLE studies are confounded by low-dose oral CS.