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Research ArticleADULT BRAIN
Open Access

Magnetic Susceptibility from Quantitative Susceptibility Mapping Can Differentiate New Enhancing from Nonenhancing Multiple Sclerosis Lesions without Gadolinium Injection

Y. Zhang, S.A. Gauthier, A. Gupta, L. Tu, J. Comunale, G.C.-Y. Chiang, W. Chen, C.A. Salustri, W. Zhu and Y. Wang
American Journal of Neuroradiology October 2016, 37 (10) 1794-1799; DOI: https://doi.org/10.3174/ajnr.A4856
Y. Zhang
aFrom the Department of Radiology (Y.Z., W.C., W.Z.), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
bDepartment of Radiology (Y.Z., C.A.S., Y.W.), Weill Cornell Medical College, New York, New York
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S.A. Gauthier
cDepartments of Neurology (S.A.G.)
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A. Gupta
dRadiology (A.G., J.C., G.C.-Y.C.), Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York
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L. Tu
eSchool of Applied and Engineering Physics (L.T.)
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J. Comunale
dRadiology (A.G., J.C., G.C.-Y.C.), Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York
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G.C.-Y. Chiang
dRadiology (A.G., J.C., G.C.-Y.C.), Weill Cornell Medical College, New York-Presbyterian Hospital, New York, New York
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W. Chen
aFrom the Department of Radiology (Y.Z., W.C., W.Z.), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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C.A. Salustri
bDepartment of Radiology (Y.Z., C.A.S., Y.W.), Weill Cornell Medical College, New York, New York
fDepartment of Biomedical Engineering (Y.W.), Cornell University, Ithaca, New York
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W. Zhu
aFrom the Department of Radiology (Y.Z., W.C., W.Z.), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Y. Wang
bDepartment of Radiology (Y.Z., C.A.S., Y.W.), Weill Cornell Medical College, New York, New York
fDepartment of Biomedical Engineering (Y.W.), Cornell University, Ithaca, New York
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Abstract

BACKGROUND AND PURPOSE: Magnetic susceptibility values of multiple sclerosis lesions increase as they change from gadolinium-enhancing to nonenhancing. Can susceptibility values measured on quantitative susceptibility mapping without gadolinium injection be used to identify the status of lesion enhancement in surveillance MR imaging used to monitor patients with MS?

MATERIALS AND METHODS: In patients who had prior MR imaging and quantitative susceptibility mapping in a current MR imaging, new T2-weighted lesions were evaluated for enhancement on conventional T1-weighted imaging with gadolinium, and their susceptibility values were measured on quantitative susceptibility mapping. Receiver operating characteristic analysis was used to assess the diagnostic accuracy of using quantitative susceptibility mapping in distinguishing new gadolinium-enhancing from new nonenhancing lesions. A generalized estimating equation was used to assess differences in susceptibility values among lesion types.

RESULTS: In 54 patients, we identified 86 of 133 new lesions that were gadolinium-enhancing and had relative susceptibility values significantly lower than those of nonenhancing lesions (β = −17.2; 95% CI, −20.2 to −14.2; P < .0001). Using susceptibility values to discriminate enhancing from nonenhancing lesions, we performed receiver operating characteristic analysis and found that the area under the curve was 0.95 (95% CI, 0.92–0.99). Sensitivity was measured at 88.4%, and specificity, at 91.5%, with a cutoff value of 11.2 parts per billion for quantitative susceptibility mapping–measured susceptibility.

CONCLUSIONS: During routine MR imaging monitoring to detect new MS lesion activity, quantitative susceptibility mapping can be used without gadolinium injection for accurate identification of the BBB leakage status in new T2WI lesions.

ABBREVIATIONS:

Gd
gadolinium
GRE
gradient echo
ppb
parts per billion
QSM
quantitative susceptibility mapping
  • © 2016 by American Journal of Neuroradiology

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American Journal of Neuroradiology: 37 (10)
American Journal of Neuroradiology
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Magnetic Susceptibility from Quantitative Susceptibility Mapping Can Differentiate New Enhancing from Nonenhancing Multiple Sclerosis Lesions without Gadolinium Injection
Y. Zhang, S.A. Gauthier, A. Gupta, L. Tu, J. Comunale, G.C.-Y. Chiang, W. Chen, C.A. Salustri, W. Zhu, Y. Wang
American Journal of Neuroradiology Oct 2016, 37 (10) 1794-1799; DOI: 10.3174/ajnr.A4856

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Magnetic Susceptibility from Quantitative Susceptibility Mapping Can Differentiate New Enhancing from Nonenhancing Multiple Sclerosis Lesions without Gadolinium Injection
Y. Zhang, S.A. Gauthier, A. Gupta, L. Tu, J. Comunale, G.C.-Y. Chiang, W. Chen, C.A. Salustri, W. Zhu, Y. Wang
American Journal of Neuroradiology Oct 2016, 37 (10) 1794-1799; DOI: 10.3174/ajnr.A4856
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  • Gadolinium-Enhanced Susceptibility-Weighted Imaging in Multiple Sclerosis: Optimizing the Recognition of Active Plaques for Different MR Imaging Sequences
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  • Heterogeneity of Cortical Lesion Susceptibility Mapping in Multiple Sclerosis
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