Pooled analysis of multiple sclerosis findings on multi-site 7 Tesla MRI

项目摘要/摘要 背景：尽管目前的MRI在测量MS的白质(WM)炎症方面表现良好， 它能够量化灰质(GM)病理、脑膜炎症和慢性炎症变化 是有限的。出于这个原因，研究人员一直在寻找7-特斯拉(7T)磁共振成像，以获得更强大的活体测量 病理学。尽管7T磁共振对多发性硬化症这些方面的敏感性增加 由于样本量小，方法各异，以前的研究的影响有限， 繁琐的分析方法和相互矛盾的结果--所有这些都限制了研究结果的普遍性 并更广泛地传播这一工具的使用。 目的：在这项研究中，我们旨在促进7T MRI作为诊断、预后和治疗工具的应用。 通过多点、大样本量的成像相关性评估来监测治疗效果 皮质和深层GM病变，慢性活动性WM病变(MRI上有顺磁边缘的WM病变)，以及 脑膜炎(MRI上的软脑膜炎(LME))及其临床相关性的验证。 我们还将寻求开发自动化工具来识别和量化7T MRI上的这些发现。 研究设计：影像和临床数据将来自之前和正在进行的7T使用研究 MS的磁共振成像在MS的北美成像的保护伞下在多个协作站点进行 (NAIMS)合作，包括马里兰大学、巴尔的摩大学、哈佛-布里格姆分校和女子学院 医院、国家神经疾病和中风研究所、宾夕法尼亚大学和 麦吉尔大学蒙特利尔神经学研究所。这包括多达814名患有 MS，1232次个人学习访问，以及长达5年的随访期。GM病变、WM病变与 顺磁环和LME将在7T上识别，并对方法及其关系进行关键评估 临床数据。此外，人工分析结果将被用作深度学习算法的训练集 以便在未来的7T磁共振扫描中识别这些异常。 影响：这项研究将提供有关测量变异性和可推广的临床重要性的数据 正在调查的成像结果，以及为未来的高吞吐量提供自动化工具 学习。在推进这些对多发性硬化症病理方面的精确测量时，只有在较低的视野下测量得很差 MRI，这项研究将导致更准确的MS诊断，提高监测MS变化的能力 随着时间的推移，病理，并可能导致筛选针对转基因的新药物干预 病变、具有顺磁边缘的西医病变和LME。

Project Summary/Abstract Background: Although current MRI performs well as a tool to measure white matter (WM) inflammation in MS, its ability to quantify gray matter (GM) pathology, meningeal inflammation, and chronic inflammatory changes are limited. For this reason, researchers have looked to 7-tesla (7T) MRI for more robust in vivo measures of pathology. Although the increased sensitivity of 7T MRI for these aspects of MS have stimulated much interest, the impact of previous studies have been limited due to small sample sizes, varying methodologies, cumbersome analysis methods, and conflicting results – all of which have limited the generalizability of findings and more widespread dissemination of the use of this tool. Objective: In this study, we aim to advance the use of 7T MRI as a tool for diagnosis, prognosis, and treatment effect monitoring by performing multi-site, large sample size evaluation of imaging correlates of cortical and deep GM lesions, chronic active WM lesions (WM lesions with paramagnetic rims on MRI), and meningeal inflammation (leptomeningeal inflammation (LME) on MRI) and validation of their clinical relevance. We also will look develop automated tools for identification and quantification of these findings on 7T MRI. Study Design: Imaging and clinical data will be derived from previous and ongoing studies of the use of 7T MRI in MS performed at multiple collaborative sites under the umbrella of the North American Imaging in MS (NAIMS) Collaborative, including the University of Maryland, Baltimore, Harvard-Brigham and Women’s Hospital, the National Institutes of Neurological Disorders and Stroke, the University of Pennsylvania, and the Montreal Neurological Institute at McGill University. This includes data on up to 814 individual persons with MS, 1232 individual study visits, and a follow up period of up to 5 years. GM lesions, WM lesions with paramagnetic rims, and LME will be identified on 7T, with critical evaluation of methods and their relationship to clinical data. Further, the manual analysis results will be used as training sets for deep learning algorithms for identification of these abnormalities on future 7T MRI scans. Impact: This study would provide the data on measurement variability and generalizable clinical importance of the imaging findings being investigated, along with providing automated tools for future, high-throughput studies. In advancing these precise measures of aspects of MS pathology only poorly measured on lower field MRI, this study will lead to more accurate MS diagnoses, improvements in the ability to monitor changes in MS pathology over time, and perhaps lead to the screening of new pharmaceutical interventions to target GM lesions, WM lesions with paramagnetic rims, and LME.