Clinical 3-tesla FLAIR* MRI improves diagnostic accuracy in multiple sclerosis

Multiple Sclerosis : Clinical and Laboratory Research
Ilena C GeorgeDaniel S Reich

Abstract

To evaluate clinical fluid-attenuated inversion recovery (FLAIR)* 3T magnetic resonance imaging (MRI), which is sensitive to perivenular inflammatory demyelinating lesions, in diagnosing multiple sclerosis (MS). Central veins may be a distinguishing feature of MS lesions. FLAIR*, a combined contrast derived from clinical MRI scans, has not been studied as a clinical tool for diagnosing MS. Two experienced MS neurologists evaluated 87 scan pairs (T2-FLAIR/FLAIR*), separately and side-by-side, from 68 MS cases, 8 healthy volunteers, and 11 individuals with other neurological diseases. Raters judged cases based on experience, published criteria, and a visual assessment of the "40% rule," whereby MS is favored if >40% of lesions demonstrate a central vein. Diagnostic accuracy was determined with area under the receiver operating characteristic curve (AUC), and inter-rater reliability was assessed with Cohen's kappa (κ). Diagnostic accuracy was high: rater 1, AUC 0.94 (95% confidence interval: 0.89, 0.97) for T2-FLAIR, 0.95 (0.92, 0.98) for FLAIR*; rater 2, 0.94 (0.90, 0.98) and 0.90 (0.85, 0.95). AUC improved when images were considered together: rater 1, 0.99 (0.98, 1.00); rater 2, 0.98 (0.96, 0.99). Inter-rater agreement was subs...Continue Reading

References

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Jun 20, 2012·Multiple Sclerosis : Clinical and Laboratory Research·Jens WuerfelJan Dörr
Dec 19, 2012·Multiple Sclerosis : Clinical and Laboratory Research·María I GaitánDaniel S Reich
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Citations

Feb 18, 2016·Journal of Neurology·Martina AbsintaMassimo Filippi
Feb 24, 2016·Annals of Clinical and Translational Neurology·Andrew J SolomonDaniel S Reich
Jun 15, 2016·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Amal P R SamaraweeraNikos Evangelou
Aug 19, 2017·Multiple Sclerosis : Clinical and Laboratory Research·Andrew J SolomonDaniel S Reich
Apr 30, 2016·Nature Reviews. Neurology·Martina AbsintaDaniel S Reich
Mar 9, 2018·Neurology·Aaron E Miller, Peter A Calabresi
Aug 20, 2019·JAMA Neurology·Tim SinneckerUNKNOWN MAGNIMS Study Group
Jun 14, 2017·Therapeutic Advances in Neurological Disorders·Ulrike W Kaunzner, Susan A Gauthier
May 5, 2018·AJNR. American Journal of Neuroradiology·M AbsintaD S Reich
Jan 7, 2021·Multiple Sclerosis : Clinical and Laboratory Research·Pascal Sati, Daniel S Reich
May 15, 2018·Neurología : publicación oficial de la Sociedad Española de Neurología·A Pato PatoJ M Prieto González
Jul 20, 2021·Expert Review of Neurotherapeutics·Àlex Rovira, Cristina Auger
Nov 20, 2021·Acta Neurologica Scandinavica·Lara ChaabanSalem Hannoun

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Software Mentioned

JIST ( Java Image Science Toolkit
MIPAV ( Medical Image Processing , Analysis & Visualization
MIPAV

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