High-Field-Blinded Assessment of Portable Ultra-Low-Field Brain MRI for Multiple Sclerosis.

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2025-01-01 DOI:10.1111/jon.70005

Serhat V Okar, Govind Nair, Karan D Kawatra, Ashley A Thommana, Corinne A Donnay, María I Gaitán, Joel M Stein, Daniel S Reich

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Abstract

Background and purpose: MRI is crucial for multiple sclerosis (MS), but the relative value of portable ultra-low field MRI (pULF-MRI), a technology that holds promise for extending access to MRI, is unknown. We assessed white matter lesion (WML) detection on pULF-MRI compared to high-field MRI (HF-MRI), focusing on blinded assessments, assessor self-training, and multiplanar acquisitions.

Methods: Fifty-five adults with MS underwent pULF-MRI following their HF-MRI. Two neuroradiologists independently assessed pULF-MRI images in an evaluation process, including initial assessment blinded to HF-MRI, self-training with reference to HF-MRI and evaluation of 20 cases with additional T2-fluid-attenuated inversion recovery in an additional plane. A third rater conducted cross-referenced analysis with HF-MRI data to determine true-positive lesions, false-positive areas, and case-level sensitivity and positive predictive value.

Results: The mean age of participants was 50 years (standard deviation: 11; 74% women). Initially, Rater 2 marked more false-positive areas than Rater 1 (p = 0.003). After self-training, both raters embraced a conservative approach, with Rater 2 marking fewer false-positive areas (p = 0.01). Both raters maintained 100% case-level sensitivity and positive predictive value for detecting at least one WML, particularly in periventricular areas. Multiplanar acquisitions reduced both false-positive areas and true-positive lesions. True-positive lesions and false-positive areas had similar contrast-to-noise ratios in the juxtacortical region (p = 0.73) but not in periventricular, deep parenchymal regions (p = 0.004, p = 0.01).

Conclusion: With adequate training, radiological interpretation of pULF-MRI has high sensitivity and positive predictive value for MS lesions but should be approached conservatively. These results suggest utility for patient triage, potentially reducing diagnostic delay, and screening high-risk individuals.

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便携式超低场脑MRI对多发性硬化症的高场盲法评估。

背景和目的：MRI对多发性硬化症（MS）至关重要，但便携式超低场MRI （pULF-MRI）的相对价值尚不清楚，该技术有望扩大MRI的应用范围。与高场MRI （HF-MRI）相比，我们评估了pULF-MRI对白质病变（WML）的检测，重点是盲法评估、评估者自我培训和多平面采集。方法：55例成年MS患者在行HF-MRI检查后行pULF-MRI检查。两名神经放射科医生在评估过程中独立评估了pULF-MRI图像，包括对HF-MRI进行盲法初始评估，参照HF-MRI进行自我训练，以及对20例在另一个平面上进行t2 -液体衰减反转恢复的患者进行评估。第三位研究人员与HF-MRI数据进行交叉参考分析，以确定真阳性病变、假阳性区域、病例级敏感性和阳性预测值。结果：参与者的平均年龄为50岁(标准差：11；74%的女性)。最初，Rater 2比Rater 1标记出更多假阳性区域（p = 0.003）。自我训练后，两名评分者均采用保守方法，评分者2标记的假阳性区域较少（p = 0.01）。两种评分方法在检测至少一种WML，特别是在心室周围区域，均保持100%的病例级敏感性和阳性预测值。多平面成像减少了假阳性区域和真阳性病变。在皮质旁区，真阳性病变和假阳性病变的对比噪声比相似（p = 0.73），但在心室周围、深实质区域则不同（p = 0.004, p = 0.01）。结论：经过充分的训练，pULF-MRI的放射学解释对MS病变具有较高的敏感性和阳性的预测价值，但应谨慎对待。这些结果表明病人分诊的效用，潜在地减少诊断延误，并筛选高风险个体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!