MRI is crucial for monitoring multiple sclerosis (MS). However, it has limitations and depends on interpretation. At the 2023 CMSC Annual Meeting, Dr. Darin Okuda urged reevaluation of MRI interpretation. He uses advanced 3D MRI to understand MS better.
Current MRI techniques in MS yield false positives due to high white matter sensitivity. 2D MRI lacks comprehensive lesion information. 3D imaging offers valuable insights and advances MS management towards remyelination.
3D imaging shows promise for understanding remyelination. Dr. Okuda’s lab compares lesion site oxygenation using the BOLD signal. Better oxygenation supports healing.
In a study with 23 MS individuals and 109 brain lesions, Dr. Okuda analyzed lesion shape, texture, and factors like BOLD, CBF, and CMRO2 using 3D techniques. Active lesions with higher integrity displayed higher BOLD slopes, CBF, and CMRO2. Symmetrical shapes and complex textures were observed in active lesions. Identifying healing potential aids precision medicine for MS.
Dr. Okuda discussed other 3D imaging applications. Positioning lesions relative to the cortex helps distinguish MS from small vessel disease. Another study compared neurodegeneration rates in MS lesions between Black/African and European ancestry.
Black/African individuals often experience aggressive MS. In a two-year study with 209 nonprogressive MS patients (half Black/African, half European), changes in brainstem and upper cervical spinal cord volume and surface were assessed. Black/African individuals showed increased surface texture and curvature changes.
Identifying vulnerable regions in the brainstem and cervical cord enables personalized disease surveillance and management for MS patients.