Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis

Claudia E. Weber; Julia Krämer; Matthias Wittayer; Johannes Gregori; Sigurd Randoll; Florian Weiler; Stefan Heldmann; Christina Roßmanith; Michael Platten; Achim Gass; Philipp Eisele

doi:10.1007/s00330-021-08233-w

Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis

Claudia E. Weber
, Julia Krämer
, Matthias Wittayer
, Johannes Gregori
, Sigurd Randoll
, Florian Weiler
, Stefan Heldmann
, Christina Roßmanith
, Michael Platten
, Achim Gass^*
, Philipp Eisele

^*Korrespondierende/r Autor/-in für diese Arbeit

Institut für Mathematische Methoden der Bildverarbeitung

Ruprecht-Karls-Universität Heidelberg
Westfälische Wilhelms-Universität Münster
Mediri GmbH

40 Zitate (Scopus)

Abstract

Objectives
In multiple sclerosis (MS), iron rim lesions (IRLs) are indicators of chronic low-grade inflammation and ongoing tissue destruction. The aim of this study was to assess the relationship of IRLs with clinical measures and magnetic resonance imaging (MRI) markers, in particular brain and cervical cord volume.

Methods
Clinical and MRI parameters from 102 relapsing MS patients (no relapses for at least 6 months, no contrast-enhancing lesions) were included; follow-up data obtained after 12 months was available in 49 patients. IRLs were identified on susceptibility-weighted images (SWIs). In addition to standard brain and spinal cord MRI parameters, normalised cross-sectional area (nCSA) of the upper cervical cord was calculated.

Results
Thirty-eight patients had at least one IRL on SWI MRI. At baseline, patients with IRLs had higher EDSS scores, higher lesion loads (brain and spinal cord), and lower cortical grey matter volumes and a lower nCSA. At follow-up, brain atrophy rates were higher in patients with IRLs. IRLs correlated spatially with T1-hypointense lesions.

Conclusions
Relapsing MS patients with IRLs showed more aggressive MRI disease characteristics in both the cross-sectional and longitudinal analyses.

Originalsprache	Englisch
Zeitschrift	European Radiology
Jahrgang	32
Ausgabenummer	3
Seiten (von - bis)	2012-2022
Seitenumfang	11
ISSN	0938-7994
DOIs	https://doi.org/10.1007/s00330-021-08233-w
Publikationsstatus	Veröffentlicht - 03.2022

Fördermittel

The authors of this manuscript declare relationships with the following companies: Dr. Krämer has received honoraria for lecturing from Biogen, Novartis, Genzyme, Merck, Mylan, and Teva and financial research support from Sanofi Genzyme and Novartis. Dr. Gregori is managing director of mediri GmbH. Prof. Platten has a consultant relationship with Novartis, Merck, and Genentech/Roche; has received non-personal, institutional honoraria from Medac, Merck, Novartis, TEVA, and Genentech/Roche; and has research agreements with Bayer Health Care. Prof. Gass has received honoraria for lecturing, travel expenses for attending meetings, and financial support for research from Bayer Schering, Biogen Idec, Merck Serono, Novartis, and TEVA Neurosciences. Dr. Eisele has received travel expenses from Bayer Health Care. The remaining authors declare no conflict of interest.

Träger
TEVA Neurosciences
Bayer Schering

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title = "Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis",

abstract = "Objectives: In multiple sclerosis (MS), iron rim lesions (IRLs) are indicators of chronic low-grade inflammation and ongoing tissue destruction. The aim of this study was to assess the relationship of IRLs with clinical measures and magnetic resonance imaging (MRI) markers, in particular brain and cervical cord volume. Methods: Clinical and MRI parameters from 102 relapsing MS patients (no relapses for at least 6 months, no contrast-enhancing lesions) were included; follow-up data obtained after 12 months was available in 49 patients. IRLs were identified on susceptibility-weighted images (SWIs). In addition to standard brain and spinal cord MRI parameters, normalised cross-sectional area (nCSA) of the upper cervical cord was calculated. Results: Thirty-eight patients had at least one IRL on SWI MRI. At baseline, patients with IRLs had higher EDSS scores, higher lesion loads (brain and spinal cord), and lower cortical grey matter volumes and a lower nCSA. At follow-up, brain atrophy rates were higher in patients with IRLs. IRLs correlated spatially with T1-hypointense lesions. Conclusions: Relapsing MS patients with IRLs showed more aggressive MRI disease characteristics in both the cross-sectional and longitudinal analyses. Key Points: • Multiple sclerosis patients with iron rim lesions had higher EDSS scores, higher brain and spinal cord lesion loads, lower cortical grey matter volumes, and a lower normalised cross-sectional area of the upper cervical spinal cord. • Iron rim lesions are a new lesion descriptor obtained from susceptibility-weighted MRI. Our data suggests that further exploration of this lesion characteristic in regard to a poorer prognosis in multiple sclerosis patients is warranted.",

author = "Weber, \{Claudia E.\} and Julia Kr{\"a}mer and Matthias Wittayer and Johannes Gregori and Sigurd Randoll and Florian Weiler and Stefan Heldmann and Christina Ro{\ss}manith and Michael Platten and Achim Gass and Philipp Eisele",

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year = "2022",

month = mar,

doi = "10.1007/s00330-021-08233-w",

language = "English",

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}

TY - JOUR

T1 - Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis

AU - Weber, Claudia E.

AU - Krämer, Julia

AU - Wittayer, Matthias

AU - Gregori, Johannes

AU - Randoll, Sigurd

AU - Weiler, Florian

AU - Heldmann, Stefan

AU - Roßmanith, Christina

AU - Platten, Michael

AU - Gass, Achim

AU - Eisele, Philipp

PY - 2022/3

Y1 - 2022/3

N2 - Objectives: In multiple sclerosis (MS), iron rim lesions (IRLs) are indicators of chronic low-grade inflammation and ongoing tissue destruction. The aim of this study was to assess the relationship of IRLs with clinical measures and magnetic resonance imaging (MRI) markers, in particular brain and cervical cord volume. Methods: Clinical and MRI parameters from 102 relapsing MS patients (no relapses for at least 6 months, no contrast-enhancing lesions) were included; follow-up data obtained after 12 months was available in 49 patients. IRLs were identified on susceptibility-weighted images (SWIs). In addition to standard brain and spinal cord MRI parameters, normalised cross-sectional area (nCSA) of the upper cervical cord was calculated. Results: Thirty-eight patients had at least one IRL on SWI MRI. At baseline, patients with IRLs had higher EDSS scores, higher lesion loads (brain and spinal cord), and lower cortical grey matter volumes and a lower nCSA. At follow-up, brain atrophy rates were higher in patients with IRLs. IRLs correlated spatially with T1-hypointense lesions. Conclusions: Relapsing MS patients with IRLs showed more aggressive MRI disease characteristics in both the cross-sectional and longitudinal analyses. Key Points: • Multiple sclerosis patients with iron rim lesions had higher EDSS scores, higher brain and spinal cord lesion loads, lower cortical grey matter volumes, and a lower normalised cross-sectional area of the upper cervical spinal cord. • Iron rim lesions are a new lesion descriptor obtained from susceptibility-weighted MRI. Our data suggests that further exploration of this lesion characteristic in regard to a poorer prognosis in multiple sclerosis patients is warranted.

AB - Objectives: In multiple sclerosis (MS), iron rim lesions (IRLs) are indicators of chronic low-grade inflammation and ongoing tissue destruction. The aim of this study was to assess the relationship of IRLs with clinical measures and magnetic resonance imaging (MRI) markers, in particular brain and cervical cord volume. Methods: Clinical and MRI parameters from 102 relapsing MS patients (no relapses for at least 6 months, no contrast-enhancing lesions) were included; follow-up data obtained after 12 months was available in 49 patients. IRLs were identified on susceptibility-weighted images (SWIs). In addition to standard brain and spinal cord MRI parameters, normalised cross-sectional area (nCSA) of the upper cervical cord was calculated. Results: Thirty-eight patients had at least one IRL on SWI MRI. At baseline, patients with IRLs had higher EDSS scores, higher lesion loads (brain and spinal cord), and lower cortical grey matter volumes and a lower nCSA. At follow-up, brain atrophy rates were higher in patients with IRLs. IRLs correlated spatially with T1-hypointense lesions. Conclusions: Relapsing MS patients with IRLs showed more aggressive MRI disease characteristics in both the cross-sectional and longitudinal analyses. Key Points: • Multiple sclerosis patients with iron rim lesions had higher EDSS scores, higher brain and spinal cord lesion loads, lower cortical grey matter volumes, and a lower normalised cross-sectional area of the upper cervical spinal cord. • Iron rim lesions are a new lesion descriptor obtained from susceptibility-weighted MRI. Our data suggests that further exploration of this lesion characteristic in regard to a poorer prognosis in multiple sclerosis patients is warranted.

UR - https://www.scopus.com/pages/publications/85115265691

U2 - 10.1007/s00330-021-08233-w

DO - 10.1007/s00330-021-08233-w

M3 - Journal articles

C2 - 34549326

AN - SCOPUS:85115265691

SN - 0938-7994

VL - 32

SP - 2012

EP - 2022

JO - European Radiology

JF - European Radiology

IS - 3

ER -

Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis

Abstract

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