Abstract
New magnetic resonance (MR) measures considered to be putative markers of demyelination and axonal loss were found to be more closely related to clinical disability than T2-weighted MR imaging (MRI) findings in patients with multiple sclerosis (MS). In this study, we evaluated the reproducibility of such measurements in order to assess their reliability for longitudinal studies in MS. The intra-observer coefficients of variation for repeated measurements did not significantly differ among the MR techniques studied [2.6% for T2-weighted MRI, 4.38% for unenhanced T1-weighted MRI, 3.65% for magnetisation transfer imaging (MTI) and 2.28% for spinal cord cross-sectional area at C5]. Our findings suggest that non-conventional MR techniques may be reliable outcome measures for clinical trials in MS.
Similar content being viewed by others
References
Bland JM, Altaian DG (1986) Statistical methods of assessing agreement between two methods of clinical measurement. Lancet 1:307–310
British Standards Institution (1979) Precision of test methods. I. Guide for the determination and reproducibility of a standard test method. British Standard 5497
Davie CA, Hawkins CP, Barker GJ, Brennan A, Tofts PS, Miller DH, McDonald WI (1994) Serial proton magnetic resonance spectroscopy in acute multiple sclerosis lesions. Brain 117: 49–58
Davie CA, Barker GJ, Webb S, Tofts PS, Thompson AJ, Harding AE, McDonald WI, Miller DH (1995) Persistent functional deficit in multiple sclerosis and autosomal dominant cerebellar ataxia is associated with axonal loss. Brain 118:1583–1592
De Stefano N, Matthews PM, Antel JP, Preul M, Francis GS, Arnold DL (1995) Chemical pathology of acute demyelinating lesions and its correlation with disability. Ann Neurol 38: 901–909
Dousset V, Grossman RI, Ramer KN, Schnall MD, Young LH, Gonzalez-Scarano F, Lavi E, Cohen JA (1992) Experimental allergic encephalomyelitis and multiple sclerosis: lesion characterization with magnetization transfer imaging. Radiology 182:483–491
Filippi M, Barker GJ, Horsfield MA, Sacares PR, MacManus DG, Thompson AJ, Tofts PS, McDonald WI, Miller DH (1994) Benign and secondary progressive multiple sclerosis: a preliminary quantitative MRI study. J Neurol 241:246–251
Filippi M, Campi A, Dousset V, Baratti C, Martinelli V, Canal N, Scotti G, Comi G (1995) A magnetisation transfer imaging study of normal-appearing white matter in multiple sclerosis. Neurology 45:478–482
Filippi M, Horsfield MA, Bressi S, Martinelli V, Baratti C, Reganati P, Campi A, Miller DH, Comi G (1995) Intra- and inter-observer agreement of brain MRI lesion volume measurements in multiple sclerosis: a comparison of techniques. Brain 118:1583–1592
Filippi M, Horsfield MA, Tofts PS, Barkhof F, Thompson AJ Miller DH (1995) Quantitative assessment of MRI lesion load in monitoring the evolution of multiple sclerosis. Brain 118:1601–1612
Filippi M, Horsfield MA, Gasperini C, Waesberghe JH van, Gawne-Cain ML, Rocca MA, Bastianello S, Lycklama è Nijeholt GJ, Miller DH (1996) Inter-scanner variation in brain MRI lesion load measurement in multiple sclerosis. Proc Fourth Sci Meeting Int Soc Magn Reson Med 1:171
Filippi M, Campi A, Colombo B, Pereira C, Martinelli V, Baratti C, Comi G (in press) A spinal cord MRI study of benign and secondary progressive multiple sclerosis. J Neurol 243:502–505
Gass A, Barker GJ, Kidd D, Thorpe JW, MacManus DG, Brennan A, Tofts PS, Thompson AJ, McDonald WI, Miller DH (1994) Correlation of magnetization transfer ratio with disability in multiple sclerosis. Ann Neurol 36:62–67
Gawne-Cain ML, Webb S, Tofts PS, Miller DH (1996) The effect of repositioning inaccuracies on intracranial MS lesion volume measurements (abstract). Proc Fourth Sci Meeting Int Soc Magn Reson Med 1:534
Grimaud J, Lai M, Thorpe JW, Adeleine P, Plummer D, Barker GJ, Wang L, Tofts PS, McDonald WI, Miller DH (1995) Evaluation of computer-assisted quantification of MS lesions in cranial MR imaging (abstract). Proc Third Sci Meeting Int Soc Magn Reson Med 1:283
Grossman RI (1994) Magnetization transfer in multiple sclerosis. Ann Neurol 36: S97-S99
Hiehle JF, Grossman RI, Ramer KN, Gonzalez-Scarano F, Cohen JA (1995) Magnetization transfer effect in MR-detected multiple sclerosis lesions: comparison with gadolinium-enhanced spin-echo images and non-enhanced T1-weighted images. AJNR 16:69–77
Kidd D, Thorpe JW, Thompson AJ, Kendall BE, Moseley IF, MacManus DG, McDonald WI, Miller DH (1993) Spinal cord MRI using multi-array coils and fast-spin echo. II. Findings in multiple sclerosis. Neurology 43: 2632–2637
Loevener LA, Grossman RI, McGowan JC, Ramer KN, Cohen JA (1995) Characterization of multiple sclerosis plaques with T1-weighted MR and quantitative magnetization transfer. AJNR 16:1473–1479
Losseff N, Lai M, Miller DH, McDonald WI, Thompson AJ (1995) The prognostic value of serial axial cord area measurement by magnetic resonance imaging in multiple sclerosis (abstract). J Neurol 242 [Suppl 2]: 110
Miller DH (1994) Magnetic resonance in monitoring the treatment of multiple sclerosis. Ann Neurol 36: S91-S94
Miller DH, Barkhof F, Berry I, Kappos L, Scotti G, Thompson AJ (1991) Magnetic resonance imaging in monitoring the treatment of multiple sclerosis: concerted action guidelines. J Neurol Neurosurg Psychiatry 54:683–688
Miller DH, Albert PS, Barkhof F, Francis G, Frank JA, Hodgkinson S, Lublin FD, Paty DW, Reingold SC, Simon J (1996) Guidelines for the use of magnetic resonance techniques in monitoring the treatment of multiple sclerosis. Ann Neurol 39:6–16
Paty DW, Li DKB, UBC MS/MRI Study Group, IFNB Multiple Sclerosis Study Group (1993) Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. II. MRI analysis results of a multicenter, randomized, double-blind, placebo-controlled trial. Neurology 43:662–667
Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231
Smith ME, Stone LA, Albert PS, Frank JA, Martin R, Armstrong M, Maloni H, McFarlin DE, McFarland HF (1993) Clinical worsening in multiple sclerosis is associated with increased frequency and area of gadopentetate dimeglumine-enhancing magnetic resonance imaging lesions. Ann Neurol 33: 480–489
Van Walderveen MAA, Barkhof F, Hommes OR, Polman CH, Tobi H, Frequin STFM, Valk J (1995) Correlating MRI and clinical disease activity in multiple sclerosis: relevance of hypointense lesions on short TR/short TE (T1-weighted) spin-echo images. Neurology 45:1684–1690
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rovaris, M., Filippi, M., Calori, G. et al. Intra-observer reproducibility in measuring new putative MR markers of demyelination and axonal loss in multiple sclerosis: a comparison with conventional T2-weighted images. J Neurol 244, 266–270 (1997). https://doi.org/10.1007/s004150050083
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s004150050083