eprintid: 10065984
rev_number: 18
eprint_status: archive
userid: 608
dir: disk0/10/06/59/84
datestamp: 2019-01-17 14:48:37
lastmod: 2021-09-25 23:00:00
status_changed: 2019-01-17 14:48:37
type: article
metadata_visibility: show
creators_name: Elliott, C
creators_name: Wolinsky, JS
creators_name: Hauser, SL
creators_name: Kappos, L
creators_name: Barkhof, F
creators_name: Bernasconi, C
creators_name: Wei, W
creators_name: Belachew, S
creators_name: Arnold, DL
title: Slowly expanding/evolving lesions as a magnetic resonance imaging marker of chronic active multiple sclerosis lesions
ispublished: inpress
divisions: UCL
divisions: B02
divisions: C07
divisions: D07
divisions: F82
keywords: Chronic active lesions, progressive multiple sclerosis, relapsing multiple sclerosis, slowly expanding/evolving lesions, smoldering plaques
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abstract: BACKGROUND:: Chronic lesion activity driven by smoldering inflammation is a pathological hallmark of progressive forms of multiple sclerosis (MS). OBJECTIVE:: To develop a method for automatic detection of slowly expanding/evolving lesions (SELs) on conventional brain magnetic resonance imaging (MRI) and characterize such SELs in primary progressive MS (PPMS) and relapsing MS (RMS) populations. METHODS:: We defined SELs as contiguous regions of existing T2 lesions showing local expansion assessed by the Jacobian determinant of the deformation between reference and follow-up scans. SEL candidates were assigned a heuristic score based on concentricity and constancy of change in T2- and T1-weighted MRIs. SELs were examined in 1334 RMS patients and 555 PPMS patients. RESULTS:: Compared with RMS patients, PPMS patients had higher numbers of SELs ( p = 0.002) and higher T2 volumes of SELs ( p < 0.001). SELs were devoid of gadolinium enhancement. Compared with areas of T2 lesions not classified as SEL, SELs had significantly lower T1 intensity at baseline and larger decrease in T1 intensity over time. CONCLUSION:: We suggest that SELs reflect chronic tissue loss in the absence of ongoing acute inflammation. SELs may represent a conventional brain MRI correlate of chronic active MS lesions and a candidate biomarker for smoldering inflammation in MS.
date: 2018-12-19
date_type: published
official_url: https://doi.org/10.1177/1352458518814117
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
article_type_text: Journal Article
verified: verified_manual
elements_id: 1616628
doi: 10.1177/1352458518814117
lyricists_name: Barkhof, Frederik
lyricists_id: FBARK32
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: Multiple Sclerosis Journal
event_location: England
issn: 1477-0970
citation:        Elliott, C;    Wolinsky, JS;    Hauser, SL;    Kappos, L;    Barkhof, F;    Bernasconi, C;    Wei, W;         ... Arnold, DL; + view all <#>        Elliott, C;  Wolinsky, JS;  Hauser, SL;  Kappos, L;  Barkhof, F;  Bernasconi, C;  Wei, W;  Belachew, S;  Arnold, DL;   - view fewer <#>    (2018)    Slowly expanding/evolving lesions as a magnetic resonance imaging marker of chronic active multiple sclerosis lesions.                   Multiple Sclerosis Journal        10.1177/1352458518814117 <https://doi.org/10.1177/1352458518814117>.    (In press).    Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10065984/1/1352458518814117.pdf