title: 7T MRI in natalizumab-associated PML and ongoing MS disease activity: A case study.
abstract: OBJECTIVE
  To assess the ability of ultra-high-field MRI to distinguish early progressive multifocal leukoencephalopathy (PML) from multiple sclerosis (MS) lesions in a rare case of simultaneous presentation of natalizumab-associated PML and ongoing MS activity.
  
  
  METHODS
  Advanced neuroimaging including 1.5T, 3T, and 7T MRI with a spatial resolution of up to 0.08 mm(3) was performed.
  
  
  RESULTS
  7T MRI differentiated between PML-related and MS-related brain damage in vivo. Ring-enhancing MS plaques displayed a central vein, whereas confluent PML lesions were preceded by punctate or milky way-like T2 lesions.
  
  
  CONCLUSIONS
  Given the importance of early diagnosis of treatment-associated PML, future systematic studies are warranted to assess the value of highly resolving MRI in differentiating between early PML- and MS-induced brain parenchymal lesions.
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Tim
authors.initials: T
authors.lastname: Sinnecker
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Jalal
authors.initials: J
authors.lastname: Othman
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Kühl
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Ralf
authors.initials: R
authors.lastname: Mekle
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Inga
authors.initials: I
authors.lastname: Selbig
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Thoralf
authors.initials: T
authors.lastname: Niendorf
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Annett
authors.initials: A
authors.lastname: Kunkel
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Wienecke
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Kern
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Friedemann
authors.initials: F
authors.lastname: Paul
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Juergen
authors.initials: J
authors.lastname: Faiss
authors.affiliation: Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
authors.forename: Jens
authors.initials: J
authors.lastname: Wuerfel