title: An Ultra-High Field Study of Cerebellar Pathology in Early Relapsing-Remitting Multiple Sclerosis Using MP2RAGE.
abstract: The aim of this study was to study focal cerebellar pathology in early stages of multiple sclerosis (MS) using ultra-high-field magnetization-prepared 2 inversion-contrast rapid gradient-echo (7T MP2RAGE).
  
  
  
  Twenty early-stage relapsing-remitting MS patients underwent an MP2RAGE acquisition at 7 T magnetic resonance imaging (MRI) (images acquired at 2 different resolutions: 0.58 × 0.58 × 0.58 mm, 7T_0.58, and 0.75 × 0.75 × 0.90 mm, 7T_0.75) and 3 T MRI (1.0 × 1.0 × 1.2 mm, 3T_1.0). Total cerebellar lesion load and volume and mean cerebellar lesion volume were compared across images using a Wilcoxon signed-rank test. Mean T1 relaxation times in lesions and normal-appearing tissue as well as contrast-to-noise ratio (CNR) measurements were also compared using a Wilcoxon signed-rank test. A multivariate analysis was applied to assess the contribution of MRI metrics to clinical performance in MS patients.
  
  
  
  Both 7T_0.58 and 7T_0.75 MP2RAGE showed significantly higher lesion load compared with 3T_1.0 MP2RAGE (P < 0.001). Plaques that were judged as leukocortical in 7T_0.75 and 3T_1.0 MP2RAGEs were instead identified as WM lesions in 7T_0.58 MP2RAGE. Cortical lesion CNR was significantly higher in MP2RAGEs at 7 T than at 3 T. Total lesion load as well as total and mean lesion volume obtained at both 7 T and 3 T MP2RAGE significantly predicted attention (P < 0.05, adjusted R = 0.5), verbal fluency (P < 0.01, adjusted R = 0.6), and motor performance (P = 0.01, adjusted R = 0.7).
  
  
  
  This study demonstrates the value of 7 T MP2RAGE to study the cerebellum in early MS patients. 7T_0.58 MP2RAGE provides a more accurate anatomical description of white and gray matter pathology compared with 7T_0.75 and 3T_1.0 MP2RAGE, likely due to the improved spatial resolution, lower partial volume effects, and higher CNR.
authors.affiliation: From the *Advanced Clinical Imaging Technology, Siemens Healthcare AG; †Department of Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland; ‡Centre for Advanced Imaging, University of Queensland; §Siemens Healthcare Pty Ltd, Brisbane, Queensland, Australia; ∥Department of Radiology, Valais Hospital, Sion, Switzerland; ¶Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA; #Signal Processing Laboratory, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; **Siemens Medical Solutions USA, Inc, Malvem, PA; ††Medical Image Analysis Laboratory, Centre d'Imagerie BioMédicale; and ‡‡Neuroimmunology Unit, Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
authors.forename: Mário João
authors.initials: MJ
authors.lastname: Fartaria
authors.forename: Kieran
authors.initials: K
authors.lastname: OʼBrien
authors.forename: Alexandra
authors.initials: A
authors.lastname: Şorega
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bonnier
authors.forename: Alexis
authors.initials: A
authors.lastname: Roche
authors.forename: Pavel
authors.initials: P
authors.lastname: Falkovskiy
authors.forename: Gunnar
authors.initials: G
authors.lastname: Krueger
authors.forename: Tobias
authors.initials: T
authors.lastname: Kober
authors.forename: Meritxell
authors.initials: M
authors.lastname: Bach Cuadra
authors.forename: Cristina
authors.initials: C
authors.lastname: Granziera
mesh_terms: D000328:Adult; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult