Low-Field (64 mT) Portable MRI for Rapid Point-of-Care Diagnosis of Dissemination in Space in Patients Presenting with Optic Neuritis.

Autor:	Lim TR; From the Division of Neuroradiology, Department of Medical Imaging (T.R.L., S.S., A.W.L., Y.A.C., S.M. A.B.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada., Suthiphosuwan S; From the Division of Neuroradiology, Department of Medical Imaging (T.R.L., S.S., A.W.L., Y.A.C., S.M. A.B.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada., Micieli J; Department of Ophthalmology and Vision Sciences (J.M.), University of Toronto, Toronto, Ontario, Canada.; Kensington Vision and Research Center (J.M.), Toronto, Ontario, Canada.; Department of Ophthalmology (J.M.), St. Michael's Hospital, Unity Health, Toronto, Ontario, Canada., Vosoughi R; Division of Neurology, Department of Medicine (R.V., R.S., A.M., J.J.M., D.S., J.O.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada., Schneider R; Division of Neurology, Department of Medicine (R.V., R.S., A.M., J.J.M., D.S., J.O.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.; Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science (R.S. D.S., S.M.), Toronto, Ontario, Canada., Lin AW; From the Division of Neuroradiology, Department of Medical Imaging (T.R.L., S.S., A.W.L., Y.A.C., S.M. A.B.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada., Chen YA; From the Division of Neuroradiology, Department of Medical Imaging (T.R.L., S.S., A.W.L., Y.A.C., S.M. A.B.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada., Muccilli A; Division of Neurology, Department of Medicine (R.V., R.S., A.M., J.J.M., D.S., J.O.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada., Marriott JJ; Division of Neurology, Department of Medicine (R.V., R.S., A.M., J.J.M., D.S., J.O.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada., Selchen D; Division of Neurology, Department of Medicine (R.V., R.S., A.M., J.J.M., D.S., J.O.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.; Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science (R.S. D.S., S.M.), Toronto, Ontario, Canada., Mathur S; From the Division of Neuroradiology, Department of Medical Imaging (T.R.L., S.S., A.W.L., Y.A.C., S.M. A.B.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.; Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science (R.S. D.S., S.M.), Toronto, Ontario, Canada., Oh J; Division of Neurology, Department of Medicine (R.V., R.S., A.M., J.J.M., D.S., J.O.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.; Department of Neurology (J.O.), Johns Hopkins University, Baltimore, Maryland., Bharatha A; From the Division of Neuroradiology, Department of Medical Imaging (T.R.L., S.S., A.W.L., Y.A.C., S.M. A.B.), St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada aditya.bharatha@unityhealth.to.
Jazyk:	angličtina
Zdroj:	AJNR. American journal of neuroradiology [AJNR Am J Neuroradiol] 2024 Nov 07; Vol. 45 (11), pp. 1819-1825. Date of Electronic Publication: 2024 Nov 07.
DOI:	10.3174/ajnr.A8395
Abstrakt:	Background and Purpose: Low-field 64 mT portable brain MRI has recently shown diagnostic promise for MS. This study aimed to evaluate the utility of portable MRI (pMRI) in assessing dissemination in space (DIS) in patients presenting with optic neuritis and determine whether deploying pMRI in the MS clinic can shorten the time from symptom onset to MRI. Materials and Methods: Newly diagnosed patients with optic neuritis referred to a tertiary academic MS center from July 2022 to January 2024 underwent both point-of-care pMRI and subsequent 3T conventional MRI (cMRI). Images were evaluated for periventricular (PV), juxtacortical (JC), and infratentorial (IT) lesions. DIS was determined on brain MRI per 2017 McDonald criteria. Test characteristics were computed by using cMRI as the reference. Interrater and intermodality agreement between pMRI and cMRI were evaluated by using the Cohen κ. Time from symptom onset to pMRI and cMRI during the study period was compared with the preceding 1.5 years before pMRI implementation by using Kruskal-Wallis with post hoc Dunn tests. Results: Twenty patients (median age: 32.5 years [interquartile range {IQR}, 28-40]; 80% women) were included, of whom 9 (45%) and 5 (25%) had DIS on cMRI and pMRI, respectively. Median time interval between pMRI and cMRI was 7 days (IQR, 3.5-12.5). Interrater agreement was very good for PV (95%, κ = 0.89), and good for JC and IT lesions (90%, κ = 0.69 for both). Intermodality agreement was good for PV (90%, κ = 0.80) and JC (85%, κ = 0.63), and moderate for IT lesions (75%, κ = 0.42) and DIS (80%, κ = 0.58). pMRI had a sensitivity of 56% and specificity of 100% for DIS. The median time from symptom onset to pMRI was significantly shorter (8.5 days [IQR 7-12]) compared with the interval to cMRI before pMRI deployment (21 days [IQR 8-49], n  = 50) and after pMRI deployment (15 days [IQR 12-29], n  = 30) (both P < .01). Time from symptom onset to cMRI in those periods was not significantly different ( P  = .29). Conclusions: In patients with optic neuritis, pMRI exhibited moderate concordance, moderate sensitivity, and high specificity for DIS compared with cMRI. Its integration into the MS clinic reduced the time from symptom onset to MRI. Further studies are warranted to evaluate the role of pMRI in expediting early MS diagnosis and as an imaging tool in resource-limited settings. (© 2024 by American Journal of Neuroradiology.)
Databáze:	MEDLINE
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