Evaluation of the Central Vein Sign as a Diagnostic Imaging Biomarker in Multiple Sclerosis
| Autor: | Sinnecker T., Clarke M. A., Meier D., Enzinger C., Calabrese M., De Stefano N., Pitiot A., Giorgio A., Schoonheim M. M., Paul F., Pawlak M. A., Schmidt R., Kappos L., Montalban X., Rovira A., Evangelou N., Wuerfel J., MAGNIMS Study Group, Filippi M, Rocca M. A. |
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| Přispěvatelé: | Anatomy and neurosciences, Amsterdam Neuroscience - Neuroinfection & -inflammation, Sinnecker, T., Clarke, M. A., Meier, D., Enzinger, C., Calabrese, M., De Stefano, N., Pitiot, A., Giorgio, A., Schoonheim, M. M., Paul, F., Pawlak, M. A., Schmidt, R., Kappos, L., Montalban, X., Rovira, A., Evangelou, N., Wuerfel, J., MAGNIMS Study, Group, Filippi, M, Rocca, M. A. |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Central Nervous System
Male Imaging biomarker diagnosis Cluster Headache Relapsing-Remitting multiple sclerosis 0302 clinical medicine 80 and over 030212 general & internal medicine Aged 80 and over Clinically isolated syndrome medicine.diagnostic_test Lupus Vasculitis Central Nervous System Neuromyelitis Optica Brain Middle Aged Magnetic Resonance Imaging medicine.anatomical_structure Biomarker (medicine) biomarker Female Radiology medicine.symptom Adult medicine.medical_specialty Adolescent Migraine Disorders Lupus Vasculitis Sensitivity and Specificity Lesion Young Adult 03 medical and health sciences Multiple Sclerosis Relapsing-Remitting central vein sign clinical 3T magnetic resonance imaging medicine Humans Vein Aged Expanded Disability Status Scale business.industry Multiple sclerosis Correction Magnetic resonance imaging Case-Control Studies Cerebral Veins Cross-Sectional Studies Demyelinating Diseases Multiple Sclerosis medicine.disease Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Sinnecker, T, Clarke, M A, Meier, D, Enzinger, C, Calabrese, M, De Stefano, N, Pitiot, A, Giorgio, A, Schoonheim, M M, Paul, F, Pawlak, M A, Schmidt, R, Kappos, L, Montalban, X, Rovira, À, Evangelou, N, Wuerfel, J & MAGNIMS Study Group 2019, ' Evaluation of the Central Vein Sign as a Diagnostic Imaging Biomarker in Multiple Sclerosis ', JAMA Neurology, vol. 76, no. 12, pp. 1446-1456 . https://doi.org/10.1001/jamaneurol.2019.2478 JAMA Neurology, 76(12), 1446-1456. American Medical Association JAMA Neurol |
| ISSN: | 2168-6149 |
| DOI: | 10.1001/jamaneurol.2019.2478 |
| Popis: | Importance: The central vein sign has been proposed as a specific imaging biomarker for distinguishing between multiple sclerosis (MS) and not MS, mainly based on findings from ultrahigh-field magnetic resonance imaging (MRI) studies. The diagnostic value of the central vein sign in a multicenter setting with a variety of clinical 3 tesla (T) MRI protocols, however, remains unknown.Objective: To evaluate the sensitivity and specificity of various central vein sign lesion criteria for differentiating MS from non-MS conditions using 3T brain MRI with various commonly used pulse sequences.Design, Setting, and Participants: This large multicenter, cross-sectional study enrolled participants (n = 648) of ongoing observational studies and patients included in neuroimaging research databases of 8 neuroimaging centers in Europe. Patient enrollment and MRI data collection were performed between January 1, 2010, and November 30, 2016. Data analysis was conducted between January 1, 2016, and April 30, 2018. Investigators were blinded to participant diagnosis by a novel blinding procedure.Main Outcomes and Measures: Occurrence of central vein sign was detected on 3T T2*-weighted or susceptibility-weighted imaging. Sensitivity and specificity were assessed for these MRI sequences and for different central vein sign lesion criteria, which were defined by the proportion of lesions with central vein sign or by absolute numbers of lesions with central vein sign.Results: A total of 606 participants were included in the study after exclusion of 42 participants. Among the 606 participants, 413 (68.2%) were women. Patients with clinically isolated syndrome and relapsing-remitting MS (RRMS) included 235 women (66.6%) and had a median (range) age of 37 (14.7-61.4) years, a median (range) disease duration of 2 (0-33) years, and a median (range) Expanded Disability Status Scale score of 1.5 (0-6.5). Patients without MS included 178 women (70.4%) and had a median (range) age of 54 (18-83) years. A total of 4447 lesions were analyzed in a total of 487 patients: 690 lesions in 98 participants with clinically isolated syndrome, 2815 lesions in 225 participants with RRMS, 54 lesions in 13 participants with neuromyelitis optica spectrum disorder, 54 lesions in 14 participants with systemic lupus erythematosus, 121 lesions in 29 participants with migraine or cluster headache, 240 lesions in 20 participants with diabetes, and 473 lesions in 88 participants with other types of small-vessel disease. The sensitivity was 68.1% and specificity was 82.9% for distinguishing MS from not MS using a 35% central vein sign proportion threshold. The 3 central vein sign lesion criteria had a sensitivity of 61.9% and specificity of 89.0%. Sensitivity was higher when an optimized T2*-weighted sequence was used.Conclusions and Relevance: In this study, use of the central vein sign at 3T MRI yielded a high specificity and a moderate sensitivity in differentiating MS from not MS; international, multicenter studies may be needed to ascertain whether the central vein sign-based criteria can accurately detect MS. |
| Databáze: | OpenAIRE |
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