Marloes Hagens1, Bart van Berckel, Frederik Barkhof. 1. aDepartment of Neurology bDepartment of Radiology and Nuclear Medicine, MS Center Amsterdam, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands.
Abstract
PURPOSE OF REVIEW: Gadolinium-enhancement depicts blood-brain barrier disruption associated with new inflammatory MRI lesions in multiple sclerosis (MS) and is widely used for diagnosis and therapeutic monitoring. However, earlier and more specific markers of inflammation are urgently needed. RECENT FINDINGS: Susceptibility-weighted images demonstrate the importance of the central vein in the formation of MS lesions. Perfusion weighted imaging techniques can show focal and diffuse low-grade inflammatory changes not visible on conventional MRI. Leptomeningeal enhancement could be part of the aetiology of subpial cortical MS lesions. Ultrasmall superparamagnetic particles of iron oxide can identify neuroinflammatory changes in addition to gadolinium enhancement and as such identify different types and phases of MS lesions. 18kD-translocator protein PET tracers identify activated microglia and an increase in TSPO uptake in both MS lesions and normal appearing brain tissue is related to disease severity and progression. A range of novel tracers for microglia activation is under development as well as radioligands that can label therapeutic drugs. SUMMARY: Novel MRI and PET techniques improve in-vivo visualization and quantification of the pleomorphic aspects of neuroinflammation, providing us with a unique insight in its pathogenesis, clinical relevance, and therapy responsiveness in MS.
PURPOSE OF REVIEW: Gadolinium-enhancement depicts blood-brain barrier disruption associated with new inflammatory MRI lesions in multiple sclerosis (MS) and is widely used for diagnosis and therapeutic monitoring. However, earlier and more specific markers of inflammation are urgently needed. RECENT FINDINGS: Susceptibility-weighted images demonstrate the importance of the central vein in the formation of MS lesions. Perfusion weighted imaging techniques can show focal and diffuse low-grade inflammatory changes not visible on conventional MRI. Leptomeningeal enhancement could be part of the aetiology of subpial cortical MS lesions. Ultrasmall superparamagnetic particles of iron oxide can identify neuroinflammatory changes in addition to gadolinium enhancement and as such identify different types and phases of MS lesions. 18kD-translocator protein PET tracers identify activated microglia and an increase in TSPO uptake in both MS lesions and normal appearing brain tissue is related to disease severity and progression. A range of novel tracers for microglia activation is under development as well as radioligands that can label therapeutic drugs. SUMMARY: Novel MRI and PET techniques improve in-vivo visualization and quantification of the pleomorphic aspects of neuroinflammation, providing us with a unique insight in its pathogenesis, clinical relevance, and therapy responsiveness in MS.
Authors: Marloes H J Hagens; Sandeep V Golla; Martijn T Wijburg; Maqsood Yaqub; Dennis Heijtel; Martijn D Steenwijk; Patrick Schober; John J P Brevé; Robert C Schuit; Tristan A Reekie; Michael Kassiou; Anne-Marie van Dam; Albert D Windhorst; Joep Killestein; Frederik Barkhof; Bart N M van Berckel; Adriaan A Lammertsma Journal: J Neuroinflammation Date: 2018-11-13 Impact factor: 8.322
Authors: Anne Nack; Matthias Brendel; Julia Nedelcu; Markus Daerr; Stella Nyamoya; Cordian Beyer; Carola Focke; Maximilian Deussing; Chloé Hoornaert; Peter Ponsaerts; Christoph Schmitz; Peter Bartenstein; Axel Rominger; Markus Kipp Journal: Cells Date: 2019-01-28 Impact factor: 6.600
Authors: Mercy I Akerele; Sara A Zein; Sneha Pandya; Anastasia Nikolopoulou; Susan A Gauthier; Ashish Raj; Claire Henchcliffe; P David Mozley; Nicolas A Karakatsanis; Ajay Gupta; John Babich; Sadek A Nehmeh Journal: EJNMMI Phys Date: 2021-04-29
Authors: Shanzeh M Ahmed; Nina L Fransen; Hanane Touil; Iliana Michailidou; Inge Huitinga; Jennifer L Gommerman; Amit Bar-Or; Valeria Ramaglia Journal: JCI Insight Date: 2022-03-08