Maryam Azizian1, Nadia Ghasemi Darestani2, Athena Aliabadi3, Mahdieh Afzali4, Nooshin Tavoosi5, Mahnaz Fosouli6, Jalil Khataei6, Halimeh Aali7, Sayed Mohammad Amin Nourian8. 1. School of Medicine, Kerman University of Medical Sciences Kerman, Iran. 2. School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran. 3. Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Science Tehran, Iran. 4. Department of Neurology, School of Medicine, Yas Hospital, Tehran University of Medical Sciences Tehran, Iran. 5. Department of Midwifery, School of Nursing and Midwifery, Islamic Azad University Shahrekord Branch Shahrekord, Iran. 6. Department of Radiology, Isfahan University of Medical Sciences Isfahan, Iran. 7. Department of Internal Medicine, University of Medical Sciences Zabol, Iran. 8. Florida International University-FIU/AUA Miami, Florida, USA.
Abstract
BACKGROUND: Multiple Sclerosis (MS) is an autoimmune, inflammatory disease of the central nervous system. Magnetic resonance imaging (MRI) findings are associated with disease clinical activity and response to treatment. This study aimed to evaluate the future value of plaque number and volume in MRI as radiological criteria in determining the treatment response to INF-B in patients with MS. METHODS: This is a cross-sectional study performed in 2016-2021 in Iran on patients with the newly diagnosed (less than one year) relapsing-remitting MS. Brain MRI was taken for all patients. The number and volumes of the MS plaques were evaluated from FLAIR images by the two radiologists. Patients were treated with INF-B1a with a dosage of 12 million units equal to 44 micrograms subcutaneously, three times per week. Patients were visited monthly by neurologists to examine their clinical status. After one year, the brain MRI was conducted with the similar characteristics to the beginning of the study, and the number and volume of MS plaques were measured again. RESULTS: The study population consisted of 33 males and 90 females with a mean age of 28.37 ± 6.29 years. The mean Expanded Disability Status Scale (EDSS) of the patients was 3.16 ± 0.23 at the beginning of the study. The specificity for a 50% reduction in the number and volume of plaques as two separate criteria was the same and equal to 100%. The sensitivity of the number and volume of plaques were 65.5% and 90.6%, respectively. In addition, considering 10% as the cut-off point of the number of plaques, the sensitivity of the number of plaques as a criterion was equal to the sensitivity of the plaque volume. CONCLUSION: The results of this study showed that imaging criteria provide a more objective tool for evaluating the effectiveness of treatment. These findings indicate that the number and volume of plaques could be two reliable MRI imaging criteria for assessing therapy response. The number of plaques was less accurate than the volume of plaques. AJND
BACKGROUND: Multiple Sclerosis (MS) is an autoimmune, inflammatory disease of the central nervous system. Magnetic resonance imaging (MRI) findings are associated with disease clinical activity and response to treatment. This study aimed to evaluate the future value of plaque number and volume in MRI as radiological criteria in determining the treatment response to INF-B in patients with MS. METHODS: This is a cross-sectional study performed in 2016-2021 in Iran on patients with the newly diagnosed (less than one year) relapsing-remitting MS. Brain MRI was taken for all patients. The number and volumes of the MS plaques were evaluated from FLAIR images by the two radiologists. Patients were treated with INF-B1a with a dosage of 12 million units equal to 44 micrograms subcutaneously, three times per week. Patients were visited monthly by neurologists to examine their clinical status. After one year, the brain MRI was conducted with the similar characteristics to the beginning of the study, and the number and volume of MS plaques were measured again. RESULTS: The study population consisted of 33 males and 90 females with a mean age of 28.37 ± 6.29 years. The mean Expanded Disability Status Scale (EDSS) of the patients was 3.16 ± 0.23 at the beginning of the study. The specificity for a 50% reduction in the number and volume of plaques as two separate criteria was the same and equal to 100%. The sensitivity of the number and volume of plaques were 65.5% and 90.6%, respectively. In addition, considering 10% as the cut-off point of the number of plaques, the sensitivity of the number of plaques as a criterion was equal to the sensitivity of the plaque volume. CONCLUSION: The results of this study showed that imaging criteria provide a more objective tool for evaluating the effectiveness of treatment. These findings indicate that the number and volume of plaques could be two reliable MRI imaging criteria for assessing therapy response. The number of plaques was less accurate than the volume of plaques. AJND
Authors: Claudio Gasperini; Luca Prosperini; Mar Tintoré; Maria Pia Sormani; Massimo Filippi; Jordi Rio; Jacqueline Palace; Maria A Rocca; Olga Ciccarelli; Frederik Barkhof; Jaume Sastre-Garriga; Hugo Vrenken; Jette L Frederiksen; Tarek A Yousry; Christian Enzinger; Alex Rovira; Ludwig Kappos; Carlo Pozzilli; Xavier Montalban; Nicola De Stefano Journal: Neurology Date: 2018-12-26 Impact factor: 9.910
Authors: Tanuja Chitnis; Douglas L Arnold; Brenda Banwell; Wolfgang Brück; Angelo Ghezzi; Gavin Giovannoni; Benjamin Greenberg; Lauren Krupp; Kevin Rostásy; Marc Tardieu; Emmanuelle Waubant; Jerry S Wolinsky; Amit Bar-Or; Tracy Stites; Yu Chen; Norman Putzki; Martin Merschhemke; Jutta Gärtner Journal: N Engl J Med Date: 2018-09-13 Impact factor: 91.245
Authors: Francisco Coret; Francisco C Pérez-Miralles; Francisco Gascón; Carmen Alcalá; Arantxa Navarré; Ana Bernad; Isabel Boscá; Matilde Escutia; Sara Gil-Perotin; Bonaventura Casanova Journal: Mult Scler J Exp Transl Clin Date: 2018-06-26