Ultra-high-field Brain MRI in Multiple Sclerosis

NCT05718947 | Completed

• 1 other identifier: Z2022009
• Study Type: observational
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

The MRI scan is one of the most important tools for diagnosing multiple sclerosis (MS) and for monitoring disease progression and medication effects. Increasingly strong MRI magnets (higher field strength) enable us to see abnormalities in the brain in greater detail. On the other hand, it poses challenges because these higher field strength MRIs are more sensitive to disturbances, for example due to motion, including physiological motion such as breathing and swallowing. In current practice, field strengths of up to 3 Tesla are common. The aim of this study is to compare scanning at field strengths of 3 Tesla in 10 MS patients at two different moments (baseline and 6 months) with scanning at field strengths that are higher, namely 7 and 9.4 Tesla, in order to identify the advantages and disadvantages. With the further development of this technique, the investigators may be able to make a better diagnosis in the future and detect subtle changes in the course of the disease more quickly in order to optimize treatments.

Conditions

Multiple Sclerosis

Keywords

Multiple Sclerosis; MRI; Ultra-high field

Outcome Measures

Primary Outcomes (1)

• Detected white- and grey-matter lesions

  Given that the present study is a pilot, descriptive statistics will be employed to identify important trends between field strengths, evaluating the number of lesions that can be identified in white as well as grey matter, in what proportion of lesions a perivenous localization can be identified

  6 months

Secondary Outcomes (1)

• Image quality parameters (signal-to-noise and contrast-to-noise ratios)

  6 months

Study Arms (1)

MS scan cohort

10 patients with a known clinical diagnosis of relapsing remitting MS according to the 2017 McDonald criteria between ages of 18-65 years, who had a new lesion on their clinical brain MRI in the prior 15 months. The investigators intend to include patients on low-efficacy medication (interferon β, peginterferon, glatiramer acetate, teriflunomide) as well as patients on high-efficacy medication (natalizumab, ocrelizumab, alemtuzumab, fingolimod) to have a varied and representative study population.

Diagnostic Test: Brain MRI (3T, 7T, 9.4T)

Interventions

Brain MRI (3T, 7T, 9.4T) DIAGNOSTIC_TEST

All patients will undergo anatomical brain imaging on a 3T, 7T and 9.4T MRI scanner within the same day at baseline and again 6 months later. An optimized protocol for every separate field strength will be run. Sequences will include at least T1-weighted, T2\*-weighted and a T2 SPACE or FLAIR sequence. No intravenous contrast will be used.

MS scan cohort

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The investigators aim to include 10 patients from our outpatient clinic, with a known clinical diagnosis of relapsing remitting MS according to the 2017 McDonald criteria between ages of 18-65 years, who had a new lesion on their clinical brain MRI in the prior 15 months. The intention is to include patients on low-efficacy medication (interferon β, peginterferon, glatiramer acetate, teriflunomide) as well as patients on high-efficacy medication (natalizumab, ocrelizumab, alemtuzumab, fingolimod) to have a varied and representative study population. The investigators estimate it highly realistic that inclusion of these 10 patients can be achieved.

You may qualify if:

• Relapsing remitting MS patients (according to the 2017 McDonald criteria)
• Age 18-65 years
• New brain MRI lesion in the past 15 months.

You may not qualify if:

• Non-compatible implanted material/devices
• Not being able to lie flat long enough (for the MRI) because of another medical condition

Sponsors & Collaborators

• Zuyderland Medisch Centrum: lead
• Scannexus: collaborator

Study Sites (1)

Zuyderland MC

Geleen, Limburg, 6162BG, Netherlands

Location

Related Publications (7)

• Ceccarelli A, Bakshi R, Neema M. MRI in multiple sclerosis: a review of the current literature. Curr Opin Neurol. 2012 Aug;25(4):402-9. doi: 10.1097/WCO.0b013e328354f63f.

  PMID: 22691759 BACKGROUND

• Bruschi N, Boffa G, Inglese M. Ultra-high-field 7-T MRI in multiple sclerosis and other demyelinating diseases: from pathology to clinical practice. Eur Radiol Exp. 2020 Oct 22;4(1):59. doi: 10.1186/s41747-020-00186-x.

  PMID: 33089380 BACKGROUND

• Sati P. Diagnosis of multiple sclerosis through the lens of ultra-high-field MRI. J Magn Reson. 2018 Jun;291:101-109. doi: 10.1016/j.jmr.2018.01.022. Epub 2018 Apr 26.

  PMID: 29705032 BACKGROUND

• Trattnig S, Bogner W, Gruber S, Szomolanyi P, Juras V, Robinson S, Zbyn S, Haneder S. Clinical applications at ultrahigh field (7 T). Where does it make the difference? NMR Biomed. 2016 Sep;29(9):1316-34. doi: 10.1002/nbm.3272. Epub 2015 Mar 12.

  PMID: 25762432 BACKGROUND

• van der Kolk AG, Hendrikse J, Zwanenburg JJ, Visser F, Luijten PR. Clinical applications of 7 T MRI in the brain. Eur J Radiol. 2013 May;82(5):708-18. doi: 10.1016/j.ejrad.2011.07.007. Epub 2011 Sep 19.

  PMID: 21937178 BACKGROUND

• Tallantyre EC, Morgan PS, Dixon JE, Al-Radaideh A, Brookes MJ, Evangelou N, Morris PG. A comparison of 3T and 7T in the detection of small parenchymal veins within MS lesions. Invest Radiol. 2009 Sep;44(9):491-4. doi: 10.1097/RLI.0b013e3181b4c144.

  PMID: 19652606 BACKGROUND

• Absinta M, Sati P, Schindler M, Leibovitch EC, Ohayon J, Wu T, Meani A, Filippi M, Jacobson S, Cortese IC, Reich DS. Persistent 7-tesla phase rim predicts poor outcome in new multiple sclerosis patient lesions. J Clin Invest. 2016 Jul 1;126(7):2597-609. doi: 10.1172/JCI86198. Epub 2016 Jun 6.

  PMID: 27270171 BACKGROUND

MeSH Terms

Conditions

Multiple Sclerosis

Condition Hierarchy (Ancestors)

Demyelinating Autoimmune Diseases, CNS; Autoimmune Diseases of the Nervous System; Nervous System Diseases; Demyelinating Diseases; Autoimmune Diseases; Immune System Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 30, 2023
• First Posted: February 8, 2023
• Study Start: September 12, 2023
• Primary Completion: June 17, 2024
• Study Completion: June 17, 2024
• Last Updated: September 19, 2024

Record last verified: 2024-09

Locations

NL (1)