Poster Presentation 23rd International Society of Magnetic Resonance Conference 2023

Utility of 3D quantitative susceptibility mapping for clinical correlations of iron-rich deep grey matter of people with relapsing-remitting multiple sclerosis (#316)

Ibrahim Khormi 1 2 3 , Oun Al-iedani 2 4 , Amir Fazlollahi 5 6 , Abdulaziz Alshehri 1 2 7 , Kieran O'Brien 8 9 , Steffen Bollmann 9 10 , Rishma Vidyasagar 11 , Scott Ayton 11 , Saadallah Ramadan 1 2 , Jeanette Lechner-Scott 2 12 13
  1. School of Health Sciences, University of Newcastle, Callaghan, NSW, Australia
  2. Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
  3. College of Applied Medical Sciences, University of Jeddah, Jeddah, Saudi Arabia
  4. School of Biomedical Sciences and Pharmacy, University of Newcastle, Challaghan, NSW, Australia
  5. Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
  6. Department of Radiology, University of Melbourne, Melbourne, VIC, Australia
  7. Department of Radiology, King Fahad University Hospital, , Imam Abdulrahman Bin Faisal University, Dammam , Saudi Arabia
  8. Siemens Healthcare Pty Ltd,, Brisbane, QLD, Australia
  9. ARC Training Centre for Innovation in Biomedical Imaging Technology, The University of Queensland, Brisbane, QLD, Australia
  10. School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD
  11. The Florey Institute of Neuroscience & Mental Health, Parkville, VIC, Australia
  12. Department of Neurology, John Hunter Hospital, New Lambton Heights, NSW, Australia
  13. School of Medicine and Public Health, University of Newcastle, Challaghan, NSW, Australia

Introduction: MS demyelination and atrophy alter the tissue's diamagnetic properties leading to higher tissue magnetic susceptibility1. High levels of iron accumulation have been detected in the deep grey matter (DGM) structures of people with MS (pwMS)1. Quantitative susceptibility mapping (QSM) is a novel post-processing imaging modality that quantifies tissue magnetic susceptibility using a gradient-recalled-echo (GRE) sequence.

Objective: To characterise the magnetic susceptibility in selected DGM structures with reference to medial-frontal white matter for pwMS and healthy controls (HC). Correlation between DGM QSM metrics and selected MS clinical parameters were computed.

Method: Five relapsing-remitting multiple sclerosis (RRMS) participants and nine age-matched HC were recruited (mean age: 46±14 yrs). MRI scans were performed on a 3T scanner. The STI Suite (v2.2) was used for QSM map reconstruction from 3D GRE images. The significant QSM differences associated with selected DGM structures were assessed using repeated-measures ANOVA controlling for the reference region. RRMS clinical measures included disease duration, cognitive, fatigue, mental health assessment as well as Expanded Disability Status Scale. Correlations between clinical measurement scores and iron-rich regions, accounting for age, were performed using Pearson’s correlation.

Result: The RRMS participants showed significantly higher susceptibility compared to HCs in the caudate (β= +26.2, p = 0.004), pallidum (β= +38.9, p = 0.006) with a trend toward significant for putamen (β= +21.2, p = 0.09), and significantly lower susceptibility in thalamus (β= –10.2, p = 0.04). For RRMS cohort, pallidum and thalamus QSM values were highly correlated with the anxiety scale (r=0.98, r=-0.93, respectively). The dentate nucleus and putamen were highly correlated with the disease duration (r=-0.93, r=-0.91, respectively) with p<0.05.

Conclusion: These preliminary QSM results from pwMS suggest that neurodegenerative and neuroinflammatory processes in DGM (caudate, pallidum, putamen, thalamus, dentate nucleus) might lead to clinical symptoms. While the studied cohorts were small, our research supports the promising nature of QSM to investigate the contribution of iron in the pathophysiology of MS.

  1. Zivadinov, R., Tavazzi, E., Bergsland, N., Hagemeier, J., Lin, F., Dwyer, M.G., Carl, E., Kolb, C., Hojnacki, D., Ramasamy, D. and Durfee, J., 2018. Brain iron at quantitative MRI is associated with disability in multiple sclerosis. Radiology, 289(2), pp.487-496.