Quantitative FLAIR MRI in amyotrophic lateral sclerosis

Journal article

Rationale and Objectives T2-weighted MRI hyperintensity assessed visually in the corticospinal tract (CST) lacks sensitivity for a diagnosis of amyotrophic lateral sclerosis (ALS). We sought to explore a quantitative approach to FLAIR MRI intensity across a range of ALS phenotypes. Materials & Methods Thirty three classical ALS patients, 10 with a flail arm presentation, and 6 with primary lateral sclerosis underwent MRI at 3 Tesla. Comparisons of quantitative FLAIR intensity in the corticospinal tract (CST) and corpus callosum were made between 21 healthy controls and within patient phenotypic sub-groups, some of who were studied longitudinally. Results Mean FLAIR intensity was greater in patient groups. The cerebral peduncle intensity provided the strongest sub-group classification. FLAIR intensity increased longitudinally. The rate of change of FLAIR within CST correlated with rate of decline in executive function and ALS Functional Rating Score. Conclusion FLAIR MRI encodes quantifiable information of potential diagnostic, stratification and monitoring value.

Authors: Fabes, J; Matthews, L; Filippini, N; Talbot, K; Jenkinson, M

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Academic Radiology More from this journal
• Volume: 24
• Issue: 10
• Pages: 1187-1194
• Publication date: 2017-05-29
• Acceptance date: 2017-04-24
• DOI: 10.1016/j.acra.2017.04.008
• ISSN: 1076-6332
• Keywords: phenotype; amyotrophic lateral sclerosis; motor neuron disease; prognosis; neuroimaging; biomarker