Neuroimaging Christopher Bever, MD, MBA (MODERATOR) Use of ...

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Evaluating the Therapeutic Response In The Individual Patient • Patient ---------Self-Report • Physician ------Global Impression • Other -----------More Objective Data – MS symptoms, relapses, disability – Biological Markers – MRI metrics Adapted from R. Rudick, Cleveland Clinic
Evidence-Based Studies to Define Treatment Failure Classification Parameters & Outcome Measure • Rudick et al (2004) • Rio et al (2008) • Durelli et al (2008) • Kinkel et al (2008) Gd/New T2 /Relapse Active Lesions (N,E,Gd+) Active MRI (and Nab) Gd+ and T2 Outcome Measure – atrophy, disability, clinical event
Page 1 and 2: Neuroimaging Christopher Bever, MD,
Page 3 and 4: Disclaimer • The speaker has rece
Page 5 and 6: MRI in the Individual Patient (As O
Page 7 and 8: FROM SIMPLE TO COMPLEX T2-Lesions G
Page 9 and 10: Gadolinium Enhancing Lesions Cell T
Page 11 and 12: T2 Lesions Non-Specific Pathology I
Page 13 and 14: Distribution--Periventricular >> Pe
Page 15 and 16: T1 “Black Holes” A subset of T2
Page 17 and 18: Spinal Cord Proton/T2 Proton densit
Page 19 and 20: Number Lesions Most of the Disease
Page 21 and 22: MRI in Diagnostic Criteria
Page 23 and 24: Accurate Prediction of Earliest MS
Page 25 and 26: Barkoff Combined Criteria More Accu
Page 27 and 28: McDonald Criteria Annals of Neurolo
Page 29 and 30: Earlier Diagnosis of MS with MRI Ev
Page 31 and 32: The Criteria are Imperfect - Vigila
Page 33: Both criteria highly specific (>90%
Page 36 and 37: 2003 Cortical Lesions only in retro
Page 38 and 39: Okuda et al. Neurology 2009;72:800
Page 40 and 41: Use of MRI to Follow Subclinical Di
Page 42 and 43: 1 4 7 10 13 16 19 22 25 28 37 40 43
Page 44 and 45: Use of MRI to Determine Treatment R
Page 48 and 49: Two year follow-up ; Outcome = Disa
Page 50 and 51: Treated Patients with 2 or more les
Page 52 and 53: New atypical weakness or seizure In
Page 54 and 55: PML Concern is Detecting PML +MS
Page 56 and 57: Yousry et al. NEJM;2006 354:924-933
Page 59 and 60: Standardized MRI For Improved Care
Page 61 and 62: Standardized MRI Guidelines PD opti
Page 63 and 64: Update T. Traboulsee et al In 2009
Page 65 and 66: Field Strength Matters Sicotte, 200
Page 67 and 68: We Expect 3D Acquisitions to become
Page 69 and 70: 3D FLAIR - 1mm partitions reconstru
Page 71 and 72: MRI Signal and Field Strength 3T sc
Page 73 and 74: 7T MS MPRAGE 0.8 mm thick AIRC at O
Page 75 and 76: MS, Fe Permeability Study OHSU 7T,
Page 77 and 78: Summary- And Learning • Classical

Neuroimaging Christopher Bever, MD, MBA (MODERATOR) Use of ...

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