Abstract #1920

T2*-weighted ex vivo whole-hemisphere 7 T MRI localizes novel focal iron-rich pathology in frontotemporal lobar degeneration

M. Dylan Tisdall¹, Daniel Ohm², Rebecca Lobrovich², Sandhitsu R Das¹, Gabor Mizsei¹, Karthik Prabhakaran², Ranjit Ittyerah¹, Sydney Lim¹, Corey T McMillan², James Gee¹, John Q Trojanowski³, Edward B Lee³, David Wolk², John A Detre^1,2, Paul Yushkevich¹, Murray Grossman², and David Irwin²

¹Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States, ²Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States, ³Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States

We describe novel, focal iron-rich pathology in frontotemporal lobar degeneration (FTLD), detected via combined ex vivo 7 T whole-hemisphere MRI and MRI-guided histopathology. While previous work has shown iron-positive plaques in AD, and focal iron-positive pathology in the motor cortex of ALS patients, we find novel focal pathologic features across a diverse range of FTLD patients, including both FTLD-tau and FTLD-TDP. These focal features occurred in regions often missed with standardized diagnostic sampling, demonstrating the sensitivity of an MRI-guided approach to histopathology. Additionally, these focal iron deposits are candidates for future in vivo detection, providing new sources of imaging contrast.

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