Abstract #2796

T1 abnormalities in atlas-based white matter tracts: reducing the clinico-radiological paradox in multiple sclerosis using qMRI

Veronica Ravano^1,2,3, Gian Franco Piredda^1,2,3, Manuela Vaneckova⁴, Jan Krasensky⁴, Michaela Andelova⁵, Tomas Uher⁵, Barbora Srpova⁵, Eva Kubala Havrdova⁵, Karolina Vodehnalova⁵, Dana Horakova⁵, Tom Hilbert^1,2,3, Bénédicte Maréchal^1,2,3, Reto Meuli², Jean-Philippe Thiran^2,3, Tobias Kober^1,2,3, and Jonas Richiardi²

¹Advanced Clinical Imaging Technology, Siemens Healthineers, Lausanne, Switzerland, ²Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ³LTS5, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland, ⁴Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic, ⁵Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic

In multiple sclerosis, standard radiological metrics (i.e. lesion load) correlate poorly with clinical outcomes. To overcome this limitation, we propose a novel method to evaluate T₁ relaxometry abnormalities along thirty-seven major white matter pathways extracted from a tractography atlas, i.e. without needing a diffusion scan. Evaluating T₁ z-scores along WM tracts strongly improved correlation with disability compared to lesion load. The strongest correlations were found for T₁ abnormalities in normal-appearing white matter, especially in infratentorial tracts. These results suggest that diffuse pathological changes in normal-appearing WM measured along atlas-based tracts using T₁ relaxometry could aid clinical evaluation of multiple sclerosis.

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