Abstract #0979

Identifying Multiple Sclerosis Lesion Subtypes with Distinct Microstructural Features using Advanced Microstructural MRI

Hyeong-Geol Shin^1,2, Blake E. Dewey³, Jan Brabec^1,2, Jinwei Zhang⁴, Omar Ezzedin³, Kaitlyn Ecoff³, Anna Kim³, Alexandra Ramirez³, Anna DuVal³, Kathryn Fitzgerald³, Linda Knutsson^1,2,5, Filip Szczepankiewicz⁵, Jerry Prince⁴, Shiv Saidha³, Peter A. Calabresi³, Peter van Zijl^1,2, and Xu Li^1,2

¹Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ²F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, MD, United States, ³Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁴Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, United States, ⁵Department of Medical Radiation Physics, Clinical Sciences Lund, Lund University, Lund, Sweden

Synopsis

Keywords: Multiple Sclerosis, Multiple Sclerosis

Motivation: Conventional MRI struggles to capture heterogeneous histopathological subtypes within multiple sclerosis (MS) lesions, mainly due to a lack of microstructural specificity.

Goal(s): (i) To unveil distinct subtypes of microstructural alteration MS lesions using advanced multi-contrast microstructural MRI; (ii) increase sensitivity to individual microstructure.

Approach: K-means clustering was applied to multi-contrast microstructural MRI quantities, including parameters from diffusometry (μFA [axonal integrity marker], MD), susceptometry (QSM, 𝜒_dia [demyelination marker] 𝜒_para [marker for iron-laden microglia]), and relaxometry (R2*, R2, T1).

Results: Five MRI-driven lesion subtypes, each with unique microstructural property combinations, revealed potential histopathological features of MS lesions and showed enhanced sensitivities to clinical outcomes.

Impact: We used a novel imaging multi-biomarker for in-vivo MS pathology to assess lesion types for potential treatment monitoring in MS. Some MS subtypes with microstructure alterations, potentially related to disease histopathology, showed improved clinical sensitivity over conventional imaging markers.

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