Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical Relevance
Background: Hypointense lesions on T1-weighted images have important clinical relevance in multiple sclerosis patients. Traditionally, spin-echo (SE) sequences are used to assess these lesions (termed black holes), but Fast Spoiled Gradient-Echo (FSPGR) sequences provide an excellent alternative.Obj...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.619135/full |
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| author | Krisztián Kocsis Nikoletta Szabó Eszter Tóth András Király Péter Faragó Bálint Kincses Dániel Veréb Bence Bozsik Katalin Boross Melinda Katona Péter Bodnár Nyúl Gábor László László Vécsei László Vécsei Péter Klivényi Krisztina Bencsik Zsigmond Tamás Kincses Zsigmond Tamás Kincses |
| author_facet | Krisztián Kocsis Nikoletta Szabó Eszter Tóth András Király Péter Faragó Bálint Kincses Dániel Veréb Bence Bozsik Katalin Boross Melinda Katona Péter Bodnár Nyúl Gábor László László Vécsei László Vécsei Péter Klivényi Krisztina Bencsik Zsigmond Tamás Kincses Zsigmond Tamás Kincses |
| author_sort | Krisztián Kocsis |
| collection | DOAJ |
| description | Background: Hypointense lesions on T1-weighted images have important clinical relevance in multiple sclerosis patients. Traditionally, spin-echo (SE) sequences are used to assess these lesions (termed black holes), but Fast Spoiled Gradient-Echo (FSPGR) sequences provide an excellent alternative.Objective: To determine whether the contrast difference between T1 hypointense lesions and the surrounding normal white matter is similar on the two sequences, whether different lesion types could be identified, and whether the clinical relevance of these lesions types are different.Methods: Seventy-nine multiple sclerosis patients' lesions were manually segmented, then registered to T1 sequences. Median intensity values of lesions were identified on all sequences, then K-means clustering was applied to assess whether distinct clusters of lesions can be defined based on intensity values on SE, FSPGR, and FLAIR sequences. The standardized intensity of the lesions in each cluster was compared to the intensity of the normal appearing white matter in order to see if lesions stand out from the white matter on a given sequence.Results: 100% of lesions on FSPGR images and 69% on SE sequence in cluster #1 exceeded a standardized lesion distance of Z = 2.3 (p < 0.05). In cluster #2, 78.7% of lesions on FSPGR and only 17.7% of lesions on SE sequence were above this cutoff value, meaning that these lesions were not easily seen on SE images. Lesion count in the second cluster (lesions less identifiable on SE) significantly correlated with the Expanded Disability Status Scale (EDSS) (R: 0.30, p ≤ 0.006) and with disease duration (R: 0.33, p ≤ 0.002).Conclusion: We showed that black holes can be separated into two distinct clusters based on their intensity values on various sequences, only one of which is related to clinical parameters. This emphasizes the joint role of FSPGR and SE sequences in the monitoring of MS patients and provides insight into the role of black holes in MS. |
| first_indexed | 2024-12-19T14:33:04Z |
| format | Article |
| id | doaj.art-79a3c51b641c485c831700cfd1c994d8 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-19T14:33:04Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-79a3c51b641c485c831700cfd1c994d82022-12-21T20:17:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-03-011210.3389/fneur.2021.619135619135Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical RelevanceKrisztián Kocsis0Nikoletta Szabó1Eszter Tóth2András Király3Péter Faragó4Bálint Kincses5Dániel Veréb6Bence Bozsik7Katalin Boross8Melinda Katona9Péter Bodnár10Nyúl Gábor László11László Vécsei12László Vécsei13Péter Klivényi14Krisztina Bencsik15Zsigmond Tamás Kincses16Zsigmond Tamás Kincses17Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Radiology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Image Processing and Computer Graphics, University of Szeged, Szeged, HungaryDepartment of Image Processing and Computer Graphics, University of Szeged, Szeged, HungaryDepartment of Image Processing and Computer Graphics, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryMagyar Tudományos Akadémia-Szegedi Tudományegyetem (MTA-SZTE) Neuroscience Research Group, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryDepartment of Radiology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, HungaryBackground: Hypointense lesions on T1-weighted images have important clinical relevance in multiple sclerosis patients. Traditionally, spin-echo (SE) sequences are used to assess these lesions (termed black holes), but Fast Spoiled Gradient-Echo (FSPGR) sequences provide an excellent alternative.Objective: To determine whether the contrast difference between T1 hypointense lesions and the surrounding normal white matter is similar on the two sequences, whether different lesion types could be identified, and whether the clinical relevance of these lesions types are different.Methods: Seventy-nine multiple sclerosis patients' lesions were manually segmented, then registered to T1 sequences. Median intensity values of lesions were identified on all sequences, then K-means clustering was applied to assess whether distinct clusters of lesions can be defined based on intensity values on SE, FSPGR, and FLAIR sequences. The standardized intensity of the lesions in each cluster was compared to the intensity of the normal appearing white matter in order to see if lesions stand out from the white matter on a given sequence.Results: 100% of lesions on FSPGR images and 69% on SE sequence in cluster #1 exceeded a standardized lesion distance of Z = 2.3 (p < 0.05). In cluster #2, 78.7% of lesions on FSPGR and only 17.7% of lesions on SE sequence were above this cutoff value, meaning that these lesions were not easily seen on SE images. Lesion count in the second cluster (lesions less identifiable on SE) significantly correlated with the Expanded Disability Status Scale (EDSS) (R: 0.30, p ≤ 0.006) and with disease duration (R: 0.33, p ≤ 0.002).Conclusion: We showed that black holes can be separated into two distinct clusters based on their intensity values on various sequences, only one of which is related to clinical parameters. This emphasizes the joint role of FSPGR and SE sequences in the monitoring of MS patients and provides insight into the role of black holes in MS.https://www.frontiersin.org/articles/10.3389/fneur.2021.619135/fullmultiple sclerosisT1 hypointense lesionsblack holesMRI protocolclusteringclinical state |
| spellingShingle | Krisztián Kocsis Nikoletta Szabó Eszter Tóth András Király Péter Faragó Bálint Kincses Dániel Veréb Bence Bozsik Katalin Boross Melinda Katona Péter Bodnár Nyúl Gábor László László Vécsei László Vécsei Péter Klivényi Krisztina Bencsik Zsigmond Tamás Kincses Zsigmond Tamás Kincses Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical Relevance Frontiers in Neurology multiple sclerosis T1 hypointense lesions black holes MRI protocol clustering clinical state |
| title | Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical Relevance |
| title_full | Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical Relevance |
| title_fullStr | Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical Relevance |
| title_full_unstemmed | Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical Relevance |
| title_short | Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical Relevance |
| title_sort | two classes of t1 hypointense lesions in multiple sclerosis with different clinical relevance |
| topic | multiple sclerosis T1 hypointense lesions black holes MRI protocol clustering clinical state |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2021.619135/full |
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