November 21, 2024
This study explores the potential of low-field (64 mT) portable MRI (pMRI) as a diagnostic tool for identifying dissemination in space (DIS) in patients presenting with optic neuritis. The research highlights how pMRI could expedite diagnosis and improve access to imaging, particularly in resource-limited settings.
Purpose of the Study
The study aimed to evaluate the effectiveness of portable MRI (pMRI) for assessing DIS in patients with optic neuritis and compare its diagnostic utility against conventional 3T MRI (cMRI). It also investigated whether deploying pMRI could reduce the time between symptom onset and imaging.
How the Study Was Done
Patients newly diagnosed with optic neuritis were referred to a tertiary MS center and underwent both point-of-care pMRI and conventional cMRI. The images were assessed for key MS markers in the brain—periventricular, juxtacortical, and infratentorial lesions—based on the 2017 McDonald criteria. Sensitivity, specificity, and intermodality agreement between pMRI and cMRI were analyzed, alongside the time intervals from symptom onset to imaging.
Key Findings
pMRI showed moderate concordance with cMRI for diagnosing DIS, with a sensitivity of 56% and specificity of 100%.
The time from symptom onset to pMRI was significantly shorter (median: 8.5 days) compared to cMRI (21 days before pMRI deployment and 15 days after pMRI deployment).
Interrater agreement was very good for periventricular lesions (κ = 0.89) and good for other lesion types.
These findings suggest pMRI has the potential to improve diagnostic timelines and improve imaging accessibility in patients suspected to have MS.
Who Performed the Study
This study was conducted by a team from Toronto Radiology and collaborating institutions. Timothy Reynold Lim and Aditya Bharatha from Toronto Radiology led the research efforts, with key contributions from Suradech Suthiphosuwan, Jonathan Micieli, Reza Vosoughi, Raphael Schneider, Amy W. Lin, Yingming Amy Chen, Alexandra Muccilli, James J. Marriott, Daniel Selchen, Shobhit Mathur, and Jiwon Oh.
