Comparative Diagnostic Yield of 3 Tesla Versus 1.5 Tesla MRI in Early Detection of Multiple Sclerosis Among Saudi Patients: A Prospective, Blinded Study
DOI:
https://doi.org/10.69980/ajpr.v28i5.597Keywords:
Multiple sclerosis; Magnetic resonance imaging; 3 Tesla MRI; 1.5 Tesla MRI; Diagnostic yield; Saudi Arabia; Demyelination; NeuroimagingAbstract
Background: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by demyelination and neurodegeneration. Early and accurate diagnosis is critical to initiate disease-modifying therapies and improve patient outcomes. High-resolution magnetic resonance imaging (MRI) at 3 Tesla (3T) has been shown to offer superior sensitivity in detecting MS lesions compared to conventional 1.5 Tesla (1.5T) MRI; however, comparative data specific to the Saudi population remain limited.
Aim: This study aims to evaluate the effectiveness of high-resolution 3T MRI compared to conventional 1.5T MRI in the early detection of multiple sclerosis lesions among Saudi patients.
Methods: A prospective comparative study was conducted involving Saudi patients presenting with clinical features suggestive of early MS. Each participant underwent both 1.5T and 3T brain and spinal MRI scans following the same imaging protocols based on the 2017 McDonald Criteria. Lesion load, anatomical distribution, and contrast enhancement characteristics were independently assessed by two blinded neuroradiologists. Statistical analysis was performed to compare the diagnostic yield of 3T versus 1.5T MRI.
Results: A total of 60 patients were enrolled (mean age 29.4 years; 63.3% female). The average lesion count per patient was significantly higher on 3T MRI (mean = 9.2, SD = 3.4) compared to 1.5T MRI (mean = 6.1, SD = 2.9; p < 0.001). Lesions were more frequently detected across all anatomical regions with 3T imaging, including the periventricular (p = 0.003), juxtacortical (p = 0.001), infratentorial (p = 0.007), spinal cord (p = 0.009), and corpus callosum (p = 0.012) areas. Contrast-enhancing lesions were identified in 30.0% of patients using 3T MRI versus 16.7% with 1.5T (p = 0.039). Inter-observer agreement was higher for 3T (κ = 0.89) than 1.5T (κ = 0.76), indicating improved diagnostic consistency.
Conclusion: Preliminary findings suggest that 3T MRI may provide enhanced sensitivity in the early identification of MS lesions compared to 1.5T MRI in Saudi patients. Improved lesion detection at higher field strength could contribute to earlier diagnosis, better disease monitoring, and potentially optimized therapeutic interventions. Further analysis of the full study data will confirm these observations and inform future imaging protocols for MS evaluation in Saudi Arabia.
References
• Abel, E., Silander, E., Nyman, J., & Bove, M. (2017). Impact on quality of life of IMRT versus 3-D conformal radiation therapy in head and neck cancer patients: A case control study. Clinical and Translational Radiation Oncology, 5, 1–5.
• Alterio, D., Gugliandolo, S. G., & Augugliaro, M. (2021). IMRT versus 2D/3D conformal radiotherapy in oropharyngeal cancer: A review of the literature and meta‐analysis. Oral Diseases, 27(Suppl 3), 1151–1160.
• Cramer SP, Simonsen H, Frederiksen JL, et al. Abnormal blood-brain barrier permeability in normal appearing white matter in multiple sclerosis investigated by MRI. Neuroimage Clin. 2014;4:182-189.
• De Felice, F., Pranno, N., Papi, P., & Brugnoletti, O. (2020). Intensity modulated radiotherapy (IMRT) versus three-dimensional conformal radiotherapy (3D-CRT) for head and neck squamous cell carcinoma: A meta-analysis. In Vivo, 34(2), 623–629.
• de Graaf WL, Zwanenburg JJ, Visser F, et al. Lesion detection at seven Tesla in multiple sclerosis using magnetisation prepared 3D-FLAIR and 3D-DIR. Eur Radiol. 2012;22(1):221-231.
• Dula AN, Pawate S, Dortch RD, et al. Magnetic resonance imaging of the cervical spinal cord in multiple sclerosis at 7T. Mult Scler. 2016;22(3):320-328.
• Gaitan MI, Maggi P, Wohler J, et al. Perivenular brain lesions in a primate multiple sclerosis model at 7-tesla magnetic resonance imaging. Mult Scler. 2014;20(1):64-71.
• Ghosh, G., Tallari, R., & Malviya, A. (2016). Toxicity profile of IMRT vs. 3D-CRT in head and neck cancer: A retrospective study. Journal of Clinical and Diagnostic Research, 10(11), XC01–XC04.
• Gupta, T., Agarwal, J. P., Jain, S., & Phurailatpam, R. (2012). Three-dimensional conformal radiotherapy (3D-CRT) versus intensity modulated radiation therapy (IMRT) in squamous cell carcinoma of the head and neck: A randomized clinical trial. Radiotherapy and Oncology.
• Gupta, T., Kannan, S., Ghosh-Laskar, S., & Agarwal, J. P. (2018). Intensity modulated radiation therapy versus conventional two-dimensional and/or three-dimensional radiotherapy in curative-intent management of head and neck squamous cell carcinoma: A systematic review. PLOS ONE, 13(7), e0200137.
• Harrison DM, Roy S, Oh J, et al. Association of Cortical Lesion Burden on 7-T Magnetic Resonance Imaging With Cognition and Disability in Multiple Sclerosis. JAMA Neurol. 2015;72(9):1004-1012.
• Kilsdonk ID, Jonkman LE, Klaver R, et al. Increased cortical grey matter lesion detection in multiple sclerosis with 7 T MRI: a post-mortem verification study. Brain. 2016;139(Pt 5):1472-1481.
• Kollia K, Maderwald S, Putzki N, et al. First clinical study on ultra-high-field MR imaging in patients with multiple sclerosis: comparison of 1.5T and 7T. AJNR Am J Neuroradiol. 2009;30(4):699-702.
• Kucha, N., Soni, T. P., Jakhotia, N., Patni, N., & Singh, D. K. (2020). Comparative toxicity profile between three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) in locally advanced head and neck cancer. Clinical Oncology and Research, 5(3), 1–8.
• Lohia, S., Rajapurkar, M., & Nguyen, S. A. (2014). A comparison of outcomes using intensity-modulated radiation therapy and 3-dimensional conformal radiation therapy in treatment of oropharyngeal cancer. JAMA Otolaryngology–Head & Neck Surgery, 140(2), 142–146.
• Mistry N, Tallantyre EC, Dixon JE, et al. Focal multiple sclerosis lesions abound in 'normal appearing white matter'. Mult Scler. 2011;17(11):1313-1323.
• Nair G, Absinta M, Reich DS. Optimized T1-MPRAGE sequence for better visualization of spinal cord multiple sclerosis lesions at 3T. AJNR Am J Neuroradiol. 2013;34(11):2215-2222.
• Peszynska-Piorun, M., & Malicki, J. (2012). Doses in organs at risk during head and neck radiotherapy using IMRT and 3D-CRT. Reports of Practical Oncology and Radiotherapy, 17(4), 219–223.
• Sigmund EE, Suero GA, Hu C, et al. High-resolution human cervical spinal cord imaging at 7 T. NMR Biomed. 2012;25(7):891-899.
• Spiotto, M. T., & Weichselbaum, R. R. (2014). Locally advanced head and neck cancers treated with concurrent chemoradiation using IMRT with or without simultaneous integrated boost. PLOS ONE, 9(4), e94456.
• Springer E, Dymerska B, Cardoso PL, et al. Comparison of Routine Brain Imaging at 3 T and 7 T. Invest Radiol. 2016;51(8):469-482.
• Stankiewicz JM, Glanz BI, Healy BC, et al. Brain MRI lesion load at 1.5T and 3T versus clinical status in multiple sclerosis. J Neuroimaging. 2011;21(2):e50-e56.
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