Multiple Sclerosis diagnosis and prognosis. Antibody-based MRI. Quantitative MRI. Part 2 of 2. 12
Where do you see MRI brain imaging technology progressing in the next 5 to 10 years? Dr. Anton Titov, MD. More novel imaging methods are increasingly being explored for magnetic resonance imaging [MRI]. MRI continues to reinvent itself each few years. Dr. Paul M. Matthews, MD. First, there are improvements in the speed of examinations by MRI. There is greater sensitivity for measurements particularly around axon bundle density and direction. Diffusion Tensor Imaging MRI improved with the introduction of so-called multiband techniques. This method greatly reduced the time for acquisition of high-quality diffusion tensor. There are other fast imaging-based tools. Dr. Paul M. Matthews, MD. Additional kinds of measures are being explored with novel contrast substances for MRI. Although new contrast substances have yet to fully make their way into man. For example, antibody-based contrast medications that help identify expression of inflammation-associated integrins. These molecules are present on endothelial cells of the cerebral vasculature. Dr. Anton Titov, MD. They are increasingly being explored and being brought towards human clinical trials by new companies. Finally, I would emphasize that there is a potential emerging future for additional optical imaging tools. Dr. Paul M. Matthews, MD. The near-infrared fluorescence methods already are providing data in preclinical models that can be related to inflammation. There’s still a long path to go before these will be useful in patients with multiple sclerosis. Because of the greater complexity of receiving optical signals from the brain. It is difficult also because of the need for some exogenous contrast agents to be given. Dr. Paul M. Matthews, MD. But I predict that these two in the end will contribute to our ability to characterize pathologies such as multiple sclerosis. Dr. Anton Titov, MD. That’s a very small review of the range of imaging tools for better diagnosis of multiple sclerosis. Dr. Paul M. Matthews, MD. We continue to move forward. We might expect new brain imaging modalities for multiple sclerosis in the next 10 or 20 years. I think the only thing I would add is that the nature of the imaging research in multiple sclerosis. MRI, PET, other imaging technology is also beginning to fundamentally change. Dr. Paul M. Matthews, MD. More and more the emphasis is on development of highly quantitative automated tools. They allow very reproducible data to be acquired from increasingly harmonized methods for primary data acquisition. Dr. Paul M. Matthews, MD. Secondly, I think there is something that we are only beginning to see in multiple sclerosis. This new brain imaging technology is already used for Alzheimer’s disease and other major neurodegenerative disorders. There has been a much more open data sharing to allow researchers and doctors to move forward more rapidly in development of new diagnostic tools. Some of these are becoming commercialized already. Dr. Anton Titov, MD. There are online solutions for measurement of brain volume change. We can measure multiple sclerosis lesion change. Both of this can contribute to a practical clinical monitoring for multiple sclerosis therapeutic efficacy. Imaging is coming full circle. Dr. Paul M. Matthews, MD. Brain imaging is getting a new range of techniques. But at the same time there’s a lot of attention paid to making the old MRI methods deliver more information. Already we are starting to see that information becoming part of clinical treatment criteria in multiple sclerosis.
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