ABSTRACT
Background and Purpose
MRI is crucial for multiple sclerosis (MS), but the relative value of portable ultra-low field MRI (pULF-MRI), a technology that holds promise for extending access to MRI, is unknown. We assessed white matter lesion (WML) detection on pULF-MRI compared to high-field MRI (HF-MRI), focusing on blinded assessments, assessor self-training, and multiplanar acquisitions.
Methods
Fifty-five adults with MS underwent pULF-MRI following their HF-MRI. Two neuroradiologists independently assessed pULF-MRI images in an evaluation process, including initial assessment blinded to HF-MRI, self-training with reference to HF-MRI and evaluation of 20 cases with additional T2-fluid-attenuated inversion recovery in an additional plane. A third rater conducted cross-referenced analysis with HF-MRI data to determine true-positive lesions, false-positive areas, and case-level sensitivity and positive predictive value.
Results
The mean age of participants was 50 years (standard deviation: 11; 74% women). Initially, Rater 2 marked more false-positive areas than Rater 1 (p = 0.003). After self-training, both raters embraced a conservative approach, with Rater 2 marking fewer false-positive areas (p = 0.01). Both raters maintained 100% case-level sensitivity and positive predictive value for detecting at least one WML, particularly in periventricular areas. Multiplanar acquisitions reduced both false-positive areas and true-positive lesions. True-positive lesions and false-positive areas had similar contrast-to-noise ratios in the juxtacortical region (p = 0.73) but not in periventricular, deep parenchymal regions (p = 0.004, p = 0.01).
Conclusion
With adequate training, radiological interpretation of pULF-MRI has high sensitivity and positive predictive value for MS lesions but should be approached conservatively. These results suggest utility for patient triage, potentially reducing diagnostic delay, and screening high-risk individuals.
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This post is Copyright: Serhat V. Okar,
Govind Nair,
Karan D. Kawatra,
Ashley A. Thommana,
Corinne A. Donnay,
María I. Gaitán,
Joel M. Stein,
Daniel S. Reich | January 16, 2025
Wiley: Journal of Neuroimaging: Table of Contents