Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN.
Judith Jaffe Multiple Sclerosis Center, Department of Neurology, Feil Family Brain and Mind Institute, and Department of Radiology, Weill Cornell Medicine, New York, NY.
J Neuroimaging. 2020 May;30(3):251-266. doi: 10.1111/jon.12700.
Clinicians involved with different aspects of the care of persons with multiple sclerosis (MS) and scientists with expertise on clinical and imaging techniques convened in Dallas, TX, USA on February 27, 2019 at a North American Imaging in Multiple Sclerosis Cooperative workshop meeting. The aim of the workshop was to discuss cardinal pathobiological mechanisms implicated in the progression of MS and novel imaging techniques, beyond brain atrophy, to unravel these pathologies. Indeed, although brain volume assessment demonstrates changes linked to disease progression, identifying the biological mechanisms leading up to that volume loss are key for understanding disease mechanisms. To this end, the workshop focused on the application of advanced magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging techniques to assess and measure disease progression in both the brain and the spinal cord. Clinical translation of quantitative MRI was recognized as of vital importance, although the need to maintain a relatively short acquisition time mandated by most radiology departments remains the major obstacle toward this effort. Regarding PET, the panel agreed upon its utility to identify ongoing pathological processes. However, due to costs, required expertise, and the use of ionizing radiation, PET was not considered to be a viable option for ongoing care of persons with MS. Collaborative efforts fostering robust study designs and imaging technique standardization across scanners and centers are needed to unravel disease mechanisms leading to progression and discovering medications halting neurodegeneration and/or promoting repair.
2019 年 2 月 27 日，来自美国德克萨斯州达拉斯市的多位参与多发性硬化症（MS）患者治疗的临床医生和具有临床及影像学专业知识的科学家齐聚一堂，参加了北美多发性硬化症合作影像学研讨会。本次研讨会的目的是讨论与 MS 进展相关的主要病理生物学机制，以及除脑萎缩之外的新型影像学技术，以阐明这些病理学。实际上，尽管脑容量评估显示与疾病进展相关的变化，但确定导致该体积损失的生物学机制是理解疾病机制的关键。为此，研讨会重点关注了应用先进的磁共振成像（MRI）和正电子发射断层扫描（PET）技术，以评估和测量大脑和脊髓中的疾病进展。定量 MRI 的临床转化被认为至关重要，尽管大多数放射科部门要求的相对较短的采集时间仍然是实现这一目标的主要障碍。关于 PET，专家组一致认为其可用于识别正在发生的病理过程。然而，由于成本、所需专业知识以及电离辐射的使用，PET 尚未被认为是 MS 患者常规护理的可行选择。需要开展合作努力，以制定稳健的研究设计，并在扫描仪和中心之间实现影像学技术标准化，从而揭示导致疾病进展的机制，并发现能够阻止神经退行性变和/或促进修复的药物。
