Skip to main content
SpringerLink
Log in

Intra-observer reproducibility in measuring new putative MR markers of demyelination and axonal loss in multiple sclerosis: a comparison with conventional T2-weighted images

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

New magnetic resonance (MR) measures considered to be putative markers of demyelination and axonal loss were found to be more closely related to clinical disability than T2-weighted MR imaging (MRI) findings in patients with multiple sclerosis (MS). In this study, we evaluated the reproducibility of such measurements in order to assess their reliability for longitudinal studies in MS. The intra-observer coefficients of variation for repeated measurements did not significantly differ among the MR techniques studied [2.6% for T2-weighted MRI, 4.38% for unenhanced T1-weighted MRI, 3.65% for magnetisation transfer imaging (MTI) and 2.28% for spinal cord cross-sectional area at C5]. Our findings suggest that non-conventional MR techniques may be reliable outcome measures for clinical trials in MS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bland JM, Altaian DG (1986) Statistical methods of assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    Article  CAS  Google Scholar 

  2. British Standards Institution (1979) Precision of test methods. I. Guide for the determination and reproducibility of a standard test method. British Standard 5497

  3. Davie CA, Hawkins CP, Barker GJ, Brennan A, Tofts PS, Miller DH, McDonald WI (1994) Serial proton magnetic resonance spectroscopy in acute multiple sclerosis lesions. Brain 117: 49–58

    Article  Google Scholar 

  4. Davie CA, Barker GJ, Webb S, Tofts PS, Thompson AJ, Harding AE, McDonald WI, Miller DH (1995) Persistent functional deficit in multiple sclerosis and autosomal dominant cerebellar ataxia is associated with axonal loss. Brain 118:1583–1592

    Article  Google Scholar 

  5. De Stefano N, Matthews PM, Antel JP, Preul M, Francis GS, Arnold DL (1995) Chemical pathology of acute demyelinating lesions and its correlation with disability. Ann Neurol 38: 901–909

    Article  Google Scholar 

  6. Dousset V, Grossman RI, Ramer KN, Schnall MD, Young LH, Gonzalez-Scarano F, Lavi E, Cohen JA (1992) Experimental allergic encephalomyelitis and multiple sclerosis: lesion characterization with magnetization transfer imaging. Radiology 182:483–491

    Article  CAS  Google Scholar 

  7. Filippi M, Barker GJ, Horsfield MA, Sacares PR, MacManus DG, Thompson AJ, Tofts PS, McDonald WI, Miller DH (1994) Benign and secondary progressive multiple sclerosis: a preliminary quantitative MRI study. J Neurol 241:246–251

    Article  CAS  Google Scholar 

  8. Filippi M, Campi A, Dousset V, Baratti C, Martinelli V, Canal N, Scotti G, Comi G (1995) A magnetisation transfer imaging study of normal-appearing white matter in multiple sclerosis. Neurology 45:478–482

    Article  CAS  Google Scholar 

  9. Filippi M, Horsfield MA, Bressi S, Martinelli V, Baratti C, Reganati P, Campi A, Miller DH, Comi G (1995) Intra- and inter-observer agreement of brain MRI lesion volume measurements in multiple sclerosis: a comparison of techniques. Brain 118:1583–1592

    Article  Google Scholar 

  10. Filippi M, Horsfield MA, Tofts PS, Barkhof F, Thompson AJ Miller DH (1995) Quantitative assessment of MRI lesion load in monitoring the evolution of multiple sclerosis. Brain 118:1601–1612

    Article  Google Scholar 

  11. Filippi M, Horsfield MA, Gasperini C, Waesberghe JH van, Gawne-Cain ML, Rocca MA, Bastianello S, Lycklama è Nijeholt GJ, Miller DH (1996) Inter-scanner variation in brain MRI lesion load measurement in multiple sclerosis. Proc Fourth Sci Meeting Int Soc Magn Reson Med 1:171

    Google Scholar 

  12. Filippi M, Campi A, Colombo B, Pereira C, Martinelli V, Baratti C, Comi G (in press) A spinal cord MRI study of benign and secondary progressive multiple sclerosis. J Neurol 243:502–505

    Article  CAS  Google Scholar 

  13. Gass A, Barker GJ, Kidd D, Thorpe JW, MacManus DG, Brennan A, Tofts PS, Thompson AJ, McDonald WI, Miller DH (1994) Correlation of magnetization transfer ratio with disability in multiple sclerosis. Ann Neurol 36:62–67

    Article  CAS  Google Scholar 

  14. Gawne-Cain ML, Webb S, Tofts PS, Miller DH (1996) The effect of repositioning inaccuracies on intracranial MS lesion volume measurements (abstract). Proc Fourth Sci Meeting Int Soc Magn Reson Med 1:534

    Google Scholar 

  15. Grimaud J, Lai M, Thorpe JW, Adeleine P, Plummer D, Barker GJ, Wang L, Tofts PS, McDonald WI, Miller DH (1995) Evaluation of computer-assisted quantification of MS lesions in cranial MR imaging (abstract). Proc Third Sci Meeting Int Soc Magn Reson Med 1:283

    Google Scholar 

  16. Grossman RI (1994) Magnetization transfer in multiple sclerosis. Ann Neurol 36: S97-S99

    Article  Google Scholar 

  17. Hiehle JF, Grossman RI, Ramer KN, Gonzalez-Scarano F, Cohen JA (1995) Magnetization transfer effect in MR-detected multiple sclerosis lesions: comparison with gadolinium-enhanced spin-echo images and non-enhanced T1-weighted images. AJNR 16:69–77

    PubMed  Google Scholar 

  18. Kidd D, Thorpe JW, Thompson AJ, Kendall BE, Moseley IF, MacManus DG, McDonald WI, Miller DH (1993) Spinal cord MRI using multi-array coils and fast-spin echo. II. Findings in multiple sclerosis. Neurology 43: 2632–2637

    Article  CAS  Google Scholar 

  19. Loevener LA, Grossman RI, McGowan JC, Ramer KN, Cohen JA (1995) Characterization of multiple sclerosis plaques with T1-weighted MR and quantitative magnetization transfer. AJNR 16:1473–1479

    Google Scholar 

  20. Losseff N, Lai M, Miller DH, McDonald WI, Thompson AJ (1995) The prognostic value of serial axial cord area measurement by magnetic resonance imaging in multiple sclerosis (abstract). J Neurol 242 [Suppl 2]: 110

    Google Scholar 

  21. Miller DH (1994) Magnetic resonance in monitoring the treatment of multiple sclerosis. Ann Neurol 36: S91-S94

    Article  Google Scholar 

  22. Miller DH, Barkhof F, Berry I, Kappos L, Scotti G, Thompson AJ (1991) Magnetic resonance imaging in monitoring the treatment of multiple sclerosis: concerted action guidelines. J Neurol Neurosurg Psychiatry 54:683–688

    Article  CAS  Google Scholar 

  23. Miller DH, Albert PS, Barkhof F, Francis G, Frank JA, Hodgkinson S, Lublin FD, Paty DW, Reingold SC, Simon J (1996) Guidelines for the use of magnetic resonance techniques in monitoring the treatment of multiple sclerosis. Ann Neurol 39:6–16

    Article  CAS  Google Scholar 

  24. Paty DW, Li DKB, UBC MS/MRI Study Group, IFNB Multiple Sclerosis Study Group (1993) Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. II. MRI analysis results of a multicenter, randomized, double-blind, placebo-controlled trial. Neurology 43:662–667

    Article  Google Scholar 

  25. Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, Johnson KP, Sibley WA, Silberberg DH, Tourtellotte WW (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231

    Article  CAS  Google Scholar 

  26. Smith ME, Stone LA, Albert PS, Frank JA, Martin R, Armstrong M, Maloni H, McFarlin DE, McFarland HF (1993) Clinical worsening in multiple sclerosis is associated with increased frequency and area of gadopentetate dimeglumine-enhancing magnetic resonance imaging lesions. Ann Neurol 33: 480–489

    Article  CAS  Google Scholar 

  27. Van Walderveen MAA, Barkhof F, Hommes OR, Polman CH, Tobi H, Frequin STFM, Valk J (1995) Correlating MRI and clinical disease activity in multiple sclerosis: relevance of hypointense lesions on short TR/short TE (T1-weighted) spin-echo images. Neurology 45:1684–1690

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. MS Biosignal Analysis Centre, Department of Neurology, Scientific Institute Ospedale San Raffaele, University of Milan, via Olgettina 60, 1-20132, Milan, Italy

    Marco Rovaris, Massimo Filippi, Mariemma Rodegher, Bruno Colombo & Giancarlo Comi

  2. Department of Neuroradiology, Scientific Institute Ospedale San Raffaele, University of Milan, Milan, Italy

    Adriana Campi

  3. Department of Medical Statistics, Scientific Institute Ospedale San Raffaele, University of Milan, Milan, Italy

    Giliola Calori

Authors
  1. Marco Rovaris
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Massimo Filippi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giliola Calori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mariemma Rodegher
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Adriana Campi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bruno Colombo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Giancarlo Comi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rovaris, M., Filippi, M., Calori, G. et al. Intra-observer reproducibility in measuring new putative MR markers of demyelination and axonal loss in multiple sclerosis: a comparison with conventional T2-weighted images. J Neurol 244, 266–270 (1997). https://doi.org/10.1007/s004150050083

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004150050083

Key words

Search

Navigation