Quantitative susceptibility mapping as a monitoring biomarker in cerebral cavernous malformations with recent hemorrhage. Issue 4 (9th August 2017)

• Record Type: Journal Article
• Authors: Zeineddine, Hussein A.; Girard, Romuald; Cao, Ying; Hobson, Nicholas; Fam, Maged D.; Stadnik, Agnieszka; Tan, Huan; Shen, Jingjing; Chaudagar, Kiranj; Shenkar, Robert; Thompson, Richard E.; McBee, Nichol; Hanley, Daniel; Carroll, Timothy; Christoforidis, Gregory A.; Awad, Issam A.
• Is Part Of: Journal of magnetic resonance imaging. Volume 47:Issue 4(2018)
• Page Start: 1133
• Page End: 1138
• Publication Date: 2017-08-09
• Subjects: cerebral cavernous malformation -- imaging biomarker -- clinical trials -- QSM; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.25831
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Background: Quantitative Susceptibility Mapping (QSM) MRI allows accurate assessment of iron content in cerebral cavernous malformations (CCM), and a threshold increase by 6% in QSM has been shown to reflect new symptomatic hemorrhage (SH) in previously stable lesions. Purpose/Hypothesis: It is unclear how lesional QSM evolves in CCMs after recent SH, and whether this could serve as a monitoring biomarker in clinical trials aimed at preventing rebleeding in these lesions. Study Type: This is a prospective observational cohort study. Population: 16 CCM patients who experienced a SH within the past year, whose lesion was not resected or irradiated. Field Strength/Sequence: The data acquisition was performed using QSM sequence implemented on a 3T MRI system Assessment: The lesional QSM assessments at baseline and yearly during 22 patient‐years of follow‐up were performed by a trained research staff including imaging scientists. Statistical Tests: Biomarker changes were assessed in relation to clinical events. Clinical trial modeling was performed using two‐tailed tests of time‐averaged difference (assuming within‐patient correlation of 0.8, power = 0.9 and alpha = 0.1) to detect 20%, 30% or 50% effects of intervention on clinical and biomarkers event rates during two years of follow‐up. Results: The change in mean lesional QSM of index hemorrhagic lesions was +7.93% per patient‐year in the whole cohort. There were 5 cases (31%) of recurrent SH or lesional growth, and twice as many instances (62%) with a threshold (6%) increase in QSM. There were no instances of SH hemorrhage or lesional growth without an associated threshold increase in QSM during the same epoch. Level of Evidence: 1 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2018;47:1133–1138.