Imaging features to distinguish AQP4-positive NMOSD and MS at disease onset: A retrospective analysis in a single-center cohort. Issue 146 (January 2022)

• Record Type: Journal Article
• Authors: Zrzavy, Tobias; Leutmezer, Fritz; Rommer, Paulus; Bsteh, Gabriel; Kornek, Barbara; Berger, Thomas; Prayer, Daniela; Thurnher, Majda; Haider, Lukas
• Is Part Of: European journal of radiology. Issue 146(2022)
• Publication Date: 2022-01
• Subjects: Multiple sclerosis -- AQP4+ neuromyelitis optica spectrum disorders -- MRI -- Real-life -- Diagnostic criteria; AUC area under the curve -- AQP4 aquaporin 4 -- CC Cacciaguerra criteria -- DO disease onset -- FU follow-up -- IPND International Consensus Diagnostic Criteria Neuromyelitis Optica Spectrum Disorders -- LETM longitudinal extensive transverse myelitis -- McD-DIS 2017 McDonald criteria for dissemination in space -- MC Matthews criteria -- MS Multiple Sclerosis -- NA not applicable -- NMOSD Neuromyelitis Optica Spectrum Disorder -- OCB Cerebrospinal fluid oligoclonal bands -- ONbilat. ant. opticus neuritis bilateral nterior -- ON chiasm. opticus neuritis involving chiasma -- ONunilat. ant. opticus neuritis unilateral anterior -- Peri-ependymal LVL peri-ependymal lesions along the lateral ventricles -- PWM periventricular white matter -- RRMS relapsing-remitting MS -- WM white matter -- IL infratentorial lesion -- JC juxtacortical lesion count -- SC GAD+ lesion spinal cord gadolinium-enhancing lesion -- SC segments spinal cord longitudinal extension measured in vertebral segments -- SCL spinal cord lesions -- Temp. L temporal lobe -- TL total lesion count; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2021.110063
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: To compare the diagnostic performance of imaging criteria that differentiate AQP4 + Neuromyelitis Optica Spectrum Disorders (NMOSD) and Multiple Sclerosis (MS) at disease onset (DO) and follow-up (FU). Methods: We retrospectively analyzed MRI scans at DO (defined as the first 60 days of patient-reported symptom onset) in 10 AQP4 + NMOSD and 25 (time to MRI matched) relapsing-remitting MS patients from a monocentric cohort. Results: The Matthews criteria were met in 20% of AQP4 + NMOSD patients at DO vs. 33% at FU, and in 96% of RRMS patients vs.100% at FU. Specificity (SP) and sensitivity (SE) were thus high at both time-points: SP-DO: 96%; SP-FU:100%; and SE-DO: 80%; SE-FU: 67%, with similar area under the curve (AUC) values at DO: 88% [95% CI 74%-100%] and FU: 83% [95% CI 67%-100%]. The Cacciaguerra criteria were met in 90% of AQP4 + NMOSD patients at DO vs. 88.9% at FU and in 24% of RRMS patients vs. 14% at FU; SP-DO: 87%; SP-FU: 86%; and SE-DO: 90%; SE-FU: 89%, with similar AUC values at DO: 88% [95% CI 76%-98%] and FU: 87% [95% CI 74%-98%]. Conclusions: While diagnostic MRI criteria were developed on data acquired years after disease onset, our study demonstrates their high applicability at the earliest disease stages, thus emphasising their valuable use in clinical practice.