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Non-Contrast MRI Effectively Monitors MS Patients

By MedImaging International staff writers
Posted on 03 Apr 2019

Image: Axial T1 MRIs obtained in 32-year-old woman with MS, with a new lesion (arrow) (Photo courtesy of TUM).

A new study suggests that magnetic resonance imaging (MRI) without contrast agent is just as effective as a contrast-enhanced approach for monitoring multiple sclerosis (MS) patients.

Researchers at Munich Technical University (TUM; Germany), SyNergy (Munich, Germany), and other institutions conducted a retrospective study of 359 patients with MS (mean age, 38.2 years) to examine whether the use of contrast agents has an effect on the detection of new or enlarged MS lesions and, consequently, the assessment of interval progression. For the study, 507 follow-up MRI T1-weighted images were assessed for new or enlarged lesions by two independent readers blinded to each other’s findings and to clinical information.

The primary outcome of the study was percentage of new or enlarged lesions detected only on contrast-enhanced T1-weighted images, and the assessment of interval progression, defined as at least one new or unequivocally enlarged lesion on follow-up MRI. The results revealed that of the 507 follow-up scans, 264 showed interval progression, with a total of 1,992 new or enlarged lesions. Assessment of interval progression did not differ significantly between the contrast-enhanced and non-enhanced MRI scans. The study was published on March 12, 2019, in Radiology.

“In over 500 follow-up scans, we missed only four of 1,992 new or enlarged lesions. Importantly, we did not miss disease activity in the non-enhanced scans in a single follow-up scan,” said senior author Benedikt Wiestler, MD, of TUM. “These factors warrant evaluation of strategies for reducing or omitting contrast agent, especially in MS patients who often accumulate a high number of MRI scans over their lifetimes.”

MRI with the administration of gadolinium-based contrast material is widely considered obligatory for follow-up scans of patients with MS. The researchers credited a proprietary approach developed at TUM that combines three dimensional (3D) MRI and algorithmic subtraction techniques tin order to cancel out unchanged areas in the follow-up MRI, with substantially improved visualization of new or enlarging white matter lesions seen in the study.

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Munich Technical University
SyNergy

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71 (467.06199645996): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294777491 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (808.0005645752): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (82.015991210938): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (538.11073303223): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (!!!!! 1306.7722320557): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (226.97448730469): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (608.92105102539): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (854.9690246582): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (!!!!! 3017.1871185303): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (202.89421081543): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (97.036361694336): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294777491 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (!!!!! 7920.0267791748): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294777491 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (!!!!! 7930.9940338135): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (300.88424682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

105 (128.98445129395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

106 (69.141387939453): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294777491 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (66.041946411133): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294777491 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (694.99015808105): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

109 (!!!!! 3267.0497894287): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

110 (52.928924560547): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294777491 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (432.01446533203): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294777491 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 2046.8235015869): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (!!!!! 4709.005355835): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (!!!!! 4715.9194946289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

115 (735.04447937012): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

116 (638.96179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

117 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

118 (!!!!! 2626.1806488037): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

119 (!!!!! 2028.9421081543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

120 (!!!!! 5599.9755859375): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 110467.9107666): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

123 (62.942504882812): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

124 (!!!!! 1472.9499816895): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294777491 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294777491 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1182179.9278259): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 854459.0473175): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (118.01719665527): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (53.882598876953): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (51.975250244141): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (29.802322387695): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (38.862228393555): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (589.13230895996): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (!!!!! 1621.9615936279): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (555.03845214844): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (221.96769714355): SELECT name FROM jos_deeppockets WHERE id=212

136 (50.067901611328): SELECT name FROM jos_deeppockets WHERE id=212

137 (!!!!! 1437.9024505615): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (764.13154602051): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 2869.1291809082): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

140 (!!!!! 1102.9243469238): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

141 (!!!!! 19378.185272217): TRUNCATE TABLE jos_trademed_module

142 (159.02519226074): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294777491 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (712.87155151367): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294777491 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 1518.9647674561): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (!!!!! 1878.9768218994): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (134.94491577148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

147 (111.10305786133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

148 (!!!!! 2261.1618041992): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (194.07272338867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

150 (491.85752868652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

151 (!!!!! 1740.9324645996): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294777491 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294777491 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (760.07843017578): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

153 (130.89179992676): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

154 (283.00285339355): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 1131.7729949951): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

156 (144.95849609375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777491 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777491 AND published='1' LIMIT 1

157 (!!!!! 5937.0994567871): select jos_twitters.link from jos_twitters where cat=10

158 (160.93254089355): select jos_facebook.link from jos_facebook where cat=10

159 (195.02639770508): select jos_google_plus.link from jos_google_plus where cat=10

160 (251.05476379395): select jos_linkedin.link from jos_linkedin where cat=10

161 (!!!!! 6240.8447265625): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1394.0334320068): insert into jos_banners_delta values (14615,'2025-05-02 09:27:18','3.19.74.8','view'),(14202,'2025-05-02 09:27:18','3.19.74.8','view'),(14203,'2025-05-02 09:27:18','3.19.74.8','view')

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