Rapid Simultaneous Mapping of Total and Myelin Water Content, T1 and T2* in Multiple Sclerosis

TL;DR

This paper introduces a rapid MRI method that simultaneously maps T1, T2*, total water, and myelin water content in the brain, offering a quick and reliable tool for assessing multiple sclerosis progression.

Contribution

The study extends previous MRI techniques by enabling fast, simultaneous measurement of multiple tissue parameters, including myelin water content, with optimized constraints and validation.

Findings

Whole brain maps acquired in 10 minutes.

Reliable measurement of myelin water content in MS patients.

Method validated through simulation studies.

Abstract

Quantitative magnetic resonance imaging might provide a more specific insight into disease process, progression and therapeutic response of multiple sclerosis. We present an extension of a previously published approach for the simultaneous mapping of brain T1, T2* and total water content. In addition to those three parameters, the method presented in the current work allows for the measurement of myelin bound water content, a surrogate marker of tissue myelination. Myelin water was measured based on its distinct relaxation with reduced T2*, resulting in a multiexponential decay signal. However, only 10 points could be acquired on the relaxation curve within a maximum echo time of <40ms as the quantitative protocol has been adapted previously for fast acquisitions with whole brain coverage. The sparse sampling required an adaption of the optimisation approach with additional constraints necessary in order to obtain reliable results. Therefore, the corresponding pool fractions were determined using linear optimisation instead of the standard nonnegative least squares (NNLS). The whole approach including the proper choice of constraints was optimised and validated in simulation studies. Furthermore, the independent determination of total water content allows for an absolute quantification of myelin water content, resulting in a more reliable measurement in oedemateous tissue. Whole brain maps of T1, T2*, total and myelin water content were acquired in 12 patients suffering from multiple sclerosis with mild disease grade. With an acquisition time of 10 minutes only, the presented multidimensional quantitative MRI protocol provides an interesting option for the clinical assessment and monitoring of multiple sclerosis, even on a routine basis.