Published in:
01-07-2021 | Multiple Sclerosis | Diagnostic Neuroradiology
Adding brain volume measures into response criteria in multiple sclerosis: the Río-4 score
Authors:
Francisco Carlos Pérez-Miralles, Jordi Río, Deborah Pareto, Àngela Vidal-Jordana, Cristina Auger, Georgina Arrambide, Joaquín Castilló, Mar Tintoré, Àlex Rovira, Xavier Montalban, Jaume Sastre-Garriga
Published in:
Neuroradiology
|
Issue 7/2021
Login to get access
Abstract
Purpose
Brain volume changes (BVC) on therapy in MS are being considered as predictor for treatment response at an individual level. We ought to assess whether adding BVC as a factor to monitor interferon-beta response improves the predictive ability of the (no) evidence of disease activity (EDA-3) and Río score (RS-3) criteria for confirmed disability progression in a historical cohort.
Methods
One hundred one patients from an observational cohort treated with interferon-beta were assessed for different cutoff points of BVC (ranged 0.2–1.2%), presence of active lesions (≥ 1 for EDA/≥ 3 for RS), relapses, and 6-month confirmed disability progression (CDP), measured by the Expanded Disability Status Scale, after 1 year. Sensitivity, specificity, and positive and negative predictive values for predicting confirmed disability progression at 4 years in original EDA (EDA-3) and RS (RS-3) as well as EDA and RS including BVC (EDA-4 and RS-4) were compared.
Results
Adding BVC to EDA slightly increased sensitivity, but not specificity or predictive values, nor the OR for predicting CDP; only EDA-3 showed a trend for predicting CDP (OR 3.701, p = 0.050). Adding BVC to RS-3 (defined as ≥ 2 criteria) helped to improve sensitivity and negative predictive value, and increased OR for predicting CDP using a cutoff of ≤ − 0.86% (RS-3 OR 23.528, p < 0.001; RS-4 for all cutoffs ranged from 15.06 to 32, p < 0.001). RS-4 showed areas under the curve larger than RS-3 for prediction of disability at 4 years.
Conclusion
Addition of BVC to RS improves its prediction of response to interferon-beta.