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European Radiology

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Open Access 21-05-2022 | Magnetic Resonance Imaging | Magnetic Resonance

Quantitative water T2 relaxometry in the early detection of neuromuscular diseases: a retrospective biopsy-controlled analysis

Authors: Noah Locher, Benedikt Wagner, Fabian Balsiger, Olivier Scheidegger

Published in: European Radiology | Issue 11/2022

Abstract

Objectives

To assess quantitative water T2 relaxometry for the early detection of neuromuscular diseases (NMDs) in comparison to standard qualitative MR imaging in a clinical setting.

Methods

This retrospective study included 83 patients with suspected NMD who underwent multiparametric MRI at 3 T with a subsequent muscle biopsy between 2015 and 2019. Qualitative T1-weighted and T2-TIRM images were graded by two neuroradiologists to be either pathological or normal. Mean and median water T2 relaxation times (water T2) were obtained from manually drawn volumes of interests in biopsied muscle from multi-echo sequence. Histopathologic pattern of corresponding muscle biopsies was used as a reference.

Results

In 34 patients, the T1-weighted images showed clear pathological alternations indicating late-stage fatty infiltration in NMDs. In the remaining 49 patients without late-stage changes, T2-TIRM grading achieved a sensitivity of 56.4%, and mean and median water T2 a sensitivity of 87.2% and 97.4% to detect early-stage NMDs. Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.682, 0.715, and 0.803 for T2-TIRM, mean water T2, and median water T2, respectively. Median water T2 ranged between 36 and 42 ms depending on histopathologic pattern.

Conclusions

Quantitative water T2 relaxometry had a significantly higher sensitivity in detecting muscle abnormalities than subjective grading of T2-TIRM, prior to late-stage fatty infiltration signal alternations in T1-weighted images. Normal-appearing T2-TIRM does not rule out early-stage NMDs. Our findings suggest considering water T2 relaxometry complementary to T2-TIRM for early detection of NMDs in clinical diagnostic routine.

Key Points

• Quantitative water T2 relaxometry is more sensitive than subjective assessment of fat-suppressed T2-weighted images for the early detection of neuromuscular diseases, prior to late-stage fatty infiltration signal alternations in T1-weighted images.

• Normal-appearing muscles in fat-suppressed T2-weighted images do not rule out early-stage neuromuscular diseases.

• Quantitative water T2 relaxometry should be considered complementary to subjectively rated fat-suppressed T2-weighted images in clinical practice.

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Title: Quantitative water T2 relaxometry in the early detection of neuromuscular diseases: a retrospective biopsy-controlled analysis
Authors: Noah Locher
Benedikt Wagner
Fabian Balsiger
Olivier Scheidegger
Publication date: 21-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: European Radiology / Issue 11/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-022-08862-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantitative water T2 relaxometry in the early detection of neuromuscular diseases: a retrospective biopsy-controlled analysis

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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