Abstract Details

Title Susceptibility-based Imaging Aids Accurate Distinction of Pediatric-onset MS from Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease

Topic Multiple Sclerosis

Presentation(s) S42 - Multiple Sclerosis: Biomarkers/Neuroimaging (1:00 PM-1:12 PM)

Poster/Presentation
Number 001

Background

MOG antibody-associated disease (MOGAD) and pediatric-onset MS (POMS) share clinical and MRI features but differ in prognosis and management. Early POMS diagnosis is essential to avoid disability accumulation. Central vein sign (CVS), paramagnetic rim lesions (PRLs), and central core lesions (CCL) are susceptibility-based imaging (SbI)-related signs understudied in pediatric populations that may help discerning POMS from MOGAD.

Objective The aim of this study is to investigate the use of susceptibility-based imaging (SbI) in distinguishing between pediatric-onset multiple sclerosis (POMS) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD).

Design/Methods

T2-FLAIR and SbI (3D-EPI/SWI or similar) were acquired on 1.5T/3T scanners. Two readers assessed CVS positive rate (%CVS+) and their average score was used to build a receiver operator curve (ROC) assessing the ability to discriminate disease type. PRLs and CCL were identified using a consensual approach.

Results

%CVS+ distinguished 26 POMS cases (mean age 13.7 years, 63% females, median EDSS 1.5) from 14 MOGAD cases (10.8 years, 35% females, EDSS 1.0) with ROC=1, p<0.0001, (cutoff 41%). PRLs were only detectable in POMS participants (mean 2.1 ± 2.3, range 1-10) discriminating the two conditions with a sensitivity of 69% and a specificity of 100%. CCLs were more sensitive (81%) but less specific (71.43%)

Conclusions

%CVS+ and PRLs are highly specific markers of POMS. After proprer validation on larger multicenter cohorts, consideration should be given to including such imaging markers for diagnosing POMS at disease onset.

Authors/Disclosures
Akash Virupakshaiah, MD (UCSF) PRESENTER	Dr. Virupakshaiah has nothing to disclose.
Simone Sacco (UCSF)	No disclosure on file
Nico Papinutto	No disclosure on file
Vinicius A. Schoeps, MD (University of California, San Francisco)	Dr. Schoeps has nothing to disclose.
Amit Akula (University of California, San Francisco)	No disclosure on file
HAOJUN ZHAO (UCSF)	No disclosure on file
Jennifer Arjona	No disclosure on file
William Stern	No disclosure on file
Janet Chong (University of California, San Francisco)	No disclosure on file
Janace Hart	No disclosure on file
Scott S. Zamvil, MD, PhD, FAAN (University of CA, San Francisco)	Dr. Zamvil has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Zamvil has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Dr. Zamvil has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Zamvil has received personal compensation in the range of $500-$4,999 for serving as a Advisory Board with Genzyme. Dr. Zamvil has received personal compensation in the range of $500-$4,999 for serving as a Advisory Board with Genentech. Dr. Zamvil has received personal compensation in the range of $500-$4,999 for serving as a Advisory Board with Alexion.
Pascal Sati (Cedars Sinai)	No disclosure on file
Roland G. Henry, PhD (University of California, San Francisco)	Dr. Henry has received personal compensation in the range of $500-$4,999 for serving as a Consultant for MEDDAY. Dr. Henry has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Henry has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Henry has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi/Genzyme.
Emmanuelle Waubant, MD, PhD, FAAN (USCF MS Center)	Dr. Waubant has received personal compensation in the range of $500-$4,999 for serving as a Consultant for emerald pharmaceuticals. Dr. Waubant has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for elsevier. The institution of Dr. Waubant has received research support from NIH. The institution of Dr. Waubant has received research support from NMSS. The institution of Dr. Waubant has received research support from PCORI. The institution of Dr. Waubant has received research support from Race to Erase MS. The institution of Dr. Waubant has received research support from Roche. The institution of Dr. Waubant has received research support from Biogen. The institution of Dr. Waubant has received research support from Department of Defense. Dr. Waubant has received publishing royalties from a publication relating to health care.