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Quantitative susceptibility mapping as a monitoring biomarker in cerebral cavernous malformations with recent hemorrhage
Author(s) -
Zeineddine Hussein A.,
Girard Romuald,
Cao Ying,
Hobson Nicholas,
Fam Maged D.,
Stadnik Agnieszka,
Tan Huan,
Shen Jingjing,
Chaudagar Kiranj,
Shenkar Robert,
Thompson Richard E.,
McBee Nichol,
Hanley Daniel,
Carroll Timothy,
Christoforidis Gregory A.,
Awad Issam A.
Publication year - 2018
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25831
Subject(s) - medicine , biomarker , quantitative susceptibility mapping , imaging biomarker , cohort , lesion , radiology , clinical trial , magnetic resonance imaging , population , pathology , biochemistry , chemistry , environmental health
Background Quantitative Susceptibility Mapping (QSM) MRI allows accurate assessment of iron content in cerebral cavernous malformations (CCM), and a threshold increase by 6% in QSM has been shown to reflect new symptomatic hemorrhage (SH) in previously stable lesions. Purpose/Hypothesis It is unclear how lesional QSM evolves in CCMs after recent SH, and whether this could serve as a monitoring biomarker in clinical trials aimed at preventing rebleeding in these lesions. Study Type This is a prospective observational cohort study. Population 16 CCM patients who experienced a SH within the past year, whose lesion was not resected or irradiated. Field Strength/Sequence The data acquisition was performed using QSM sequence implemented on a 3T MRI system Assessment The lesional QSM assessments at baseline and yearly during 22 patient‐years of follow‐up were performed by a trained research staff including imaging scientists. Statistical Tests Biomarker changes were assessed in relation to clinical events. Clinical trial modeling was performed using two‐tailed tests of time‐averaged difference (assuming within‐patient correlation of 0.8, power = 0.9 and alpha = 0.1) to detect 20%, 30% or 50% effects of intervention on clinical and biomarkers event rates during two years of follow‐up. Results The change in mean lesional QSM of index hemorrhagic lesions was +7.93% per patient‐year in the whole cohort. There were 5 cases (31%) of recurrent SH or lesional growth, and twice as many instances (62%) with a threshold (6%) increase in QSM. There were no instances of SH hemorrhage or lesional growth without an associated threshold increase in QSM during the same epoch. Level of Evidence: 1 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2018;47:1133–1138.