Accurate Diagnosis of Multiple Sclerosis Using PET/MR
Condition: Multiple Sclerosis
MeSH terms: Multiple Sclerosis; Sclerosis
Study type: Interventional

Summary: 
      Multiple sclerosis (MS) is an immune-mediated chronic inflammatory demyelinating disease of
      the central nervous system. Its main feature is progressive demyelination, which ultimately
      leads to axon damage and neuron loss. MR is the main imaging technique in the current
      diagnostic criteria of MS. The conventional MR sequence recommended in this diagnostic
      criteria has high sensitivity for detecting demyelination and axon damage, but has poor
      specificity, which makes disease modification therapy (DMT) blind, and it is also difficult
      to accurately determine the long-term prognosis.

      PET is a non-invasive molecular imaging technology that can quantitatively monitor
      physiological or pathological processes in vivo. 18F-labeled thioflavin derivative probe
      (18F-florbetapir) can bind to myelin basic protein in the white matter, providing
      quantitative assessment of myelin content. Our preliminary studies have confirmed that the
      uptake of 18F-florbetapir in MS lesions is significantly related to the myelin content
      measured by histological staining. Therefore, 18F-florbetapir PET may be a very effective
      myelin imaging technology.

      Advanced MR sequence such as magnetic resonance spectroscopy (MRS) can evaluate axonal damage
      by analyzing neuronal activity marker N-acetyl aspartate (NAA). The new whole-brain fast 3D
      MRS sequence breaks through the bottleneck of low signal-to-noise ratio and spatial
      resolution of the current MRS sequence, and provides a reliable method for obtaining neuronal
      activity markers in the three-dimensional space of MS sporadic lesions in the whole brain.

      Integrated PET/MR makes PET detector implant in the MR magnet, which realizes the
      simultaneous acquisition of PET and MR in one scan, ensuring the high consistency of the two
      modes. This makes it possible to simultaneously analyze PET and MRS quantitative parameters
      in multiple and different sizes of MS lesions, that is, to obtain two different pathological
      features of demyelination and neuronal damage. Separating these two pathological changes will
      help to more accurately and quantitatively evaluate the efficacy of DMT, program selection
      and prognostic judgment.

      This project intends to recruit 30 MS patients between 18-65 years old, and 30 healthy
      volunteers with matched age and sex as normal controls. PET/MR imaging, serological
      examination and cerebrospinal fluid testing and scale evaluation will be performed. The aim
      of this project is to planned to establish a new imaging evaluation technology for accurate
      diagnosis and prognosis evaluation of MS.
    


Intervention name(s): 18F-florbetapir PET+MRSI
Intervention type(s): Diagnostic Test
Intervention description(s): PET and MRS quantitative parameters in MS lesions are simultaneously analyzed using hybrid PET/MR for obtaining demyelination and neuronal damage information.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic