Longitudinal Multiparametric Quantitative <scp>MRI</scp> Evaluation of Acute and Chronic Multiple Sclerosis Paramagnetic Rim Lesions
Bibliographic record
Abstract
Background Multiple sclerosis (MS) paramagnetic rim lesions (PRLs) are markers of chronic active biology and exhibit complex iron and myelin changes that may complicate quantification when using conventional MRI approaches. Purpose To conduct a multiparametric MRI analysis of PRLs. Study Type Retrospective/longitudinal. Subjects Ninety‐five progressive MS subjects with at least one persistent PRL who were enrolled in the CONSONANCE trial. Field Strength/Sequence 3‐T/Susceptibility‐weighted, T1‐weighted, T2‐weighted, and fluid‐attenuated inversion recovery. Assessment Acute/chronic PRLs and non‐PRLs were measured at screening, 24, 48, and 96 weeks using quantitative magnetic susceptibility (QS), R2*, and standardized T1w/T2w ratio (sT1w/T2w). PRL analyses were performed for whole lesion, core, and rim. The correlations between PRL core and rim sT1w/T2w, QS, and R2* were assessed. Statistical Tests Linear mixed models. A P‐value <0.05 was considered significant. Results There was a significant decrease in sT1w/T2w (−0.24 ± −5.3 × 10−3) and R2* (−3.6 ± 2.2 Hz) but a significant increase in QS (+21 ± 1.3 ppb) using whole‐lesion analysis of chronic PRLs compared to non‐PRLs at screening. Tissue damage accumulated at the 96‐week time point was more evident in acute/chronic PRLs compared to acute/chronic non‐PRLs (ΔsT1w/T2w = −0.21/−0.24 ± 0.033/0.0053; ΔR2* = −4.4/−3.6 ± 1.4/2.2 Hz). New, acute PRL sT1w/T2w significantly increased in lesion core (+4.3 × 10−3 ± 1.2 × 10−4) and rim (+5.6 × 10−3 ± 1.2 × 10−4) 24 weeks post lesion inception, suggestive of partial recovery. Chronic PRLs, contrastingly, showed significant decreases in sT1w/T2w over the initial 24 weeks for both core (−2.1 × 10−4 ± 2.0 × 10−5) and rim (−2.4 × 10−4 ± 2.0 × 10−5), indicative of irreversible tissue damage. Significant positive correlations between PRL core and rim sT1w/T2w (R2 = 0.53), R2* (R2 = 0.69) and QS (R2 = 0.52) were observed. Data Conclusion Multiparametric assessment of PRLs has the potential to be a valuable tool for assessing complex iron and myelin changes in chronic active PRLs of progressive MS patients. Level of Evidence 2 Technical Efficacy Stage 3
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".