One year activity on subtraction MRI predicts subsequent 4 year activity and progression in XXXX .

@entity1 @entity8 @entity15
OBJECTIVE: To investigate the predictive value of 1 year subtraction MRI (sMRI) on activity and progression over the next 4 years in early phase @entity15 ( @entity15 ). To compare sensitivity of sMRI and contrast enhanced MRI towards disease activity. METHODS: The study was performed on 127 @entity15 @entity1 with brain MRI within 5 years of symptom onset (y0), after 1 year (y1) and after 5 years (y5). Measures of clinical (Expanded Disability Status Scale, relapse rate) and conventional MRI outcomes (brain parenchyma fraction (BPF); T2 lesion volume (T2LV); @entity8 ( @entity8 )) were available at all time points. sMRI was obtained from y1-y0, y5-y1 and y5-y0 image pairs and the number of new, enlarged, resolved and regressed lesions was counted. RESULTS: One year lesion change measured by sMRI predicted sMRI lesion change (p<0.0001), BPF and T2LV (p<0.05) changes, as well as clinical relapse rate (p<0.02) in the subsequent 4 years. sMRI measures were retained in stepwise predictive models that included other candidate MRI predictors. Active lesions on sMRI over a 1, 4 or 5 year interval provided a more sensitive assessment of disease activity than number of @entity8 at y0, y1 and/or y5: 83%, 93% and 90% of @entity1 without @entity8 showed sMRI activity during the y1-y0, y5-y1, and y5-y0 intervals. CONCLUSIONS: sMRI is a feasible and sensitive tool for detecting @entity15 activity and may provide an alternative to contrast enhanced MRI in clinical practice, particularly in cases where @entity8 are not available or inconclusive. Furthermore, sMRI metrics combined with conventional MRI outcomes ( @entity8 , T2LV, BPF) can increase the prediction of longer term MRI activity and progression.
