Title :

Asymptomatic Progressive Multifocal Leukoencephalopathy Associated with Natalizumab: Diagnostic Precision with MR Imaging

Author(s) :

Hodel, Jerome [Auteur]
Outteryck, Olivier [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Dubron, Celine [Auteur]
Dutouquet, Bastien [Auteur]
Benadjaoud Mohamed, Amine [Auteur]
Duhin, Emeline [Auteur]
Verclytte, Sebastien [Auteur]
Zins, Marc [Auteur]
Luciani, Alain [Auteur]
Rahmouni, Alain [Auteur]
Pruvo, Jean-Pierre [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Vermersch, Patrick [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Leclerc, Xavier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]

Journal title :

Radiology

Abbreviated title :

Radiology

Volume number :

278

Pages :

863-872

Publication date :

2016-03-01

Keyword(s) :

Mesh:Humans
Mesh:Leukoencephalopathy
Mesh:Progressive Multifocal/chemically induced*
Mesh:Immunologic Factors/adverse effects*
Mesh:Leukoencephalopathy
Mesh:Progressive Multifocal/diagnosis*
Mesh:Multiple Sclerosis
Mesh:Relapsing-Remitting/drug therapy*
Mesh:Magnetic Resonance Imaging/methods*
Mesh:Case-Control Studies
Mesh:Retrospective Studies
Mesh:Natalizumab/adverse effects*
Mesh:Middle Aged
Mesh:Aged
Mesh:Female
Mesh:Adult
Mesh:Male

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVE: To determine diagnostic precision with magnetic resonance (MR) imaging of the brain, the most predictive MR imaging features, and the added value of comparison with previous data for the diagnosis of asymptomatic ...
Show more >OBJECTIVE: To determine diagnostic precision with magnetic resonance (MR) imaging of the brain, the most predictive MR imaging features, and the added value of comparison with previous data for the diagnosis of asymptomatic progressive multifocal leukoencephalopathy (PML) associated with natalizumab (NTZ). METHODS: This retrospective study was approved by the institutional review board, and written informed consent was obtained. Eleven consecutive patients with multiple sclerosis (MS) who had received a definitive diagnosis of asymptomatic NTZ-associated PML (NTZ PML, 18 brain lesions) underwent 3-T MR imaging. The control group included 40 patients with MS but without PML who were treated with NTZ. Three readers independently performed blinded analysis of MR images. First, the readers were asked to detect NTZ PML lesions without comparing current images with previously obtained MR imaging data by evaluating MR images for the following features: U fiber and/or cortex involvement, lesion signal intensity and borders, and occurrence of punctate lesions. Second, they reassessed NTZ PML lesions with all the previous MR imaging data available. Diagnostic precision with MR imaging was assessed with and without comparison with previously obtained data. Logistic regression analyses were performed to identify the association of MR imaging features with NTZ PML. RESULTS: Overall interobserver agreement was good (κ = 0.76; 95% confidence interval [CI]: 0.71, 0.81). Hyperintensity on diffusion-weighted images and involvement of U fibers were the most predictive features (odds ratio, 33.7; 95% CI: 4.9, 229.7 [P < .0001] and odds ratio, 8.7; 95% CI: 1.2, 61.4 [P = .03], respectively), while punctate lesions were exclusively observed in patients with NTZ PML. Comparison with previous MR imaging data improved specificity of MR imaging for the detection of NTZ PML lesions (from 88% to 100%, P = .05). CONCLUSIONS: Recognition of the most predictive imaging features and comparison with previous MR imaging data may facilitate the detection of asymptomatic NTZ PML.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille
CNRS

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Submission date :

2019-03-01T14:19:03Z
2019-11-18T13:30:27Z