Can post-mortem MRI be used as a proxy for in-vivo?
ECTRIMS Online Library. Steenwijk M. 09/13/19; 279566; 308
Martijn D. Steenwijk
Martijn D. Steenwijk
Contributions
Abstract

Abstract: 308

Type: Scientific Session

Abstract Category: Pathology and pathogenesis of MS - MRI and PET

B.D.C. Boon1, P.J.W. Pouwels1, L.E. Jonkman1, M.J. Keijzer1, P. Preziosa2, W.D.J. van de Berg1, J.J.G. Geurts1, P. Scheltens1, F. Barkhof1, A.J.M. Rozemuller1, F.H. Bouwman1, M.D. Steenwijk1

1Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands, 2Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy

Introduction: Post-mortem in-situ magnetic resonance imaging (MRI) has been used often to link brain histo(patho)logy with the in-vivo situation. However, it is not known how comparable post-mortem in-situ actually is to ante-mortem imaging. We report the unique situation of a patient with familial early-onset Alzheimer's disease due to a PSEN1 mutation, who underwent a post-mortem in-situ brain MRI with post-mortem delay of 9 hours, only 4 days after ante-mortem imaging.
Objectives: To investigate the effects of death on atrophy and diffusion measures derived from brain MRI.
Methods: T1-weighted and diffusion MRI was performed at 3-Tesla at both time points. Visual atrophy rating scales, brain volume, cortical thickness, and diffusion measures were derived from both scans and compared.
Results: Post-mortem visual atrophy scores decreased 0.5-1 point compared to ante-mortem, indicating an increase in brain volume. This was confirmed by quantitative analysis; showing a 27% decrease of ventricular and 7% increase of whole-brain volume. This increase was more pronounced in the cerebellum and supratentorial white matter than in gray matter. Furthermore, axial and radial diffusivity decreased up to 60% post mortem while average fractional anisotropy of white matter increased approximately 10%.
Conclusions: This unique case study shows that the process of dying affects several imaging markers. These changes need to be taken into account when using post-mortem MRI to make inferences for the in-vivo situation.
Disclosure: B.D.C. Boon, M.J. Keijzer, and M.D. Steenwijk report no disclosures. PJWP receives research support from the Dutch MS Research Foundation, grant number 14-876.
P. Preziosa received speakers honoraria from Biogen Idec, Novartis, Merck Serono, and ExceMED. Ph. Scheltens has acquired grant support (for the institution) from Piramal. In the past 2 years he has received consultancy/speaker fees (paid to the institution) from Biogen and Roche (Diagnostics). He is PI of studies with Probiodrug, EIP Pharma, IONIS, CogRx, AC Immune, and Toyama.
F. Barkhof is a consultant for Biogen-Idec, Janssen Alzheimer
Immunotherapy, Bayer-Schering, Merck-Serono, Roche, Novartis,
Genzume, and Sanofi-Aventis; has received sponsoring from European
Commission-Horizon 2020, National Institute for Health
Research-University College London Hospitals Biomedical Research
Centre, Scottish Multiple Sclerosis Register, TEVA, Novartis, and
Toshiba; is supported by the University College London Hospitals NHS
Foundation Trust Biomedical Research Center; and serves on the editorial
boards of Radiology, Brain, Neuroradiology, Multiple Sclerosis
Journal, and Neurology. J.J. Geurts is Editor for Europe at Multiple Sclerosis Journal. He has received research support from Biogen, Sanofi Genzyme and Novartis Pharma.

Abstract: 308

Type: Scientific Session

Abstract Category: Pathology and pathogenesis of MS - MRI and PET

B.D.C. Boon1, P.J.W. Pouwels1, L.E. Jonkman1, M.J. Keijzer1, P. Preziosa2, W.D.J. van de Berg1, J.J.G. Geurts1, P. Scheltens1, F. Barkhof1, A.J.M. Rozemuller1, F.H. Bouwman1, M.D. Steenwijk1

1Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands, 2Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy

Introduction: Post-mortem in-situ magnetic resonance imaging (MRI) has been used often to link brain histo(patho)logy with the in-vivo situation. However, it is not known how comparable post-mortem in-situ actually is to ante-mortem imaging. We report the unique situation of a patient with familial early-onset Alzheimer's disease due to a PSEN1 mutation, who underwent a post-mortem in-situ brain MRI with post-mortem delay of 9 hours, only 4 days after ante-mortem imaging.
Objectives: To investigate the effects of death on atrophy and diffusion measures derived from brain MRI.
Methods: T1-weighted and diffusion MRI was performed at 3-Tesla at both time points. Visual atrophy rating scales, brain volume, cortical thickness, and diffusion measures were derived from both scans and compared.
Results: Post-mortem visual atrophy scores decreased 0.5-1 point compared to ante-mortem, indicating an increase in brain volume. This was confirmed by quantitative analysis; showing a 27% decrease of ventricular and 7% increase of whole-brain volume. This increase was more pronounced in the cerebellum and supratentorial white matter than in gray matter. Furthermore, axial and radial diffusivity decreased up to 60% post mortem while average fractional anisotropy of white matter increased approximately 10%.
Conclusions: This unique case study shows that the process of dying affects several imaging markers. These changes need to be taken into account when using post-mortem MRI to make inferences for the in-vivo situation.
Disclosure: B.D.C. Boon, M.J. Keijzer, and M.D. Steenwijk report no disclosures. PJWP receives research support from the Dutch MS Research Foundation, grant number 14-876.
P. Preziosa received speakers honoraria from Biogen Idec, Novartis, Merck Serono, and ExceMED. Ph. Scheltens has acquired grant support (for the institution) from Piramal. In the past 2 years he has received consultancy/speaker fees (paid to the institution) from Biogen and Roche (Diagnostics). He is PI of studies with Probiodrug, EIP Pharma, IONIS, CogRx, AC Immune, and Toyama.
F. Barkhof is a consultant for Biogen-Idec, Janssen Alzheimer
Immunotherapy, Bayer-Schering, Merck-Serono, Roche, Novartis,
Genzume, and Sanofi-Aventis; has received sponsoring from European
Commission-Horizon 2020, National Institute for Health
Research-University College London Hospitals Biomedical Research
Centre, Scottish Multiple Sclerosis Register, TEVA, Novartis, and
Toshiba; is supported by the University College London Hospitals NHS
Foundation Trust Biomedical Research Center; and serves on the editorial
boards of Radiology, Brain, Neuroradiology, Multiple Sclerosis
Journal, and Neurology. J.J. Geurts is Editor for Europe at Multiple Sclerosis Journal. He has received research support from Biogen, Sanofi Genzyme and Novartis Pharma.

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