A multicenter pilot study evaluating simplified central vein assessment for the diagnosis of multiple sclerosis

Lynn Daboul; Carly M. O’Donnell; Moein Amin; Paulo Rodrigues; John Derbyshire; Christina Azevedo; Amit Bar-Or; Eduardo Caverzasi; Peter A. Calabresi; Bruce A.C. Cree; Leorah Freeman; Roland G. Henry; Erin E. Longbrake; Jiwon Oh; Nico Papinutto; Daniel Pelletier; Vesna Prchkovska; Praneeta Raza; Marc Ramos; Rohini D. Samudralwar; Matthew K. Schindler; Elias S. Sotirchos; Nancy L. Sicotte; Andrew J. Solomon; Russell T. Shinohara; Daniel Salo Reich; Pascal Sati; Daniel Ontaneda

doi:10.1177/13524585231214360

A multicenter pilot study evaluating simplified central vein assessment for the diagnosis of multiple sclerosis

Lynn Daboul, Carly M. O’Donnell, Moein Amin, Paulo Rodrigues, John Derbyshire, Christina Azevedo, Amit Bar-Or, Eduardo Caverzasi, Peter A. Calabresi, Bruce A.C. Cree, Leorah Freeman, Roland G. Henry, Erin E. Longbrake, Jiwon Oh, Nico Papinutto, Daniel Pelletier, Vesna Prchkovska, Praneeta Raza, Marc Ramos, Rohini D. SamudralwarMatthew K. Schindler, Elias S. Sotirchos, Nancy L. Sicotte, Andrew J. Solomon, Russell T. Shinohara, Daniel Salo Reich, Pascal Sati, Daniel Ontaneda

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: The central vein sign (CVS) is a proposed magnetic resonance imaging (MRI) biomarker for multiple sclerosis (MS); the optimal method for abbreviated CVS scoring is not yet established. Objective: The aim of this study was to evaluate the performance of a simplified approach to CVS assessment in a multicenter study of patients being evaluated for suspected MS. Methods: Adults referred for possible MS to 10 sites were recruited. A post-Gd 3D T2*-weighted MRI sequence (FLAIR*) was obtained in each subject. Trained raters at each site identified up to six CVS-positive lesions per FLAIR* scan. Diagnostic performance of CVS was evaluated for a diagnosis of MS which had been confirmed using the 2017 McDonald criteria at thresholds including three positive lesions (Select-3*) and six positive lesions (Select-6*). Inter-rater reliability assessments were performed. Results: Overall, 78 participants were analyzed; 37 (47%) were diagnosed with MS, and 41 (53%) were not. The mean age of participants was 45 (range: 19–64) years, and most were female (n = 55, 71%). The area under the receiver operating characteristic curve (AUROC) for the simplified counting method was 0.83 (95% CI: 0.73–0.93). Select-3* and Select-6* had sensitivity of 81% and 65% and specificity of 68% and 98%, respectively. Inter-rater agreement was 78% for Select-3* and 83% for Select-6*. Conclusion: A simplified method for CVS assessment in patients referred for suspected MS demonstrated good diagnostic performance and inter-rater agreement.

Original language	English (US)
Pages (from-to)	25-34
Number of pages	10
Journal	Multiple Sclerosis Journal
Volume	30
Issue number	1
DOIs	https://doi.org/10.1177/13524585231214360
State	Published - Jan 2024

Keywords

Central vein sign
FLAIR*
MRI
biomarkers
multiple sclerosis

ASJC Scopus subject areas

Neurology
Clinical Neurology

Access to Document

10.1177/13524585231214360

Cite this

Daboul, L., O’Donnell, C. M., Amin, M., Rodrigues, P., Derbyshire, J., Azevedo, C., Bar-Or, A., Caverzasi, E., Calabresi, P. A., Cree, B. A. C., Freeman, L., Henry, R. G., Longbrake, E. E., Oh, J., Papinutto, N., Pelletier, D., Prchkovska, V., Raza, P., Ramos, M., ... Ontaneda, D. (2024). A multicenter pilot study evaluating simplified central vein assessment for the diagnosis of multiple sclerosis. Multiple Sclerosis Journal, 30(1), 25-34. https://doi.org/10.1177/13524585231214360

Daboul, L, O’Donnell, CM, Amin, M, Rodrigues, P, Derbyshire, J, Azevedo, C, Bar-Or, A, Caverzasi, E, Calabresi, PA, Cree, BAC, Freeman, L, Henry, RG, Longbrake, EE, Oh, J, Papinutto, N, Pelletier, D, Prchkovska, V, Raza, P, Ramos, M, Samudralwar, RD, Schindler, MK, Sotirchos, ES, Sicotte, NL, Solomon, AJ, Shinohara, RT, Reich, DS, Sati, P & Ontaneda, D 2024, 'A multicenter pilot study evaluating simplified central vein assessment for the diagnosis of multiple sclerosis', Multiple Sclerosis Journal, vol. 30, no. 1, pp. 25-34. https://doi.org/10.1177/13524585231214360

@article{e213833602fa441fbcfe9ecf9182d19f,

title = "A multicenter pilot study evaluating simplified central vein assessment for the diagnosis of multiple sclerosis",

abstract = "Background: The central vein sign (CVS) is a proposed magnetic resonance imaging (MRI) biomarker for multiple sclerosis (MS); the optimal method for abbreviated CVS scoring is not yet established. Objective: The aim of this study was to evaluate the performance of a simplified approach to CVS assessment in a multicenter study of patients being evaluated for suspected MS. Methods: Adults referred for possible MS to 10 sites were recruited. A post-Gd 3D T2*-weighted MRI sequence (FLAIR*) was obtained in each subject. Trained raters at each site identified up to six CVS-positive lesions per FLAIR* scan. Diagnostic performance of CVS was evaluated for a diagnosis of MS which had been confirmed using the 2017 McDonald criteria at thresholds including three positive lesions (Select-3*) and six positive lesions (Select-6*). Inter-rater reliability assessments were performed. Results: Overall, 78 participants were analyzed; 37 (47%) were diagnosed with MS, and 41 (53%) were not. The mean age of participants was 45 (range: 19–64) years, and most were female (n = 55, 71%). The area under the receiver operating characteristic curve (AUROC) for the simplified counting method was 0.83 (95% CI: 0.73–0.93). Select-3* and Select-6* had sensitivity of 81% and 65% and specificity of 68% and 98%, respectively. Inter-rater agreement was 78% for Select-3* and 83% for Select-6*. Conclusion: A simplified method for CVS assessment in patients referred for suspected MS demonstrated good diagnostic performance and inter-rater agreement.",

keywords = "Central vein sign, FLAIR*, MRI, biomarkers, multiple sclerosis",

author = "Lynn Daboul and O{\textquoteright}Donnell, {Carly M.} and Moein Amin and Paulo Rodrigues and John Derbyshire and Christina Azevedo and Amit Bar-Or and Eduardo Caverzasi and Calabresi, {Peter A.} and Cree, {Bruce A.C.} and Leorah Freeman and Henry, {Roland G.} and Longbrake, {Erin E.} and Jiwon Oh and Nico Papinutto and Daniel Pelletier and Vesna Prchkovska and Praneeta Raza and Marc Ramos and Samudralwar, {Rohini D.} and Schindler, {Matthew K.} and Sotirchos, {Elias S.} and Sicotte, {Nancy L.} and Solomon, {Andrew J.} and Shinohara, {Russell T.} and Reich, {Daniel Salo} and Pascal Sati and Daniel Ontaneda",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2023.",

year = "2024",

month = jan,

doi = "10.1177/13524585231214360",

language = "English (US)",

volume = "30",

pages = "25--34",

journal = "Multiple Sclerosis Journal",

issn = "1352-4585",

publisher = "SAGE Publications Ltd",

number = "1",

}

TY - JOUR

T1 - A multicenter pilot study evaluating simplified central vein assessment for the diagnosis of multiple sclerosis

AU - Daboul, Lynn

AU - O’Donnell, Carly M.

AU - Amin, Moein

AU - Rodrigues, Paulo

AU - Derbyshire, John

AU - Azevedo, Christina

AU - Bar-Or, Amit

AU - Caverzasi, Eduardo

AU - Calabresi, Peter A.

AU - Cree, Bruce A.C.

AU - Freeman, Leorah

AU - Henry, Roland G.

AU - Longbrake, Erin E.

AU - Oh, Jiwon

AU - Papinutto, Nico

AU - Pelletier, Daniel

AU - Prchkovska, Vesna

AU - Raza, Praneeta

AU - Ramos, Marc

AU - Samudralwar, Rohini D.

AU - Schindler, Matthew K.

AU - Sotirchos, Elias S.

AU - Sicotte, Nancy L.

AU - Solomon, Andrew J.

AU - Shinohara, Russell T.

AU - Reich, Daniel Salo

AU - Sati, Pascal

AU - Ontaneda, Daniel

PY - 2024/1

Y1 - 2024/1

N2 - Background: The central vein sign (CVS) is a proposed magnetic resonance imaging (MRI) biomarker for multiple sclerosis (MS); the optimal method for abbreviated CVS scoring is not yet established. Objective: The aim of this study was to evaluate the performance of a simplified approach to CVS assessment in a multicenter study of patients being evaluated for suspected MS. Methods: Adults referred for possible MS to 10 sites were recruited. A post-Gd 3D T2*-weighted MRI sequence (FLAIR*) was obtained in each subject. Trained raters at each site identified up to six CVS-positive lesions per FLAIR* scan. Diagnostic performance of CVS was evaluated for a diagnosis of MS which had been confirmed using the 2017 McDonald criteria at thresholds including three positive lesions (Select-3*) and six positive lesions (Select-6*). Inter-rater reliability assessments were performed. Results: Overall, 78 participants were analyzed; 37 (47%) were diagnosed with MS, and 41 (53%) were not. The mean age of participants was 45 (range: 19–64) years, and most were female (n = 55, 71%). The area under the receiver operating characteristic curve (AUROC) for the simplified counting method was 0.83 (95% CI: 0.73–0.93). Select-3* and Select-6* had sensitivity of 81% and 65% and specificity of 68% and 98%, respectively. Inter-rater agreement was 78% for Select-3* and 83% for Select-6*. Conclusion: A simplified method for CVS assessment in patients referred for suspected MS demonstrated good diagnostic performance and inter-rater agreement.

AB - Background: The central vein sign (CVS) is a proposed magnetic resonance imaging (MRI) biomarker for multiple sclerosis (MS); the optimal method for abbreviated CVS scoring is not yet established. Objective: The aim of this study was to evaluate the performance of a simplified approach to CVS assessment in a multicenter study of patients being evaluated for suspected MS. Methods: Adults referred for possible MS to 10 sites were recruited. A post-Gd 3D T2*-weighted MRI sequence (FLAIR*) was obtained in each subject. Trained raters at each site identified up to six CVS-positive lesions per FLAIR* scan. Diagnostic performance of CVS was evaluated for a diagnosis of MS which had been confirmed using the 2017 McDonald criteria at thresholds including three positive lesions (Select-3*) and six positive lesions (Select-6*). Inter-rater reliability assessments were performed. Results: Overall, 78 participants were analyzed; 37 (47%) were diagnosed with MS, and 41 (53%) were not. The mean age of participants was 45 (range: 19–64) years, and most were female (n = 55, 71%). The area under the receiver operating characteristic curve (AUROC) for the simplified counting method was 0.83 (95% CI: 0.73–0.93). Select-3* and Select-6* had sensitivity of 81% and 65% and specificity of 68% and 98%, respectively. Inter-rater agreement was 78% for Select-3* and 83% for Select-6*. Conclusion: A simplified method for CVS assessment in patients referred for suspected MS demonstrated good diagnostic performance and inter-rater agreement.

KW - Central vein sign

KW - FLAIR

KW - MRI

KW - biomarkers

KW - multiple sclerosis

UR - http://www.scopus.com/inward/record.url?scp=85180674283&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85180674283&partnerID=8YFLogxK

U2 - 10.1177/13524585231214360

DO - 10.1177/13524585231214360

M3 - Article

C2 - 38088067

AN - SCOPUS:85180674283

SN - 1352-4585

VL - 30

SP - 25

EP - 34

JO - Multiple Sclerosis Journal

JF - Multiple Sclerosis Journal

IS - 1

ER -

A multicenter pilot study evaluating simplified central vein assessment for the diagnosis of multiple sclerosis

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this