Author Of 1 Presentation
P0135 - Preventing multiple sclerosis misdiagnosis using the “central vein sign”: A real-world study (ID 500)
Abstract
Background
Misdiagnosis of multiple sclerosis (MS) is common and often occurs due to misattribution of non-MS magnetic resonance imaging (MRI) lesions to MS demyelination. A recently developed MRI biomarker, the central vein sign (CVS), has demonstrated high specificity for MS lesions and may thus help prevent misdiagnosis.
Objectives
We explored the potential “real world” value of CVS in preventing MS misdiagnosis by comparing CVS in patients with MS and patients previously misdiagnosed with MS by standard clinical practice and established diagnostic tools.
Methods
30 patients (15 with MS and 15 misdiagnosed with MS) were prospectively recruited to undergo 3T brain MRI. T2-weighted fluid-attenuated inversion recovery (FLAIR) and T2*-weighted segmented echo-planar-imaging (T2*-EPI) were acquired to generate FLAIR* images, then analyzed by two independent raters blinded to clinical information. The percentage of lesions with CVS was calculated for each patient.
Results
The number of brain lesions per patient did not significantly differ between the two groups. The number of lesions with CVS, however, did differ, with a mean of 0.93 lesions (range 0-6) in the misdiagnosed group versus 6.3 (range 0-15) in the MS group. A CVS lesion threshold of 29% or higher resulted in high adjusted sensitivity of 0.79 (95% CI: 0.68-0.95) and specificity of 0.88 (95% CI: 0.68-0.95) for MS and correctly identified 87% of patients previously misdiagnosed with MS. Interrater reliability for CVS was excellent with a Cohen’s kappa coefficient of 0.86.
Conclusions
Our study found that CVS differentiated with high sensitivity and specificity patients with MS from patients who were previously misdiagnosed with MS after undergoing routine clinical evaluation. We believe that our findings further support the incorporation of CVS in the diagnostic approach to MS to increase accuracy and reduce misdiagnosis.
Presenter Of 1 Presentation
P0135 - Preventing multiple sclerosis misdiagnosis using the “central vein sign”: A real-world study (ID 500)
Abstract
Background
Misdiagnosis of multiple sclerosis (MS) is common and often occurs due to misattribution of non-MS magnetic resonance imaging (MRI) lesions to MS demyelination. A recently developed MRI biomarker, the central vein sign (CVS), has demonstrated high specificity for MS lesions and may thus help prevent misdiagnosis.
Objectives
We explored the potential “real world” value of CVS in preventing MS misdiagnosis by comparing CVS in patients with MS and patients previously misdiagnosed with MS by standard clinical practice and established diagnostic tools.
Methods
30 patients (15 with MS and 15 misdiagnosed with MS) were prospectively recruited to undergo 3T brain MRI. T2-weighted fluid-attenuated inversion recovery (FLAIR) and T2*-weighted segmented echo-planar-imaging (T2*-EPI) were acquired to generate FLAIR* images, then analyzed by two independent raters blinded to clinical information. The percentage of lesions with CVS was calculated for each patient.
Results
The number of brain lesions per patient did not significantly differ between the two groups. The number of lesions with CVS, however, did differ, with a mean of 0.93 lesions (range 0-6) in the misdiagnosed group versus 6.3 (range 0-15) in the MS group. A CVS lesion threshold of 29% or higher resulted in high adjusted sensitivity of 0.79 (95% CI: 0.68-0.95) and specificity of 0.88 (95% CI: 0.68-0.95) for MS and correctly identified 87% of patients previously misdiagnosed with MS. Interrater reliability for CVS was excellent with a Cohen’s kappa coefficient of 0.86.
Conclusions
Our study found that CVS differentiated with high sensitivity and specificity patients with MS from patients who were previously misdiagnosed with MS after undergoing routine clinical evaluation. We believe that our findings further support the incorporation of CVS in the diagnostic approach to MS to increase accuracy and reduce misdiagnosis.