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Synthetic magnetic resonance imaging (SyMRI) appears to be a valid option for quantifying myelin fraction in patients with multiple sclerosis (MS), according to a new study that compared the technology with other measurement approaches.Myelin imaging can be an important clinical tool for tracking the prognosis of patients with MS and evaluating the effectiveness of therapy. But, as a team of investigators from Japan and France note in a study in the journal Cells, accurately assessing myelin can be an exceedingly difficult challenge.“There is currently no recognized gold standard for myelin estimation, although myelin water fraction is one of the best validated and most commonly used quantitative measurements for noninvasive assessment of myelin content in the brain,” write the investigators, including corresponding author Shigeki Aoki, MD, Phd, of Juntendo University School of Medicine, in Tokyo.Lately, however, a new technology has emerged that has the potential to improve the situation. SyMRI uses multislice, multiecho, and multidelay acquisition to simultaneously measure longitudinal T1 relaxation rate, transverse T2 relaxation rate, proton density, and local radiofrequency field B1. The latter measurement can help correct location variations in flip angle. The system is able to obtain full head coverage in about 6 minutes, Aoki and colleagues said.“From these absolute parameters, it is possible to create any contrast-weighted image that is clinically useful, including T1-weighted (T1w) or T2-weighted (T2w) images, using SyMRI software,” the investigators say. “Using the same absolute parameters, SyMRI also allows myelin measurement.”Knowing that it was feasible to measure myelin using SyMRI, Aoki and colleagues wanted to know whether such a measure was accurate compared to other existing measurement strategies.
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