Abstract: This study explored the effect of glatiramer acetate (GA, 20 mg) on lesion activity using the 1.5 T standard MRI protocol (single dose gadolinium [Gd] and 5-min delay) or optimized 3 T protocol (triple dose of Gd, 20-min delay and application of an off-resonance saturated magnetization transfer pulse). A 15-month, phase IV, open-label, single-blinded, prospective, observational study included 12 patients with relapsing-remitting multiple sclerosis who underwent serial MRI scans (Days −45, −20, 0; the minus ign indicates the number of days before GA treatment; and on Days 30, 60, 90, 120, 150, 180, 270 and 360 during GA treatment) on 1.5 T and 3 T protocols. Cumulative number and volume of Gd enhancing (Gd-E) and T2 lesions were calculated. At Days −45 and 0, there were higher number (p < 0.01) and volume (p < 0.05) of Gd-E lesions on 3 T optimized compared to 1.5 T standard protocol. However, at 180 and 360 days of the study, no significant differences in total and cumulative number of new Gd-E and T 2 lesions were found between the two protocols. Compared to pre-treatment period, at Days 180 and 360 a significantly greater decrease in the cumulative number of Gd-E lesions (p = 0.03 and 0.021, respectively) was found using the 3 T vs. the 1.5 T protocol (p = NS for both time points). This MRI mechanistic study suggests that GA may exert a greater effect on decreasing lesion activity as measured on 3 T optimized compared to 1.5 T standard protocol.
Keywords: glatiramer acetate; gadolinium-enhancing lesions; magnetic resonance imaging; 1.5 T; 3 T; T2 lesions; pilot trial
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Zivadinov, R.; Hojnacki, D.; Hussein, S.; Bergsland, N.; Carl, E.; Durfee, J.; Dwyer, M.G.; Kennedy, C.; Weinstock-Guttman, B. Comparison of Standard 1.5 T vs. 3 T Optimized Protocols in Patients Treated with Glatiramer Acetate. A Serial MRI Pilot Study. Int. J. Mol. Sci. 2012, 13, 5659-5673.
Zivadinov R, Hojnacki D, Hussein S, Bergsland N, Carl E, Durfee J, Dwyer MG, Kennedy C, Weinstock-Guttman B. Comparison of Standard 1.5 T vs. 3 T Optimized Protocols in Patients Treated with Glatiramer Acetate. A Serial MRI Pilot Study. International Journal of Molecular Sciences. 2012; 13(5):5659-5673.
Zivadinov, Robert; Hojnacki, David; Hussein, Sara; Bergsland, Niels; Carl, Ellen; Durfee, Jacqueline; Dwyer, Michael G.; Kennedy, Cheryl; Weinstock-Guttman, Bianca. 2012. "Comparison of Standard 1.5 T vs. 3 T Optimized Protocols in Patients Treated with Glatiramer Acetate. A Serial MRI Pilot Study." Int. J. Mol. Sci. 13, no. 5: 5659-5673.