Research: my lesion load has just gone up

Epub ahead of printde Graaf et al. Lesion detection at seven Tesla in multiple sclerosis using magnetisation prepared 3D-FLAIR and 3D-DIR. Eur Radiol. 2011 Aug 27. 

MRI scanners can be classified on the strength of their magnets. A typical diagnostic scanner is 1.5 Tesla with newer models being 3 Tesla. This study examined the feasibility and value of a 7 Tesla scanner in MS.  

Methods: High-resolution 3D images were obtained using a 7 Tesla scanner and compared with with conventional imaging in 10 MS'ers and 5 healthy controls. 

Results
  1. MR imaging at 7 T was safe. 
  2. Cortical and total lesion counts were 97/592 on the 7 Tesla scanner compared with 84/384 on the 3 Tesla scanner; a 15% and 54% increase in lesion number. respectively. 
  3. 205 juxta-cortical lesions were seen with 7 Tesla 3D imagingaing compared to 125 with 2D 3 Tesla imaging; a 64% increase. 
  4. Higher numbers of lesions were also found in the deep white matter using the 7 Tesla scanner:  196 vs. 155; a 26% increase. 
Conclusions: 7 Tesla MRI is safe and is more sensitive in detecting MS lesions compared to current technology. This is particularly important in detecting gray matter or cortical lesions.

"This confirms pathological studies that show that for every lesions seen with the naked eye there are many more lesions seen under the microscope; what is important about this study is that 7 Tesla scanners will allow us to focus on cortical pathology, the substrate that drives cognitive impairment in MS. Let's hope the newer technology will allow us to visualise B cell follicles on the surface of the brain. If we can do this then we can test the effectiveness of therapies that target such lesions."