% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Breckwoldt:119320,
      author       = {M. O. Breckwoldt and J. Gradl$^*$ and S. Hähnel$^*$ and T.
                      Hielscher$^*$ and B. Wildemann$^*$ and R. Diem$^*$ and M.
                      Platten$^*$ and W. Wick$^*$ and S. Heiland and M. Bendszus},
      title        = {{I}ncreasing the sensitivity of {MRI} for the detection of
                      multiple sclerosis lesions by long axial coverage of the
                      spinal cord: a prospective study in 119 patients.},
      journal      = {Journal of neurology},
      volume       = {264},
      number       = {2},
      issn         = {0340-5354},
      address      = {Berlin},
      publisher    = {Springer59671},
      reportid     = {DKFZ-2017-00075},
      pages        = {341-349},
      year         = {2017},
      abstract     = {Diagnostic imaging criteria of multiple sclerosis (MS)
                      include the spatial and temporal dissemination of cerebral
                      and/or spinal cord lesions. Magnetic resonance imaging (MRI)
                      is the method of choice for initial diagnosis and follow-up
                      disease monitoring. Current guidelines for spinal MRI
                      recommend sagittal imaging of the spinal cord and lesion
                      confirmation on axial planes if lesions are detected.
                      Sagittal imaging is, however, hampered by technical (e.g.
                      partial volume effects, motion artifacts) and anatomical
                      (e.g. scoliosis) limitations. We hypothesized that long
                      coverage of the spinal cord by axial image acquisition has
                      superior diagnostic performance compared to sagittal imaging
                      and can identify otherwise undetected lesions. Our
                      prospective clinical study included 119 MS patients. Axial
                      MRI revealed ~2.5-fold more lesions than the sagittal
                      angulation (axial lesion load: 4.0 ± 2.4 vs. 1.6 ± 1.2
                      lesions on sagittal planes, p < 0.001). Importantly, 20
                      patients $(17\%)$ with normal sagittal MRI scans had
                      unequivocal lesions only visible on axial planes (mean
                      lesion number on axial planes in these patients:
                      2.0 ± 1.3). Moreover, 45 patients $(38\%)$ showed a
                      discrepancy of ≥3 lesions that were found additionally on
                      axial scans (mean difference 4.4 ± 1.7). Additionally
                      identified lesions were on average smaller in size and
                      located more laterally within the spinal cord. No lesion on
                      sagittal images was missed on the axial angulation. Our
                      study demonstrates that imaging of small axial segments for
                      lesion confirmation is insufficient in spinal imaging. We
                      recommend implementing a long coverage axial MRI sequence
                      for spinal imaging of MS patients.},
      cin          = {G370 / G160 / C060 / L101},
      ddc          = {610},
      cid          = {I:(DE-He78)G370-20160331 / I:(DE-He78)G160-20160331 /
                      I:(DE-He78)C060-20160331 / I:(DE-He78)L101-20160331},
      pnm          = {317 - Translational cancer research (POF3-317)},
      pid          = {G:(DE-HGF)POF3-317},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:27909801},
      doi          = {10.1007/s00415-016-8353-3},
      url          = {https://inrepo02.dkfz.de/record/119320},
}