Evidence map›Paper›PMID 39932567›Full record

ArticleJournal of neurology2025

Portable ultra-low-field MRI for progressive multifocal leukoencephalopathy: Case studies, sensitivity, and potential applications.

Serhat V Okar, Karan D Kawatra, Ashley A Thommana, Daniela C Vultorius, Govind Nair, María I Gaitán, Gina Norato, Yair Mina, Anita Fletcher, Daniel S Reich and 1 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Serhat V OkarTranslational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA.ORCID http://orcid.org/0000-0003-3716-2196
Karan D KawatraNeuroimmunology Clinic, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Ashley A ThommanaTranslational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA.
Daniela C VultoriusExperimental Immunotherapeutics Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 10, Room 5C103, 10 Center Drive, Bethesda, MD, 20814, USA.
Govind NairqMRI Core Facility, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA.
María I GaitánTranslational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA.
Gina NoratoOffice of Biostatistics, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Yair MinaNeuroimmunology Clinic, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Anita FletcherNeuroimmunology Clinic, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Daniel S ReichTranslational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA.
Irene CorteseExperimental Immunotherapeutics Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 10, Room 5C103, 10 Center Drive, Bethesda, MD, 20814, USA. corteseir@ninds.nih.gov.

Funding

National Multiple Sclerosis Society FG-2208-40289The Intramural Research Program of NINDS, NIH Z01 NS003119
6 · The paper itself

Abstract

BACKGROUND AND

objectiveProgressive multifocal leukoencephalopathy (PML) is a severe, disabling infection caused by JC virus reactivation. PML-related disability complicates the MRI monitoring needed to assess treatment interventions in clinical trial or compassionate use settings. Portable ultra-low-field MRI (pULF-MRI) offers a convenient approach when such frequent imaging is needed. We evaluated the potential utility of pULF-MRI as an adjunctive tool for decreasing the burden of clinical study participation and clinical management in PML.

methodsWe examined paired high-field (HF) and pULF-MRI scans from 11 patients, aged 49 ± 15 years. pULF-MRI images with corresponding HF-MRI were coupled to depict key imaging findings of PML, including three patients with longitudinal evaluations, one with bedside pULF-MRI. The images were then independently assessed by two blinded raters, not involved in image acquisition or initial evaluations, who sequentially rated diagnostic accuracy of pULF-MRI scans compared to the HF-MRI. Longitudinal evaluations were performed for three patients, one with bedside pULF-MRI.

resultsT2-FLAIR lesions were detected with pULF-ULF in all cases when present on HF-MRI. Median sensitivity and specificity were 62% and 100%, respectively. T1WI hypointense areas showed similar performance. Focal volume loss was present in 8/11 HF-MRI scans, with sensitivity and specificity of detection by pULF-MRI of 100% and 94%, respectively. Contrast enhancement was seen in a single case on both pULF- and HF-MRI. Follow-up pULF-MRI showed lesion changes in two cases, and stable findings in one case, consistent with HF-MRI. DISCUSSION: pULF-MRI shows promise in evaluation and monitoring of PML, showing moderate-to-high accuracy even when evaluations were unaided by HF-MRI. Our results highlight a potential application of pULF-MRI for facilitating participation in PML clinical research and more generally as a way to reduce burden of clinical management for this disabled patient population.

Indexed as

BrainLeukoencephalopathy, Progressive MultifocalMagnetic Resonance ImagingAdultAgedFemaleHumansMaleMiddle AgedSensitivity and Specificitylow-field MRIneuroimagingportable MRprogressive multifocal leukoencephalopathy

Identifiers

PMID39932567
PMCPMC11814002

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.