Low-field MRI could improve care access and convenience for patients with MS who are treated in the outpatient setting.

The spotlight shined on more than just the pathogenic mechanisms of multiple sclerosis (MS) at ACTRIMS Forum 2024. Several presentations also addressed access barriers and patient-centered models of care delivery.

One session at the meeting highlighted advancements in portable imaging platforms. Andrew Siyoon Ham shared his team’s research into the feasibility and quality of using portable low-field MRI to manage MS in the outpatient setting. In the corresponding abstract, Ham and colleagues wrote that low-field MRI could be implemented as part of outpatient care to increase patient access and convenience.

A Portable MRI for Outpatients

Ham and colleagues, affiliated with Massachusetts General Hospital, tested the feasibility, tolerability, and image quality of the 0.064 Tesla low-field MRI compared with the 1.5 Tesla MRI (standard care).

“[MRI] is a usual element of disease surveillance for patients with [MS], but frequent visits to a dedicated neuroimaging facility can impose significant burdens on patients with physical disabilities, employment obligations, transportation needs, and out-of-pocket costs,” the researchers wrote. “Recent advances in low-field MRI have the potential to expand access to MRI by offering a new point-of-care option in outpatient, ambulatory care settings.”

The study included 50 patients with MS (mean age 46.5 ±15.3 years; 72% female; median disease duration 5.9 years) who were treated at the hospital from December 2022 to August 2023. Participants underwent low-field MRI at the hospital’s outpatient neurology clinic and had documented T1-weighted, T2-weighted, and T2 FLAIR images. Ham and colleagues administered pre- and post-MRI surveys to gauge patient satisfaction and potential barriers to care.

To evaluate the MRI’s sensitivity in identifying demyelinating lesions, the team created a subgroup of participants (n=22) who underwent low- and high-field scans within 120 days. Two independent readers then compared the cortical hyperintense lesions on patients’ axial FLAIR imaging sequences.

Patient Satisfaction & MRI Accuracy

According to the findings, 38% of patients experienced barriers to clinical MRI prior to the study. The most reported barriers were fatigue (n=21) and “interference with responsibilities” (n=20).

Overall, patients reported strongly positive experiences with low-field MRI (mean rating of 9.2 ±1.4 on a 10-point scale) and greater comfort with it than standard MRI (mean rating of 7.4 ± 2.2).

More than half of participants preferred low-field MRI over standard MRI. Findings also indicated that 70% of patients were willing to use low-field MRI in the future.

As for imaging sensitivity, researchers reported that low-field MRI “has lower resolution compared to conventional MRI, but FLAIR-hyperintense lesions are detectable.”

The low-field MRI identified 54% of cortical lesions that appeared on standard MRI. A median of 14 lesions appears on standard care, compared with 8 on low-field MRI. Given their findings, the team concluded that low-field MRI offers patients with MS advantages such as tolerability and convenience, which is “critical for their integration into a one-stop, patient-centered model of MS care.”

“The availability of a [low-field] MRI with lower cost and improved ease-of-use could supplement the standard outpatient practice of MS care, particularly for those with barriers to care,” Ham and colleagues wrote.