• Salem Hannoun, Damien Heidelberg, Roula Hourani, Thi Thuy Trang Nguyen, Jean-Christophe Brisset, Sylvie Grand, Stéphane Kremer, Fabrice Bonneville, GuttmannCharles R GCRGCenter for Neurological Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Vincent Dousset, François Cotton, and Imaging Working Group of the Observatoire Français de la Sclérose en Plaques.
• Observatoire Français de la Sclerose en Plaques (OFSEP), University of Lyon, Lyon, France; CREATIS, CNRS UMR 5220 & INSERM U1206, University of Lyon 1, Villeurbanne, France; Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
• Eur J Radiol. 2018 May 1; 102: 146-151.

Background And PurposeThe aim of this prospective study is to investigate and evaluate in clinical practice the diagnostic impact of 3DFLAIR in regards to 2DT2/PD in terms of infratentorial lesions detection in multiple sclerosis (MS).Material And Methods164 MS patients from the OFSEP database were reviewed retrospectively. MR examinations were performed on 1.5T or 3T systems from four different centers. Infratentorial lesions were counted and allocated to different regions of the posterior fossa by three raters independently (junior resident, resident with an expertise in neuroradiology, and senior neuro-radiologist) on the 3DFLAIR and 2DT2/PD. Both sequences do not have the same spatial resolution but reflect what is recommended by most of the consensus and done in clinical practice.ResultsWith an overall number of 528 for Rater-1 and 798 for Rater-2 infratentorial lesions, 3DFLAIR had a significantly higher number of lesions detected than 2DT2/PD (303 for Rater-1 and 370 for Rater-2). The prevalence of trigeminal lesions detected by using 3DFLAIR was also significantly higher than 2DT2/PD. ROC analysis showed 3DFLAIR to be more specific and sensitive than 2DT2/PD. An overall difference between all three Raters has been observed. The more the Rater is experienced the more lesions he detects.ConclusionAlong with the radiologist ability to detect lesions based on his level of experience, the OFSEP optimized 3DFLAIR can significantly improve infratentorial lesion detection in MS compared to 2DT2/PD. This is important in MS follow-up that takes into account new lesions number to adapt patients' treatment.Copyright © 2018 Elsevier B.V. All rights reserved.

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