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. 2021 Jul;64(1):8-22.
doi: 10.1002/mus.27133. Epub 2021 Jan 8.

Using MRI to quantify skeletal muscle pathology in Duchenne muscular dystrophy: A systematic mapping review

Lejla Alic  1   2 , John F Griffin 4th  3 , Aydin Eresen  4   5 , Joe N Kornegay  3 , Jim X Ji  1   5
Affiliations

Using MRI to quantify skeletal muscle pathology in Duchenne muscular dystrophy: A systematic mapping review

Lejla Alic et al. Muscle Nerve. 2021 Jul.

Abstract

There is a great demand for accurate non-invasive measures to better define the natural history of disease progression or treatment outcome in Duchenne muscular dystrophy (DMD) and to facilitate the inclusion of a large range of participants in DMD clinical trials. This review aims to investigate which MRI sequences and analysis methods have been used and to identify future needs. Medline, Embase, Scopus, Web of Science, Inspec, and Compendex databases were searched up to 2 November 2019, using keywords "magnetic resonance imaging" and "Duchenne muscular dystrophy." The review showed the trend of using T1w and T2w MRI images for semi-qualitative inspection of structural alterations of DMD muscle using a diversity of grading scales, with increasing use of T2map, Dixon, and MR spectroscopy (MRS). High-field (>3T) MRI dominated the studies with animal models. The quantitative MRI techniques have allowed a more precise estimation of local or generalized disease severity. Longitudinal studies assessing the effect of an intervention have also become more prominent, in both clinical and animal model subjects. Quality assessment of the included longitudinal studies was performed using the Newcastle-Ottawa Quality Assessment Scale adapted to comprise bias in selection, comparability, exposure, and outcome. Additional large clinical trials are needed to consolidate research using MRI as a biomarker in DMD and to validate findings against established gold standards. This future work should use a multiparametric and quantitative MRI acquisition protocol, assess the repeatability of measurements, and correlate findings to histologic parameters.

Keywords: DMD; GRMD; MDX; MRI; imaging biomarkers; systematic literature review.

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Conflict of interest statement

JNK is a paid consultant for Solid Biosciences.

Figures

FIGURE 1
FIGURE 1
Results of the literature search. PRISMA flow diagram for study collection, 16 showing the number of studies identified, screened, eligible, and included in the systematic review
FIGURE 2
FIGURE 2
The number of papers differentiating studies based on the type of subjects: human, murine, canine (A), study population: diseased with intervention, diseased without intervention, healthy with intervention, healthy without intervention (B), MRI sequence (C), and cross‐sectional vs. longitudinal (D)
FIGURE 3
FIGURE 3
Distribution of studies (subject type, population, and number of muscles assessed) by different field strengths (A‐C) and different MRI sequences (D‐F). HF, high field strength; MF, medium field strength; T1w, T1‐weighted; T2w, T2‐weighted; T1m, T1‐mapping; T2m, T2‐mapping
See this image and copyright information in PMC

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