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Review
. 2024 Mar;30(3):283-291.
doi: 10.1177/13524585241233448. Epub 2024 Feb 22.

T1/T2-weighted ratio: A feasible MRI biomarker in multiple sclerosis

Mateus Boaventura  1 , Jaume Sastre-Garriga  2 , Carolina de Medeiros Rimkus  3 , Àlex Rovira  4 , Deborah Pareto  4
Affiliations
Review

T1/T2-weighted ratio: A feasible MRI biomarker in multiple sclerosis

Mateus Boaventura et al. Mult Scler. 2024 Mar.

Abstract

T1/T2-weighted ratio is a novel magnetic resonance imaging (MRI) biomarker based on conventional sequences, related to microstructural integrity and with increasing use in multiple sclerosis (MS) research. Different from other advanced MRI techniques, this method has the advantage of being based on routinely acquired MRI sequences, a feature that enables analysis of retrospective cohorts with considerable clinical value. This article provides an overview of this method, describing the previous cross-sectional and longitudinal findings in the main MS clinical phenotypes and in different brain tissues: focal white matter (WM) lesions, normal-appearing white matter (NAWM), cortical gray matter (GM), and deep normal-appearing gray matter (NAGM). We also discuss the clinical associations, possible reasons for conflicting results, correlations with other MRI-based measures, and histopathological associations. We highlight the limitations of the biomarker itself and the methodology of each study. Finally, we update the reader on its potential use as an imaging biomarker in research.

Keywords: Biomarker; T1/T2-weighted ratio; magnetic resonance imaging; multiple sclerosis.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.B. has received a speaker honorarium and/or travel expenses for scientific meetings from Biogen, Horizon, Merck, Novartis, and Roche and received a grant as ECTRIMS Clinical Training fellow. J.S.-G. has engaged in consulting and/or participating as speaker/chair in events organized by Merck, Bayer, Celgene, Sanofi, and Biogen and is director of Revista de Neurología and editor for controversies of the Multiple Sclerosis Journal. C.d.M. has received a grant from MSIF-ECTRIMS, speaker honoraria from Roche, Guerbet, and Biogen and is associate editor of Arquivos de Neuropsiquiatria. A.R. serves/served on scientific advisory boards for Novartis, Sanofi-Genzyme, Icometrix, Synthetic MR, Bayer, Biogen, and OLEA Medical and has received speaker honoraria from Bayer, Sanofi-Genzyme, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd, Novartis, Roche, and Biogen. D.P. has received speaking honoraria from Novartis and Sanofi-Genzyme and a research grant from Biogen Idec.

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