Quantitative susceptibility mapping of the motor cortex: a comparison of susceptibility among patients with amyotrophic lateral sclerosis, cerebrovascular disease, and healthy controls.

PURPOSE: The purpose of this study was to investigate the differences in motor cortex susceptibility among patients with amyotrophic lateral sclerosis (ALS), cerebrovascular disease (CVD), and healthy controls using quantitative susceptibility mapping (QSM).

METHODS: We retrospectively reviewed 78 QSM images from 26 patients with ALS, 26 age- and sex-matched patients with CVD, and 26 healthy controls. A region of interest was drawn in the hand lobule of both the motor cortexes and subcortical white matter. The relative susceptibility (RS) of the motor cortex was obtained by subtracting the susceptibility of the subcortical white matter from that of the motor cortex. We compared the cortexmean , cortexmax , subcortical white mattermean , RSmean , and RSmax values among the three groups using analysis of variance and Tukey's post hoc test. Receiver operating characteristic (ROC) curve analysis was also performed.

RESULTS: There were significant differences in the cortexmean , cortexmax , RSmean , and RSmax among the three groups, with higher values in patients with ALS (p = 0.01, p = 0.004, p < 0.001, and p < 0.001, respectively). Subcortical white mattermean was significantly lower in patients with ALS compared with patients with CVD and healthy controls (p = 0.04). ROC curve analysis showed that the area under the curve of RSmean was 0.70, the highest among the measured parameters.

CONCLUSION: Quantitative measurements of susceptibility of the motor cortex with QSM demonstrate its potential as an imaging biomarker in ALS patients.