Atrophied Lesion Volume as Biomarker in Progressive MS: Robert Zivadinov, MD, PhD


The professor of neurology and director of the Buffalo Neuroimaging Analysis Center discussed the development of the aT2-LV biomarker.

“A couple of years ago, we embarked on the invention of a new biomarker in progressive MS, which is called atrophied lesion volume. So, instead of looking for the lesions that are new or enlarging in MS, we look at the lesions that are disappearing or shrinking into the cerebral spinal fluid.”

Data from a recent study suggest that ocrelizumab (Ocrevus; Genentech) reduced atrophied T2-lesion volume (aT2-LV) in patients with primary progressive multiple sclerosis (PPMS). These findings were presented at the 2021 American Academy of Neurology (AAN) Annual Meeting, April 17-22, by Robert Zivadinov, MD, PhD, professor, neurology, and director, Translational Imaging Center, Clinical Translational Research Center, Buffalo Neuroimaging Analysis Center, and director, Buffalo Neuroimaging Analysis Center.

Zivadinov and colleagues evaluated data from 732 patients with PPMS enrolled in the ORATORIO trial (NCT01194570) randomized to ocrelizumab (n = 488) or placebo (n = 244). They further validated the aT2-LV biomarker by confirming that accumulation of aT2-LV in placebo patients (366.1mm3 in 120 weeks) was consistent with previous reports of PPMS. They found that patients treated with ocrelizumab had significantly slower accumulation of aT2-LV (319.4mm3; P = .013). Including scanner model, software, protocol changes, and additional covariates confirmed these results (P = .029).

NeurologyLive spoke with Zivadinov to learn more about the development of the aT2-LV biomarker in PPMS. He discussed several findings in investigating this biomarker that surprised him.

Zivadinov R, Pei J, Clayton D, et al. Evolution of lesions that shrink or disappear into cerebrospinal fluid (atrophied t2 lesion volume) in primary-progressive multiple sclerosis: Results from the phase III ORATORIO study. Presented at 2021 American Academy of Neurology Annual Meeting; April 17-22. Abstract P15 151
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