Rovira, Àlex

We evaluated the energy consumption of a 3T MRI using a central monitoring system, focusing on hospital energy costs during peak winter months from 2021 to 2023. We analyzed consumption during non-productive phases like end-of-day standby and assessed their impact. For active use, we compared standard and AI-enhanced protocols on phantoms, scheduling high-demand protocols during off-peak hours to benefit from lower energy prices. Standard protocols consumed 3.4 to 15 kWh, while optimized protocols used 2.3 to 10.6 kWh, reducing consumption by 32% on average. Savings per scan ranged from EUR 0.03 to EUR 3.7. The electrical consumption of a brain MRI protocol is equivalent to that of 3–4 knee protocols or 2–3 lumbar spine protocols. Using AI-optimized protocols and management, 41 protocols can be completed in 12 h, up from 30, reducing daily costs by EUR 2.38 to EUR 29.18. Annually, AI-optimized protocols could save 7900 to 8800 kWh per MRI unit, totaling 10,500 to 11,600 MWh across France’s MRI fleet, equivalent to the yearly consumption of about 4700 to 5300 people. Optimizing MRI resource use can expand patient access while significantly reducing the associated energy footprint. These findings support the implementation of more sustainable practices in medical imaging without compromising care quality.

Importance While the typical onset of multiple sclerosis (MS) occurs in early adulthood, 2% to 10% of cases initially present prior to age 18 years, and approximately 5% after age 50 years. Guidance on approaches to differential diagnosis in suspected MS specific to these 2 age groups is needed. Observations There are unique biological factors in children younger than 18 years and in adults older than age 50 years compared to typical adult-onset MS. These biological differences, particularly immunological and hormonal, may influence the clinical presentation of MS, resilience to neuronal injury, and differential diagnosis. While mimics of MS at the typical age at onset have been described, a comprehensive approach focused on the younger and older ends of the age spectrum has not been previously published. Conclusions and Relevance An international committee of MS experts in pediatric and adult MS was formed to provide consensus guidance on diagnostic approaches and key clinical and paraclinical red flags for non-MS diagnosis in children and older adults.

Objectives: The objectives of this paper are to compare in a multicenter setting patterns of regional cortical thickness in patients with relapsing–remitting multiple sclerosis (RRMS) and cognitive impairment (CI) and those cognitively preserved (CP), and explore the relationship between cortical thinning and cognitive performance. Methods: T1-weighted isotropic brain scans were collected at 3T from seven European centers in 60 RRMS patients and 65 healthy controls (HCs). Patients underwent clinical and neuropsychological examinations. Cortical thickness (CTh) measures were calculated using FreeSurfer (failing in four) and both lobar and vertex-based general linear model (GLM) analyses were compared between study groups. Results: Twenty (36%) MS patients were classified as CI. Mean global CTh was smaller in RRMS patients compared to HCs (left 2.43 vs. 2.53 mm, right 2.44 vs. 2.54 mm, p < 0.001). Multivariate GLM regional analysis showed significantly more temporal thinning in CI compared to CP patients. Verbal memory scores correlated to regional cortical thinning in the insula whereas visual memory scores correlated to parietal thinning. Conclusions: This multicenter study showed mild global cortical thinning in RRMS. The extent of thinning is less pronounced than previously reported. Only subtle regional differences between CI and CP patients were observed, some of which related to specific cognitive domains.