A multi-center digital MRI network for adrenoleukodystrophy (ALD)

The ability to evaluate therapy outcomes in a multi-center clinical trial for adrenoleukodystrophy (ALD) is enhanced by an electronic magnetic resonance imaging (MRI) network of clinical institutions. Brain MRI and magnetic resonance spectroscopy (MRS) are the most sensitive indices for the evaluation of ALD therapies. Using the Loes score (D.J. Loes et al., 1994), which is an objective scoring mechanism of brain MRI abnormalities, the physician can make an accurate therapy appraisal. However, because ALD is a rare disorder, it is difficult for a single institution to perform a clinical trial due to the lack of cases generated. The network allows participating sites to send ALD MRI cases to a central clinical database. By consolidating the data, a sufficient patient pool for evaluation of ALD therapies is formed. With the network in place, ALD-experienced physicians have the ability to independently summon up the ALD MRI cases remotely on softcopy display stations, review the study and provide the subsequent Loes score online in a Web-accessible database. Scoring of the MRl studies independently increases the validity of the interpretation. Implementation of this multi-center MRI network for ALD can serve as a model for many other disorders.