Healthcare providers use continuous MRI scans performed over the course of a patient's life to monitor the progression of multiple sclerosis, where the immune system attacks the protective myelin around the nerves within the central nervous system. 

MRIs are used to identify lesions or areas of scarring (sclerosis) within the central nervous system. The scarring is the result of the damage caused by these attacks.

Terrie Livingston, head of patient outcomes and solutions at EMD Serono, the healthcare business of Merck KGaA, Darmstadt, Germany, tells MobiHealthNews how the company uses 3D printing based on MRI scans to evaluate the shape, size and texture of MS lesions to better understand disease progression and treatment outcomes. 

MobiHealthNews: Can you describe the MS-Link project and what it hopes to accomplish?

Terrie Livingston: So, I'll start with the MS-Link program itself. I joined the company to develop and start this program. It launched in 2018. It's an acronym, and it stands for MS Leadership in Innovation Network. So we thought that for EMD, with our long-standing heritage and legacy within neurology and immunology with over 20 years in the space, that we want it to be able to demonstrate our commitment and our scientific leadership. 

[The MS-Link program] is a collaborative research network in which we are partnering with the broader MS community to advance MS research with the goal of improving patient outcomes. One of the first collaborations we entered into was with UT Southwestern, in particular with Dr. Darin Okuda, around his 3D MRI technology that he uses to look at MS lesions.

If you think about an MRI scan, it's kind of a 2D flat image. And when healthcare providers and patients are looking at that 2D scan, it's just a little spot on an image. And so what he's done is applied 3D technology to really visualize the shape and structure of a MS lesion. What he's been able to do and demonstrate is that those MS lesions look very different than lesions that are developed from other disorders, like from migraine headaches, high blood pressure or just normal aging. And so he does demonstrate that, over time, that these lesions do change as far as shape, texture and structure.

MHN: How has he been able to see that they changed? In what ways do they change?

Livingston: In his paper that was presented in the Journal of Neuroimmunology, if you think about how MS lesions are described, they're ovoid. They're, you know, in certain locations within the CNS. What he has shown is that these MS lesions vary in shape, texture and size. So, he's able to look at it at one time point, and then to see and monitor how it does at a second time point, or even longitudinally.

MHN: Is the technology being distributed through EMD Serono and being used in different ways?

Livingston: What we've done is we have collaborated with him to incorporate it into our clinical studies. Within a clinical trial, you have an MRI protocol. And so with this technology, it isn't as extroverted on the patient. It's actually just one additional sequence that's required. And then he applies the technology to the scans that's acquired. And what he does is he's able to then take these lesions, and he's able to print them through 3D printers to actually then visualize at the lesion-level what they look like.

MHN: And how does knowing exactly what they look like help providers and patients?

Livingston: Well, you don't want the lesions to expand, because that's not a good thing. So I think it helps not only to understand disease progression, but actually treatment responses as well. So you hope that those lesions stay stable.

MHN: How has this been beneficial for EMD Serono to use this technology?

Livingston: What it's done is given both healthcare providers and patients a different perspective and really to be able to visualize what that lesion looks like and how it may change over time. I had the benefit of hearing firsthand from a patient, when they saw that lesion first, it was a little overwhelming.

But then, when they sat with it to really be able to hold and to see what an MS lesion looks like, it is very powerful. And even for healthcare providers, it gives a better appreciation for how the disease may be progressing, or how an individual patient may be responding to therapy.

This is kind of a new innovation. It is exploratory, but we hope that, again, we can apply that in our clinical trials with these products.