A Comparative Analysis of Different QSM Reconstruction Approaches for the Characterization of Multiple Sclerosis Pathology

Motivation: Variability in QSM acquisition and post-processing techniques complicates the interpretation of research findings in multiple sclerosis (MS) and hinders clinical integration. Goal(s): To evaluate the impact of different acquisition and QSM reconstruction methods on characterizing MS brain pathology. Approach: We analyzed brain MRI scans from MS and healthy individuals, reconstructed QSM from 3D-EPI and ME-GRE sequences using various methods, and assessed agreement and associations with clinical variables. Results: QSM showed strong agreement across acquisition and reconstruction methods and correlated with MS severity, although variations in sensitivity to pathological changes highlighted the need for standardized protocols to improve clinical application. Impact: QSM demonstrated substantial agreement across various acquisition and reconstruction methods and correlated with MS severity. The different QSM implementations exhibited small variations in sensitivity to pathological changes, underscoring the necessity for standardized protocols to enhance clinical application.