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Radiomics in multiple sclerosis and neuromyelitis optica spectrum disorder

  • Magnetic Resonance
  • Published:
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Abstract

Objective

To develop and validate an individual radiomics nomogram for differential diagnosis between multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD).

Methods

We retrospectively collected 67 MS and 68 NMOSD with spinal cord lesions as a primary cohort and prospectively recruited 28 MS and 26 NMOSD patients as a validation cohort. Radiomic features were extracted from the spinal cord lesions. A prediction model for differentiating MS and NMOSD was built by combining the radiomic features with several clinical and routine MRI measurements. The performance of the model was assessed with respect to its calibration plot and clinical discrimination in the primary and validation cohorts.

Results

Nine radiomics features extracted from an initial set of 485, predominantly reflecting lesion heterogeneity, combined with lesion length, patient sex, and EDSS, were selected to build the model for differentiating MS and NMOSD. The areas under the ROC curves (AUC) for differentiating the two diseases were 0.8808 and 0.7115, for the primary and validation cohort, respectively. This model demonstrated good calibration (C-index was 0.906 and 0.802 in primary and validation cohort).

Conclusions

A validated nomogram that incorporates the radiomic signature of spinal cord lesions, as well as cord lesion length, sex, and EDSS score, can usefully differentiate MS and NMOSD.

Key Points

• Radiomic features of spinal cord lesions in MS and NMOSD were different.

• Radiomic signatures can capture pathological alterations and help differentiate MS and NMOSD.

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Abbreviations

AUC:

Areas under the ROC curves

EDSS:

Expanded disability status scale

LASSO:

Least absolute shrinkage and selection operator

LETM:

Longitudinal extensive transverse myelitis

MS:

Multiple sclerosis

NMOSD:

Neuromyelitis optica spectrum disorder

ROC:

Receiver operating characteristic

ROI:

Region of interest

RRMS:

Relapsing-remitting MS

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Acknowledgements

We thank our patients in this study and members of the neuroimmunology team and staffs of the department of radiology for various supports.

Funding

This work was supported by the ECTRIMS-MAGNMIS Fellowship from ECTRIMS (Y.L), the National Science Foundation of China (Nos. 81101038, 81227901, 81771924, 81501736, 61231004, 81401377, 81471221 and 81230028), the National Basic Research Program of China (2013CB966900), National Key R&D Program of China (2017YFA0205200, 2017YFC1308700, 2017YFC1308701), the Beijing Natural Science fund (No.7133244), the Beijing Nova Programme (xx2013045), Beijing Municipal Administration of Hospital Clinical Medicine Development of Special Funding Support (code:ZYLX201609), the Science and Technology Service Network Initiative of the Chinese Academy of Sciences (KFJ-SW-STS-160), and Key Projects in the National Science & Technology Pillar Program during the Twelfth Five-year Plan Period (2012BAI10B04).

Author information

Author notes

  1. Yaou Liu and Di Dong contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China

    Yaou Liu, Yunyun Duan & Kuncheng Li

  2. Tiantan Image Research Center, China National Clinical Research Center for Neurological Diseases, Beijing, 100050, People’s Republic of China

    Yaou Liu & Yunyun Duan

  3. Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, 1007 MB, Amsterdam, The Netherlands

    Yaou Liu & Frederik Barkhof

  4. Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People’s Republic of China

    Yaou Liu, Xiaolu Qiu, Jing Huang & Kuncheng Li

  5. CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China

    Di Dong, Liwen Zhang, Yali Zang, Chaoen Hu, Mengjie Fang & Jie Tian

  6. University of Chinese Academy of Sciences, Beijing, China

    Di Dong, Liwen Zhang, Yali Zang, Chaoen Hu, Mengjie Fang & Jie Tian

  7. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People’s Republic of China

    Huiqing Dong

  8. Institutes of Neurology and Healthcare Engineering, UCL, London, UK

    Frederik Barkhof

Authors
  1. Yaou Liu
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  2. Di Dong
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Corresponding authors

Correspondence to Yaou Liu or Jie Tian.

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Guarantor

The scientific guarantor of this publication is Yaou Liu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Liu, Y., Dong, D., Zhang, L. et al. Radiomics in multiple sclerosis and neuromyelitis optica spectrum disorder. Eur Radiol 29, 4670–4677 (2019). https://doi.org/10.1007/s00330-019-06026-w

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  • DOI: https://doi.org/10.1007/s00330-019-06026-w

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