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Neuroimage Clin. 2018 Jan 28;18:143-148. doi: 10.1016/j.nicl.2018.01.013. eCollection 2018.

Diagnostic accuracy of semiautomatic lesion detection plus quantitative susceptibility mapping in the identification of new and enhancing multiple sclerosis lesions.

Author information

1
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
2
Department of Radiology, Weill Cornell Medicine, New York, NY, USA.
3
Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA.
4
Department of Neurology, Weill Cornell Medicine, New York, NY, USA.
5
Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
6
Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA.

Abstract

Purpose:

To evaluate the diagnostic accuracy of a novel non-contrast brain MRI method based on semiautomatic lesion detection using T2w FLAIR subtraction image, the statistical detection of change (SDC) algorithm (T2w + SDC), and quantitative susceptibility mapping (QSM). This method identifies new lesions and discriminates between enhancing and nonenhancing lesions in multiple sclerosis (MS).

Methods:

Thirty three MS patients who had MRIs at two different time points with at least one new Gd-enhancing lesion on the 2nd MRI were included in the study. For a reference standard, new lesions were identified by two neuroradiologists on T2w and post-Gd T1w images with the help of T2w + SDC. The diagnostic accuracy of the proposed method based on QSM and T2w + SDC lesion detection (T2w + SDC + QSM) for assessing lesion enhancement status was determined. Receiver operating characteristic (ROC) analysis was performed to compute the optimal lesion susceptibility cutoff value.

Results:

A total of 165 new lesions (54 enhancing, 111 nonenhancing) were identified. The sensitivity and specificity of T2w + SDC + QSM in predicting lesion enhancement status were 90.7% and 85.6%, respectively. For lesions ≥50 mm3, ROC analysis showed an optimal QSM cutoff value of 13.5 ppb with a sensitivity of 88.4% and specificity of 88.6% (0.93, 95% CI, 0.87-0.99). For lesions ≥15 mm3, the optimal QSM cutoff was 15.4 ppb with a sensitivity of 77.9% and specificity of 94.0% (0.93, 95% CI, 0.89-0.97).

Conclusion:

The proposed T2w + SDC + QSM method is highly accurate for identifying and predicting the enhancement status of new MS lesions without the use of Gd injection.

KEYWORDS:

Image subtraction; Multiple sclerosis; Quantitative susceptibility mapping (QSM)

PMID:
29387531
PMCID:
PMC5790036
DOI:
10.1016/j.nicl.2018.01.013
[Indexed for MEDLINE]
Free PMC Article

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