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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleAdult Brain
Open Access

Evaluation of the Statistical Detection of Change Algorithm for Screening Patients with MS with New Lesion Activity on Longitudinal Brain MRI

M. Homssi, E.M. Sweeney, E. Demmon, W. Mannheim, M. Sakirsky, Y. Wang, S.A. Gauthier, A. Gupta and T.D. Nguyen
American Journal of Neuroradiology May 2023, DOI: https://doi.org/10.3174/ajnr.A7858
M. Homssi
aFrom the Department of Radiology (M.H., Y.W., A.G., T.D.N.), Weill Cornell Medicine, New York, New York
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E.M. Sweeney
dPenn Statistics in Imaging and Visualization Endeavor Center, Department of Biostatistics, Epidemiology, and Informatics (E.M.S.), University of Pennsylvania, Philadelphia, Pennsylvania
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E. Demmon
bDepartment of Neurology (E.D., W.M., M.S., S.A.G.), Weill Cornell Medicine, New York, New York
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W. Mannheim
bDepartment of Neurology (E.D., W.M., M.S., S.A.G.), Weill Cornell Medicine, New York, New York
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M. Sakirsky
bDepartment of Neurology (E.D., W.M., M.S., S.A.G.), Weill Cornell Medicine, New York, New York
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Y. Wang
aFrom the Department of Radiology (M.H., Y.W., A.G., T.D.N.), Weill Cornell Medicine, New York, New York
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S.A. Gauthier
bDepartment of Neurology (E.D., W.M., M.S., S.A.G.), Weill Cornell Medicine, New York, New York
cThe Feil Family Brain & Mind Institute (S.A.G.), Weill Cornell Medicine, New York, New York
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A. Gupta
aFrom the Department of Radiology (M.H., Y.W., A.G., T.D.N.), Weill Cornell Medicine, New York, New York
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T.D. Nguyen
aFrom the Department of Radiology (M.H., Y.W., A.G., T.D.N.), Weill Cornell Medicine, New York, New York
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Abstract

BACKGROUND AND PURPOSE: Identification of new MS lesions on longitudinal MR imaging by human readers is time-consuming and prone to error. Our objective was to evaluate the improvement in the performance of subject-level detection by readers when assisted by the automated statistical detection of change algorithm.

MATERIALS AND METHODS: A total of 200 patients with MS with a mean interscan interval of 13.2 (SD, 2.4) months were included. Statistical detection of change was applied to the baseline and follow-up FLAIR images to detect potential new lesions for confirmation by readers (Reader + statistical detection of change method). This method was compared with readers operating in the clinical workflow (Reader method) for a subject-level detection of new lesions.

RESULTS: Reader + statistical detection of change found 30 subjects (15.0%) with at least 1 new lesion, while Reader detected 16 subjects (8.0%). As a subject-level screening tool, statistical detection of change achieved a perfect sensitivity of 1.00 (95% CI, 0.88–1.00) and a moderate specificity of 0.67 (95% CI, 0.59–0.74). The agreement on a subject level was 0.91 (95% CI, 0.87–0.95) between Reader + statistical detection of change and Reader, and 0.72 (95% CI, 0.66–0.78) between Reader + statistical detection of change and statistical detection of change.

CONCLUSIONS: The statistical detection of change algorithm can serve as a time-saving screening tool to assist human readers in verifying 3D FLAIR images of patients with MS with suspected new lesions. Our promising results warrant further evaluation of statistical detection of change in prospective multireader clinical studies.

ABBREVIATIONS:

PPV
positive predictive value
SDC
statistical detection of change

Footnotes

  • ↵† M. Homssi and E.M. Sweeney contributed equally to this work.

  • Paper previously presented, in part, at: Annual Meeting of the American Society of Neuroradiology, May 16-28, 2022; New York, New York.

  • This work was supported in part by grants from the National Institutes of Health (R01 NS105144, R01 NS090464, R01 NS104283) and the National Multiple Sclerosis Society (RR-1602-07671).

  • Disclosure forms provided by the authors are available with the full text and PDF of this article at www.ajnr.org.

  • © 2023 by American Journal of Neuroradiology

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M. Homssi, E.M. Sweeney, E. Demmon, W. Mannheim, M. Sakirsky, Y. Wang, S.A. Gauthier, A. Gupta, T.D. Nguyen
Evaluation of the Statistical Detection of Change Algorithm for Screening Patients with MS with New Lesion Activity on Longitudinal Brain MRI
American Journal of Neuroradiology May 2023, DOI: 10.3174/ajnr.A7858

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Evaluation of the Statistical Detection of Change Algorithm for Screening Patients with MS with New Lesion Activity on Longitudinal Brain MRI
M. Homssi, E.M. Sweeney, E. Demmon, W. Mannheim, M. Sakirsky, Y. Wang, S.A. Gauthier, A. Gupta, T.D. Nguyen
American Journal of Neuroradiology May 2023, DOI: 10.3174/ajnr.A7858
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