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).
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