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Open Access 01-12-2023 | Artificial Intelligence | Original Article

AI-based detection of contrast-enhancing MRI lesions in patients with multiple sclerosis

Authors: Sarah Schlaeger, Suprosanna Shit, Paul Eichinger, Marco Hamann, Roland Opfer, Julia Krüger, Michael Dieckmeyer, Simon Schön, Mark Mühlau, Claus Zimmer, Jan S. Kirschke, Benedikt Wiestler, Dennis M. Hedderich

Published in: Insights into Imaging | Issue 1/2023

Abstract

Background

Contrast-enhancing (CE) lesions are an important finding on brain magnetic resonance imaging (MRI) in patients with multiple sclerosis (MS) but can be missed easily. Automated solutions for reliable CE lesion detection are emerging; however, independent validation of artificial intelligence (AI) tools in the clinical routine is still rare.

Methods

A three-dimensional convolutional neural network for CE lesion segmentation was trained externally on 1488 datasets of 934 MS patients from 81 scanners using concatenated information from FLAIR and T1-weighted post-contrast imaging. This externally trained model was tested on an independent dataset comprising 504 T1-weighted post-contrast and FLAIR image datasets of MS patients from clinical routine. Two neuroradiologists (R1, R2) labeled CE lesions for gold standard definition in the clinical test dataset. The algorithmic output was evaluated on both patient- and lesion-level.

Results

On a patient-level, recall, specificity, precision, and accuracy of the AI tool to predict patients with CE lesions were 0.75, 0.99, 0.91, and 0.96. The agreement between the AI tool and both readers was within the range of inter-rater agreement (Cohen’s kappa; AI vs. R1: 0.69; AI vs. R2: 0.76; R1 vs. R2: 0.76). On a lesion-level, false negative lesions were predominately found in infratentorial location, significantly smaller, and at lower contrast than true positive lesions (p < 0.05).

Conclusions

AI-based identification of CE lesions on brain MRI is feasible, approaching human reader performance in independent clinical data and might be of help as a second reader in the neuroradiological assessment of active inflammation in MS patients.

Critical relevance statement

Al-based detection of contrast-enhancing multiple sclerosis lesions approaches human reader performance, but careful visual inspection is still needed, especially for infratentorial, small and low-contrast lesions.

Graphical Abstract

Available only for authorised users

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Title: AI-based detection of contrast-enhancing MRI lesions in patients with multiple sclerosis
Authors: Sarah Schlaeger
Suprosanna Shit
Paul Eichinger
Marco Hamann
Roland Opfer
Julia Krüger
Michael Dieckmeyer
Simon Schön
Mark Mühlau
Claus Zimmer
Jan S. Kirschke
Benedikt Wiestler
Dennis M. Hedderich
Publication date: 01-12-2023
Publisher: Springer Vienna
Keywords: Artificial Intelligence
Multiple Sclerosis
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Insights into Imaging / Issue 1/2023
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-023-01460-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

AI-based detection of contrast-enhancing MRI lesions in patients with multiple sclerosis

Abstract

Background

Methods

Results

Conclusions

Critical relevance statement

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Critical relevance statement

Graphical Abstract

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