Published in:
03-03-2022 | Systemic Lupus Erythematosus | Imaging Informatics and Artificial Intelligence
Multi-lesion radiomics model for discrimination of relapsing-remitting multiple sclerosis and neuropsychiatric systemic lupus erythematosus
Published in: European Radiology | Issue 8/2022
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Objectives
To develop an MRI-based multi-lesion radiomics model for discrimination of relapsing-remitting multiple sclerosis (RRMS) and its mimicker neuropsychiatric systemic lupus erythematosus (NPSLE).
Methods
A total of 112 patients with RRMS (n = 63) or NPSLE (n = 49) were assigned to training and test sets with a ratio of 3:1. All lesions across the whole brain were manually segmented on T2-weighted fluid-attenuated inversion recovery images. For each single lesion, 371 radiomics features were extracted and trained using machine learning algorithms, producing Radiomics Index for Lesion (RIL) for each lesion and a single-lesion radiomics model. Then, for each subject, single lesions were assigned to one of two disease courts based on their distance to decision threshold, and a Radiomics Index for Subject (RIS) was calculated as the mean RIL value of lesions on the higher-weighted court. Accordingly, a subject-level discrimination model was constructed and compared with performances of two radiologists.
Results
The subject-based discrimination model satisfactorily differentiated RRMS and NPSLE in both training (AUC = 0.967, accuracy = 0.892, sensitivity = 0.917, and specificity = 0.872) and test sets (AUC = 0.962, accuracy = 0.931, sensitivity = 1.000, and specificity = 0.875), significantly better than the single-lesion radiomics method (training: p < 0.001; test: p = 0.001) Besides, the discrimination model significantly outperformed the senior radiologist in the training set (training: p = 0.018; test: p = 0.077) and the junior radiologist in both the training and test sets (training: p = 0.008; test: p = 0.023).
Conclusions
The multi-lesion radiomics model could effectively discriminate between RRMS and NPSLE, providing a supplementary tool for accurate differential diagnosis of the two diseases.
Key Points
• Radiomic features of brain lesions in RRMS and NPSLE were different.
• The multi-lesion radiomics model constructed using a merging strategy was comprehensively superior to the single-lesion-based model for discrimination of RRMS and NPSLE.
• The RRMS-NPSLE discrimination model showed a significantly better performance or a trend toward significance than the radiologists.