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. 2022 Jul 28:jnnp-2022-329333.
doi: 10.1136/jnnp-2022-329333. Online ahead of print.

Thalamic atrophy measured by artificial intelligence in a multicentre clinical routine real-word study is associated with disability progression

Robert Zivadinov  1   2 , Niels Bergsland  3 , Dejan Jakimovski  3 , Bianca Weinstock-Guttman  4 , Ralph H B Benedict  4 , Jon Riolo  5 , Diego Silva  5 , Michael G Dwyer  3   2 ; DeepGRAI Registry Study group
Collaborators, Affiliations

Thalamic atrophy measured by artificial intelligence in a multicentre clinical routine real-word study is associated with disability progression

Robert Zivadinov et al. J Neurol Neurosurg Psychiatry. .

Abstract

Background: The thalamus is a key grey matter structure, and sensitive marker of neurodegeneration in multiple sclerosis (MS). Previous reports indicated that thalamic volumetry using artificial intelligence (AI) on clinical-quality T2-fluid-attenuated inversion recovery (FLAIR) images alone is fast and reliable.

Objective: To investigate whether thalamic volume (TV) loss, measured longitudinally by AI, is associated with disability progression (DP) in patients with MS, participating in a large multicentre study.

Methods: The DeepGRAI (Deep Grey Rating via Artificial Intelligence) Registry is a multicentre (30 USA sites), longitudinal, observational, retrospective, real-word study of relapsing-remitting (RR) MS patients. Each centre enrolled between 30 and 35 patients. Brain MRI exams acquired at baseline and follow-up on 1.5T or 3T scanners with no prior standardisation were collected. TV measurement was performed on T2-FLAIR using DeepGRAI, and on two dimensional (D)-weighted and 3D T1-weighted images (WI) by using FMRIB's Integrated Registration and Segmentation Tool software where possible.

Results: 1002 RRMS patients were followed for an average of 2.6 years. Longitudinal TV analysis was more readily available on T2-FLAIR (96.1%), compared with 2D-T1-WI (61.8%) or 3D-T1-WI (33.2%). Over the follow-up, DeepGRAI TV loss was significantly higher in patients with DP, compared with those with disability improvement (DI) or disease stability (-1.35% in DP, -0.87% in DI and -0.57% in Stable, p=0.045, Bonferroni-adjusted, age-adjusted and follow-up time-adjusted analysis of covariance). In a regression model including MRI scanner change, age, sex, disease duration and follow-up time, DP was associated with DeepGRAI TV loss (p=0.022).

Conclusions: Thalamic atrophy measured by AI in a multicentre clinical routine real-word setting is associated with DP over mid-term follow-up.

Keywords: CLINICAL NEUROLOGY; MULTIPLE SCLEROSIS.

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Conflict of interest statement

Competing interests: RZ has received personal compensation from Bristol Myers Squibb, EMD Serono, Sanofi, Keystone Heart, Protembis and Novartis for speaking and consultant fees. He received financial support for research activities from Sanofi, Novartis, Bristol Myers Squibb, Octave, Mapi Pharma, Keystone Heart, Protembis and V-WAVE Medical. NB and and DJ have nothing to disclose. BW-G received honoraria as a speaker and/or as a consultant for Biogen Idec, Sanofi &Genzyme, Genentech, Novartis, BMS, Bayer, Horizon and Janssen. BW-G received research funds from Biogen Idec, Genentech and Novartis. RHBB has received consultation or speaking fees from Bristol Myer Squibb, Biogen, Merck, EMD Serono, Roche, Verasci, Immune Therapeutics, Novartis, and Sanofi-GenzymeJon Riolo and Diego Silva are employees of Bristol-Myers Squibb. MGD has received personal compensation from Keystone Heart for consultant fees. He received financial support for research activities from Bristol Myers Squibb, Mapi Pharma, Keystone Heart, Protembis and V-WAVE Medical.

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