Multicenter Study

. 2023 Sep;58(3):864-876.

doi: 10.1002/jmri.28618. Epub 2023 Jan 28.

A Multicenter Longitudinal MRI Study Assessing LeMan-PV Software Accuracy in the Detection of White Matter Lesions in Multiple Sclerosis Patients

Alexandra Ramona Todea^{1

2}, Lester Melie-Garcia^{2

3}, Muhamed Barakovic^{2

3}, Alessandro Cagol^{2

3}, Reza Rahmanzadeh^{2

3}, Riccardo Galbusera^{2

3}, Po-Jui Lu^{2

3}, Matthias Weigel^{2

3

4}, Esther Ruberte^{2

3}, Ernst-Wilhelm Radue², Sabine Schaedelin⁵, Pascal Benkert⁵, Yaldizli Oezguer^{2

3}, Tim Sinnecker^{2

3

6}, Stefanie Müller⁷, Lutz Achtnichts⁸, Jochen Vehoff⁷, Giulio Disanto⁹, Oliver Findling⁸, Andrew Chan¹⁰, Anke Salmen¹⁰, Caroline Pot¹¹, Patrice Lalive¹², Claire Bridel¹², Chiara Zecca^{9

13}, Tobias Derfuss³, Luca Remonda¹⁴, Franca Wagner¹⁵, Maria Vargas¹⁶, Renaud Du Pasquier¹¹, Emanuele Pravata^{13

17}, Johannes Weber¹⁸, Claudio Gobbi^{9

13}, David Leppert³, Jens Wuerfel⁶, Tobias Kober^{19

20

21}, Benedicte Marechal^{19

20

21}, Ricardo Corredor-Jerez^{19

20

21}, Marios Psychogios¹, Johanna Lieb¹, Ludwig Kappos^{2

3}, Meritxell Bach Cuadra²², Jens Kuhle³, Cristina Granziera^{2

3}; Swiss MS Cohort Study

Affiliations

¹ Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital of Basel, Basel, Switzerland.
² Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland.
³ Department of Neurology, University Hospital Basel, Switzerland, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland.
⁴ Division of Radiological Physics, Department of Radiology, University Hospital Basel and University of Basel, Basel, Switzerland.
⁵ Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
⁶ Medical Image Analysis Center (MIAC) and qbig, Department of Biomedical Engineering, University Basel, Basel, Switzerland.
⁷ Department of Neurology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
⁸ Department of Neurology, Cantonal Hospital Aarau, Switzerland.
⁹ Department of Neurology, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland.
¹⁰ Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
¹¹ Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
¹² Department of Clinical Neurosciences, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
¹³ Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland.
¹⁴ Department of Radiology, Cantonal Hospital Aarau, Switzerland.
¹⁵ Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
¹⁶ Department of Radiology, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
¹⁷ Department of Neuroradiology, Neurocenter of Southern Switzerland, Lugano, Switzerland.
¹⁸ Department of Radiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
¹⁹ Advanced Clinical Imaging Technology, Siemens Healthineers International, Lausanne, Switzerland.
²⁰ Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
²¹ LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland.
²² CIBM Center for Biomedical Imaging, Radiology Department, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.

PMID: 36708267
DOI: 10.1002/jmri.28618

Free article

Multicenter Study

A Multicenter Longitudinal MRI Study Assessing LeMan-PV Software Accuracy in the Detection of White Matter Lesions in Multiple Sclerosis Patients

Alexandra Ramona Todea et al. J Magn Reson Imaging. 2023 Sep.

Free article

. 2023 Sep;58(3):864-876.

doi: 10.1002/jmri.28618. Epub 2023 Jan 28.

Authors

Affiliations

¹ Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital of Basel, Basel, Switzerland.
² Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland.
³ Department of Neurology, University Hospital Basel, Switzerland, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland.
⁴ Division of Radiological Physics, Department of Radiology, University Hospital Basel and University of Basel, Basel, Switzerland.
⁵ Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
⁶ Medical Image Analysis Center (MIAC) and qbig, Department of Biomedical Engineering, University Basel, Basel, Switzerland.
⁷ Department of Neurology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
⁸ Department of Neurology, Cantonal Hospital Aarau, Switzerland.
⁹ Department of Neurology, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland.
¹⁰ Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
¹¹ Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
¹² Department of Clinical Neurosciences, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
¹³ Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland.
¹⁴ Department of Radiology, Cantonal Hospital Aarau, Switzerland.
¹⁵ Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
¹⁶ Department of Radiology, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
¹⁷ Department of Neuroradiology, Neurocenter of Southern Switzerland, Lugano, Switzerland.
¹⁸ Department of Radiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
¹⁹ Advanced Clinical Imaging Technology, Siemens Healthineers International, Lausanne, Switzerland.
²⁰ Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
²¹ LTS5, École Polytechnique FÉdÉrale de Lausanne (EPFL), Lausanne, Switzerland.
²² CIBM Center for Biomedical Imaging, Radiology Department, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.

PMID: 36708267
DOI: 10.1002/jmri.28618

Abstract

Background: Detecting new and enlarged lesions in multiple sclerosis (MS) patients is needed to determine their disease activity. LeMan-PV is a software embedded in the scanner reconstruction system of one vendor, which automatically assesses new and enlarged white matter lesions (NELs) in the follow-up of MS patients; however, multicenter validation studies are lacking.

Purpose: To assess the accuracy of LeMan-PV for the longitudinal detection NEL white-matter MS lesions in a multicenter clinical setting.

Study type: Retrospective, longitudinal.

Subjects: A total of 206 patients with a definitive MS diagnosis and at least two follow-up MRI studies from five centers participating in the Swiss Multiple Sclerosis Cohort study. Mean age at first follow-up = 45.2 years (range: 36.9-52.8 years); 70 males.

Field strength/sequence: Fluid attenuated inversion recovery (FLAIR) and T1-weighted magnetization prepared rapid gradient echo (T1-MPRAGE) sequences at 1.5 T and 3 T.

Assessment: The study included 313 MRI pairs of datasets. Data were analyzed with LeMan-PV and compared with a manual "reference standard" provided by a neuroradiologist. A second rater (neurologist) performed the same analysis in a subset of MRI pairs to evaluate the rating-accuracy. The Sensitivity (Se), Specificity (Sp), Accuracy (Acc), F1-score, lesion-wise False-Positive-Rate (aFPR), and other measures were used to assess LeMan-PV performance for the detection of NEL at 1.5 T and 3 T. The performance was also evaluated in the subgroup of 123 MRI pairs at 3 T.

Statistical tests: Intraclass correlation coefficient (ICC) and Cohen's kappa (CK) were used to evaluate the agreement between readers.

Results: The interreader agreement was high for detecting new lesions (ICC = 0.97, Pvalue < 10^-20 , CK = 0.82, P value = 0) and good (ICC = 0.75, P value < 10^-12 , CK = 0.68, P value = 0) for detecting enlarged lesions. Across all centers, scanner field strengths (1.5 T, 3 T), and for NEL, LeMan-PV achieved: Acc = 61%, Se = 65%, Sp = 60%, F1-score = 0.44, aFPR = 1.31. When both follow-ups were acquired at 3 T, LeMan-PV accuracy was higher (Acc = 66%, Se = 66%, Sp = 66%, F1-score = 0.28, aFPR = 3.03).

Data conclusion: In this multicenter study using clinical data settings acquired at 1.5 T and 3 T, and variations in MRI protocols, LeMan-PV showed similar sensitivity in detecting NEL with respect to other recent 3 T multicentric studies based on neural networks. While LeMan-PV performance is not optimal, its main advantage is that it provides automated clinical decision support integrated into the radiological-routine flow.

Evidence level: 4 TECHNICAL EFFICACY: Stage 2.

Keywords: lesion activity; lesion segmentation; longitudinal analysis; longitudinal lesion segmentation; multiple sclerosis; white matter lesions.

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Comment in

Editorial for "A Multicenter Longitudinal MRI Study Assessing LeMan-PV Software Accuracy in the Detection of White Matter Lesions in Multiple Sclerosis Patients".
Wu S, Shi D. Wu S, et al. J Magn Reson Imaging. 2023 Sep;58(3):877-878. doi: 10.1002/jmri.28652. Epub 2023 Feb 21. J Magn Reson Imaging. 2023. PMID: 36811223 No abstract available.

References

REFERENCES

1. Lassmann H, Brück W, Lucchinetti CF. The immunopathology of multiple sclerosis: An overview. Brain Pathol 2007;17:210-218.
1. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018;17:162-173.
1. Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011;69:292-302.
1. Lassmann H. Targets of therapy in progressive MS. Mult Scler 2017;23:1593-1599.
1. Río J, Castilló J, Rovira A, et al. Measures in the first year of therapy predict the response to interferon beta in MS. Mult Scler 2009;15:848-853.

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A Multicenter Longitudinal MRI Study Assessing LeMan-PV Software Accuracy in the Detection of White Matter Lesions in Multiple Sclerosis Patients

Affiliations

A Multicenter Longitudinal MRI Study Assessing LeMan-PV Software Accuracy in the Detection of White Matter Lesions in Multiple Sclerosis Patients

Authors

Affiliations

Abstract

Comment in

References

REFERENCES

Publication types

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LinkOut - more resources

Full Text Sources

Medical

Research Materials