Abstract Details

Title Machine Learning-Based Detection of Slowly Expanding Lesions using Radiomic Features from Cross-sectional Brain MRI

Topic Multiple Sclerosis

Presentation(s) S26 - MS Imaging (1:36 PM-1:48 PM)

Poster/Presentation
Number 004

Background Slowly expanding lesions (SELs) are identifiable on magnetic resonance imaging (MRI) as contiguous regions of existing T2 lesions showing gradual concentric expansion. Currently, SEL detection requires at least 3 serial MRI scans, typically spanning 1 or 2 years of follow-up.

Objective Develop a machine-learning (ML)-based classifier discriminating SELs from non-SELs in chronic non-enhancing white matter, using deep radiomic features extracted from cross-sectional T1- and T2-weighted non-contrast brain MRI.

Design/Methods Brain T1- and T2-weighted MRIs from ADVANCE (1,512 patients with relapsing-remitting [RR]MS, NCT00906399), ASCEND (886 patients with secondary progressive [SP]MS, NCT01416181) and SYNERGY (419 patients with RRMS/SPMS, NCT01864148) trials were retrospectively analysed. Each lesion was sampled using a ball of radius 4 mm (core) with a 3 mm periphery around it. Topology-agnostic radiomics were extracted from each region, yielding 372 radiomic features. Linear and non-linear robust feature selection was performed. ADVANCE was used for training/validation; ASCEND and SYNERGY for testing.

Results Feature selection yielded 15 features, among which 8 were core-based and 7 were periphery-based; 10 were T1-based and 5 were T2-based. The classification framework reached 66.8% balanced accuracy, 65.9% precision, 69.7% sensitivity, 63.9% specificity and 72.2% AUC on the validation set. On the ASCEND and SYNERGY test datasets, the classification performances were 65.7% and 68.5% balanced accuracy, 63.1% and 69.3% precision, 75.9% and 66.5% sensitivity, 55.5% and 70.6% specificity, and 71.1% and 74.3% AUC.

Conclusions The proposed ML method showed promise for SEL detection using cross-sectional T1 and T2-weighted MRI, alleviating the need for longitudinal analysis and potentially enabling baseline quantification of lesion subtypes. Applications of this algorithm could include population enrichment in clinical trials and improved patient prognostication in clinic. Future work should focus on improving specificity in the SPMS population and incorporating chronic active lesions detected by phase-rim identification into the classification algorithm.

Authors/Disclosures
Bastien C. Caba (Biogen Canada) PRESENTER	Mr. Caba has received personal compensation for serving as an employee of Therapanacea. Mr. Caba has received personal compensation for serving as an employee of Biogen. Mr. Caba has received personal compensation in the range of $50,000-$99,999 for serving as a Research Engineer with Therapanacea. Mr. Caba has received personal compensation in the range of $100,000-$499,999 for serving as a Scientist II, ML/AI with Biogen.
Arie Gafson, MD, PhD (Biogen)	Dr. Gafson has stock in Biogen.
	No disclosure on file
Dawei Liu	Dawei Liu has received personal compensation for serving as an employee of Biogen. Dawei Liu has received stock or an ownership interest from Biogen.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Elizabeth Fisher	Elizabeth Fisher has received personal compensation for serving as an employee of Biogen. Elizabeth Fisher has stock in Biogen. Elizabeth Fisher has received intellectual property interests from a discovery or technology relating to health care.
Nathalie Franchimont	Nathalie Franchimont has received personal compensation for serving as an employee of Biogen. An immediate family member of Nathalie Franchimont has received personal compensation for serving as an employee of Biogen. An immediate family member of Nathalie Franchimont has received personal compensation for serving as an employee of Akcea. Nathalie Franchimont has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for OMass Therapeutics. Nathalie Franchimont has received stock or an ownership interest from Biogen. An immediate family member of Nathalie Franchimont has received stock or an ownership interest from Biogen.
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has stock in NeuroRx.
Colm Elliott (NeuroRx Research)	Colm Elliott has received personal compensation for serving as an employee of NeuroRx Research.
	No disclosure on file
Shibeshih Belachew, MD	Dr. Belachew has received personal compensation for serving as an employee of Biogen Inc. Dr. Belachew has received stock or an ownership interest from Biogen Inc.