A Radiodensity Histogram Study of the Brain in Multiple Sclerosis

Area of Science:

• Neuroimaging
• Radiology
• Neurology

Background:

• Multiple sclerosis (MS) is a progressive neurodegenerative disease impacting millions globally.
• Current MS diagnosis relies on clinical assessment, with Magnetic Resonance Imaging (MRI) used for monitoring, but it has limitations in quantitative characterization.
• Discrepancies exist between MRI findings and clinical presentation in MS patients.

Purpose of the Study:

• To investigate the utility of digital analysis of noncontrast head computed tomography (CT) images for detecting global brain changes in MS.
• To assess if histogram metrics from CT images can serve as quantitative biomarkers for MS.
• To correlate CT-derived radiodensity metrics with plaque burden observed on MRI.

Main Methods:

• Retrospective review of noncontrast head CT scans from 54 patients with confirmed MS.
• Comparison of histogram metrics (radiodensity) from MS patients' CT scans with age- and gender-matched control subjects.
• Correlation analysis between CT histogram metrics and plaque burden assessed via MRI.

Main Results:

• Patients with MS exhibited significantly increased total brain radiodensity and modal radiodensity compared to controls (P < .0001).
• A significant decrease in histogram skewness was observed in MS patients (P < .0001).
• Brain radiodensity metrics showed a negative correlation with plaque burden, with similar findings in patients with mild plaque burden.

Conclusions:

• Digital analysis of brain radiodensity histogram metrics derived from noncontrast head CT scans is a sensitive indicator of multiple sclerosis.
• These quantitative CT metrics correlate with MS presence, even in cases with minimal plaque burden.
• Radiodensity offers a unique, measurable tissue metric potentially valuable for MS diagnosis and monitoring.