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Prognosis of a second clinical event from baseline MRI in patients with a CIS: a multicenter study using a machine
Deborah Pareto1, Aran Garcia-Vidal2, Sergiu Groppa3
1Department of Radiology (IDI), Neuroradiology Section, Hospital Universitari Vall d'Hebron and Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain. deborah.pareto.idi@gencat.cat.
Purpose:
To predict the occurrence of a second clinical event in patients with a CIS suggestive of MS, from baseline magnetic resonance imaging (MRI), by means of a pattern recognition approach.
Methods:
Two hundred sixty-six patients with a CIS were recruited from four participating centers. Over a follow-up of 3 years, 130 patients had a second clinical episode and 136 did not. Grey matter and white matter T1-hypointensities masks segmented from 3D T1-weighted images acquired on 3 T scanners were used as features for the classification approach. Differences between CIS that remained CIS and those that developed a second event were assessed at a global level and at a regional level, arranging the regions according to their contribution to the classification model.
Results:
All classification metrics were around or even below 50% for both global and regional approaches. Accuracies did not change when T1-hypointensity maps were added to the model; just the specificity was increased up to 80%. Among the 30 regions with the largest contribution, 26 were grey matter and 4 were white matter regions. For grey matter, regions contributing showed either a larger or a smaller volume in the group of patients that remained CIS, compared to those with a second event. The volume of T1-hypointensities was always larger for the group that presented a second event.
Conclusions:
Prediction of a second clinical event in CIS patients from baseline MRI seems to present a highly heterogeneous pattern, leading to very low classification accuracies. Adding the T1-hypointensity maps does not seem to improve the accuracy of the classification model.
