Related Experiment Video
Updated: Jan 17, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Association of Spinal Cord Radiomic Features and Disability in Multiple Sclerosis
Jeffrey Lambe1, Nicolas R Thompson2,3, Yadi Li2,3
1Mellen Center for Multiple Sclerosis Treatment and Research, Neurology Department, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
Background And Purpose:
Spinal cord pathology underpins disability accumulation in people with multiple sclerosis (pwMS). Visual inspection of spinal cord magentic resonance imaging (MRI) often fails to reliably detect injury. Radiomics analyzes signal intensities in images to identify pathological changes that may be imperceptible to the human eye. This study evaluated the application of radiomics to spinal cord MRI to distinguish subgroups of pwMS and disability correlations.
Methods:
Radiomic features were extracted from upper cervical cord coverage on cross-sectional 3.0T brain noncontrasted T1-weighted MRI scans in pwMS and healthy controls (HCs). Ninety-three radiomic features-predominantly gray-level matrices-were extracted using Pyradiomics, with pixel heterogeneity considered to reflect neuroaxonal pathology. T2 lesion and brain substructure volumes were segmented from 3D fluid-attenuated inversion recovery and magnetization-prepared rapid gradient-echo sequences using an in-house 2.5D U-Net convolutional neural network to encapsulate neuroinflammation and neurodegeneration. Cervical cross-sectional area (C1-C3) was measured using in-house atlas-based segmentation. Imaging features were compared between pwMS and HCs, and pwMS by phenotype (relapsing vs. progressive), age, and race. Associations of imaging features with Patient-Determined Disease Steps (PDDS) were examined.
Results:
Among 2966 pwMS and 41 HCs, we identified radiomic features distinguishing pwMS from HCs, and pwMS by phenotype, age, and race. Radiomic features exhibited stronger correlations with PDDS than conventional MRI measures.
Conclusions:
Radiomics identified pathological changes in pwMS in varying stages of the disease course that are undetectable by conventional spinal cord MRI. Radiomics may increase the yield of spinal cord MRI in pwMS and serve as biomarkers predicting disability worsening.
Insights
Radiomics analysis of spinal cord MRI reveals subtle pathology in multiple sclerosis (MS) patients, distinguishing disease subtypes and correlating with disability. This advanced imaging technique offers improved detection of neuroaxonal changes compared to conventional MRI.
Area of Science:
- Neuroimaging
- Radiology
- Biomarkers
Background:
- Spinal cord pathology is a key driver of disability in multiple sclerosis (MS).
- Conventional MRI often fails to detect subtle spinal cord injuries in people with MS (pwMS).
- Radiomics offers a novel approach to analyze image data for detecting imperceptible pathological changes.
Purpose of the Study:
- To evaluate the utility of radiomics in spinal cord MRI for differentiating MS patient subgroups.
- To assess the correlation between radiomic features and disability progression in pwMS.
Main Methods:
- Radiomic features were extracted from T1-weighted MRI scans of the upper cervical cord in pwMS and healthy controls (HCs).
- Neuroinflammation and neurodegeneration were assessed using U-Net convolutional neural networks on FLAIR and MPRAGE sequences.
- Cervical cross-sectional area was measured, and imaging features were compared across groups and correlated with Patient-Determined Disease Steps (PDDS).
Main Results:
- Radiomic features successfully distinguished pwMS from HCs and identified differences based on MS phenotype, age, and race.
- Radiomic features demonstrated stronger correlations with PDDS than conventional MRI measures.
- A total of 2966 pwMS and 41 HCs were included in the study.
Conclusions:
- Radiomics can detect spinal cord pathologies in pwMS that are missed by conventional MRI.
- This technique holds potential as a biomarker for predicting disability worsening in MS.
- Radiomics may enhance the diagnostic yield of spinal cord MRI in the management of MS.
