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Assessing optic nerve integrity in optic neuritis with conventional magnetic resonance imaging
Helena Sánchez-Ulloa1, Neus Mongay-Ochoa1, Manel Alberich1
1From the BCN Medtech, Department of Engineering, Universitat Pompeu Fabra, Barcelona, Spain; Neuroradiology Group, Vall d'Hebron Institut Recerca, Barcelona, Spain; Department of Neurology. Centre d'Esclerosi Múltiple de Catalunya (CEMCAT), Vall d'Hebron University Hospital, Barcelona, Spain; Department of Neuroscience, Imaging and Clinical Sciences, University G. D'Annunzio of Chieti, Italy; School of Medicine and Surgery and Milan Centre for Neuroscience (NeuroMI), University of Milano-Bicocca, Milan, Italy; Estacio de Sá University, Brazil; Neuroradiology Section, Radiology Department (IDI), Vall d'Hebron University Hospital, Barcelona, Spain; Neurophysiology Section, Vall d'Hebron University Hospital, Barcelona, Spain; and Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Background And Purpose:
The aim of this study was to investigate the integrity of the optic nerve using the ratio between T1WI and T2WI (T1/T2) MRI signal intensities, and to assess whether inter-eye differences could indicate the presence of lesions in the optic nerve.
Material And Methods:
The cohort included eighteen healthy controls and forty-nine individuals with multiple sclerosis; from those, thirty-two had a previous episode of optic neuritis. A method was trained to generate automatic segmentations of the optic nerve. Provided masks were then applied to the T1/T2 map and the mean profile was extracted. Inter-eye asymmetry was calculated from the area under the profiles. The presence of optic nerve lesions was confirmed using double inversion recovery MRI. Group differences were evaluated with non-parametric statistical tests, and the ability of inter-eye asymmetry to identify lesions was assessed using logistic regression.
Results:
Automated masks showed a moderate agreement with the reference segmentations (mean Dice coefficient ± SD = 0.53 ± 0.12). Eyes with a visible lesion on MRI showed a significantly lower T1/T2 (mean ± SD = 0.61 ± 0.09) compared to other groups (multiple sclerosis without optic neuritis 0.74 ± 0.06, p<0.001; and healthy subjects 0.77 ± 0.09, p<0.001). Inter-eye asymmetry demonstrated a good discriminative performance, with an area under the curve of 0.83, a sensitivity of 0.74, and a specificity of 0.82.
Conclusion:
The findings indicate that conventional MRI can provide clinically meaningful information regarding optic nerve integrity and support the development of automated tools for detecting optic nerve lesions.
