White Matter Lesion Tracking in Multiple Sclerosis

Purpose	To accurately assess the progression of white matter disease in multiple sclerosis on MRI.
Tag(s)
Panel	Neuroradiology
Define-AI ID	21020021
Originator	Mark Lum
Lead	Mark Lum
Panel Chair	Alex Norbash
Panel Reviewers	Neuroradiology Panel
License	Creative Commons 4.0
Status	Public Comment
RadElement Set	RDES186

                               

Value Proposition

Imaging plays an important role not only in the diagnosis of multiple sclerosis, but also in the follow-up. While there is only modest correlation between white matter disease volume and disability, the presence of new or enlarging lesions has implications for disease modifying therapy (Kauzner 2017). Lesion tracking can be challenging and time consuming. Subtle changes between exams may only be apparent when comparing to multiple consecutive exams, and there is the risk of perpetuating "stable disease." Automatic co-registration of multiple prior exams would be useful in efficiently identifying new or enlarging white matter lesions.

Narrative(s)

55 year-old woman with known multiple sclerosis presents with progressive difficulty walking over the past 10 years and now requires a cane. She has been previously told that her imaging has shown that her disease is unchanged. She presents for routine follow-up brain MRI.

Workflow Description

Multiple prior exams are selected by the radiologist for co-registration of volumetric T2-weighted FLAIR sequences. A fused heat map is generated in the axial, coronal, or sagittal plane to highlight white matter lesions that have changed the most over a specified time frame. Additionally, the total volume of white matter lesions is generated for the current exam.

Inputs

 

DICOM Study

Primary Outputs

Change-over-time Color Map

White Matter Lesion Burden

Kaunzner UW, Gauthier SA. MRI in the assessment and monitoring of multiple sclerosis: an update on best practice. Ther Adv Neurol Disord. 2017;10(6):247-261.