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Abstract Details

Evaluating the Performance of an Atlas-Free Automated Method of Brain Classification for Lesion Segmentation in Progressive Multifocal Leukoencephalopathy
Multiple Sclerosis
P2 - Poster Session 2 (8:00 AM-9:00 AM)
9-004
To explore the feasibility of an automated approach for segmentation and quantification of white matter lesions in the context of Progressive Multifocal Leukoencephalopathy (PML).
PML is a rare and often fatal infection caused by JC polyomavirus that almost exclusively occurs in people with impaired cellular immunity.  Magnetic resonance imaging (MRI) demonstrates typical multifocal hyperintense lesions on T2-weighted images affecting subcortical white matter and posterior fossa structures. MRI is helpful for monitoring PML disease course and development of an imaging-based quantitative measure of disease burden as an outcome measure, would be of great value. Therefore, we sought to develop an automated method of brain classification using derivative-based features (C-DEF) optimized for segmentation of PML lesions.
Using serial MRIs from a PML test subject, white matter lesions were manually segmented on T1-weighted and fluid-attenuated inversion recovery (FLAIR) images. CDEF was trained using these ‘gold-standard’ brain segmentation masks to identify healthy white and gray matter and PML lesions. Once CDEF was optimized on the test subject, the algorithm was applied to images obtained from 7 additional PML patients.
CDEF performed well on the test subject with average Dice coefficients between CDEF and gold-standard classification of 0.73 for lesions, 0.97 for grey matter, and 0.99 for white matter. Application to the larger cohort, however, was relatively poor. Generally, supratentorial lesions were accurately segmented, including small foci. However, CDEF often misclassified periventricular regions, cerebellar regions and healthy gray matter as lesions.
Rapid and reliable quantification of PML lesion burden is desirable for monitoring disease progression and stabilization of PML, yet, this remains challenging due to the non-uniform, widespread nature of PML lesions. Preliminary results demonstrate that CDEF could be developed into a useful tool to measure disease burden by combining different MRI sequences to improve the segmentation quality of CDEF.
Authors/Disclosures

PRESENTER 		No disclosure on file
Hadar Kolb Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Hadar Kolb has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for MAPI pharma. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neopharm Scientific. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Marck. The institution of Hadar Kolb has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MAPI pharma. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medison pharma. Hadar Kolb has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Marck.
Daniel Reich, MD, PhD (National Institutes of Health, Neuroimmunology Branch, NINDS) Dr. Reich has received research support from NIH. The institution of Dr. Reich has received research support from Adelson Medical Research Foundation. The institution of Dr. Reich has received research support from Sanofi. The institution of Dr. Reich has received research support from Abata Therapeutics. The institution of Dr. Reich has received research support from National Multiple Sclerosis Society. The institution of Dr. Reich has received research support from Cure Alzheimer's Fund. Dr. Reich has received intellectual property interests from a discovery or technology relating to health care. Dr. Reich has received personal compensation in the range of $5,000-$9,999 for serving as a CME Faculty with Integrity. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a CME Faculty with Letters and Sciences. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a CME Faculty with Academic CME. Dr. Reich has a non-compensated relationship as a Advisor with Sanofi that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Board of Directors with ACTRIMS that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Abata Therapeutics that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with University of Basel RC2NB that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Multiple Sclerosis Society of Canada that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Tuscan Doctorate in Neuroscience that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Editorial Board with Multiple Sclerosis Journal that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator, Advisor with Hyperfine that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Imaginab that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Annexon that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator, Advisor with Philips that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Siemens that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Calico Life Sciences that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Cognito Therapeutics that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Sudo that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Allumis that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with BioCentury that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Regeneron that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Collaborator with Eli Lilly that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with SetPoint that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
Irene Cortese, MD Dr. Cortese has stock in Keires, AG. Dr. Cortese has stock in Nouscom, AG. Dr. Cortese has stock in PDC*line Pharma.
Govind Nair No disclosure on file