title: Texture analysis of magnetization transfer maps from patients with clinically isolated syndrome and multiple sclerosis.
abstract: OBJECTIVE
  To investigate the behavior of texture parameters derived from the gray level co-occurrence matrix from gray matter (GM) and white matter (WM) (with lesions removed) segments of magnetization transfer ratio maps from controls and patients.
  
  
  METHODS
  Magnetization transfer ratio maps from 23 controls and patients with either a clinically isolated syndrome (CIS) (38 patients) or clinically definite multiple sclerosis (MS) (35) were scanned and texture parameters extracted. The texture parameters were compared between the groups and correlated with clinical measures of disability in the MS patients to investigate any association with disease severity.
  
  
  RESULTS
  No significant differences were found between the texture parameters from controls and CIS patients; however, several parameters differ between MS patients and the two other groups, particularly in the GM, but also in the WM. The expanded disability status score and timed walk test correlate with GM texture measures, while the Paced Auditory Serial Addition Test 3 score, a cognitive measure, correlates with WM texture. Texture abnormalities were seen in MS WM and GM, indicating tissue damage beyond classical WM lesions, the abnormalities being more evident in GM.
  
  
  CONCLUSIONS
  The findings highlight potential for texture analysis measures in classifying central nervous system demyelinating diseases that warrants further investigation.
authors.affiliation: UCL Institute of Neurology, London, UK. d.tozer@ion.ucl.ac.uk
authors.forename: D J
authors.initials: DJ
authors.lastname: Tozer
authors.forename: G
authors.initials: G
authors.lastname: Marongiu
authors.forename: J K
authors.initials: JK
authors.lastname: Swanton
authors.forename: A J
authors.initials: AJ
authors.lastname: Thompson
authors.forename: D H
authors.initials: DH
authors.lastname: Miller
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping / Q000379:methods; D015331:Cohort Studies; D003711:Demyelinating Diseases / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D012720:Severity of Illness Index