title: Recommendations to improve imaging and analysis of brain lesion load and atrophy in longitudinal studies of multiple sclerosis.
abstract: Focal lesions and brain atrophy are the most extensively studied aspects of multiple sclerosis (MS), but the image acquisition and analysis techniques used can be further improved, especially those for studying within-patient changes of lesion load and atrophy longitudinally. Improved accuracy and sensitivity will reduce the numbers of patients required to detect a given treatment effect in a trial, and ultimately, will allow reliable characterization of individual patients for personalized treatment. Based on open issues in the field of MS research, and the current state of the art in magnetic resonance image analysis methods for assessing brain lesion load and atrophy, this paper makes recommendations to improve these measures for longitudinal studies of MS. Briefly, they are (1) images should be acquired using 3D pulse sequences, with near-isotropic spatial resolution and multiple image contrasts to allow more comprehensive analyses of lesion load and atrophy, across timepoints. Image artifacts need special attention given their effects on image analysis results. (2) Automated image segmentation methods integrating the assessment of lesion load and atrophy are desirable. (3) A standard dataset with benchmark results should be set up to facilitate development, calibration, and objective evaluation of image analysis methods for MS.
authors.affiliation: Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands, h.vrenken@vumc.nl.
authors.forename: H
authors.initials: H
authors.lastname: Vrenken
authors.forename: M
authors.initials: M
authors.lastname: Jenkinson
authors.forename: M A
authors.initials: MA
authors.lastname: Horsfield
authors.forename: M
authors.initials: M
authors.lastname: Battaglini
authors.forename: R A
authors.initials: RA
authors.lastname: van Schijndel
authors.forename: E
authors.initials: E
authors.lastname: Rostrup
authors.forename: J J G
authors.initials: JJ
authors.lastname: Geurts
authors.forename: E
authors.initials: E
authors.lastname: Fisher
authors.forename: A
authors.initials: A
authors.lastname: Zijdenbos
authors.forename: J
authors.initials: J
authors.lastname: Ashburner
authors.forename: D H
authors.initials: DH
authors.lastname: Miller
authors.forename: M
authors.initials: M
authors.lastname: Filippi
authors.forename: F
authors.initials: F
authors.lastname: Fazekas
authors.forename: M
authors.initials: M
authors.lastname: Rovaris
authors.forename: A
authors.initials: A
authors.lastname: Rovira
authors.forename: F
authors.initials: F
authors.lastname: Barkhof
authors.forename: N
authors.initials: N
authors.lastname: de Stefano
mesh_terms: D001284:Atrophy / Q000209:etiology / Q000473:pathology; D001921:Brain / Q000473:pathology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008137:Longitudinal Studies; D009103:Multiple Sclerosis / Q000150:complications / Q000473:pathology*; D059906:Neuroimaging / Q000379:methods / Q000592:standards