title: MRI texture heterogeneity in the optic nerve predicts visual recovery after acute optic neuritis.
abstract: OBJECTIVE
  To test the feasibility of using multi-scale MRI texture analysis to assess optic nerve pathology and to investigate how visual recovery relates to the severity of acute tissue damage in the optic nerve in patients after optic neuritis (ON).
  
  
  METHODS
  We recruited 25 patients with acute ON. Retinal nerve fiber layer (RNFL) thickness; MRI lesion length and enhancement; optic nerve area ratio; and multi-scale MRI texture analysis, a measure of structural integrity, were used to assess tissue damage at baseline, and at 6 and 12 months. The recovery in vision was defined as the functional outcome. Eight healthy subjects were imaged for control.
  
  
  RESULTS
  We identified 25 lesions in the affected eyes (9 enhanced) and 5 in the clinically non-affected eyes (none enhanced). At baseline, we found that RNFL values were 20% thicker and lesion texture 14% more heterogeneous in the affected eyes than in the non-affected eyes, and lesion texture ratio of affected to non-affected eyes was greater in patients than in controls. In the affected eyes, visual acuity recovered significantly over 6 (18/23 patients) and 12 months (18/21 patients) when RNFL thickness and optic nerve area ratio decreased over time. Texture heterogeneity in the standard MRI of acute optic nerve lesions was the only measure that predicted functional recovery after ON.
  
  
  CONCLUSIONS
  Tissue heterogeneity may be a potential measure of functional outcome in ON patients and advanced analysis of the texture in standard MRI could provide insights into mechanisms of injury and recovery in patients with similar disorders.
authors: Department of Radiology, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada ; Department of Clinical Neurosciences, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada ; Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada.
authors: Yunyan
authors: Y
authors: Zhang
authors: Department of Clinical Neurosciences, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada ; Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada.
authors: Luanne M
authors: LM
authors: Metz
authors: Department of Radiology, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada ; Department of Clinical Neurosciences, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada.
authors: James N
authors: JN
authors: Scott
authors: Department of Clinical Neurosciences, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada ; Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada.
authors: Jessie
authors: J
authors: Trufyn
authors: Department of Community Health Sciences, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada.
authors: Gordon H
authors: GH
authors: Fick
authors: Department of Clinical Neurosciences, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada ; Hotchkiss Brain Institute, University of Calgary, 3330 Hospital Dr NW, Calgary, Alberta T2N 4N1, Canada.
authors: Fiona
authors: F
authors: Costello
mesh_terms: D000208:Acute Disease; D000328:Adult; D000465:Algorithms; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009902:Optic Neuritis / Q000150:complications* / Q000473:pathology*; D010363:Pattern Recognition, Automated / Q000379:methods; D020127:Recovery of Function; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology*; D014792:Visual Acuity; D055815:Young Adult
keywords: Acute tissue damage; MRI; Optic neuritis; Prediction; Texture heterogeneity; Visual recovery