Eshaghi, A;
Wottschel, V;
Cortese, R;
Calabrese, M;
Sahraian, MA;
Thompson, AJ;
Alexander, DC;
(2016)
Gray matter MRI differentiates neuromyelitis optica from multiple sclerosis using random forest.
Neurology
, 87
(23)
pp. 2463-2470.
10.1212/WNL.0000000000003395.
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Abstract
OBJECTIVE: We tested whether brain gray matter (GM) imaging measures can differentiate between multiple sclerosis (MS) and neuromyelitis optica (NMO) using random-forest classification. METHODS: Ninety participants (25 patients with MS, 30 patients with NMO, and 35 healthy controls [HCs]) were studied in Tehran, Iran, and 54 (24 patients with MS, 20 patients with NMO, and 10 HCs) in Padua, Italy. Participants underwent brain T1 and T2/fluid-attenuated inversion recovery MRI. Volume, thickness, and surface of 50 cortical GM regions and volumes of the deep GM nuclei were calculated and used to construct 3 random-forest models to classify patients as either NMO or MS, and separate each patient group from HCs. Clinical diagnosis was the gold standard against which the accuracy was calculated. RESULTS: The classifier distinguished patients with MS, who showed greater atrophy especially in deep GM, from those with NMO with an average accuracy of 74% (sensitivity/specificity: 77/72; p < 0.01). When we used thalamic volume (the most discriminating GM measure) together with the white matter lesion volume, the accuracy of the classification of MS vs NMO was 80%. The classifications of MS vs HCs and NMO vs HCs achieved higher accuracies (92% and 88%). CONCLUSIONS: GM imaging biomarkers, automatically obtained from clinical scans, can be used to distinguish NMO from MS, even in a 2-center setting, and may facilitate the differential diagnosis in clinical practice. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that GM imaging biomarkers can distinguish patients with NMO from those with MS.
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