Abstract Details

Title Machine Learning-Based Prediction of New Multiple Sclerosis Lesion Formation Using Radiomic Features from Pre-Lesion Normal Appearing White Matter

Topic Multiple Sclerosis

Presentation(s) S26 - MS Imaging (2:36 PM-2:48 PM)

Poster/Presentation
Number 009

Background New lesions on T2-weighted brain MRI of patients with multiple sclerosis (MS) are a marker of inflammatory disease. Evidence suggests that abnormalities exist within the NAWM prior to lesion formation, however conventional imaging methods cannot detect these abnormalities.

Objective Build a machine learning (ML) algorithm able to predict new T2 lesions using cross-sectional T1-and T2-weighted non-contrast brain magnetic resonance imaging (MRI) data from the normal-appearing white matter (NAWM) up to 48 weeks prior to new lesion emergence.

Design/Methods Brain T1- and T2-weighted MRIs from ADVANCE (1,512 patients with relapsing-remitting MS, NCT00906399) and ASCEND (886 patients with secondary progressive MS, NCT01416181) trials were analysed. Cubic patches of 15 mm edge were sampled from the NAWM of baseline scans. Patches co-locating with a future lesion at 48 weeks were labelled “positive” patches, while those not associated with a future lesion in spatially matched white matter were labelled “negative”. Intensity-based radiomic features were extracted from the core and periphery of each patch, yielding 372 radiomic features per patch. Linear and non-linear robust feature selection was performed. ADVANCE was used for training/validation; ASCEND for testing.

Results Feature selection yielded 40 features, among which 22 were core-based and 18 were periphery-based; 18 are T1-based, 22 are T2-based. The classification framework reached 66.4% balanced accuracy, 66.5% precision, 66.0% sensitivity, 66.8% specificity, and 72.6% AUC on the validation set. The corresponding testing set metrics in the ASCEND cohort were 64.6%, 63.7%, 68.0%, 61.2%, and 71.4%.

Conclusions The proposed ML method demonstrated relatively high and generalizable performance across trials. These results further inform our understanding of the nature of lesion formation in MS, which seemingly arises from areas of normal-appearing white matter that are in fact abnormal. More work involving post-mortem MRI is needed to characterize the underlying pathologies in precursory lesion tissue.

Authors/Disclosures
Bastien C. Caba (Biogen Canada) PRESENTER	Mr. Caba has received personal compensation for serving as an employee of Therapanacea. Mr. Caba has received personal compensation for serving as an employee of Biogen. Mr. Caba has received personal compensation in the range of $50,000-$99,999 for serving as a Research Engineer with Therapanacea. Mr. Caba has received personal compensation in the range of $100,000-$499,999 for serving as a Scientist II, ML/AI with Biogen.
Arie Gafson, MD, PhD (Biogen)	Dr. Gafson has stock in Biogen.
	No disclosure on file
Dawei Liu	Dawei Liu has received personal compensation for serving as an employee of Biogen. Dawei Liu has received stock or an ownership interest from Biogen.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Elizabeth Fisher	Elizabeth Fisher has received personal compensation for serving as an employee of Biogen. Elizabeth Fisher has stock in Biogen. Elizabeth Fisher has received intellectual property interests from a discovery or technology relating to health care.
Nathalie Franchimont	Nathalie Franchimont has received personal compensation for serving as an employee of Biogen. An immediate family member of Nathalie Franchimont has received personal compensation for serving as an employee of Biogen. An immediate family member of Nathalie Franchimont has received personal compensation for serving as an employee of Akcea. Nathalie Franchimont has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for OMass Therapeutics. Nathalie Franchimont has received stock or an ownership interest from Biogen. An immediate family member of Nathalie Franchimont has received stock or an ownership interest from Biogen.
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has stock in NeuroRx.
Colm Elliott (NeuroRx Research)	Colm Elliott has received personal compensation for serving as an employee of NeuroRx Research.
	No disclosure on file
Shibeshih Belachew, MD	Dr. Belachew has received personal compensation for serving as an employee of Biogen Inc. Dr. Belachew has received stock or an ownership interest from Biogen Inc.