Abstract Details

Title A Deep-Learning Approach to Predicting Disease Progression in Multiple Sclerosis Using Magnetic Resonance Imaging

Topic Multiple Sclerosis

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 310

Objective The aim of this study was to develop and apply an artificial intelligence deep-learning algorithm on a large multicenter cohort of patients collected from the Italian Neuroimaging Network Initiative (INNI) to predict disease evolution (based on clinical disability and cognitive impairment) at two years of follow-up in multiple sclerosis (MS) patients from their baseline magnetic resonance imaging (MRI) features. The performance of the algorithm was then evaluated on an independent test-set and compared to that of two expert physicians.

Background MRI is an important tool for diagnosis and monitoring disease course in MS patients. However, its prognostic value for predicting disease worsening is still being debated.

Design/Methods For 373 MS patients, baseline T2-weighted and T1-weighted brain MRI scans, as well as baseline and two-year clinical and cognitive assessments were collected from the INNI repository. A deep-learning architecture based on convolutional neural networks (CNN) was implemented to predict: (1) clinical worsening (Expanded Disability Status Scale [EDSS]-based model), (2) cognitive deterioration (Symbol Digit Modalities Test [SDMT]-based model), or (3) both (EDSS+SDMT-based model). The method was tested on an independent dataset and compared to the performance of two expert physicians.

Results For the independent test set, the CNN model showed high predictive accuracy for clinical (83.3%) and cognitive (67.7%) worsening, although the highest accuracy was reached when training the algorithm using both EDSS and SDMT information (85.7%). Artificial intelligence classification performance exceeded that of two expert physicians (70% of accuracy for the human raters).

Conclusions We developed a robust and accurate model for predicting clinical and cognitive worsening of MS patients after two years, based on conventional T2-weighted and T1-weighted brain MRI scans obtained at baseline. This algorithm may be valuable for supporting physicians in their clinical practice for the earlier identification of MS patients at risk of disease worsening.

Authors/Disclosures
Paolo Preziosa (Ospedale San Raffaele) PRESENTER	Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb . Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi Genzyme. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Mr. Preziosa has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Loredana Storelli	Loredana Storelli has nothing to disclose.
Matteo Azzimonti	No disclosure on file
Mor Gueye	No disclosure on file
Gioacchino Tedeschi, MD (University of Campania "L. Vanvitelli")	Dr. Tedeschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Tedeschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Tedeschi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis.
Nicola De Stefano, MD (University of Siena)	Dr. De Stefano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck Healthcare KGaA. Dr. De Stefano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Immunic AG. Dr. De Stefano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis Pharma AG. Dr. De Stefano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck Serono S.p.A. Dr. De Stefano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi Genzyme. Dr. De Stefano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche S.p.A.. The institution of Dr. De Stefano has received research support from Italian MS Society. The institution of Dr. De Stefano has received research support from Merck Healthcare KGaA.
Patrizia Pantano	Patrizia Pantano has nothing to disclose.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit)	Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Maria A. Rocca (Neuroimaging Research Unit)	Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.

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