Demonstrate how three dimensional (3D) brain MRI can be visualized utilizing the topographical model of multiple sclerosis (MS) to facilitate assessment of MS disease burden.

Brain MRIs contain hundreds of images across an array of sequences, and standard radiology reports may not comprehensively convey the total burden of disease.

The topographical model of MS was developed as a visualization of MS that depicts localized lesions in a pool of variable reserve. To date, this model has only been used to show emblematic disease phenotypes rather than utilizing MRI data to depict individual patient data. We present the first visualizations of patients in the topographical model using novel 3D brain MRI technology.

Using a well-characterized cohort of patients with relapsing-remitting multiple sclerosis (PwMS), case-depiction feasibility was assessed utilizing MRIs with 3D T1 & T2 FLAIR sequences, processed through NeuroQuantMS 3.1 (cortechs.ai) and THINQ (Corticometrics) to extract lesion counts and volumes, parenchymal volumetrics, and 3D surface meshes. Volumetric and lesion meshes were then grouped into FBX files and imported into Unity, in which lesion localizations were mapped and scaled for depiction according to topographical model parameters.

Novel visualizations of PwMS in the topographical model will be shown, demonstrating the feasibility of this technique to depict radiographic burden of disease. Each 3D brain MRI is paired with topographical model rendering showing lesion size/severity, surface morphology, and laterality/localization in juxtacortical, subcortical, periventricular, and segmented infratentorial regions. Clinical factors including age, sex, race, disease duration, current treatment, and Patient Determined Disease Steps (PDDS) are shown for each PwMS.

3D brain visualizations in tandem with the topographical model of MS convey disease burden in an intuitive format emphasizing the importance of lesion localization, with potential as an educational/communication tool. Future iterations will seek to incorporate spinal cord MRI and depict functional reserve using parenchymal volumetrics.