Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
Neuroscience Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran
Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Neurology, Shiraz University of medical Sciences
Multiple sclerosis (MS) is a disease which cause
multiple symptoms in vision, mobility and sense of balance. There are different drugs that avoid the disease worsening such as TYSABRI (natalizumab). Routinely, the neurologist examines the patient with MRI imaging at regular intervals to check the effect of the medication and the condition of the MS plaques. For quantitative and objective assessment of disease some software have been developed to reduce the human error.
The objective of this study was to evaluate the conformity of radiologist and neurologist diagnosis with dedicative software developed for assessment the MS plaques volumes.
35 MS patients participated in this study. All the patients had a one-year treatment of TYSABRI. The patients underwent two MRI imaging before and after the treatment. Both imaging performed with the same imaging parameters in the same center. A MATLAB code was written to evaluate the MRI images to determine the MS plaque volumes. The code was verified with comparison of the its result with the result of a commercial software called Jim 7. After the objective assessment of MRI images before and after treatment, a radiologist and two neurologists assessed both images and declared if the MS plaques reduced or increased in the MRI image performed after treatment. The physicians were blind to software results.
21 females and 14 males with the mean-age of 23 years old participated in this study. According to home-made software 13 patients (37.14%) improved and 22 patients (62.86%) worsen after a year of TYSABRI treatment. The radiologist agreed with the software’s results in 48.57% of cases and the neurologists agreed with software results in 54.29 and 45.71% of cases. There were 2 reason that the physicians disagree to software results almost in 50% of cases. Firstly, because the changes in successive imaging were small in some cases so they couldn’t detect them and secondly because they expected to see the improvement of patients. This expectation can change the diagnosis.
The results of this study showed that for evaluation the MS disease status after treatment, it is better to assess the successive MRI images objectively in order to reduce human errors