Abstract #0525

Improving longitudinal spinal cord atrophy measurements in multiple sclerosis using the Generalised Boundary Shift Integral

Marcello Moccia^1,2, Ferran Prados^1,3,4,5, Massimo Filippi⁶, Maria A Rocca⁶, Paola Valsasina⁶, Wallace Brownlee¹, Chiara Zecca⁷, Antonio Gallo^8,9, Alex Rovira¹⁰, Achim Gass¹¹, Jacqueline Palace¹², Carsten Lukas¹³, Claudia AM Gandini Wheeler-Kingshott¹, Olga Ciccarelli^1,3, and Frederik Barkhof^1,3,4,14

¹Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom, ²Department of Neurosciences, Federico II University, Naples, Italy, ³National Institute for Health Research (NIHR), University College London Hospitals (UCLH) Biomedical Research Centre, London, United Kingdom, ⁴Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, United Kingdom, ⁵Universitat Oberta de Catalunya, Barcelona, Spain, ⁶Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy, ⁷Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, Lugano, Switzerland, ⁸Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, University of Campania Luigi Vanvitelli, Naples, Italy, ⁹MRI Research Center SUN-FISM, Institute of Diagnosis and Care (IDC) Hermitage-Capodimonte, Naples, Italy, ¹⁰MR Unit and Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain, ¹¹Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany, ¹²Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom, ¹³St. Josef Hospital, Ruhr University, Bochum, Germany, ¹⁴Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, Netherlands

Spinal cord atrophy is a clinically-relevant feature of multiple sclerosis (MS), but can be difficult to estimate longitudinally using segmentation-based methods. We applied a fully-automated registration-based technique for spinal cord atrophy measurement (Generalised Boundary Shift Integral-GBSI-) on MS patients (n=282) and controls (n=82), from MAGNIMS and Queen Square cohorts. GBSI provided similar spinal cord atrophy rates, compared with cervical cord cross-sectional area (CSA), but with lower variability and favourable sample size estimates. GBSI performed better than CSA in differentiating cases from controls, and in depicting MS clinical features. GBSI could be used to monitor disease progression and in neuroprotective trials.

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