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Abstract #0525

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

Marcello Moccia1,2, Ferran Prados1,3,4,5, Massimo Filippi6, Maria A Rocca6, Paola Valsasina6, Wallace Brownlee1, Chiara Zecca7, Antonio Gallo8,9, Alex Rovira10, Achim Gass11, Jacqueline Palace12, Carsten Lukas13, Claudia AM Gandini Wheeler-Kingshott1, Olga Ciccarelli1,3, and Frederik Barkhof1,3,4,14

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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