Multiple sclerosis (MS) lesion characterization using MRI is valuable for monitoring MS and probing remyelination therapies. However, there is a lack of in-vivo MRI metrics in clinical studies. We assessed MS lesion types using statistical texture measures of advanced and conventional MRIs, accompanied by random forest classification and percentile statistics, to differentiate MS lesions based on myelination. The best texture parameters and percentiles that classified re- and de-myelinated lesions were derived from histology-verified MRI. Applying the established parameters from postmortem to in-vivo MRI identified two types of lesions: highly demyelinated and potentially remyelinated.
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