COMPUTER-ASSISTED QUANTITATION OF ENHANCING LESIONS IN MULTIPLE-SCLEROSIS - CORRELATION WITH CLINICAL CLASSIFICATION

PURPOSE: To study the utility of a computer-assisted method of quantit ating enhancing multiple sclerosis (MS) lesions and to correlate this quantitation with the type and duration of disease. METHODS: Forty unt reated patients with MS were studied. The patients had been classified clinically as having either relapsing-remitting (n = 27) or chronic-p rogressive (n = 13) disease. Postcontrast contiguous 3-mm-thick MR ima ges of the brain were obtained for up to 3 years. The computer program selected potential lesion sites automatically on the basis of the the ory of ''fuzzy connectedness,'' which was incorporated into 3DVIEWNIX software. True lesions were selected from these previously detected po tential lesions by means of yes/no responses to the program query. The number of enhancing lesions and the enhancing lesion volume were subs equently computed. RESULTS: The enhancing lesion volume in patients wi th relapsing-remitting disease was statistically significantly higher than that of patients with chronic-progressive disease. There was a st rong positive correlation between the number of enhancing lesions and the enhancing lesion volume. No significant correlation was noted betw een the change in score on the expanded disability status scale (EDSS) and the change in the number of enhancing lesions, or between the cha nge in EDSS score and the change in enhancing lesion volume. A negativ e correlation was found between enhancing lesion volume and duration o f disease, and between the number of enhancing lesions and duration of disease in the patients who nad enhancing lesions. CONCLUSIONS: Our d ata suggest that enhancing lesion volume reflects differences in the c lassification of clinical MS and in the disease activity over time. Co mputer-assisted quantitation of enhancing lesion volume is a robust, p ractical, and objective measure of MS activity.