Choroid plexus volume differentiates MS from its mimics

Elle Levit; Zheng Ren; Virgilio Gonzenbach; Christina J Azevedo; Peter A Calabresi; Bruce Ac Cree; Leorah Freeman; Erin E Longbrake; Jiwon Oh; Matthew K Schindler; Nancy L Sicotte; Daniel S Reich; Daniel Ontaneda; Pascal Sati; Quy Cao; Russell T Shinohara; Andrew J Solomon

doi:10.1177/13524585241238094

Choroid plexus volume differentiates MS from its mimics

Mult Scler. 2024 Jul;30(8):1072-1076. doi: 10.1177/13524585241238094. Epub 2024 Mar 13.

Authors

Elle Levit^{1

2}, Zheng Ren³, Virgilio Gonzenbach³, Christina J Azevedo⁴, Peter A Calabresi⁵, Bruce Ac Cree⁶, Leorah Freeman⁷, Erin E Longbrake⁸, Jiwon Oh⁹, Matthew K Schindler¹⁰, Nancy L Sicotte¹¹, Daniel S Reich¹², Daniel Ontaneda¹³, Pascal Sati¹¹, Quy Cao³, Russell T Shinohara³, Andrew J Solomon^{1

2}

Affiliations

¹ Department of Neurological Sciences, Larner College of Medicine, The University of Vermont, Burlington, VT, USA.
² The University of Vermont Medical Center, Burlington, VT, USA.
³ Penn Statistics in Imaging and Visualization Center (PennSIVE), Department of Biostatistics, Epidemiology and Informatics and Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
⁴ Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁵ Departments of Neurology and Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁶ UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
⁷ Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
⁸ Department of Neurology, Yale University, New Haven, CT, USA.
⁹ Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
¹⁰ Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
¹¹ Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
¹² Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
¹³ Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, USA.

Abstract

This study aimed to determine whether choroid plexus volume (CPV) could differentiate multiple sclerosis (MS) from its mimics. A secondary analysis of two previously enrolled studies, 50 participants with MS and 64 with alternative diagnoses were included. CPV was automatically segmented from 3T magnetic resonance imaging (MRI), followed by manual review to remove misclassified tissue. Mean normalized choroid plexus volume (nCPV) to intracranial volume demonstrated relatively high specificity for MS participants in each cohort (0.80 and 0.76) with an area under the receiver-operator characteristic curve of 0.71 (95% confidence interval (CI) = 0.55-0.87) and 0.65 (95% CI = 0.52-0.77). In this preliminary study, nCPV differentiated MS from its mimics.

Keywords: MRI; Multiple sclerosis; biomarker; diagnosis; differential diagnosis; misdiagnosis.

MeSH terms

Adult
Choroid Plexus* / diagnostic imaging
Choroid Plexus* / pathology
Diagnosis, Differential
Female
Humans
Magnetic Resonance Imaging*
Male
Middle Aged
Multiple Sclerosis* / diagnostic imaging
Multiple Sclerosis* / pathology

Abstract

MeSH terms

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