Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

New Technique Accurately Estimates MS Lesion Size

Am J Neuroradiol; ePub 2018 Feb 22; Dworkin, Linn, et al

A novel technique for counting pathologically distinct multiple sclerosis (MS) lesions using cross-sectional data demonstrates its ability in a recent study to recover obscured longitudinal information. Therefore, the proposed count allows more accurate estimation of lesion size, which correlated more closely with disability scores than either lesion load or lesion count alone. MR imaging was used to assess the probability of a lesion at each location. The texture of this map was quantified using a novel technique, and clusters resembling the center of a lesion were counted. Validity compared with a criterion standard count was demonstrated in 60 subjects observed longitudinally, and reliability was determined using 14 scans of a clinically stable subject acquired at 7 sites. Investigators found:

  • The proposed count and the criterion standard count were highly correlated and not significantly different, and the variability of the proposed count across repeat scans was equivalent to that of lesion load.
  • After accounting for lesion load and age, lesion count was negatively associated with the Expanded Disability Status Scale.


Dworkin JD, Linn KA, Oguz I, et al. An automated statistical technique for counting distinct multiple sclerosis lesions. [Published online ahead of print February 22, 2018]. Am J Neuroradiol. doi:10.3174/ajnr.A5556.

This Week's Must Reads

Coexisting Dementia Rising Among Stroke Patients, J Stroke Cerebrovasc Dis; ePub 2018 Mar 14; Sherzai, et al

Excessive Daytime Sleepiness and β-Amyloid Buildup, JAMA Neurology; ePub 2018 Mar 12; Carvalho, et al

Cognitive Impairment and ICAS in General Population, Neurology; ePub 2018 Mar 9; Suri, Zhou, et al

FDA Approves Apadaz for Acute Pain Relief, KemPharm, Inc. news release; 2018 Feb 23

Must Reads in Multiple Sclerosis

Sun Exposure Associated with Lower MS Risk, Neurology; ePub 2018 Mar 7; Tremlett, et al

BEEMS Improved Several Outcomes in Patients with MS, Neurology; ePub 2018 Feb 27; Hebert, Corboy, et al

Factors Linked with Early Initiation of DMD Treatment, Curr Med Res Opin; ePub 2018 Mar 1; Edwards, et al

Predicting Episodic Memory Loss in Patients with MS, Mult Scler; ePub 2018 Mar 7; Koenig, et al

Diet Characteristics Examined in People with MS, Mult Scler Relat Disord; ePub Feb 27; Fitzgerald, et al