AI in Radiology: Where are we today in Multiple Sclerosis Imaging?

Background MR imaging is an essential component in managing patients with Multiple sclerosis (MS). This holds true for the initial diagnosis as well as for assessing the clinical course of MS. In recent years, a growing number of computer tools were developed to analyze imaging data in MS. This review gives an overview of the most important applications with special emphasis on artificial intelligence (AI). Methods Relevant studies were identified through a literature search in recognized databases, and through parsing the references in studies found this way. Literature published as of November 2019 was included with a special focus on recent studies from 2018 and 2019. Results There are a number of studies which focus on optimizing lesion visualization and lesion segmentation. Some of these studies accomplished these tasks with high accuracy, enabling a reproducible quantitative analysis of lesion loads. Some studies took a radiomics approach and aimed at predicting clinical endpoints such as the conversion from a clinically isolated syndrome to definite MS. Moreover, recent studies investigated synthetic imaging, i.e. imaging data that is not measured during an MR scan but generated by a computer algorithm to optimize the contrast between MS lesions and brain parenchyma. Conclusion Computer-based image analysis and AI are hot topics in imaging MS. Some applications are ready for use in clinical routine. A major challenge for the future is to improve prediction of expected disease courses and thereby helping to find optimal treatment decisions on an individual level. With technical improvements, more questions arise about the integration of new tools into the radiological workflow.