Evaluation of two AI techniques for the detection of new T2/FLAIR lesions in the follow-up of multiple sclerosis patients

Background Multiple sclerosis is an inflammatory demyelinating disease of the CNS. Annual MRI exams are crucial for disease monitoring. Interpreting high T2/FLAIR lesion loads can be laborious. AI aids in lesion detection, and choosing between different solutions can be challenging. Aim This study compares two distinct software, Pixyl.Neuro.MS ® and Jazz ® , to assess their performance in T2/FLAIR lesion detection between two-time points. Methods Retrospective analysis included follow-up MRIs from 35 MS patients. Pixyl.Neuro.MS ® automatically segments and classifies lesions. Jazz ® automates the reading process and image display. Two readers (15 and 4 years of experience) conducted radiological analysis, followed by AI-assisted readings. A number of new lesions (NL) and reading times were recorded, with ground truth (GT) established by consensus. AI-detected lesions were classified as true (TP) and false positives (FP). Statistical analysis used SPSS ( p < 0.05). Results Pixyl.Neuro.MS ® readings averaged 2 min 46 s ± 1 min 4 s while using Jazz ® 3 min 33 s ± 2 min 24 s. Over 50% of the population had a high lesion load (>20 lesions). Both software significantly improved NL detection ( p < 0.01 for both), revealing them in more patients than standard readings. Standard reports found 8 NL in 2 patients, while AI-assisted readings detected at least 17 TP in 7 patients and rejected 61 FP lesions. GT detected 21 lesions in 19 patients. Conclusion Both AI software have been found to enhance NL detection in MS patients, outperforming standard methods. These tools offer crucial advantages for accurate disease monitoring.