Automatic segmentation of gadolinium-enhanced multiple sclerosis lesions

Automatic detection and quantitation of contrast-enhanced lesions on MRI is expected to be useful in characterizing the disease state in multiple sclerosis (MS). The enhancing structures such as cerebral vasculature and regions with no blood-brain barrier complicate automated analysis of lesion enhancement. A pulse sequence that incorporates both stationary and marching saturation bands and gradient dephasing is described for suppressing the enhancements within the cerebral vasculature. A postprocessing technique based on automatic image segmentation is implemented for eliminating enhancing structures such as choroid plexus. All MS lesions larger than 5 mm(3) have been successfully identified. The automated analysis produced no false-positives or false-negative lesions above this volume in 13 patients with MS who were evaluated using the acquisition and evaluation techniques described.