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A Radiodensity Histogram Study of the Brain in Multiple Sclerosis

Keith A. Cauley
1,* and
Samuel W. Fielden
Geisinger Medical Center, Department of Radiology, Danville, PA 17821, USA
Department of Imaging Science & Innovation, Geisinger Health System, Lewisburg, PA, USA
Author to whom correspondence should be addressed.
Tomography 2018, 4(4), 194-203;
Submission received: 3 October 2018 / Revised: 9 October 2018 / Accepted: 8 November 2018 / Published: 1 December 2018


Multiple sclerosis (MS) is a progressive neurodegenerative disease, affecting 1 million Americans and 2.5 million people globally. Although the diagnosis is made clinically, imaging plays a major role in diagnosing and monitoring disease progression and treatment response. Magnetic resonance imaging (MRI) has proven sensitive in imaging MS lesions, but the characterization offered by routine clinical MRI remains qualitative and with discrepancies between imaging and clinical findings. We investigated the ability of digital analysis of noncontrast head computed tomography (CT) images to detect global brain changes of MS. All routine diagnostic head CTs obtained on patients with known MS obtained from 1 of 2 scan platforms from 6/1/2011 to 6/1/2015 were reviewed. Head CT images from 54 patients with MS met inclusion criteria. Head CT images were processed and histogram metrics were compared to age- and gender- matched control subjects from the same CT scanners during the same time interval. Histogram metrics were correlated with plaque burden as seen on MRI studies. Compared with control subjects, patients had increased total brain radiodensity (P < 0.0001), further characterized as an increased histogram modal radiodensity (P < 0.0001) with decrease in histogram skewness (P < 0.0001). Radiodensity decreased with increasing plaque burden. Similar findings were seen in the patients with only mild plaque burden sub- group. Radiodensity is a unique tissue metric that is not measured by other imaging techniques. Our study finds that brain radiodensity histogram metrics highly correlate with MS, even in cases with minimal plaque burden.
Keywords: computed tomography; radiodensity; histogram; multiple sclerosis computed tomography; radiodensity; histogram; multiple sclerosis

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MDPI and ACS Style

Cauley, K.A.; Fielden, S.W. A Radiodensity Histogram Study of the Brain in Multiple Sclerosis. Tomography 2018, 4, 194-203.

AMA Style

Cauley KA, Fielden SW. A Radiodensity Histogram Study of the Brain in Multiple Sclerosis. Tomography. 2018; 4(4):194-203.

Chicago/Turabian Style

Cauley, Keith A., and Samuel W. Fielden. 2018. "A Radiodensity Histogram Study of the Brain in Multiple Sclerosis" Tomography 4, no. 4: 194-203.

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