AI and Neurological Rare & Neuroimmune Diseases ── Multiple sclerosis ── 2026-11-03
Multiple sclerosis: treatment, trials and AI
- Abstract
AIM: This study assessed to what extent ico brain ms , a commercially available artificial intelligence (AI)-assisted magnetic resonance imaging (MRI) volumetry software, detected disease activity in patients with clinically and radiologically stable relapsing multiple sclerosis (RMS), and estimated its impact on radiologists' assessments. PATIENTS AND METHODS: We retrospectively enrolled 111 RMS patients with two consecutive MRI scans at one year interval, without relapses, progression or radiological changes while remaining on stable therapy. MRI scans were analyzed by four radiologists acting independently, and by ico brain ms . The radiologists performed their assessments both without and with ico brain ms support and categorized patient status based on lesion and brain volume changes. RESULTS: Radiologists' detection of lesion activity non-significantly increased from 6.8% to 8.6% (McNemar p = 0.215; ordinal regression p = 0.06; sign-test p = 0.08) using ico brain ms . Detection of accelerated brain volume loss increased from 2.0% to 7.7% (all p p brain ms detected new or significantly enlarged lesions in 16.2% and accelerated brain volume loss in 6.3% of participants. CONCLUSION: AI-assisted MRI volumetry may support radiologists to detect subclinical disease activity in patients characterized as having stable disease. What is this study about? Multiple sclerosis, a heterogeneous disease affecting the brain and spinal cord, results in a wide range of visible and invisible symptoms. The disease course is largely unpredictable with potential development of progression over time. Careful monitoring is recommended, both clinically and radiologically. In the absence of clinical signs, subtle changes may be detected with regular imaging of the brain through magnetic resonance imaging (MRI) scans. In this study, we tested whether ico brain ms , an artificial intelligence (AI) tool, can help radiologists to assess scans and spot changes over time in the brain of patients who were clinically and radiologically stable. Four radiologists were asked to compare two MRI scans of 111 patients on 2 occasions, without and with additional information from the AI-tool. What were the results? The tool flagged new or growing lesions and accelerated brain volume loss in a number of patients. Based on information provided by the tool, radiologists slightly raised the identification of new or growing lesions, while significantly increasing the detection of accelerated brain volume loss. The tool also helped to achieve a higher level of agreement across the 4 participating radiologists. What do the results mean? The study shows that an AI-tool can support radiologists to detect changes in the brain of patients with multiple sclerosis, in the absence of clinical worsening. Nonetheless, the review by radiologists remains necessary and cannot be replaced by the AI tool on its own.
Journal IF-equivalent: 1.9 (OpenAlex 2-year mean citedness, value as of 2026-11-01, retrieved 2026-11-03; not the official Clarivate IF)Reference: D’hooghe MB, Fockaert N, Glibert N, Elands S, Elosegi JA, Etxeberria Izal A, et al. A Belgian study assessing relapsing multiple sclerosis activity through automated magnetic resonance imaging volumetry. Neurodegenerative Disease Management. 2026 Nov 1 [Epub ahead of print]. doi:10.1080/17582024.2026.2752856.Checked: Abstract only