Sensitive and reproducible techniques for spinal cord morphometry on magnetic resonance images with application to multiple sclerosis

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Multiple sclerosis (MS) attacks the brain and spinal cord, which can lead to severe disability. Magnetic resonance imaging (MRI) is a highly sensitive tool for observing MS damage in vivo, and is therefore used in the majority of clinical trials evaluating the efficacy of new MS therapies. To understand the complex pathology of MS, the disease-induced changes in both the brain and the spinal cord must be studied and precisely measured where possible. However, while accurate image analysis algorithms for measuring structural changes in the brain are commonly used in MS studies, and the morphometry of specific brain structures remains a very active area of research, the development of algorithms for spinal cord analysis seems to be lagging. The main objective of the proposed project is to improve the sensitivity and reproducibility of spinal cord morphometry on MRI for studying MS. We will design and implement new software methods to address a number of technical issues that we have identified. Pilot data will be collected on healthy volunteers for initial development of the new algorithms, with subsequent validation performed on real clinical data from the MS/MRI Research Group, an interdisciplinary group at the University of British Columbia with extensive experience in the application of neuroimaging biomarkers in MS clinical trials. The primary mandate of the MS/MRI Research Group is to develop better trial methodologies to improve the lives of patients with neurological diseases. MS costs the Canadian economy over $1 billion dollars per year in prescription medications, medical services, and lost earnings. We believe that increasing the sensitivity of spinal cord MRI biomarkers would have a strong impact on the cost-effectiveness of developing new MS drugs, which would directly benefit the pharmaceutical industry and Canadian health care system. By making the drug development process more efficient, better drugs can get to market faster, and the burden of MS on Canadian patients and the economy can be reduced.