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A multi-reader study based on retrospective data was performed between December 2023 and June 2024 to compare the performance of 20 clinicians in interpreting upper and lower SC acquisitions with and without the use of the tool. A ground truth was established by three experts. Sensitivity, precision, and inter-reader variability were evaluated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We included 50 patients (39 females, median age: 41 years [range: 15\u201367]) with SC MRI acquired between February 2017 and December 2022. When reading with the tool, the clinicians\u2019 mean sensitivity to detect SC lesions improved (from 74.3% [95% CI\u2009=\u200967.8\u201380.6%] to 79.2% [95% CI: 73.5\u201385.0%]; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), with no evidence of difference in the mean precision: (69.0% [95% CI: 62.8\u201375.2%] vs 70.1% [95% CI: 64.3\u201375.9%]; <jats:italic>p<\/jats:italic>\u2009=\u20090.08). Inter-reader variability in lesion detection was slightly improved with the tool (Light\u2019s kappa\u2009= 0.55 vs 0.60), but without statistical difference (<jats:italic>p<\/jats:italic>\u2009=\u20090.056).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The use of an automatic tool can help clinicians detect SC lesions in pwMS by increasing their sensitivity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Question<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>No tool to help detect MS SC lesions is used in clinical practice despite their frequency and prognostic value<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Findings<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>This DL-based tool led to improvement in clinicians\u2019 sensitivity in detecting SC lesions from both sagittal T2 and STIR sequences, without decreasing precision<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Clinical relevance<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Our study indicated the potential of a DL-based tool to assist clinicians in the challenging task of detecting SC lesions in people with MS on a combination of sequences commonly acquired in clinical practice<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          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All clinical and imaging data used in the study were extracted (de-identified) from the French MS registry in October 2023 (NCT02889965). All patients included in the OFSEP database consented to the use of their medical data for research purposes, by signed consent after being fully informed. Data confidentiality and security were consistent with the recommendations of the French Data Protection Agency (CNIL).","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained (Rennes local ethics advisory committee no. 24.100).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}