{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:07:52Z","timestamp":1783930072590,"version":"3.55.0"},"reference-count":59,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,14]],"date-time":"2025-09-14T00:00:00Z","timestamp":1757808000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Spinal cord pathology underpins disability accumulation in people with multiple sclerosis (pwMS). Visual inspection of spinal cord magentic resonance imaging (MRI) often fails to reliably detect injury. Radiomics analyzes signal intensities in images to identify pathological changes that may be imperceptible to the human eye. This study evaluated the application of radiomics to spinal cord MRI to distinguish subgroups of pwMS and disability correlations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Radiomic features were extracted from upper cervical cord coverage on cross\u2010sectional 3.0T brain noncontrasted T1\u2010weighted MRI scans in pwMS and healthy controls (HCs). Ninety\u2010three radiomic features\u2014predominantly gray\u2010level matrices\u2014were extracted using Pyradiomics, with pixel heterogeneity considered to reflect neuroaxonal pathology. T2 lesion and brain substructure volumes were segmented from 3D fluid\u2010attenuated inversion recovery and magnetization\u2010prepared rapid gradient\u2010echo sequences using an in\u2010house 2.5D U\u2010Net convolutional neural network to encapsulate neuroinflammation and neurodegeneration. Cervical cross\u2010sectional area (C1\u2212C3) was measured using in\u2010house atlas\u2010based segmentation. Imaging features were compared between pwMS and HCs, and pwMS by phenotype (relapsing vs. progressive), age, and race. Associations of imaging features with Patient\u2010Determined Disease Steps (PDDS) were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2966 pwMS and 41 HCs, we identified radiomic features distinguishing pwMS from HCs, and pwMS by phenotype, age, and race. Radiomic features exhibited stronger correlations with PDDS than conventional MRI measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Radiomics identified pathological changes in pwMS in varying stages of the disease course that are undetectable by conventional spinal cord MRI. Radiomics may increase the yield of spinal cord MRI in pwMS and serve as biomarkers predicting disability worsening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70089","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T03:35:39Z","timestamp":1757907339000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Spinal Cord Radiomic Features and Disability in Multiple Sclerosis"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3306-0988","authenticated-orcid":false,"given":"Jeffrey","family":"Lambe","sequence":"first","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research Neurology Department Cleveland Clinic Lerner College of Medicine of Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas R.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic  Cleveland Ohio USA"},{"name":"Neurological Institute Center for Outcomes Research &amp; Evaluation Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yadi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic  Cleveland Ohio USA"},{"name":"Neurological Institute Center for Outcomes Research &amp; Evaluation Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7833-8138","authenticated-orcid":false,"given":"Kunio","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Cleveland Clinic Research Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Ontaneda","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research Neurology Department Cleveland Clinic Lerner College of Medicine of Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61620-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21423"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756286419859722"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awx247"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/135245859900500415"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00019052-200206000-00003"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24241"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008466"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000036566.00866.26"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-019-09591-8"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2011.11.036"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015151169"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2022.103756"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-023-10529-y"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-021-03015-w"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06026-w"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2025.106315"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000094"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awae251"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy245"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7274"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2024.01.032"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30470-2"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000560"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1109\/42.668698"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-199403000-00005"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24574-4_28"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2012.01.021"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.101525"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.05.077"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.media.2007.06.004"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-17-0339"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1109\/TSMC.1973.4309314"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0146-664X(75)80008-6"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1142\/S0218001413570024"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1109\/21.44046"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/0734-189X(83)90032-4"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-16520-9"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.05.053"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.45.2.251"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/135245859900500508"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.3791\/51318"},{"key":"e_1_2_8_44_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2020"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-11829-5"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1177\/13524585241260145"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.62.2.226"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s003300050058"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2021.679941"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1522-2594(199911)42:5<929::AID-MRM13>3.0.CO;2-2"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23867"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458519868990"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26843"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181cff6fb"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.13122566"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-308021"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1080\/23808993.2016.1164013"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000210259"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.0993"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.12.064"}],"container-title":["Journal of Neuroimaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jon.70089","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jon.70089","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jon.70089","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:24:11Z","timestamp":1783927451000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jon.70089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":59,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/jon.70089"],"URL":"https:\/\/doi.org\/10.1111\/jon.70089","archive":["Portico"],"relation":{},"ISSN":["1051-2284","1552-6569"],"issn-type":[{"value":"1051-2284","type":"print"},{"value":"1552-6569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-05-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70089"}}