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300 Improving the diagnosis and classification of facial pain conditions with MRI-based features

Published online by Cambridge University Press:  19 April 2022

Kellen Mulford
Affiliation:
University of Minnesota
Sean Moen
Affiliation:
University of Minnesota
Andrew W. Grande
Affiliation:
University of Minnesota
Donald R. Nixdorf
Affiliation:
University of Minnesota
Pierre-Francois Van de Moortele
Affiliation:
University of Minnesota
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Abstract

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OBJECTIVES/GOALS: Trigeminal Neuralgia (TN) is a debilitating neuropathic condition characterized by electric-shock-like pain attacks. TN is considered a clinical diagnosis, and few proposed objective markers exist. This work studies the ability of advanced MRI techniques to diagnose and classify TN. METHODS/STUDY POPULATION: Anatomical MRI data from patients undergoing radiosurgery to treat TN was collected. A custom deep-learning UNet algorithm was trained to segment trigeminal nerves from the pons to the anterior wall of Meckels cave using segments drawn by an expert in neuroanatomy. 108 radiomics features related to nerve shape, voxel intensity, and image texture were extracted from the segmented nerves. A 2 layer neural network was trained to distinguish TN affected nerves from the pain-free contralateral nerves. Feature selection was performed within a cross-validation scheme to prevent model overfitting. Mean model performance over the validation sets was used to estimate model generalizability. RESULTS/ANTICIPATED RESULTS: 134 patients and 268 nerves were included. The average number of years with TN was 8. The average validation set accuracy was 78% [range: 75-80%]. The average validation set sensitivity and specificity were 0.82 [range: 0.79-0.84] and 0.76 [range: 0.70-0.79]. 34% of patients had undergone a prior invasive procedure to treat their TN. To evaluate whether the model detected signal changes relating to the previous treatment, those patients were excluded and the model was retrained on the surgically naive patients. Model performance in a reduced cohort of patients was similar to the model trained on all the patients, with accuracy of 77% [range: 73-82%]. DISCUSSION/SIGNIFICANCE: This study suggests that radiomics features calculated from MRIs of trigeminal nerves correlate with anatomical changes in TN affected nerves. This technique will need to be verified in a larger, more heterogeneous cohort of TN patients with a range of MRI acquisition parameters.

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Valued Approaches
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2022. The Association for Clinical and Translational Science