Textural analysis and artificial intelligence as decision support tools in the diagnosis of multiple sclerosis - a systematic review

Introduction Magnetic resonance imaging (MRI) is conventionally used for the detection and diagnosis of multiple sclerosis (MS), often complemented by lumbar puncture-a highly invasive method-to validate the diagnosis. Additionally, MRI is periodically repeated to monitor disease progression and treatment efficacy. Recent research has focused on the application of artificial intelligence (AI) and radiomics in medical image processing, diagnosis, and treatment planning. Methods A review of the current literature was conducted, analyzing the use of AI models and texture analysis for MS lesion segmentation and classification. The study emphasizes common models, including U-Net, Support Vector Machine, Random Forest, and K-Nearest Neighbors, alongside their evaluation metrics. Results The analysis revealed a fragmented research landscape, with significant variation in model architectures and performance. Evaluation metrics such as Accuracy, Dice score, and Sensitivity are commonly employed, with some models demonstrating robustness across multi-center datasets. However, most studies lack validation in clinical scenarios. Discussion The absence of consensus on the optimal model for MS lesion segmentation highlights the need for standardized methodologies and clinical validation. Future research should prioritize clinical trials to establish the real-world applicability of AI-driven decision support tools. This review provides a comprehensive overview of contemporary advancements in AI and radiomics for analyzing and monitoring emerging MS lesions in MRI.