Evaluating Early Nerve Injury and Its Relationship With Leprosy Reactions in Patients With Leprosy: A Prospective Cohort Study

Objective: Leprosy is an infectious disease that can be accompanied by disability caused by peripheral neuropathy. Early detection of leprosy is essential to reduce its debilitating sequelae. Ultrasound is a noninvasive test that can detect nerve loss, but ultrasound measurement depends on the skill level of operators. Radiomics is an emerging field related to the extraction and quantification of information, which may provide new solutions for early detection of neuropathy caused by leprosy. This study aimed to combine radiomics and ultrasonography to evaluate nerve damage in the early stages of leprosy in China.

Methods: Patients were enrolled at the Wenshan Prefecture Institute of Dermatology between October 2018 and December 2022. High-resolution ultrasound imaging of the peripheral nerves was performed. Quantitative ultrasound features were extracted from the images from 5 follow-ups. Radiomic features were selected for a comparative analysis of the disease course using a linear mixed-effects model to control for potential confounding effects.

Results: Nine patients with leprosy were enrolled in this study, consisting of 5 males and 4 females with an average age of 34.44 ± 13.58 years. With the change of treatment time, the ultrasound radiomics features of different parts of the linear mixed-effects model showed a trend of change: the nerve density (mean, skewness) was improved, the fascicular structure (kurtosis) was restored, and the abnormal morphological features in some parts were reduced (P < 0.05). Patients with type 1 leprosy reactions exhibited a lower mean and skewness, higher kurtosis, and increased quantitative morphological characteristics.

Conclusion: The study provided the feasibility of ultrasound radiomics to digitally visualize the progression of nerve damage in leprosy patients. Ultrasound radiomics can be a low-cost method with high-throughput characteristics for clinical operators of different skill levels in early nerve injury detection of leprosy.