Updated Guidelines on the Role of MRI in Multiple Sclerosis

International consensus recommendations on the use of standardized magnetic resonance imaging (MRI) in multiple sclerosis (MS) developed by the Magnetic Resonance Imaging in MS (MAGNIMS) group, the Consortium of Multiple Sclerosis Centers (CMSC), and the North American Imaging in MS Cooperative (NAIMS) were presented at the 2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers, held October 25-28, 2021 in Orlando, Florida.

Previously, the MAGNIMS group published guidelines on the use of MRI in 2015 and the CMSC published recommendations on the diagnosis and monitoring of patients with MS and for the appropriate use of MRI in 2016. The current consensus merges recommendations from the 3 groups.

A panel of experts that convened in Graz, Austria, in April 2019 reviewed and updated the MAGNIMS guidelines and a second panel that convened in Newark, New Jersey, USA, in October 2019, updated the CMSC guidelines. Subsequently, all 3 groups collaborated to reach an international consensus.

The recommendations are intended to improve the use of MRI for diagnosis, prognosis, and monitoring of patients with MS. Core brain sequences are used for lesion identification and monitoring response to treatment, and gadolinium-based contrast is recommended for diagnostic studies.

For safety monitoring of patients with progressive multifocal leukoencephalopathy, additional diffusion-weighted imaging are recommended.

In the future, high resolution 3D-T1 weighted MRI may be recommended for brain atrophy monitoring, double inversion recovery/phase sensitive inversion recovery may be used for identifying cortical lesions, and susceptibility weighted imaging may be recommended for the central vein sign evaluation.

“Dissemination of the 2021 evidence-based MAGNIMS-CMSC-NAIMS international consensus guidelines through congress would be a welcome addition to the advocacy efforts in promoting the use of standardized MRI in MS diagnosis and follow-up of people with MS,” concluded the researchers.

Reference

Traboulsee A, Wattjes M, Ciccarelli O, et al. International MAGNIMS-CMSC-NAIMS consensus recommendations on the use of standardized magnetic resonance imaging in multiple sclerosis. Presented at: CMSC 2021 Annual Meeting; October 25-28, 2021; Orlando, Florida. Abstract IMG03.