title: Clinical applications of imaging disease burden in multiple sclerosis: MRI and advanced imaging techniques.
abstract: This review will address the critical role of radiographic techniques in monitoring multiple sclerosis disease course and response to therapeutic interventions using conventional imaging. We propose an algorithm of obtaining a contrast-enhanced brain MRI 6 months after starting a disease-modifying therapy, and considering a gadolinium-enhancing lesion on that scan to indicate suboptimal response to therapy. New or enlarging T2 lesions should be followed on scans at 6-month intervals to assess for change, and the presence of one or more enhancing lesions on a 6- or 12-month scan, or two or more new or enlarging T2 lesions on a 12-month scan should prompt consideration of therapy change. New techniques such as PET imaging, magnetic resonance spectroscopy, magnetic resonance relaxometry, iron-sensitive imaging and perfusion MRI will also be overviewed, with their potential roles in monitoring disease course and activity.
authors.affiliation: Yale University School of Medicine, Yale Multiple Sclerosis Center, 40 Temple St LL, New Haven, CT 06510, USA. claire.riley@yale.edu
authors.forename: Claire
authors.initials: C
authors.lastname: Riley
authors.forename: Christina
authors.initials: C
authors.lastname: Azevedo
authors.forename: Mary
authors.initials: M
authors.lastname: Bailey
authors.forename: Daniel
authors.initials: D
authors.lastname: Pelletier
mesh_terms: D000465:Algorithms; D001921:Brain / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000175:diagnosis*