title: MRI in the Diagnosis and Monitoring of Multiple Sclerosis: An Update.
abstract: Magnetic resonance imaging (MRI) is the most powerful tool for the early (differential) diagnosis of multiple sclerosis (MS) and has been part of the International Panel criteria (2001, 2005, 2010) for more than 10 years. The role of brain and spinal cord MRI in the diagnosis of MS is well established. New MR techniques and markers will further improve the diagnostic value in a research and clinical routine setting. In addition to diagnosis, MRI is widely used for prognostic evaluation as well as treatment efficacy and safety monitoring. This field has gained importance with the introduction of new MS therapeutics. Therefore, the scope of MRI-guided MS disease monitoring has been widened to include rigorous treatment monitoring aiming at "no evidence of disease activity (NEDA)". Next, safety monitoring of treated MS patients has become major concern to enable early detection of opportunistic infections such as progressive multifocal leukoencephalopathy (PML). Driven by these new developments, recently published expert panel guidelines stressed the need for standardized imaging protocols and targeted specialized imaging markers for MS diagnosis and disease monitoring. This review article aims to give an update on the role of MRI in the diagnosis and monitoring of MS with particular emphasis to treatment efficacy and safety, both in clinical practice and in research.
authors.affiliation: MS Center and Department of Radiology & Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands. m.wattjes@vumc.nl.
authors.forename: M P
authors.initials: MP
authors.lastname: Wattjes
authors.affiliation: MS Center and Department of Radiology & Nuclear Medicine, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.
authors.forename: M D
authors.initials: MD
authors.lastname: Steenwijk
authors.affiliation: Clinical Neuroimmunology and Neurochemistry, Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Stangel
mesh_terms: D001921:Brain / Q000473:pathology*; D005858:Germany; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000592:standards*; D008279:Magnetic Resonance Imaging / Q000592:standards*; D009103:Multiple Sclerosis / Q000473:pathology*; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013116:Spinal Cord / Q000473:pathology*
keywords: Disease monitoring; MRI; Multiple sclerosis; PML; Safety monitoring