Multiple Sclerosis Centers Revise MRI Guidelines

Driven by new developments, the Consortium of Multiple Sclerosis Centers (CMSC) has revised MRI guidelines for using MRI to diagnosis individuals suspected of having MS.

The big question that a majority of neurologists ponder over is how often they should be monitoring their MS patients with MRI scans. “We tell them that they should be monitoring patients who are on treatment at least once a year with standard MRI. That will give them important information on whether the patient is stable or if there's evidence of new disease activity that might prompt a change in treatment,” said Dr. Anthony Traboulsee, research chair of the MS Society of Canada at the University of British Columbia.

In January of 2017, a group of experts consisting of radiologists, neurologists, and imaging scientists from North America and Europe, met in Newark, New Jersey, to revise the guidelines. The experts included those from the Radiological Society of North America, The American Academy of Neurology, the American Society of Neuroradiology, and the North American Imaging in Multiple Sclerosis Cooperative. They updated information on MRI scans of the brain and spinal cord, regarding situations for which the scans should be used to diagnosis and monitor MS. The newly-revised MRI guidelines were released on CMSC’s website, under the document - “Revised Guidelines of the CMSC MRI Protocol for the Diagnosis and Follow-up of MS.”

Use of a contrast agent has been modified

One particular change made under the newly-revised MRI guidelines was the use of gadolinium, a contrast agent, in the MRI scans of the brain and spinal cord. The group of experts formed opinions based on new data, which focused on the use of gadolinium in four imaging protocols: spinal cord, routine brain, progressive multifocal leukoencephalopathy surveillance, and orbits. Previous published guidelines showed no limitations to using gadolinium; however, data surfaced about how although gadolinium is not toxic, it can build up in the brain. Therefore, the U.S. FDA recommends limiting dosages of gadolinium-based contrast agents (GBCAs) to “appropriate clinical circumstances.” They also urge producers of GBCAs to perform human and animal research studies in order to further evaluate the safety and tolerability of these agents.

Read on to learn more about the updated MRI guidelines for multiple sclerosis.