Revised 2017 MRI guidelines for MS released

In January 2017, groups of neurologists, radiologists, and imaging scientists from North America and Europe met in Newark, New Jersey, to revise and update brain and spinal cord MRI guidelines to diagnosis and monitor multiple sclerosis (MS). On October 11, the official 2017 MRI guidelines were officially released on The Consortium of Multiple Sclerosis Centers (CMSC) website.

The meeting, sponsored by CMSC, addressed concerns when using gadolinium in MRIs. The 2017 guidelines were made based on new data, survey results and opinions from meeting attendees, with a focus on the use of gadolinium in four imaging protocols: routine brain, progressive multifocal leukoencephalopathy surveillance, spinal cord and orbits.

Attendees at the meeting included the American Academy of Neurology, the Radiological Society of North America, the American Society of Neuroradiology and the North American Imaging in Multiple Sclerosis Cooperative.

Below is a summary of the official 2017 MRI guidelines for MRI protocol in diagnosing and monitoring MS:

• A brain MRI with gadolinium is recommended for the diagnosis of MS.
• A spinal cord MRI is recommended if the brain MRI is non-diagnostic or if the presenting symptoms are at the level of the spinal cord.
• Recommendations for a follow-up evaluation include brain MRI to demonstrate dissemination in time and ongoing clinically silent disease activity while on treatment, to evaluate unexpected clinical worsening, for reassessment of the original diagnosis and for use as a new baseline MRI before starting or modifying therapy.
• A routine brain MRI should be considered every six months to two years for patients with relapsing MS.
• Gadolinium-based contrast agents should be used only when necessary.
• The clinical question being addressed should be included in the requisition for the MRI.

Please note, revised guidelines are subject to change pending review by the CMSC Task Force.