Click here to receive MS news via e-mail
MRI Guidelines in MS UpdatedAnnual 3D imaging using gadolinium contrast is recommended to monitor patients with multiple sclerosis, a guideline update notes.Pauline Anderson – May 29, 2015
INDIANAPOLIS, Indiana — A panel of neurology and radiology experts has updated imaging protocols for patients with multiple sclerosis (MS) that promise to improve diagnostic accuracy.
The panel recommends using higher-resolution three-dimensional (3D) imaging over two-dimensional (2D) imaging wherever possible because it’s faster and better able to show breakthrough disease activity, said Anthony Traboulsee, MD, University of British Columbia, Vancouver, who led the expert panel.
“The advantage of 3D imaging technology is that it provides complete coverage of the brain, so you’re not missing pieces like we were before, said Dr Traboulsee.
Not only can it improve detection of lesions, but it make it easier to compare a patient over time, he added. “We are comparing apples to apples now.”
|
|
|
Dr Anthony Traboulsee
|
Dr Traboulsee discussed MRI guidelines at the Consortium of Multiple Sclerosis Centers (CMSC) 2015 Annual Meeting.
About 80% of scanners in North America have 3D imaging. If a 3D scanner isn’t available, Dr Traboulsee suggests making sure to use a “good-quality” 2D scanner.
Physicians should order a first MRI as soon as they suspect a patient may have MS and then a series of subsequent MRIs to confirm that suspicion. Typically, a patient with MS eventually would undergo MRI once a year.
Big Question
“The big question for neurologists is how often should they be monitoring their MS patients with MRI,” Dr Traboulsee told Medscape Medical News. “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.”
However, there are exceptions. For example, a scan every 6 months might be in order for patients with a more aggressive, active disease course, or those who have just changed therapy in whom it’s important to see whether the new therapy is working.
As well, more frequent scanning is recommended to monitor for progressive multifocal leukoencephalopathy in patients taking natalizumab (Tysabri, Biogen), who are at high risk for this condition. For these patients, diffusion-weighted imaging would be added to the imaging protocol, said Dr Traboulsee.
MRI can be used to help diagnose MS or clinically isolated syndromes. But it’s important not to use MRI scans by themselves because this can lead to misdiagnosis, said Dr Traboulsee.
“If you take 100 normal people off the street, 5% of them will have an abnormal-looking brain MRI — it’s just the way they were put together; it doesn’t mean they have MS.”
White Spots
And in certain patient populations, it might be even more difficult to read an MRI correctly. “If you do an MRI in people over age 60, they will have white spots that look like MS, but that’s just part of natural aging.”
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
MS Views and News
Provides educational information, resources and services for those affected by MS
We Believe YOU (the MS Patients and Caregivers) should Be Empowered with Multiple Sclerosis information
.===================================
Visit our MS Learning Channel on YouTube: http://www.youtube.com/msviewsandnews