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Cited by 674Multiple Sclerosis Research StudiesAdvanced MRI Techniques and ApplicationsPolyomavirus and related diseases

2021 MAGNIMS–CMSC–NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis

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Wattjes, Mike P, Ciccarelli, Olga, Reich, Daniel S, Banwell, Brenda, de Stefano, Nicola, Enzinger, Christian, Fazekas, Franz, Filippi, Massimo +46 more·2021·The Lancet Neurology
DOI 10.1016/s1474-4422(21)00095-8
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Abstract

The 2015 Magnetic Resonance Imaging in Multiple Sclerosis and 2016 Consortium of Multiple Sclerosis Centres guidelines on the use of MRI in diagnosis and monitoring of multiple sclerosis made an important step towards appropriate use of MRI in routine clinical practice. Since their promulgation, there have been substantial relevant advances in knowledge, including the 2017 revisions of the McDonald diagnostic criteria, renewed safety concerns regarding intravenous gadolinium-based contrast agents, and the value of spinal cord MRI for diagnostic, prognostic, and monitoring purposes. These developments suggest a changing role of MRI for the management of patients with multiple sclerosis. This 2021 revision of the previous guidelines on MRI use for patients with multiple sclerosis merges recommendations from the Magnetic Resonance Imaging in Multiple Sclerosis study group, Consortium of Multiple Sclerosis Centres, and North American Imaging in Multiple Sclerosis Cooperative, and translates research findings into clinical practice to improve the use of MRI for diagnosis, prognosis, and monitoring of individuals with multiple sclerosis. We recommend changes in MRI acquisition protocols, such as emphasising the value of three dimensional-fluid-attenuated inversion recovery as the core brain pulse sequence to improve diagnostic accuracy and ability to identify new lesions to monitor treatment effectiveness, and we provide recommendations for the judicious use of gadolinium-based contrast agents for specific clinical purposes. Additionally, we extend the recommendations to the use of MRI in patients with multiple sclerosis in childhood, during pregnancy, and in the post-partum period. Finally, we discuss promising MRI approaches that might deserve introduction into clinical practice in the near future.

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Authors
Wattjes, M. P., Ciccarelli, O., Reich, D. S., Banwell, B., de Stefano, N., Enzinger, C., Fazekas, F., Filippi, M., Frederiksen, J., Gasperini, C., Hacohen, Y., Kappos, L., Li, D. K. B., Mankad, K., Montalban, X., Newsome, S. D., Oh, J., Palace, J., Rocca, M. A., Sastre-Garriga, J., Tintoré, M., Traboulsee, A., Vrenken, H., Yousry, T., Barkhof, F., Rovira, À., Wattjes, M. P., Ciccarelli, O., de Stefano, N., Enzinger, C., Fazekas, F., Filippi, M., Frederiksen, J., Gasperini, C., Hacohen, Y., Kappos, L., Mankad, K., Montalban, X., Palace, J., Rocca, M. A., Sastre-Garriga, J., Tintore, M., Vrenken, H., Yousry, T., Barkhof, F., Rovira, A., Li, D. K. B., Traboulsee, A., Newsome, S. D., Banwell, B., Oh, J., Reich, D. S., Reich, D. S., & Oh, J.
Venue
The Lancet Neurology
Publisher
Elsevier BV
Published
2021-08
Volume
20
Issue
8
Pages
653-670
ISSN
1474-4422 (ISSN-L)
DOI
10.1016/s1474-4422(21)00095-8
OpenAlex
W3171747481
Cited by
674
References
3
Citations by year
2026: 100 · 2025: 127 · 2024: 166 · 2023: 146 · 2022: 104 · 2021: 30 · 2016: 1
FWCI
74.33
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
  • Use Siena air (University of Siena) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • Pfizer
  • GlaxoSmithKline España
  • Schweizerische Multiple Sklerose Gesellschaft
  • Novartis
  • Roche España
  • UCLH Biomedical Research Centre
  • Sanofi
  • Multiple Sclerosis Society of Canada
  • EMD Serono
  • Ministero della Salute
  • UCB
  • MedImmune
  • Eli Lilly and Company
  • Sanofi Genzyme
  • Siemens
  • F. Hoffmann-La Roche
  • Bayer HealthCare
  • National Institutes of Health
  • Fondazione Italiana Sclerosi Multipla
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
  • National Institute of Neurological Disorders and Stroke
  • Chugai Pharmaceutical
  • National Multiple Sclerosis Society
  • Ono Pharmaceutical
  • National Institute for Health and Care Research
  • MedDay Pharmaceuticals
  • Biogen
  • Multiple Sclerosis Society
  • Teva Pharmaceutical Industries
  • European Commission
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
  • Health Sciences › Medicine › Oncology › Polyomavirus and related diseases
Keywords
multiple sclerosis, magnetic resonance imaging, MRI acquisition protocol, FLAIR, gadolinium-based contrast agents, spinal cord MRI, disease surveillance, prognosis, pediatric multiple sclerosis, pregnancy, postpartum period
MeSH terms
Adolescent, Adult, Aged, Child, Contrast Media, Female, Gadolinium, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Monitoring, Physiologic, Multiple Sclerosis, Pediatrics, Pregnancy, Prognosis, Reproducibility of Results, Treatment Outcome, Disease Progression, Consensus, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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