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Cited by 340Multiple Sclerosis Research StudiesAdvanced MRI Techniques and ApplicationsPolyomavirus and related diseases

Revised recommendations of the Consortium of MS Centers task force for a standardized MRI protocol and clinical guidelines for the diagnosis and follow-up of multiple sclerosis

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Traboulsee, A., Simon, J.H., Stone, L., Fisher, E., Jones, D.E., Malhotra, A., Newsome, S.D., Oh, J. +8 more·2016·American Journal of Neuroradiology
DOI 10.3174/ajnr.a4539PMC PMC5094650
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Abstract

An international group of neurologists and radiologists developed revised guidelines for standardized brain and spinal cord MR imaging for the diagnosis and follow-up of MS. A brain MR imaging with gadolinium is recommended for the diagnosis of MS. A spinal cord MR imaging is recommended if the brain MR imaging is nondiagnostic or if the presenting symptoms are at the level of the spinal cord. A follow-up brain MR imaging with gadolinium is recommended to demonstrate dissemination in time and ongoing clinically silent disease activity while on treatment, to evaluate unexpected clinical worsening, to re-assess the original diagnosis, and as a new baseline before starting or modifying therapy. A routine brain MR imaging should be considered every 6 months to 2 years for all patients with relapsing MS. The brain MR imaging protocol includes 3D T1-weighted, 3D T2-FLAIR, 3D T2-weighted, post-single-dose gadolinium-enhanced T1-weighted sequences, and a DWI sequence. The progressive multifocal leukoencephalopathy surveillance protocol includes FLAIR and DWI sequences only. The spinal cord MR imaging protocol includes sagittal T1-weighted and proton attenuation, STIR or phase-sensitive inversion recovery, axial T2- or T2*-weighted imaging through suspicious lesions, and, in some cases, postcontrast gadolinium-enhanced T1-weighted imaging. The clinical question being addressed should be provided in the requisition for the MR imaging. The radiology report should be descriptive, with results referenced to previous studies. MR imaging studies should be permanently retained and available. The current revision incorporates new clinical information and imaging techniques that have become more available.

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  • The qualitative demonstration of two or more CSF-specific oligoclonal bands (OCBs) more reliably indicates intrathecal antibody synthesis than other tests, such as IgG Index.

    “The qualitative demonstration of two or more CSF-specific oligoclonal bands (OCBs) more reliably indicates intrathecal antibody synthesis than other tests, such as IgG Index. 58-60”

    From Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria (2018) · cites this paper as [60]

    The Clinical Guidelines: Diagnostic Imaging for Suspected MS section mentions CSF analysis only as a paraclinical test alongside evoked potentials. Searches for CSF-specific oligoclonal bands, intrathecal antibody synthesis, and IgG Index found no passage addressing the claimed threshold or comparison of test reliability. No page number is available in our copy. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

  • The sensitivity of OCB testing depends on the method used; agarose gel electrophoresis with isoelectric focusing and immunoblotting or immunofixation for IgG is the most sensitive at present.

    “The sensitivity of OCB testing depends on the method used; agarose gel electrophoresis with isoelectric focusing and immunoblotting or immunofixation for IgG is the most sensitive at present. 58-60”

    From Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria (2018) · cites this paper as [60]

    The Clinical Guidelines: Diagnostic Imaging for Suspected MS section mentions CSF analysis only as another test that may aid diagnosis; it does not discuss oligoclonal-band testing methods. Searches for isoelectric focusing, immunoblotting, immunofixation, and OCB sensitivity found no passage addressing which method is most sensitive. Page numbers are unavailable in our copy. (LLM, conf=0.76)

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Authors
Traboulsee, A., Simon, J. H., Stone, L., Fisher, E., Jones, D. E., Malhotra, A., Newsome, S. D., Oh, J., Reich, D. S., Richert, N., Rammohan, K., Khan, O., Radue, E.-W., Ford, C., Halper, J., & Li, D.
Affiliations
  • University of British Columbia (CA)
  • Portland VA Research Foundation (US)
  • Cleveland Clinic (US)
  • University of Virginia (US)
  • Yale University (US)
  • Johns Hopkins University (US)
  • St. Michael's Hospital (CA)
  • National Institutes of Health (US)
  • Biogen (United States) (US)
  • University of Miami (US)
  • Wayne State University (US)
  • University Hospital of Basel (CH)
  • University of New Mexico (US)
ORCID
Venue
American Journal of Neuroradiology
Publisher
American Society of Neuroradiology (ASNR)
Published
2015-11-12
Volume
37
Issue
3
Pages
394-401
ISSN
  • 0195-6108 (ISSN-L)
  • 1936-959X
DOI
10.3174/ajnr.a4539
PMC
PMC5094650
OpenAlex
W2257766930
Cited by
340
References
2
Citations by year
2026: 12 · 2025: 11 · 2024: 18 · 2023: 14 · 2022: 56 · 2021: 44 · 2020: 38 · 2019: 44 · 2018: 47 · 2017: 31 · 2016: 24 · 2015: 1
FWCI
27.27
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • American Journal of Neuroradiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Sanofi
  • Biogen
  • Teva Pharmaceutical Industries
  • F. Hoffmann-La Roche
  • Vertex Pharmaceuticals
  • University of British Columbia
  • National Institutes of Health (Z99 NS999999)
  • National Institute of Neurological Disorders and Stroke (ZIANS003119)
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, MRI protocol standardization, gadolinium-enhanced MRI, spinal cord MRI, brain MRI, disease activity monitoring, relapsing-remitting multiple sclerosis, diffusion-weighted imaging, clinical follow-up, radiology report writing
MeSH terms
Brain, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Multiple Sclerosis, Spinal Cord, Gadolinium DTPA, Neuroimaging

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