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The contemporary role of MRI in the monitoring and management of people with multiple sclerosis in the UK

(2021) The contemporary role of MRI in the monitoring and management of people with multiple sclerosis in the UK. Multiple Sclerosis and Related Disorders , 55 , Article 103190. 10.1016/j.msard.2021.103190. Green open access

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Abstract

BACKGROUND: Compare the contemporary use of magnetic resonance imaging (MRI) in the monitoring and management of people with MS in the UK to current consensus guidelines. METHODS: This retrospective multicentre audit of clinical practice gathered data on 2567 patients with MS from 25 MS centres across the UK. RESULTS: Routine monitoring (44.7%), and recent clinical relapse (20.3%) were the most common scan indications. In routine monitoring, the addition of spinal imaging to brain showed no significant difference in disease modifying treatment (DMT) decision at subsequent clinical review. Approximately 1 in 5 gadolinium administered scans showed enhancement, and in 1 in 20 patients, gadolinium enhancement was the only evidence of radiological disease activity. Mean inter-scan intervals in relapsing-remitting MS for routine monitoring was 19.2 months (SD 20.7) with wide variation between centres. Only 53.8% of patients under progressive multifocal leukoencephalopathy (PML) surveillance met the recommended scanning frequency. MRI protocols demonstrated heterogeneity in the sequences used for diagnostic, monitoring and PML surveillance scans. CONCLUSIONS: MS centres across the UK demonstrate varied practice and protocols when using MRI to monitor people with MS. In this cohort, gadolinium use and spinal imaging demonstrates limited impact on subsequent DMT decisions.

Type: Article
Title: The contemporary role of MRI in the monitoring and management of people with multiple sclerosis in the UK
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.msard.2021.103190
Publisher version: https://doi.org/10.1016/j.msard.2021.103190
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Multiple sclerosis, Magnetic resonance imaging, Progressive multifocal leukoencephalopathy, Disease modifying treatment, Neuroimaging
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/10134894
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