Advanced MRI Methods for Diagnosis and Monitoring of Multiple Sclerosis (MS)

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Multiple sclerosis (MS) is an autoimmune neuroinflammatory disorder impacting the central nervous system (CNS), characterized by demyelination.
• Conventional MRI sequences (T1w, T2w, FLAIR, T1ce) are standard for MS diagnosis but have limitations in detecting subtle lesions and differentiating subtypes.
• Radiologist expertise and difficulty in assessing normal-appearing white and gray matter heterogeneity pose challenges for conventional MRI.

Purpose of the Study:

• To review advanced MRI methods for diagnosing and monitoring multiple sclerosis (MS).
• To explore novel biomarkers for demyelination and neurodegeneration in MS using advanced MRI techniques.
• To discuss the weaknesses and future prospects of advanced MRI in MS imaging and propose an optimized imaging protocol.

Main Methods:

• Review of advanced MRI techniques including MRS, MT, DTI, QSM, Na-MRI, DIR, PSIR, M2PRAGE, Rs-fMRI, DWI, SWI, MWI, MRF, CEST MRI, and USPIO.
• Analysis of current knowledge, weaknesses, and future potential of these advanced MRI methods.
• Inclusion of original clinical images and discussion of disease progression monitoring.

Main Results:

• Advanced MRI methods show promise in overcoming limitations of conventional MRI for MS diagnosis and monitoring.
• These techniques offer improved accuracy in detecting demyelination and assessing neurodegeneration.
• Novel biomarkers for MS pathophysiology can be derived from advanced MRI data.

Conclusions:

• Advanced MRI techniques provide enhanced diagnostic accuracy and monitoring capabilities for multiple sclerosis (MS).
• These methods offer novel biomarkers for understanding MS pathophysiology and disease progression.
• The proposed advanced MRI protocol aims to optimize imaging for MS across various disease stages.