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Related Concept Videos

Magnetic Resonance Imaging01:24

Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) is a noninvasive medical imaging technique based on a phenomenon of nuclear physics discovered in the 1930s, in which matter exposed to magnetic fields and radio waves was found to emit radio signals. In 1970, a physician and researcher named Raymond Damadian noticed that malignant (cancerous) tissue gave off different signals than normal body tissue. He applied for a patent for the first MRI scanning device in clinical use by the early 1980s. The early MRI...

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Harmonized magnetic resonance imaging protocols for multiple sclerosis: HARMONY-MS, a pilot project.

Andrea Surcinelli1, Ilaria Massa2, Nicola Gentili3

  • 1Department of Neuroscience, Multiple Sclerosis Center-Neurology Unit, S. Maria Delle Croci Hospital, AUSL Romagna, Viale Vincenzo Randi 5, 48121, Ravenna, Italy. andrea.surcinelli@auslromagna.it.

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|December 22, 2025
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Summary

Implementing harmonized Magnetic Resonance Imaging (MRI) protocols in multiple sclerosis (MS) care significantly reduced contrast use and costs. This approach improved scanner efficiency while maintaining stable clinical outcomes and supporting earlier high-efficacy treatment initiation.

Keywords:
GadoliniumHarmonizationHealth care efficiencyMagnetic resonance imagingMultiple sclerosisSustainability

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Area of Science:

  • Neuroimaging
  • Clinical Practice Guidelines
  • Health Services Research

Background:

  • Magnetic Resonance Imaging (MRI) is crucial for multiple sclerosis (MS) management.
  • Current MRI practices in MS often deviate from established guidelines.
  • Large-scale studies evaluating harmonized MRI protocols are limited.

Purpose of the Study:

  • To assess the impact of harmonized MRI referral and acquisition protocols in MS care.
  • To evaluate changes in MRI utilization, costs, and clinical outcomes.
  • To determine the feasibility of a scalable model for guideline-concordant MS imaging.

Main Methods:

  • Retrospective observational study of CNS MRI examinations in a large Italian healthcare system (N=143,592).
  • Analysis of MRI volumes, scanner time, and gadolinium expenditure using statistical models (Poisson, Gamma, ITS).
  • Evaluation of clinical outcomes including relapse rates, MRI inflammatory activity, and No Evidence of Disease (NEDA-3), and disease-modifying therapy (DMT) initiation.

Main Results:

  • Contrast-enhanced MRI and gadolinium studies decreased by over 90%; total MRI volume reduced by 86%.
  • Significant reductions in scanner time and gadolinium expenditure were observed.
  • Annualized relapse rate (ARR) decreased, while NEDA-3 and first-line high-efficacy DMT use increased significantly.

Conclusions:

  • The HARMONY-MS program successfully reduced contrast use, unnecessary imaging, and healthcare costs.
  • The study demonstrates a scalable model for guideline-adherent MS MRI practices.
  • This approach supports stable clinical outcomes and promotes earlier initiation of effective DMTs.