Synthetic MRI and radiomics in multiple sclerosis: improving precision in diagnosis and prognosis

Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by inflammation, neurodegeneration, and gliosis in the central nervous system (CNS). While conventional magnetic resonance imaging (MRI) is essential for diagnosing and monitoring MS, it often fails to detect subtle microstructural changes. Synthetic MRI (SyMRI) produces multiple contrast-weighted images from a single acquisition and has emerged as a valuable tool for detailed tissue analysis. Combining SyMRI with radiomics, a method for extracting high-dimensional, sub-visual features from images, holds promise for enhancing MS assessment. This review critically evaluates the potential of this integration to improve lesion characterization, uncover early biomarkers of disease progression, and provide a more quantitative framework for monitoring treatment response, thereby moving towards personalized management strategies.