Updated French OFSEP recommendations for multiple sclerosis MRI: alignment with the 2024 McDonald criteria

Area of Science:

• Radiology
• Neurology
• Medical Imaging

Background:

• Magnetic resonance imaging (MRI) is crucial for diagnosing and monitoring multiple sclerosis (MS).
• The 2024 McDonald criteria update diagnostic standards, including the optic nerve and biomarkers like the central vein sign (CVS) and paramagnetic rim lesion (PRL).

Purpose of the Study:

• To revise the French OFSEP MRI recommendations for MS diagnosis and follow-up.
• Ensure updated protocols are compatible with all 1.5 T and 3 T MRI scanners in France.

Main Methods:

• A multidisciplinary OFSEP-SFNR working group utilized a modified Delphi-like consensus process.
• Developed standardized MRI protocols for brain, orbit, and spinal cord imaging.

Main Results:

• The core brain protocol includes 3D FLAIR, DWI with ADC maps, and susceptibility-sensitive sequences for CVS and PRL detection.
• Diagnostic imaging incorporates contrast-enhanced 3D T1 and orbital protocols for optic neuritis; spinal cord imaging uses complementary sequences.
• Follow-up imaging emphasizes reproducible 3D FLAIR, with restricted gadolinium use.

Conclusions:

• The new framework facilitates earlier and more precise MS diagnosis.
• Standardized protocols aim to reduce unnecessary gadolinium administration across French healthcare centers.