Related Experiment Video
Updated: Jul 2, 2026

Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
Missed radiologic disease activity by conventional side-by-side MRI comparison is associated with future disease
Suradech Suthiphosuwan1, Timothy Reynold Lim1, Fasna Raufdeen2
1Department of Medical Imaging, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Background:
Monitoring radiologic disease activity (RDA) is standard of care in multiple sclerosis (MS) because new lesions on magnetic resonance imaging (MRI) are associated with adverse outcomes and frequently prompt treatment reassessment and optimization. Coregistration-fusion comparison (CF) is more sensitive than conventional side-by-side comparison (CS) for detecting new lesions.
Objectives:
To apply CF to identify CS-missed RDA on brain MRIs originally reported as "stable" and to evaluate whether CS-missed RDA predicts future disease activity.
Methods:
This retrospective cohort included 314 people with MS (pwMS) with three consecutive brain MRIs: previous MRI (t1), index MRI (t2; reported "stable" on CS), and subsequent MRI (t3). CF was applied to three-dimensional Fluid-Attenuated Inversion Recovery (FLAIR) to identify CS-missed new lesions on t2 versus t1. Future RDA was defined as ⩾1 new lesion on t3 versus t2. Clinical disease activity (CDA) was defined as clinical relapse and/or confirmed disability progression during follow-up after t2.
Results:
CF identified 183 CS-missed new lesions in 65/314 pwMS (20.7%). Future RDA (70.8% vs. 16.1%; p < 0.001) and CDA (20.0% vs. 10.0%; p = 0.028) were more frequent in the CS-missed lesion group. Relapse and disability progression, when analyzed separately, did not differ between groups. CS-missed RDA independently predicted future RDA (adjusted odds ratio (aOR) = 10.43; 95% confidence interval (CI) = 5.31-20.46, p < 0.001) and CDA (aOR = 2.49; 95% CI = 1.10-5.65, p = 0.029). Each additional missed lesion at t2 was associated with more new lesions at t3 (incidence rate ratio (IRR) = 1.205; 95% CI = 1.184-1.226, p < 0.001).
Conclusion:
CF reclassified one in five pwMS reported as "stable" on CS as having CS-missed RDA, which predicted future disease activity.
Related Concept Videos
Magnetic Resonance Imaging
Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
Imaging Studies IV: Magnetic Resonance Imaging
Imaging Studies II: Positron Emission Tomography and Scintigraphy
Fundamental Principles of PET
Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
Imaging Studies III: Computed Tomography
