Current Imaging Practices for Diagnosing and Monitoring MS Progression

In this episode, the panel discusses how clinicians use MRI and other imaging tools to track the progression of multiple sclerosis. They describe traditional methods, such as comparing sequential brain scans to detect new lesions or signs of disease activity and using both brain and spinal cord imaging to capture changes that might affect mobility or cognition. The use of contrast agents, like gadolinium, is considered, with many panelists noting they reserve it for specific scenarios rather than routine monitoring. The group acknowledges limitations, pointing out that many patients with progressive MS do not show new lesions on imaging even as their symptoms worsen. While some centers use advanced metrics like brain or thalamic volume loss, access to these is not universal. The conversation emphasizes the need for both careful visual review of MRIs and individualized imaging strategies, as well as the importance of better tools for assessing subtle disease progression.