MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

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doi:10.1038/nrneurol.2015.157

Cited by 407 publications

(160 citation statements)

References 136 publications

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“…7 Traditionally, STIR and PDWTSE have been used in combination to overcome each other's shortcomings. 10,23 The LES in WMS was marginally but statistically better than that on STIR and PDWTSE; this finding may be due to better background suppression of the normal white matter. Better LES could also be a result of a shorter TE, which, in addition to improving lesion contrast by decreasing T2-weighting, also limited the dephasing effects of CSF pulsation, which could result in blurring of the tissue interfaces.…”

Section: Discussionmentioning

confidence: 75%

Evaluation of Focal Cervical Spinal Cord Lesions in Multiple Sclerosis: Comparison of White Matter-Suppressed T1 Inversion Recovery Sequence versus Conventional STIR and Proton Density-Weighted Turbo Spin-Echo Sequences

Sundarakumar

Smith

Hwang

et al. 2016

American Journal of Neuroradiology

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Section: Discussionmentioning

confidence: 75%

Evaluation of Focal Cervical Spinal Cord Lesions in Multiple Sclerosis: Comparison of White Matter-Suppressed T1 Inversion Recovery Sequence versus Conventional STIR and Proton Density-Weighted Turbo Spin-Echo Sequences

Sundarakumar

Smith

Hwang

et al. 2016

American Journal of Neuroradiology

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“…However, there is a lack of scientific evidence to support a specific interval between follow‐up examinations. The interindividual variation in disease activity between patients with MS makes it difficult to specify a general examination frequency suitable for all cases, as reflected in the recommendations given in other available guideline documents 21, 23, 28. While we acknowledge this and would like to emphasize that the MRI frequency and timing should be adapted to the clinical situation, it is our opinion that general recommendations of MRI frequency are still valuable in the clinical care of patients.…”

Section: Resultsmentioning

confidence: 99%

“…Revisions of the guidelines will become necessary as the knowledge regarding the use of MRI in the care of individuals with MS evolves. Other important guidelines21, 23, 27, 28, 29, 30 for the current work have been taken into account and the MAGNIMS research group requires special mention 21, 23…”

Section: Methodsmentioning

confidence: 99%

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Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society

et al. 2016

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Multiple sclerosis (MS) is associated with inflammatory lesions in the brain and spinal cord. The detection of such inflammatory lesions using magnetic resonance imaging (MRI) is important in the consideration of the diagnosis and differential diagnoses of MS, as well as in the monitoring of disease activity and predicting treatment efficacy. Although there is strong evidence supporting the use of MRI for both the diagnosis and monitoring of disease activity, there is a lack of evidence regarding which MRI protocols to use, the frequency of examinations, and in what clinical situations to consider MRI examination. A national workshop to discuss these issues was held in Stockholm, Sweden, in August 2015, which resulted in a Swedish consensus statement regarding the use of MRI in the care of individuals with MS. The aim of this consensus statement is to provide practical advice for the use of MRI in this setting. The recommendations are based on a review of relevant literature and the clinical experience of workshop attendees. It is our hope that these recommendations will benefit individuals with MS and guide healthcare professionals responsible for their care.

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“…Subsequent evolution of the NEPAD measure may include the integration of cognitive and visual performance outcomes such as the symbol‐digit modalities test or low‐contrast letter acuity, respectively. Chronic T2 lesions with evolving T1 hypointensity may also be considered as a readout for permanent tissue damage accumulation, as well as whole‐brain volume loss, where more research is needed to discriminate pathological atrophy from normal aging or noise of the measurement, and determine personalized thresholds of annualized rates of brain volume change 28, 29, 30…”

Section: Discussionmentioning

confidence: 99%

Evaluation of no evidence of progression or active disease (NEPAD) in patients with primary progressive multiple sclerosis in the ORATORIO trial

Wolinsky

Montalbán

Hauser

et al. 2018

Annals of Neurology

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ObjectiveNo evidence of progression or active disease (NEPAD) is a novel combined endpoint defined by the absence of both progression and inflammatory disease activity in primary progressive multiple sclerosis (PPMS). In the placebo‐controlled phase III ORATORIO study (NCT01194570), we investigated the effect of ocrelizumab on this comprehensive outcome and its components in a post‐hoc analysis.MethodsThe proportion of patients with NEPAD (no evidence of progression [NEP; no 12‐week confirmed progression of ≥1/≥0.5 points on the Expanded Disability Status Scale if the baseline score was ≤5.5/>5.5 points, respectively; no 12‐week confirmed progression of ≥20% on the Timed 25‐Foot Walk test and 9‐Hole Peg Test], no brain magnetic resonance imaging activity [no new/enlarging T2 lesions and no T1 gadolinium‐enhancing lesions], and no protocol‐defined relapse) from baseline to week 120 was determined in ocrelizumab‐ (600 mg; n = 465) and placebo‐treated (n = 234) patients.ResultsThe majority of ORATORIO study patients with PPMS experienced clinical progression or evidence of disease activity. From baseline to week 120, 29.9% and 42.7% ocrelizumab‐treated compared to 9.4% and 29.1% placebo‐treated patients maintained NEPAD (relative risk [95% confidence interval {CI}], 3.15 [2.07–4.79]; p < 0.001) and NEP (relative risk [95% CI], 1.47 [1.17–1.84]; p < 0.001), respectively. Effects on the individual components of both measures were consistent with the compound outcomes.InterpretationCompared to placebo, ocrelizumab enhanced 3‐fold the proportion of PPMS patients with no evidence of either progression or inflammatory disease activity. NEPAD may represent a sensitive and meaningful comprehensive measure of disease control in patients with PPMS. Ann Neurol 2018;84:527–536

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MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—establishing disease prognosis and monitoring patients

Cited by 407 publications

References 136 publications

Evaluation of Focal Cervical Spinal Cord Lesions in Multiple Sclerosis: Comparison of White Matter-Suppressed T1 Inversion Recovery Sequence versus Conventional STIR and Proton Density-Weighted Turbo Spin-Echo Sequences

Evaluation of Focal Cervical Spinal Cord Lesions in Multiple Sclerosis: Comparison of White Matter-Suppressed T1 Inversion Recovery Sequence versus Conventional STIR and Proton Density-Weighted Turbo Spin-Echo Sequences

Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society

Evaluation of no evidence of progression or active disease (NEPAD) in patients with primary progressive multiple sclerosis in the ORATORIO trial

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