Imaging chronic active lesions in multiple sclerosis: a consensus statement.

Publication Type Academic Article
Authors Bagnato F, Sati P, Hemond C, Elliott C, Gauthier S, Harrison D, Mainero C, Oh J, Pitt D, Shinohara R, Smith S, Trapp B, Azevedo C, Calabresi P, Henry R, Laule C, Ontaneda D, Rooney W, Sicotte N, Reich D, Absinta M
Journal Brain
Volume 147
Issue 9
Pagination 2913-2933
Date Published 09/03/2024
ISSN 1460-2156
Keywords Multiple Sclerosis, Magnetic Resonance Imaging, Consensus
Abstract Chronic active lesions (CAL) are an important manifestation of chronic inflammation in multiple sclerosis and have implications for non-relapsing biological progression. In recent years, the discovery of innovative MRI and PET-derived biomarkers has made it possible to detect CAL, and to some extent quantify them, in the brain of persons with multiple sclerosis, in vivo. Paramagnetic rim lesions on susceptibility-sensitive MRI sequences, MRI-defined slowly expanding lesions on T1-weighted and T2-weighted scans, and 18-kDa translocator protein-positive lesions on PET are promising candidate biomarkers of CAL. While partially overlapping, these biomarkers do not have equivalent sensitivity and specificity to histopathological CAL. Standardization in the use of available imaging measures for CAL identification, quantification and monitoring is lacking. To fast-forward clinical translation of CAL, the North American Imaging in Multiple Sclerosis Cooperative developed a consensus statement, which provides guidance for the radiological definition and measurement of CAL. The proposed manuscript presents this consensus statement, summarizes the multistep process leading to it, and identifies the remaining major gaps in knowledge.
DOI 10.1093/brain/awae013
PubMed ID 38226694
PubMed Central ID PMC11370808
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