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