Chapter 2 - Novel imaging approaches in multiple sclerosis.

Abstract

In recent years, there has been significant advancement in the utilization of magnetic resonance imaging (MRI) for the diagnostic evaluation of patients with multiple sclerosis (pwMS). The 2017 McDonald criteria have demonstrated high sensitivity and accuracy in predicting a second clinical attack in patients with a typical clinically isolated syndrome, enabling earlier diagnosis of Multiple Sclerosis (MS) (Thompson et al. (2018). Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. The Lancet Neurology, 17(2), 162–173). These criteria have been validated and are supported by evidence, simplifying the clinical application of MRI criteria and enhancing the management of MS patients. However, in order to minimize the risk of misdiagnosis, these criteria should only be applied by expert clinicians after thorough exclusion of alternative diagnoses (Filippi et al. (2023). Present and future of the diagnostic work-up of multiple sclerosis: The imaging perspective. Journal of Neurology. 270(3), 1286–1299), a task that often is not easy. Thus, several imaging methods are currently being developed or studied and are the goal of this chapter.