TY - JOUR
T1 - Value of Optic Nerve MRI in Multiple Sclerosis Clinical Management
T2 - A MAGNIMS Position Paper and Future Perspectives
AU - Sastre-Garriga, Jaume
AU - Vidal-Jordana, Angela
AU - Toosy, Ahmed T
AU - Enzinger, Christian
AU - Granziera, Cristina
AU - Frederiksen, Jette
AU - Ciccarelli, Olga
AU - Filippi, Massimo
AU - Montalban, Xavier
AU - Tintore, Mar
AU - Pareto, Deborah
AU - Rovira, Àlex
AU - MAGNIMS Study Group
PY - 2024/8/13
Y1 - 2024/8/13
N2 - The optic nerve is frequently involved in multiple sclerosis (MS). However, MRI of the optic nerve is considered optional in the differential diagnosis of optic neuropathy symptoms either at presentation or in established MS. In addition, unlike spinal cord imaging in comparable scenarios, no role is currently recommended for optic nerve MRI in patients presenting with optic neuritis for its confirmation, to plan therapeutic strategy, within the MS diagnostic framework, nor for the detection of subclinical activity in established MS. In this article, evidence related to these 3 aspects will be summarized and gaps in knowledge will be highlighted, including (1) the acquisition challenges and novel sequences that assess pathologic changes within the anterior visual pathways; (2) the clinical implications of quantitative magnetic resonance studies of the optic nerve, focusing on atrophy measures, magnetization transfer, and diffusion tensor imaging; and (3) the relevant clinical studies performed to date. Finally, an algorithm for the application of optic nerve MRI will be proposed to guide future studies aimed at addressing our knowledge gaps.
AB - The optic nerve is frequently involved in multiple sclerosis (MS). However, MRI of the optic nerve is considered optional in the differential diagnosis of optic neuropathy symptoms either at presentation or in established MS. In addition, unlike spinal cord imaging in comparable scenarios, no role is currently recommended for optic nerve MRI in patients presenting with optic neuritis for its confirmation, to plan therapeutic strategy, within the MS diagnostic framework, nor for the detection of subclinical activity in established MS. In this article, evidence related to these 3 aspects will be summarized and gaps in knowledge will be highlighted, including (1) the acquisition challenges and novel sequences that assess pathologic changes within the anterior visual pathways; (2) the clinical implications of quantitative magnetic resonance studies of the optic nerve, focusing on atrophy measures, magnetization transfer, and diffusion tensor imaging; and (3) the relevant clinical studies performed to date. Finally, an algorithm for the application of optic nerve MRI will be proposed to guide future studies aimed at addressing our knowledge gaps.
KW - Humans
KW - Multiple Sclerosis/diagnostic imaging
KW - Magnetic Resonance Imaging/methods
KW - Optic Nerve/diagnostic imaging
KW - Optic Neuritis/diagnostic imaging
KW - Disease Management
UR - http://www.scopus.com/inward/record.url?scp=85199126710&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000209677
DO - 10.1212/WNL.0000000000209677
M3 - Review
C2 - 39018513
SN - 0028-3878
VL - 103
SP - e209677
JO - Neurology
JF - Neurology
IS - 3
M1 - e209677
ER -