Abstract
Magnetic resonance imaging (MRI) is an important paraclinical tool for the diagnosis of multiple sclerosis (MS) and for monitoring its disease course. The efficacy of most of the available MS disease-modifying treatments has been tested in clinical trials where MRI-derived quantities served as primary or secondary outcome measures. However, conventional MRI measures (i.e., the number and volume of contrast-enhancing, the volumes of T2-hyperintense and TI-hypointense lesions and the assessment of brain volume changes) are limited in terms of pathological specificity and, as a consequence, are modestly correlated with clinical measures of disease activity and have a modest prognostic value as predictors of MS evolution. In the present review, we discuss the main factors potentially responsible for the so-called 'clinical MRI paradox' and how modem quantitative MR-based techniques might contribute to, at least partially, overcome it. The lessons learned from MS trials suggest that future applications of MRI to assess MS evolution should rely upon the use of composite measures thought to reflect the various components of the disease, as well as on study protocols specifically designed on the individual trial characteristics.
| Original language | English |
|---|---|
| Pages (from-to) | 341-347 |
| Number of pages | 7 |
| Journal | Multiple Sclerosis Journal |
| Volume | 10 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Aug 2004 |
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Keywords
- Clinical trials
- Magnetic resonance imaging
- Multiple sclerosis
ASJC Scopus subject areas
- Clinical Neurology
Cite this
The use of magnetic resonance imaging in multiple sclerosis : Lessons learned from clinical trials. / Boneschi, Filippo Martinelli; Rovaris, Marco; Comi, Giancarlo; Filippi, Massimo.
In: Multiple Sclerosis Journal, Vol. 10, No. 4, 08.2004, p. 341-347.Research output: Contribution to journal › Article
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TY - JOUR
T1 - The use of magnetic resonance imaging in multiple sclerosis
T2 - Lessons learned from clinical trials
AU - Boneschi, Filippo Martinelli
AU - Rovaris, Marco
AU - Comi, Giancarlo
AU - Filippi, Massimo
PY - 2004/8
Y1 - 2004/8
N2 - Magnetic resonance imaging (MRI) is an important paraclinical tool for the diagnosis of multiple sclerosis (MS) and for monitoring its disease course. The efficacy of most of the available MS disease-modifying treatments has been tested in clinical trials where MRI-derived quantities served as primary or secondary outcome measures. However, conventional MRI measures (i.e., the number and volume of contrast-enhancing, the volumes of T2-hyperintense and TI-hypointense lesions and the assessment of brain volume changes) are limited in terms of pathological specificity and, as a consequence, are modestly correlated with clinical measures of disease activity and have a modest prognostic value as predictors of MS evolution. In the present review, we discuss the main factors potentially responsible for the so-called 'clinical MRI paradox' and how modem quantitative MR-based techniques might contribute to, at least partially, overcome it. The lessons learned from MS trials suggest that future applications of MRI to assess MS evolution should rely upon the use of composite measures thought to reflect the various components of the disease, as well as on study protocols specifically designed on the individual trial characteristics.
AB - Magnetic resonance imaging (MRI) is an important paraclinical tool for the diagnosis of multiple sclerosis (MS) and for monitoring its disease course. The efficacy of most of the available MS disease-modifying treatments has been tested in clinical trials where MRI-derived quantities served as primary or secondary outcome measures. However, conventional MRI measures (i.e., the number and volume of contrast-enhancing, the volumes of T2-hyperintense and TI-hypointense lesions and the assessment of brain volume changes) are limited in terms of pathological specificity and, as a consequence, are modestly correlated with clinical measures of disease activity and have a modest prognostic value as predictors of MS evolution. In the present review, we discuss the main factors potentially responsible for the so-called 'clinical MRI paradox' and how modem quantitative MR-based techniques might contribute to, at least partially, overcome it. The lessons learned from MS trials suggest that future applications of MRI to assess MS evolution should rely upon the use of composite measures thought to reflect the various components of the disease, as well as on study protocols specifically designed on the individual trial characteristics.
KW - Clinical trials
KW - Magnetic resonance imaging
KW - Multiple sclerosis
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U2 - 10.1191/1352458504ms1067rr
DO - 10.1191/1352458504ms1067rr
M3 - Article
VL - 10
SP - 341
EP - 347
JO - Multiple Sclerosis
JF - Multiple Sclerosis
SN - 1352-4585
IS - 4
ER -