The evaluation of disease progression in multiple sclerosis (MS) patients through magnetic resonance imaging (MRI) can be performed without the use of a contrast agent, new research has shown.
These findings suggest that routine use of contrast-enhanced MRI is unnecessary for most follow-ups with MS patients, reducing both imaging time and cost without missing new or enlarged lesions.
The research article, “Accuracy of Unenhanced MRI in the Detection of New Brain Lesions in Multiple Sclerosis,” was published in the journal Radiology.
MRI with the administration of a contrast agent is generally considered a requirement for follow-up scans in MS patients.
Typically, the contrast agent used is gadolinium — a heavy metal that enhances the MRI result, helping provide diagnostic data. However, the use of gadolinium contributes to longer MRI scan times and increased costs. Also, there is some evidence that not all gadolinium leaves the body after administration, though its long-term health impact is unclear.
Now, MRI with higher magnetic field strengths — such as 3 Tesla MRI (Tesla is the unit for magnetic field strength) — have become widely available, especially for brain imaging. Also, recently introduced three-dimensional MRI outperforms conventional two-dimensional MRI in visualizing lesions. Improvements in MRI technology, as well as scanning methods, have also improved the sensitivity in detecting new or enlarged lesions in MS at follow-ups.
Researchers from the Technical University of Munich, Germany, tested whether using contrast material influences the detection of new or enlarged MS lesions, critical for the assessment of interval disease progression — defined as at least one new or enlarged lesion on follow-up MRI scans.
“These factors warrant evaluation of strategies for reducing or omitting contrast agent, especially in MS patients who often accumulate a high number of MRI scans over their lifetimes,” Benedikt Wiestler, MD, the study’s senior author, said in a press release.
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