6-minute MRI matches lumbar puncture's accuracy in diagnosing multiple sclerosis
A quick MRI brain scan is equally as effective as lumbar puncture procedures in diagnosing multiple sclerosis.
That’s according to new data published in Neurology Open Access, where experts compared the two diagnostic pathways to the neurological condition, which can be challenging to accurately pinpoint. Researchers determined that a six-minute MRI is equally as sensitive as oligoclonal bands (OCB) testing via lumbar puncture, and significantly less invasive.
“Making a diagnosis of multiple sclerosis can be challenging due to other conditions that mimic the symptoms, examination findings, and investigation results seen in MS,” lead author Nikos Evangelou, PhD, clinical professor of neurology at the University of Nottingham, and colleagues noted. “Diagnostic uncertainty can therefore arise, and patients frequently wait months, sometimes years, before the diagnosis is confirmed and treatment can start.”
Visible on T2-weighted MRI brain scans, the central vein sign (CVS) represents an accurate marker of MS when six or more lesions with venules are present. When this method was compared to OCB testing on a group of 99 individuals who underwent both exams, CVS testing yielded equivalent results.
The “rule of 6” achieved a 91% sensitivity for diagnosing MS. However, CVS testing, which involves an MRI only, was significantly better tolerated compared to the lumbar punctures patients endured. Negative side effects were reported after 75% of the lumbar punctures, while just 9% of MRI exams triggered side effects. Every participant indicated they preferred imaging over the lumbar puncture.
“With increasing recognition of MS misdiagnosis, the desire to reach a diagnosis earlier (even in RIS), and our findings of a unanimous preference for an additional MRI scan over an LP, we encourage the widespread adoption of susceptibility-based imaging for MS diagnosis. CVS assessment should be particularly helpful in older patients or those presenting with vascular risk factors.”
The group acknowledged that some patients may still require lumbar puncture to confirm an MS diagnosis. However, they suggested that utilizing MRI and the “rule of 6” could significantly reduce the overall number of patients requiring OCB testing. This could result in substantial time and cost savings for imaging departments, the authors added.
Learn more about the findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.