How often do you perform surveillance brain MRIs in patients with MS on highly effective DMTs?
Do you routinely do MRIs without contrast? How often do you include C/T spine?
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How often do you perform surveillance brain MRIs in patients with MS on highly effective DMTs?
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Neurology · University of Kentucky
Answered on
- The so-called guidelines to do MRIs on an annual basis pre-dated the introduction of anti-CD20 drugs. After these drugs were introduced in 2017, the need for MRIs has fallen off a cliff (as it ought to). With 95% or better suppression of new disease activity (inflammatory component and not the iron rim lesions, per se) with these new drugs, yearly MRIs have lost their edge in my opinion. Iron rim lesion (paramagnetic iron rim lesions) evaluation, even on anti-CD20 drugs, can go on despite good control of the inflammatory component of the disease, and is best seen on SWI imaging, but its inclusion varies from center to center and based on clinical indication of the patient. So, doing an annual MRI for monitoring SWI phenomena might sound lo...
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