Imaging chronic active lesions in multiple sclerosis: a consensus statement
Bagnato, Francesca ; Sati, Pascal ; Hemond, Christopher C ; Elliott, Colm ; Gauthier, Susan A ; Harrison, Daniel M ; Mainero, Caterina ; Oh, Jiwon ; Pitt, David ; Shinohara, Russell T ... show 10 more
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Authors
Sati, Pascal
Hemond, Christopher C
Elliott, Colm
Gauthier, Susan A
Harrison, Daniel M
Mainero, Caterina
Oh, Jiwon
Pitt, David
Shinohara, Russell T
Smith, Seth A
Trapp, Bruce
Azevedo, Christina J
Calabresi, Peter A
Henry, Roland G
Laule, Cornelia
Ontaneda, Daniel
Rooney, William D
Sicotte, Nancy L
Reich, Daniel S
Absinta, Martina
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UMass Chan Affiliations
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Abstract
Chronic active lesions (CAL) are an important manifestation of chronic inflammation in multiple sclerosis and have implications for non-relapsing biological progression. In recent years, the discovery of innovative MRI and PET-derived biomarkers has made it possible to detect CAL, and to some extent quantify them, in the brain of persons with multiple sclerosis, in vivo. Paramagnetic rim lesions on susceptibility-sensitive MRI sequences, MRI-defined slowly expanding lesions on T1-weighted and T2-weighted scans, and 18-kDa translocator protein-positive lesions on PET are promising candidate biomarkers of CAL. While partially overlapping, these biomarkers do not have equivalent sensitivity and specificity to histopathological CAL. Standardization in the use of available imaging measures for CAL identification, quantification and monitoring is lacking. To fast-forward clinical translation of CAL, the North American Imaging in Multiple Sclerosis Cooperative developed a consensus statement, which provides guidance for the radiological definition and measurement of CAL. The proposed manuscript presents this consensus statement, summarizes the multistep process leading to it, and identifies the remaining major gaps in knowledge.
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Bagnato F, Sati P, Hemond CC, Elliott C, Gauthier SA, Harrison DM, Mainero C, Oh J, Pitt D, Shinohara RT, Smith SA, Trapp B, Azevedo CJ, Calabresi PA, Henry RG, Laule C, Ontaneda D, Rooney WD, Sicotte NL, Reich DS, Absinta M. Imaging chronic active lesions in multiple sclerosis: a consensus statement. Brain. 2024 Sep 3;147(9):2913-2933. doi: 10.1093/brain/awae013. PMID: 38226694; PMCID: PMC11370808.