Update to MRI Protocols for Multiple Sclerosis from the Consortium of Multiple Sclerosis Centers

The Consortium of Multiple Sclerosis Centers (CMSC) has revised MRI protocols for multiple sclerosis (MS). The updated Standardized Brain MRI Protocol includes 
•    Mandatory axial FLAIR, sagittal FLAIR, and axial T2 imaging
•    Use of gadolinium contrast when indicated
•    Optional sequences include optimum plus (3D high-resolution T1- and susceptibility-weighted) 
•    Surveillance for progressive multifocal encephalopathy
•    Spinal cord sequences
•    Judicious use of gadolinium 

Attention was paid to making he CMSC and Magnetic Resonance Imaging in MS Group (MAGNIMS) MRI protocols similar so that the updated protocol could ultimately be accepted by international consensus. The updates include re-emphasis of the critical importance of using the subcallosal plane for consistent repositioning and the requirement for thin (≤3mm) contiguous slices.

The protocols were revised by a CMSC-convened group of experts and developed with the intention to make protocols for imaging in MS universal and usable, creating a standard of care for individuals with MS. 

Representatives from CMSC, MAGNIMS, North American Imaging in Multiple Sclerosis Cooperative, National MS Society, MS Association of America, MRI manufacturers and commercial image analysis companies were present. Before the meeting, CMSC members were surveyed about standardized MRI protocol, gadolinium, diffusion weighted imaging (DWI), and the central vein sign.