Advanced Radiological Assessment of the Spinal Cord in Multiple Sclerosis)

Abstract

Multiple sclerosis (MS) is a chronic demyelinating disease and among the most common neuroinflammatory disorders. MS contributes to substantial functional decline and is diagnosed via evidence of lesions in the brain and spinal cord (SC), though the SC has been radiologically understudied given the challenges of guaranteeing good image quality and lesion sensitivity despite the association of SC lesions with a higher risk of relapse and disability progression. Moreover, while T1- and T2-weighted images are the clinical standard, their utility is limited as they lack specificity for MS pathology and have low sensitivity to detecting damage to normal-appearing tissue. To address these limitations, advanced imaging techniques have been developed to more effectively assess alterations in the integrity of the MS SC. However, there remains a need to harmonize these approaches and evaluate their potential to capture the breadth of MS pathology. Clinically translating such methods could provide a more comprehensive understanding of the impact of a devastating neurologic disease and contribute to improved patient care.