ABSTRACT
Although conventional magnetic resonance imaging (MRI) can detect multiple sclerosis (MS) lesions with high sensitivity, it is not without relevant limitations. First, MRI is not specific with regard to the heterogeneous pathological substrates of individual lesions1 and, as a consequence, is limited in characterization and quantification of tissue damage. Specifically, edema, inflammation, demyelination, remyelination, gliosis and axonal loss2 all lead to a similar appearance of hyperintensity on T2-weighted images. Second, MRI does not delineate tissue damage occurring in the gray matter (GM) and in the normal-appearing white matter (NAWM), which typically represents a substantial portion of the brain tissue from MS patients and which is known to be damaged in these patients3.
