ABSTRACT
Over the past decade multiple sclerosis (MS) clinical trials have expanded, resulting in Food and Drug Administration (FDA) approval of five medications. After the diagnosis of MS is made and treatment started, monitoring of treatment response is necessary to guide ongoing care decisions. The traditional clinical tools of history and examination are more often than not insufficient to make an early diagnosis of MS, and insensitive for disease monitoring. Magnetic resonance imaging (MRI) has become an important tool for the diagnosis, prognosis and monitoring of MS patients. Similarly, MRI has moved to the forefront of MS research as the primary outcome parameter in early-stage development of putative therapies, and an important secondary outcome measure for drug efficacy in phase II and III studies1. Despite its many advantages over the subjective and limited clinical end-points, conflicting data exist regarding which MRI parameters should be utilized as study end-points and to guide treatment decisions. In this chapter, we review the use of MRI in the diagnosis
of MS, prognosis during the early stages of disease, monitoring disease activity and progression and monitoring therapy. Additional details regarding MRI in MS are provided in Chapters 7, 8 and 11.
