MRI a Viable Alternative to Lumbar Puncture for MS Diagnosis?
To diagnose multiple sclerosis (MS), the central vein sign (CVS) on brain MRI appears to work as well as oligoclonal bands (OCBs) in cerebrospinal fluid (CSF), and combining the two biomarkers yields the highest predictive value for MS, a new study indicates. The presence of OCBs is "very specific for MS and is obtained by lumbar puncture, which is invasive and can be unpleasant, so it's not an ideal test," study investigator Daniel Ontaneda, MD, PhD, with the Mellen Center for MS Treatment and Research at the Cleveland Clinic, in Ohio, told Medscape Medical News.
@timir OCBs in CSF are commonly used as a diagnostic biomarker for MS and can serve to meet the requirement for dissemination in time in the 2017 McDonald criteria. CVS is an emerging neuroimaging biomarker for MS that may improve diagnostic accuracy and reduce the need for lumbar puncture. For the study, the investigators compared the sensitivity, specificity, and positive predictive value (PPV) of CVS on MRI with that of OCBs in CSF for MS diagnosis. Among the 53 participants, 24 (45%) met 2017 McDonald criteria for dissemination in space and time at baseline, and 27 (51%) met the criteria at 12-month follow-up.