Table 3

Summary of imaging outcomes for remyelination and repair in multiple sclerosis

ModalityMyelin sensitivityMyelin specificityClinical correlationAcquisition timeComments
T2 lesion evolutionExcellentPoorPoorShortConfounded by inflammation, axonal loss and oedema
T1 lesion evolutionGoodPoorPoorShortT1 hypointense lesion evolution may be useful in neuroprotection trials
MTRExcellentGoodGoodShortSemiquantitative
qMTExcellentGoodGoodModerate/longModelling the MT effect in tissue is complex
MWFExcellentGoodGoodLongLimited brain coverage
 ▸ mcDESPOTExcellentGoodUnknownModerateAccuracy questioned
 ▸ T2prep 3D SPIRALExcellentUnknownUnknownModerateLimited evidence in patient groups
 ▸ 3D-GRASEExcellentUnknownUnknownShortLimited evidence in patient groups
DTIExcellentGoodGoodModerateLow resolution and SNR, motion artefact susceptibility
PETExcellentExcellentUnknownModerate/longFurther in vivo studies required
OCTPoorPoorExcellentModerateUseful to detect secondary neuroprotective effects
  • Ratings of ‘Excellent’, ‘Good’ and ‘Poor’ are qualitative and, although based on best currently available data, are inherently subjective in nature. Clinical correlation: refers to associations that have been observed between the imaging measure and a relevant clinical function measure. Acquisition times: Short <15 min, Moderate=15–30 min and Long >30 min.

  • DTI, diffusion tensor imaging; MT, magnetisation transfer; MTR, magnetisation transfer ratio; MWF, myelin water fraction; OCT, optical coherence tomography; PET, positron emission tomography; qMT, quantitative MT.