Adherence to MRI protocol consensus guidelines in multiple sclerosis

An Australian multi-centre study

Michael Curley, Lawrence Josey, Robyn Lucas, Keith Dear, Bruce Taylor, Alan Coulthard, The Ausimmune Investigator Group, Caron Chapman, Terence Dwyer, Trevor Kilpatrick, Anthony McMichael, Michael Pender, Anne-Louise Ponsonby, Patricia Valery, Ingrid Van Der Mei, David Williams

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction: Multiple sclerosis (MS) is a debilitating disease that causes significant morbidity within a young demographic. Diagnostic guidelines for MS have evolved, and imaging has played an increasingly important role in diagnosis over the last two decades. For imaging to contribute to diagnosis in a meaningful way, it must be reproducible. Consensus guidelines for MRI in MS exist to define correct sequence type and imaging technique, but it is not clear to what extent they are followed. This study reviewed MRI studies performed on Australian individuals presenting with a first clinical diagnosis of central nervous system demyelination (FCD) for adherence to published guidelines and discussed practical implementation of MS guidelines in light of recent updates.
Methods: The Ausimmune study was a prospective case control study of Australian participants presenting with FCD from 2003 to 2006. Baseline cranial and spinal cord MRI studies of 226 case participants from four separate Australian regions were reviewed. MRI sequences were classified according to anatomical location, slice plane, tissue weighting and use of gadolinium-containing contrast media. Results were compared with the 2003 Consortium of Multiple Sclerosis Centres MRI protocol for the diagnosis of MS.
Results: The composition of core cranial MRI sequences performed varied across the 226 scans. Of the studies, 91% included sagittal fluid attenuated inversion recovery (FLAIR) sequences. Cranial axial T2-weighted, axial FLAIR and axial proton density-weighted sequences were performed in 88%, 60% and 16% (respectively) of scans. Only 25% of the studies included a T1-weighted contrast-enhanced sequence. Concordance with the guidelines in all sequences was very low (2).
Conclusion: Only a small number of MRI investigations performed included all of the sequences stipulated by consensus guidelines. This is likely due to poor awareness in the imaging community of the guidelines and the rationale behind certain sequences. Radiologists with a sub-speciality interest in neuroradiology should take ownership of this issue and ensure that recommended imaging guidelines are followed.
Original languageEnglish
Pages (from-to)594-598
Number of pages5
JournalJournal of Medical Imaging and Radiation Oncology
Volume56
Issue number6
DOIs
Publication statusPublished - Dec 2012

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Multiple Sclerosis
Guidelines
Sequence Inversion
Ownership
Consensus Sequence
Gadolinium
Demyelinating Diseases
Contrast Media
Protons
Case-Control Studies
Spinal Cord
Central Nervous System
Demography
Morbidity

Cite this

Curley, Michael ; Josey, Lawrence ; Lucas, Robyn ; Dear, Keith ; Taylor, Bruce ; Coulthard, Alan ; The Ausimmune Investigator Group ; Chapman, Caron ; Dwyer, Terence ; Kilpatrick, Trevor ; McMichael, Anthony ; Pender, Michael ; Ponsonby, Anne-Louise ; Valery, Patricia ; Van Der Mei, Ingrid ; Williams, David. / Adherence to MRI protocol consensus guidelines in multiple sclerosis : An Australian multi-centre study. In: Journal of Medical Imaging and Radiation Oncology. 2012 ; Vol. 56, No. 6. pp. 594-598.
@article{d8db43f66d5b4b48b80e33e903a23b13,
title = "Adherence to MRI protocol consensus guidelines in multiple sclerosis: An Australian multi-centre study",
abstract = "Introduction: Multiple sclerosis (MS) is a debilitating disease that causes significant morbidity within a young demographic. Diagnostic guidelines for MS have evolved, and imaging has played an increasingly important role in diagnosis over the last two decades. For imaging to contribute to diagnosis in a meaningful way, it must be reproducible. Consensus guidelines for MRI in MS exist to define correct sequence type and imaging technique, but it is not clear to what extent they are followed. This study reviewed MRI studies performed on Australian individuals presenting with a first clinical diagnosis of central nervous system demyelination (FCD) for adherence to published guidelines and discussed practical implementation of MS guidelines in light of recent updates.Methods: The Ausimmune study was a prospective case control study of Australian participants presenting with FCD from 2003 to 2006. Baseline cranial and spinal cord MRI studies of 226 case participants from four separate Australian regions were reviewed. MRI sequences were classified according to anatomical location, slice plane, tissue weighting and use of gadolinium-containing contrast media. Results were compared with the 2003 Consortium of Multiple Sclerosis Centres MRI protocol for the diagnosis of MS.Results: The composition of core cranial MRI sequences performed varied across the 226 scans. Of the studies, 91{\%} included sagittal fluid attenuated inversion recovery (FLAIR) sequences. Cranial axial T2-weighted, axial FLAIR and axial proton density-weighted sequences were performed in 88{\%}, 60{\%} and 16{\%} (respectively) of scans. Only 25{\%} of the studies included a T1-weighted contrast-enhanced sequence. Concordance with the guidelines in all sequences was very low (2).Conclusion: Only a small number of MRI investigations performed included all of the sequences stipulated by consensus guidelines. This is likely due to poor awareness in the imaging community of the guidelines and the rationale behind certain sequences. Radiologists with a sub-speciality interest in neuroradiology should take ownership of this issue and ensure that recommended imaging guidelines are followed.",
author = "Michael Curley and Lawrence Josey and Robyn Lucas and Keith Dear and Bruce Taylor and Alan Coulthard and {The Ausimmune Investigator Group} and Caron Chapman and Terence Dwyer and Trevor Kilpatrick and Anthony McMichael and Michael Pender and Anne-Louise Ponsonby and Patricia Valery and {Van Der Mei}, Ingrid and David Williams",
year = "2012",
month = "12",
doi = "10.1111/1754-9485.12000",
language = "English",
volume = "56",
pages = "594--598",
journal = "Journal of Medical Imaging and Radiation Oncology",
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Curley, M, Josey, L, Lucas, R, Dear, K, Taylor, B, Coulthard, A, The Ausimmune Investigator Group, Chapman, C, Dwyer, T, Kilpatrick, T, McMichael, A, Pender, M, Ponsonby, A-L, Valery, P, Van Der Mei, I & Williams, D 2012, 'Adherence to MRI protocol consensus guidelines in multiple sclerosis: An Australian multi-centre study', Journal of Medical Imaging and Radiation Oncology, vol. 56, no. 6, pp. 594-598. https://doi.org/10.1111/1754-9485.12000

Adherence to MRI protocol consensus guidelines in multiple sclerosis : An Australian multi-centre study. / Curley, Michael; Josey, Lawrence; Lucas, Robyn; Dear, Keith; Taylor, Bruce; Coulthard, Alan; The Ausimmune Investigator Group; Chapman, Caron; Dwyer, Terence; Kilpatrick, Trevor; McMichael, Anthony; Pender, Michael; Ponsonby, Anne-Louise; Valery, Patricia ; Van Der Mei, Ingrid; Williams, David.

In: Journal of Medical Imaging and Radiation Oncology, Vol. 56, No. 6, 12.2012, p. 594-598.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Adherence to MRI protocol consensus guidelines in multiple sclerosis

T2 - An Australian multi-centre study

AU - Curley, Michael

AU - Josey, Lawrence

AU - Lucas, Robyn

AU - Dear, Keith

AU - Taylor, Bruce

AU - Coulthard, Alan

AU - The Ausimmune Investigator Group, null

AU - Chapman, Caron

AU - Dwyer, Terence

AU - Kilpatrick, Trevor

AU - McMichael, Anthony

AU - Pender, Michael

AU - Ponsonby, Anne-Louise

AU - Valery, Patricia

AU - Van Der Mei, Ingrid

AU - Williams, David

PY - 2012/12

Y1 - 2012/12

N2 - Introduction: Multiple sclerosis (MS) is a debilitating disease that causes significant morbidity within a young demographic. Diagnostic guidelines for MS have evolved, and imaging has played an increasingly important role in diagnosis over the last two decades. For imaging to contribute to diagnosis in a meaningful way, it must be reproducible. Consensus guidelines for MRI in MS exist to define correct sequence type and imaging technique, but it is not clear to what extent they are followed. This study reviewed MRI studies performed on Australian individuals presenting with a first clinical diagnosis of central nervous system demyelination (FCD) for adherence to published guidelines and discussed practical implementation of MS guidelines in light of recent updates.Methods: The Ausimmune study was a prospective case control study of Australian participants presenting with FCD from 2003 to 2006. Baseline cranial and spinal cord MRI studies of 226 case participants from four separate Australian regions were reviewed. MRI sequences were classified according to anatomical location, slice plane, tissue weighting and use of gadolinium-containing contrast media. Results were compared with the 2003 Consortium of Multiple Sclerosis Centres MRI protocol for the diagnosis of MS.Results: The composition of core cranial MRI sequences performed varied across the 226 scans. Of the studies, 91% included sagittal fluid attenuated inversion recovery (FLAIR) sequences. Cranial axial T2-weighted, axial FLAIR and axial proton density-weighted sequences were performed in 88%, 60% and 16% (respectively) of scans. Only 25% of the studies included a T1-weighted contrast-enhanced sequence. Concordance with the guidelines in all sequences was very low (2).Conclusion: Only a small number of MRI investigations performed included all of the sequences stipulated by consensus guidelines. This is likely due to poor awareness in the imaging community of the guidelines and the rationale behind certain sequences. Radiologists with a sub-speciality interest in neuroradiology should take ownership of this issue and ensure that recommended imaging guidelines are followed.

AB - Introduction: Multiple sclerosis (MS) is a debilitating disease that causes significant morbidity within a young demographic. Diagnostic guidelines for MS have evolved, and imaging has played an increasingly important role in diagnosis over the last two decades. For imaging to contribute to diagnosis in a meaningful way, it must be reproducible. Consensus guidelines for MRI in MS exist to define correct sequence type and imaging technique, but it is not clear to what extent they are followed. This study reviewed MRI studies performed on Australian individuals presenting with a first clinical diagnosis of central nervous system demyelination (FCD) for adherence to published guidelines and discussed practical implementation of MS guidelines in light of recent updates.Methods: The Ausimmune study was a prospective case control study of Australian participants presenting with FCD from 2003 to 2006. Baseline cranial and spinal cord MRI studies of 226 case participants from four separate Australian regions were reviewed. MRI sequences were classified according to anatomical location, slice plane, tissue weighting and use of gadolinium-containing contrast media. Results were compared with the 2003 Consortium of Multiple Sclerosis Centres MRI protocol for the diagnosis of MS.Results: The composition of core cranial MRI sequences performed varied across the 226 scans. Of the studies, 91% included sagittal fluid attenuated inversion recovery (FLAIR) sequences. Cranial axial T2-weighted, axial FLAIR and axial proton density-weighted sequences were performed in 88%, 60% and 16% (respectively) of scans. Only 25% of the studies included a T1-weighted contrast-enhanced sequence. Concordance with the guidelines in all sequences was very low (2).Conclusion: Only a small number of MRI investigations performed included all of the sequences stipulated by consensus guidelines. This is likely due to poor awareness in the imaging community of the guidelines and the rationale behind certain sequences. Radiologists with a sub-speciality interest in neuroradiology should take ownership of this issue and ensure that recommended imaging guidelines are followed.

U2 - 10.1111/1754-9485.12000

DO - 10.1111/1754-9485.12000

M3 - Article

VL - 56

SP - 594

EP - 598

JO - Journal of Medical Imaging and Radiation Oncology

JF - Journal of Medical Imaging and Radiation Oncology

SN - 0004-8461

IS - 6

ER -