MRI-Based Test Speeds Multiple Sclerosis Diagnosis and Reduces Lumbar Punctures

Diagnosis can be difficult because symptoms vary and the disease can progress at different rates. Many patients suspected of having MS have undergone lumbar puncture after standard MRI, a procedure that can cause headaches, back pain, and unintended complications. Researchers have now introduced an MRI-based test that aims to make diagnosis faster and less invasive.

The University of Nottingham team developed the test using a T2*-weighted MRI scan on a clinical MRI scanner of the type used in neuroscience centers. The scan adds about six minutes to the imaging session and allows clinicians to view MS lesions in greater detail. It specifically helps doctors identify whether small veins run through the middle of lesions, a finding known as the central vein sign.

The central vein sign is clinically useful because MS lesions form around small veins. Other conditions do not form around veins in the same way, which allows the sign to help distinguish MS from alternative diagnoses. The Nottingham team has incorporated the method into the National Health Service diagnostic process for MS, with scans scheduled before first clinic appointments to improve service efficiency.

During rollout at an NHS trust in England, the average time to diagnosis was 2.9 months with the new process. This compared with 5.6 months in the usual outpatient pathway, reducing the diagnostic wait by an average of 83 days. The team also estimated cost savings of about GBP 292 per patient in Nottingham, while noting that the estimate may understate savings for hospitals that perform more lumbar punctures.

The findings were published in Neurology: Clinical Practice. The test is now in use in Nottingham and is being adopted in other neurology departments worldwide. The team has also encouraged other hospitals across the UK to begin using the MRI-based approach.

“Spotting the central vein sign completely changes the MS diagnostic journey. By viewing lesions in far greater clarity, we can make an accurate diagnosis without invasive lumbar punctures—reducing unnecessary delays so people can start getting answers sooner,” said Dr. Christopher Gilmartin, the project's first author.

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