2021 CMSC Annual Meeting

First Steps Towards Implementation of a Standardized MRI Protocol to Improve Care for People with MS in British Columbia

IMG07

Background: Magnetic resonance imaging (MRI) is important in the diagnosis and monitoring of people with multiple sclerosis (MS). Using a standardized MRI protocol is key.
Objectives: To assess the use of the Consortium of MS Centers (CMSC) recommended standardized MRI protocols for people with MS in British Columbia (BC).
Methods: BC hospitals with MRIs were surveyed regarding their scanning protocols for MS patients.
Results: Only 2 of 15 MRI centres fully satisfied CMSC recommendations for a standardized brain MRI protocol. FLAIR (Fluid Attenuated Inversion Recovery) and T2 scans were performed in all centres, except 1 that obtained FLAIR but not T2, however for 10 of 15 FLAIR scans and 12 of 14 T2 scans, the slices were thicker (>4mm vs recommended < 3mm) with slice gaps (0.5-1.0 mm vs recommended no gap). 3D T1 scans were routinely obtained in only 4 of 15 centres, with 3 satisfying CMSC slice thickness recommendation of < 1mm and 1 with thicker slices (1.2 mm). Of 9 centres responding, 3 used the recommended subcallosal plane for consistent prescription of axial slices. Conclusions: Recommendations for a standardized MRI for patients with MS have been proposed, updated and revised since 2001 (Simon et al AJNR 27:455-461 2006; Traboulsee et al AJNR 37: 394-401, 2016; www.mscare.org/page/MRI_protocol) but disappointingly are still not widely adopted and used. Having reviewed these survey results, the BC Medical Imaging Advisory Committee, a provincial group that provides advice and recommendations to the BC Ministry of Health to support continuous improvement in medical imaging, has committed to implementing the CMSC recommended protocols as the provincial standardized MRI protocol for MS patients for all BC MRI facilities, to improve care. A follow-up survey is planned for 2021.