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Appropriateness Criteria

Reference Study Type Patients/Events Study Objective(Purpose of Study) Study Results Study Quality
1. Barkhof F, Koeller KK. Demyelinating Diseases of the CNS (Brain and Spine). In: Hodler J, Kubik-Huch RA, von Schulthess GK, eds. Diseases of the Brain, Head and Neck, Spine 2020-2023: Diagnostic Imaging. Cham (CH); 2020:165-76. Review/Other-Dx None listed. No objective available. No results available. 4
2. Klistorner A, Arvind H, Nguyen T, et al. Fellow eye changes in optic neuritis correlate with the risk of multiple sclerosis. Mult Scler. 2009 Aug;15(8):928-32. Review/Other-Dx 48 patients To study the relationship between electrophysiological parameters in the fellow eye of ON patients, and risk of conversion to MS. Average mfVEP amplitude was 240 +/- 35, 232 +/- 36, 181 +/- 38, and 169 +/- 48 nV for controls, LR, HR, and MS groups respectively. Average mfVEP latency for controls, LR, HR, and MS patients was 139.7 +/- 5.5, 141.7 +/- 3.6, 145.9 +/- 8.9, and 152.0 +/- 9.9 ms respectively. 4
3. Idiman E, Ozakbas S. The limited demyelinating diseases: the voyage of optic neuritis and transverse myelitis to multiple sclerosis and neuromyelitis. Expert Rev Neurother. 2011 Mar;11(3):451-62. Review/Other-Dx N/A Accurate and early diagnosis is critical to facilitate initiation of immunosuppressive and/or immunomodulatory therapy to prevent attacks and disability progression. No results stated in abstract. 4
4. Sati P, Oh J, Constable RT, et al. The central vein sign and its clinical evaluation for the diagnosis of multiple sclerosis: a consensus statement from the North American Imaging in Multiple Sclerosis Cooperative. Nat Rev Neurol. 2016 Dec;12(12):714-722. Review/Other-Dx N/A Article that provides statements and recommendations aimed at helping radiologists and neurologists to better understand, refine, standardize and evaluate the CVS in the diagnosis of MS. No results stated in abstract. 4
5. Cortese R, Magnollay L, Tur C, et al. Value of the central vein sign at 3T to differentiate MS from seropositive NMOSD. Neurology. 2018 Apr 03;90(14):e1183-e1190. Observational-Dx 18 aquaporin-4-antibody-positive patients with NMOSD 18 patients with relapsing-remitting MS 25 healthy controls To assess the value of the central vein sign (CVS) on a clinical 3T scanner to distinguish between multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). The proportion of lesions with the CVS was higher in MS than NMOSD (80% vs 32%, p < 0.001). A greater proportion of lesions with the CVS predicted the diagnosis of MS, rather than NMOSD (odds ratio 1.10, 95% confidence interval [CI] 1.04 to 1.16, p = 0.001), suggesting that each percent unit increase in the proportion of lesions with the CVS in an individual patient was associated with a 10% increase in the risk of the same patient having MS. If more than 54% of the lesions on any given scan show the CVS, then the patient can be given a diagnosis of MS with an accuracy of 94% (95% CIs 81.34, 99.32, p < 0.001, sensitivity/specificity 90%/100%). 4
6. Calvi A, Haider L, Prados F, Tur C, Chard D, Barkhof F. In vivo imaging of chronic active lesions in multiple sclerosis. Mult Scler. 2022 Apr;28(5):683-690. Review/Other-Dx None listed. No objective listed. No results listed. 4
7. Pittock SJ, Berthele A, Fujihara K, et al. Eculizumab in Aquaporin-4-Positive Neuromyelitis Optica Spectrum Disorder. N Engl J Med. 2019 Aug 15;381(7):614-625.
8. Cree BAC, Bennett JL, Kim HJ, et al. Inebilizumab for the treatment of neuromyelitis optica spectrum disorder (N-MOmentum): a double-blind, randomised placebo-controlled phase 2/3 trial. Lancet. 2019 Oct 12;394(10206):S0140-6736(19)31817-3.
9. Traboulsee A, Greenberg BM, Bennett JL, et al. Safety and efficacy of satralizumab monotherapy in neuromyelitis optica spectrum disorder: a randomised, double-blind, multicentre, placebo-controlled phase 3 trial. Lancet Neurol. 2020 May;19(5):S1474-4422(20)30078-8.
10. Pittock SJ, Barnett M, Bennett JL, et al. Ravulizumab in Aquaporin-4-Positive Neuromyelitis Optica Spectrum Disorder. Ann Neurol. 2023 Jun;93(6):1053-1068.
11. Kolasa M, Hakulinen U, Helminen M, et al. Longitudinal assessment of clinically isolated syndrome with diffusion tensor imaging and volumetric MRI. Clinical Imaging. 39(2):207-12, 2015 Mar-Apr.Clin Imaging. 39(2):207-12, 2015 Mar-Apr.
12. Wolanczyk M, Bladowska J, Koltowska A, et al. Diffusion tensor imaging of normal-appearing cervical spinal cords in patients with multiple sclerosis: Correlations with clinical evaluation and cerebral diffusion tensor imaging changes. Preliminary experience. Advances in Clinical & Experimental Medicine. 29(4):441-448, 2020 Apr.Adv. Clin. Exp. Med.. 29(4):441-448, 2020 Apr.
13. Combes AJE, O'Grady KP, Rogers BP, et al. Functional connectivity in the dorsal network of the cervical spinal cord is correlated with diffusion tensor imaging indices in relapsing-remitting multiple sclerosis. NeuroImage Clinical. 35:103127, 2022.Neuroimage (Amst). 35:103127, 2022.
14. Kerbrat A, Combes B, Commowick O, et al. USPIO-positive MS lesions are associated with greater tissue damage than gadolinium-positive-only lesions during 3-year follow-up. Multiple Sclerosis. 24(14):1852-1861, 2018 12.Mult Scler. 24(14):1852-1861, 2018 12.
15. Strumia M, Schmidt FR, Anastasopoulos C, Granziera C, Krueger G, Brox T. White Matter MS-Lesion Segmentation Using a Geometric Brain Model. IEEE Transactions on Medical Imaging. 35(7):1636-46, 2016 07.IEEE Trans Med Imaging. 35(7):1636-46, 2016 07.
16. Hindsholm AM, Cramer SP, Simonsen HJ, et al. Assessment of Artificial Intelligence Automatic Multiple Sclerosis Lesion Delineation Tool for Clinical Use. Clinical Neuroradiology. 32(3):643-653, 2022 Sep.Clin Neuroradiol. 32(3):643-653, 2022 Sep.
17. Dell'Oglio E, Ceccarelli A, Glanz BI, et al. Quantification of global cerebral atrophy in multiple sclerosis from 3T MRI using SPM: the role of misclassification errors. Journal of Neuroimaging. 25(2):191-199, 2015 Mar-Apr.J Neuroimaging. 25(2):191-199, 2015 Mar-Apr.
18. Ingrisch M, Sourbron S, Herberich S, et al. Dynamic Contrast-Enhanced Magnetic Resonance Imaging Suggests Normal Perfusion in Normal-Appearing White Matter in Multiple Sclerosis. Investigative Radiology. 52(3):135-141, 2017 03.Invest Radiol. 52(3):135-141, 2017 03.
19. Aliaga ES, Barkhof F. MRI mimics of multiple sclerosis. Handb Clin Neurol. 2014;122():B978-0-444-52001-2.00012-1. Review/Other-Dx None listed. No objective listed. No results listed. 4
20. Wingerchuk DM, Banwell B, Bennett JL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015 Jul 14;85(2):177-89. Review/Other-Dx N/A To develop revised diagnostic criteria using systematic literature reviews and electronic surveys to facilitate consensus. No results stated in abstract. 4
21. Salama S, Khan M, Levy M, Izbudak I. Radiological characteristics of myelin oligodendrocyte glycoprotein antibody disease. Mult Scler Relat Disord. 2019 Apr;29():S2211-0348(19)30021-5. Review/Other-Dx 26 MOG positive patients To characterize the radiological features of MOG antibody disease and compare the findings with those previously described. The majority of the abnormal findings was located on orbital MRIs, with more involvement of the anterior structures and bilateral involvement of the optic nerves. Brain abnormalities were distinct from both NMOSD and MS lesions. Spinal cord was the least affected. 4
22. Bartels F, Lu A, Oertel FC, Finke C, Paul F, Chien C. Clinical and neuroimaging findings in MOGAD-MRI and OCT. Clin Exp Immunol. 2021 Dec;206(3):266-281. Review/Other-Dx N/A To discuss key clinical and neuroimaging characteristics of paediatric and adult MOGAD. Myelin oligodendrocyte glycoprotein antibody-associated disorders (MOGAD) are rare in both children and adults, and have been recently suggested to be an autoimmune neuroinflammatory group of disorders that are different from aquaporin-4 autoantibody-associated neuromyelitis optica spectrum disorder and from classic multiple sclerosis. In-vivo imaging of the MOGAD patient central nervous system has shown some distinguishing features when evaluating magnetic resonance imaging of the brain, spinal cord and optic nerves, as well as retinal imaging using optical coherence tomography. 4
23. Matthews L, Kolind S, Brazier A, et al. Imaging Surrogates of Disease Activity in Neuromyelitis Optica Allow Distinction from Multiple Sclerosis. PLoS One. 2015;10(9):e0137715. Review/Other-Dx N/A To conduct a longitudinal advanced MRI study of the brain and spinal cord in neuromyelitis optica patients, comparing to patients with multiple sclerosis and controls. found both cross-sectional and longitudinal evidence of diffusely distributed neurodegenerative surrogates in the multiple sclerosis group (including thalamic atrophy, cervical cord atrophy and progressive widespread diffusion and myelin water imaging abnormalities in the normal appearing white matter) but not in those with neuromyelitis optica, where localised abnormalities in the optic radiations of those with severe visual impairment were noted. In addition, between relapses, there were no new silent brain lesions in the neuromyelitis optica group. These findings indicate that global central nervous system neurodegeneration is not a feature of neuromyelitis optica. 4
24. Traboulsee A, Simon JH, Stone L, et al. Revised Recommendations of the Consortium of MS Centers Task Force for a Standardized MRI Protocol and Clinical Guidelines for the Diagnosis and Follow-Up of Multiple Sclerosis. Ajnr: American Journal of Neuroradiology. 37(3):394-401, 2016 Mar.AJNR Am J Neuroradiol. 37(3):394-401, 2016 Mar. Review/Other-Dx N/A To discuss the revised guidelines for standardized brain and spinal cord MR imaging for the diagnosis and follow-up of MS No results stated in the abstract. 4
25. Filippi M, Preziosa P, Meani A, et al. Performance of the 2017 and 2010 Revised McDonald Criteria in Predicting MS Diagnosis After a Clinically Isolated Syndrome: A MAGNIMS Study. Neurology. 2022 Jan 04;98(1):e1-e14. Review/Other-Dx 785 patients To compare the performance of the 2017 revisions to the McDonald criteria with the 2010 McDonald criteria in establishing multiple sclerosis (MS) diagnosis and predicting prognosis in patients with clinically isolated syndrome (CIS) suggestive of MS. At follow-up (median 69.1 months), 406/785 patients with CIS developed CDMS. At 36 months, the 2017 DIS plus DIT criteria had higher sensitivity (0.83 vs 0.66), lower specificity (0.39 vs 0.60), and similar area under the curve values (0.61 vs 0.63). Median time to MS diagnosis was shorter with the 2017 vs the 2010 or CDMS criteria (2017 revision, 3.2; 2010 revision, 13.0; CDMS, 58.5 months). The 2 sets of criteria similarly predicted EDSS =3.0 milestone. Three periventricular lesions improved specificity in patients =45 years. 4
26. Brisset JC, Kremer S, Hannoun S, et al. New OFSEP recommendations for MRI assessment of multiple sclerosis patients: Special consideration for gadolinium deposition and frequent acquisitions. J Neuroradiol. 2020 Jun;47(4):S0150-9861(20)30095-X. Review/Other-Dx N/A To reduce the number of Gd injections required during MS patient follow-up. The French Observatory of MS recommends the use of macrocyclic Gd enhancement at time of diagnosis, when a new DMT is introduced, at 6-month re-baseline, and when previous scans are unavailable for comparison. Gd administration can be performed as an option in case of relapse or suspicion of intercurrent disease such as progressive multifocal leukoencephalopathy. Other follow-up MRIs do not require contrast enhancement, provided current and previous MRI acquisitions follow the same standardized protocol including 3D FLAIR sequences. 4
27. Meaton I, Altokhis A, Allen CM, et al. Paramagnetic rims are a promising diagnostic imaging biomarker in multiple sclerosis. Mult Scler. 2022 Dec;28(14):2212-2220. Review/Other-Dx 254 patients with MS 91 with MS mimics 217 older healthy controls To evaluate the sensitivity and specificity of PRLs in differentiating MS from mimics using clinical 3T MRI scanners. At least one PRL was found in 22.9% of MS and 26.1% of clinically isolated syndrome (CIS) patients. Only one PRL was found elsewhere. The identification of ?1 PRL was the optimal cut-off and had high specificity (99.7%, confidence interval (CI) = 98.20%-99.99%) when distinguishing MS and CIS from mimics and healthy controls, but lower sensitivity (24.0%, CI = 18.9%-36.6%). All patients with a PRL showing a central vein sign (CVS) in the same lesion (n = 54) had MS or CIS, giving a specificity of 100% (CI = 98.8%-100.0%) but equally low sensitivity (21.3%, CI = 16.4%-26.81%). 4
28. Tisavipat N, Flanagan EP. Current perspectives on the diagnosis and management of acute transverse myelitis. Expert Rev Neurother. 2023 Apr;23(4):389-411. Review/Other-Dx N/A Acute transverse myelitis (ATM) is a term that encompasses a wide range of etiologies from immune-mediated to infectious. No results stated in abstract. 4
29. Pekcevik Y, Mitchell CH, Mealy MA, et al. Differentiating neuromyelitis optica from other causes of longitudinally extensive transverse myelitis on spinal magnetic resonance imaging. Mult Scler. 2016 Mar;22(3):302-11. Review/Other-Dx 94 patients To investigate the spinal MRI findings of LETM that help differentiate NMO at the acute stage from multiple sclerosis (MS) and other causes of LETM. Patients with NMO had a greater amount of BSL and T1 dark lesions (p < 0.001 and 0.003, respectively). The lesions in NMO patients were more likely to involve greater than one-half of the spinal cord's cross-sectional area; to enhance and be centrally-located, or both centrally- and peripherally-located in the cord. Of the 62 available brain MRIs, 14 of the 27 whom were NMO patients had findings that may be specific to NMO. 4
30. Wattjes MP, Ciccarelli O, Reich DS, et al. 2021 MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis. Lancet Neurol. 2021 Aug;20(8):S1474-4422(21)00095-8. Review/Other-Dx N/A To present the 2021 revision of the previous guidelines on MRI use for patients with multiple sclerosis No results stated in abstract. 4
31. Traboulsee A, Li DKB. Routine MR Imaging Protocol and Standardization in Central Nervous System Demyelinating Diseases. Neuroimaging Clin N Am. 2024 Aug;34(3):S1052-5149(24)00022-4. Review/Other-Dx N/A Standardized MR imaging protocols are important for the diagnosis and monitoring of patients with multiple sclerosis (MS) and the appropriate use of MR imaging in routine clinical practice. No results stated in abstract. 4
32. Lim TRU, Kumaran SP, Suthiphosuwan S, et al. Limited utility of adding 3T cervical spinal cord MRI to monitor disease activity in multiple sclerosis. Mult Scler. 2024 Apr;30(4-5):505-515. Review/Other-Dx 1576 patients To measure the frequency of new isolated cervical spinal cord lesions (CSLs) in people with MS (pwMS) undergoing routine brain and cervical SC-MRI for disease monitoring and determine the factors associated with the development of new CSLs and their prognostic value. In 1285 pwMS (median interval: 13-14 months) who were clinically stable with respect to relapses, 73 (5.7%) had new CSLs, of which 49 (3.8%) had concomitant new BLs and 24 (1.9%) had new isolated CSLs only. New asymptomatic CSLs were associated with ? 3 prior relapses (p = 0.04), no disease-modifying therapy (DMT) use (p = 0.048), and ? 3 new BLs (p < 0.001); ? 3 new BLs (OR: 7.11, 95% CI: 4.3-11.7, p < 0.001) remained independently associated with new CSLs on multivariable analysis. Having new asymptomatic CSLs was not independently associated with subsequent relapse or disability worsening after the follow-up MRI (median follow-up time of 26 months). 4
33. Lin TY, Chien C, Lu A, Paul F, Zimmermann HG. Retinal optical coherence tomography and magnetic resonance imaging in neuromyelitis optica spectrum disorders and MOG-antibody associated disorders: an updated review. Expert Rev Neurother. 2021 Oct;21(10):1101-1123. Review/Other-Dx N/A To summarize the current status of imaging research in NMOSD and MOGAD, and reviews the clinical relevance of OCT, MRI and other relevant imaging techniques for differential diagnosis, screening and monitoring of the disease course. Retinal OCT and MRI can visualize and quantify CNS damage in vivo, improving our understanding of NMOSD and MOGAD pathology. Further efforts on the standardization of these imaging techniques are essential for implementation into clinical practice and as outcome parameters in clinical trials. 4
34. Sasiadek M, Hartel M, Siger M, et al. Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for a protocol concerning routinely used magnetic resonance imaging in patients with multiple sclerosis. Neurol Neurochir Pol. 2020;54(5):410-415. Review/Other-Dx N/A To present the second version of their recommendations for investigations routinely conducted in magnetic resonance imaging departments in patients with multiple sclerosis. Multiple sclerosis (MS) is a chronic immune mediated inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in a CNS destruction process disseminated in time (DIT) and space (DIS). MRI detects focal lesions in the white and grey matter with high sensitivity (although with significantly lower specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume (GMV) and white matter volume (WMV) as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, and hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. 4
35. Cruz A, Pereira D, Batista S. [Use of Gadolinium in Follow-Up MRI of Multiple Sclerosis Patients: Current Recommendations]. Acta Med Port. 2024 Jan 03;37(1):53-63. Review/Other-Dx N/A To collate current recommendations regarding the use of gadolinium in the imaging follow-up of multiple sclerosis and establish effective and safe guidelines for clinical practice. Although no biological or clinical consequences have been unequivocally attributed to the retention of gadolinium in the brain, which were mostly reported with linear agents, health authorities have been recommending the restriction of contrast to essential clinical circumstances. In multiple sclerosis, the detection of subclinical contrast-enhancing lesions with no corresponding new/ enlarging T2-WI lesions is rare and has a questionable impact on therapeutic decisions. On the other hand, gadolinium has a higher sensitivity in the differential diagnosis of relapses, in the detection of recent disease activity, before and after treatment initiation, and in patients with a large lesion burden or diffuse/confluent T2-WI lesions. 4
36. Khanna S, Sharma A, Huecker J, Gordon M, Naismith RT, Van Stavern GP. Magnetic resonance imaging of optic neuritis in patients with neuromyelitis optica versus multiple sclerosis. J Neuroophthalmol. 2012 Sep;32(3):216-20. Review/Other-Dx 17 patients To look systematically for any differences in the imaging appearance of the optic nerve in NMO and MS-related ON. No significant differences were observed in the presence, degree, or the type of signal alteration and contrast enhancement of the affected nerve segments between NMO and MS groups. There was a trend toward more posterior involvement of the optic nerve in the NMO group with chiasmatic enhancement exclusively seen in NMO patients. 4
37. Kennedy TA, Corey AS, Policeni B, et al. ACR Appropriateness Criteria® Orbits Vision and Visual Loss. J Am Coll Radiol 2018;15:S116-S31. Review/Other-Dx N/A Evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for orbits, vision and visual loss. No results stated in abstract. 4
38. Rovira À, Wattjes MP, Tintoré M, et al. Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis-clinical implementation in the diagnostic process. Nat Rev Neurol. 2015 Aug;11(8):471-82. Review/Other-Dx N/A To provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. No results stated in abstract. 4
39. Wattjes MP, Steenwijk MD, Stangel M. MRI in the Diagnosis and Monitoring of Multiple Sclerosis: An Update. Clin Neuroradiol. 2015 Oct;25 Suppl 2():157-65. Review/Other-Dx N/A To give an update on the role of MRI in the diagnosis and monitoring of MS with particular emphasis to treatment efficacy and safety, both in clinical practice and in research. No results stated in abstract. 4
40. Van den Bergh PYK, van Doorn PA, Hadden RDM, et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force-Second revision. Eur J Neurol. 2021 Nov;28(11):3556-3583. Review/Other-Dx N/A To revise the 2010 consensus guideline on chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Statements were prepared according to the GRADE Evidence-to-Decision frameworks. Typical CIDP and CIDP variants were distinguished. The previous term "atypical CIDP" was replaced by "CIDP variants" because these are well characterized entities (multifocal, focal, distal, motor, or sensory CIDP). The levels of diagnostic certainty were reduced from three (definite, probable, possible CIDP) to only two (CIDP and possible CIDP), because the diagnostic accuracy of criteria for probable and definite CIDP did not significantly differ. Good Practice Points were formulated for supportive criteria and investigations to be considered to diagnose CIDP. The principal treatment recommendations were: (a) intravenous immunoglobulin (IVIg) or corticosteroids are strongly recommended as initial treatment in typical CIDP and CIDP variants; (b) plasma exchange is strongly recommended if IVIg and corticosteroids are ineffective; (c) IVIg should be considered as first-line treatment in motor CIDP (Good Practice Point); (d) for maintenance treatment, IVIg, subcutaneous immunoglobulin or corticosteroids are recommended; (e) if the maintenance dose of any of these is high, consider either combination treatments or adding an immunosuppressant or immunomodulatory drug (Good Practice Point); and (f) if pain is present, consider drugs against neuropathic pain and multidisciplinary management (Good Practice Point). 4
41. van Doorn PA, Van den Bergh PYK, Hadden RDM, et al. European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain-Barré syndrome. Eur J Neurol. 2023 Dec;30(12):3646-3674. Review/Other-Dx N/A To develop an evidence-based guideline for the diagnosis and treatment of GBS. No results stated in abstract. 4
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