Beyond White Spots: Rethinking MRI in MS

MRI scans can reveal far more than just "white spots." New imaging techniques are uncovering hidden inflammation, silent disease activity, and smoldering lesions that may continue damaging the brain even when someone feels stable and routine MRI scans appear unchanged. This episode explores how MRI is evolving from a diagnostic tool into a window into the underlying biology of multiple sclerosis. We discuss why spinal cord imaging can sometimes reveal disease missed in the brain, how the "central vein sign" may help prevent MS misdiagnosis, and why brain shrinkage remains difficult to measure reliably in individuals living with multiple sclerosis. The conversation also dives into some of the most exciting frontiers in MS imaging including myelin repair, functional MRI, and how artificial intelligence could dramatically improve the speed and precision of MRI scans in the future. Barry Singer, MD, Director of The MS Center for Innovations in Care, interviews: Anthony Traboulsee, MD, Professor of Neurology, University of British Columbia and Director of the UBC MS/MRI Research Group in Vancouver Frederik Barkhof, MD, PhD, Professor of Neuroradiology, Amsterdam UMC and University College London