How often should I have an MRI scan with MS?

This is not a straightforward question to answer unfortunately as there is no official guidance which specifies the frequency that people with MS should have an MRI scan in the UK.

MRIs are usually conducted at the discretion of the patient’s neurologist, considering how they think a new scan may influence or improve the care they can offer the person in their MS treatment.

For people taking the DMT Tysabri (natalizumab) who are deemed a high risk of developing progressive multifocal leukoencephalopathy (PML), it is suggested that MRI scans be taken regularly at 3 to 6 month intervals. The National Institute for Health and Care Excellence (NICE) recommend MRI scans be conducted annually for all patients taking Tysabri. This helps to detect PML related activity, such as white matter lesions, which are consistent to its development.

Furthermore, people with secondary progressive (SPMS) and primary progressive (PPMS) MS may also be offered a new MRI scan to determine if they are eligible for the DMTs Siponimod and Ocrevus respectively.

In 2022 it was reported on the website of the Neurology Academy that The British Society of Neuroradiology (BSNR) in conjunction with the Association of British Neurologists (ABN) were drafting guidelines to help neurologists with consistency of approach when monitoring MS patients. They suggest the best approach would be for people with relapsing remitting MS (RRMS) to undergo an annual brain and cord MRI scan plus a re-baseline scan six months post diagnosis.

In cases where there has been no historical evidence of MS affecting the spinal cord, cord MRI scans can be conducted less frequently, so just the brain would be scanned annually. Furthermore, they suggest a re-baseline MRI is conducted routinely post-partum as this is a time when MS activity can be unstable, and upon switching DMT.

The sticking point is that there can be significant differences in the availability of resources and problems with capacity in the many public health trusts around the UK. This will need to be accounted for before any standardised monitoring approaches are put into practice, to ensure that all people affected by MS receive the same level of treatment no matter where they reside.