MRI in multiple sclerosis follow-up: does the BartsMS experience support the case for AI assistance?

Abstract

Introduction The 2021 magnetic resonance imaging in MS (MAGNIMS) guidance offers benchmarks for MRI in people with multiple sclerosis (pwMS) on disease- modifying treatment (DMT). The MS service at Barts Health NHS Trust (BartsMS) has adopted an amended version of this guidance, with extended timelines following the COVID pandemic. Aims To review MRI monitoring of pwMS at BartsMS. To inform sample size in 'AssistMS', a multicenter project testing artificial intelligence (AI) supported MRI reading in pwMS. Methods Demographics, timelines, reports and multi-disciplinary team (MDT) decisions were reviewed October-December 2022. Patients were identified via PACS. Results 189 pwMS undergoing MRI were identified. 160/189 datasets were obtained for DMT follow-up. Mean time from request to MRI 104 days (range 0- 371); mean time since previous scan 595 days (9-2834); mean time for reporting 52 days (0-312). Of 25 pwMS discussed at MDT, mean time from acquisition to MDT was 84 days (11-331). MRI changes alone led to DMT changes in 9.5% (18/189). Conclusion Whilst MRI scans were obtained within recommended timelines, significant variation, and delays in reporting and MDT decisions, were observed. Backlogs due to shortage of neuroradiological expertise may be eased by employing AIsupported MRI registration and analysis.