MS Frontiers 2022 | Slowly expanding lesions as predictive biomarkers in MS

Slowly expanding lesions (SELs) are MRI markers of chronic active lesions in multiple sclerosis (MS), which have been shown to associate with clinical worsening and the accumulation of more destructive pathology. Changes in existing MS lesions over time are poorly characterized on conventional MRI. The detection of SELs instead relies on serial scans, where calculated deformation fields are used to detect expansion over time. Alberto Calvi, MD, PhD Candidate, UCL Queen Square Institute of Neurology, Barts Health NHS Trust, London, UK, comments on the promise of SELs as prognostic/predictive markers in MS. The automated acquisition of a quantitative measure of lesion expansion may provide value information on chronic inflammatory activity and thus, risk of disability progression. While many clinical measures are correlated with the burden of SELs, further investigation is needed to understand how they relate to treatment response and if they can be used to predict outcomes. Dr Calvi also highlights the necessity of combining SELs with a panel of other markers for optimal performance. This interview took place during the MS Frontiers 2022 congress in Swansea, UK.