Evaluation of MRI criteria for dissemination in space

The Barkhof/Tintore criteria for providing MRI evidence of dissemination in space has important prognostic value, according to investigators finding that patients who fulfill the criteria have an increased likelihood of conversion to clinically definite MS. The authors applied the criteria to the baseline MRI scans of 532 patients with clinically isolated syndromes and assessed the criteria's accuracy in predicting conversion to definite MS using a second clinical event as the main outcome. They found the overall conversion rate was 32.5%, but the risk of conversion was almost four times more likely in patients whose MRI scans fulfilled the criteria than in those whose did not (odds ratio 3.7, 95% CI 2.3 - 5.9; pThe authors add, "Also, the number of Barkhof/Tintore criteria fulfilled created significant discrimination in the Kaplan Meier analysis, revealing a higher risk and faster conversion to clinically definite multiple sclerosis for subgroups fulfilling more Barkhof/Tintore criteria."The study cohort included patients with clinically isolated syndrome, including many patients without asymptomatic lesions at baseline. The authors note, "This group therefore provides an opportunity to investigate the performance of the criteria in a patient group representative of those seen in daily practice in different centres." They say the clinical implications of their study are that patients who fulfull the Barkhof/Tintore criteria are much more likely to convert to clinically definite MS, and in a much shorter time, than patients who do not fulfill the criteria. However, clinically definite MS can still develop in patients not fulfilling the criteria, but probably at a later stage.Reference...