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Table 1: Frequency of MRI surveillance
Clinical Indication Frequency of Imaging Imaging Protocol
RRMS, routine surveillance Annually for at least the first 2 or 3 years after starting therapy or switching DMT T2-weighted and contrast-enhanced T1-weighted
Higher risk patients (positive for JC virus serum antibodies) with >24 mo of NTZ exposure Every 3–6 months T2WI, T2 FLAIR, DWI, SWI (if indicated)
Low risk of PML (negative for JC virus serum antibodies) Annually T2WI, T2 FLAIR, DWI, SWI (if indicated)
Patients at high risk of developing opportunistic infections who are switching DMT MRI when the current treatment is discontinued and 3–6 months after the new treatment is started T2WI, T2 FLAIR, DWI, SWI (if indicated)
Patients who switch from NTZ to other therapeutics (including fingolimod, alemtuzumab, and dimethyl fumarate) Enhanced pharmacovigilance, including brain MRI every 3–4 mo for up to 12 mo T2WI, T2 FLAIR, DWI, SWI (if indicated)
Patients who require enhanced pharmacovigilance for other reasons Every 3–6 mo As indicated
Note:—RRMS indicates relapsing-remitting MS.