An NHS Trust in England has successfully implemented a new MRI-based diagnostic test for multiple sclerosis (MS) that replaces painful spinal taps. Developed by University of Nottingham experts, the T2*-weighted MRI scan reduces the average time to diagnosis from 5.6 months to 2.9 months, saving patients an average of 83 days.
The new diagnostic approach allows doctors to identify MS using a clinical MRI scanner—equipment standard in neuroscience centers—by adding only six minutes to the scanning process. This shift eliminates the need for lumbar punctures, which are known to cause back pain, headaches, and other unintended complications.
The Central Vein Sign and T2*-weighted MRI
Multiple sclerosis is characterized by lesions, or scars, in the spine or brain. These lesions typically form around small veins. The T2*-weighted MRI scan provides enough detail for clinicians to detect a central vein sign
, which is the presence of a vein in the middle of a lesion.
This specific marker allows medical professionals to distinguish MS from other neurological conditions that do not form lesions around veins in the same manner. According to Dr Christopher Gilmartin, the project’s first author, viewing these lesions with greater clarity enables an accurate diagnosis without invasive procedures, which in turn reduces delays for patients.
NHS Implementation and Patient Outcomes
To maximize efficiency, the Nottingham team integrated the MRI test into the NHS diagnostic pathway by scheduling the scan before the patient’s first clinic appointment. This restructuring significantly accelerated the timeline for patients to receive answers about their condition.
| Metric | Standard Outpatient Pathway | New MRI Diagnostic Pathway |
|---|---|---|
| Average Time to Diagnosis | 5.6 months | 2.9 months |
| Average Time Saved | — | 83 days |
The transition also offers financial benefits. The team estimated cost savings of around £292 per patient in Nottingham. However, because Nottingham performs a relatively low number of lumbar punctures, these figures likely underestimate the potential savings for other hospitals with higher puncture rates.
Research Evolution and Global Adoption
The test originated from a chance observation using a powerful 7 Tesla research scanner at the university, with early development supported by a grant from Nottingham University Hospitals. Professor Evangelou, a Professor of Clinical Neurology, has spent two decades pioneering the research from its initial recognition through clinical trials.
“I am delighted that a test developed in Nottingham has been embraced by the rest of the world, and we have been lucky to see it become part of the international diagnostic criteria for MS.”
Professor Evangelou, Professor of Clinical Neurology
The method is now being adopted by neurology departments globally, and the findings regarding its rollout have been published in Neurology: Clinical Practice.
Impact on Patient Stress
For the approximately 150,000 people in the UK living with MS, the diagnosis process is often difficult because the disease progresses at different rates and symptoms vary between sufferers.
“It’s a petrifying thing when you consider about the side effects and how you feel afterwards and you don’t want that on top of an already daunting diagnosis. That is why this development is an amazing thing. To have something non-invasive and quicker, eases the stress, and stress is a big thing for MS too.”
Rachel Mellor, MS patient
The research team continues to encourage other hospitals across the UK to adopt the MRI test to reduce patient stress and accelerate the start of treatment.
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