Updated French OFSEP recommendations for multiple sclerosis MRI: alignment with the 2024 McDonald criteria
Journal of Neuroradiology. 2026-09-01; 53(5): 101576
DOI: 10.1016/j.neurad.2026.101576
Lecler A(1), Mondot L(2), Homo C(3), Tourdias T(4), Vukusic S(3), Durand-Dubief
F(5), Bapst B(6), Cotton F(7); OFSEP imaging group; MS Working Group of the
French Society of Neuroradiology (Société Française de Neuroradiologie, SFNR).
Author information:
(1)Université Paris Cité, Faculté de Médecine 75006 Paris, France; Department of
Imaging, Hôpital Fondation Adolphe de Rothschild, 29 rue Manin 75019 Paris,
France; INSERM UMR 970 75015 Paris, France. Electronic address:
.
(2)Université Nice Côte d’Azur, UR2CA (URRIS), Centre Hospitalier Universitaire
de Nice, Service d’imagerie Pasteur 2 06000 Nice, France.
(3)Université de Lyon, Université Claude Bernard Lyon 1 F-69000 Lyon, France;
Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies
de la myéline et neuro-inflammation F-69677 Bron, France; Observatoire Français
de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM
1028 et CNRS UMR 5292 F-69003 Lyon, France; Fondation Eugène Devic EDMUS contre
la sclérose en plaques, fondation reconnue d’utilité publique, F-69677 Bron,
France.
(4)CHU de Bordeaux, Neuroimagerie diagnostique et thérapeutique F-33000
Bordeaux, France; Université de Bordeaux, INSERM, Neurocentre Magendie, U1215
F-33000 Bordeaux, France.
(5)Université de Lyon, Université Claude Bernard Lyon 1 F-69000 Lyon, France;
Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies
de la myéline et neuro-inflammation F-69677 Bron, France; CREATIS, INSERM U1044,
CNRS UMR 5220, Université Claude Bernard Lyon 1 69100 Villeurbanne, France.
(6)Department of Neuroradiology, AP-HP, Henri Mondor University Hospital,
Créteil, France; EA 4391, Université Paris Est Créteil, Créteil, France.
(7)CREATIS, INSERM U1044, CNRS UMR 5220, Université Claude Bernard Lyon 1 69100
Villeurbanne, France; Radiology Department, Centre Hospitalier Lyon-Sud,
Hospices Civils de Lyon 69310 Pierre-Bénite, France.
BACKGROUND: Magnetic resonance imaging (MRI) is central to the diagnosis and
follow-up of multiple sclerosis (MS). Since the 2020 OFSEP recommendations, the
2024 McDonald criteria have introduced major changes, including recognition of
the optic nerve as a fifth anatomical topography and integration of two
specificity biomarkers – the central vein sign (CVS) and the paramagnetic rim
lesion (PRL).
OBJECTIVE: To update the French OFSEP MRI recommendations for MS while remaining
feasible on every 1.5 T and 3 T scanner in France.
METHODS: A multidisciplinary OFSEP-SFNR working group conducted a modified
Delphi-like consensus process.
RECOMMENDATIONS: The core brain protocol comprises isotropic fat-suppressed 3D
FLAIR (1 mm³), DWI with ADC maps, and an optimised 3D susceptibility-sensitive
sequence (3D T2* GRE or 3D SWI with filtered phase) for CVS and PRL. A
contrast-enhanced 3D spin-echo T1 sequence and a dedicated orbital protocol for
suspected optic neuritis are added at diagnosis. The spinal cord protocol
includes at least two complementary sequences, with a high-contrast heavily
T1-weighted sequence when available. Follow-up uses the same core protocol with
strictly reproducible 3D FLAIR; gadolinium is restricted to targeted
indications.
CONCLUSION: This vendor-neutral framework supports earlier, more specific MS
diagnosis and reduced gadolinium use across French centres.
Copyright © 2026. Published by Elsevier Masson SAS.
DOI: 10.1016/j.neurad.2026.101576
PMID: 42250869
Conflict of interest statement: Declaration of competing interest A. Lecler has
received speaker honoraria from Biogen, Amgen, Alexion, Bayer, and Bracco. F.
Cotton has received speaker honoraria from Alexion, Biogen, Bracco, Bayer,
Merck, and Novartis. B. Bapst has received speaker honoraria from Biogen. The
other authors declare no competing interests.