Diagnostic performance of central vein sign and paramagnetic rim lesion integration for multiple sclerosis
BACKGROUND: The central vein sign (CVS) and the paramagnetic rim lesion (PRL) are neuroimaging biomarkers of multiple sclerosis (MS). OBJECTIVES: To determine the diagnostic performance of CVS and PRL integration in people presenting for initial diagnostic evaluation of MS. METHODS: Adults with clinical/radiological suspicion of MS, aged 18-65, with CVS and PRL assessment from the CentrAl Vein Sign in MS (CAVS-MS) pilot were included. Diagnostic performance of CVS and PRL combinations was evaluated, with 2017 McDonald criteria as the reference standard. RESULTS: = 46, 24 with MS), ⩾6 CVS and ⩾1 PRL diagnostic specificity was 1.00 (95% CI, 0.85, 1.00), similar to that of oligoclonal bands and dissemination in space by magnetic resonance imaging (0.82 [95% CI, 0.60, 0.95]). DISCUSSION: Integrating CVS and PRL represents potentially advantageous MS diagnostic biomarkers, with increased specificity and without substantial reduction in sensitivity.
Authors
- Eduardo Caverzasi (ORCID: https://orcid.org/0000-0002-0350-0460)
- Léorah Freeman (ORCID: https://orcid.org/0000-0002-5696-1797)
- Daniel Ontaneda (ORCID: https://orcid.org/0000-0002-2838-9148)
- Daniel S. Reich (ORCID: https://orcid.org/0000-0002-2628-4334)
- Brian Renner (ORCID: https://orcid.org/0000-0003-3729-5255)
- Erin E. Longbrake (ORCID: https://orcid.org/0000-0002-1179-3937)
- Melissa L. Martin (ORCID: https://orcid.org/0000-0001-8631-5596)
- Lynn Daboul (ORCID: https://orcid.org/0000-0002-2158-3992)
- Christina Azevedo (ORCID: https://orcid.org/0000-0002-8622-1845)
- Matthew K. Schindler (ORCID: https://orcid.org/0000-0003-0157-5669)
- Carly M. O’Donnell (ORCID: https://orcid.org/0000-0003-2730-6758)
- Quy Cao (ORCID: https://orcid.org/0000-0002-6204-1305)
- Karlo Toljan (ORCID: https://orcid.org/0000-0002-3189-9659)
- Elias S. Sotirchos (ORCID: https://orcid.org/0000-0002-8812-1637)
- Nancy L. Sicotte (ORCID: https://orcid.org/0000-0002-5131-3352)
- Nico Papinutto (ORCID: https://orcid.org/0000-0003-2184-4782)
- Kunio Nakamura (ORCID: https://orcid.org/0000-0002-7833-8138)
- A Bar-Or
- Pascal Sati (ORCID: https://orcid.org/0000-0002-6763-0125)
- Rohini Samudralwar
- Andrew J. Solomon
- Roland G Henry
- Paulo Henrique de Almeida Rodrigues
- Russell T Shinohara
- Jiwon Oh (ORCID: https://orcid.org/0000-0001-5519-6088)
- Daniel Pelletier
- Peter A Calabresi (ORCID: https://orcid.org/0000-0002-7776-6472)
- Bruce A C Cree (ORCID: https://orcid.org/0000-0001-7689-2533)
- John Derbyshire
Institutions
- University of Vermont (US)
- University of Southern California (US)
- Cedars-Sinai Medical Center (US)
- St. Michael's Hospital (CA)
- National Institutes of Health (US)
- Cleveland Clinic (US)
- Johns Hopkins University (US)
- University of California, San Francisco (US)
- University of Toronto (CA)
- University of Pavia (IT)
- Yale University (US)
- National Institute of Neurological Disorders and Stroke (US)
- National Institute of Mental Health (US)
- University of Pennsylvania (US)
- The University of Texas at Austin (US)
- The University of Texas Health Science Center at Houston (US)
Publication Details
- Journal
- Multiple Sclerosis Journal
- Published
- 2026-04-20
- DOI
- https://doi.org/10.1177/13524585261434218
- Primary Topic
- Multiple Sclerosis Research Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Race to Erase MS
- National Institutes of Health
- National Institute of Neurological Disorders and Stroke