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We sought to establish evidence\u2010based guidelines detailing the neuroimaging surveillance of boys with neurologically asymptomatic adrenoleukodystrophy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To establish the most frequent age and diagnostic neuroimaging modality for CCALD, we completed a meta\u2010analysis of relevant studies published between January 1, 1970 and September 10, 2019. We used the consensus development conference method to incorporate the resulting data into guidelines to inform the timing and techniques for neuroimaging surveillance. Final guideline agreement was defined as &gt;80% consensus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred twenty\u2010three studies met inclusion criteria yielding 1285 patients. The overall mean age of CCALD diagnosis is 7.91\u2009years old. The median age of CCALD diagnosis calculated from individual patient data is 7.0\u2009years old (IQR: 6.0\u20109.5, n = 349). Ninety percent of patients were diagnosed between 3 and 12. Conventional MRI was most frequently reported, comprised most often of T2\u2010weighted and contrast\u2010enhanced T1\u2010weighted MRI. The expert panel achieved 95.7% consensus on the following surveillance parameters: (a) Obtain an MRI between 12 and 18\u2009months old. (b) Obtain a second MRI 1 year after baseline. (c) Between 3 and 12\u2009years old, obtain a contrast\u2010enhanced MRI every 6 months. (d) After 12\u2009years, obtain an annual MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Boys with adrenoleukodystrophy identified early in life should be monitored with serial brain MRIs during the period of highest risk for conversion to CCALD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jimd.12356","type":"journal-article","created":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T03:08:07Z","timestamp":1609297687000},"page":"728-739","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["<scp>MRI<\/scp> surveillance of boys with X\u2010linked adrenoleukodystrophy identified by newborn screening: Meta\u2010analysis and consensus guidelines"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2678-8807","authenticated-orcid":false,"given":"Eric J.","family":"Mallack","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Child 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