{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:37:14Z","timestamp":1790897834913,"version":"4.1.0"},"reference-count":64,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Voros Innovation and Impact Fund"},{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["I01CX002160-01A1"],"award-info":[{"award-number":["I01CX002160-01A1"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000890","name":"National Multiple Sclerosis Society","doi-asserted-by":"publisher","award":["RG-1901-33190"],"award-info":[{"award-number":["RG-1901-33190"]}],"id":[{"id":"10.13039\/100000890","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>We conducted a systematic review to examine the use of spinal cord (SC) magnetic resonance imaging (MRI) in clinical trials for multiple sclerosis (MS) and discussed the significant challenges that impede its widespread implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Major findings:<\/jats:title>\n                    <jats:p>\n                      We identified 291 phase II and phase III clinical trials. Of these, 228 (78.4%) included at least one MRI outcome. Eight clinical trials (2.7%) were planned to include at least one SC MRI outcome, but only three (1.0%) reported related methodologies or results. The MRI metrics considered in these studies included cervical SC cross-sectional area (1.0%) and SC T\n                      <jats:sub>2<\/jats:sub>\n                      -lesion number (0.3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A very small proportion of clinical trials have used SC MRI metrics as outcome measures. Given the substantial impact of SC disease on disability, it is essential to standardize SC imaging, post-processing, and analytical methods across centres to enhance the effectiveness and applicability of SC MRI in future clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13524585261438770","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T13:12:16Z","timestamp":1776777136000},"page":"557-567","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Spinal cord imaging in multiple sclerosis: A vital component we can no longer overlook"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4688-9728","authenticated-orcid":false,"given":"Ahmad A","family":"Toubasi","sequence":"first","affiliation":[{"name":"Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7577-1887","authenticated-orcid":false,"given":"Dhairya A","family":"Lakhani","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Moore","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science, Department of Radiology and Radiological Science, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Schilling","sequence":"additional","affiliation":[{"name":"Vanderbilt University Institute of Imaging Science, Department of Radiology and Radiological Science, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9544-9019","authenticated-orcid":false,"given":"Francesca","family":"Bagnato","sequence":"additional","affiliation":[{"name":"Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA; Department of Neurology, VA Medical Centre, TN Valley Healthcare System, Nashville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756285617708911"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70003-0"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0312421"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21867"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70131-9"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01314-8"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30137-1"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30485-5"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010284"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000001037"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4635"},{"key":"e_1_3_3_14_2","unstructured":"ClinicalTrials.gov. A phase 1\/2 two-part open-label dose-escalation and double-blind placebo-controlled dose-expansion study with an open-label extension to evaluate the safety and efficacy of ATA188 in subjects with progressive multiple sclerosis 2017 https:\/\/clinicaltrials.gov\/study\/NCT03283826"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12729"},{"issue":"5","key":"e_1_3_3_16_2","first-page":"1","article-title":"Cooperative study in the evaluation of therapy in multiple sclerosis: ACTH vs. placebo \u2013 final report","volume":"20","author":"Rose AS","year":"1970","unstructured":"Rose AS, Kuzma JW, Kurtzke JF, et al. Cooperative study in the evaluation of therapy in multiple sclerosis: ACTH vs. placebo \u2013 final report. Neurology 1970; 20(5): 1\u201359.","journal-title":"Neurology"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2022.103006"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12553"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458515599246"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.28271"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25799"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458517697830"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awz156"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2019.101426"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26281"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207768"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awy352"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuri.2022.100071"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458515604905"},{"key":"e_1_3_3_30_2","article-title":"Technical issues for MRI examination of the spinal cord","volume":"172","author":"McGowan JC.","year":"2000","unstructured":"McGowan JC. Technical issues for MRI examination of the spinal cord. J Neurol Sci 2000; 172: S27\u2013S31.","journal-title":"J Neurol Sci"},{"key":"e_1_3_3_31_2","first-page":"218","article-title":"Automatic segmentation of the spinal cord nerve rootlets","volume":"2","author":"Valo\u0161ek J","year":"2024","unstructured":"Valo\u0161ek J, Mathieu T, Schlienger R, et al. Automatic segmentation of the spinal cord nerve rootlets. Imaging Neurosci (Camb) 2024; 2: 218.","journal-title":"Imaging Neurosci (Camb)"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0730-725X(01)00409-X"},{"key":"e_1_3_3_33_2","unstructured":"Figley C Stroman P. Characterization of spinal cord motion: A source of errors in spinal fMRI. In: Proceedings of the International Society for Magnetic Resonance 2006 https:\/\/archive.ismrm.org\/2006\/0997.html"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.12659\/PJR.892628"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12666"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.637198"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/1352458514564494"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-015-7754-z"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2009.12.121"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2019.116489"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2024.120775"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2018.09.081"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.media.2025.103473"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1162\/IMAG.a.1105"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(99)00276-2"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4638"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-72649-9"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2023.122846"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-024-02700-6"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-025-13068-2"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2020.07.005"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0155557"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.adh9853"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2014.03.005"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.26909"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.08.055"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2017.07.003"},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2013.04.124"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.10.009"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1109\/ISBI.2019.8759196"},{"key":"e_1_3_3_61_2","unstructured":"Snoussi H Cohen-Adad J Commowick O et al. Evaluation of distortion correction methods in diffusion MRI of the spinal cord 2021 https:\/\/arxiv.org\/abs\/2108.03817"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2024.01.008"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2017.10.041"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.06.040"},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.09.026"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585261438770","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13524585261438770","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13524585261438770","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T10:44:13Z","timestamp":1779101053000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13524585261438770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":64,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/13524585261438770"],"URL":"https:\/\/doi.org\/10.1177\/13524585261438770","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]}}}