Conventional and Advanced Magnetic Resonance Imaging Biomarkers of Multiple Sclerosis in the Brain

Multiple sclerosis (MS) is a heterogeneous disease, and each MS patient exhibits different clinical symptoms that are reflected in their magnetic resonance imaging (MRI) results. Each MS lesion should be interpreted carefully and evaluated in conjunction with a clinical examination. MRI plays a major role in evaluating how MS lesions are aggregated in the central nervous system and how they change over time. There are several conventional MRI biomarkers of MS that could be utilized to evaluate each MS phenotype. MRI is useful for clinical decisions, aiding in the determination of disease-modifying treatment or disease prognosis. Despite its higher sensitivity, MRI provides low specificity due to the heterogeneity of MS lesions. However, advanced MRI biomarkers show promise in terms of defining MS lesions, as each imaging biomarker correlates differently with the clinical scenario of each MS phenotype. The aim of this review is to summarise the current state of MRI biomarkers for MS in the brain and how they relate to neurological disabilities.