New test diagnoses MS without needle procedure

A test developed in Nottingham is helping to diagnose multiple sclerosis (MS) without the need for an invasive lumbar puncture.

Experts at the University of Nottingham (UoN) found they could successfully identify MS with a new type of MRI scan, after more than 20 years of research.

Patients being tested for the neurological condition - caused when the immune system mistakenly attacks nerves in the brain and spinal cord - previously had to undergo a procedure involving a needle being inserted into their lower back.

Medical experts behind the test, which has been rolled out in the city, said it is faster, cheaper, and they hope it will now be rolled out across the country.

The lumbar puncture procedure involves a needle being inserted into the lower back so fluid can be collected from the spine.

Dr Chris Gilmartin, neurology researcher and doctor at Queen's Medical Centre in Nottingham, said: "This involves a day trip to hospital and can cause headaches and back pain, and so it wasn't very much liked by patients.

"When people are being diagnosed with MS it's clearly a very stressful time.

"People have new strange symptoms that they don't yet have an answer for what's causing them. To say on top of that, 'What you need is a needle to go into the back', can be quite scary.

The MRI test has reduced diagnosis time and is "much less invasive", Gilmartin added.

"We really do hope it gets rolled out across the country. We're working on it."

Teresa Needham, from Stapleford, is among the patients who have been diagnosed with MS through the MRI scan.

She underwent a scan after it was suspected she had suffered a stroke due to facial paralysis affecting her lip.

"The team there started to talk about MS and at that point, it's devastating to hear that they're thinking MS. I was very shocked and surprised to find out that was what I'd got."

Needham, who said she did not like needles, was offered the MRI option.

The lab manager for the geography school at UoN added: "The last thing I wanted was something invasive at that point when I was feeling quite stressed.

"It's absolutely brilliant because I was able to go to that test and go to work straight after."

MS is characterised by multiple scars in the brain or spine. These scars, or lesions, form around little veins.

The new test lets doctors see MS lesions in close detail so they can tell if there are veins in the middle of lesions. This 'central vein sign' distinguishes MS from other conditions, which do not form around veins in the same way.

A 7 Tesla scanner - the most powerful of its kind at the time - was installed at UoN more than 10 years ago.

Prof Paul Morgan, professor of medical physics at UoN, who has been involved with the research for more than 20 years, said: "This [scanner] allowed us to zoom up the magnification when undertaking people's brain scans."

He added: "We found that if we cranked up the magnification on the brain scans of people with multiple sclerosis, we could see not only the multiple sclerosis lesions, but within those lesions we saw a small dark hole, which we later realised was a vein going through the lesion."

By adding an "extra six minutes" to a scan on a standard scanner, the new test can identify MS from other suspected diagnoses, Gilmartin said.

Morgan added: "People will know that there will be a long history of MRI research in Nottingham, from the inventions of [Sir] Peter Mansfield onwards."

Sir Peter Mansfield led the team which developed magnetic resonance imaging (MRI) - which generates 3D internal images of the body using strong magnetic fields and radio waves - in Nottingham in the 1970s.

Of the MS test, Morgan said: "It shows you the great story of great research, all the way to clinical practice."

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