I have been wondering about the value of an MRI with and without contrast. With the FDA saying gadolinium is safe, but accumulates in the brain, what would be the times in which you might *skip* the gadolinium part of the MRI? If you have had a year with no relapses and nothing showed on the previous MRI and if you don't have any new active symptoms would it be worth using the contrast still? If there was some inflammation but weren't likely to change the DMT would you still recommend contrast? Would having an MRI every other year with contrast be a reasonable approach?
Different practitioners approach this differently and there can be specific reasons certain individuals should get MRIs WITH contrast every year. That said, if there are no new symptoms, one option is to get a MRI each year without contrast and then return for another MRI with new contrast if new lesions are seen on the non-contrast MRI.
Benjamin M. Greenberg, MD, MHS
Vice Chair of Translational Research and Strategic Initiatives
Cain Denius Scholar of Mobility Disorders
Distinguished Teaching Professor
Department of Neurology and Neurotherapeutics
Department of Pediatrics
UT Southwestern Medical Center