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We have entered an exciting period in the study of multiple sclerosis and its treatment. Central to this progress has been the introduction of magnetic reso nance techniques. When Young and his colleagues published the first images of the brain in multiple sclerosis at the end of 1981, it was at once obvious that magnetic resonance imaging would playa major role in diagnosis. Intuitively one felt that it would also have a role in increasing our understanding of the pathogenesis of the disease and in monitoring treatment. And so it has proved. Important problems however remain, perhaps the most important of which at present is the weak predictive power of standard magnetic resonance ima ging methods in determining the possibility of progression of impairment and disability. Recently, there have been advances which promise to overcome some of these problems, but decisions about what approach to adopt in selecting patients for clinical trials and which techniques to use in monitoring treatment during their course are still difficult. In this book, Dr. Filippi and his colleagues have assembled an outstanding group of contributors whose work is central to the progress that is being made. The coverage of the issues involved in the use of magnetic resonance techniques in assessing therapeutic effect is comprehensive and, though the field is chan ging rapidly, the principles and much of the detail in the book are likely to have lasting value.
List of contents
Clinical and Paraclinical Outcomes for Treatment Trials in Multiple Sclerosis.- The Use of Magnetic Resonance Imaging to Select Patients for Multiple Sclerosis Clinical Trials.- The Application of Magnetic Resonance Imaging to Phase II Trials in Multiple Sclerosis.- Magnetic Resonance Imaging Techniques to Monitor Phase III Treatment Trials.- New Strategies to Increase Magnetic Resonance Imaging Sensitivity in Detecting Individual Multiple Sclerosis Lesions and Short-term Disease Activity: Perspectives for Future Clinical Trials.- Problems with Conventional Magnetic Resonance Imaging and New Strategies to Improve the Utility of MRI in Future Clinical Trials.- Review of the Results of Previous Phase II, Magnetic Resonance Imaging-monitored Clinical Trials.- Magnetic Resonance Imaging Techniques in Phase III Clinical Trials in Multiple Sclerosis.- Standardisation, Optimisation and Organisation of Magnetic Resonance Imaging for Monitoring Clinical Trials.- Statistical Approaches to the Use of Magnetic Resonance Imaging Data for Clinical Trials.
