In this episode of the ECTRIMS Podcast, recorded in collaboration with the Multiple Sclerosis Journal "Controversies in MS" series, host Prof. Anneke van der Walt moderates a discussion between Prof. Andy Solomon and Prof. Enrique Gómez on one of the most debated developments in modern multiple sclerosis diagnosis.

Together, they explore:

• Why misdiagnosis remains a major challenge in MS care
• The role of the central vein sign (CVS) and paramagnetic rim lesions (PRLs) in improving specificity
• Whether expanding diagnostic sensitivity may increase false positives
• The practical realities of implementing advanced MRI biomarkers globally
• The importance of radiology training, implementation science, and AI-assisted imaging
• How clinicians should approach MRI interpretation in real-world practice

This conversation examines the balance between earlier diagnosis, diagnostic accuracy, and equitable implementation of emerging diagnostic tools across different healthcare settings.

This episode is part of the MS Journal Controversies in MS series on The revised 2024 McDonald criteria can solve the misdiagnosis problem in MS. The accompanying Yes, No, and Commentary articles are available to read open access for the next month, compliments of MS Journal.