Jaume Sastre-Garriga, MD, PhD, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain, discusses the developing research regarding the use of MRI as a biomarker in multiple sclerosis (MS). From a diagnostic standpoint, current investigations are focused on finding which brain lesions are specific to MS, such as paramagnetic rim lesions and the central vein sign. Assessing the extent of optic nerve damage through MRI, optical coherence tomography, and evoked potentials is also under continued investigation to try to refine its diagnostic capabilities. Additionally, MRI can be used as a prognostic/predictive tool, with current research investigating how smoldering lesions, leptomeningeal enhancement, and brain volumetry can predict outcomes and treatment response in MS. This interview took place at the American Academy of Neurology 2022 Congress in Seattle, WA.