From pixels to pathology: what can MRI–histology studies teach us about myelin damage and repair?

Medical imaging is increasingly expected to deliver information that is quantitative, interpretable, and scalable. In MRI, a major challenge is moving from visually compelling images to measurements that meaningfully reflect underlying biology. Using myelin—the "insulation" that helps nerve signals travel efficiently—as an example, this keynote will explore how quantitative MRI methods, including myelin water imaging, magnetization transfer–based contrasts, and diffusion-derived measures, aim to characterize tissue microstructure beyond what routine scans can provide. I will share lessons from studies that directly compare MRI with histology, highlighting both the promise and the pitfalls of using imaging as a surrogate for pathology. The talk will close with practical translation considerations (standardization, reproducibility, and deployment constraints) and a forward-looking view of how myelin-sensitive MRI can support clinical trials and, ultimately, patient care.