The article discusses the concept of "dissemination in time" (DIT) in the diagnosis of multiple sclerosis (MS). DIT has been a key component of MS diagnosis for decades, helping to exclude other diseases that mimic MS. However, the article highlights the limitations of relying solely on DIT, as misdiagnosis rates for MS are high and there is moderate reliability in determining dissemination in space (DIS) through MRI. The article suggests that emerging imaging biomarkers, such as the central vein sign (CVS) and the paramagnetic rim lesion (PRL), may offer high specificity for MS diagnosis in the future. However, the fulfillment of DIS criteria remains important for optimal sensitivity in MS diagnosis. [Extracted from the article]