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Objective: The aim of this study is to investigate the use of susceptibility-based imaging (SbI) in distinguishing between pediatric-onset multiple sclerosis (POMS) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Background: MOG antibody-associated disease (MOGAD) and pediatric-onset MS (POMS) share clinical and MRI features but differ in prognosis and management. Early POMS diagnosis is essential to avoid disability accumulation. Central vein sign (CVS), paramagnetic rim lesions (PRLs), and central core lesions (CCL) are susceptibility-based imaging (SbI)-related signs understudied in pediatric populations that may help discerning POMS from MOGAD. Design/Methods: T2-FLAIR and SbI (3D-EPI/SWI or similar) were acquired on 1.5 T/3T scanners. Two readers assessed CVS positive rate (% CVS+) and their average score was used to build a receiver operator curve …