1
|
Murali S, Ding H, Adedeji F, Qin C, Obungoloch J, Asllani I, Anazodo U, Ntusi NAB, Mammen R, Niendorf T, Adeleke S. Bringing MRI to low- and middle-income countries: Directions, challenges and potential solutions. NMR IN BIOMEDICINE 2024; 37:e4992. [PMID: 37401341 DOI: 10.1002/nbm.4992] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 07/05/2023]
Abstract
The global disparity of magnetic resonance imaging (MRI) is a major challenge, with many low- and middle-income countries (LMICs) experiencing limited access to MRI. The reasons for limited access are technological, economic and social. With the advancement of MRI technology, we explore why these challenges still prevail, highlighting the importance of MRI as the epidemiology of disease changes in LMICs. In this paper, we establish a framework to develop MRI with these challenges in mind and discuss the different aspects of MRI development, including maximising image quality using cost-effective components, integrating local technology and infrastructure and implementing sustainable practices. We also highlight the current solutions-including teleradiology, artificial intelligence and doctor and patient education strategies-and how these might be further improved to achieve greater access to MRI.
Collapse
Affiliation(s)
- Sanjana Murali
- School of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Hao Ding
- School of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Fope Adedeji
- School of Medicine, Faculty of Medicine, University College London, London, UK
| | - Cathy Qin
- Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - Johnes Obungoloch
- Department of Biomedical Engineering, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Iris Asllani
- Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, New York, USA
| | - Udunna Anazodo
- Department of Medical Biophysics, Western University, London, Ontario, Canada
- The Research Institute of London Health Sciences Centre and St. Joseph's Health Care, London, Ontario, Canada
| | - Ntobeko A B Ntusi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
- South African Medical Research Council Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, Cape Town, South Africa
| | - Regina Mammen
- Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, UK
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrück Centre for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sola Adeleke
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
- High Dimensional Neuro-oncology, University College London Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| |
Collapse
|
2
|
Tian Y, Nayak KS. New clinical opportunities of low-field MRI: heart, lung, body, and musculoskeletal. MAGMA (NEW YORK, N.Y.) 2024; 37:1-14. [PMID: 37902898 PMCID: PMC10876830 DOI: 10.1007/s10334-023-01123-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 11/01/2023]
Abstract
Contemporary whole-body low-field MRI scanners (< 1 T) present new and exciting opportunities for improved body imaging. The fundamental reason is that the reduced off-resonance and reduced SAR provide substantially increased flexibility in the design of MRI pulse sequences. Promising body applications include lung parenchyma imaging, imaging adjacent to metallic implants, cardiac imaging, and dynamic imaging in general. The lower cost of such systems may make MRI favorable for screening high-risk populations and population health research, and the more open configurations allowed may prove favorable for obese subjects and for pregnant women. This article summarizes promising body applications for contemporary whole-body low-field MRI systems, with a focus on new platforms developed within the past 5 years. This is an active area of research, and one can expect many improvements as MRI physicists fully explore the landscape of pulse sequences that are feasible, and as clinicians apply these to patient populations.
Collapse
Affiliation(s)
- Ye Tian
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, 3740 McClintock Ave, EEB 406, Los Angeles, CA, 90089-2564, USA.
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, 3740 McClintock Ave, EEB 406, Los Angeles, CA, 90089-2564, USA
| |
Collapse
|
3
|
Germonpré J, Vandekerckhove LMJ, Raes E, Chiers K, Jans L, Vanderperren K. Post-mortem feasibility of dual-energy computed tomography in the detection of bone edema-like lesions in the equine foot: a proof of concept. Front Vet Sci 2024; 10:1201017. [PMID: 38249561 PMCID: PMC10797750 DOI: 10.3389/fvets.2023.1201017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction In this proof-of-concept study, the post-mortem feasibility of dual-energy computed tomography (DECT) in the detection of bone edema-like lesions in the equine foot is described in agreement with the gold standard imaging technique, which is magnetic resonance imaging (MRI). Methods A total of five equine cadaver feet were studied, of which two were pathological and three were within normal limits and served as references. A low-field MRI of each foot was performed, followed by a DECT acquisition. Multiplanar reformations of DECT virtual non-calcium images were compared with MRI for the detection of bone edema-like lesions. A gross post-mortem was performed, and histopathologic samples were obtained of the navicular and/or distal phalanx of the two feet selected based on pathology and one reference foot. Results On DECT virtual non-calcium imaging, the two pathological feet showed diffuse increased attenuation corresponding with bone edema-like lesions, whereas the three reference feet were considered normal. These findings were in agreement with the findings on the MRI. Histopathology of the two pathologic feet showed abnormalities in line with bone edema-like lesions. Histopathology of the reference foot was normal. Conclusion DECT virtual non-calcium imaging can be a valuable diagnostic tool in the diagnosis of bone edema-like lesions in the equine foot. Further examination of DECT in equine diagnostic imaging is warranted in a larger cohort, different locations, and alive animals.
Collapse
Affiliation(s)
- Jolien Germonpré
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Louis M. J. Vandekerckhove
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Els Raes
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Koen Chiers
- Department of Pathobiology, Pharmacology, and Zoological Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lennart Jans
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Katrien Vanderperren
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| |
Collapse
|
4
|
van Zandwijk JK, Schuurmann RCL, Haken BT, Stassen CM, Geelkerken RH, de Vries JPPM, Simonis FFJ. Endograft position and endoleak detection after endovascular abdominal aortic repair with low-field tiltable MRI: a feasibility study. Eur Radiol Exp 2023; 7:82. [PMID: 38123829 PMCID: PMC10733271 DOI: 10.1186/s41747-023-00395-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/11/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Abdominal aortic endoleaks after endovascular aneurysm repair might be position-dependent, therefore undetectable using supine imaging. We aimed to determine the feasibility and benefit of using a low-field tiltable magnetic resonance imaging (MRI) scanner allowing to study patients who can be imaged in both supine and upright positions of endoleaks. METHODS Ten EVAR patients suspected of endoleak based on ultrasound examination were prospectively included. MRI in upright and supine positions was compared with routine supine computed tomography angiography (CTA). Analysis was performed through (1) subjective image quality assessment by three observers, (2) landmark registration between MRI and CTA scans, (3) Euclidean distances between renal and endograft landmarks, and (4) evaluation of endoleak detection on MRI by a consensus panel. Statistical analysis was performed by one-way repeated measures analysis of variance. RESULTS The image quality of upright/supine MRI was inferior compared to CTA. Median differences in both renal and endograft landmarks were approximately 6-7 mm between upright and supine MRI and 5-6 mm between supine MRI and CTA. In the proximal sealing zone of the endograft, no differences were found among all three scan types (p = 0.264). Endoleak detection showed agreement between MRI and CTA in 50% of the cases, with potential added value in only one patient. CONCLUSIONS The benefit of low-field upright MRI for endoleak detection was limited. While MRI assessment was non-inferior to standard CTA in detecting endoleaks in selected cases, improved hardware and sequences are needed to explore the potential of upright MRI in patients with endoleaks. RELEVANCE STATEMENT Upright low-field MRI has limited clinical value in detecting position-dependent endoleaks; improvements are required to fulfil its potential as a complementary modality in this clinical setting. KEY POINTS • Upright MRI shows potential for imaging endoleaks in aortic aneurysm patients in different positions. • The image quality of upright MRI is inferior to current techniques. • Upright MRI complements CTA, but lacks accurate deformation measurements for clinical use. • Advancements in hardware and imaging sequences are needed to fully utilise upright MRI capabilities.
Collapse
Affiliation(s)
- Jordy K van Zandwijk
- Magnetic Detection & Imaging, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
- Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.
| | - Richte C L Schuurmann
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands
- Multimodality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Bennie Ten Haken
- Magnetic Detection & Imaging, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Chrit M Stassen
- Department of Radiology, Ziekenhuisgroep Twente, Hengelo, The Netherlands
| | - Robert H Geelkerken
- Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
- Multimodality Medical Imaging Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Jean-Paul P M de Vries
- Department of Surgery, Division of Vascular Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Frank F J Simonis
- Magnetic Detection & Imaging, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| |
Collapse
|
5
|
Lopez Schmidt I, Haag N, Shahzadi I, Frohwein LJ, Schneider C, Niehoff JH, Kroeger JR, Borggrefe J, Moenninghoff C. Diagnostic Image Quality of a Low-Field (0.55T) Knee MRI Protocol Using Deep Learning Image Reconstruction Compared with a Standard (1.5T) Knee MRI Protocol. J Clin Med 2023; 12:jcm12051916. [PMID: 36902704 PMCID: PMC10003576 DOI: 10.3390/jcm12051916] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/21/2023] [Accepted: 02/25/2023] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVES Low-field MRI at 0.55 Tesla (T) with deep learning image reconstruction has recently become commercially available. The objective of this study was to evaluate the image quality and diagnostic reliability of knee MRI performed at 0.55T compared with 1.5T. METHODS A total of 20 volunteers (9 female, 11 male; mean age = 42 years) underwent knee MRI on a 0.55T system (MAGNETOM Free.Max, Siemens Healthcare, Erlangen, Germany; 12-channel Contour M Coil) and a 1.5T scanner (MAGNETOM Sola, Siemens Healthcare, Erlangen, Germany; 18-channel transmit/receive knee coil). Standard two-dimensional (2D) turbo spin echo (TSE), fat-suppressed (fs) proton density-weighted (PDw), T1w TSE, and T2w TSE sequences were acquired in approximately 15 min. In total, 2 radiologists blinded to the field strength subjectively assessed all MRI sequences (overall image quality, image noise, and diagnostic quality) using a 5-point Likert scale (1-5; 5 = best). Additionally, both radiologists evaluated the possible pathologies of menisci, ligaments, and cartilage. Contrast ratios (CRs) of different tissues (bone, cartilage, and menisci) were determined on coronal PDw fs TSE images. The statistical analysis included Cohen's kappa and the Wilcoxon rank sum test. RESULTS The overall image quality of the 0.55T T2w, T1w, and PDw fs TSE sequences was diagnostic and rated similar for T1w (p > 0.05), but lower for PDw fs TSE and T2w TSE compared with 1.5T (p < 0.05). The diagnostic accordance of meniscal and cartilage pathologies at 0.55T was similar to 1.5T. The CRs of the tissues were not significantly different between 1.5T and 0.55T (p > 0.05). The inter-observer agreement of the subjective image quality was generally fair between both readers and almost perfect for the pathologies. CONCLUSIONS Deep learning-reconstructed TSE imaging at 0.55T yielded diagnostic image quality for knee MRI compared with standard 1.5T MRI. The diagnostic performance of meniscal and cartilage pathologies was equal for 0.55T and 1.5T without a significant loss of diagnostic information.
Collapse
Affiliation(s)
- Ingo Lopez Schmidt
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, 32429 Minden, Germany
| | - Nina Haag
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, 32429 Minden, Germany
| | - Iram Shahzadi
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, 32429 Minden, Germany
- Siemens Healthcare, GmbH, 91052 Erlangen, Germany
| | | | - Claus Schneider
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, 32429 Minden, Germany
| | - Julius Henning Niehoff
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, 32429 Minden, Germany
| | - Jan Robert Kroeger
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, 32429 Minden, Germany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, 32429 Minden, Germany
| | - Christoph Moenninghoff
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, 32429 Minden, Germany
- Correspondence: ; Tel.: +49-571-790-54602; Fax: +49-571-790-294601
| |
Collapse
|
6
|
Modern Low-Field MRI of the Musculoskeletal System: Practice Considerations, Opportunities, and Challenges. Invest Radiol 2023; 58:76-87. [PMID: 36165841 DOI: 10.1097/rli.0000000000000912] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
ABSTRACT Magnetic resonance imaging (MRI) provides essential information for diagnosing and treating musculoskeletal disorders. Although most musculoskeletal MRI examinations are performed at 1.5 and 3.0 T, modern low-field MRI systems offer new opportunities for affordable MRI worldwide. In 2021, a 0.55 T modern low-field, whole-body MRI system with an 80-cm-wide bore was introduced for clinical use in the United States and Europe. Compared with current higher-field-strength MRI systems, the 0.55 T MRI system has a lower total ownership cost, including purchase price, installation, and maintenance. Although signal-to-noise ratios scale with field strength, modern signal transmission and receiver chains improve signal yield compared with older low-field magnetic resonance scanner generations. Advanced radiofrequency coils permit short echo spacing and overall compacter echo trains than previously possible. Deep learning-based advanced image reconstruction algorithms provide substantial improvements in perceived signal-to-noise ratios, contrast, and spatial resolution. Musculoskeletal tissue contrast evolutions behave differently at 0.55 T, which requires careful consideration when designing pulse sequences. Similar to other field strengths, parallel imaging and simultaneous multislice acquisition techniques are vital for efficient musculoskeletal MRI acquisitions. Pliable receiver coils with a more cost-effective design offer a path to more affordable surface coils and improve image quality. Whereas fat suppression is inherently more challenging at lower field strengths, chemical shift selective fat suppression is reliable and homogeneous with modern low-field MRI technology. Dixon-based gradient echo pulse sequences provide efficient and reliable multicontrast options, including postcontrast MRI. Metal artifact reduction MRI benefits substantially from the lower field strength, including slice encoding for metal artifact correction for effective metal artifact reduction of high-susceptibility metallic implants. Wide-bore scanner designs offer exciting opportunities for interventional MRI. This review provides an overview of the economical aspects, signal and image quality considerations, technological components and coils, musculoskeletal tissue relaxation times, and image contrast of modern low-field MRI and discusses the mainstream and new applications, challenges, and opportunities of musculoskeletal MRI.
Collapse
|
7
|
Arnold TC, Freeman CW, Litt B, Stein JM. Low-field MRI: Clinical promise and challenges. J Magn Reson Imaging 2023; 57:25-44. [PMID: 36120962 PMCID: PMC9771987 DOI: 10.1002/jmri.28408] [Citation(s) in RCA: 63] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 02/03/2023] Open
Abstract
Modern MRI scanners have trended toward higher field strengths to maximize signal and resolution while minimizing scan time. However, high-field devices remain expensive to install and operate, making them scarce outside of high-income countries and major population centers. Low-field strength scanners have drawn renewed academic, industry, and philanthropic interest due to advantages that could dramatically increase imaging access, including lower cost and portability. Nevertheless, low-field MRI still faces inherent limitations in image quality that come with decreased signal. In this article, we review advantages and disadvantages of low-field MRI scanners, describe hardware and software innovations that accentuate advantages and mitigate disadvantages, and consider clinical applications for a new generation of low-field devices. In our review, we explore how these devices are being or could be used for high acuity brain imaging, outpatient neuroimaging, MRI-guided procedures, pediatric imaging, and musculoskeletal imaging. Challenges for their successful clinical translation include selecting and validating appropriate use cases, integrating with standards of care in high resource settings, expanding options with actionable information in low resource settings, and facilitating health care providers and clinical practice in new ways. By embracing both the promise and challenges of low-field MRI, clinicians and researchers have an opportunity to transform medical care for patients around the world. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 6.
Collapse
Affiliation(s)
- Thomas Campbell Arnold
- Department of Bioengineering, School of Engineering & Applied ScienceUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Center for Neuroengineering and TherapeuticsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Colbey W. Freeman
- Department of Radiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Brian Litt
- Center for Neuroengineering and TherapeuticsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of Neurology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Joel M. Stein
- Center for Neuroengineering and TherapeuticsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of Radiology, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| |
Collapse
|
8
|
Wang B, Siddiq SS, Walczyk J, Bruno M, Khodarahmi I, Brinkmann IM, Rehner R, Lakshmanan K, Fritz J, Brown R. A flexible MRI coil based on a cable conductor and applied to knee imaging. Sci Rep 2022; 12:15010. [PMID: 36056131 PMCID: PMC9440226 DOI: 10.1038/s41598-022-19282-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/26/2022] [Indexed: 11/08/2022] Open
Abstract
Flexible radiofrequency coils for magnetic resonance imaging (MRI) have garnered attention in research and industrial communities because they provide improved accessibility and performance and can accommodate a range of anatomic postures. Most recent flexible coil developments involve customized conductors or substrate materials and/or target applications at 3 T or above. In contrast, we set out to design a flexible coil based on an off-the-shelf conductor that is suitable for operation at 0.55 T (23.55 MHz). Signal-to-noise ratio (SNR) degradation can occur in such an environment because the resistance of the coil conductor can be significant with respect to the sample. We found that resonating a commercially available RG-223 coaxial cable shield with a lumped capacitor while the inner conductor remained electrically floating gave rise to a highly effective "cable coil." A 10-cm diameter cable coil was flexible enough to wrap around the knee, an application that can benefit from flexible coils, and had similar conductor loss and SNR as a standard-of-reference rigid copper coil. A two-channel cable coil array also provided good SNR robustness against geometric variability, outperforming a two-channel coaxial coil array by 26 and 16% when the elements were overlapped by 20-40% or gapped by 30-50%, respectively. A 6-channel cable coil array was constructed for 0.55 T knee imaging. Incidental cartilage and bone pathologies were clearly delineated in T1- and T2-weighted turbo spin echo images acquired in 3-4 min with the proposed coil, suggesting that clinical quality knee imaging is feasible in an acceptable examination timeframe. Correcting for T1, the SNR measured with the cable coil was approximately threefold lower than that measured with a 1.5 T state-of-the-art 18-channel coil, which is expected given the threefold difference in main magnetic field strength. This result suggests that the 0.55 T cable coil conductor loss does not deleteriously impact SNR, which might be anticipated at low field.
Collapse
Affiliation(s)
- Bili Wang
- Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R), New York University Grossman School of Medicine, 660 First Ave, New York, NY, USA
| | - Syed S Siddiq
- Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R), New York University Grossman School of Medicine, 660 First Ave, New York, NY, USA
- Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jerzy Walczyk
- Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R), New York University Grossman School of Medicine, 660 First Ave, New York, NY, USA
| | - Mary Bruno
- Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R), New York University Grossman School of Medicine, 660 First Ave, New York, NY, USA
| | - Iman Khodarahmi
- Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R), New York University Grossman School of Medicine, 660 First Ave, New York, NY, USA
- Division of Musculoskeletal Radiology, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | | | | | - Karthik Lakshmanan
- Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R), New York University Grossman School of Medicine, 660 First Ave, New York, NY, USA
| | - Jan Fritz
- Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R), New York University Grossman School of Medicine, 660 First Ave, New York, NY, USA
- Division of Musculoskeletal Radiology, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Ryan Brown
- Department of Radiology, Center for Advanced Imaging Innovation and Research (CAI2R), New York University Grossman School of Medicine, 660 First Ave, New York, NY, USA.
| |
Collapse
|
9
|
Guallart-Naval T, Algarín JM, Pellicer-Guridi R, Galve F, Vives-Gilabert Y, Bosch R, Pallás E, González JM, Rigla JP, Martínez P, Lloris FJ, Borreguero J, Marcos-Perucho Á, Negnevitsky V, Martí-Bonmatí L, Ríos A, Benlloch JM, Alonso J. Portable magnetic resonance imaging of patients indoors, outdoors and at home. Sci Rep 2022; 12:13147. [PMID: 35907975 PMCID: PMC9338984 DOI: 10.1038/s41598-022-17472-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/26/2022] [Indexed: 12/25/2022] Open
Abstract
Mobile medical imaging devices are invaluable for clinical diagnostic purposes both in and outside healthcare institutions. Among the various imaging modalities, only a few are readily portable. Magnetic resonance imaging (MRI), the gold standard for numerous healthcare conditions, does not traditionally belong to this group. Recently, low-field MRI technology companies have demonstrated the first decisive steps towards portability within medical facilities and vehicles. However, these scanners' weight and dimensions are incompatible with more demanding use cases such as in remote and developing regions, sports facilities and events, medical and military camps, or home healthcare. Here we present in vivo images taken with a light, small footprint, low-field extremity MRI scanner outside the controlled environment provided by medical facilities. To demonstrate the true portability of the system and benchmark its performance in various relevant scenarios, we have acquired images of a volunteer's knee in: (i) an MRI physics laboratory; (ii) an office room; (iii) outside a campus building, connected to a nearby power outlet; (iv) in open air, powered from a small fuel-based generator; and (v) at the volunteer's home. All images have been acquired within clinically viable times, and signal-to-noise ratios and tissue contrast suffice for 2D and 3D reconstructions with diagnostic value. Furthermore, the volunteer carries a fixation metallic implant screwed to the femur, which leads to strong artifacts in standard clinical systems but appears sharp in our low-field acquisitions. Altogether, this work opens a path towards highly accessible MRI under circumstances previously unrealistic.
Collapse
Affiliation(s)
| | - José M Algarín
- Institute for Molecular Imaging and Instrumentation, Spanish National Research Council, 46022, Valencia, Spain
- Institute for Molecular Imaging and Instrumentation, Universitat Politècnica de València, 46022, Valencia, Spain
| | - Rubén Pellicer-Guridi
- PhysioMRI Tech S.L., 46022, Valencia, Spain
- Asociación de investigación MPC, 20018, San Sebastián, Spain
| | - Fernando Galve
- Institute for Molecular Imaging and Instrumentation, Spanish National Research Council, 46022, Valencia, Spain
- Institute for Molecular Imaging and Instrumentation, Universitat Politècnica de València, 46022, Valencia, Spain
| | - Yolanda Vives-Gilabert
- PhysioMRI Tech S.L., 46022, Valencia, Spain
- Intelligent Data Analysis Laboratory, Department of Electronic Engineering, Universitat de València, 46100, Burjassot, Spain
| | | | - Eduardo Pallás
- Institute for Molecular Imaging and Instrumentation, Spanish National Research Council, 46022, Valencia, Spain
- Institute for Molecular Imaging and Instrumentation, Universitat Politècnica de València, 46022, Valencia, Spain
| | | | | | | | | | | | | | | | - Luis Martí-Bonmatí
- Medical Imaging Department, Hospital Universitari i Politècnic La Fe, 46026, Valencia, Spain
| | | | - José M Benlloch
- Institute for Molecular Imaging and Instrumentation, Spanish National Research Council, 46022, Valencia, Spain
- Institute for Molecular Imaging and Instrumentation, Universitat Politècnica de València, 46022, Valencia, Spain
| | - Joseba Alonso
- Institute for Molecular Imaging and Instrumentation, Spanish National Research Council, 46022, Valencia, Spain.
- Institute for Molecular Imaging and Instrumentation, Universitat Politècnica de València, 46022, Valencia, Spain.
| |
Collapse
|
10
|
Grau-Ruiz D, Rigla JP, Pallás E, Algarín JM, Borreguero J, Bosch R, López-Comazzi G, Galve F, Díaz-Caballero E, Gramage C, González JM, Pellicer R, Ríos A, Benlloch JM, Alonso J. Magneto-stimulation limits in medical imaging applications with rapid field dynamics. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac515c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/02/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. The goal of this work is to extend previous peripheral nerve stimulation (PNS) studies to scenarios relevant to magnetic particle imaging (MPI) and low-field magnetic resonance imaging (MRI), where field dynamics can evolve at kilo-hertz frequencies. Approach. We have constructed an apparatus for PNS threshold determination on a subject’s limb, capable of narrow and broad-band magnetic stimulation with pulse characteristic times down to 40 μs. Main result. From a first set of measurements on 51 volunteers, we conclude that the PNS dependence on pulse frequency/rise-time is compatible with traditional stimulation models where nervous responses are characterized by a rheobase and a chronaxie. Additionally, we have extended pulse length studies to these fast timescales and confirm thresholds increase significantly as trains transition from tens to a few pulses. We also look at the influence of field spatial distribution on PNS effects, and find that thresholds are higher in an approximately linearly inhomogeneous field (relevant to MRI) than in a rather homogeneous distribution (as in MPI). Significance. PNS constrains the clinical performance of MRI and MPI systems. Extensive magneto-stimulation studies have been carried out recently in the field of MPI, where typical operation frequencies range from single to tens of kilo-hertz. However, PNS literature is scarce for MRI in this fast regime, relevant to small (low inductance) dedicated MRI setups, and where the resonant character of MPI coils prevents studies of broad-band stimulation pulses. This work advances in this direction.
Collapse
|
11
|
Carrell T, Gu M, Bosshard JC, Sun C, McDougall MP, Wright SM. Assessing the Feasibility of Dynamic 31P Spectroscopy for Metabolic Studies with a 1.0T Extremity Scanner. IEEE Trans Biomed Eng 2021; 69:1975-1982. [PMID: 34855583 DOI: 10.1109/tbme.2021.3132252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective: The feasibility of conducting in vivo non-localized 31P Magnetic Resonance Spectroscopy (MRS) with a 1.0T extremity scanner and the potential to increase accessibility of this important diagnostic tool for low cost applications is revisited. Methods: This work presents a custom transmit-only quadrature birdcage, four-element receive coil array, and spectrometer interfaced to a commercial ONI 1.0T magnet for enabling multi-channel, non-1H frequency capabilities. A custom, magnetic resonance compatible plantar flexion-extension exercise device was also developed to enable exercise protocols. The coils were assessed with bench measurements and 31P phantom studies before an in vivo demonstration. Results: In pulse and acquire spectroscopy of a phantom, the array was found to improve the signal-to-noise ratio (SNR) by a factor of 1.31 and reduce the linewidth by 13.9% when compared to a large loop coil of the same overall size. In vivo testing results show that two averages and a four second repetition time for a temporal resolution of eight seconds was sufficient to obtain phosphocreatine recovery values and baseline pH levels aligned with expected literature values. Conclusion: Initial in vivo human skeletal muscle 31P MRS allowed successful monitoring of metabolic changes during an 18-minute exercise protocol. Significance: Adding an array coil and multinuclear capability to a commercial low-cost 1.0T extremity scanner enabled the observation of characteristic 31P metabolic information, such as the phosphocreatine recovery rate and underlying baseline pH.
Collapse
|
12
|
Ehrle A, Lilge S, Clegg PD, Maddox TW. Equine flexor tendon imaging part 2: Current status and future directions in advanced diagnostic imaging, with focus on the deep digital flexor tendon. Vet J 2021; 278:105763. [PMID: 34678501 DOI: 10.1016/j.tvjl.2021.105763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 09/17/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022]
Abstract
Flexor tendon injuries are a common cause of lameness and early retirement in equine athletes. While ultrasonography is most frequently utilised, advanced diagnostic imaging modalities are becoming more widely available for detection and monitoring of flexor tendon lesions. Part two of this literature review details current experience with low- and high-field magnetic resonance imaging (MRI) and computed tomography (CT) for the diagnosis of equine flexor tendinopathy with a focus on the deep digital flexor tendon. Implications of the 'magic angle' artefact as well as injection techniques and the use of contrast media are discussed. Future developments in tendon imaging aim to gain enhanced structural information about the tendon architecture with the prospect to prevent injury. Techniques as described for the assessment of the human Achilles tendon including ultra-high field MRI and positron emission tomography are highlighted.
Collapse
Affiliation(s)
- Anna Ehrle
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK; Equine Clinic, Freie Universität Berlin, 10965 Berlin, Germany.
| | - Svenja Lilge
- Equine Clinic, Freie Universität Berlin, 10965 Berlin, Germany
| | - Peter D Clegg
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK
| | - Thomas W Maddox
- Department of Musculoskeletal and Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston CH64 7TE, UK
| |
Collapse
|
13
|
Vazquez F, Marrufo O, Solis-Najera SE, Martin R, Rodriguez AO. External Waveguide Magnetic Resonance Imaging for lower limbs at 3 T. Med Phys 2021; 49:158-168. [PMID: 34633673 DOI: 10.1002/mp.15281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION We report a method based on the travelling-wave MRI approach, in order to acquire images of human lower limbs with an external waveguide at 3 T. METHOD We use a parallel-plate waveguide and an RF surface coil for reception, while a whole-body birdcage is used for transmission. The waveguide and the surface coil are located right outside the magnet, in the MR conditional devices zone. We ran numerical simulations to investigate the B1 field generated by the surface coil located at one of the waveguides, as well as a saline-solution phantom positioned on the opposite side (150 cm away) inside the magnet. RESULTS We obtained phantom images by varying the distance between the coil and the phantom, in order to investigate the signal-to-noise ratio and to validate our numerical simulations. Lower limb images of a healthy volunteer were also acquired, demonstrating the viability of this approach. Standard pulse sequences were used and no physical modifications were made to the MR imager. CONCLUSIONS These numerical and experimental results show that travelling-wave MRI can produce high-quality images with only a simple waveguide and an RF coil located outside the magnet. This can be particularly favorable when acquiring images of lower limbs requiring a larger field of view.
Collapse
Affiliation(s)
- F Vazquez
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurocirugia MVS, Mexico City, 14269, Mexico
| | - S E Solis-Najera
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - R Martin
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitama Iztapalapa, Mexico City, 09340, Mexico
| |
Collapse
|
14
|
Cobianchi Bellisari F, Bruno F, Monti R, Cicerone C, Palumbo P, Arrigoni F, Mariani S, Gianneramo C, Mangoni di S Stefano ML, Carbone M, Gentili F, Mazzei MA, Masciocchi C, Barile A. Diagnostic performance of DIXON sequences on low-field scanner for the evaluation of knee joint pathology. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021403. [PMID: 34505845 PMCID: PMC8477066 DOI: 10.23750/abm.v92is5.11870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIM Recently, there has been a growing interest in the use of Dixon sequence for knee MRI in order to save time spent on the scanner, and improving diagnostic utility. Our purpose was to compare the diagnostic performance of Dixon sequence on low-field MRI with the proton-density sequence on high-field MRI. METHODS This prospective study included 40 patients who underwent 0.25T knee MRI, using the routine protocol with the addition of a sagittal 4-point Dixon sequence (SPED), and an additional sequence on 1.5T scanner, consisting in a fat-suppressed proton-density fast-spin-echo (FS PD-FSE). Two radiologists independently examined the images, evaluating the anatomic identification score and diagnostic performances of the two sequences. Interreader agreement was evaluated using an intraclass correlation coefficient (ICC). RESULTS Final population counted 34 patients (36 knee MR images) with a mean age of 52.9 years (range, 18-75 years). Interreader agreement was very high except for cartilage injuries at medial femoral condyle and medial tibial plateau (ICC SPED: 0.757, ICC FS PD-FSE: 0.746), even if not statistically significant. There were no significant differences in mean signal-to-noise ratio (SNR), artifacts presence and diagnostic confidence between SPED and PD-FS sequence. CONCLUSIONS Dixon sequences on low-field scanner have a comparable diagnostic accuracy to PD-FS sequence obtained on a high field scanner for knee MR imaging. (www.actabiomedica.it).
Collapse
Affiliation(s)
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy .
| | - Riccardo Monti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy .
| | - Claudia Cicerone
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy .
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy and Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122, Milan, Italy .
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Silvia Mariani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Camilla Gianneramo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | - Mattia Carbone
- Department of Radiology, San Giovanni E Ruggi D'Aragona Hospital, Ospedale, Via San Leonardo, Salerno, Italy.
| | - Francesco Gentili
- Section of Radiology, Unit of Surgical Sciences, University of Parma, Parma, Italy.
| | - Maria Antonietta Mazzei
- Department of Medical, Surgical and Neuro Sciences, University of Siena, Department of Radiological Sciences, Unit of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy .
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy .
| |
Collapse
|
15
|
Jogi SP, Thaha R, Rajan S, Mahajan V, Venugopal VK, Mehndiratta A, Singh A. Device for Assessing Knee Joint Dynamics During Magnetic Resonance Imaging. J Magn Reson Imaging 2021; 55:895-907. [PMID: 34369633 DOI: 10.1002/jmri.27877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Knee assessment with and without load using magnetic resonance imaging (MRI) can provide information on knee joint dynamics and improve the diagnosis of knee joint diseases. Performing such studies on a routine MRI-scanner require a load-exerting device during scanning. There is a need for more studies on developing loading devices and evaluating their clinical potential. PURPOSE Design and develop a portable and easy-to-use axial loading device to evaluate the knee joint dynamics during the MRI study. STUDY TYPE Prospective study. SUBJECTS Nine healthy subjects. FIELD STRENGTH/SEQUENCE A 0.25 T standing-open MRI and 3.0 T MRI. PD-T2 -weighted FSE, 3D-fast-spoiled-gradient-echo, FS-PD, and CartiGram sequences. ASSESSMENT Design and development of loading device, calibration of loads, MR safety assessment (using projectile angular displacement, torque, and temperature tests). Scoring system for ease of doing. Qualitative (by radiologist) and quantitative (using structural similarity index measure [SSIM]) image-artifact assessment. Evaluation of repeatability, comparison with various standing stances load, and loading effect on knee MR parameters (tibiofemoral bone gap [TFBG], femoral cartilage thickness [FCT], tibial cartilage thickness [TCT], femoral cartilage T2 -value [FCT2], and tibia cartilage T2 -value [TCT2]). The relative percentage change (RPC) in parameters due to the device load was computed. STATISTICAL TEST Pearson's correlation coefficient (r). RESULTS The developed device is conditional-MR safe (details in the manuscript and supplementary materials), 15 × 15 × 45 cm3 dimension, and <3 kg. The ease of using the device was 4.9/5. The device introduced no visible image artifacts, and SSIM of 0.9889 ± 0.0153 was observed. The TFBG intraobserver variability (absolute difference) was <0.1 mm. Interobserver variability of all regions of interest was <0.1 mm. The load exerted by the device was close to the load during standing on both legs in 0.25 T scanner with r > 0.9. Loading resulted in RPC of 1.5%-11.0%, 7.9%-8.5%, and -1.5% to 13.0% in the TFBG, FCT, and TCT, respectively. FCT2 and TCT2 were reduced in range of 1.5-2.7 msec and 0.5-2.3 msec due to load. DATA CONCLUSION The proposed device is conditionally MR safe, low cost (material cost < INR 6000), portable, and effective in loading the knee joint with up to 50% of body weight. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
Collapse
Affiliation(s)
- Sandeep P Jogi
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Department of Biomedical Engineering, ASET, Amity University Haryana, Gurgaon, Haryana, India
| | - Rafeek Thaha
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | | | | | | | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India
| | - Anup Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
16
|
Dooley K, Snodgrass SJ, Stanwell P, Birse S, Schultz A, Drew MK, Edwards S. Spatial muscle activation patterns during different leg exercise protocols in physically active adults using muscle functional MRI: a systematic review. J Appl Physiol (1985) 2020; 129:934-946. [PMID: 32853111 DOI: 10.1152/japplphysiol.00290.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
An emerging method to measure muscle activation patterns is muscle functional magnetic resonance imaging (mfMRI), where preexercise and postexercise muscle metabolism differences indicate spatial muscle activation patterns. We evaluated studies employing mfMRI to determine activation patterns of lumbar or lower limb muscles following exercise in physically active adults. Electronic systematic searches were conducted until March 2020. All studies employing ≥1.5 Tesla MRI scanners to compare spatial muscle activation patterns at the level of or inferior to the first lumbar vertebra in healthy, active adults. Two authors independently assessed study eligibility before appraising methodological quality using a National Institutes of Health assessment tool. Because of heterogeneity, findings were synthesized without meta-analysis. Of the 1,946 studies identified, seven qualified for inclusion and pertained to hamstring (n = 5), quadriceps (n = 1) or extrinsic foot (n = 1) muscles. All included studies controlled for internal validity, with one employing assessor blinding. MRI physics and differing research questions explain study methodology heterogeneity. Significant mfMRI findings were: following Nordic exercise, hamstrings with previous trauma (strain or surgical autograft harvest) demonstrated reduced activation compared with unharmed contralateral muscles, and asymptomatic individuals preferentially activated semitendinosus; greater biceps femoris long head to semitendinosus ratios reported following 45° hip extension over Nordic exercise; greater rectus femoris activation occurred in "flywheel" over barbell squats. mfMRI parameters differ on the basis of individual research questions. Individual muscles show greater activation following specific exercises, suggesting exercise specificity may be important for rehabilitation, although evidence is limited to single cohort studies comparing interlimb differences preexercise versus postexercise.
Collapse
Affiliation(s)
- Katherine Dooley
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Suzanne J Snodgrass
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Peter Stanwell
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Samantha Birse
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, New South Wales, Australia
| | - Adrian Schultz
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, New South Wales, Australia
| | - Michael K Drew
- Department of Physical Therapies, Australian Institute of Sport, Canberra, Australia
| | - Suzi Edwards
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, New South Wales, Australia
| |
Collapse
|
17
|
Byrne CA, Marshall JF, Voute LC. Clinical magnetic resonance image quality of the equine foot is significantly influenced by acquisition system. Equine Vet J 2020; 53:469-480. [PMID: 32767582 DOI: 10.1111/evj.13330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/22/2020] [Accepted: 07/16/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Investigation of image quality in clinical equine magnetic resonance (MR) imaging may optimise diagnostic value. OBJECTIVES To assess the influence of field strength and anaesthesia on image quality in MR imaging of the equine foot in a clinical context. STUDY DESIGN Analytical clinical study. METHODS Fifteen equine foot studies (five studies per system) were randomly selected from the clinical databases of three MR imaging systems: low-field standing (LF St), low-field anaesthetised (LF GA) and high-field anaesthetised (HF GA). Ten experienced observers graded image quality for entire studies and seven clinically important anatomical structures within the foot (briefly, grade 1: textbook quality, grade 2: high diagnostic quality, grade 3: satisfactory diagnostic quality, grade 4: non-diagnostic). Statistical analysis assessed the effect of anaesthesia and field strength using a combination of the Pearson chi-square test or Fisher's exact test and Mann-Whitney test. RESULTS There was no difference in the proportion of entire studies of diagnostic quality between LF St (90%, 95% CI 78%-97%) and LF GA (88%, 76-95%, P = .7). No differences were evident in the proportion of diagnostic studies or median image quality gradings between LF St and LF GA when assessing individual anatomical structures (both groups all median grades = 3). There was a statistically significant difference in the proportion of entire studies of diagnostic quality between LF GA and HF GA (100%, 95% CI lower bound 94%, P = .03). There were statistically significant differences in median image quality gradings between LF GA (all median grades = 3) and HF GA (median grades = 1 (5/7 structures) or 2 (2/7 structures) for all individual anatomical structures (all P < .001). The reasons reported for reduced image quality differed between systems. MAIN LIMITATIONS Randomised selection of cases from clinical databases. Individual observer preferences may influence image quality assessment. CONCLUSIONS Field strength is a more important influencer of image quality than anaesthesia for magnetic resonance imaging of the equine foot in clinical patients.
Collapse
Affiliation(s)
- Christian A Byrne
- Weipers Centre Equine Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - John F Marshall
- Weipers Centre Equine Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Lance C Voute
- Weipers Centre Equine Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|
18
|
Schröder FF, Post CE, van Raak SM, Simonis FFJ, Wagenaar FCBM, Huis In't Veld RMHA, Verdonschot N. The diagnostic potential of low-field MRI in problematic total knee arthroplasties - a feasibility study. J Exp Orthop 2020; 7:59. [PMID: 32737621 PMCID: PMC7394973 DOI: 10.1186/s40634-020-00274-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/15/2020] [Indexed: 12/29/2022] Open
Abstract
Purpose Low-field MRI, allowing imaging in supine and weight-bearing position, may be utilized as a non-invasive and affordable tool to differentiate between causes of dissatisfaction after TKA (‘problematic TKA’). However, it remains unclear whether low-field MRI results in sufficient image quality with limited metal artefacts. Therefore, this feasibility study explored the diagnostic value of low-field MRI concerning pathologies associated with problematic TKA’s’ by comparing low-field MRI findings with CT and surgical findings. Secondly, differences in patellofemoral parameters between supine and weight-bearing low-field MRI were evaluated. Methods Eight patients with a problematic TKA were scanned using low-field MRI in weight-bearing and supine conditions. Six of these patients underwent revision surgery. Scans were analysed by a radiologist for pathologies associated with a problematic TKA. Additional patellofemoral and alignment parameters were measured by an imaging expert. MRI observations were compared to those obtained with CT, the diagnosis based on the clinical work-up, and findings during revision surgery. Results MRI observations of rotational malalignment, component loosening and patellofemoral arthrosis were comparable with the clinical diagnosis (six out of eight) and were confirmed during surgery (four out of six). All MRI observations were in line with CT findings (seven out of seven). Clinical diagnosis and surgical findings of collateral excessive laxity could not be confirmed with MRI (two out of eight). Conclusion Low-field MRI shows comparable diagnostic value as CT and might be a future low cost and ionizing radiation free alternative. Differences between supine and weight-bearing MRI did not yield clinically relevant information. The study was approved by the Medical Research Ethics Committees of Twente (Netherlands Trial Register: Trial NL7009 (NTR7207). Registered 5 March 2018, https://www.trialregister.nl/trial/7009).
Collapse
Affiliation(s)
- Femke F Schröder
- OCON, centre for orthopaedic surgery, Geerdinksweg 141 postbus 546, 7550, AM, Hengelo, The Netherlands. .,University of Twente, Faculty of Engineering Technology, Biomechanical Engineering, postbus 217 7500 AE, Enschede, The Netherlands.
| | - Corine E Post
- OCON, centre for orthopaedic surgery, Geerdinksweg 141 postbus 546, 7550, AM, Hengelo, The Netherlands.,University of Twente, Faculty of Engineering Technology, Biomechanical Engineering, postbus 217 7500 AE, Enschede, The Netherlands.,Orthopaedic Research Laboratory, Radboud University Medical Center, postbus, 9101 6500, HB, Nijmegen, The Netherlands
| | - Sjoerd M van Raak
- Department of Radiology, Ziekenhuisgroep Twente, Zilvermeeuw 1, 7609PP, Almelo, The Netherlands
| | - Frank F J Simonis
- University of Twente, Faculty of science and technology, Magnetic Detection and Imaging, postbus 217 7500 AE, Enschede, The Netherlands
| | | | | | - Nico Verdonschot
- University of Twente, Faculty of Engineering Technology, Biomechanical Engineering, postbus 217 7500 AE, Enschede, The Netherlands.,Orthopaedic Research Laboratory, Radboud University Medical Center, postbus, 9101 6500, HB, Nijmegen, The Netherlands
| |
Collapse
|
19
|
Carrell T, Gu M, McDougall MP, Wright SM. Feasibility of Using a 1T Extremity Scanner with a Four-Element Array to Detect 31P in the Human Calf. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:6806-6809. [PMID: 31947403 DOI: 10.1109/embc.2019.8857122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The feasibility of conducting in vivo non-localized skeletal muscle 31P Magnetic Resonance Spectroscopy (MRS) with a low-cost extremity 1 Tesla magnet is demonstrated. We designed and built a transmit-only quadrature birdcage, four-element receive coil array, and employed a home-built spectrometer interfaced with a commercial ONI 1.0T magnet. In phantom comparison tests with a large loop coil of comparable size, the array was found to improve the SNR by a factor of 1.8 and the linewidth from 0.72 ppm to 0.45 ppm. Phantom and in vivo testing results show only 6 averages with a 4 second repetition time are required to obtain quantifiable 31P spectra. Initial in vivo human skeletal muscle 31P spectra successfully allowed for peak characterization. A low-cost approach to MRS could enable more widespread use of this tool in clinical diagnosis and in vivo metabolic research.
Collapse
|
20
|
Sewerin P, Ostendorf B, Schleich C. [MRI diagnostics in inflammatory joint and spinal diseases: protocols and special sequences: when and for what?]. Z Rheumatol 2019; 77:538-548. [PMID: 29916005 DOI: 10.1007/s00393-018-0497-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Magnetic resonance imaging (MRI) is an important component in rheumatology for imaging diagnostics and therapy monitoring of inflammatory and non-inflammatory diseases of the spine and peripheral joints. The correct selection of suitable and practical MRI protocols and sequences represents a great challenge for physicians with respect to requesting and interpreting the indications for MRI investigations. This review article provides recommendations and suggestions for MRI investigation protocols for clinical utilization and practice. New sequences are evaluated and assessed in order to generate the best possible standardized and comparable examinations for rheumatology in the future and therefore optimize the quality of radiological interventions.
Collapse
Affiliation(s)
- P Sewerin
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum, Heinrich-Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - B Ostendorf
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum, Heinrich-Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - C Schleich
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Heinrich-Heine Universität Düsseldorf, Düsseldorf, Deutschland
| |
Collapse
|
21
|
Stecco A, Arioli R, Buemi F, Parziale G, Trisoglio A, Soligo E, Cerini P, Leigheb M, Brambilla M, Di Nardo G, Guzzardi G, Carriero A. Overcoming metallic artefacts from orthopaedic wrist volar plating on a low-field MRI scanner. Radiol Med 2018; 124:392-399. [PMID: 30560500 DOI: 10.1007/s11547-018-0973-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 12/05/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE To quantitatively compare the artefact reduction between standard and metallic artefact reduction (MAR) fast spin echo (FSE) T2 sequences in a low-field magnetic resonance imaging (MRI) scanner (0.3 T) in patients with titanium volar wrist plating. MATERIALS AND METHODS Sixteen patients with fractures of the distal radius, treated with titanium volar wrist plating and screws, were examined using a dedicated 0.3 T MRI scanner. Coronal standard FSE T2, FSE T2 high bandwidth (HiBW) and FSE T2 view angle tilting (VAT) sequences were performed. Metallic artefact volume, consisting of both "black" and "bright" artefacts, was calculated for each sequence. Quantitative differences were compared using repeated measures ANOVA test (P < 0.05). RESULTS FSE T2 HiBW and FSE T2 VAT showed a significant reduction in artefact volume compared to the standard sequence. Differences between the artefact volume of the standard FSE T2, HiBW and VAT sequences were statistically significant for both the "black" and "bright" artefacts (P < 0.0001). Differences between the 1.5 HiBW and VAT sequences were statistically significant (black P < 0.0001, bright P < 0.0302). CONCLUSIONS MAR sequences significantly reduced metallic artefacts in vivo using a 0.3 T MRI scanner.
Collapse
Affiliation(s)
- Alessandro Stecco
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy.
| | - Roberto Arioli
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy
| | - Francesco Buemi
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy
| | - Giuseppe Parziale
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy
| | - Alessandra Trisoglio
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy
| | - Eleonora Soligo
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy
| | - Paolo Cerini
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy
| | - Massimiliano Leigheb
- Orthopaedics and Traumatology Department, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Marco Brambilla
- Medical Physics Department, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Gerardo Di Nardo
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy
| | - Giuseppe Guzzardi
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy
| | - Alessandro Carriero
- Radiology Institute, Services Diagnosis and Therapies Department, Maggiore della Carità Hospital, University of Eastern Piedmont - UPO University, Corso Mazzini 18, 28100, Novara, Italy
| |
Collapse
|
22
|
Leigheb M, Guzzardi G, Barini M, Abruzzese M, Riva S, Paschè A, Pogliacomi F, Rimondini L, Stecco A, Grassi FA, Carriero A. Role of low field MRI in detecting knee lesions. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 90:116-122. [PMID: 30715009 PMCID: PMC6503414 DOI: 10.23750/abm.v90i1-s.7977] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 11/23/2022]
Abstract
Objective: The aim of this work is to evaluate the diagnostic accuracy of 0.3T sectoral MR imaging, compared with arthroscopy, for meniscal, cruciate ligaments and chondral knee lesions. Materials and Methods: We conducted a retrospective study analyzing all the consecutive knees subjected to arthroscopy at our institution between January 2014 and June 2017 and preceded within 3 months by knee MR examination at our institution with 0.3 T equipment. Patients with history of a new trauma in the time interval between MR exam and arthroscopy were excluded from the study. Two independent experienced radiologists evaluated in double blind the MR findings of menisci, cruciate ligaments and articular cartilage. Both radiological findings were independently compared with those of the arthroscopic report considered as gold standard. For each of the examined targets we calculated the following parameters: sensitivity, specificity, accuracy, positive and negative predictive value; interobserver concordance statistically calculated using Cohen’s Kappa test. Results: 214 knees (95R/119L) of 214 patients (143M/71F) aged from 18 to 72 years (mean 44) were included and analyzed. We found a good diagnostic accuracy of the low field MR in identifying the injuries of the menisci (93%) and the crossed ligaments (96%), but a lower accuracy for the articular cartilage (85%). Sensitivity resulted 90% for menisci, 73% for ligaments and 58% for cartilage. Specificity was 91% for menisci, 97% for ligaments and 92% for cartilage. Inter-observer concordance resulted to be excellent for cruciate ligaments (K of Cohen’s test = 0.832), good (K = 0.768) for menisci, modest to moderate for articular cartilage (K from 0.236 to 0.389) with worse concordance for tibial cartilage. Conclusions: Low-field MR sectoral device with dedicated joint equipment confirms its diagnostic reliability for the evaluation of meniscal and cruciate ligaments lesions but is weak in evaluating low grade chondral lesions. (www.actabiomedica.it)
Collapse
Affiliation(s)
- Massimiliano Leigheb
- Orthopaedics and Traumatology, A.O.U. "Maggiore d.c." Universiy of Eastern Piedmont, Novara.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Schröder FF, Huis in’t Veld R, den Otter LA, van Raak SM, ten Haken B, Vochteloo AJH. Metal artefacts severely hamper magnetic resonance imaging of the rotator cuff tendons after rotator cuff repair with titanium suture anchors. Shoulder Elbow 2018; 10:107-113. [PMID: 29560036 PMCID: PMC5851124 DOI: 10.1177/1758573217710833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/16/2017] [Accepted: 04/24/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND The rate of retear after rotator cuff surgery is 17%. Magnetic resonance imaging (MRI) scans are used for confirmative diagnosis of retear. However, because of the presence of titanium suture anchors, metal artefacts on the MRI are common. The present study evaluated the diagnostic value of MRI after rotator cuff tendon surgery with respect to assessing the integrity as well as the degeneration and atrophy of the rotator cuff tendons when titanium anchors are in place. METHODS Twenty patients who underwent revision surgery of the rotator cuff as a result of a clinically suspected retear between 2013 and 2015 were included. The MRI scans of these patients were retrospectively analyzed by four specialized shoulder surgeons and compared with intra-operative findings (gold standard). Sensitivity and interobserver agreement among the surgeons in assessing retears as well as the Goutallier and Warner classification were examined. RESULTS In 36% (range 15% to 50%) of the pre-operative MRI scans, the observers could not review the rotator cuff tendons. When the rotator cuff tendons were assessable, a diagnostic accuracy with a mean sensitivity of 0.84 (0.70 to 1.0) across the surgeons was found, with poor interobserver agreement (kappa = 0.12). CONCLUSIONS Metal artefacts prevented accurate diagnosis from MRI scans of rotator cuff retear in 36% of the patients studied.
Collapse
Affiliation(s)
- Femke F. Schröder
- Centre for Orthopaedic Surgery OCON, Shoulder Unit, Hengelo, The Netherlands,MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands,Femke F. Schröder, Geerdinksweg 141 Hengelo, 7555 DL, The Netherlands.
| | | | - Lydia A. den Otter
- Centre for Orthopaedic Surgery OCON, Shoulder Unit, Hengelo, The Netherlands,MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Sjoerd M. van Raak
- Department of Radiology, Ziekenhuisgroep Twente, Hengelo, The Netherlands
| | - Bennie ten Haken
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | | |
Collapse
|
24
|
Schröder FF, Verdonschot NJJ, Ten Haken B, Peters A, Vochteloo AJH, Pakvis DFM, Huis In't Veld R. Low-field magnetic resonance imaging offers potential for measuring tibial component migration. J Exp Orthop 2018; 5:4. [PMID: 29330713 PMCID: PMC5766455 DOI: 10.1186/s40634-017-0116-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Roentgen stereophotogrammetric analysis (RSA) is used to measure early prosthetic migration and to predict future implant failure. RSA has several disadvantages, such as the need for perioperatively inserted tantalum markers. Therefore, this study evaluates low-field MRI as an alternative to RSA. The use of traditional MRI with prostheses induces disturbing metal artifacts which are reduced by low-field MRI. The purpose of this study is to assess the feasibility to use low-field (0.25 Tesla) MRI for measuring the precision of zero motion. This was assessed by calculating the virtual prosthetic motion of a zero-motion prosthetic reconstruction in multiple scanning sessions. Furthermore, the effects of different registration methods on these virtual motions were tested. RESULTS The precision of zero motion for low-field MRI was between 0.584 mm and 1.974 mm for translation and 0.884° and 3.774° for rotation. The manual registration method seemed most accurate, with μ ≤ 0.13 mm (σ ≤ 0.931 mm) for translation and μ ≤ 0.15° (σ ≤ 1.63°) for rotation. CONCLUSION Low-field MRI is not yet as precise as today's golden standard (marker based RSA) as reported in the literature. However, low-field MRI is feasible of measuring the relative position of bone and implant with comparable precision as obtained with marker-free RSA techniques. Of the three registration methods tested, manual registration was most accurate. Before starting clinical validation further research is necessary and should focus on improving scan sequences and registration algorithms.
Collapse
Affiliation(s)
- F F Schröder
- Centre for Orthopaedic Surgery OCON, Hengelo, The Netherlands. .,MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands.
| | - N J J Verdonschot
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands.,Radboud Institute for Health Sciences, Orthopaedic Research Lab, Radboud university medical center, Nijmegen, The Netherlands
| | - B Ten Haken
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands
| | - A Peters
- Centre for Orthopaedic Surgery OCON, Hengelo, The Netherlands
| | - A J H Vochteloo
- Centre for Orthopaedic Surgery OCON, Hengelo, The Netherlands
| | - D F M Pakvis
- Centre for Orthopaedic Surgery OCON, Hengelo, The Netherlands
| | | |
Collapse
|
25
|
Matsuzawa K, Abe M, Kose K, Terada Y. Oval gradient coils for an open magnetic resonance imaging system with a vertical magnetic field. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2017; 278:51-59. [PMID: 28359940 DOI: 10.1016/j.jmr.2017.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/06/2017] [Accepted: 03/18/2017] [Indexed: 06/07/2023]
Abstract
Existing open magnetic resonance imaging (MRI) systems use biplanar gradient coils for the spatial encoding of signals. We propose using novel oval gradient coils for an open vertical-field MRI. We designed oval gradients for a 0.3T open MRI system and showed that such a system could outperform a traditional biplanar gradient system while maintaining adequate gradient homogeneity and subject accessibility. Such oval gradient coils would exhibit high efficiency, low inductance and resistance, and high switching capability. Although the designed oval Y and Z coils showed more heat dissipation and less cooling capability than biplanar coils with the same gap, they showed an efficient heat-dissipation path to the surrounding air, which would alleviate the heat problem. The performance of the designed oval-coil system was demonstrated experimentally by imaging a human hand.
Collapse
Affiliation(s)
- Koki Matsuzawa
- Institute of Applied Physics, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
| | - Mitsushi Abe
- Applied Energy Systems Research Department Center for Technology Innovation, Hitachi, Ltd., Hitachi, Japan
| | - Katsumi Kose
- Institute of Applied Physics, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan
| | - Yasuhiko Terada
- Institute of Applied Physics, University of Tsukuba, Tsukuba, Ibaraki 305-8573, Japan.
| |
Collapse
|
26
|
Tanaka K, Okamoto Y, Makihara T, Maehara K, Yoshizawa T, Minami M, Yamazaki M. Clinical interpretation of asymptomatic medial collateral ligament injury observed on magnetic resonance imaging in adolescent baseball players. Jpn J Radiol 2017; 35:319-326. [PMID: 28421395 DOI: 10.1007/s11604-017-0636-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/27/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE Magnetic resonance imaging (MRI) of medial collateral ligament (MCL) injury of the elbow was often observed in asymptomatic adolescent baseball players. We aimed to clarify the clinical interpretation of "asymptomatic MCL injury observed on MRI" by comparing MRI, ultrasonography (US), and physical findings. MATERIALS AND METHODS Sixty-four asymptomatic adolescent baseball players (mean 11.2 years) were enrolled. An open-type 0.2T MRI was used. MCL function was evaluated by measuring the opening of the ulnohumeral joint using US. Physical findings included MCL tenderness, the moving valgus test, and the Milking test. The correlation between MRI and US, and MRI and physical findings were analyzed. RESULTS Thirty-four subjects (53.1%) showed MCL injury by MRI. The mean laterality of the ulnohumeral joint opening showed no significant difference (P = 0.16) between the group with (0.29 ± 1.06 mm) and without (0.08 ± 0.96 mm) MCL injury on MRI. There was no correlation between MRI and physical findings except for a weak correlation between subjects with positive Milking test and MCL injury on MRI (φ coefficient = 0.3, P = 0.02). CONCLUSION 'Asymptomatic MCL injury on MRI' had little correlation to ligament dysfunction. It might represent the transition period to MCL thickening called "adaptation."
Collapse
Affiliation(s)
- Kenta Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Yoshikazu Okamoto
- Department of Radiology, Faculty of Medicine University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan.
| | - Takeshi Makihara
- Department of Orthopaedic Surgery, Faculty of Medicine University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Kiyoshi Maehara
- Gradient School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tomohiro Yoshizawa
- Department of Orthopaedic Surgery, Faculty of Medicine University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Manabu Minami
- Department of Radiology, Faculty of Medicine University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| |
Collapse
|
27
|
Incidence of elbow injuries in adolescent baseball players: screening by a low field magnetic resonance imaging system specialized for small joints. Jpn J Radiol 2016; 34:300-6. [DOI: 10.1007/s11604-016-0526-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/21/2016] [Indexed: 10/22/2022]
|
28
|
Puig S, Kuruvilla YCK, Ebner L, Endel G. Magnetic resonance tomography of the knee joint. Skeletal Radiol 2015; 44:1427-34. [PMID: 26130068 DOI: 10.1007/s00256-015-2178-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/30/2015] [Accepted: 05/21/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To compare the diagnostic performance of magnetic resonance imaging (MRI) in terms of sensitivity and specificity using a field strength of <1.0 T (T) versus ≥1.5 T for diagnosing or ruling out knee injuries or knee pathologies. METHODS The systematic literature research revealed more than 10,000 references, of which 1598 abstracts were reviewed and 87 full-text articles were retrieved. The further selection process resulted in the inclusion of four systematic reviews and six primary studies. RESULTS No differences could be identified in the diagnostic performance of low- versus high-field MRI for the detection or exclusion of meniscal or cruciate ligament tears. Regarding the detection or grading of cartilage defects and osteoarthritis of the knee, the existing evidence suggests that high-field MRI is tolerably specific but not very sensitive, while there is literally no evidence for low-field MRI because only a few studies with small sample sizes and equivocal findings have been performed. CONCLUSIONS We can recommend the use of low-field strength MRI systems in suspected meniscal or cruciate ligament injuries. This does, however, not apply to the diagnosis and grading of knee cartilage defects and osteoarthritis because of insufficient evidence.
Collapse
Affiliation(s)
- Stefan Puig
- Department of Interventional, Pediatric and Diagnostic Radiology Inselspital, University Hospital, University of Berne, Freiburgstr. 10, CH-3010, Berne, Switzerland,
| | | | | | | |
Collapse
|
29
|
Mathew AJ, Bird P. Utility of in-office extremity magnetic resonance imaging in rheumatology. INDIAN JOURNAL OF RHEUMATOLOGY 2015. [DOI: 10.1016/j.injr.2015.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
30
|
Extremity-dedicated low-field MRI shows good diagnostic accuracy and interobserver agreement for the diagnosis of the acutely injured knee. Clin Imaging 2015; 39:871-5. [DOI: 10.1016/j.clinimag.2015.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/28/2015] [Accepted: 05/13/2015] [Indexed: 11/24/2022]
|
31
|
Affiliation(s)
- Ashish J. Mathew
- Deptartment of Clinical Immunology & Rheumatology; Christian Medical College; Vellore India
| | - John V. Crues
- Radnet Inc; Los Angeles California USA
- UCSD School of Medicine; California USA
| | - Debashish Danda
- Deptartment of Clinical Immunology & Rheumatology; Christian Medical College; Vellore India
| |
Collapse
|
32
|
Lee CS, Davis SM, McGroder C, Kouk S, Sung RM, Stetson WB, Powell SE. Analysis of Low-Field MRI Scanners for Evaluation of Shoulder Pathology Based on Arthroscopy. Orthop J Sports Med 2014; 2:2325967114540407. [PMID: 26535341 PMCID: PMC4588525 DOI: 10.1177/2325967114540407] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Many studies have compared the diagnostic capabilities of low-field magnetic resonance imaging (MRI) scanners to high-field MRI scanners; however, few have evaluated the low-field MRI diagnoses compared with intraoperative findings. PURPOSE To determine the accuracy and sensitivity of low-field MRI scanners in diagnosing lesions of the rotator cuff and glenoid labrum. STUDY DESIGN Cohort study (diagnosis); Level of evidence, 3. METHODS Over a 2-year period, MRI examinations without intra-articular contrast were performed on 79 patients for shoulder pathologies using an in-office 0.2-T extremity scanner. The MRI examinations were read by board-certified, musculoskeletal fellowship-trained radiologists. All patients underwent shoulder arthroscopy performed by a single sports fellowship-trained orthopaedic surgeon within a mean time of 56 days (range, 8-188 days) after the MRI examination. The mean patient age was 54 years (range, 18-81 years). Operative notes from the shoulder arthroscopies were then retrospectively reviewed by a single blinded observer, and the intraoperative findings were compared with the MRI reports. RESULTS For partial-thickness rotator cuff tears, the sensitivity, specificity, positive predictive value, and negative predictive value were 85%, 89%, 79%, and 92%, respectively. For full-thickness rotator cuff tears, the respective values were 97%, 100%, 100%, and 98%. For anterior labral lesions, the values were 86%, 99%, 86%, and 99%, and for superior labral anterior-posterior (SLAP) lesions, the values were 20%, 100%, 100%, and 79%, respectively. CONCLUSION Low-field MRI is an accurate tool for evaluation of partial- and full-thickness rotator cuff tears; however, it is not effective in diagnosing SLAP lesions. More information is needed to properly assess its ability to diagnose anterior and posterior labral lesions.
Collapse
Affiliation(s)
- Christopher S Lee
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - Shane M Davis
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - Claire McGroder
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - Shalen Kouk
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - Ryan M Sung
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - William B Stetson
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - Scott E Powell
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| |
Collapse
|
33
|
Hong C, Lee DH, Han BS. Characteristics of geometric distortion correction with increasing field-of-view in open-configuration MRI. Magn Reson Imaging 2014; 32:786-90. [PMID: 24698340 DOI: 10.1016/j.mri.2014.02.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 02/03/2014] [Accepted: 02/03/2014] [Indexed: 11/29/2022]
Abstract
Open-configuration magnetic resonance imaging (MRI) systems are becoming increasingly desirable for musculoskeletal imaging and image-guided radiotherapy because of their non-claustrophobic configuration. However, geometric image distortion in large fields-of-view (FOV) due to field inhomogeneity and gradient nonlinearity hinders the practical applications of open-type MRI. We demonstrated the use of geometric distortion correction for increasing FOV in open MRI. Geometric distortion was modeled and corrected as a global polynomial function. The appropriate polynomial order was identified as the minimum difference between the coordinates of control points in the distorted MR image space and those predicted by polynomial modeling. The sixth order polynomial function was found to give the optimal value for geometric distortion correction. The area of maximum distortion was<1 pixel with an FOV of 285mm. The correction performance error was increased at most 1.2% and 2.9% for FOVs of 340mm and~400mm compared with the FOV of 285mm. In particular, unresolved distortion was generated by local deformation near the gradient coil center.
Collapse
Affiliation(s)
- Cheolpyo Hong
- Center for Medical Metrology, Korea Research Institute of Standards and Science, Daejeon, Republic of Korea.
| | - Dong-Hoon Lee
- Center for Medical Metrology, Korea Research Institute of Standards and Science, Daejeon, Republic of Korea; Department of Radiological Science, College of Health Science, Yonsei University, Kwangwon-do, Republic of Korea
| | - Bong Soo Han
- Department of Radiological Science, College of Health Science, Yonsei University, Kwangwon-do, Republic of Korea
| |
Collapse
|
34
|
Lee CS, Davis SM, McGroder C, Stetson WB, Powell SE. Analysis of Low-Field Magnetic Resonance Imaging Scanners for Evaluation of Knee Pathology Based on Arthroscopy. Orthop J Sports Med 2013; 1:2325967113513423. [PMID: 26535258 PMCID: PMC4555514 DOI: 10.1177/2325967113513423] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: In recent years, few studies have evaluated low-field magnetic resonance imaging (MRI) diagnoses compared with intraoperative findings of the knee. Purpose: To determine the accuracy and sensitivity of low-field MRI scanners in diagnosing pathology of the menisci, cruciate ligaments, and osteochondral surfaces. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: MRI examinations without intra-articular contrast were performed on 379 patients for knee pathologies over a 4-year period. The MRI examinations were done using a 0.2-tesla scanner utilizing a dedicated knee coil and read by 1 of 3 board-certified, musculoskeletal fellowship–trained radiologists. Within a mean time of 50 days after MRI, all patients underwent knee arthroscopy performed by 1 of 2 sports fellowship–trained orthopaedic surgeons. Operative notes from the knee arthroscopies were then reviewed by a single independent observer, and the intraoperative findings were compared with the MRI reports. Results: For medial meniscus tears, the sensitivity, specificity, positive predictive value, and negative predictive value were 83%, 81%, 89%, and 71%, respectively. For lateral meniscus tears, the values were 51%, 93%, 84%, and 73%, respectively. For anterior cruciate ligament (ACL) tears, the values were 85%, 94%, 69%, and 97%, respectively. For osteochondral lesions, the values were 8%, 99%, 29%, and 94%, respectively. For posterior cruciate ligament (PCL) tears, the specificity and negative predictive value were 99% and 100%, respectively. Conclusion: Low-field MRI was an accurate tool for evaluation of medial meniscus and ACL tears. However, within the study population, it is not as effective in diagnosing lateral meniscus tears and showed a poor ability to detect osteochondral lesions. More information is needed to properly assess its ability to diagnose PCL tears.
Collapse
Affiliation(s)
- Christopher S Lee
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - Shane M Davis
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - Claire McGroder
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - William B Stetson
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| | - Scott E Powell
- Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA
| |
Collapse
|
35
|
Kirsch S, Kreinest M, Reisig G, Schwarz MLR, Ströbel P, Schad LR. In vitro mapping of 1H ultrashort T2* and T2 of porcine menisci. NMR IN BIOMEDICINE 2013; 26:1167-1175. [PMID: 23505140 DOI: 10.1002/nbm.2931] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 12/14/2012] [Accepted: 01/23/2013] [Indexed: 06/01/2023]
Abstract
In this study, mapping of ultrashort T2 and T2* of acutely isolated porcine menisci at B0 = 9.4 T was investigated. Maps of T2 were measured from a slice through the pars intermedia with a spin echo-prepared two-dimensional ultrashort-TE T2 mapping technique published previously. T2* mapping was performed by two-dimensional ultrashort-TE MRI with variable acquisition delay. The measured signal decays were fitted by monoexponential, biexponential and Gaussian-exponential fitting functions. The occurrence of Gaussian-like signal decays is outlined theoretically. The quality of the curve fits was visualized by mapping the value δ = abs(1 - χ(2) red). For T2 mapping, the Gaussian-exponential fit showed the best performance, whereas the monoexponential and biexponential fits showed regionally high values of δ (δ > 20). Interpretation of the Gaussian-exponential parameter maps was found to be difficult, because a Gaussian signal component can be related to mesoscopic (collagen texture) or macroscopic (slice profile, shim, sample geometry) magnetic field inhomogeneities and/or residual (1) H dipole-dipole couplings. It seems likely that an interplay of these effects yielded the observed signal decays. Modulation of the T2* signal decay caused by chemical shift was observed and addressed to fat protons by means of histology. In the T2 measurements, no modulation of the signal decay was observed and the biexponential and Gaussian-exponential fits showed the best performance with comparable values of δ. Our results suggest that T2 mapping provides the more robust method for the characterization of meniscal tissue by means of MRI relaxometry. However, mapping of ultrashort T2, as performed in this study, is time consuming and provides less signal-to-noise ratio per time than the mapping of T2*. If T2* mapping is used, pixel-wise monitoring of the fitting quality based on reduced χ(2) should be employed and great care should be taken when interpreting the parameter maps of the fits.
Collapse
Affiliation(s)
- S Kirsch
- Department of Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | | | | | | | | | | |
Collapse
|
36
|
Gutierrez-Nibeyro S, Werpy N, White Ii N. Standing low-field magnetic resonance imaging in horses with chronic foot pain. Aust Vet J 2013; 90:75-83. [PMID: 22339118 DOI: 10.1111/j.1751-0813.2011.00875.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Conventional imaging modalities can diagnose the source of foot pain in most cases, but have limitations in some horses, which can be overcome by using magnetic resonance imaging (MRI). However, there are no reports of the MRI appearance and prevalence of foot lesions of a large series of horses with chronic foot lameness. METHODS In the present study, 79 horses with unilateral or bilateral forelimb lameness because of chronic foot pain underwent standing low-field MRI to make a definitive diagnosis. RESULTS Of the 79 horses, 74 (94%) had alterations in >1 structure in the lame or lamest foot. Navicular bone lesions occurred most frequently (78%) followed by navicular bursitis (57%), deep digital flexor tendonopathies (54%) and collateral desmopathy of the distal interphalangeal joint (39%). Effusion of the distal interphalangeal joint was also a frequent finding (53%). CONCLUSION Low-field MRI in a standing patient can detect many lesions of the equine foot associated with chronic lameness without the need for general anaesthesia.
Collapse
Affiliation(s)
- Sd Gutierrez-Nibeyro
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA.
| | | | | |
Collapse
|
37
|
Fonseca C, Caminal M, Peris D, Barrachina J, Fàbregas PJ, Garcia F, Cairó JJ, Gòdia F, Pla A, Vives J. An arthroscopic approach for the treatment of osteochondral focal defects with cell-free and cell-loaded PLGA scaffolds in sheep. Cytotechnology 2013; 66:345-54. [PMID: 23673652 DOI: 10.1007/s10616-013-9581-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 04/30/2013] [Indexed: 12/25/2022] Open
Abstract
Osteochondral injuries are common in humans and are relatively difficult to manage with current treatment options. The combination of novel biomaterials and expanded progenitor or stem cells provides a source of therapeutic and immunologically compatible medicines that can be used in regenerative medicine. However, such new medicinal products need to be tested in translational animal models using the intended route of administration in humans and the intended delivery device. In this study, we evaluated the feasibility of an arthroscopic approach for the implantation of biocompatible copolymeric poly-D,L-lactide-co-glycolide (PLGA) scaffolds in an ovine preclinical model of knee osteochondral defects. Moreover this procedure was further tested using ex vivo expanded autologous chondrocytes derived from cartilaginous tissue, which were loaded in PLGA scaffolds and their potential to generate hyaline cartilage was evaluated. All scaffolds were successfully implanted arthroscopically and the clinical evolution of the animals was followed by non invasive MRI techniques, similar to the standard in human clinical practice. No clinical complications occurred after the transplantation procedures in any of the animals. Interestingly, the macroscopic evaluation demonstrated significant improvement after treatment with scaffolds loaded with cells compared to untreated controls.
Collapse
Affiliation(s)
- C Fonseca
- Departament de Medicina i Cirurgia Animals, Àrea de Medicina i Cirurgia Animal, Facultat de Veterinària, Edifici V, Campus de la UAB, 08193, Bellaterra, Cerdanyola del Vallès, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
Magnetic resonance imaging (MRI) is capable of producing images in any anatomical plane, visualizing and analyzing a variety of tissue characteristics, as well as quantifying blood flow and metabolic functions. Although MRI details of compact bone and calcium are poor when compared to those taken with plain radiography or computed tomography, its high soft tissue contrast discrimination and multiplanar imaging capabilities are significant advantages. Musculoskeletal anatomy and neurovascular bundles are well delineated. The advent of MRI has revolutionized the clinician's ability to confirm a proper diagnosis for musculoskeletal problems, which has led to more directed, specific rehabilitative protocols. However, the value of MRI to rehabilitative professionals has been even greater in its ability to identify serious, more uncommon pathologies, such as in those with underlying infection, fracture, or tumor, that require immediate care and are considered to be beyond their scope of practice. Furthermore, MRI, with its precise delineation of fat, muscle, and bone, is an ideal candidate for imaging of muscle disease or injury and has emerged as the method of choice for the detection of early cartilage wear in young patients, such as osteoarthritis. Finally, this imaging modality can avoid radiation exposure in a predominantly younger patient cohort commonly affected by musculoskeletal diseases. The aim of this paper is to consider how physical therapists may take advantage of the diagnostic value of MRI of the upper limb, while avoiding the pitfalls of misinterpretation of images as a result of technical issues, pathological changes, or normal variants.
Collapse
|
39
|
Gudbergsen H, Boesen M, Christensen R, Astrup A, Bliddal H. Radiographs and low field MRI (0.2T) as predictors of efficacy in a weight loss trial in obese women with knee osteoarthritis. BMC Musculoskelet Disord 2011; 12:56. [PMID: 21356061 PMCID: PMC3065448 DOI: 10.1186/1471-2474-12-56] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 02/28/2011] [Indexed: 11/10/2022] Open
Abstract
Background To study the predictive value of baseline radiographs and low-field (0.2T) MRI scans for the symptomatic outcome of clinically significant weight loss in obese patients with knee osteoarthritis. Methods In this study we hypothesize that imaging variables assessed with radiographs and MRI scans pre-treatment can predict the symptomatic changes following a recommended clinically significant weight reduction Patients were recruited from the Department of Rheumatology, Frederiksberg Hospital, Denmark. Eligibility criteria were: age >18 years; primary osteoarthritis according to ACR; BMI > 28 kg/m2; motivation for weight loss. Subjects were randomly assigned to either intervention by low-energy diet (LED) for 8 weeks followed by another 24 weeks of dietary instruction or control-group. MRI scans and radiographs were scored for structural changes and these parameters were examined as independent predictors of changes in osteoarthritis symptoms after 32 weeks. The outcome assessor and statistician were blinded to group allocation. Results No significant correlations were found between imaging variables and changes in Western Ontario and McMaster Universities Index of Osteoarthritis (Spearman's test, r < 0.33 and P > 0.07). Only the LED group achieved a weight loss, with a mean difference of 16.3 kg (95%CI: 13.4-19.2;P < 0.0001) compared to the control group. The total WOMAC index showed a significant difference favouring LED, with a group mean difference of - 321.3 mm (95%CI: -577.5 to -65.1 mm; P = 0.01). No significant adverse events were reported. Conclusion Stage of joint destruction, assessed on either radiographs or low-field MRI (0.2T), does not preclude a symptoms relief following a clinically relevant weight loss in elderly obese female patients with knee osteoarthritis.
Collapse
Affiliation(s)
- Henrik Gudbergsen
- The Parker Institute, Copenhagen University Hospital, Frederiksberg, Denmark
| | | | | | | | | |
Collapse
|
40
|
Murray RC, Mair TS, Sherlock CE, Blunden AS. Comparison of high-field and low-field magnetic resonance images of cadaver limbs of horses. Vet Rec 2009; 165:281-8. [PMID: 19734560 DOI: 10.1136/vr.165.10.281] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Eleven limbs taken postmortem from 10 lame horses were examined by MRI in a low-field 0.27T system designed for standing horses and a high-field 1.5T system used to examine anaesthetised horses. Nine limbs were examined in the foot/pastern region and two in the fetlock region, and the results were compared with gross pathological examinations and histological examinations of selected tissues. The appearance of normal tissues was similar between the two systems, but the anatomical arrangement of the structures was different due to differences in positioning, and a magic angle artefact was observed at different sites in some imaging sequences. Articular cartilage could be differentiated into two articular surfaces in most joints in the high-field images but could generally be separated only at the joint margins in the low-field images. Abnormalities of tendon, ligament and bone detected by gross examination were detected by both forms of MRI, but some details were clearer on the high-field images. Articular cartilage found to be normal on pathological examination was also classified as normal on MRI, but lesions in articular cartilage detected on pathological examination were identified only by high-field MRI. An abnormality was detected on MRI of all the limbs that had abnormal navicular flexor fibrocartilage on pathological examination.
Collapse
Affiliation(s)
- R C Murray
- Animal Health Trust, Lanwades Park, Kentford, Newmarket CB8 7UU, UK
| | | | | | | |
Collapse
|
41
|
Abstract
Magnetic resonance imaging has become an important diagnostic adjunct in the evaluation of shoulder conditions, and the technology continues to evolve. Direct magnetic resonance arthrography can improve detection of labral and rotator cuff pathology, especially partial thickness tears of the rotator cuff. Special positioning, such as abducted-externally rotated views, improves visualization of the rotator cuff and posterior superior labrum in throwing athletes. Diagnosis-specific sequencing such as fat suppression, spin-echo and proton-density techniques, and higher power magnets (3.0 T) allow for an unprecedented level of soft tissue detail. Clinical expertize is required to differentiate between normal anatomic variants, incidental findings, and true pathology. Although magnetic resonance imaging findings may be diagnostic in some cases, clinical correlation with history and physical examination findings is critical.
Collapse
|
42
|
Boesen M, Østergaard M, Cimmino MA, Kubassova O, Jensen KE, Bliddal H. MRI quantification of rheumatoid arthritis: current knowledge and future perspectives. Eur J Radiol 2009; 71:189-96. [PMID: 19477615 DOI: 10.1016/j.ejrad.2009.04.048] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Accepted: 04/15/2009] [Indexed: 12/20/2022]
Abstract
The international consensus on treatment of rheumatoid arthritis (RA) involves early initiation of disease modifying anti-rheumatic drugs (DMARDs) for which a reliable identification of early disease is mandatory. Conventional radiography of the joints is considered the standard method for detecting and quantifying joint damage in RA. However, radiographs only show late disease manifestations as joint space narrowing and bone erosions, whereas it cannot detect synovitis and bone marrow oedema, i.e., inflammation in the synovium or the bone, which may be visualized by magnetic resonance imaging (MRI) months to years before erosions develop. Furthermore, MRI allows earlier visualization of bone erosions than radiography. In order to allow early treatment initiation and optimal guidance of the therapeutic strategy, there is a need for methods which are capable of early detection of inflammatory joint changes. In this review, we will discuss available data, advantages, limitations and potential future of MRI in RA.
Collapse
Affiliation(s)
- Mikael Boesen
- Parker Institute, Frederiksberg University Hospital, Copenhagen, Denmark.
| | | | | | | | | | | |
Collapse
|
43
|
|
44
|
|
45
|
Handa S, Haishi T, Kose K. Development of a local electromagnetic shielding for an extremity magnetic resonance imaging system. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2008; 79:113706. [PMID: 19045894 DOI: 10.1063/1.3030856] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A local radio frequency (rf) shielding consisting of a Cu plate and an LC balun circuit has been developed for a compact magnetic resonance imaging (MRI) system with a 0.3 T permanent magnet. Performance of the local rf shielding was evaluated using an artificial external noise source irradiating a human subject whose hand was inserted into the rf coil of the MRI system. Power spectra of the rf signal detected through the rf coil demonstrated that the local rf shield achieved 30.1 dB external noise suppression. With the local rf shielding, a MRI of the subject's hand was performed using a three-dimensional gradient-echo sequence. Anatomical structures of the subject's hand were clearly visualized. It was concluded that the local rf shielding could be used for the compact MRI system instead of a rf shielded room.
Collapse
Affiliation(s)
- Shinya Handa
- Institute of Applied Physics, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | | | | |
Collapse
|
46
|
Busse H, Thomas M, Seiwerts M, Moche M, Busse MW, von Salis-Soglio G, Kahn T. In vivo glenohumeral analysis using 3D MRI models and a flexible software tool: feasibility and precision. J Magn Reson Imaging 2008; 27:162-70. [PMID: 18050335 DOI: 10.1002/jmri.21228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To implement a PC-based morphometric analysis platform and to evaluate the feasibility and precision of MRI measurements of glenohumeral translation. MATERIALS AND METHODS Using a vertically open 0.5T MRI scanner, the shoulders of 10 healthy subjects were scanned in apprehension (AP) and in neutral position (NP), respectively. Surface models of the humeral head (HH) and the glenoid cavity (GC) were created from segmented MR images by three readers. Glenohumeral translation was determined by the projection point of the manually fitted HH center on the GC plane defined by the two main principal axes of the GC model. RESULTS Positional precision, given as mean (extreme value at 95% confidence level), was 0.9 (1.8) mm for the HH center and 0.7 (1.6) mm for the GC centroid; angular GC precision was 1.3 degrees (2.3 degrees ) for the normal and about 4 degrees (7 degrees ) for the anterior and superior coordinate axes. The two-dimensional (2D) precision of the HH projection point was 1.1 (2.2) mm. A significant HH translation between AP and NP was found. CONCLUSION Despite a limited quality of the underlying model data, our PC-based analysis platform allows a precise morphometric analysis of the glenohumeral joint. The software is easily extendable and may potentially be used for an objective evaluation of therapeutical measures.
Collapse
Affiliation(s)
- Harald Busse
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Leipzig, Germany.
| | | | | | | | | | | | | |
Collapse
|
47
|
Qazi AA, Folkesson J, Pettersen PC, Karsdal MA, Christiansen C, Dam EB. Separation of healthy and early osteoarthritis by automatic quantification of cartilage homogeneity. Osteoarthritis Cartilage 2007; 15:1199-206. [PMID: 17493841 DOI: 10.1016/j.joca.2007.03.016] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Accepted: 03/20/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Cartilage loss as determined either by magnetic resonance imaging (MRI) or by joint space narrowing in X-rays is the result of cartilage erosion. However, metabolic processes within the cartilage that later result in cartilage loss may be a more accurate assessment method for early changes. Early biological processes of cartilage destruction are among other things, a combination of proteoglycan turnover, as a result of altered charge distributions, and local alterations in water content (edema). As water distribution is detectable by MRI, the aim of this study was to investigate cartilage homogeneity visualized by MRI related to water distribution, as a potential very early marker for early detection of knee osteoarthritis (OA). DESIGN One hundred and fourteen right and left knees from 71 subjects aged 22-79 years were scanned using a Turbo 3D T(1) sequence on a 0.18T MRI Esaote scanner. The medial compartment of the tibial cartilage sheet was segmented using a fully automatic voxel classification scheme based on supervised learning. From the segmented cartilage sheet, homogeneity was quantified by measuring entropy from the distribution of signal intensities inside the compartment. For each knee an X-ray was acquired and the knees were categorized by the Kellgren and Lawrence (KL) index and the joint space width (JSW) was measured. The P-values for separating the groups by each of JSW, cartilage volume, cartilage mean intensity, and cartilage homogeneity were calculated using the unpaired t-test. RESULTS The P-value for separating the group diagnosed as KL 0 from the group being KL 1 based on JSW, volume and mean signal intensity the values were P=0.9, P=0.4 and P=0.0009, respectively. In contrast, the P-value for homogeneity was P=0.0004. The precision of the measures assessed, as a test-retest root mean square coefficient of variation (RMS-CV%) was 3.9% for JSW, 7.4% for volume, 3.9% for mean signal intensity and 3.0% for homogeneity quantification. CONCLUSION These data demonstrate that the distribution of components of the articular matrix precedes erosion, as measured by cartilage homogeneity related to water concentration. We show that homogeneity was able to separate early OA from healthy individuals in contrast to traditional volume and JSW quantifications. These data suggest that cartilage homogeneity quantification may be able to quantify early biochemical changes in articular cartilage prior to cartilage loss and thereby provide better identification of patients for OA trials who may respond better to medicinal intervention of some treatments. In addition, this study supports the feasibility of using low-field MRI in clinical studies.
Collapse
Affiliation(s)
- A A Qazi
- Image Group, University of Copenhagen, Denmark
| | | | | | | | | | | |
Collapse
|