In vivo MR imaging of the human skin at subnanoliter resolution using a superconducting surface coil at 1.5 Tesla

Bringing MRI to low- and middle-income countries: Directions, challenges and potential solutions

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.

A cryogenic 14-channel 13 C receiver array for 3T human head imaging

PURPOSE

This article presents a novel 14-channel receive-only array for ¹³ C human head imaging at 3 T that explores the SNR gain by operating at cryogenic temperature cooled by liquid nitrogen.

METHODS

Cryostats are developed to evaluate single-coil bench SNR performance and cool the 14-channel array with liquid nitrogen while having enough thermal insulation between the coils and the sample. The temperature distribution for the coil array is measured. Circuits are adapted to the -189°C environment and implemented in the 14-channel array. ¹³ C images are acquired with the array at cryogenic and room temperature in a 3T scanner.

RESULTS

Compared with room temperature, the array at cryogenic temperature provides 27%-168% SNR improvement over all voxels and 47% SNR improvement near the image center. The measurements show a decrease of the element noise correlation at cryogenic temperature.

CONCLUSION

It is demonstrated that higher SNR can be achieved by cryogenically cooling the 14-channel array. A cryogenic array suitable for clinical imaging can be further developed on the array proposed. The cryogenic coil array is most likely suited for scenarios in which high SNR deep in a head and decent SNR on the periphery are required.

Sodium in the dermis colocates to glycosaminoglycan scaffold, with diminishment in type 2 diabetes mellitus

BACKGROUND

Dietary sodium intake mismatches urinary sodium excretion over prolonged periods. Our aims were to localize and quantify electrostatically bound sodium within human skin using triple-quantum-filtered (TQF) protocols for MRI and magnetic resonance spectroscopy (MRS) and to explore dermal sodium in type 2 diabetes mellitus (T2D).

METHODS

We recruited adult participants with T2D (n = 9) and euglycemic participants with no history of diabetes mellitus (n = 8). All had undergone lower limb amputations or abdominal skin reduction surgery for clinical purposes. We used 20 μm in-plane resolution 1H MRI to visualize anatomical skin regions ex vivo from skin biopsies taken intraoperatively, 23Na TQF MRI/MRS to explore distribution and quantification of freely dissolved and bound sodium, and inductively coupled plasma mass spectrometry to quantify sodium in selected skin samples.

RESULTS

Human dermis has a preponderance (>90%) of bound sodium that colocalizes with the glycosaminoglycan (GAG) scaffold. Bound and free sodium have similar anatomical locations. T2D associates with a severely reduced dermal bound sodium capacity.

CONCLUSION

We provide the first evidence to our knowledge for high levels of bound sodium within human dermis, colocating to the GAG scaffold, consistent with a dermal "third space repository" for sodium. T2D associates with diminished dermal electrostatic binding capacity for sodium.

Conflicting Reports Regarding the Histopathological Features of Androgenic Alopecia: Are Biopsy Location, Hair Diameter Diversity, and Relative Hair Follicle Miniaturization Partly to Blame?

Despite decades of study, debate persists over the role of inflammation, fibrosis, and prostaglandins in the histopathology of androgenic alopecia (AGA). This brief review proposes that inconsistent findings across histological studies are a consequence of three inadequately controlled variables: 1) biopsy location, 2) hair diameter diversity (HDD), and 3) relative hair follicle miniaturization (HFM) within and across subjects. We suggest new methodological considerations to improve AGA histopathological research, as well as a novel classification system to quantify HFM by its stages. Finally, we hypothesize a dynamic relationship between inflammation, fibrosis, and prostaglandin activity dependent on relative HFM.

The value of preoperative high-resolution MRI with microscopy coil for facial nonmelanoma skin cancers

BACKGROUND

The extent and depth of facial nonmelanoma skin cancers and the involvement of adjacent structures are critical features for surgical planning, but they are difficult to assess clinically. High-resolution MRI (HR-MRI) with microscopy coil may facilitate detailed evaluation of skin lesions. The authors performed this prospective study to determine the value of high-resolution microscopy coil MRI in the preoperative evaluation of nonmelanoma skin cancer.

MATERIALS AND METHODS

Between October 2018 and August 2019, 16 lesions from fifteen consecutive patients with facial nonmelanoma skin cancer were evaluated using high-resolution microscopy coil MRI about tumor extent, depth, margins, characteristic, and their spatial relationship with adjacent structures. The preoperative HR-MRI results were compared with the intraoperative findings and with the histopathology, with special note to the depth of invasion.

RESULTS

Among the 16 lesions, HR-MRI imaging was found to provide accurate evaluation of tumor extent, depth, and margins and determine whether there was involvement of adjacent structures. The tumor depth measured on HR-MRI showed good correlation with histopathologic results (CCC: 0.973), and Bland-Altman analysis finding no significant bias existed between the two measurements. All lesions except one were completely resected with primary excision. Only one lesion required further excision. During follow-up for 3-15 months, no tumor recurrence was observed in any case.

CONCLUSIONS

HR-MRI is an accurate, noninvasive imaging technique that can be used as preoperative evaluation tool for facial nonmelanoma skin cancer. It can accurate predict tumor depth, margins, and involvement of structure. The valuable information it provided facilitates surgeons optimize surgical planning.

Quantitative analysis of the anatomical changes in the scalp and hair follicles in androgenetic alopecia using magnetic resonance imaging

BACKGROUND

Although the structural changes of the scalp in androgenetic alopecia (AGA) have been reported, these changes have been poorly understood. It is expected that modern MRI would visualize the scalp anatomy in vivo. This study aimed to explore whether AGA causes (a) changes in the thickness of the scalp, (b) anatomical changes in the hair follicles, and (c) changes in the signal intensity of MRI.

MATERIALS AND METHODS

Twenty-seven volunteers underwent MRI for hair and scalp (MRH) and were categorized into two according to the Hamilton-Norwood Scale: the "AGA group" and the "normal group." Two radiologists analyzed the thickness and signal intensity of the scalp, and the depth of hair follicles. These measurements were compared between the two groups.

RESULTS

The thickness of the hypodermis and the entire scalp was significantly thinner in the AGA group than in the control group. The AGA group had significantly shallower depth of hair follicles and relative depth of the hair follicles to that of the entire scalp than the normal group. The hypodermis showed higher signal intensity in the AGA group than the normal group.

CONCLUSION

MRH allowed noninvasive visualization of the scalp anatomy and demonstrated the thinner nature of the entire scalp and hypodermis, along with the shallower depth of the hair follicles in the AGA group in comparison to the normal group. Additionally, MRH demonstrated the increased MR signal intensity in the scalp associated with AGA. MRH may be a promising new method for quantitative and objective analyses of AGA.

Selection and application of coils in temporomandibular joint MRI

Objective:

To compare and evaluate the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) values between a 15-channel phased array head coil and 6-channel dS Flex M surface coil in the MRI of temporomandibular joint.

Methods:

300 patients were randomly assigned to two groups: 150 patients were examined by using a 15-channel phased array head coil and the other 150 patients were scanned by using a 6-channel dS Flex M surface coil. All of the data were set in the same 6 regions of interest including the temporal lobe, condyle neck, lateral pterygoid muscle, parotid gland, the adipose area and an area of the background noise）. SNR and CNR values were measured respectively.

Results:

The numerical variation law of SNR and CNR values measured in regionsof interest of each group was similar, although different coils were used. There were statistically significant differences of SNR values in all of the oblique sagittal (OSag) proton density-weighted imaging, the part of OSag T₂ weighted image (T₂WI) except for SNR₄ and SNR₅. and oblique coronal (OCor) T₂WI sequence except for SNR₂. On the contrary, SNR₄ and SNR₅ values in the OCor T₂WI and SNR₅ values in OSag T₂WI sequences by using the surface coil were higher than those by using the head coil. There were no statistically significant intergroup differences of CNR values in OSag proton density-weighted imaging sequence except CNR₁ and in OSag T₂WI sequence except CNR₅. But, statistically significant differences of all the values in the OCor T₂WI sequence except for CNR₁ were observed.

Conclusion:

Both the phased array head coil and dS Flex M surface coil can be used for temporomandibular joint MRI.

Multi-turn multi-gap transmission line resonators - Concept, design and first implementation at 4.7T and 7T

A novel design scheme for monolithic transmission line resonators (TLRs) is presented - the multi-turn multi-gap TLR (MTMG-TLR) design. The MTMG-TLR design enables the construction of TLRs with multiple turns and multiple gaps. This presents an additional degree of freedom in tuning self-resonant TLRs, as their resonance frequency is fully determined by the coil geometry (e.g. diameter, number of turns, conductor width, etc.). The novel design is evaluated at 4.7T and 7T by simulations and experiments, where it is demonstrated that MTMG-TLRs can be used for MRI, and that the B1 distribution of MTMG-TLRs strongly depends on the number and distribution of turns. A comparison to conventional loop coils revealed that the B1 performance of MTMG-TLRs is comparable to a loop coil with the same mean diameter; however, lower 10g SAR values were found for MTMG-TLRs. The MTMG-TLR design is expected to bring most benefits at high static field, where it allows for independent size and frequency selection, which cannot be achieved with standard TLR design. However, it also enables more accurate geometric optimization at low static field. Thereby, the MTMG-TLR design preserves the intrinsic advantages of TLRs, i.e. mechanical flexibility, high SAR efficiency, mass production, and coil miniaturization.

Multiparametric Classification of Skin from Osteogenesis Imperfecta Patients and Controls by Quantitative Magnetic Resonance Microimaging

The purpose of this study is to evaluate the ability of quantitative magnetic resonance imaging (MRI) to discriminate between skin biopsies from individuals with osteogenesis imperfecta (OI) and skin biopsies from individuals without OI. Skin biopsies from nine controls (unaffected) and nine OI patients were imaged to generate maps of five separate MR parameters, T₁, T₂, k_m, MTR and ADC. Parameter values were calculated over the dermal region and used for univariate and multiparametric classification analysis. A substantial degree of overlap of individual MR parameters was observed between control and OI groups, which limited the sensitivity and specificity of univariate classification. Classification accuracies ranging between 39% and 67% were found depending on the variable of investigation, with T₂ yielding the best accuracy of 67%. When several MR parameters were considered simultaneously in a multivariate analysis, the classification accuracies improved up to 89% for specific combinations, including the combination of T₂ and k_m. These results indicate that multiparametric classification by quantitative MRI is able to detect differences between the skin of OI patients and of unaffected individuals, which motivates further study of quantitative MRI for the clinical diagnosis of OI.

Siloxane Nanoprobes for Labeling and Dual Modality Functional Imaging of Neural Stem Cells

Cell therapy represents a promising therapeutic for a myriad of medical conditions, including cancer, traumatic brain injury, and cardiovascular disease among others. A thorough understanding of the efficacy and cellular dynamics of these therapies necessitates the ability to non-invasively track cells in vivo. Magnetic resonance imaging (MRI) provides a platform to track cells as a non-invasive modality with superior resolution and soft tissue contrast. We recently reported a new nanoprobe platform for cell labeling and imaging using fluorophore doped siloxane core nanoemulsions as dual modality ((1)H MRI/Fluorescence), dual-functional (oximetry/detection) nanoprobes. Here, we successfully demonstrate the labeling, dual-modality imaging, and oximetry of neural progenitor/stem cells (NPSCs) in vitro using this platform. Labeling at a concentration of 10 μL/10(4) cells with a 40%v/v polydimethylsiloxane core nanoemulsion, doped with rhodamine, had minimal effect on viability, no effect on migration, proliferation and differentiation of NPSCs and allowed for unambiguous visualization of labeled NPSCs by (1)H MR and fluorescence and local pO2 reporting by labeled NPSCs. This new approach for cell labeling with a positive contrast (1)H MR probe has the potential to improve mechanistic knowledge of current therapies, and guide the design of future cell therapies due to its clinical translatability.

Advancing Cardiovascular, Neurovascular, and Renal Magnetic Resonance Imaging in Small Rodents Using Cryogenic Radiofrequency Coil Technology

Research in pathologies of the brain, heart and kidney have gained immensely from the plethora of studies that have helped shape new methods in magnetic resonance (MR) for characterizing preclinical disease models. Methodical probing into preclinical animal models by MR is invaluable since it allows a careful interpretation and extrapolation of data derived from these models to human disease. In this review we will focus on the applications of cryogenic radiofrequency (RF) coils in small animal MR as a means of boosting image quality (e.g., by supporting MR microscopy) and making data acquisition more efficient (e.g., by reducing measuring time); both being important constituents for thorough investigational studies on animal models of disease. This review attempts to make the (bio)medical imaging, molecular medicine, and pharmaceutical communities aware of this productive ferment and its outstanding significance for anatomical and functional MR in small rodents. The goal is to inspire a more intense interdisciplinary collaboration across the fields to further advance and progress non-invasive MR methods that ultimately support thorough (patho)physiological characterization of animal disease models. In this review, current and potential future applications for the RF coil technology in cardiovascular, neurovascular, and renal disease will be discussed.

In vivo assessment of aged human skin with a unilateral NMR scanner

Human skin undergoes morphological and biochemical changes as a result of chronological aging and exposure to solar ultraviolet irradiation (photoaging). Noninvasive detection of these changes may aid in the prevention and treatment of both types of aging. This article presents a noninvasive method for the evaluation of aging skin with a unilateral stray field NMR scanner. These portable and inexpensive scanners may be suitable for in-depth skin characterization. In vivo profiles of sun-protected and sun-exposed skin from the forearms of female subjects of different ages (n = 9) were measured. Skin biopsies for histopathological examination were used as reference. T2 analysis with a bi-exponential decay model was applied and the extracted parameters were examined as markers for dermal aging. In the upper reticular dermis, a significant increase in the fraction of the slow T2 component and in the T2 value itself was found to correlate with chronological aging. For most subjects, there was an additional increase in the values of the slow T2 component and the T2 values from the sun-exposed forearm, superimposed on that measured for the sun-protected forearm. These results are in agreement with the decline in collagen content and the increase in free water content with aging. The results suggest that such a technique can be used as a tool for the assessment of aging, and that bi-exponential fitting can produce sensitive fingerprint parameters for the dermal alterations that occur during aging.

Skin imaging in systemic sclerosis

Fibrotic involvement of the skin is a cardinal feature of systemic sclerosis (SSc). The extent of skin involvement is associated with internal organ involvement, coinciding with more severe disease course and poor prognosis. A palpation-based semi-quantitative score, the modified Rodnan skin score, is widely used for the assessment of skin involvement, but it is entailed by significant limitations. More objective approaches to measure skin involvement employing imaging have been explored continuously in the past decades and are currently advancing. Here, we review the use of different imaging techniques for the assessment of skin involvement in patients with SSc, focusing mainly on ultrasound, magnetic resonance imaging, and optical coherence tomography.