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Reinert CP, Liang C, Weissinger M, Vogel J, Forschner A, Nikolaou K, la Fougère C, Seith F. Whole-Body Magnetic Resonance Imaging (MRI) for Staging Melanoma Patients in Direct Comparison to Computed Tomography (CT): Results from a Prospective Positron Emission Tomography (PET)/CT and PET/MRI Study. Diagnostics (Basel) 2023; 13:diagnostics13111963. [PMID: 37296815 DOI: 10.3390/diagnostics13111963] [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: 04/06/2023] [Revised: 05/16/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE The consideration of radiation exposure is becoming more important in metastatic melanoma due to improved prognoses. The aim of this prospective study was to investigate the diagnostic performance of whole-body (WB) magnetic resonance imaging (MRI) in comparison to computed tomography (CT) with 18F-FDG positron emission tomography (PET)/CT and 18F-PET/MRI together with a follow-up as the reference standard. METHODS Between April 2014 and April 2018, a total of 57 patients (25 females, mean age of 64 ± 12 years) underwent WB-PET/CT and WB-PET/MRI on the same day. The CT and MRI scans were independently evaluated by two radiologists who were blinded to the patients' information. The reference standard was evaluated by two nuclear medicine specialists. The findings were categorized into different regions: lymph nodes/soft tissue (I), lungs (II), abdomen/pelvis (III), and bone (IV). A comparative analysis was conducted for all the documented findings. Inter-reader reliability was assessed using Bland-Altman procedures, and McNemar's test was utilized to determine the differences between the readers and the methods. RESULTS Out of the 57 patients, 50 were diagnosed with metastases in two or more regions, with the majority being found in region I. The accuracies of CT and MRI did not show significant differences, except in region II where CT detected more metastases compared to MRI (0.90 vs. 0.68, p = 0.008). On the other hand, MRI had a higher detection rate in region IV compared to CT (0.89 vs. 0.61, p > 0.05). The level of agreement between the readers varied depending on the number of metastases and the specific region, with the highest agreement observed in region III and the lowest observed in region I. CONCLUSIONS In patients with advanced melanoma, WB-MRI has the potential to serve as an alternative to CT with comparable diagnostic accuracy and confidence across most regions. The observed limited sensitivity for the detection of pulmonary lesions might be improved through dedicated lung imaging sequences.
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Affiliation(s)
- Christian Philipp Reinert
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Cecilia Liang
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Matthias Weissinger
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Jonas Vogel
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
| | - Andrea Forschner
- Department of Dermatology, University Hospital Tübingen, Liebermeisterstrasse 25, 72076 Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) "Image Guided and Functionally Instructed Tumor Therapies", University of Tübingen, 72076 Tübingen, Germany
- German Cancer Consortium (DKTK), Partner Site Tübingen, 72076 Tübingen, Germany
| | - Christian la Fougère
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
- Cluster of Excellence iFIT (EXC 2180) "Image Guided and Functionally Instructed Tumor Therapies", University of Tübingen, 72076 Tübingen, Germany
- German Cancer Consortium (DKTK), Partner Site Tübingen, 72076 Tübingen, Germany
| | - Ferdinand Seith
- Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany
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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: 50] [Impact Index Per Article: 50.0] [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.
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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
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Machine Learning-Based MRI LAVA Dynamic Enhanced Scanning for the Diagnosis of Hilar Lesions. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9592970. [PMID: 35251299 PMCID: PMC8894067 DOI: 10.1155/2022/9592970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/03/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022]
Abstract
Objective To explore the value of machine learning-based magnetic resonance imaging (MRI) liver acceleration volume acquisition (LAVA) dynamic enhanced scanning for diagnosing hilar lesions. Methods A total of 90 patients with hilar lesions and 130 patients without hilar lesions who underwent multiphase dynamic enhanced MRI LAVA were retrospectively selected as the study subjects. The 10-fold crossover method was used to establish the data set, 7/10 (154 cases) data were used to establish the training set, and 3/10 (66 cases) data were used to establish the validation set to verify the model. The region of interest was extracted from MRI images using radiomics, and the hilar lesion model was constructed based on a convolutional neural network. Results There were significant differences in respiration and pulse frequency between patients with hilar lesions and without hilar lesions (P <0.05). The subjective scores of the images in the first three phases of dynamic enhanced scanning in the training set were higher than those in the validation set (P < 0.05). There was no significant difference between the training and validation set in the last three phases of dynamic enhanced scanning. Conclusion Machine learn-based MRI LAVA dynamic enhanced scanning for diagnosing hilar lesions has high diagnostic efficiency and can be used as an auxiliary diagnostic method.
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Qin C, Murali S, Lee E, Supramaniam V, Hausenloy DJ, Obungoloch J, Brecher J, Lin R, Ding H, Akudjedu TN, Anazodo UC, Jagannathan NR, Ntusi NAB, Simonetti OP, Campbell-Washburn AE, Niendorf T, Mammen R, Adeleke S. Sustainable low-field cardiovascular magnetic resonance in changing healthcare systems. Eur Heart J Cardiovasc Imaging 2022; 23:e246-e260. [PMID: 35157038 PMCID: PMC9159744 DOI: 10.1093/ehjci/jeab286] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/14/2021] [Indexed: 11/14/2022] Open
Abstract
Cardiovascular disease continues to be a major burden facing healthcare systems worldwide. In the developed world, cardiovascular magnetic resonance (CMR) is a well-established non-invasive imaging modality in the diagnosis of cardiovascular disease. However, there is significant global inequality in availability and access to CMR due to its high cost, technical demands as well as existing disparities in healthcare and technical infrastructures across high-income and low-income countries. Recent renewed interest in low-field CMR has been spurred by the clinical need to provide sustainable imaging technology capable of yielding diagnosticquality images whilst also being tailored to the local populations and healthcare ecosystems. This review aims to evaluate the technical, practical and cost considerations of low field CMR whilst also exploring the key barriers to implementing sustainable MRI in both the developing and developed world.
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Affiliation(s)
- Cathy Qin
- Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - Sanjana Murali
- Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - Elsa Lee
- School of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | | | - Derek J Hausenloy
- Division of Medicine, University College London, London, UK.,Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore, Singapore.,National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore.,Hatter Cardiovascular Institue, UCL Institute of Cardiovascular Sciences, University College London, London, UK.,Cardiovascular Research Center, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Johnes Obungoloch
- Department of Biomedical Engineering, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Rongyu Lin
- School of Medicine, University College London, London, UK
| | - Hao Ding
- Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - Theophilus N Akudjedu
- Institute of Medical Imaging and Visualisation, Faculty of Health and Social Science, Bournemouth University, Poole, UK
| | | | - Naranamangalam R Jagannathan
- Department of Electrical Engineering, Indian Institute of Technology, Chennai, India.,Department of Radiology, Sri Ramachandra University Medical College, Chennai, India.,Department of Radiology, Chettinad Hospital and Research Institute, Kelambakkam, India
| | - Ntobeko A B Ntusi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Orlando P Simonetti
- Division of Cardiovascular Medicine, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA.,Department of Radiology, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Adrienne E Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.), Max-Delbrück Centre for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Regina Mammen
- Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, UK
| | - Sola Adeleke
- School of Cancer & Pharmaceutical Sciences, King's College London, Queen Square, London WC1N 3BG, UK.,High Dimensional Neurology, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
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Khodarahmi I, Fritz J. The Value of 3 Tesla Field Strength for Musculoskeletal Magnetic Resonance Imaging. Invest Radiol 2021; 56:749-763. [PMID: 34190717 DOI: 10.1097/rli.0000000000000801] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Musculoskeletal magnetic resonance imaging (MRI) is a careful negotiation between spatial, temporal, and contrast resolution, which builds the foundation for diagnostic performance and value. Many aspects of musculoskeletal MRI can improve the image quality and increase the acquisition speed; however, 3.0-T field strength has the highest impact within the current diagnostic range. In addition to the favorable attributes of 3.0-T field strength translating into high temporal, spatial, and contrast resolution, many 3.0-T MRI systems yield additional gains through high-performance gradients systems and radiofrequency pulse transmission technology, advanced multichannel receiver technology, and high-end surface coils. Compared with 1.5 T, 3.0-T MRI systems yield approximately 2-fold higher signal-to-noise ratios, enabling 4 times faster data acquisition or double the matrix size. Clinically, 3.0-T field strength translates into markedly higher scan efficiency, better image quality, more accurate visualization of small anatomic structures and abnormalities, and the ability to offer high-end applications, such as quantitative MRI and magnetic resonance neurography. Challenges of 3.0-T MRI include higher magnetic susceptibility, chemical shift, dielectric effects, and higher radiofrequency energy deposition, which can be managed successfully. The higher total cost of ownership of 3.0-T MRI systems can be offset by shorter musculoskeletal MRI examinations, higher-quality examinations, and utilization of advanced MRI techniques, which then can achieve higher gains and value than lower field systems. We provide a practice-focused review of the value of 3.0-T field strength for musculoskeletal MRI, practical solutions to challenges, and illustrations of a wide spectrum of gainful clinical applications.
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Affiliation(s)
- Iman Khodarahmi
- From the Division of Musculoskeletal Radiology, Department of Radiology, NYU Grossman School of Medicine, New York, NY
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Rapid Musculoskeletal MRI in 2021: Value and Optimized Use of Widely Accessible Techniques. AJR Am J Roentgenol 2021; 216:704-717. [DOI: 10.2214/ajr.20.22901] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Gómez-Gaviro MV, Sanderson D, Ripoll J, Desco M. Biomedical Applications of Tissue Clearing and Three-Dimensional Imaging in Health and Disease. iScience 2020; 23:101432. [PMID: 32805648 PMCID: PMC7452225 DOI: 10.1016/j.isci.2020.101432] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 12/27/2022] Open
Abstract
Three-dimensional (3D) optical imaging techniques can expand our knowledge about physiological and pathological processes that cannot be fully understood with 2D approaches. Standard diagnostic tests frequently are not sufficient to unequivocally determine the presence of a pathological condition. Whole-organ optical imaging requires tissue transparency, which can be achieved by using tissue clearing procedures enabling deeper image acquisition and therefore making possible the analysis of large-scale biological tissue samples. Here, we review currently available clearing agents, methods, and their application in imaging of physiological or pathological conditions in different animal and human organs. We also compare different optical tissue clearing methods discussing their advantages and disadvantages and review the use of different 3D imaging techniques for the visualization and image acquisition of cleared tissues. The use of optical tissue clearing resources for large-scale biological tissues 3D imaging paves the way for future applications in translational and clinical research.
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Affiliation(s)
- Maria Victoria Gómez-Gaviro
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain.
| | - Daniel Sanderson
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | - Jorge Ripoll
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
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Technological Advances of Magnetic Resonance Imaging in Today's Healthcare Environment. Invest Radiol 2020; 55:543-544. [PMID: 32404628 DOI: 10.1097/rli.0000000000000683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Are we reacting adequately to a constantly changing clinical and scientific environment, regarding our patients, the economy, or new technologies, such as artificial intelligence? The authors of this review article have identified 3 major challenges regarding the use of magnetic resonance imaging (MRI) in our clinical practice today and tomorrow: (1) the need for faster acquisitions, optimized workflows, and higher patient throughput, making MRI broadly available and applicable, also under the light of rising economic pressure; (2) adaptation to the demographic change, tailoring protocols, and procedures to the needs of an aging and multimorbid patient population; and (3) providing quantifiable data, reproducible imaging biomarkers, and integrated artificial intelligence algorithms, to make MRI an integral part of modern precision medicine. The authors conclude that with constant advances in MR technology, workflow and scanning efficiency can be optimized, while providing consistent, high-quality personalized examination results at the same time.
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Yuan J. Editorial for "Irregularity of Carotid Plaque Surface Predicts Subsequent Vascular Event: An MRI Study". J Magn Reson Imaging 2020; 52:195-196. [PMID: 32154968 DOI: 10.1002/jmri.27121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/06/2022] Open
Abstract
LEVEL OF EVIDENCE 5 TECHNICAL EFFICACY: Stage 2 J. Magn. Reson. Imaging 2020;52:195-196.
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Affiliation(s)
- Jing Yuan
- Medical Physics and Research Department, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
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