Zero Echo Time Magnetic Resonance Imaging; Techniques and Clinical Utility in Musculoskeletal System

Recent topics in musculoskeletal imaging focused on clinical applications of AI: How should radiologists approach and use AI?

The advances in artificial intelligence (AI) technology in recent years have been remarkable, and the field of radiology is at the forefront of applying and implementing these technologies in daily clinical practice. Radiologists must keep up with this trend and continually update their knowledge. This narrative review discusses the application of artificial intelligence in the field of musculoskeletal imaging. For image generation, we focused on the clinical application of deep learning reconstruction and the recently emerging MRI-based cortical bone imaging. For automated diagnostic support, we provided an overview of qualitative diagnosis, including classifications essential for daily practice, and quantitative diagnosis, which can serve as imaging biomarkers for treatment decision making and prognosis prediction. Finally, we discussed current issues in the use of AI, the application of AI in the diagnosis of rare diseases, and the role of AI-based diagnostic imaging in preventive medicine as part of our outlook for the future.

Bone injury imaging in knee and ankle joints using fast-field-echo resembling a CT using restricted echo-spacing MRI: a feasibility study

Purpose

To explore the consistency of FRACTURE (Fast-field-echo Resembling A CT Using Restricted Echo-spacing) MRI and X-Ray/computerized tomography (CT) in the evaluation of bone injuries in knee and ankle joints.

Methods

From Nov. 2020 to Jul. 2023, 42 patients with knee joint or ankle joint injuries who underwent FRACTURE MRI examinations were retrospectively collected. 11 patients were examined by both X-Ray and FRACTURE examinations. 31 patients were examined by both CT and FRACTURE examinations. The fracture, osteophyte, and bone destruction of the joints were evaluated by two radiologists using X-Ray/CT and FRACTURE images, respectively. Kappa test was used for consistency analysis.

Results

The evaluation consistency of fracture, osteophyte and bone destruction via X-Ray and FRACTURE images by radiologist 1 were 0.879, 0.867 and 0.847 respectively, and for radiologist 2 were 0.899, 0.930, and 0.879, respectively. The evaluation consistency of fracture, osteophyte and bone destruction via CT and FRACTURE images by radiologist 1 were 0.938, 0.937 and 0.868 respectively, and for radiologist 2 were 0.961, 0.930, and 0.818, respectively.

Conclusion

For fracture, osteophyte, and bone destruction of knee and ankle joints. FRACTURE MRI showed a high consistency with X-Ray/CT examinations.

Development of Ln(III) Derivatives as 19F Parashift Probes

19F parashift probes with paramagnetically shifted reporter nuclei provide attractive platforms to develop molecular imaging probes. These probes enable ratiometric detection of molecular disease markers using a direct detection technique. Here, we describe a series of trivalent lanthanide (Ln(III)) complexes that are structural analogues of the clinically approved MR contrast agent (CA) ProHance to obtain LnL 19F parashift probes. We evaluated trans-gadolinium paramagnetic lanthanides compared to diamagnetic YL for 19F chemical shift and relaxation rate enhancement. The paramagnetic contribution to chemical shift (δPCS) for paramagnetic LnL exhibited either shifts to lower frequency (δPCS < 0 for TbL, DyL, and HoL) or shifts to higher frequency (δPCS > 0 for ErL, TmL, and YbL) compared to YL 19F spectroscopic signal. Zero-echo time pulse sequences achieved 56-fold sensitivity enhancement for DyL over YL, while developing probe-specific pulse sequences with fast delay times and acquisition times achieved 0.6-fold enhancement in limit of detection for DyL. DyL provides an attractive platform to develop 19F parashift probes for ratiometric detection of enzymatic activity.