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Samardzija A, Selvaganesan K, Zhang HZ, Sun H, Sun C, Ha Y, Galiana G, Constable RT. Low-Field, Low-Cost, Point-of-Care Magnetic Resonance Imaging. Annu Rev Biomed Eng 2024; 26:67-91. [PMID: 38211326 DOI: 10.1146/annurev-bioeng-110122-022903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Low-field magnetic resonance imaging (MRI) has recently experienced a renaissance that is largely attributable to the numerous technological advancements made in MRI, including optimized pulse sequences, parallel receive and compressed sensing, improved calibrations and reconstruction algorithms, and the adoption of machine learning for image postprocessing. This new attention on low-field MRI originates from a lack of accessibility to traditional MRI and the need for affordable imaging. Low-field MRI provides a viable option due to its lack of reliance on radio-frequency shielding rooms, expensive liquid helium, and cryogen quench pipes. Moreover, its relatively small size and weight allow for easy and affordable installation in most settings. Rather than replacing conventional MRI, low-field MRI will provide new opportunities for imaging both in developing and developed countries. This article discusses the history of low-field MRI, low-field MRI hardware and software, current devices on the market, advantages and disadvantages, and low-field MRI's global potential.
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Affiliation(s)
- Anja Samardzija
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
| | - Kartiga Selvaganesan
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
| | - Horace Z Zhang
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
| | - Heng Sun
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
| | - Chenhao Sun
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - Yonghyun Ha
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - Gigi Galiana
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| | - R Todd Constable
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut, USA;
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
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Jensen LJ, Kim D, Elgeti T, Steffen IG, Schaafs LA, Hamm B, Nagel SN. Differentiating inflammatory and malignant pulmonary lesions on 3T lung MRI with radiomics of apparent diffusion coefficient maps and T2w derived radiomic feature maps. J Thorac Dis 2024; 16:2875-2893. [PMID: 38883623 PMCID: PMC11170409 DOI: 10.21037/jtd-23-1456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/15/2024] [Indexed: 06/18/2024]
Abstract
Background Differentiating inflammatory from malignant lung lesions continues to be challenging in clinical routine, frequently requiring invasive methods like biopsy. Therefore, we aimed to investigate if inflammatory and malignant pulmonary lesions could be distinguished noninvasively using radiomics of apparent diffusion coefficient (ADC) maps and radiomic feature maps calculated from T2-weighted (T2w) 3 Tesla (3T) magnetic resonance imaging (MRI) of the lung. Methods Fifty-four patients with an unclear pulmonary lesion on computed tomography (CT) were prospectively included and examined by 3T MRI with T2w and diffusion-weighted sequences (b values of 50 and 800). ADC maps were calculated automatically. All patients underwent biopsy or bronchoalveolar lavage (BAL). Sixteen patients were excluded (e.g., motion artifacts), leaving 19 patients each with malignant and inflammatory pulmonary lesions. Target lesions were defined by biopsy or as the largest lesion (BAL-based pathogen detection), and two readers placed volumes of interest (VOIs) around the lesions on T2w images and ADC maps. One hundred and seven features were conventionally extracted from the ADC maps using PyRadiomics. T2w images were converted to 107 parametric feature maps per patient using a PyRadiomics-based, pretested software tool developed by our group. VOIs were copied from T2w images to T2 maps for feature quantification. Features were tested for significant differences using the Mann-Whitney U-test. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis and interreader agreement by intraclass correlation coefficients (ICCs). Results Fifty-eight features derived from ADC maps differed significantly between malignant and inflammatory pulmonary lesions, with areas under the curve (AUCs) >0.90 for 5 and >0.80 for 27 features, compared with 67 features from T2 maps (5 features with AUCs >0.80). ICCs were excellent throughout. Conclusions ADC and T2 maps differentiate inflammatory and malignant pulmonary lesions with outstanding (ADC) and excellent (T2w derived feature maps) diagnostic performance. MRI could thus guide the further diagnostic workup and a timely initiation of the appropriate therapy.
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Affiliation(s)
- Laura J Jensen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Berlin, Germany
| | - Damon Kim
- Helios Klinikum Emil von Behring, Department of Radiology, Berlin, Germany
| | - Thomas Elgeti
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Berlin, Germany
| | - Ingo G Steffen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Berlin, Germany
| | - Lars-Arne Schaafs
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Berlin, Germany
| | - Bernd Hamm
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Berlin, Germany
| | - Sebastian N Nagel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Berlin, Germany
- Bielefeld University, Medical School and University Medical Center East Westphalia-Lippe, Protestant Hospital of the Bethel Foundation, Academic Department of Diagnostic and Interventional Radiology and Paediatric Radiology, Bielefeld, Germany
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Dietzel M, Laun FB, Heiß R, Wenkel E, Bickelhaupt S, Hack C, Uder M, Ohlmeyer S. Initial experience with a next-generation low-field MRI scanner: Potential for breast imaging? Eur J Radiol 2024; 173:111352. [PMID: 38330534 DOI: 10.1016/j.ejrad.2024.111352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Broader clinical adoption of breast magnetic resonance imaging (MRI) faces challenges such as limited availability and high procedural costs. Low-field technology has shown promise in addressing these challenges. We report our initial experience using a next-generation scanner for low-field breast MRI at 0.55T. METHODS This initial cases series was part of an institutional review board-approved prospective study using a 0.55T scanner (MAGNETOM Free.Max, Siemens Healthcare, Erlangen/Germany: height < 2 m, weight < 3.2 tons, no quench pipe) equipped with a seven-channel breast coil (Noras, Höchberg/Germany). A multiparametric breast MRI protocol consisting of dynamic T1-weighted, T2-weighted, and diffusion-weighted sequences was optimized for 0.55T. Two radiologists with 12 and 20 years of experience in breast MRI evaluated the examinations. RESULTS Twelve participants (mean age: 55.3 years, range: 36-78 years) were examined. The image quality was diagnostic in all examinations and not impaired by relevant artifacts. Typical imaging phenotypes were visualized. The scan time for a complete, non-abbreviated breast MRI protocol ranged from 10:30 to 18:40 min. CONCLUSION This initial case series suggests that low-field breast MRI is feasible at diagnostic image quality within an acceptable examination time.
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Affiliation(s)
- Matthias Dietzel
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Frederik B Laun
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Rafael Heiß
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Evelyn Wenkel
- Radiologie München, Burgstrasse 7, 80331 München, Germany.
| | - Sebastian Bickelhaupt
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Carolin Hack
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Universitätsstraße 21/23, 91054 Erlangen, Germany.
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Sabine Ohlmeyer
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
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Azour L, Chandarana H, Maier C, Babb J, Moore W. Low Field MRI Surveillance 6-24 Months Post-acute COVID-19 Pneumonia: Factors Influencing Severity and Evolution of Lung Opacities. Acad Radiol 2024:S1076-6332(24)00092-8. [PMID: 38443207 DOI: 10.1016/j.acra.2024.02.021] [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: 12/23/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
RATIONALE AND OBJECTIVES To determine factors influencing low-field MRI lung opacity severity 6-24 months after acute Covid-19 pneumonia. MATERIALS AND METHODS 104 post-acute Covid-19 patients with 167 MRI exams were included. 32 patients had more than one exam, and 63 exams were serial exams. Pulmonary findings were graded on a scale of 0-4 by quadrant, total score ranging from 0 (no opacity) to 16 (opacity > 75%), and score >8 considered moderate and >12 severe opacity. Kruskal-Wallis, Mann-Whitney, and Spearman rank correlation was used to assess the association of clinical and demographic factors with MR opacity severity at time intervals from acute infection. Random coefficients regression was used to assess whether opacity score changed over time. RESULTS Severity of initial illness was associated with increased MR opacity score at timeframes up to 24 months (p < .05). Among the 167 exams, moderate to severe MR opacities (total opacity score >8) were identified in 33% of exams beyond 6 months: 37% at 6 - <12 months (n = 23/63); 31% at 12- < 18 months (n = 13/42); 25% at 18- < 24 months (n = 6/24); and 50% at > 24 months (n = 3/6). No significant change in total opacity score over time was identified by random coefficients regression. Among the 32 patients with serial exams, 11 demonstrated no change in opacity score from initial to final exam, 10 decrease in score (mean 2.3, stdev 1.25, range 1-4), and 11 increase in score (average 2.8, stdev 1.48, range 1-7). CONCLUSION Initial Covid-19 disease severity was associated with increased MRI total opacity score at time intervals up to 24 months, and moderate to severe opacities were commonly identified by low-field MRI beyond 6 months from acute illness.
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Affiliation(s)
- Lea Azour
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, NY; Department of Radiological Sciences, David Geffen School of Medicine at UCLA, UCLA Health, Los Angeles, CA.
| | - Hersh Chandarana
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, NY
| | - Christoph Maier
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, NY
| | - James Babb
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, NY
| | - William Moore
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York, NY
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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.
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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
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Landini N, Orlandi M, Calistri L, Nardi C, Ciet P, Bellando-Randone S, Guiducci S, Benkert T, Panebianco V, Morana G, Matucci-Cerinic M, Colagrande S. Advanced and traditional chest MRI sequence for the clinical assessment of systemic sclerosis related interstitial lung disease, compared to CT: disease extent analysis and correlations with pulmonary function tests. Eur J Radiol 2024; 170:111239. [PMID: 38056347 DOI: 10.1016/j.ejrad.2023.111239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/22/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND MRI is a radiation-free emerging alternative to CT in systemic sclerosis related interstitial lung disease (SSc-ILD) assessment. We aimed to compare a T2 radial TSE and a PD UTE MRI sequence with CT in SSc-ILD extent evaluation and correlations with pulmonary function tests (PFT). MATERIAL AND METHODS 29 SSc-ILD patients underwent CT, MRI and PFT. ILD extent was visually assessed. Lin's concordance correlation coefficients (CCC) and Kruskal Wallis test (p-value < 0.05) were computed for inter-method comparison. Patients were divided in limited and extended disease, defining extended ILD with two methods: (A) ILD>30% or 10%20% or 20% with FVC%<70%. MRI Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and Accuracy were assessed. Pearson correlation coefficients r (p-value<0.025) were computed between ILD extents and PFT (FVC% and DLCO%). RESULTS Median ILD extents were 11%, 11%, 10% on CT, radial TSE and UTE, respectively. CCC between CT and MRI was 0.95 for both sequences (Kruskal-Wallis p-value=0.64). Sensitivity, Specificity, PPV, NPV and Accuracy in identifying extended disease were: (A) 87.5 %, 100 %, 100 %, 95.5 and 96.6 % with radial TSE and 87.5 %, 95.2 %, 87.5 %, 95.2 and 93.1 % with UTE; (B) 86.7 %, 86.4 %, 66.7 %, 95.0 % and 86.2 % for both sequences. Pearson r of CT, radial TSE and UTE ILD extents with FVC were -0.66, -0.60 and -0.68 with FVC, -0.59, -0.56 and -0.57 with DLCO, respectively (p<0.002). CONCLUSIONS MRI sequences may have similar accuracy to CT to determine SSc-ILD extent and severity, with analogous correlations with PFT.
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Affiliation(s)
- Nicholas Landini
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, Rome, Italy.
| | - Martina Orlandi
- Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC Careggi, University of Florence, Florence, Italy.
| | - Linda Calistri
- Department of Experimental and Clinical Biomedical Sciences, University of Florence & Radiodiagnostic Unit n. 2 AOUC, Florence, Italy.
| | - Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence & Radiodiagnostic Unit n. 2 AOUC, Florence, Italy.
| | - Pierluigi Ciet
- Department of Radiology and Nuclear Medicine, Erasmus MC - Sophia, Rotterdam, Netherlands; Department of Radiology, Policlinico Universitario, Cagliari, Italy.
| | - Silvia Bellando-Randone
- Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC Careggi, University of Florence, Florence, Italy.
| | - Serena Guiducci
- Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC Careggi, University of Florence, Florence, Italy.
| | - Thomas Benkert
- MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany.
| | - Valeria Panebianco
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, Rome, Italy.
| | - Giovanni Morana
- Department of Radiology, S. Maria Ca' Foncello Regional Hospital, Treviso, Italy.
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC Careggi, University of Florence, Florence, Italy; Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Hospital, Milan, Italy.
| | - Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, University of Florence & Radiodiagnostic Unit n. 2 AOUC, Florence, Italy.
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Shetty AS, Ludwig DR, Ippolito JE, Andrews TJ, Narra VR, Fraum TJ. Low-Field-Strength Body MRI: Challenges and Opportunities at 0.55 T. Radiographics 2023; 43:e230073. [PMID: 37917537 DOI: 10.1148/rg.230073] [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: 11/04/2023]
Abstract
Advances in MRI technology have led to the development of low-field-strength (hereafter, "low-field") (0.55 T) MRI systems with lower weight, fewer shielding requirements, and lower cost than those of traditional (1.5-3 T) systems. The trade-offs of lower signal-to-noise ratio (SNR) at 0.55 T are partially offset by patient safety and potential comfort advantages (eg, lower specific absorption rate and a more cost-effective larger bore diameter) and physical advantages (eg, decreased T2* decay, shorter T1 relaxation times). Image reconstruction advances leveraging developing technologies (such as deep learning-based denoising) can be paired with traditional techniques (such as increasing the number of signal averages) to improve SNR. The overall image quality produced by low-field MRI systems, although perhaps somewhat inferior to 1.5-3 T MRI systems in terms of SNR, is nevertheless diagnostic for a broad variety of body imaging applications. Effective low-field body MRI requires (a) an understanding of the trade-offs resulting from lower field strengths, (b) an approach to modifying routine sequences to overcome SNR challenges, and (c) a workflow for carefully selecting appropriate patients. The authors describe the rationale, opportunities, and challenges of low-field body MRI; discuss important considerations for low-field imaging with common body MRI sequences; and delineate a variety of use cases for low-field body MRI. The authors also include lessons learned from their preliminary experience with a new low-field MRI system at a tertiary care center. Finally, they explore the future of low-field MRI, summarizing current limitations and potential future developments that may enhance the clinical adoption of this technology. ©RSNA, 2023 Supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center. See the invited commentary by Venkatesh in this issue.
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Affiliation(s)
- Anup S Shetty
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
| | - Daniel R Ludwig
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
| | - Joseph E Ippolito
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
| | - Trevor J Andrews
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
| | - Vamsi R Narra
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
| | - Tyler J Fraum
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St. Louis, MO 63110
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Moore WH, Chandarana H. The Role of Proton MRI to Evaluate Patient Pathophysiology in Severe Asthma. Radiol Cardiothorac Imaging 2023; 5:e230372. [PMID: 38166342 PMCID: PMC11163240 DOI: 10.1148/ryct.230372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 11/20/2023] [Accepted: 11/20/2023] [Indexed: 01/04/2024]
Affiliation(s)
- William H. Moore
- From the Department of Radiology, New York University, 660 1st
Ave, New York, NY 10016 (W.H.M.); Department of Radiology, Center for Advanced
Imaging Innovation and Research, New York, NY (H.C.); and Department of
Radiology and Biomedical Imaging, NYU Grossman School of Medicine, New York, NY
(H.C.)
| | - Hersh Chandarana
- From the Department of Radiology, New York University, 660 1st
Ave, New York, NY 10016 (W.H.M.); Department of Radiology, Center for Advanced
Imaging Innovation and Research, New York, NY (H.C.); and Department of
Radiology and Biomedical Imaging, NYU Grossman School of Medicine, New York, NY
(H.C.)
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9
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Seiberlich N. Research Studies Evaluating Image Quality on Commercial 0.55 T MRI Systems Are Essential for Sequence Optimization and Appropriate Clinical Deployment. Acad Radiol 2023; 30:2447-2449. [PMID: 37550155 DOI: 10.1016/j.acra.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Nicole Seiberlich
- Department of Radiology, University of Michigan, Ann Arbor, Michigan.
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Campbell-Washburn AE, Keenan KE, Hu P, Mugler JP, Nayak KS, Webb AG, Obungoloch J, Sheth KN, Hennig J, Rosen MS, Salameh N, Sodickson DK, Stein JM, Marques JP, Simonetti OP. Low-field MRI: A report on the 2022 ISMRM workshop. Magn Reson Med 2023; 90:1682-1694. [PMID: 37345725 PMCID: PMC10683532 DOI: 10.1002/mrm.29743] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/21/2023] [Accepted: 05/17/2023] [Indexed: 06/23/2023]
Abstract
In March 2022, the first ISMRM Workshop on Low-Field MRI was held virtually. The goals of this workshop were to discuss recent low field MRI technology including hardware and software developments, novel methodology, new contrast mechanisms, as well as the clinical translation and dissemination of these systems. The virtual Workshop was attended by 368 registrants from 24 countries, and included 34 invited talks, 100 abstract presentations, 2 panel discussions, and 2 live scanner demonstrations. Here, we report on the scientific content of the Workshop and identify the key themes that emerged. The subject matter of the Workshop reflected the ongoing developments of low-field MRI as an accessible imaging modality that may expand the usage of MRI through cost reduction, portability, and ease of installation. Many talks in this Workshop addressed the use of computational power, efficient acquisitions, and contemporary hardware to overcome the SNR limitations associated with low field strength. Participants discussed the selection of appropriate clinical applications that leverage the unique capabilities of low-field MRI within traditional radiology practices, other point-of-care settings, and the broader community. The notion of "image quality" versus "information content" was also discussed, as images from low-field portable systems that are purpose-built for clinical decision-making may not replicate the current standard of clinical imaging. Speakers also described technical challenges and infrastructure challenges related to portability and widespread dissemination, and speculated about future directions for the field to improve the technology and establish clinical value.
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Affiliation(s)
- Adrienne E Campbell-Washburn
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kathryn E Keenan
- Physical Measurement Laboratory, National Institute of Standards and Technology, Boulder, Colorado, USA
| | - Peng Hu
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, China
| | - John P Mugler
- Department of Radiology & Medical Imaging, Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
| | - Andrew G Webb
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Kevin N Sheth
- Division of Neurocritical Care and Emergency Neurology, Departments of Neurology and Neurosurgery, and the Yale Center for Brain and Mind Health, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jürgen Hennig
- Dept.of Radiology, Medical Physics, University Medical Center Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthew S Rosen
- Massachusetts General Hospital, A. A. Martinos Center for Biomedical Imaging, Boston, Massachusetts, USA
- Department of Physics, Harvard University, Cambridge, Massachusetts, USA
| | - Najat Salameh
- Center for Adaptable MRI Technology (AMT Center), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Daniel K Sodickson
- Department of Radiology, NYU Langone Health, New York, New York, USA
- Center for Advanced Imaging Innovation and Research, NYU Langone Health, New York, New York, USA
| | - Joel M Stein
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - José P Marques
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Orlando P Simonetti
- Division of Cardiovascular Medicine, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Department of Radiology, The Ohio State University, Columbus, Ohio, USA
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11
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Landini N, Ciet P, Janssens HM, Bertolo S, Ros M, Mattone M, Catalano C, Majo F, Costa S, Gramegna A, Lucca F, Parisi GF, Saba L, Tiddens HAWM, Morana G. Management of respiratory tract exacerbations in people with cystic fibrosis: Focus on imaging. Front Pediatr 2022; 10:1084313. [PMID: 36814432 PMCID: PMC9940849 DOI: 10.3389/fped.2022.1084313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/28/2022] [Indexed: 02/09/2023] Open
Abstract
Respiratory tract exacerbations play a crucial role in progressive lung damage of people with cystic fibrosis, representing a major determinant in the loss of functional lung tissue, quality of life and patient survival. Detection and monitoring of respiratory tract exacerbations are challenging for clinicians, since under- and over-treatment convey several risks for the patient. Although various diagnostic and monitoring tools are available, their implementation is hampered by the current definition of respiratory tract exacerbation, which lacks objective "cut-offs" for clinical and lung function parameters. In particular, the latter shows a large variability, making the current 10% change in spirometry outcomes an unreliable threshold to detect exacerbation. Moreover, spirometry cannot be reliably performed in preschool children and new emerging tools, such as the forced oscillation technique, are still complementary and need more validation. Therefore, lung imaging is a key in providing respiratory tract exacerbation-related structural and functional information. However, imaging encompasses several diagnostic options, each with different advantages and limitations; for instance, conventional chest radiography, the most used radiological technique, may lack sensitivity and specificity in respiratory tract exacerbations diagnosis. Other methods, including computed tomography, positron emission tomography and magnetic resonance imaging, are limited by either radiation safety issues or the need for anesthesia in uncooperative patients. Finally, lung ultrasound has been proposed as a safe bedside option but it is highly operator-dependent and there is no strong evidence of its possible use during respiratory tract exacerbation. This review summarizes the clinical challenges of respiratory tract exacerbations in patients with cystic fibrosis with a special focus on imaging. Firstly, the definition of respiratory tract exacerbation is examined, while diagnostic and monitoring tools are briefly described to set the scene. This is followed by advantages and disadvantages of each imaging technique, concluding with a diagnostic imaging algorithm for disease monitoring during respiratory tract exacerbation in the cystic fibrosis patient.
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Affiliation(s)
- Nicholas Landini
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, Rome, Italy
| | - Pierluigi Ciet
- Department of Radiology and Nuclear Medicine, Erasmus MC - Sophia, Rotterdam, Netherlands.,Department of Radiology, University Cagliari, Cagliari, Italy.,Department of Pediatrics, division of Respiratory Medicine and Allergology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Hettie M Janssens
- Department of Pediatrics, division of Respiratory Medicine and Allergology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Silvia Bertolo
- Department of Radiology, S. Maria Ca'Foncello Regional Hospital, Treviso, Italy
| | - Mirco Ros
- Department of Pediatrics, Ca'Foncello S. Maria Hospital, Treviso, Italy
| | - Monica Mattone
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I Hospital, "Sapienza" Rome University, Rome, Italy
| | - Fabio Majo
- Pediatric Pulmonology & Cystic Fibrosis Unit Bambino Gesú Children's Hospital, IRCCS Rome, Rome, Italy
| | - Stefano Costa
- Department of Pediatrics, Gaetano Martino Hospital, Messina, Italy
| | - Andrea Gramegna
- Department of Pathophisiology and Transplantation, University of Milan, Milan, Italy.,Respiratory Disease and Adult Cystic Fibrosis Centre, Internal Medicine Department, IRCCS Ca' Granda, Milan, Italy
| | - Francesca Lucca
- Regional Reference Cystic Fibrosis Center, University Hospital of Verona, Verona, Italy
| | - Giuseppe Fabio Parisi
- Pediatric Pulmonology Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Luca Saba
- Department of Radiology, University Cagliari, Cagliari, Italy
| | - Harm A W M Tiddens
- Department of Radiology and Nuclear Medicine, Erasmus MC - Sophia, Rotterdam, Netherlands.,Department of Pediatrics, division of Respiratory Medicine and Allergology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Giovanni Morana
- Department of Radiology, S. Maria Ca'Foncello Regional Hospital, Treviso, Italy
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