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Qiu Y, Dai K, Zhong S, Chen S, Wang C, Chen H, Frydman L, Zhang Z. Spatiotemporal encoding MRI in a portable low-field system. Magn Reson Med 2024; 92:1011-1021. [PMID: 38623991 DOI: 10.1002/mrm.30104] [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: 12/05/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Demonstrate the potential of spatiotemporal encoding (SPEN) MRI to deliver largely undistorted 2D, 3D, and diffusion weighted images on a 110 mT portable system. METHODS SPEN's quadratic phase modulation was used to subsample the low-bandwidth dimension of echo planar acquisitions, delivering alias-free images with an enhanced immunity to image distortions in a laboratory-built, low-field, portable MRI system lacking multiple receivers. RESULTS Healthy brain images with different SPEN time-bandwidth products and subsampling factors were collected. These compared favorably to EPI acquisitions including topup corrections. Robust 3D and diffusion weighted SPEN images of diagnostic value were demonstrated, with 2.5 mm isotropic resolutions achieved in 3 min scans. This performance took advantage of the low specific absorption rate and relative long TEs associated with low-field MRI. CONCLUSION SPEN MRI provides a robust and advantageous fast acquisition approach to obtain faithful 3D images and DWI data in low-cost, portable, low-field systems without parallel acceleration.
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Affiliation(s)
- Yueqi Qiu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Ke Dai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Sijie Zhong
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Suen Chen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Changyue Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Hao Chen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Lucio Frydman
- Department of Chemical and Biological Physics, Weizmann Institute of Science, Rehovot, Israel
| | - Zhiyong Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- National Engineering Research Center of Advanced Magnetic Resonance Technologies for Diagnosis and Therapy (NERC-AMRT), Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Balaji S, Wiley N, Poorman ME, Kolind SH. Low-field MRI for use in neurological diseases. Curr Opin Neurol 2024; 37:381-391. [PMID: 38813835 DOI: 10.1097/wco.0000000000001282] [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: 05/31/2024]
Abstract
PURPOSE OF REVIEW To review recent clinical uses of low-field magnetic resonance imaging (MRI) to guide incorporation into neurological practice. RECENT FINDINGS Use of low-field MRI has been demonstrated in applications including tumours, vascular pathologies, multiple sclerosis, brain injury, and paediatrics. Safety, workflow, and image quality have also been evaluated. SUMMARY Low-field MRI has the potential to increase access to critical brain imaging for patients who otherwise may not obtain imaging in a timely manner. This includes areas such as the intensive care unit and emergency room, where patients could be imaged at the point of care rather than be transported to the MRI scanner. Such systems are often more affordable than conventional systems, allowing them to be more easily deployed in resource constrained settings. A variety of systems are available on the market or in a research setting and are currently being used to determine clinical uses for these devices. The utility of such devices must be fully evaluated in clinical scenarios before adoption into standard practice can be achieved. This review summarizes recent clinical uses of low-field MR as well as safety, workflows, and image quality to aid practitioners in assessing this new technology.
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Affiliation(s)
- Sharada Balaji
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Neale Wiley
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Shannon H Kolind
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine (Neurology)
- Department of Radiology
- International Collaboration on Repair Discoveries, Blusson Spinal Cord Centre, University of British Columbia, Vancouver, British Columbia, Canada
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3
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Röhrs KJ, Audebert H. Pre-Hospital Stroke Care beyond the MSU. Curr Neurol Neurosci Rep 2024; 24:315-322. [PMID: 38907812 PMCID: PMC11258185 DOI: 10.1007/s11910-024-01351-0] [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] [Accepted: 06/11/2024] [Indexed: 06/24/2024]
Abstract
PURPOSE OF REVIEW Mobile stroke units (MSU) have established a new, evidence-based treatment in prehospital stroke care, endorsed by current international guidelines and can facilitate pre-hospital research efforts. In addition, other novel pre-hospital modalities beyond the MSU are emerging. In this review, we will summarize existing evidence and outline future trajectories of prehospital stroke care & research on and off MSUs. RECENT FINDINGS The proof of MSUs' positive effect on patient outcomes is leading to their increased adoption in emergency medical services of many countries. Nevertheless, prehospital stroke care worldwide largely consists of regular ambulances. Advancements in portable technology for detecting neurocardiovascular diseases, telemedicine, AI and large-scale ultra-early biobanking have the potential to transform prehospital stroke care also beyond the MSU concept. The increasing implementation of telemedicine in emergency medical services is demonstrating beneficial effects in the pre-hospital setting. In synergy with telemedicine the exponential growth of AI-technology is already changing and will likely further transform pre-hospital stroke care in the future. Other promising areas include the development and validation of miniaturized portable devices for the pre-hospital detection of acute stroke. MSUs are enabling large-scale screening for ultra-early blood-based biomarkers, facilitating the differentiation between ischemia, hemorrhage, and stroke mimics. The development of suitable point-of-care tests for such biomarkers holds the potential to advance pre-hospital stroke care outside the MSU-concept. A multimodal approach of AI-supported telemedicine, portable devices and blood-based biomarkers appears to be an increasingly realistic scenario for improving prehospital stroke care in regular ambulances in the future.
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Affiliation(s)
- Kian J Röhrs
- Department of Neurology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Heinrich Audebert
- Department of Neurology, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
- Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
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4
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Al-Naser Y, Alshadeedi F. Bringing imaging to the people: Enhancing access and equity in healthcare through mobile imaging. J Med Imaging Radiat Sci 2024; 55:101715. [PMID: 39047372 DOI: 10.1016/j.jmir.2024.101715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 06/19/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024]
Affiliation(s)
- Yousif Al-Naser
- Medical Radiation Sciences, McMaster University, Hamilton, ON, Canada; Department of Diagnostic Imaging, Trillium Health Partners, Mississauga, ON, Canada.
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5
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Hadi YH, Hawsawi HB, Abu Aqil AI. Driving healthcare forward: The potential of mobile MRI and CT units in streamlining radiological services in Saudi Arabia - A narrative review. J Med Imaging Radiat Sci 2024; 55:101444. [PMID: 38986296 DOI: 10.1016/j.jmir.2024.101444] [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: 03/11/2024] [Revised: 05/20/2024] [Accepted: 05/27/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND AND PURPOSE This narrative review focuses on the role of mobile MRI and CT units in addressing the challenges of healthcare accessibility and patient wait times in Saudi Arabia. It underscores the growing demand for diagnostic imaging amid infrastructural and geographical barriers, emphasizing mobile units as innovative solutions for enhancing radiological services across diverse Saudi landscapes. The purpose of this study is to assess how these mobile technologies can mitigate service delays, improve patient outcomes, and support healthcare delivery in remote or underserved areas, reflecting on global trends towards more dynamic, patient-centered healthcare models. METHODS This review utilizes an expanded database search and refined keywords to ensure comprehensive literature coverage. The study focused on peer-review articles and grey literatures that directly examined the impact of these mobile units on healthcare accessibility, wait times, and service delivery. A thematic analysis identified significant contributions to accessibility improvements, emergency responses, and rural healthcare, highlighting areas for further research and policy development. DISCUSSION Mobile units have advanced technical specifications with high-field magnets and multi-slice CT scanners on par with fixed facilities. They prioritize patient comfort and safety with examination areas, control rooms, and waiting areas. Telemedicine capabilities allow real-time image transmission to specialists. Strategic deployment can address workforce shortages by distributing services equitably. Mobile units represent cost-effective solutions to expand healthcare access without fixed infrastructure. CONCLUSION Integration of mobile MRI and CT units in Saudi Arabia can transform access to diagnostic imaging by decentralizing services and directly reaching patients, including rural areas. Evidence shows mobile units reduce diagnostic delays and optimize resource use. Despite challenges, strategic investments and collaborations can overcome obstacles to make radiological services more equitable, flexible and patient-focused in Saudi Arabia.
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Affiliation(s)
- Yasser H Hadi
- Department of Medical Imaging and Intervention, King Abdullah Medical City (KAMC), Muzdalifah Rd, Al Mashair, Makkah 24246, Saudi Arabia; Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Brookfield, College Rd, University College, Cork, T12 AK54, Ireland.
| | - Hassan B Hawsawi
- Department of Medical Physics, King Abdullah Medical City (KAMC), Muzdalifah Rd, Al Mashair, Makkah 24246, Saudi Arabia
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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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7
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Altaf A, Shakir M, Irshad HA, Atif S, Kumari U, Islam O, Kimberly WT, Knopp E, Truwit C, Siddiqui K, Enam SA. Applications, limitations and advancements of ultra-low-field magnetic resonance imaging: A scoping review. Surg Neurol Int 2024; 15:218. [PMID: 38974534 PMCID: PMC11225429 DOI: 10.25259/sni_162_2024] [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: 03/04/2024] [Accepted: 05/17/2024] [Indexed: 07/09/2024] Open
Abstract
Background Ultra-low-field magnetic resonance imaging (ULF-MRI) has emerged as an alternative with several portable clinical applications. This review aims to comprehensively explore its applications, potential limitations, technological advancements, and expert recommendations. Methods A review of the literature was conducted across medical databases to identify relevant studies. Articles on clinical usage of ULF-MRI were included, and data regarding applications, limitations, and advancements were extracted. A total of 25 articles were included for qualitative analysis. Results The review reveals ULF-MRI efficacy in intensive care settings and intraoperatively. Technological strides are evident through innovative reconstruction techniques and integration with machine learning approaches. Additional advantages include features such as portability, cost-effectiveness, reduced power requirements, and improved patient comfort. However, alongside these strengths, certain limitations of ULF-MRI were identified, including low signal-to-noise ratio, limited resolution and length of scanning sequences, as well as variety and absence of regulatory-approved contrast-enhanced imaging. Recommendations from experts emphasize optimizing imaging quality, including addressing signal-to-noise ratio (SNR) and resolution, decreasing the length of scan time, and expanding point-of-care magnetic resonance imaging availability. Conclusion This review summarizes the potential of ULF-MRI. The technology's adaptability in intensive care unit settings and its diverse clinical and surgical applications, while accounting for SNR and resolution limitations, highlight its significance, especially in resource-limited settings. Technological advancements, alongside expert recommendations, pave the way for refining and expanding ULF-MRI's utility. However, adequate training is crucial for widespread utilization.
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Affiliation(s)
- Ahmed Altaf
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Muhammad Shakir
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | | | - Shiza Atif
- Medical College, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Usha Kumari
- Medical College, Peoples University of Medical and Health Sciences for Women, Karachi, Sindh, Pakistan
| | - Omar Islam
- Department of Diagnostic Radiology, Queen’s University, Kingston General Hospital, Kingston, Canada
| | - W. Taylor Kimberly
- Department of Neurology, Massachusetts General Hospital, Boston, United States
| | | | | | | | - S. Ather Enam
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan
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8
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Kolangarakath A, Chalil Madathil K, Hegde S, Agrawal S, Bian M, Simmons L, Molloseau G, Holmstedt C, LeBlanc D, Harvey J, McGeorge T, Spampinato M, Roberts D. Barriers to integrating portable Magnetic Resonance Imaging systems in emergency medical service ambulances for stroke care. ERGONOMICS 2024:1-20. [PMID: 38916114 DOI: 10.1080/00140139.2024.2367157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/06/2024] [Indexed: 06/26/2024]
Abstract
This study examines the barriers to integrating portable Magnetic Resonance Imaging (MRI) systems into ambulance services to enable effective triaging of patients to the appropriate hospitals for timely stroke care and potentially reduce door-to-needle time for thrombolytic administration. The study employs a qualitative methodology using a digital twin of the patient handling process developed and demonstrated through semi-structured interviews with 18 participants, including 11 paramedics from an Emergency Medical Services system and seven neurologists from a tertiary stroke care centre. The interview transcripts were thematically analysed to determine the barriers based on the Systems Engineering Initiative for Patient Safety framework. Key barriers include the need for MRI operation skills, procedural complexities in patient handling, space constraints, and the need for training and policy development. Potential solutions are suggested to mitigate these barriers. The findings can facilitate implementing MRI systems in ambulances to expedite stroke treatment.
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Affiliation(s)
- Arvind Kolangarakath
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
| | - Kapil Chalil Madathil
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
| | - Sudeep Hegde
- Department of Industrial Engineering, Clemson University, Clemson, South Carolina, USA
| | - Shubham Agrawal
- Department of Psychology, Clemson University, Clemson, South Carolina, USA
| | - Mary Bian
- Department of Psychology, Clemson University, Clemson, South Carolina, USA
| | - Lauren Simmons
- Department of Genetics and Biochemistry, Clemson University, Clemson, South Carolina, USA
| | - Gabby Molloseau
- College of Medicine, Medical University of South Carolina, Clemson, South Carolina, USA
| | - Christine Holmstedt
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Dustin LeBlanc
- Department of Emergency Medicine, Medical University of South Carolina,Charleston, South Carolina, USA
| | - Jillian Harvey
- Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Todd McGeorge
- Charleston County Emergency Medical Services, Charleston, South Carolina, USA
| | - Maria Spampinato
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Donna Roberts
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
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9
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Abate F, Adu-Amankwah A, Ae-Ngibise KA, Agbokey F, Agyemang VA, Agyemang CT, Akgun C, Ametepe J, Arichi T, Asante KP, Balaji S, Baljer L, Basser PJ, Beauchemin J, Bennallick C, Berhane Y, Boateng-Mensah Y, Bourke NJ, Bradford L, Bruchhage M, Lorente RC, Cawley P, Cercignani M, D Sa V, Canha AD, Navarro ND, Dean DC, Delarosa J, Donald KA, Dvorak A, Edwards AD, Field D, Frail H, Freeman B, George T, Gholam J, Guerrero-Gonzalez J, Hajnal JV, Haque R, Hollander W, Hoodbhoy Z, Huentelman M, Jafri SK, Jones DK, Joubert F, Karaulanov T, Kasaro MP, Knackstedt S, Kolind S, Koshy B, Kravitz R, Lafayette SL, Lee AC, Lena B, Lepore N, Linguraru M, Ljungberg E, Lockart Z, Loth E, Mannam P, Masemola KM, Moran R, Murphy D, Nakwa FL, Nankabirwa V, Nelson CA, North K, Nyame S, O Halloran R, O'Muircheartaigh J, Oakley BF, Odendaal H, Ongeti CM, Onyango D, Oppong SA, Padormo F, Parvez D, Paus T, Pepper MS, Phiri KS, Poorman M, Ringshaw JE, Rogers J, Rutherford M, Sabir H, Sacolick L, Seal M, Sekoli ML, Shama T, Siddiqui K, Sindano N, Spelke MB, Springer PE, Suleman FE, Sundgren PC, Teixeira R, Terekegn W, Traughber M, Tuuli MG, Rensburg JV, Váša F, Velaphi S, Velasco P, Viljoen IM, Vokhiwa M, Webb A, Weiant C, Wiley N, Wintermark P, Yibetal K, Deoni S, Williams S. UNITY: A low-field magnetic resonance neuroimaging initiative to characterize neurodevelopment in low and middle-income settings. Dev Cogn Neurosci 2024; 69:101397. [PMID: 39029330 DOI: 10.1016/j.dcn.2024.101397] [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: 12/20/2023] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 07/21/2024] Open
Abstract
Measures of physical growth, such as weight and height have long been the predominant outcomes for monitoring child health and evaluating interventional outcomes in public health studies, including those that may impact neurodevelopment. While physical growth generally reflects overall health and nutritional status, it lacks sensitivity and specificity to brain growth and developing cognitive skills and abilities. Psychometric tools, e.g., the Bayley Scales of Infant and Toddler Development, may afford more direct assessment of cognitive development but they require language translation, cultural adaptation, and population norming. Further, they are not always reliable predictors of future outcomes when assessed within the first 12-18 months of a child's life. Neuroimaging may provide more objective, sensitive, and predictive measures of neurodevelopment but tools such as magnetic resonance (MR) imaging are not readily available in many low and middle-income countries (LMICs). MRI systems that operate at lower magnetic fields (< 100mT) may offer increased accessibility, but their use for global health studies remains nascent. The UNITY project is envisaged as a global partnership to advance neuroimaging in global health studies. Here we describe the UNITY project, its goals, methods, operating procedures, and expected outcomes in characterizing neurodevelopment in sub-Saharan Africa and South Asia.
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Affiliation(s)
- F Abate
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; Waisman Research Center, Madison, WI, USA
| | - A Adu-Amankwah
- Korle-Bu Teaching Hospital, Accra, Ghana; Waisman Research Center, Madison, WI, USA
| | - K A Ae-Ngibise
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana; Waisman Research Center, Madison, WI, USA
| | - F Agbokey
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana; Waisman Research Center, Madison, WI, USA
| | - V A Agyemang
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana; Waisman Research Center, Madison, WI, USA
| | - C T Agyemang
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana; Waisman Research Center, Madison, WI, USA
| | - C Akgun
- flywheel.io Minneapolis, MN, USA; Waisman Research Center, Madison, WI, USA
| | - J Ametepe
- Cardiff University Brain Research Imaging Center, Cardiff University, Cardiff, UK; Waisman Research Center, Madison, WI, USA
| | - T Arichi
- Centre for the Developing Brain, Kings College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - K P Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana; Waisman Research Center, Madison, WI, USA
| | - S Balaji
- Dept. of Neurology, University of British Columbia, Vancouver, BC, Canada; Waisman Research Center, Madison, WI, USA
| | - L Baljer
- Centre for Neuroimaging Sciences, King's College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - P J Basser
- National Institutes of Health, Washington, DC, USA; Waisman Research Center, Madison, WI, USA
| | - J Beauchemin
- Advanced Baby Imaging Lab, Providence, RI, USA; Waisman Research Center, Madison, WI, USA
| | - C Bennallick
- Centre for Neuroimaging Sciences, King's College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - Y Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; Waisman Research Center, Madison, WI, USA
| | - Y Boateng-Mensah
- Korle-Bu Teaching Hospital, Accra, Ghana; Waisman Research Center, Madison, WI, USA
| | - N J Bourke
- Centre for Neuroimaging Sciences, King's College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - L Bradford
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and the Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Waisman Research Center, Madison, WI, USA
| | - Mmk Bruchhage
- Dept. of Psychology, Stavanger University, Norway; Waisman Research Center, Madison, WI, USA
| | - R Cano Lorente
- Advanced Baby Imaging Lab, Providence, RI, USA; Waisman Research Center, Madison, WI, USA
| | - P Cawley
- Centre for the Developing Brain, Kings College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - M Cercignani
- Cardiff University Brain Research Imaging Center, Cardiff University, Cardiff, UK; Waisman Research Center, Madison, WI, USA
| | - V D Sa
- Advanced Baby Imaging Lab, Providence, RI, USA; Waisman Research Center, Madison, WI, USA
| | - A de Canha
- Institute for Cellular and Molecular Medicine, Department of Medical Immunology, University of Pretoria, Pretoria, South Africa; Waisman Research Center, Madison, WI, USA
| | - N de Navarro
- Collective Minds Radiology, Sweden; Waisman Research Center, Madison, WI, USA
| | - D C Dean
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA; Waisman Research Center, Madison, WI, USA
| | - J Delarosa
- PATH, Seattle, WA, USA; Waisman Research Center, Madison, WI, USA
| | - K A Donald
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and the Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Waisman Research Center, Madison, WI, USA
| | - A Dvorak
- Dept. of Neurology, University of British Columbia, Vancouver, BC, Canada; Waisman Research Center, Madison, WI, USA
| | - A D Edwards
- Centre for the Developing Brain, Kings College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - D Field
- Collective Minds Radiology, Sweden; Waisman Research Center, Madison, WI, USA
| | - H Frail
- Hyperfine.io, Guilford, CT, USA; Waisman Research Center, Madison, WI, USA
| | - B Freeman
- University of North Carolina, Department of Obstetrics and Gynecology, Chapel Hill, USA; Waisman Research Center, Madison, WI, USA
| | - T George
- Department of Radiology, Faculty of Health Sciences, Chris Hani Baragwanath Academic Hospital, University; Waisman Research Center, Madison, WI, USA
| | - J Gholam
- Cardiff University Brain Research Imaging Center, Cardiff University, Cardiff, UK; Waisman Research Center, Madison, WI, USA
| | - J Guerrero-Gonzalez
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA; Waisman Research Center, Madison, WI, USA
| | - J V Hajnal
- Centre for the Developing Brain, Kings College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - R Haque
- International Centre for Diarrheal Disease Research, Bangladesh (Icddr,b), Dhaka, Bangladesh; Waisman Research Center, Madison, WI, USA
| | - W Hollander
- CaliberMRI, Boulder CO USA; Waisman Research Center, Madison, WI, USA
| | - Z Hoodbhoy
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan; Waisman Research Center, Madison, WI, USA
| | - M Huentelman
- TGen, Phoenix, AZ, USA; Waisman Research Center, Madison, WI, USA
| | - S K Jafri
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan; Waisman Research Center, Madison, WI, USA
| | - D K Jones
- Cardiff University Brain Research Imaging Center, Cardiff University, Cardiff, UK; Waisman Research Center, Madison, WI, USA
| | - F Joubert
- Centre for Bioinformatics and Computational Biology, Department of Biochemistry, Microbiology and Genetics, University of Pretoria, Pretoria, South Africa; Waisman Research Center, Madison, WI, USA
| | - T Karaulanov
- CaliberMRI, Boulder CO USA; Waisman Research Center, Madison, WI, USA
| | - M P Kasaro
- University of North Carolina - Global Projects Zambia, Lusaka, Zambia; Waisman Research Center, Madison, WI, USA
| | - S Knackstedt
- PATH, Seattle, WA, USA; Waisman Research Center, Madison, WI, USA
| | - S Kolind
- Dept. of Neurology, University of British Columbia, Vancouver, BC, Canada; Waisman Research Center, Madison, WI, USA
| | - B Koshy
- Developmental Paediatrics, Christian Medical College, Vellore, India; Waisman Research Center, Madison, WI, USA
| | - R Kravitz
- International Society for Magnetic Resonance in Medicine, San Fransisco, CA, USA; Waisman Research Center, Madison, WI, USA
| | - S Lecurieux Lafayette
- Centre for the Developing Brain, Kings College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - A C Lee
- Brigham and Women's Hospital, Department of Pediatrics; Harvard Medical School; Boston, MA, USA; Waisman Research Center, Madison, WI, USA
| | - B Lena
- Dept. of Radiology, Leiden University, Leiden, the Netherlands; Waisman Research Center, Madison, WI, USA
| | - N Lepore
- Dept. of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Waisman Research Center, Madison, WI, USA
| | - M Linguraru
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC, USA; Waisman Research Center, Madison, WI, USA
| | - E Ljungberg
- Medical Radiation Physics, Lund University, Lund, Sweden; Waisman Research Center, Madison, WI, USA
| | - Z Lockart
- Department of Radiology, Faculty of Health Sciences, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa; Waisman Research Center, Madison, WI, USA
| | - E Loth
- Department of Forensic and Neurodevelopemental Science, Institute of Psychatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Waisman Research Center, Madison, WI, USA
| | - P Mannam
- Developmental Paediatrics, Christian Medical College, Vellore, India; Waisman Research Center, Madison, WI, USA
| | - K M Masemola
- Department of Paediatrics and Child Health, Kalafong Hospital and Faculty of Health Sciences, University of Pretoria, South Africa; Waisman Research Center, Madison, WI, USA
| | - R Moran
- Centre for Neuroimaging Sciences, King's College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - D Murphy
- Department of Forensic and Neurodevelopemental Science, Institute of Psychatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Waisman Research Center, Madison, WI, USA
| | - F L Nakwa
- Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Waisman Research Center, Madison, WI, USA
| | - V Nankabirwa
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University. Kampala, Uganda; Waisman Research Center, Madison, WI, USA
| | - C A Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, USA; Waisman Research Center, Madison, WI, USA
| | - K North
- Brigham and Women's Hospital, Department of Pediatrics; Harvard Medical School; Boston, MA, USA; Waisman Research Center, Madison, WI, USA
| | - S Nyame
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana; Waisman Research Center, Madison, WI, USA
| | - R O Halloran
- Hyperfine.io, Guilford, CT, USA; Waisman Research Center, Madison, WI, USA
| | - J O'Muircheartaigh
- Centre for the Developing Brain, Kings College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - B F Oakley
- Department of Forensic and Neurodevelopemental Science, Institute of Psychatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Waisman Research Center, Madison, WI, USA
| | - H Odendaal
- Dept Obstet Gynaecol, Stellenbosch University, South Africa; Waisman Research Center, Madison, WI, USA
| | - C M Ongeti
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya; Waisman Research Center, Madison, WI, USA
| | - D Onyango
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya; Waisman Research Center, Madison, WI, USA
| | - S A Oppong
- Korle-Bu Teaching Hospital, Accra, Ghana; Waisman Research Center, Madison, WI, USA
| | - F Padormo
- Hyperfine.io, Guilford, CT, USA; Waisman Research Center, Madison, WI, USA
| | - D Parvez
- Collective Minds Radiology, Sweden; Waisman Research Center, Madison, WI, USA
| | - T Paus
- Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada; Waisman Research Center, Madison, WI, USA
| | - M S Pepper
- Institute for Cellular and Molecular Medicine, Department of Medical Immunology, University of Pretoria, Pretoria, South Africa; Waisman Research Center, Madison, WI, USA
| | - K S Phiri
- Training and Research Unit of Excellence (TRUE), Zomba Malawi; Waisman Research Center, Madison, WI, USA
| | - M Poorman
- Hyperfine.io, Guilford, CT, USA; Waisman Research Center, Madison, WI, USA
| | - J E Ringshaw
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and the Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Waisman Research Center, Madison, WI, USA
| | - J Rogers
- Hyperfine.io, Guilford, CT, USA; Waisman Research Center, Madison, WI, USA
| | - M Rutherford
- Centre for the Developing Brain, Kings College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - H Sabir
- Experimental Neonatology, University Hospitals Bonn, Bonn, Germany; Waisman Research Center, Madison, WI, USA
| | - L Sacolick
- Hyperfine.io, Guilford, CT, USA; Waisman Research Center, Madison, WI, USA
| | - M Seal
- Murdoch Children's Research Institute, Melbourne, AUS; Waisman Research Center, Madison, WI, USA
| | - M L Sekoli
- Institute for Cellular and Molecular Medicine, Department of Medical Immunology, University of Pretoria, Pretoria, South Africa; Waisman Research Center, Madison, WI, USA
| | - T Shama
- International Centre for Diarrheal Disease Research, Bangladesh (Icddr,b), Dhaka, Bangladesh; Waisman Research Center, Madison, WI, USA
| | - K Siddiqui
- Hyperfine.io, Guilford, CT, USA; Waisman Research Center, Madison, WI, USA
| | - N Sindano
- University of North Carolina - Global Projects Zambia, Lusaka, Zambia; Waisman Research Center, Madison, WI, USA
| | - M B Spelke
- University of North Carolina, Department of Obstetrics and Gynecology, Chapel Hill, USA; Waisman Research Center, Madison, WI, USA
| | - P E Springer
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Waisman Research Center, Madison, WI, USA
| | - F E Suleman
- Department of Radiology, Faculty of Health Sciences, Kalafong Hospital, University of Pretoria, Pretoria, South Africa; Waisman Research Center, Madison, WI, USA
| | - P C Sundgren
- Section of Diagnostic Radiology,Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Waisman Research Center, Madison, WI, USA
| | - R Teixeira
- Hyperfine.io, Guilford, CT, USA; Waisman Research Center, Madison, WI, USA
| | - W Terekegn
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; Waisman Research Center, Madison, WI, USA
| | - M Traughber
- Hyperfine.io, Guilford, CT, USA; Waisman Research Center, Madison, WI, USA
| | - M G Tuuli
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu, Kenya; Waisman Research Center, Madison, WI, USA
| | - J van Rensburg
- Institute for Cellular and Molecular Medicine, Department of Medical Immunology, University of Pretoria, Pretoria, South Africa; Waisman Research Center, Madison, WI, USA
| | - F Váša
- Centre for Neuroimaging Sciences, King's College London, London, UK; Waisman Research Center, Madison, WI, USA
| | - S Velaphi
- Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Waisman Research Center, Madison, WI, USA
| | - P Velasco
- flywheel.io Minneapolis, MN, USA; Waisman Research Center, Madison, WI, USA
| | - I M Viljoen
- Department of Radiology, Faculty of Health Sciences, Chris Hani Baragwanath Academic Hospital, University; Waisman Research Center, Madison, WI, USA
| | - M Vokhiwa
- Training and Research Unit of Excellence (TRUE), Zomba Malawi; Waisman Research Center, Madison, WI, USA
| | - A Webb
- Dept. of Radiology, Leiden University, Leiden, the Netherlands; Waisman Research Center, Madison, WI, USA
| | - C Weiant
- CaliberMRI, Boulder CO USA; Waisman Research Center, Madison, WI, USA
| | - N Wiley
- Dept. of Neurology, University of British Columbia, Vancouver, BC, Canada; Waisman Research Center, Madison, WI, USA
| | - P Wintermark
- Division of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, QC, Canada; Waisman Research Center, Madison, WI, USA
| | - K Yibetal
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia; Waisman Research Center, Madison, WI, USA
| | - Scl Deoni
- Bill & Melinda Gates Foundation, MNCH D&T, Seattle, WA, USA; Waisman Research Center, Madison, WI, USA
| | - Scr Williams
- Centre for Neuroimaging Sciences, King's College London, London, UK; Waisman Research Center, Madison, WI, USA.
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10
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Nyakonda CN, Wedderburn CJ, Williams SR, Stein DJ, Donald KA. Understanding the impact of congenital infections and perinatal viral exposures on the developing brain using white matter magnetic resonance imaging: a scoping review. BMC Med Imaging 2024; 24:119. [PMID: 38783187 PMCID: PMC11119575 DOI: 10.1186/s12880-024-01282-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Magnetic Resonance Imaging (MRI)-based imaging techniques are useful for assessing white matter (WM) structural and microstructural integrity in the context of infection and inflammation. The purpose of this scoping review was to assess the range of work on the use of WM neuroimaging approaches to understand the impact of congenital and perinatal viral infections or exposures on the developing brain. METHODS This scoping review was conducted according to the Arksey and O' Malley framework. A literature search was performed in Web of Science, Scopus and PubMed for primary research articles published from database conception up to January 2022. Studies evaluating the use of MRI-based WM imaging techniques in congenital and perinatal viral infections or exposures were included. Results were grouped by age and infection. RESULTS A total of 826 articles were identified for screening and 28 final articles were included. Congenital and perinatal infections represented in the included studies were cytomegalovirus (CMV) infection (n = 12), human immunodeficiency virus (HIV) infection (n = 11) or exposure (n = 2) or combined (n = 2), and herpes simplex virus (HSV) infection (n = 1). The represented MRI-based WM imaging methods included structural MRI and diffusion-weighted and diffusion tensor MRI (DWI/ DTI). Regions with the most frequently reported diffusion metric group differences included the cerebellar region, corticospinal tract and association fibre WM tracts in both children with HIV infection and children who are HIV-exposed uninfected. In qualitative imaging studies, WM hyperintensities were the most frequently reported brain abnormality in children with CMV infection and children with HSV infection. CONCLUSION There was evidence that WM imaging techniques can play a role as diagnostic and evaluation tools assessing the impact of congenital infections and perinatal viral exposures on the developing brain. The high sensitivity for identifying WM hyperintensities suggests structural brain MRI is a useful neurodiagnostic modality in assessing children with congenital CMV infection, while the DTI changes associated with HIV suggest metrics such as fractional anisotropy have the potential to be specific markers of subtle impairment or WM damage in neuroHIV.
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Affiliation(s)
- Charmaine Natasha Nyakonda
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
- Neuroscience Institute, University of Cape Town, Capetown, South Africa.
| | - Catherine J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
- Neuroscience Institute, University of Cape Town, Capetown, South Africa
| | - Simone R Williams
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Capetown, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- MRC Unit of Risk and Resilience, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Capetown, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
- Neuroscience Institute, University of Cape Town, Capetown, South Africa.
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11
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Yang Z, Chan YM, Chan DSH, Wu C, Wang Z, Jiang Y, Liu D, Xia Z, Zhang L, Cai Y, Wong CY. A Biomineralized Bifunctional Patient-Friendly Nanosystem for Sustained Glucose Monitoring and Control in Diabetes. SMALL METHODS 2024:e2400159. [PMID: 38697928 DOI: 10.1002/smtd.202400159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/04/2024] [Indexed: 05/05/2024]
Abstract
Regular blood glucose monitoring and control is necessary for people with type 1 or advanced type 2 diabetes, yet diagnosing and treating patients with diabetes in an accurate, sustained and patient-friendly manner remains limited. Here, a glucose-responsive bifunctional nanosystem (PGOxMns) is constructed via one-pot biomineralisation of manganese dioxide with glucose oxidase and ε-poly-L-lysine. Under hyperglycaemic conditions, the cascade reactions that occur when glucose interacts with PGOxMns can trigger the production of Mn(II), which enhances the magnetic resonance imaging signal. Simultaneously, manganese dioxide catalyses the decomposition of toxic hydrogen peroxide into oxygen, which also maintains glucose oxidase (GOx) activity. In an in vivo model of diabetes, PGOxMns is used to monitor glucose levels (0-20 mm) and allowed identification of diabetic mice via T1-weighted MRI. Furthermore, PGOxMns is found to have a high insulin-loading capacity (83.6%), likely due to its positive charge. A single subcutaneous injection of insulin-loaded nanosystem (Ins-PGOxMns) into diabetic mice resulted in a rapid and efficient response to a glucose challenge and prolonged blood glucose level control (< 200 mg dL-1) for up to 50 h. Overall, this proof-of-concept study demonstrates the feasibility of using biomineralised nanosystems to develop patient-friendly strategies for glucose monitoring and control.
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Affiliation(s)
- Zhe Yang
- Department of Chemistry, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
| | - Yuen-Man Chan
- Department of Chemistry, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
| | - Daniel Shiu-Hin Chan
- Department of Chemistry, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
| | - Chengnan Wu
- Department of Chemistry, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
| | - Zimeng Wang
- Department of Mathematics and Information Technology, Education University of Hong Kong, Tai Po, New Territories, Hong Kong SAR, 999077, China
| | - Yuxin Jiang
- Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, Guangdong, 524023, China
| | - Danyong Liu
- Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, Guangdong, 524023, China
| | - Zhengyuan Xia
- Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, Guangdong, 524023, China
- Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangdong, 510632, China
| | - Li Zhang
- Department of Chemistry, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
| | - Yin Cai
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, 999077, China
| | - Chun-Yuen Wong
- Department of Chemistry, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong SAR, 999077, China
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12
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Munhall CC, Roberts DR, Labadie RF. The Use of Portable, Very Low-field (0.064T) MRI to Image Cochlear Implants: Metallic Image Artifact in Comparison to Traditional, Stationary 3T MRI. OTOLOGY & NEUROTOLOGY OPEN 2024; 4:e049. [PMID: 38533347 PMCID: PMC10962874 DOI: 10.1097/ono.0000000000000049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 01/08/2024] [Indexed: 03/28/2024]
Abstract
Objective To assess image artifact when imaging a cochlear implant (CI) with a conventional 3T MRI machine compared with a very low-field (0.064T) MRI. Patients None. Intervention Diagnostic study. Main Outcome Measure Image artifact size associated with the CI affixed to an MRI phantom at very low-field 0.064T MRI versus 3T MRI. Results The longest diameter of the image artifact was 125 mm for the 3T MRI and 86 mm for the 0.064T MRI, representing 45% longer image artifact generated in the 3T MRI. The actual volume of the imaging phantom was 1371 cm3. The volume of the image artifact was measured as 379 cm3 in the 3T MRI, representing a loss of 27.6% of the actual volume of the imaging phantom. The volume of image artifact was measured as 170 cm3 in the 0.064T MRI, representing a loss of 12.4% of the phantom volume. Conclusions 3T MRI had better image quality. This result was not surprising given that larger magnetic field strength is known to provide higher resolution. There was 15% less image artifact generated in the very low-field MRI machine compared with a conventional 3T device. And there was also subjectively increased distortion of the imaging phantom at 3T MRI compared with the 0.064T MRI. With minimized safety concerns and a much lower cost than conventional 3T machines, very low-field scanners may find expanded clinical uses. This preclinical study explores the potential utility of very low-field MRI in scanning CI recipients.
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Affiliation(s)
- Christopher C. Munhall
- Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Donna R. Roberts
- Department of Radiology, Medical University of South Carolina, Charleston, South Carolina
| | - Robert F. Labadie
- Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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13
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Cooper R, Hayes RA, Corcoran M, Sheth KN, Arnold TC, Stein JM, Glahn DC, Jalbrzikowski M. Bridging the gap: improving correspondence between low-field and high-field magnetic resonance images in young people. Front Neurol 2024; 15:1339223. [PMID: 38585353 PMCID: PMC10995930 DOI: 10.3389/fneur.2024.1339223] [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: 11/15/2023] [Accepted: 01/19/2024] [Indexed: 04/09/2024] Open
Abstract
Background Portable low-field-strength magnetic resonance imaging (MRI) systems represent a promising alternative to traditional high-field-strength systems with the potential to make MR technology available at scale in low-resource settings. However, lower image quality and resolution may limit the research and clinical potential of these devices. We tested two super-resolution methods to enhance image quality in a low-field MR system and compared their correspondence with images acquired from a high-field system in a sample of young people. Methods T1- and T2-weighted structural MR images were obtained from a low-field (64mT) Hyperfine and high-field (3T) Siemens system in N = 70 individuals (mean age = 20.39 years, range 9-26 years). We tested two super-resolution approaches to improve image correspondence between images acquired at high- and low-field: (1) processing via a convolutional neural network ('SynthSR'), and (2) multi-orientation image averaging. We extracted brain region volumes, cortical thickness, and cortical surface area estimates. We used Pearson correlations to test the correspondence between these measures, and Steiger Z tests to compare the difference in correspondence between standard imaging and super-resolution approaches. Results Single pairs of T1- and T2-weighted images acquired at low field showed high correspondence to high-field-strength images for estimates of total intracranial volume, surface area cortical volume, subcortical volume, and total brain volume (r range = 0.60-0.88). Correspondence was lower for cerebral white matter volume (r = 0.32, p = 0.007, q = 0.009) and non-significant for mean cortical thickness (r = -0.05, p = 0.664, q = 0.664). Processing images with SynthSR yielded significant improvements in correspondence for total brain volume, white matter volume, total surface area, subcortical volume, cortical volume, and total intracranial volume (r range = 0.85-0.97), with the exception of global mean cortical thickness (r = 0.14). An alternative multi-orientation image averaging approach improved correspondence for cerebral white matter and total brain volume. Processing with SynthSR also significantly improved correspondence across widespread regions for estimates of cortical volume, surface area and subcortical volume, as well as within isolated prefrontal and temporal regions for estimates of cortical thickness. Conclusion Applying super-resolution approaches to low-field imaging improves regional brain volume and surface area accuracy in young people. Finer-scale brain measurements, such as cortical thickness, remain challenging with the limited resolution of low-field systems.
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Affiliation(s)
- Rebecca Cooper
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Rebecca A. Hayes
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, United States
| | - Mary Corcoran
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, United States
| | - Kevin N. Sheth
- Center for Brain and Mind Health, Yale School of Medicine, New Haven, CT, United States
| | - Thomas Campbell Arnold
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA, United States
| | - Joel M. Stein
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA, United States
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - David C. Glahn
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, United States
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
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14
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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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15
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Shoghli A, Chow D, Kuoy E, Yaghmai V. Current role of portable MRI in diagnosis of acute neurological conditions. Front Neurol 2023; 14:1255858. [PMID: 37840918 PMCID: PMC10576557 DOI: 10.3389/fneur.2023.1255858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/06/2023] [Indexed: 10/17/2023] Open
Abstract
Neuroimaging is an inevitable component of the assessment of neurological emergencies. Magnetic resonance imaging (MRI) is the preferred imaging modality for detecting neurological pathologies and provides higher sensitivity than other modalities. However, difficulties such as intra-hospital transport, long exam times, and availability in strict access-controlled suites limit its utility in emergency departments and intensive care units (ICUs). The evolution of novel imaging technologies over the past decades has led to the development of portable MRI (pMRI) machines that can be deployed at point-of-care. This article reviews pMRI technologies and their clinical implications in acute neurological conditions. Benefits of pMRI include timely and accurate detection of major acute neurological pathologies such as stroke and intracranial hemorrhage. Additionally, pMRI can be potentially used to monitor the progression of neurological complications by facilitating serial measurements at the bedside.
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Affiliation(s)
| | | | | | - Vahid Yaghmai
- Department of Radiological Sciences, School of Medicine, University of California, Irvine, Irvine, CA, United States
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16
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Nebe S, Reutter M, Baker DH, Bölte J, Domes G, Gamer M, Gärtner A, Gießing C, Gurr C, Hilger K, Jawinski P, Kulke L, Lischke A, Markett S, Meier M, Merz CJ, Popov T, Puhlmann LMC, Quintana DS, Schäfer T, Schubert AL, Sperl MFJ, Vehlen A, Lonsdorf TB, Feld GB. Enhancing precision in human neuroscience. eLife 2023; 12:e85980. [PMID: 37555830 PMCID: PMC10411974 DOI: 10.7554/elife.85980] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023] Open
Abstract
Human neuroscience has always been pushing the boundary of what is measurable. During the last decade, concerns about statistical power and replicability - in science in general, but also specifically in human neuroscience - have fueled an extensive debate. One important insight from this discourse is the need for larger samples, which naturally increases statistical power. An alternative is to increase the precision of measurements, which is the focus of this review. This option is often overlooked, even though statistical power benefits from increasing precision as much as from increasing sample size. Nonetheless, precision has always been at the heart of good scientific practice in human neuroscience, with researchers relying on lab traditions or rules of thumb to ensure sufficient precision for their studies. In this review, we encourage a more systematic approach to precision. We start by introducing measurement precision and its importance for well-powered studies in human neuroscience. Then, determinants for precision in a range of neuroscientific methods (MRI, M/EEG, EDA, Eye-Tracking, and Endocrinology) are elaborated. We end by discussing how a more systematic evaluation of precision and the application of respective insights can lead to an increase in reproducibility in human neuroscience.
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Affiliation(s)
- Stephan Nebe
- Zurich Center for Neuroeconomics, Department of Economics, University of ZurichZurichSwitzerland
| | - Mario Reutter
- Department of Psychology, Julius-Maximilians-UniversityWürzburgGermany
| | - Daniel H Baker
- Department of Psychology and York Biomedical Research Institute, University of YorkYorkUnited Kingdom
| | - Jens Bölte
- Institute for Psychology, University of Münster, Otto-Creuzfeldt Center for Cognitive and Behavioral NeuroscienceMünsterGermany
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of TrierTrierGermany
- Institute for Cognitive and Affective NeuroscienceTrierGermany
| | - Matthias Gamer
- Department of Psychology, Julius-Maximilians-UniversityWürzburgGermany
| | - Anne Gärtner
- Faculty of Psychology, Technische Universität DresdenDresdenGermany
| | - Carsten Gießing
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky University of OldenburgOldenburgGermany
| | - Caroline Gurr
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe UniversityFrankfurtGermany
- Brain Imaging Center, Goethe UniversityFrankfurtGermany
| | - Kirsten Hilger
- Department of Psychology, Julius-Maximilians-UniversityWürzburgGermany
- Department of Psychology, Psychological Diagnostics and Intervention, Catholic University of Eichstätt-IngolstadtEichstättGermany
| | - Philippe Jawinski
- Department of Psychology, Humboldt-Universität zu BerlinBerlinGermany
| | - Louisa Kulke
- Department of Developmental with Educational Psychology, University of BremenBremenGermany
| | - Alexander Lischke
- Department of Psychology, Medical School HamburgHamburgGermany
- Institute of Clinical Psychology and Psychotherapy, Medical School HamburgHamburgGermany
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu BerlinBerlinGermany
| | - Maria Meier
- Department of Psychology, University of KonstanzKonstanzGermany
- University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of BaselBaselSwitzerland
| | - Christian J Merz
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University BochumBochumGermany
| | - Tzvetan Popov
- Department of Psychology, Methods of Plasticity Research, University of ZurichZurichSwitzerland
| | - Lara MC Puhlmann
- Leibniz Institute for Resilience ResearchMainzGermany
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Daniel S Quintana
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
- NevSom, Department of Rare Disorders & Disabilities, Oslo University HospitalOsloNorway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of OsloOsloNorway
- Norwegian Centre for Mental Disorders Research (NORMENT), University of OsloOsloNorway
| | - Tim Schäfer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe UniversityFrankfurtGermany
- Brain Imaging Center, Goethe UniversityFrankfurtGermany
| | | | - Matthias FJ Sperl
- Department of Clinical Psychology and Psychotherapy, University of GiessenGiessenGermany
- Center for Mind, Brain and Behavior, Universities of Marburg and GiessenGiessenGermany
| | - Antonia Vehlen
- Department of Biological and Clinical Psychology, University of TrierTrierGermany
| | - Tina B Lonsdorf
- Department of Systems Neuroscience, University Medical Center Hamburg-EppendorfHamburgGermany
- Department of Psychology, Biological Psychology and Cognitive Neuroscience, University of BielefeldBielefeldGermany
| | - Gordon B Feld
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
- Department of Psychology, Heidelberg UniversityHeidelbergGermany
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
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17
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Park D, Bascuñán J, Lee W, Iwasa Y. Conceptual Design of a Portable, Solid-Nitrogen-Cooled 0.5-T/560-mm Point-of-Care MRI Magnet. IEEE TRANSACTIONS ON APPLIED SUPERCONDUCTIVITY : A PUBLICATION OF THE IEEE SUPERCONDUCTIVITY COMMITTEE 2023; 33:4400304. [PMID: 37638131 PMCID: PMC10456986 DOI: 10.1109/tasc.2023.3242228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
We describe the conceptual design of a portable, liquid-helium-free, all-REBCO, 0.5-T/560-mm point-of-care magnetic resonance imaging (MRI) magnet. It is free from an external power supply and a refrigeration system during operation. In our portable MRI magnet, we use a detachable "cryocirculator" that circulates, in a closed circuit, cold working fluid, and most importantly for portability, it can be readily coupled to or decoupled from the magnet, in contrast, a conventional cryocooler is mechanically attached to the magnet. Another unique feature of our system is a volume of solid nitrogen (SN2) in the cold chamber that adds enough thermal mass to the magnet in the 30-36-K operating temperature range, enabling it to maintain its field over a period of, for this system, ≥10 hours, plenty enough for this portable MRI system, uncoupled from its cryocirculator, to perform its mission before it needs recooling.
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Affiliation(s)
- Dongkeun Park
- Francis Bitter Magnet Laboratory (FBML)/Plasma Science and Fusion Center (PSFC), Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Juan Bascuñán
- Francis Bitter Magnet Laboratory (FBML)/Plasma Science and Fusion Center (PSFC), Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
| | - Wooseung Lee
- FBML/PSFC, MIT, Cambridge, MA 02139, USA.; Gwangju Center, Korea Basic Science Institute, Buk-gu, Gwangju, 611856, South Korea
| | - Yukikazu Iwasa
- Francis Bitter Magnet Laboratory (FBML)/Plasma Science and Fusion Center (PSFC), Massachusetts Institute of Technology (MIT), Cambridge, MA 02139, USA
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18
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Abbas A, Hilal K, Rasool AA, Zahidi UF, Shamim MS, Abbas Q. Low-field magnetic resonance imaging in a boy with intracranial bolt after severe traumatic brain injury: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 6:CASE23225. [PMID: 37392768 PMCID: PMC10555635 DOI: 10.3171/case23225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 05/24/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Conventional magnetic resonance imaging (cMRI) is sensitive to motion and ferromagnetic material, leading to suboptimal images and image artifacts. In many patients with neurological injuries, an intracranial bolt (ICB) is placed for monitoring intracranial pressure (ICP). Repeated imaging (computed tomography [CT] or cMRI) is frequently required to guide management. A low-field (0.064-T) portable magnetic resonance imaging (pMRI) machine may provide images in situations that were previously considered contraindications for cMRI. OBSERVATIONS A 10-year-old boy with severe traumatic brain injury was admitted to the pediatric intensive care unit, and an ICB was placed. Initial head CT showed a left-sided intraparenchymal hemorrhage with intraventricular dissection and cerebral edema with mass effect. Repeated imaging was required to assess the brain structure because of continually fluctuating ICP. Transferring the patient to the radiology suite was risky because of his critical condition and the presence of an ICB; hence, pMRI was performed at the bedside. Images obtained were of excellent quality without any ICB artifact, guiding the decision to continue to manage the patient conservatively. The child later improved and was discharged from the hospital. LESSONS pMRI can be used to obtain excellent images at the bedside in patients with an ICB, providing useful information for better management of patients with neurological injuries.
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Hennig J. An evolution of low-field strength MRI. MAGMA (NEW YORK, N.Y.) 2023; 36:335-346. [PMID: 37289275 PMCID: PMC10386941 DOI: 10.1007/s10334-023-01104-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/05/2023] [Accepted: 05/17/2023] [Indexed: 06/09/2023]
Abstract
The paper describes the evolution of low-field MRI from the very early pioneering days in the late 70 s until today. It is not meant to give a comprehensive historical account of the development of MRI, but rather to highlight the different research environments then and now. In the early 90 s, when low-field systems below 1.5 T essentially vanished, there were just no reasonable means available to make up for the factor of roughly three in signal-to-noise-ratio (SNR) between 0.5 and 1.5 T. This has drastically changed. Improvements in hardware-closed Helium-free magnets, RF receiver systems and especially much faster gradients, much more flexible sampling schemes including parallel imaging and compressed sensing and especially the use of AI at all stages of the imaging process have made low-field MRI a clinically viable supplement to conventional MRI. Ultralow-field MRI with magnets around 0.05 T are also back and constitute a bold and courageous endeavor to bring MRI to communities, which have neither the means nor the infrastructure to sustain a current standard of care MRI.
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Affiliation(s)
- Juergen Hennig
- Department of Radiology, Medical Physics, Faculty of Medicine, University of Freiburg, Killianstr.5a, 79106, Freiburg, Germany.
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20
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de Havenon A, Parasuram NR, Crawford AL, Mazurek MH, Chavva IR, Yadlapalli V, Iglesias JE, Rosen MS, Falcone GJ, Payabvash S, Sze G, Sharma R, Schiff SJ, Safdar B, Wira C, Kimberly WT, Sheth KN. Identification of White Matter Hyperintensities in Routine Emergency Department Visits Using Portable Bedside Magnetic Resonance Imaging. J Am Heart Assoc 2023; 12:e029242. [PMID: 37218590 PMCID: PMC10381997 DOI: 10.1161/jaha.122.029242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/27/2023] [Indexed: 05/24/2023]
Abstract
Background White matter hyperintensity (WMH) on magnetic resonance imaging (MRI) of the brain is associated with vascular cognitive impairment, cardiovascular disease, and stroke. We hypothesized that portable magnetic resonance imaging (pMRI) could successfully identify WMHs and facilitate doing so in an unconventional setting. Methods and Results In a retrospective cohort of patients with both a conventional 1.5 Tesla MRI and pMRI, we report Cohen's kappa (κ) to measure agreement for detection of moderate to severe WMH (Fazekas ≥2). In a subsequent prospective observational study, we enrolled adult patients with a vascular risk factor being evaluated in the emergency department for a nonstroke complaint and measured WMH using pMRI. In the retrospective cohort, we included 33 patients, identifying 16 (49.5%) with WMH on conventional MRI. Between 2 raters evaluating pMRI, the interrater agreement on WMH was strong (κ=0.81), and between 1 rater for conventional MRI and the 2 raters for pMRI, intermodality agreement was moderate (κ=0.66, 0.60). In the prospective cohort we enrolled 91 individuals (mean age, 62.6 years; 53.9% men; 73.6% with hypertension), of which 58.2% had WMHs on pMRI. Among 37 Black and Hispanic individuals, the Area Deprivation Index was higher (versus White, 51.8±12.9 versus 37.9±11.9; P<0.001). Among 81 individuals who did not have a standard-of-care MRI in the preceding year, we identified WMHs in 43 of 81 (53.1%). Conclusions Portable, low-field imaging could be useful for identifying moderate to severe WMHs. These preliminary results introduce a novel role for pMRI outside of acute care and the potential role for pMRI to reduce disparities in neuroimaging.
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Affiliation(s)
- Adam de Havenon
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
- Center for Brain and Mind HealthYale University School of MedicineNew HavenCTUSA
| | | | - Anna L. Crawford
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
| | - Mercy H. Mazurek
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
| | - Isha R. Chavva
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
| | | | - Juan E. Iglesias
- Department of Neurology, Division of Neurocritical CareMassachusetts General HospitalBostonMAUSA
- Computer Science and Artificial Intelligence LabMassachusetts Institute of TechnologyCambridgeMAUSA
- Center for Biomedical ImagingMassachusetts General Hospital and Harvard Medical SchoolDepartment of Physics, Harvard UniversityBostonMAUSA
| | - Matthew S. Rosen
- Department of Neurology, Division of Neurocritical CareMassachusetts General HospitalBostonMAUSA
| | - Guido J. Falcone
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
| | - Seyedmehdi Payabvash
- Center for Brain and Mind HealthYale University School of MedicineNew HavenCTUSA
- Department of RadiologyYale University School of MedicineNew HavenCOUSA
| | - Gordon Sze
- Department of RadiologyYale University School of MedicineNew HavenCOUSA
| | - Richa Sharma
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
- Center for Brain and Mind HealthYale University School of MedicineNew HavenCTUSA
| | - Steven J. Schiff
- Department of NeurosurgeryYale University School of MedicineNew HavenCOUSA
| | - Basmah Safdar
- Department of Emergency MedicineYale University School of MedicineNew HavenCOUSA
| | - Charles Wira
- Department of Emergency MedicineYale University School of MedicineNew HavenCOUSA
| | - William T. Kimberly
- Department of Neurology, Division of Neurocritical CareMassachusetts General HospitalBostonMAUSA
| | - Kevin N. Sheth
- Department of NeurologyYale University School of MedicineNew HavenCTUSA
- Center for Brain and Mind HealthYale University School of MedicineNew HavenCTUSA
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21
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de Vos B, Remis RF, Webb AG. An integrated target field framework for point-of-care halbach array low-field MRI system design. MAGMA (NEW YORK, N.Y.) 2023:10.1007/s10334-023-01093-z. [PMID: 37208554 PMCID: PMC10386967 DOI: 10.1007/s10334-023-01093-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/18/2023] [Accepted: 04/16/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Low-cost low-field point-of-care MRI systems are used in many different applications. System design has correspondingly different requirements in terms of imaging field-of-view, spatial resolution and magnetic field strength. In this work an iterative framework has been created to design a cylindrical Halbach-based magnet along with integrated gradient and RF coils that most efficiently fulfil a set of user-specified imaging requirements. METHODS For efficient integration, target field methods are used for each of the main hardware components. These have not been used previously in magnet design, and a new mathematical model was derived accordingly. These methods result in a framework which can design an entire low-field MRI system within minutes using standard computing hardware. RESULTS Two distinct point-of-care systems are designed using the described framework, one for neuroimaging and the other for extremity imaging. Input parameters are taken from literature and the resulting systems are discussed in detail. DISCUSSION The framework allows the designer to optimize the different hardware components with respect to the desired imaging parameters taking into account the interdependencies between these components and thus give insight into the influence of the design choices.
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Affiliation(s)
- Bart de Vos
- C.J. Gorter MRI Center, Leiden University Medical Center, Leiden, Netherlands.
| | - Rob F Remis
- Signal Processing Systems, Delft University of Technology, Delft, Netherlands
| | - Andrew G Webb
- C.J. Gorter MRI Center, Leiden University Medical Center, Leiden, Netherlands
- Signal Processing Systems, Delft University of Technology, Delft, Netherlands
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22
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Guo T, He W, Wan C, Zhang Y, Xu Z. NMR Magnetometer Based on Dynamic Nuclear-Polarization for Low-Strength Magnetic Field Measurement. SENSORS (BASEL, SWITZERLAND) 2023; 23:4663. [PMID: 37430578 DOI: 10.3390/s23104663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 07/12/2023]
Abstract
Nuclear magnetic resonance (NMR) magnetometers are considered due to their ability to map magnetic fields with high precision and calibrate other magnetic field measurement devices. However, the low signal-to-noise ratio of low-strength magnetic fields limits the precision when measuring magnetic fields below 40 mT. Therefore, we developed a new NMR magnetometer that combines the dynamic nuclear polarization (DNP) technique with pulsed NMR. The dynamic pre-polarization technique enhances the SNR under a low magnetic field. Pulsed NMR was used in conjunction with DNP to improve measurement accuracy and speed. The efficacy of this approach was validated through simulation and analysis of the measurement process. Next, a complete set of equipment was constructed, and we successfully measured magnetic fields of 30 mT and 8 mT with an accuracy of only 0.5 Hz (11 nT) at 30 mT (0.4 ppm) and 1 Hz (22 nT) at 8mT (3 ppm).
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Affiliation(s)
- Taoning Guo
- School of Electrical Engineering, Chongqing University, Chongqing 400044, China
| | - Wei He
- School of Electrical Engineering, Chongqing University, Chongqing 400044, China
| | - Cai Wan
- School of Electrical Engineering, Chongqing University, Chongqing 400044, China
| | - Yuxiang Zhang
- School of Electrical Engineering, Chongqing University, Chongqing 400044, China
| | - Zheng Xu
- School of Electrical Engineering, Chongqing University, Chongqing 400044, China
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23
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Perron S, Ouriadov A. Hyperpolarized 129Xe MRI at low field: Current status and future directions. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2023; 348:107387. [PMID: 36731353 DOI: 10.1016/j.jmr.2023.107387] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/07/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Magnetic Resonance Imaging (MRI) is dictated by the magnetization of the sample, and is thus a low-sensitivity imaging method. Inhalation of hyperpolarized (HP) noble gases, such as helium-3 and xenon-129, is a non-invasive, radiation-risk free imaging technique permitting high resolution imaging of the lungs and pulmonary functions, such as the lung microstructure, diffusion, perfusion, gas exchange, and dynamic ventilation. Instead of increasing the magnetic field strength, the higher spin polarization achievable from this method results in significantly higher net MR signal independent of tissue/water concentration. Moreover, the significantly longer apparent transverse relaxation time T2* of these HP gases at low magnetic field strengths results in fewer necessary radiofrequency (RF) pulses, permitting larger flip angles; this allows for high-sensitivity imaging of in vivo animal and human lungs at conventionally low (<0.5 T) field strengths and suggests that the low field regime is optimal for pulmonary MRI using hyperpolarized gases. In this review, theory on the common spin-exchange optical-pumping method of hyperpolarization and the field dependence of the MR signal of HP gases are presented, in the context of human lung imaging. The current state-of-the-art is explored, with emphasis on both MRI hardware (low field scanners, RF coils, and polarizers) and image acquisition techniques (pulse sequences) advancements. Common challenges surrounding imaging of HP gases and possible solutions are discussed, and the future of low field hyperpolarized gas MRI is posed as being a clinically-accessible and versatile imaging method, circumventing the siting restrictions of conventional high field scanners and bringing point-of-care pulmonary imaging to global facilities.
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Affiliation(s)
- Samuel Perron
- Department of Physics and Astronomy, The University of Western Ontario, London, Ontario, Canada.
| | - Alexei Ouriadov
- Department of Physics and Astronomy, The University of Western Ontario, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; School of Biomedical Engineering, Faculty of Engineering, The University of Western Ontario, London, Ontario, Canada
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24
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Deoni SCL, Burton P, Beauchemin J, Cano-Lorente R, De Both MD, Johnson M, Ryan L, Huentelman MJ. Neuroimaging and verbal memory assessment in healthy aging adults using a portable low-field MRI scanner and a web-based platform: results from a proof-of-concept population-based cross-section study. Brain Struct Funct 2023; 228:493-509. [PMID: 36352153 PMCID: PMC9646260 DOI: 10.1007/s00429-022-02595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/01/2022] [Indexed: 11/10/2022]
Abstract
Consumer wearables and health monitors, internet-based health and cognitive assessments, and at-home biosample (e.g., saliva and capillary blood) collection kits are increasingly used by public health researchers for large population-based studies without requiring intensive in-person visits. Alongside reduced participant time burden, remote and virtual data collection allows the participation of individuals who live long distances from hospital or university research centers, or who lack access to transportation. Unfortunately, studies that include magnetic resonance neuroimaging are challenging to perform remotely given the infrastructure requirements of MRI scanners, and, as a result, they often omit socially, economically, and educationally disadvantaged individuals. Lower field strength systems (< 100 mT) offer the potential to perform neuroimaging at a participant's home, enabling more accessible and equitable research. Here we report the first use of a low-field MRI "scan van" with an online assessment of paired-associate learning (PAL) to examine associations between brain morphometry and verbal memory performance. In a sample of 67 individuals, 18-93 years of age, imaged at or near their home, we show expected white and gray matter volume trends with age and find significant (p < 0.05 FWE) associations between PAL performance and hippocampus, amygdala, caudate, and thalamic volumes. High-quality data were acquired in 93% of individuals, and at-home scanning was preferred by all individuals with prior MRI at a hospital or research setting. Results demonstrate the feasibility of remote neuroimaging and cognitive data collection, with important implications for engaging traditionally under-represented communities in neuroimaging research.
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Affiliation(s)
- Sean C L Deoni
- Maternal, Newborn, and Child Health Discovery & Tools, Bill & Melinda Gates Foundation, 500 5th Ave, Seattle, WA, 98109, USA.
| | - Phoebe Burton
- Advanced Baby Imaging Lab, Rhode Island Hospital, Providence, RI, USA
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Jennifer Beauchemin
- Advanced Baby Imaging Lab, Rhode Island Hospital, Providence, RI, USA
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Rosa Cano-Lorente
- Advanced Baby Imaging Lab, Rhode Island Hospital, Providence, RI, USA
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | | | | | - Lee Ryan
- Department of Psychology, University of Arizona, Tucson, AZ, USA
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25
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Pinter NK. The Right Imaging Protocol for the Right Patient. Continuum (Minneap Minn) 2023; 29:16-26. [PMID: 36795871 DOI: 10.1212/con.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE This article provides a high-level overview of the challenge of choosing the right imaging approach for an individual patient. It also presents a generalizable approach that can be applied to practice regardless of specific imaging technologies. ESSENTIAL POINTS This article constitutes an introduction to the in-depth, topic-focused analyses in the rest of this issue. It examines the broad principles that guide placing a patient on the right diagnostic trajectory, illustrated with real-life examples of current protocol recommendations and cases of advanced imaging techniques, as well as some thought experiments. Thinking about diagnostic imaging strictly in terms of imaging protocols is often inefficient because these protocols can be vague and have numerous variations. Broadly defined protocols may be sufficient, but their successful use often depends largely on the particular circumstances, with special emphasis on the relationship between neurologists and radiologists.
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26
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Lee PY, Wei HJ, Pouliopoulos AN, Forsyth BT, Yang Y, Zhang C, Laine AF, Konofagou EE, Wu CC, Guo J. Deep Learning Enables Reduced Gadolinium Dose for Contrast-Enhanced Blood-Brain Barrier Opening. ARXIV 2023:arXiv:2301.07248v1. [PMID: 36713234 PMCID: PMC9882566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Focused ultrasound (FUS) can be used to open the blood-brain barrier (BBB), and MRI with contrast agents can detect that opening. However, repeated use of gadolinium-based contrast agents (GBCAs) presents safety concerns to patients. This study is the first to propose the idea of modeling a volume transfer constant (Ktrans) through deep learning to reduce the dosage of contrast agents. The goal of the study is not only to reconstruct artificial intelligence (AI) derived Ktrans images but to also enhance the intensity with low dosage contrast agent T1 weighted MRI scans. We successfully validated this idea through a previous state-of-the-art temporal network algorithm, which focused on extracting time domain features at the voxel level. Then we used a Spatiotemporal Network (ST-Net), composed of a spatiotemporal convolutional neural network (CNN)-based deep learning architecture with the addition of a three-dimensional CNN encoder, to improve the model performance. We tested the ST-Net model on ten datasets of FUS-induced BBB-openings aquired from different sides of the mouse brain. ST-Net successfully detected and enhanced BBB-opening signals without sacrificing spatial domain information. ST-Net was shown to be a promising method of reducing the need of contrast agents for modeling BBB-opening K-trans maps from time-series Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) scans.
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Affiliation(s)
- Pin-Yu Lee
- Department of Biomedical Engineering, The Fu Foundation of Engineering and Applied Science, Columbia University, New York, NY 10027 USA
| | - Hong-Jian Wei
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Antonios N Pouliopoulos
- Department of Biomedical Engineering, Columbia University. He is now with the School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Britney T Forsyth
- Department of Biomedical Engineering, The Fu Foundation of Engineering and Applied Science, Columbia University, New York, NY 10027 USA
| | - Yanting Yang
- Department of Biomedical Engineering, The Fu Foundation of Engineering and Applied Science, Columbia University, New York, NY 10027 USA
| | - Chenghao Zhang
- Department of Biomedical Engineering, The Fu Foundation of Engineering and Applied Science, Columbia University, New York, NY 10027 USA
| | - Andrew F Laine
- Departments of Biomedical Engineering and Radiology (Physics), Columbia University, New York, NY 10027 USA
| | - Elisa E Konofagou
- Departments of Biomedical Engineering and Radiology (Physics), Columbia University, New York, NY 10027 USA
| | - Cheng-Chia Wu
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Jia Guo
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY 10032 USA
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de Iure D, Conti A, Galante A, Spadone S, Hilschenz I, Caulo M, Sensi S, Del Gratta C, Della Penna S. Analyzing the sensitivity of quantitative 3D MRI of longitudinal relaxation at very low field in Gd-doped phantoms. PLoS One 2023; 18:e0285391. [PMID: 37146058 PMCID: PMC10162526 DOI: 10.1371/journal.pone.0285391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/20/2023] [Indexed: 05/07/2023] Open
Abstract
PURPOSE Recently, new MRI systems working at magnetic field below 10 mT (Very and Ultra Low Field regime) have been developed, showing improved T1-contrast in projected 2D maps (i.e. images without slice selection). Moving from projected 2D to 3D maps is not trivial due to the low SNR of such devices. This work aimed to demonstrate the ability and the sensitivity of a VLF-MRI scanner operating at 8.9 mT in quantitatively obtaining 3D longitudinal relaxation rate (R1) maps and distinguishing between voxels intensities. We used phantoms consisting of vessels doped with different Gadolinium (Gd)-based Contrast Agent (CA) concentrations, providing a set of various R1 values. As CA, we used a commercial compound (MultiHance®, gadobenate dimeglumine) routinely used in clinical MRI. METHODS 3D R1 maps and T1-weighted MR images were analysed to identify each vessel. R1 maps were further processed by an automatic clustering analysis to evaluate the sensitivity at the single-voxel level. Results obtained at 8.9 mT were compared with commercial scanners operating at 0.2 T, 1.5 T, and 3 T. RESULTS VLF R1 maps offered a higher sensitivity in distinguishing the different CA concentrations and an improved contrast compared to higher fields. Moreover, the high sensitivity of 3D quantitative VLF-MRI allowed an effective clustering of the 3D map values, assessing their reliability at the single voxel level. Conversely, in all fields, T1-weighted images were less reliable, even at higher CA concentrations. CONCLUSION In summary, with few excitations and an isotropic voxel size of 3 mm, VLF-MRI 3D quantitative mapping showed a sensitivity better than 2.7 s-1 corresponding to a concentration difference of 0.17 mM of MultiHance in copper sulfate doped water, and improved contrast compared to higher fields. Based on these results, future studies should characterize R1 contrast at VLF, also with other CA, in the living tissues.
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Affiliation(s)
- Danilo de Iure
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
| | - Allegra Conti
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Angelo Galante
- MESVA, Department of Life, Health & Environmental Sciences, L'Aquila University, L'Aquila, AQ, Italy
- INFN, National Institute of Nuclear Physics, Gran Sasso National Laboratories, Assergi, L'Aquila, Italy
- CNR, SPIN-CNR Institute, Dept. of Physical and Chemical Sciences, L'Aquila, Italy
| | - Sara Spadone
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
| | - Ingo Hilschenz
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
| | - Massimo Caulo
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
- Institute for Advanced Biomedical Technologies (ITAB), G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
| | - Stefano Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
- Institute for Advanced Biomedical Technologies (ITAB), G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
| | - Cosimo Del Gratta
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
- Institute for Advanced Biomedical Technologies (ITAB), G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
| | - Stefania Della Penna
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
- Institute for Advanced Biomedical Technologies (ITAB), G. D'Annunzio University of Chieti and Pescara, Chieti, CH, Italy
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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: 60] [Impact Index Per Article: 60.0] [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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Muacevic A, Adler JR, Marino MA, Maniakhina L, Li JJ, Ku A, Ko K, Miulli DE. Utilization of Portable Brain Magnetic Resonance Imaging in an Acute Care Setting. Cureus 2022; 14:e33067. [PMID: 36726935 PMCID: PMC9886369 DOI: 10.7759/cureus.33067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/27/2022] [Indexed: 12/29/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) is an important noninvasive diagnostic tool used in multiple facets of medicine, especially in the assessment of the neurological system with increasing usage over the past decades. Advancement in technology has led to the creation of portable MRI (pMRI) that was cleared for use recently. Methodology A prospectively collected retrospective study was conducted at a single institution to include patients aged >18 years, admitted to the hospital, and requiring MRI for any brain pathology. pMRI was completed using portable MRI. Traditional MRI was completed with a standard 1.5T MRI, and when possible, the results of the two studies were compared. Results We obtained pMRI on 20 patients, with a total of 22 scans completed. Notably, on the pMRI, we were able to identify midline structures to determine midline shifts, identify the size of ventricles, and see large pathologies, including ischemic and hemorrhagic strokes, edema, and tumors. Patients with implants or electrodes in and around the calvarium sometimes pose challenges to image acquisition. Conclusions Portable brain MRI is a practical and useful technology that can provide immediate information about the head, especially in an acute care setting. Portable brain MRI has a lower resolution and quality of imaging compared to that of transitional MRI, and therefore, it is not a replacement for traditional MRI.
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Arnold TC, Tu D, Okar SV, Nair G, By S, Kawatra KD, Robert-Fitzgerald TE, Desiderio LM, Schindler MK, Shinohara RT, Reich DS, Stein JM. Sensitivity of portable low-field magnetic resonance imaging for multiple sclerosis lesions. Neuroimage Clin 2022; 35:103101. [PMID: 35792417 PMCID: PMC9421456 DOI: 10.1016/j.nicl.2022.103101] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 12/25/2022]
Abstract
Paired, same-day, 3T and 64mT MRI studies were analyzed in 33 MS patients. 64mT MRI showed 94% sensitivity for detecting any lesions in 3T confirmed cases. The diameter of the smallest detected lesion was larger at 64mT compared to 3T. Total lesion volume estimates were strongly correlated between 3T and 64mT scans. Portable low-field MRI detects white matter lesions, but smaller lesions may be missed.
Magnetic resonance imaging (MRI) is a fundamental tool in the diagnosis and management of neurological diseases such as multiple sclerosis (MS). New portable, low-field strength, MRI scanners could potentially lower financial and technical barriers to neuroimaging and reach underserved or disabled populations, but the sensitivity of these devices for MS lesions is unknown. We sought to determine if white matter lesions can be detected on a portable 64mT scanner, compare automated lesion segmentations and total lesion volume between paired 3T and 64mT scans, identify features that contribute to lesion detection accuracy, and explore super-resolution imaging at low-field. In this prospective, cross-sectional study, same-day brain MRI (FLAIR, T1w, and T2w) scans were collected from 36 adults (32 women; mean age, 50 ± 14 years) with known or suspected MS using Siemens 3T (FLAIR: 1 mm isotropic, T1w: 1 mm isotropic, and T2w: 0.34–0.5 × 0.34–0.5 × 3–5 mm) and Hyperfine 64mT (FLAIR: 1.6 × 1.6 × 5 mm, T1w: 1.5 × 1.5 × 5 mm, and T2w: 1.5 × 1.5 × 5 mm) scanners at two centers. Images were reviewed by neuroradiologists. MS lesions were measured manually and segmented using an automated algorithm. Statistical analyses assessed accuracy and variability of segmentations across scanners and systematic scanner biases in automated volumetric measurements. Lesions were identified on 64mT scans in 94% (31/33) of patients with confirmed MS. The average smallest lesions manually detected were 5.7 ± 1.3 mm in maximum diameter at 64mT vs 2.1 ± 0.6 mm at 3T, approaching the spatial resolution of the respective scanner sequences (3T: 1 mm, 64mT: 5 mm slice thickness). Automated lesion volume estimates were highly correlated between 3T and 64mT scans (r = 0.89, p < 0.001). Bland-Altman analysis identified bias in 64mT segmentations (mean = 1.6 ml, standard error = 5.2 ml, limits of agreement = –19.0–15.9 ml), which over-estimated low lesion volume and under-estimated high volume (r = 0.74, p < 0.001). Visual inspection revealed over-segmentation was driven venous hyperintensities on 64mT T2-FLAIR. Lesion size drove segmentation accuracy, with 93% of lesions > 1.0 ml and all lesions > 1.5 ml being detected. Using multi-acquisition volume averaging, we were able to generate 1.6 mm isotropic images on the 64mT device. Overall, our results demonstrate that in established MS, a portable 64mT MRI scanner can identify white matter lesions, and that automated estimates of total lesion volume correlate with measurements from 3T scans.
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Affiliation(s)
- T Campbell Arnold
- Department of Bioengineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA 19104, USA; Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Danni Tu
- Penn Statistics in Imaging and Visualization Center and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Serhat V Okar
- National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Govind Nair
- National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | | | - Karan D Kawatra
- National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Timothy E Robert-Fitzgerald
- Penn Statistics in Imaging and Visualization Center and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Lisa M Desiderio
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Matthew K Schindler
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Russell T Shinohara
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA; Penn Statistics in Imaging and Visualization Center and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Daniel S Reich
- National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Bethesda, MD 20892, USA.
| | - Joel M Stein
- Center for Neuroengineering and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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31
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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.
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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.
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