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Zugni F, Mariani L, Lambregts DMJ, Maggioni R, Summers PE, Granata V, Pecchi A, Di Costanzo G, De Muzio F, Cardobi N, Giovagnoni A, Petralia G. Whole-body MRI in oncology: acquisition protocols, current guidelines, and beyond. LA RADIOLOGIA MEDICA 2024:10.1007/s11547-024-01851-6. [PMID: 38990426 DOI: 10.1007/s11547-024-01851-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 07/04/2024] [Indexed: 07/12/2024]
Abstract
Acknowledging the increasing use of whole-body magnetic resonance imaging (WB-MRI) in the oncological setting, we conducted a narrative review focusing on practical aspects of the examination and providing a synthesis of various acquisition protocols described in the literature. Firstly, we addressed the topic of patient preparation, emphasizing methods to enhance examination acceptance. This included strategies for reducing anxiety and patient distress, improving staff-patient interactions, and increasing overall patient comfort. Secondly, we analysed WB-MRI acquisition protocols recommended in existing imaging guidelines, such as MET-RADS-P, MY-RADS, and ONCO-RADS, and provided an overview of acquisition protocols reported in the literature regarding other expanding applications of WB-MRI in oncology, in patients with breast cancer, ovarian cancer, melanoma, colorectal and lung cancer, lymphoma, and cancers of unknown primary. Finally, we suggested possible acquisition parameters for whole-body images across MR systems from three different vendors.
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Affiliation(s)
- Fabio Zugni
- Division of Radiology, IEO European Institute of Oncology IRCCS, Milan, Italy.
| | - Leonardo Mariani
- Postgraduation School in Radiodiagnostics, University of Milan, Milan, Italy
| | - Doenja M J Lambregts
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Roberta Maggioni
- Division of Radiology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Paul E Summers
- Division of Radiology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Vincenza Granata
- Division of Radiology, Istituto Nazionale Tumori Di Napoli, IRCCS "G. Pascale", Naples, Italy
| | - Annarita Pecchi
- Department of Radiology, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Federica De Muzio
- Department of Radiology, Pineta Grande Hospital, Via Domitiana Km 30, Castel Volturno, Italy
| | - Nicolò Cardobi
- Radiology Unit, Department of Pathology and Diagnostics, University Hospital of Verona, Verona, Italy
| | - Andrea Giovagnoni
- Department of Radiology, University Hospital "Azienda Ospedaliera Universitaria Delle Marche", Ancona, Italy
- Department of Clinical, Special and Dental Sciences, Università Politecnica Delle Marche, Ancona, Italy
| | - Giuseppe Petralia
- Division of Radiology, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Reinhardt C, Briody H, MacMahon PJ. AI-accelerated prostate MRI: a systematic review. Br J Radiol 2024; 97:1234-1242. [PMID: 38718224 PMCID: PMC11186563 DOI: 10.1093/bjr/tqae093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/05/2024] [Accepted: 05/04/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Prostate cancer ranks among the most prevalent cancers affecting men globally. While conventional MRI serves as a diagnostic tool, its extended acquisition time, associated costs, and strain on healthcare systems, underscore the necessity for more efficient methods. The emergence of AI-acceleration in prostate MRI offers promise to mitigate these challenges. METHODS A systematic review of studies looking at AI-accelerated prostate MRI was conducted, with a focus on acquisition time along with various qualitative and quantitative measurements. RESULTS Two primary findings were observed. Firstly, all studies indicated that AI-acceleration in MRI achieved notable reductions in acquisition times without compromising image quality. This efficiency offers potential clinical advantages, including reduced scan durations, improved scheduling, diminished patient discomfort, and economic benefits. Secondly, AI demonstrated a beneficial effect in reducing or maintaining artefact levels in T2-weighted images despite this accelerated acquisition time. Inconsistent results were found in all other domains, which were likely influenced by factors such as heterogeneity in methodologies, variability in AI models, and diverse radiologist profiles. These variances underscore the need for larger, more robust studies, standardization, and diverse training datasets for AI models. CONCLUSION The integration of AI-acceleration in prostate MRI thus far shows some promising results for efficient and enhanced scanning. These advancements may fill current gaps in early detection and prognosis. However, careful navigation and collaborative efforts are essential to overcome challenges and maximize the potential of this innovative and evolving field. ADVANCES IN KNOWLEDGE This article reveals overall significant reductions in acquisition time without compromised image quality in AI-accelerated prostate MRI, highlighting potential clinical and diagnostic advantages.
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Affiliation(s)
- Ciaran Reinhardt
- Department of Radiology, Mater Misericordiae Hospital, Dublin D07AX57, Ireland
| | - Hayley Briody
- Department of Radiology, Beaumont Hospital, Dublin, D09V2N0, Ireland
| | - Peter J MacMahon
- Department of Radiology, Mater Misericordiae Hospital, Dublin D07AX57, Ireland
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Oerther B, Engel H, Nedelcu A, Strecker R, Benkert T, Nickel D, Weiland E, Mayrhofer T, Bamberg F, Benndorf M, Weiß J, Wilpert C. Performance of an ultra-fast deep-learning accelerated MRI screening protocol for prostate cancer compared to a standard multiparametric protocol. Eur Radiol 2024:10.1007/s00330-024-10776-7. [PMID: 38780766 DOI: 10.1007/s00330-024-10776-7] [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: 12/06/2023] [Revised: 02/23/2024] [Accepted: 03/30/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES To establish and evaluate an ultra-fast MRI screening protocol for prostate cancer (PCa) in comparison to the standard multiparametric (mp) protocol, reducing scan time and maintaining adequate diagnostic performance. MATERIALS AND METHODS This prospective single-center study included consecutive biopsy-naïve patients with suspected PCa between December 2022 and March 2023. A PI-RADSv2.1 conform mpMRI protocol was acquired in a 3 T scanner (scan time: 25 min 45 sec). In addition, two deep-learning (DL) accelerated sequences (T2- and diffusion-weighted) were acquired, serving as a screening protocol (scan time: 3 min 28 sec). Two readers evaluated image quality and the probability of PCa regarding PI-RADSv2.1 scores in two sessions. The diagnostic performance of the screening protocol with mpMRI serving as the reference standard was derived. Inter- and intra-reader agreements were evaluated using weighted kappa statistics. RESULTS We included 77 patients with 97 lesions (mean age: 66 years; SD: 7.7). Diagnostic performance of the screening protocol was excellent with a sensitivity and specificity of 100%/100% and 89%/98% (cut-off ≥ PI-RADS 4) for reader 1 (R1) and reader 2 (R2), respectively. Mean image quality was 3.96 (R1) and 4.35 (R2) for the standard protocol vs. 4.74 and 4.57 for the screening protocol (p < 0.05). Inter-reader agreement was moderate (κ: 0.55) for the screening protocol and substantial (κ: 0.61) for the multiparametric protocol. CONCLUSION The ultra-fast screening protocol showed similar diagnostic performance and better imaging quality compared to the mpMRI in under 15% of scan time, improving efficacy and enabling the implementation of screening protocols in clinical routine. CLINICAL RELEVANCE STATEMENT The ultra-fast protocol enables examinations without contrast administration, drastically reducing scan time to 3.5 min with similar diagnostic performance and better imaging quality. This facilitates patient-friendly, efficient examinations and addresses the conflict of increasing demand for examinations at currently exhausted capacities. KEY POINTS Time-consuming MRI protocols are in conflict with an expected increase in examinations required for prostate cancer screening. An ultra-fast MRI protocol shows similar performance and better image quality compared to the standard protocol. Deep-learning acceleration facilitates efficient and patient-friendly examinations, thus improving prostate cancer screening capacity.
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Affiliation(s)
- B Oerther
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
| | - H Engel
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - A Nedelcu
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - R Strecker
- MR Application Predevelopment, Siemens Healthineers GmbH, Erlangen, Germany
- EMEA Scientific Partnerships, Siemens Healthineers GmbH, Erlangen, Germany
| | - T Benkert
- MR Application Predevelopment, Siemens Healthineers GmbH, Erlangen, Germany
| | - D Nickel
- MR Application Predevelopment, Siemens Healthineers GmbH, Erlangen, Germany
| | - E Weiland
- MR Application Predevelopment, Siemens Healthineers GmbH, Erlangen, Germany
| | - T Mayrhofer
- School of Business Studies, Stralsund University of Applied Sciences, Stralsund, Germany
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - F Bamberg
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - M Benndorf
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - J Weiß
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - C Wilpert
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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Hansson B, Garzón B, Lövdén M, Björkman-Burtscher IM. Decrease of 7T MR short-term effects with repeated exposure. Neuroradiology 2024; 66:567-575. [PMID: 38270624 PMCID: PMC10937769 DOI: 10.1007/s00234-024-03292-4] [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: 09/11/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE Although participants in 7 T magnetic resonance (MR) studies tolerate ultra-high field (UHF) well, subjectively experienced short-term effects, such as dizziness, inconsistent movement, nausea, or metallic taste, are reported. Evidence on subjectively experienced short-term effects in multiple exposures to UHF MR is scarce. The purpose of this study is to investigated experience of short-term effects, and occurrence of motion in healthy subjects exposed to seven weekly 7 T MR examinations. METHODS A questionnaire on short-term effects was completed by participants in an fMRI motor skill study. Seven UHF MR examinations were conducted over 7 weeks (exposure number: 1 to 7). Changes of experienced short-term effects were analyzed. Motion in fMRI images was quantified. RESULTS The questionnaire was completed 360 times by 67 participants after one to seven 7T MR examinations. Logistic mixed model analysis showed a significant association between dizziness, inconsistent movement, nausea, and headache and the examination numbers (p<0.03). Exposure to repeated examinations had no significant effect on peripheral nerve stimulation (PNS) or motion of the subjects. The overall experience of a 7T examination improved significantly (p<0.001) with increasing examination numbers. CONCLUSION During multiple 7T examinations, subjects adapt to the strong static field. The short-term effects dizziness, inconsistent movement, nausea, and headache decrease over time as the MR sessions continue and experienced comfort increases. There was no significant difference in motion during the multiple fMRI examinations.
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Affiliation(s)
- Boel Hansson
- Department of Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.
- Department of Diagnostic Radiology, Clinical Sciences, Lund University, Lund, Sweden.
| | - Benjamín Garzón
- Institute of Education, University of Zurich, Zurich, Switzerland
| | - Martin Lövdén
- Department of Psychology, Gothenburg University, Gothenburg, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Isabella M Björkman-Burtscher
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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Terzis R, Dratsch T, Hahnfeldt R, Basten L, Rauen P, Sonnabend K, Weiss K, Reimer R, Maintz D, Iuga AI, Bratke G. Five-minute knee MRI: An AI-based super resolution reconstruction approach for compressed sensing. A validation study on healthy volunteers. Eur J Radiol 2024; 175:111418. [PMID: 38490130 DOI: 10.1016/j.ejrad.2024.111418] [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: 09/21/2023] [Accepted: 03/08/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE To investigate the potential of combining Compressed Sensing (CS) and a newly developed AI-based super resolution reconstruction prototype consisting of a series of convolutional neural networks (CNN) for a complete five-minute 2D knee MRI protocol. METHODS In this prospective study, 20 volunteers were examined using a 3T-MRI-scanner (Ingenia Elition X, Philips). Similar to clinical practice, the protocol consists of a fat-saturated 2D-proton-density-sequence in coronal, sagittal and transversal orientation as well as a sagittal T1-weighted sequence. The sequences were acquired with two different resolutions (standard and low resolution) and the raw data reconstructed with two different reconstruction algorithms: a conventional Compressed SENSE (CS) and a new CNN-based algorithm for denoising and subsequently to interpolate and therewith increase the sharpness of the image (CS-SuperRes). Subjective image quality was evaluated by two blinded radiologists reviewing 8 criteria on a 5-point Likert scale and signal-to-noise ratio calculated as an objective parameter. RESULTS The protocol reconstructed with CS-SuperRes received higher ratings than the time-equivalent CS reconstructions, statistically significant especially for low resolution acquisitions (e.g., overall image impression: 4.3 ± 0.4 vs. 3.4 ± 0.4, p < 0.05). CS-SuperRes reconstructions for the low resolution acquisition were comparable to traditional CS reconstructions with standard resolution for all parameters, achieving a scan time reduction from 11:01 min to 4:46 min (57 %) for the complete protocol (e.g. overall image impression: 4.3 ± 0.4 vs. 4.0 ± 0.5, p < 0.05). CONCLUSION The newly-developed AI-based reconstruction algorithm CS-SuperRes allows to reduce scan time by 57% while maintaining unchanged image quality compared to the conventional CS reconstruction.
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Affiliation(s)
- Robert Terzis
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
| | - Thomas Dratsch
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
| | - Robert Hahnfeldt
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
| | - Lajos Basten
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
| | - Philip Rauen
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
| | - Kristina Sonnabend
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany; Philips GmbH Market DACH, Hamburg, Germany.
| | | | - Robert Reimer
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
| | - David Maintz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
| | - Andra-Iza Iuga
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
| | - Grischa Bratke
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany.
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Kadom N, Lasiecka ZM, Nemeth AJ, Rykken JB, Lui YW, Seidenwurm D. Patient Engagement in Neuroradiology: A Narrative Review and Case Studies. AJNR Am J Neuroradiol 2024; 45:250-255. [PMID: 38216301 DOI: 10.3174/ajnr.a8077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 01/14/2024]
Abstract
The field of patient engagement in radiology is evolving and offers ample opportunities for neuroradiologists to become involved. The patient journey can serve as a model that inspires patient engagement initiatives. The patient journey in radiology may be viewed in 5 stages: 1) awareness that an imaging test is needed, 2) considering having a specific imaging test, 3) access to imaging, 4) imaging service delivery, and 5) ongoing care. Here, we describe patient engagement opportunities based on literature review and paired with case studies by practicing neuroradiologists.
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Affiliation(s)
- Nadja Kadom
- From the Emory University School of Medicine (N.K.), Children's Healthcare of Atlanta, Atlanta, Georgia
| | | | - Alexander J Nemeth
- Northwestern University, Feinberg School of Medicine, Northwestern Memorial Hospital (A.J.N.), Chicago, Illinois
| | | | - Yvonne W Lui
- New York University, Grossman School of Medicine (Y.W.L.), New York, New York
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Brandi N, Renzulli M. Towards a Simplified and Cost-Effective Diagnostic Algorithm for the Surveillance of Intraductal Papillary Mucinous Neoplasms (IPMNs): Can We Save Contrast for Later? Cancers (Basel) 2024; 16:905. [PMID: 38473267 DOI: 10.3390/cancers16050905] [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: 02/08/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
The increased detection of pancreatic cysts in recent years has triggered extensive diagnostic investigations to clarify their potential risk of malignancy, resulting in a large number of patients undergoing numerous imaging follow-up studies for many years. Therefore, there is a growing need for optimization of the current surveillance protocol to reduce both healthcare costs and waiting lists, while still maintaining appropriate sensibility and specificity. Imaging is an essential tool for evaluating patients with intraductal papillary mucinous neoplasms (IPMNs) since it can assess several predictors for malignancy and thus guide further management recommendations. Although contrast-enhanced magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) has been widely recommended by most international guidelines, recent results support the use of unenhanced abbreviated-MRI (A-MRI) protocols as a surveillance tool in patients with IPMN. In fact, A-MRI has shown high diagnostic performance in malignant detection, with high sensitivity and specificity as well as excellent interobserver agreement. The aim of this paper is, therefore, to discuss the current available evidence on whether the implementation of an abbreviated-MRI (A-MRI) protocol for cystic pancreatic lesion surveillance could improve healthcare economics and reduce waiting lists in clinical practice without significantly reducing diagnostic accuracy.
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Affiliation(s)
- Nicolò Brandi
- Department of Radiology, Alma Mater Studiorum University of Bologna, 40138 Bologna, Italy
- Department of Radiology, AUSL Romagna, 48018 Faenza, Italy
| | - Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Nohava L, Czerny R, Tik M, Wurzer D, Laistler E, Frass-Kriegl R. Citizen science approach to assessing patient perception of MRI with flexible radiofrequency coils. Sci Rep 2024; 14:2811. [PMID: 38307928 PMCID: PMC10837436 DOI: 10.1038/s41598-024-53364-x] [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: 06/01/2023] [Accepted: 01/30/2024] [Indexed: 02/04/2024] Open
Abstract
Magnetic Resonance Imaging (MRI) is a major medical imaging modality, which is non-invasive and provides unique soft tissue contrast without ionizing radiation. The successful completion of MRI exams critically depends on patient compliance, and, thus patient comfort. The design, appearance and usability of local MRI radiofrequency (RF) coils potentially influences the patients' perception of the exam. However, systematic investigations and empirical evidence for these aspects are missing. A questionnaire specifically evaluating the impact of RF coils on patient comfort in MRI would be a valuable addition to clinical studies comparing the performance of novel flexible RF coils with standard rigid coils. This paper describes the development of such a questionnaire in the scope of a citizen science (CS) initiative conducted with a group of students at the upper secondary school level. In this work, the CS initiative is presented in the format of a case report and its impact on scientific projects and the students' education is outlined. The resulting questionnaire is made available in German and English so as to be directly applicable by researchers working on the clinical evaluation of novel RF coils or the comfort evaluation of specific hardware setups in general.
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Affiliation(s)
- Lena Nohava
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Raphaela Czerny
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Martin Tik
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Dagmar Wurzer
- Bundes(real)gymnasium BG/BRG Keimgasse, Mödling, Austria
| | - Elmar Laistler
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Roberta Frass-Kriegl
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
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Kirjava SA, Phelan J. Does Trauma-Informed Care Have a Place in Audiology? A Review and Practical Suggestions. Audiol Res 2023; 13:929-938. [PMID: 37987338 PMCID: PMC10660861 DOI: 10.3390/audiolres13060080] [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: 10/10/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Trauma from adverse childhood experiences (ACEs) and serious traumatic events in adulthood is a significantly prevalent concern for public-health-hearing healthcare professionals. The pediatric and geriatric populations that audiologists often work with have been shown to be at an increased risk of experiencing traumatic events. Childhood and adult trauma can significantly impact the hearing and vestibular testing and treatment of these patients. METHODS This narrative review article discusses trauma-informed care (TIC) strategies that audiologists can use to recognize and respond to trauma in patients and prevent retraumatizing patients during their encounters in audiology clinics. CONCLUSIONS This article will provide an overview of TIC and direct the reader to resources for their continued learning. Practical guidance on implementing trauma-informed practices in clinical audiology are also provided.
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Affiliation(s)
- Shade Avery Kirjava
- Department of Health, Society, and Behavior, University of California, Irvine, CA 92617, USA
| | - Jennifer Phelan
- Department of Communication Sciences and Disorders, University of South Dakota, Vermillion, SD 57069, USA;
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Wamelink IJHG, Hempel HL, van de Giessen E, Vries MHM, De Witt Hamer P, Barkhof F, Keil VC. The patients' experience of neuroimaging of primary brain tumors: a cross-sectional survey study. J Neurooncol 2023; 162:307-315. [PMID: 36977844 PMCID: PMC10167184 DOI: 10.1007/s11060-023-04290-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/04/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE To gain insight into how patients with primary brain tumors experience MRI, follow-up protocols, and gadolinium-based contrast agent (GBCA) use. METHODS Primary brain tumor patients answered a survey after their MRI exam. Questions were analyzed to determine trends in patients' experience regarding the scan itself, follow-up frequency, and the use of GBCAs. Subgroup analysis was performed on sex, lesion grade, age, and the number of scans. Subgroup comparison was made using the Pearson chi-square test and the Mann-Whitney U-test for categorical and ordinal questions, respectively. RESULTS Of the 100 patients, 93 had a histopathologically confirmed diagnosis, and seven were considered to have a slow-growing low-grade tumor after multidisciplinary assessment and follow-up. 61/100 patients were male, with a mean age ± standard deviation of 44 ± 14 years and 46 ± 13 years for the females. Fifty-nine patients had low-grade tumors. Patients consistently underestimated the number of their previous scans. 92% of primary brain tumor patients did not experience the MRI as bothering and 78% would not change the number of follow-up MRIs. 63% of the patients would prefer GBCA-free MRI scans if diagnostically equally accurate. Women found the MRI and receiving intravenous cannulas significantly more uncomfortable than men (p = 0.003). Age, diagnosis, and the number of previous scans had no relevant impact on the patient experience. CONCLUSION Patients with primary brain tumors experienced current neuro-oncological MRI practice as positive. Especially women would, however, prefer GBCA-free imaging if diagnostically equally accurate. Patient knowledge of GBCAs was limited, indicating improvable patient information.
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Affiliation(s)
- Ivar J H G Wamelink
- Radiology & Nuclear Medicine Department, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam, The Netherlands.
| | - Hugo L Hempel
- Radiology & Nuclear Medicine Department, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Elsmarieke van de Giessen
- Radiology & Nuclear Medicine Department, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Mark H M Vries
- Radiology & Nuclear Medicine Department, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Philip De Witt Hamer
- Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Radiology & Nuclear Medicine Department, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, London, UK
| | - Vera C Keil
- Radiology & Nuclear Medicine Department, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, De Boelelaan 1117, Amsterdam, The Netherlands
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11
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Vazquez F, Marrufo O, Solis-Najera SE, Martin R, Rodriguez AO. External Waveguide Magnetic Resonance Imaging for lower limbs at 3 T. Med Phys 2021; 49:158-168. [PMID: 34633673 DOI: 10.1002/mp.15281] [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: 05/11/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION We report a method based on the travelling-wave MRI approach, in order to acquire images of human lower limbs with an external waveguide at 3 T. METHOD We use a parallel-plate waveguide and an RF surface coil for reception, while a whole-body birdcage is used for transmission. The waveguide and the surface coil are located right outside the magnet, in the MR conditional devices zone. We ran numerical simulations to investigate the B1 field generated by the surface coil located at one of the waveguides, as well as a saline-solution phantom positioned on the opposite side (150 cm away) inside the magnet. RESULTS We obtained phantom images by varying the distance between the coil and the phantom, in order to investigate the signal-to-noise ratio and to validate our numerical simulations. Lower limb images of a healthy volunteer were also acquired, demonstrating the viability of this approach. Standard pulse sequences were used and no physical modifications were made to the MR imager. CONCLUSIONS These numerical and experimental results show that travelling-wave MRI can produce high-quality images with only a simple waveguide and an RF coil located outside the magnet. This can be particularly favorable when acquiring images of lower limbs requiring a larger field of view.
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Affiliation(s)
- F Vazquez
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurocirugia MVS, Mexico City, 14269, Mexico
| | - S E Solis-Najera
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - R Martin
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitama Iztapalapa, Mexico City, 09340, Mexico
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12
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MRI of the Entire Spinal Cord-Worth the While or Waste of Time? A Retrospective Study of 74 Patients with Multiple Sclerosis. Diagnostics (Basel) 2021; 11:diagnostics11081424. [PMID: 34441358 PMCID: PMC8392750 DOI: 10.3390/diagnostics11081424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 01/04/2023] Open
Abstract
Spinal cord lesions are included in the diagnosis of multiple sclerosis (MS), yet spinal cord MRI is not mandatory for diagnosis according to the latest revisions of the McDonald Criteria. We investigated the distribution of spinal cord lesions in MS patients and examined how it influences the fulfillment of the 2017 McDonald Criteria. Seventy-four patients with relapsing-remitting MS were examined with brain and entire spinal cord MRI. Sixty-five patients received contrast. The number and anatomical location of MS lesions were assessed along with the Expanded Disability Status Scale (EDSS). A Chi-square test, Fischer’s exact test, and one-sided McNemar’s test were used to test distributions. MS lesions were distributed throughout the spinal cord. Diagnosis of dissemination in space (DIS) was increased from 58/74 (78.4%) to 67/74 (90.5%) when adding cervical spinal cord MRI to brain MRI alone (p = 0.004). Diagnosis of dissemination in time (DIT) was not significantly increased when adding entire spinal cord MRI to brain MRI alone (p = 0.04). There was no association between the number of spinal cord lesions and the EDSS score (p = 0.71). MS lesions are present throughout the spinal cord, and spinal cord MRI may play an important role in the diagnosis and follow-up of MS patients.
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13
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Gentle Touch: Noninvasive Approaches to Improve Patient Comfort and Cooperation for Pediatric Imaging. Top Magn Reson Imaging 2021; 29:187-195. [PMID: 32541256 DOI: 10.1097/rmr.0000000000000245] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Pediatric imaging presents unique challenges related to patient anxiety, cooperation, and safety. Techniques to reduce anxiety and patient motion in adults must often be augmented in pediatrics, because it is always mentioned in the field of pediatrics, children are not miniature adults. This article will review methods that can be considered to improve patient experience and cooperation in imaging studies. Such techniques can range from modifications to the scanner suite, different ways of preparing and interacting with children, collaborating with parents for improved patient care, and technical advances such as accelerated acquisition and motion correction to reduce artifact. Special considerations for specific populations including transgender patients, neonates, and pregnant women undergoing fetal imaging will be described. The unique risks of sedation in children will also be briefly reviewed.
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14
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Brunnquell CL, Hoff MN, Balu N, Nguyen XV, Oztek MA, Haynor DR. Making Magnets More Attractive: Physics and Engineering Contributions to Patient Comfort in MRI. Top Magn Reson Imaging 2020; 29:167-174. [PMID: 32541257 DOI: 10.1097/rmr.0000000000000246] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Patient comfort is an important factor of a successful magnetic resonance (MR) examination, and improvements in the patient's MR scanning experience can contribute to improved image quality, diagnostic accuracy, and efficiency in the radiology department, and therefore reduced cost. Magnet designs that are more open and accessible, reduced auditory noise of MR examinations, light and flexible radiofrequency (RF) coils, and faster motion-insensitive imaging techniques can all significantly improve the patient experience in MR imaging. In this work, we review the design, development, and implementation of these physics and engineering approaches to improve patient comfort.
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Affiliation(s)
- Christina L Brunnquell
- Department of Radiology, University of Washington, Seattle, WA Department of Radiology, The Ohio State University Wexler Medical Center, Columbus, OH
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15
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Bermo MS, Patterson D, Sharar SR, Hoffman H, Lewis DH. Virtual Reality to Relieve Pain in Burn Patients Undergoing Imaging and Treatment. Top Magn Reson Imaging 2020; 29:203-208. [PMID: 32511197 DOI: 10.1097/rmr.0000000000000248] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pain from burn injuries is among the most excruciating encountered in clinical practice. Pharmacological methods often fail to achieve acceptable level of analgesia in these patients, especially during burn wound dressing and debridement. Virtual reality (VR) distraction is a promising analgesic technique that progressed significantly in the last decade with development of commercially available, low-cost, high-resolution, wide field-of-view, standalone VR devices that can be used in many clinical scenarios. VR has demonstrated clinical benefit as an adjunctive analgesic during burn wound dressing and other painful medical procedures. The technique has proven useful also in preparing patients for magnetic resonance imaging scans, particularly in claustrophobic patients. Modulation of pain-related brain activity at cortical and subcortical levels by VR, and its correlation with subjective improvement in various laboratory and clinical pain experiences has been demonstrated using multiple functional brain imaging studies including functional magnetic resonance imaging and brain perfusion single photon emission computed tomography.
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Affiliation(s)
- Mohammed S Bermo
- Texas Tech University Health Science Center at El Paso, El Paso, TX
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16
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Nguyen XV, Oztek MA, Nelakurti DD, Brunnquell CL, Mossa-Basha M, Haynor DR, Prevedello LM. Applying Artificial Intelligence to Mitigate Effects of Patient Motion or Other Complicating Factors on Image Quality. Top Magn Reson Imaging 2020; 29:175-180. [PMID: 32511198 DOI: 10.1097/rmr.0000000000000249] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Artificial intelligence, particularly deep learning, offers several possibilities to improve the quality or speed of image acquisition in magnetic resonance imaging (MRI). In this article, we briefly review basic machine learning concepts and discuss commonly used neural network architectures for image-to-image translation. Recent examples in the literature describing application of machine learning techniques to clinical MR image acquisition or postprocessing are discussed. Machine learning can contribute to better image quality by improving spatial resolution, reducing image noise, and removing undesired motion or other artifacts. As patients occasionally are unable to tolerate lengthy acquisition times or gadolinium agents, machine learning can potentially assist MRI workflow and patient comfort by facilitating faster acquisitions or reducing exogenous contrast dosage. Although artificial intelligence approaches often have limitations, such as problems with generalizability or explainability, there is potential for these techniques to improve diagnostic utility, throughput, and patient experience in clinical MRI practice.
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Affiliation(s)
- Xuan V Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Murat Alp Oztek
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
- Seattle Children's Hospital, Seattle, WA
| | - Devi D Nelakurti
- Metro Early College High School, The Ohio State University, Columbus, OH
| | | | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - David R Haynor
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Luciano M Prevedello
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
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17
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Makary MS, da Silva A, Kingsbury J, Bozer J, Dowell JD, Nguyen XV. Noninvasive Approaches for Anxiety Reduction During Interventional Radiology Procedures. Top Magn Reson Imaging 2020; 29:197-201. [PMID: 32472820 DOI: 10.1097/rmr.0000000000000238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Periprocedural anxiety is a major cause of morbidity, particularly for interventional radiology procedures that often depend on conscious sedation. Management of anxiety and pain during image-guided procedures has traditionally relied on pharmacologic agents such as benzodiazepines and opioids. Although generally safe, use of these medications risks adverse events, and newer noninvasive, nonpharmacologic techniques have evolved to address patient needs. In this review, we explore the roles of hypnosis, structured empathic attention, anodyne imagery, music, video glasses, and mobile applications in reducing procedural anxiety and pain with the goal of improving patient satisfaction, operational efficiency, and clinical outcomes.
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Affiliation(s)
- Mina S Makary
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Alexandre da Silva
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - James Kingsbury
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Jordan Bozer
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Xuan V Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
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18
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Mayr NA, Yuh WTC, Oztek MA, Nguyen XV. Human Touch for High-Tech Imaging and Imaging-Guided Procedures: Integrative Medicine Strategies for Patient-Centered Nonpharmacologic Approaches: Part 1: Challenges for High-Tech Imaging and Procedures: How Can Integrative Medicine Impact Quality and Operations? Top Magn Reson Imaging 2020; 29:123-124. [PMID: 32568973 DOI: 10.1097/rmr.0000000000000240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Nina A Mayr
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA
| | - William T C Yuh
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Murat A Oztek
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Xuan V Nguyen
- Department of Radiology, The Ohio State University College of Medicine, Columbus, OH
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19
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Human Touch for High-Tech Imaging and Imaging-Guided Procedures Integrative Medicine Strategies for Patient-Centered Nonpharmacologic Approaches: Part 2: Overcoming Anxiety in Imaging and Invasive Procedures: What can Physics, Technology, and Integrative Medicine Do for Us? Top Magn Reson Imaging 2020; 29:165-166. [PMID: 32511196 DOI: 10.1097/rmr.0000000000000250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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20
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Ajam AA, Tahir S, Makary MS, Longworth S, Lang EV, Krishna NG, Mayr NA, Nguyen XV. Communication and Team Interactions to Improve Patient Experiences, Quality of Care, and Throughput in MRI. Top Magn Reson Imaging 2020; 29:131-134. [PMID: 32568975 DOI: 10.1097/rmr.0000000000000242] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Patients undergoing MRI may experience fear, claustrophobia, or other anxiety manifestations due to the typically lengthy, spatially constrictive, and noisy MRI acquisition process and in some cases are not able to tolerate completion of the study. This article discusses several patient-centered aspects of radiology practice that emphasize interpersonal interactions. Patient education and prescan communication represent 1 way to increase patients' awareness of what to expect during MRI and therefore mitigate anticipatory anxiety. Some patient interaction strategies to promote relaxation or calming effects are also discussed. Staff teamwork and staff training in communication and interpersonal skills are also described, along with literature evidence of effectiveness with respect to patient satisfaction and productivity endpoints. Attention to how radiologists, nurses, technologists, and other members of the radiology team interact with patients before or during the MRI scan could improve patients' motivation and ability to cooperate with the MRI scanning process as well as their subjective perceptions of the quality of their care. The topics discussed in this article are relevant not only to MRI operations but also to other clinical settings in which patient anxiety or motion represent impediments to optimal workflow.
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Affiliation(s)
- Amna A Ajam
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Mina S Makary
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Sandra Longworth
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Nidhi G Krishna
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Nina A Mayr
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA
| | - Xuan V Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
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21
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Nguyen XV, Tahir S, Bresnahan BW, Andre JB, Lang EV, Mossa-Basha M, Mayr NA, Bourekas EC. Prevalence and Financial Impact of Claustrophobia, Anxiety, Patient Motion, and Other Patient Events in Magnetic Resonance Imaging. Top Magn Reson Imaging 2020; 29:125-130. [PMID: 32568974 DOI: 10.1097/rmr.0000000000000243] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, by impeding MRI workflow, they may affect the finances of an imaging practice. This review article offers an overview of the various types of patient-related unanticipated events that occur in MRI, along with estimates of their frequency of occurrence as documented in the available literature. In addition, the financial implications of these events are discussed from a microeconomic perspective, primarily from the point of view of a radiology practice or hospital, although associated limitations and other economic viewpoints are also included. Efforts to minimize these unanticipated patient events can potentially improve not only patient satisfaction and comfort but also an imaging practice's operational efficiency and diagnostic capabilities.
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Affiliation(s)
- Xuan V Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Brian W Bresnahan
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Jalal B Andre
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | | | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Nina A Mayr
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA
| | - Eric C Bourekas
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
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