Basic Principles of and Practical Guide to Clinical MRI Radiofrequency Coils

CAR/CSAR Practice Statement on Pelvic MRI for Endometriosis

The Canadian Association of Radiologists (CAR) Endometriosis Working Group was tasked with providing guidance and benchmarks to ensure the quality of technique and interpretation for advanced imaging modalities associated with diagnosing endometriosis. Advanced pelvic ultrasound is essential in diagnosing and mapping pelvic endometriosis, but pelvic MRI serves as an excellent imaging tool in instances where access to advanced ultrasound is limited, or an alternative imaging modality is required. Despite the known utility of MRI for endometriosis, there is no consensus on imaging protocol and patient preparation in Canada. To improve patient care and support excellence in imaging, the Working Group has developed recommendations for the use of pelvic MRI to assess for endometriosis with an aim to standardize MRI technique for use in both community and academic practices across Canada. The guidelines provide recommendations regarding imaging technique and patient preparation for pelvic MRI, along with suggestions for structured reporting of pelvic MRI for endometriosis.

Device for detection of activity-dependent changes in neural spheroids at MHz and GHz frequencies

Intracellular processes triggered by neural activity include changes in ionic concentrations, protein release, and synaptic vesicle cycling. These processes play significant roles in neurological disorders. The beneficial effects of brain stimulation may also be mediated through intracellular changes. There is a lack of label-free techniques for monitoring activity-dependent intracellular changes. Electromagnetic (EM) waves at frequencies larger than 1 × 106 Hz (1 MHz) were previously used to probe intracellular contents of cells, as cell membrane becomes "invisible" at this frequency range. EM waves interact with membranes of intracellular organelles, proteins, and water in the MHz - GHz range. In this work, we developed a device for probing the interaction between active neurons' intracellular contents and EM waves. The device used an array of grounded coplanar waveguides (GCPWs) to deliver EM waves to a three-dimensional (3D) spheroid of rat cortical neurons. Neural activity was evoked using optogenetics, with synchronous detection of propagation of EM waves. Broadband measurements were conducted in the MHz-GHz range to track changes in transmission coefficients. Neuronal activity was found to reversibly alter EM wave transmission. Pharmacological suppression of neuronal activity abolished changes in transmission. Time constants of changes in transmission were in the seconds - tens of seconds range, suggesting the presence of relatively slow, activity-dependent intracellular processes. This study provides the first evidence that EM transmission through neuronal tissue is activity-dependent in MHz - GHz range. Device developed in this work may find future applications in studies of the mechanisms of neurological disorders and the development of new therapies.

Advanced MRI techniques in abdominal imaging

Magnetic resonance imaging (MRI) is a crucial modality for abdominal imaging evaluation of focal lesions and tissue properties. However, several obstacles, such as prolonged scan times, limitations in patients' breath-hold capacity, and contrast agent-associated artifacts, remain in abdominal MR images. Recent techniques, including parallel imaging, three-dimensional acquisition, compressed sensing, and deep learning, have been developed to reduce the scan time while ensuring acceptable image quality or to achieve higher resolution without extending the scan duration. Quantitative measurements using MRI techniques enable the noninvasive evaluation of specific materials. A comprehensive understanding of these advanced techniques is essential for accurate interpretation of MRI sequences. Herein, we therefore review advanced abdominal MRI techniques.

Radiofrequency interference in magnetic resonance imaging: Identification and rectification

Radiofrequency (RF) interference artifact is a common type of magnetic resonance imaging (MRI) artifacts caused by the presence of unwanted RF field inside the scanner room. The artifact has the appearance of parallel bright lines or bands that resemble zippers, which can mimic pathology, obstruct the viewing of underlining tissues, and lower image signal-to-noise ratio, affecting the diagnostic evaluation of the image and sometimes even rendering it non-diagnostic. Due to the presence of multiple possible sources of RF interference in MRI and potential nonrelated MRI artifacts that resemble RF interference artifact, it may be difficult to effectively and timely resolve the artifact problem. The objective of this paper is to provide a review of RF interference in MRI and to offer guidance in the prompt and correct identification of the associated image artifacts as well as efficient approaches to resolve and prevent RF interference problems. This article should serve as a useful educational reference to magnetic resonance (MR) technologists and radiologists in dealing with MR image artifacts that may be caused by RF interference.

Use of the Perturbing Sphere Method for the Estimation of Radiofrequency Coils' Efficiency in Magnetic Resonance Applications: Experience from an Electromagnetic Laboratory

Radiofrequency (RF) transmitter and receiver coils are employed in in magnetic resonance (MR) applications to, respectively, excite the nuclei in the object to be imaged and to pick up the signals emitted by the nuclei with a high signal-to-noise ratio (SNR). The ability to obtain high-quality images and spectra in MR strongly depends on the RF coil's efficiency. Local coil efficiency can be estimated with magnetic field mapping methods evaluated at a fixed point in space. Different methods have been described in the literature, divided into electromagnetic bench tests and MR techniques. In this paper, we review our experience in designing and testing RF coils for MR in our electromagnetic laboratory with the use of the perturbing sphere method, which permits coil efficiency and magnetic field mapping to be estimated with great accuracy and in a short space of time, which is useful for periodic coil quality control checks. The method's accuracy has been verified with simulations and workbench tests performed on RF coils with different surfaces and of different volumes. Furthermore, all the precautions taken to improve the measurement sensitivity are also included in this review, in addition to the various applications of the method that have been described over the last twenty years of research in our electromagnetic laboratory.

Systematic review of MRI safety literature in relation to radiofrequency thermal injury prevention

INTRODUCTION

Magnetic resonance imaging (MRI) is a rapidly evolving modality, generally considered safe due to lack of ionising radiation. While MRI technology and techniques are improving, many of the safety concerns remain the same as when first established. Patient thermal injuries are the most frequently reported adverse event, accounting for 59% of MRI incidents to the Food and Drug Administration (FDA). Surveys indicate many incidents remain unreported. Patient thermal injuries are preventable and various methods for their mitigation have been published. However, recommendations can be variable, fragmented and confusing. The aim of this systematic review was to synthesise the evidence on MRI safety and associated skin injuries and offer comprehensive recommendations for radiographers to prevent skin thermal injuries.

METHODS

Four journal databases were searched for sources published January 2010-May 2023, presenting information on MRI safety and thermal injuries.

RESULTS

Of 26,801 articles returned, after careful screening and based on the eligibility criteria, only 79 articles and an additional 19 grey literature sources were included (n = 98). Included studies were examined using thematic analysis to determine if holistic recommendations can be provided to assist in preventing skin burns. This resulted in three simplified recommendations: Remove any electrically conductive items Insulate the patient to prevent any conductive loops or contact with objects Communicate regularly CONCLUSION: By implementing the above recommendations, it is estimated that 97% of skin burns could be prevented. With thermal injuries continuing to impact MRI safety, strategies to prevent skin burns and heating are essential. Assessing individual risks, rather than blanket policies, will help prevent skin thermal injuries occurring, improving patient care.

Design and Dynamic In Vivo Validation of a Multi-Channel Stretchable Liquid Metal Coil Array

Recent developments in the field of radiofrequency (RF) coils for magnetic resonance imaging (MRI) offer flexible and patient-friendly solutions. Previously, we demonstrated a proof-of-concept single-element stretchable coil design based on liquid metal and a self-tuning smart geometry. In this work, we numerically analyze and experimentally study a multi-channel stretchable coil array and demonstrate its application in dynamic knee imaging. We also compare our flexible coil array to a commonly used commercial rigid coil array. Our numerical analysis shows that the proposed coil array maintains its resonance frequency (<1% variation) and sensitivity (<6%) at various stretching configurations from 0% to 30%. We experimentally demonstrate that the signal-to-noise ratio (SNR) of the acquired MRI images is improved by up to four times with the stretchable coil array due to its conformal and therefore tight-fitting nature. This stretchable array allows for dynamic knee imaging at different flexion angles, infeasible with traditional, rigid coil arrays. These findings are significant as they address the limitations of current rigid coil technology, offering a solution that enhances patient comfort and image quality, particularly in applications requiring dynamic imaging.

A scan-specific quality control acquisition for clinical whole-body (WB) MRI protocols

Objective.Image quality in whole-body MRI (WB-MRI) may be degraded by faulty radiofrequency (RF) coil elements or mispositioning of the coil arrays. Phantom-based quality control (QC) is used to identify broken RF coil elements but the frequency of these acquisitions is limited by scanner and staff availability. This work aimed to develop a scan-specific QC acquisition and processing pipeline to detect broken RF coil elements, which is sufficiently rapid to be added to the clinical WB-MRI protocol. The purpose of this is to improve the quality of WB-MRI by reducing the number of patient examinations conducted with suboptimal equipment.Approach.A rapid acquisition (14 s additional acquisition time per imaging station) was developed that identifies broken RF coil elements by acquiring images from each individual coil element and using the integral body coil. This acquisition was added to one centre's clinical WB-MRI protocol for one year (892 examinations) to evaluate the effect of this scan-specific QC. To demonstrate applicability in multi-centre imaging trials, the technique was also implemented on scanners from three manufacturers.Main results. Over the course of the study RF coil elements were flagged as potentially broken on five occasions, with the faults confirmed in four of those cases. The method had a precision of 80% and a recall of 100% for detecting faulty RF coil elements. The coil array positioning measurements were consistent across scanners and have been used to define the expected variation in signal.Significance. The technique demonstrated here can identify faulty RF coil elements and positioning errors and is a practical addition to the clinical WB-MRI protocol. This approach was fully implemented on systems from two manufacturers and partially implemented on a third. It has potential to reduce the number of clinical examinations conducted with suboptimal hardware and improve image quality across multi-centre studies.

Beneath the surface: A systematic review on intraoperative imaging techniques for deep margin assessment in oral squamous cell carcinoma

Resection margins of oral squamous cell carcinoma (SCC) are often inadequate. A systematic review on clinical intraoperative whole-specimen imaging techniques to obtain adequate deep resection margins in oral SCC is lacking. Such a review may render better alternatives for the current insufficient intraoperative techniques: palpation and frozen section analyses (FSA). This review resulted in ten publications investigating ultrasound (US), four investigating fluorescence, and three investigating MRI. Both US and fluorescence were able to image the tumor intraorally and perform ex-vivo imaging of the resection specimen. Fluorescence was also able to image residual tumor tissue in the wound bed. MRI could only be used on the ex-vivo specimen. The 95 % confidence intervals for sensitivity and specificity were large, due to the small sample sizes for all three techniques. The sensitivity and specificity of US for identifying < 5 mm margins ranged from 0 % to 100 % and 60 % to 100 %, respectively. For fluorescence, this ranged from 0 % to 100 % and 76 % to 100 %, respectively. For MRI, this ranged from 7 % to 100 % and 81 % to 100 %, respectively. US, MRI and fluorescence are the currently available imaging techniques that can potentially be used intraoperatively and which can image the entire tumor-free margin, although they have insufficient sensitivity for identifying < 5 mm margins. Further research on larger cohorts is needed to improve the sensitivity by determining cut-off points on imaging for inadequate margins. This improves the number of adequate resections of oral SCC's and pave the way for routine clinical implementation of these techniques.

Magnetic resonance imaging quality in the context of a knee-spanning external fixator placed inside the MR bore: a literature review

After emergent assessment of potentially limb-threatening injuries in knee dislocation or multi-ligament knee injury patients, magnetic resonance imaging is necessary to visualize ligamentous structures and plan for soft tissue repair. However, the application of a knee-spanning external fixator may introduce artifact and reduce overall image quality, which can limit the evaluation of soft tissue injury. As a result, the utility of MRI in the context of a knee-spanning external fixator has been called into question. Signal-to-noise ratio, contrast-to-noise ratio, and qualitative scales have been used to assess image quality of MRI in the context of a knee-spanning external fixator. Despite the potential for artifact, studies have demonstrated that useful diagnostic information may be obtained from MRI in the presence of an external fixator. This review examines the general principles of anatomical assessment, magnetic field strength, device composition and design, radiofrequency coil use, and MRI sequences and artifact reduction as they pertain to MRI in the presence of a knee-spanning external fixator.

Patient Safety in MRI with the Use of a Joint-Spanning External Fixator for Knee Dislocation: A Critical Analysis Review

» Universal safety guidelines for the use of a knee-spanning external fixator in magnetic resonance imaging (MRI) are unlikely to be established considering the high variability in device construct configurations.» Per the US Food and Drug Administration, manufacturers are to provide parameters for safe MRI scanning for "MR Conditional" devices; however, such labeling may be limited in detail. Physicians should reference manufacturer labels as a starting point while making an educated clinical decision.» Scanning of a knee-spanning external fixator inside the MR bore has been safely demonstrated in previous studies, although with small sample sizes.» When considering MRI in a patient treated with a knee-spanning external fixator, physicians should use all available resources and coordinate with their medical team to make a clinically reasonable decision contrasting patient benefit vs. potential harm.