Current technical development of magnetic resonance imaging

The impact of MRI continues to grow due to progress in all phases of the development cycle. Since its initial use for human imaging approximately 20 years ago, magnetic resonance imaging (MRI) has developed into a widely used clinical imaging modality. Now, at the start of the 21st century, the number of MRI systems worldwide is in excess of 10,800. With an average of over ten patients examined per day per machine, the number of clinical studies per day is well over 100,000. Along with X-ray imaging, ultrasound, computed X-ray tomography, and nuclear medicine, MRI is well recognized as a commonly used medical imaging modality. In spite of this significant growth over the last two decades, technical and application development continues. The purpose of this article is to identify the current development of MRI and to attempt to indicate future trends. In some sense this is an update of a similar technical assessment of MRI made four years ago     

US regulatory considerations for low field magnetic resonance imaging systems

Although there has been a resurgence of interest in low field magnetic resonance imaging (MRI) systems in recent years, low field MRI is not a new concept. FDA has a long history of evaluating the safety and effectiveness of MRI systems encompassing a wide range of field strengths. Many systems seeking marketing authorization today include new technological features (such as artificial intelligence), but this does not fundamentally change the regulatory paradigm for MR systems. In this review, we discuss some of the US regulatory considerations for low field magnetic resonance imaging (MRI) systems, including applicability of existing laws and regulations and how the U.S. Food and Drug Administration (FDA) evaluates low field MRI systems for market authorization. We also discuss regulatory considerations in the review of low field MRI systems incorporating novel AI technology. We foresee that MRI systems of all field strengths intended for general diagnostic use will continue to be evaluated for marketing clearance by the metric of substantial equivalence set forth in the premarket notification pathway.

     

A brief review of hardware for catheter tracking in magnetic resonance imaging.

Magnetic resonance imaging (MRI) has traditionally been used exclusively in a role for patient diagnosis. However, it is unlikely that this role is sufficient for its continued prominence in medical imaging. Instead, the more ambitious role in diagnosis and also therapy/intervention will occur as demand for minimally invasive procedures increases. Fortunately, with recent improvement in technical specifications and creative pulse sequence design, MRI systems can now provide high quality near-real-time images that facilitate a variety of image-guided procedures, many based around delivery via catheters. While X-ray opacity is not available as a means for detecting the progression of the catheter in MRI systems today, a variety of novel hardware devices have been designed and used for MRI catheter tracking. This report provides a brief review of some fundamental methods for catheter tracking in MRI.     

An evolution of low-field strength MRI

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.

     

Gradiometer pick-up coil design for a low field SQUID-MRI system

We describe the use of liquid helium-cooled (4.2 K) gradiometer coils and a DC superconducting quantum interference device (SQUID) preamplifier to improve the SNR of magnetic resonance imaging (MRI) at 0.01 T. Gradiometer windings are used both to reduce lossy interactions with the MRI system's room temperature magnet and gradient coils and also to reject interference from more distant sources, which reduces the need for RF shielding. We have tested both axial and planar (figure-of-eight) gradiometer configurations. The figure-of-eight gradiometer has a more rapid fall-off in sensitivity with increasing distance from its windings than the axial gradiometer, but this is compensated for by reduced lossy interactions and improved interference rejection. We have used the system to image the human arm.     

Can sodium MRI be used as a method for mapping of cartilage stiffness?

Objective

Sodium concentration is responsible for (at least part of) the stiffness of articular cartilage due to the osmotic pressure it generates. Therefore, we hypothesized that we could use sodium MRI to approximate the stiffness of cartilage to assess early cartilage degeneration.

Methods

Four human tibial plateaus were retrieved from patients undergoing total knee replacement (TKR), and their cartilage stiffness mapped with indentation testing, after which samples were scanned in a 7 T MRI to determine sodium concentration. The relation of biomechanical parameters to MRI sodium and glycosaminoglycan (GAG) concentration was explored by a linear mixed model.

Results

Weak correlations of GAG concentration with apparent peak modulus (p?=?0.0057) and apparent equilibrium modulus (p?=?0.0181) were observed and lack of correlation of GAG concentration versus MRI sodium concentration was observed. MRI sodium concentration was not correlated with apparent peak modulus, though a moderate correlation of MRI sodium concentration with permeability was shown (p?=?0.0014).

Discussion and conclusion

Although there was correlation between GAG concentration and cartilage stiffness, this was not similar with sodium concentration as measured by MRI. Thus, if the correlation between MRI sodium imaging and GAG concentration could be resolved, this strategy for assessing cartilage functional quality still holds promise.

     

A brief review of hardware for catheter tracking in magnetic resonance imaging

Magnetic resonance imaging (MRI) has traditionally been used exclusively in a role for patient diagnosis. However, it is unlikely that this role is sufficient for its continued prominence in medical imaging. Instead, the more ambitious role in diagnosis and also therapy intervention will occur as demand for minimally invasive procedures increases. Fortunately, with recent improvement in technical specifications and creative pulse sequence design, MRI systems can now provide high quality near-real-time images that facilitate a variety of image-guided procedures, many based around delivery via catheters. While X-ray opacity is not available as a means for detecting the progression of the catheter in MRI systems today, a variety of novel hardware devices have been designed and used for MRI catheter tracking. This report provides a brief review of some fundamental methods for catheter tracking in MRI. Submitted at the ISMRM Hardware Workshop held 23–25 February 2001 in Cleveland, OH, USA.     

Low-frequency quadrature mode birdcage resonator

The birdcage resonator is frequently used in conventional MRI because of its excellent attributes. Its use in low-field MRI is restricted to field strengths higher than, for example, 0.1 T, dependent on the size of the coil. This is because of the intrinsically low inductance value of the birdcage coils. Furthermore, the sensitivity of the birdcage at low field strengths is significantly lower when compared to, for example, the solenoid. Both problems can be overcome with the multiturn technique and a novel wound birdcage coil. The quadrature mode wound birdcage coil presented in this paper can be used at frequencies as low as 100 kHz. Its sensitivity is also increased when compared to the conventional strip-ring birdcage. Homogeneity effective volume, and methods to increase the resonator bandwidth to match the signal bandwidth are left intact. The latter is a typical low-field problem.     

Novel revascularization therapies — TMLR and growth factor-induced angiogenesis monitored with cardiac MRI

4. Summary Employment of cardiac MRI techniques (cine MRI, wall thickening analysis, quantitative MRFPP, MR tissue tagging) allowed non-invasive localization and assessment of early and late changes in myocardial function and perfusion produced by these new approaches of myocardial revascularization. With its precision in assessment of myocardial perfusion and collateral-dependent territories, cardiac MRI techniques may be of excellent use for the evaluation of effects on myocardial function and perfusion as well as longitudinal outcomes in clinical trials with TMLR and angiogenesis therapies in patients with CAD. As growth factor therapies approach phase III clinical trials, such vital questions as the most effective delivery system, dosages and techniques used for treatment-monitoring parameters remain unanswered. In addition, better definitions of patient selection criteria for TMLR and angiogenesis therapies for both short- and long-term maximum benefits are needed at this time. Large-scale clinical trials with cardiac MRI techniques are needed to reliably assess functional and perfusion reserves of the myocardium pre and post TMLR and angiogenesis therapies. MR-based outcome parameters may aid in answering questions pertinent to the new revascularization treatments.     

Clinical applications and techniques of echo-planar imaging

The ultrafast magnetic resonance imaging technique known as echo-planar imaging has undergone considerable technical improvements in recent years. It is currently being evaluated at only a few institutions worldwide. Although EPI, invented by P. Mansfield in 1977, is the oldest fast MRI technique, it is still not widely available on clinical scanners. Only 20–30 EPI scanners exist worldwide, compared to about 7000 conventional MRI scanners. The main reason why EPI has not emerged from the scientific prototype niche is its high demands on hardware and software. However, the time is now coming when EPI is entering the clinical stage. We describe the common EPI sequence types, show clinical results, and describe the contrast in the measured images.     

Fluorine polymer probes for magnetic resonance imaging: quo vadis?

Over the last few years, the development and relevance of ¹⁹F magnetic resonance imaging (MRI) for use in clinical practice has emerged. MRI using fluorinated probes enables the achievement of a specific signal with high contrast in MRI images. However, to ensure sufficient sensitivity of ¹⁹F MRI, fluorine probes with a high content of chemically equivalent fluorine atoms are required. The majority of ¹⁹F MRI agents are perfluorocarbon emulsions, which have a broad range of applications in molecular imaging, although the content of fluorine atoms in these molecules is limited. In this review, we focus mainly on polymer probes that allow higher fluorine content and represent versatile platforms with properties tailorable to a plethora of biomedical in vivo applications. We discuss the chemical development, up to the first imaging applications, of these promising fluorine probes, including injectable polymers that form depots that are intended for possible use in cancer therapy.

     

Retrospective analysis for evaluation of the value of contrast-enhanced MRI in patients treated with breast conservative therapy

Purpose The aim of this study was to assess the value of contrast-enhanced (c.-e.) MRI in the follow-up of patients with conservatively treated breast cancer since detection and exclusion of malignancy may interfere significantly with posttherapeutic changes within the treated breast. Material and methods A total of 207 patients with a history of limited surgery and radiation therapy underwent MR imaging, 40 patients were examined 0–12 months and 167 patients were examined later than 12 months after radiotherapy. Suspicious or indeterminate findings were suggested by clinical examination or conventional imaging in 80 studies. In 127 women, MRI was performed within breast tissue that was difficult to assess due to scarring or dense breast tissue. Results Recurrent carcinoma was confirmed in 27 patients by surgical biopsy. All 27 carcinomas, except for one with a slow signal increase, demonstrated early rise of signal intensity on dynamic T1-weighted contrast enhanced images. During the first year after therapy, the diagnostic accuracy could not be improved by additional use of c.-e. MRI. Differentiation between posttherapeutic changes and recurrent carcinoma was frequently not possible because of strong and sometimes early and ill-circumscribed enhancement. Later than 12 months after therapy enhancement decreased significantly, thus the false positive calls could be reduced from 49 (conventional imaging) to 12 (conventional imaging plus MRI). A total of 12 of 26 recurrences and multifocality in 4/5 cases were diagnosed by MR imaging alone at this time interval. Conclusion In the first year after therapy, c.-e. MRI is only indicated in selected cases. The results later than 12 months emphasize that c.-e. MRI may contribute significant additional information. It allows better distinction of posttherapeutic fibrosis from recurrent carcinoma and proved to be able to detect recurrent disease more sensitive and at an earlier stage.     

Magnetic resonance imaging in obstetrics and gynecology: progress and limitations

The introduction of phase-array coils, fast spin echo, and certain other pulse sequences together with use of contrast agents has refined the application of magnetic resonance imaging (MRI) in pelvic disease. It makes management decisions in a number of benign conditions including uterine anomalies, adenomyosis, and leiomyomas of the uterus and endometriosis, especially in the context of infertility; it facilitates identification and characterisation of adnexal masses. In uterine malignancy, the multiplanar capability and excellent soft tissue contrast permit accurate assessment of depth of tumor invasion, tumor volume, and extension to adjacent structures. Its precise role in the management of primary and recurrent ovarian cancer remains to be decided. In pelvic malignancy, contrast facilitates identification of viable tumor but does not improve tissue specificity. In obstetrics, MRI is an attractive alternative to X-ray pelvimetry and assists in the evaluation of associated uterine and pelvic pathology. The use of echo-planar imaging eliminates movement artifact and has the potential to complement ultrasound in the assessment of fetal abnormalities and provide a method of identifying growth retardation from volume measurements of body organs.     

Sequential whole-body PET/MR scanner: concept, clinical use, and optimisation after two years in the clinic. The manufacturer’s perspective

PET and MRI are established clinical tools which provide complementary information, but clinical workflow limits widespread clinical application of both modalities in combination. The two modalities are usually situated in different hospital departments and operated and reported independently, and patients are referred for both scans, often consecutively. With the advent of PET/MR as a new hybrid imaging modality there is now a possibility of addressing these concerns. There are two different design philosophies for integrated PET/MR imaging—positioning PET inside the MRI magnet or in tandem, similar to PET/CT. The Ingenuity TF PET/MR by Philips Healthcare is a sequential PET/MR tomograph combining state-of-the-art time-of-flight PET and high-field MRI with parallel transmission capabilities. In this review article we describe the technology implemented in the system, for example RF and magnetic shielding, MR-based attenuation correction, peculiarities in scatter correction, MR system optimisation, and the philosophy behind its design. Furthermore, we provide an overview of how the system has been used during the last two years, and expectations of how the use of PET/MR may continue in the years to come. On the basis of these observations and experiences we discuss the utility of the system, clinical workflow and acquisition times, and possible ways of optimization.     

An efficient birdcage resonator at 2.5 MHz using a novel multilayer self-capacitance construction technique

The birdcage resonator, well appreciated for its high signal-to-noise ratio and its magnetic field uniformity characteristics, operates efficiently in mid- to high-field MRI systems but, unfortunately not for low-field (<0.4 T) applications. The inherently low inductance of the birdcage architecture is the main obstacle to achieving low-frequency resonance because of the need to use very high-value capacitors for the tuning. Small-case-size, high-value ceramic capacitors are known to have high dissipation factors which when used in the fabrication of RF coils could result in poor efficiency. To overcome this limitation, a novel technique known as multilayer self-capacitance (MLSC) construction has been developed and a prototype 2.5-MHz bird-cage resonator of length 25 cm and diameter 20 cm has been built. The technique involves the modification of the leg sections of the conductors constituting the bird cage into integrated capacitors using very low-loss materials as dielectrics. The observed unloaded Q-factor was 267 using the MLSC construction, and when loaded with a 16-cm-diameter bottle of 0.45% saline, its Q dropped to 246, The RF field uniformity plots have demonstrated that the MLSC technique has no adverse effects on the magnetic field homogeneity of the bird-cage resonator.     

A new MRI formulation for flow and motion applications

A rigorous reformulation of the magnetic resonance (MR) image formulation model (IFM) can use the integrally cumulative nature of MRI phase shifts for encoding and of time-of-flight travel corrections for magnitude. This approach characterizes each independent gradient element by its cumulant waveforms,K _N (t), instead of by particular time expansion in gradient moments. The lowest-order cumulant gradient that gives a simple monopolar waveform governs all resulting phase-encoding properties. Each gradient element specifically encodes one and only one motion-order variable. Phase sensitizations to higher order do not exist; they are mathematical psuedophasings. Magnetization isochromats may have arbitrarily complicated velocity history,V(t), appearing in both time-of-flight and motion phase-shift formulas. The subject's intravoxel motion subdistributions each automatically reference the correct mean time of encoding action and its encoding duration. This formulation yields very simple and generalizable IFM expressions for MRI acquired data, with no theoretical confusion regarding higher-order phase shifts and nonphased time-of-flight effects.     

Segmentation of human brain using structural MRI

Segmentation of human brain using structural MRI is a key step of processing in imaging neuroscience. The methods have undergone a rapid development in the past two decades and are now widely available. This non-technical review aims at providing an overview and basic understanding of the most common software. Starting with the basis of structural MRI contrast in brain and imaging protocols, the concepts of voxel-based and surface-based segmentation are discussed. Special emphasis is given to the typical contrast features and morphological constraints of cortical and sub-cortical grey matter. In addition to the use for voxel-based morphometry, basic applications in quantitative MRI, cortical thickness estimations, and atrophy measurements as well as assignment of cortical regions and deep brain nuclei are briefly discussed. Finally, some fields for clinical applications are given.     

磁共振成像仪通信及脉冲生成模块的设计

针对小型化核磁共振成像仪主控板的功能需要提出新的设计方式,采用 FPGA开发板作为主控板,以Nios II嵌入式软核作为协处理器,通过在其上移植μC／OS‐Ⅱ操作系统及 lw IP协议栈,实现与计算机的网络通信;使用Verilog硬件描述语言编写脉冲序列生成模块,实现对指令的解析以及执行,形成用户要求的脉冲序列。最终测试结果表明,主控板的通信速率以及通过示波器采集得到的脉冲序列均满足成像仪系统要求。而且这种软硬结合的设计方式与以往全软件的设计相比,使成像仪精度更高,性能更加稳定。     

Biomarkers of atherosclerosis and the potential of MRI for the diagnosis of vulnerable plaque

Atherosclerosis is a chronic inflammatory vascular disease. As it is an inflammation process, many cellular and molecular events are involved at each step of the progression of atherosclerosis from an early fatty streak lesion to a highly dangerous rupture-prone plaque. Magnetic resonance imaging (MRI) is a well-established diagnostic tool for many kinds of chronic inflammation in various systems and organs, and recent improvements in spatial resolution and contrast strategies make it a promising technique for the characterization of inflammatory vessel walls. The first part of this review will briefly introduce the main cellular and molecular processes involved in atherosclerotic lesions; the second part will focus on the use of high-resolution MRI and present-generation contrast agents for plaque characterization; and the third part will present some recent and ongoing cellular and molecular MRI studies of atherosclerosis.     

Artefacts in magnetic resonance imaging caused by dental material

A common problem in computer tomography (CT) based imaging of the oral cavity is artefacts caused by dental restorations. The aim of this study was to investigate whether magnetic resonance imaging (MRI) of the oral cavity would be less affected than CT by artefacts caused by typical dental restorative alloys. In order to assess the extent of artefact generation, corresponding MRI scans of the same anatomic region with and without dental metal restorations were matched using a stereotactic frame. MRI imaging of the oral and maxillofacial region could be performed without reduction of the image quality by metallic dental restorations made from titanium, gold or amalgam. Dental restorations made from titanium, gold or amalgam did not reduce the image quality of the MRI sequence used in imaging of the oral and maxillofacial region for dental implant planning. In this respect MRI is superior to CT in implant planning.