Joe Joslin

ALT To have an appreciation for what it means to achieve better than 1 mm spatial accuracy or to produce an image with 100 micron resolution, you also have to have a realistic appreciation for what can go wrong. In his article, Dr. Kirsch points out that - when it comes to the magnetic fields - there are many things that can occur to cause these fields to distort. However, the MRI scanner is no longer just a diagnostic device that produces images, but in the age of precision medicine it is a quantitative measurement system of biomarkers. MRI is now expected to be perfect in every way. Read the article for a brief look at just how perfect, or not-so-perfect, it is

ALT One of the most frequently performed MR examinations at imaging centers specializing in orthopedic imaging, is MRI of the hip. The relatively thin cartilage of the hip requires superior in-plane and through-plane (slice) resolution to maintain diagnostic accuracy, which results in longer scan times. Given the large number of these studies, the option for a more efficient hip MRI protocol would not only improve patient care at the individual level, but would also contribute to overall increased scanning capacity. In this article the authors outline a 3T protocol with deep learning-based image reconstruction, reduced echo spacing, and reduced specific absorption rate (SAR) with optimization of radiofrequency (RF) pulses to enable a hip MRI protocol that requires no more than 15 minutes of scan time but still maintains spatial resolution and signal-to noise ratio (SNR) on par with standard-of-care studies

ALT Recent technical advancements like PCASL, background signal suppression, and 3D readouts have greatly improved ASL’s SNR and image quality, making clinical scan times feasible for ASL at a spatial resolution of 3–4 mm isotropic. However, smaller voxel sizes may be needed in certain neurological applications, such as epilepsy or brain tumor evaluation, and are even more relevant in pediatric imaging. Deep learning techniques can further enhance image resolution and reduce scan times to under five minutes. The case studies presented in this article demonstrate the feasibility of high-resolution ASL perfusion imaging and its diagnostic efficacy to identify areas of abnormal perfusion activity. For instance, in epilepsy, ASL can detect hyper- and hypo-perfused areas linked to epileptogenic foci, aiding in the precise localization of seizure activity. In brain tumors, it offers critical insights into tumor grading, particularly useful in postoperative assessments.

ALT With the advent of deep learning-based image reconstruction (Deep Resolve Boost), the conventional way of optimizing turbo spin-echo image quality has changed and there are new ways to utilize existing parameters. Tricia explores some key parameters, including iPAT factor, PAT reference scan mode, and denoising options.

ALT One of the biggest challenges in pediatric MRI is managing motion artifacts. Sedation or anesthesia is frequently used, to minimize the motion artifacts. However, these approaches carry increased medical risks and additional costs. Motion correction techniques offer a promising solution, however, no single method has yet gained widespread clinical acceptance due to the stringent requirements for robustness, reliability, and seamless integration into clinical workflows. Data-driven retrospective motion correction offers a promising solution to these challenges. It derives the motion trajectory information from the acquired k-space data of the imaging sequence and produces the motion-corrected images without the need for additional tracking hardware or disruptive sequence modifications. Moreover, a significant advantage over prospective techniques is that radiologists can directly compare the motion-modeled reconstruction with the original, non-corrected images.

ALT QSM is an imaging technique that quantifies tissue magnetic susceptibility, aiding in the assessment of neurological conditions like iron deposition, hemorrhage, and myelin integrity. Recent advancements, such as automated QSM processing on 3T MAGNETOM Vida scanners, have made it more accessible for routine clinical use. This paper highlights the clinical utility of QSM using case studies that show - detecting chronic active lesions in multiple sclerosis - assessing venous stasis in stroke - distinguishing between microbleeds and microcalcifications, and - identifying microcalcifications in brain tumors. These examples demonstrate the robust ability of QSM to provide precise diagnostic information, making it a valuable tool that complements traditional imaging techniques and enhances diagnostic accuracy in neuroradiology.

ALT Simply ensure the coil is positioned correctly over the heart, and you're ready to go! The Beat Sensor is integrated into the BioMatrix Body 12 coil, eliminating the need for ECG electrodes and dramatically simplifying and speeding up patient preparation. Want to learn more? Explore the BioMatrix Beat Sensor from different expert perspectives: • The technologist’s view, by Bianca Samsula (ZEMODI, Zentrum für moderne Diagnostik, Bremen, Germany); • Clinical experience with arrhythmic patients, by Naokazu Mizuno, et al. (Sakakibara Heart Institute, Tokyo, Japan); • The cardiologist’s perspective on cardiac triggering, by Christina Karamarkou, MD, et al. (Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen, Germany); • The engineering behind the technology, by Peter Speier, PhD, et al. (Siemens Healthineers).

ALT This article first highlights fat suppression in the ‘joint mode’ for small fields of view (FOV) and spectral attenuated inversion recovery (SPAIR) in the ‘thorax’ or ‘abdomen/pelvis’ modes for large FOV. These modes have been chosen because their improved frequency profiles and offsets better compensate for non-uniform water-fat patterns. Then, the authors present examples of the two-point TSE-Dixon method linked with a seed-growing analysis.

ALT The battle against Alzheimer's disease (AD) has been long and challenging. However, in recent years, novel Disease Modifying Therapies (DMTs) using monoclonal antibodies (mAbs) have been developed. While promising, these DMTs require careful monitoring of patients against adverse effects once the treatment begins. On brain MRI, these adverse effects present as Amyloid Related Imaging Abnormalities (ARIA) with vasogenic edema and/or sulcal effusion (ARIA-E) and/or microhemorrhages or superficial siderosis (ARIA-H). Standardized, appropriate protocols for dementia therapeutic imaging are important. The American Society for Neuroradiology (ASNR) has partnered with equipment manufacturers to present optimized AD therapeutic imaging protocols. Washington University School of Medicine shares their imaging protocols for 1.5T and 3T MAGNETOM systems.

ALT Radiology is facing an impending shortage of qualified medical staff. Radiographers in particular are very rare. This leads to overloading of remaining staff. Since 2018, medneo has been using remote support to minimize these burdens and to train radiographers on-site. Nevertheless, more than 8% of all examinations had to be cancelled or postponed in 2022 due to a lack of staff. To avoid carrying this loss into 2023, medneo transitioned its remote support to remote scanning. This article evaluates remote scanning in terms of its benefits, impact, challenges, and outlook, based on medneo’s experience in 2023. The authors show how remote scanning has reduced examination cancellations due to staff shortages and that there is great potential for streamlining the workload of on-site staff.

ALT Traditional breast MRI protocols are comprehensive and time-consuming, typically involving multiple post-contrast images and additional T2-weighted imaging. The short first-pass MRI, which takes only 4 to 5 minutes, is based on the early, strong contrast uptake seen in breast cancer due to tumor neoangiogenesis. Since most malignancies can be detected within the first three minutes post-contrast, later images often only serve to characterize lesions rather than detect them. The streamlined protocol can effectively identify breast cancer early in women, including those with dense breast tissue, where the sensitivity of mammography is lower. It offers a significant reduction in time and cost, potentially allowing more frequent screenings and a higher examination rate.