Despite the pandemic still raging around the world, advances in neuroimaging are still being discovered by researchers, engineers, and medical professionals. Neuroradiologists from around the US presented their newest innovations in the virtual RSNA 2020 meeting held just before the end of 2020. Experts presented their clinical and research experience with MRI in a variety of novel applications.
According to Dr. Levi Chazen of Weill Cornell Medicine in New York City, MRI-guided focused ultrasound (MRgFUS) for brain imaging shows some promising breakthroughs for long-standing clinical problems such as essential tremor. There have been a variety of treatment options for this condition since the 1950s, including thalamotomy to stereotactic radiosurgery. However, through the use of MRgFUS, clinicians are able to exablate parts of the brain affected by essential tremor.
The discovery of MRgFUS technology was originally intended for treating uterine fibroids and prostate lesions. But over the past 15 years, a cranial device has been developed that transmits the ultrasound to the patient while he or she is inside the MR scanner. The target of the treatment is the ventral intermediate nucleus (VIM). The procedure was deemed quite effective and has been approved for treatment for essential tremor by the US Food and Drug Administration in 2016.
MRgFUS is expected to be used for future applications, including targeting the internal globus pallidus (GPi) to treat Parkinson’s disease and opening the blood barrier using microbubbles for drug delivery.
High-Field MR Neuroimaging
In the field of neuroimaging, high-field, 7-tesla MRI is also showing promise as siting requirements for this equipment are becoming less stringent since the magnets are actively shielded. While 7-tesla MRI has been used in the research realm for years, it has finally received clearance from both the FDA and European Union for clinical use.
Now, 7-tesla MRI is becoming known for its several advantages and innovations in standard MRI parts, including increased signal-to-noise ratio, higher spatial resolution, and improvements in contrast visibility. It also provides increased sensitivity to magnetic susceptibility, which is especially useful for susceptibility-weighted imaging and functional MRI.
When it comes to diagnosing epilepsy, 7-tesla MRI is particularly helpful for assessing epilepsy because it demonstrates focal cortical dysplasia that can be missed on lower field strengths. It also shows promise for diagnosing mesial temporal sclerosis, another epilepsy-related condition.
Machine Learning Image Reconstruction
Deep learning is one of those innovations being employed by various industries right now. In the field of image reconstruction, deep learning is pushing the boundaries of what neuroradiologists can do. Clinicians can now benefit from improved acquisition speeds, reducing artifacts, and improving echo-planar imaging distortion through the use of ultrafast MRI aided by deep learning.
There are algorithms being developed right now that could reduce scan doses and speed up scans without affecting or reducing the quality of signal-to-noise ratio or contrast-to-noise ratio.
These researchers, clinicians, and imaging experts are pioneering the development of new MRI techniques and upgrades with numerous applications that could improve pre-surgical planning, diagnosis, and treatment. These new applications have the potential to shed new light on previously untapped diagnosis techniques and treatments.
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