Trends in personalizing MR and seeing the impact

Leadership Matters Article 4 Minute Read GE Healthcare Global

Comfort plays a big part in an individual’s ability to sit still. On an airplane where one has little legroom or personal space, people fidget and try to find a comfortable position to sit in. Similarly, if a patient is uncomfortable in the magnetic resonance (MR) exam room, they may be more likely to move around. Many reasons have caused the trends to lend towards patient comfort within healthcare overall as patient satisfaction is more and more important. In the past, we have discussed the progress that has been made in coil technology and decreased noise during the MR scan, but there are many ways that the MR suite may be improved. Manufacturers and researchers in the field of magnetic resonance have started to create software to enable free-breathing and motion-corrected scans, which has the potential to reduce motion artifacts throughout the scan. These innovators have also created software programs that can help to reduce the potential for biopsy, sedation and contrast injection.

The standard magnetic resonance scan

Magnetic resonance imaging (MRI) can produce detailed images of a patient’s anatomy. It is especially helpful for imaging soft tissue structures and organs throughout the body. The magnetic field, which is altered by pulse sequences, creates signals that emanate from the patient’s body. These signals are then picked up by antenna-like coils, which transmit the data to the computer to be processed. A radiologist then uses the computer to process the images.

MRI scans of certain areas of the body, especially areas like the heart, abdomen or lungs, are impacted by respiratory and cardiac motion. These types of motion can affect scans of different areas of the chest and abdomen. In an attempt to reduce the impact created by respiratory motion, patient’s often have to hold their breath during the scans. This can cause discomfort for patients, particularly those who are having trouble breathing or who are in too much pain to be able to hold their breath that long.

In addition to the discomfort caused by the traditionally necessary breath-holding scans, patients may need to have an intravenous (IV) contrast injected to highlight different regions of interest. These contrasts work similar to temporary dye. They highlight the area that receives the injection, so the radiologist can see greater detail through the images produced in this portion of the scan. MRI contrast is often gadolinium-based and usually has no obvious ill-effects. The United States Food and Drug Administration (FDA) recently released information stating that the dye may remain in the body after imaging, though no side effects due to this were noted in patients with normal kidney function.1 Patients who are pregnant or who have kidney problems may want to talk with their doctor about the possible effects of the gadolinium contrast. In rare cases, gadolinium contrast can cause an allergic reaction.1

Needles may also be needed for sedation in patients who are unable to lie still or who are facing severe anxiety about being in an MR. Traditionally, sedation was common when imaging pediatric patients, because children may struggle to keep still due to the amount of pent up energy they have, the intimidating appearance of the MR scanner and the length of time that the scan may take.

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Addressing motion-correction in magnetic resonance scanning

In recent years, research has led to innovative software techniques that allow for free-breathing scans. These techniques track respiratory movement to gather data at the same point in the respiratory cycle, producing a similar quality image to that created during a breath-hold.2 Some software applications can track the liver and adjust for the motion from respiration to enable free-breathing exams. This elevates the patient experience by alleviating the pain and stress from this portion of the exam.

Another area of MRI that has improved with the advent of motion-correction software may be cardiac MR. Previously, it was difficult to use magnetic resonance to image the heart. This was mainly due to the cardiac motion while the heart was beating. However, new software has altered cardiac imaging by tracking the motion and imaging the heart at the same part of the cardiac cycle.3 The images produced by this method are referred to as “cine”, or in motion, MR. Cine MRI can be used to visualize a number of different cardiac issues.

Enhancing the patient experience with needle-free imaging

Many patients are afraid of or uncomfortable around needles with good reason. Being poked by a sharp metal device can cause quite a bit of pain. Unfortunately, that is often the way to inject imaging contrasts for ultrasound, computed tomography (CT), and MRI. New software techniques may pave the way toward a needle-less MR world.4 These innovative advancements aim to show radiologists blood flow around the anatomy being imaged, reducing the need for gadolinium. Another software development showed a different aspects of diffusion weighted imaging (DWI). Motion-correcting software may also help image patients without sedation, because it adjusts for the motion from patients. Both of these techniques combined with motion-correcting software may significantly reduce the necessity of needles. One radiology imaging business with over 300 centers, RadNet, finds that the needle-free approach increases the comfort of their patients and reduces the time the scan takes.

Innovative and advanced software techniques allow for free-breathing, motion-correction and needle-free exams, which can lead to increased patient comfort. Also, elevating the radiology experience and enabling patients to feel more comfortable during their exams may reduce scan times as it did for RadNet.

For more information about innovative coil technology and silent MR, please read “How does personalizing MR elevate Radiology?”

For more information about free-breathing and motion correction software, please read SIGNA PulseFree-breathing abdominal imaging with Auto Navigator.”

For more information about needle-free MR, please read SIGNA PulseRadNet skyrockets the patient experience.”

References

1. “FDA Drug Safety Communication: FDA warns that gadolinium-based contrast agents (GBCAs) are retained in the body; requires new class warnings.” FDA.gov. 16 May 2018. Web. 16 April 2019. <https://www.fda.gov/Drugs/DrugSafety/ucm589213.htm>.

2. Felix Harden, Dana McEwan and Anthony O. Obietan. “Free-breathing abdominal imaging with Auto Navigator.” SIGNA Pulse. Autumn 2018. Web. 17 April 2019. <http://www.gesignapulse.com/signapulse/autumn_2018/MobilePagedArticle.action?articleId=1444526&app=false#articleId1444526>.

3. “Cine-cardiac motion studies.” MRIQuestions.com. Web. 30 January 2019. <http://mriquestions.com/beating-heart-movies.html>.

4. Lawrence Tanenbaum and Donna Mushinsky. “RadNet skyrockets the patient experience.” SIGNA Pulse. Autumn 2018. Web. 17 April 2019. <http://www.gesignapulse.com/signapulse/autumn_2018/MobilePagedArticle.action?articleId=1444520&app=false#articleId1444520>.