Synopsis

This talk will summarize several diagnostic applications of RT-MRI. Within cardiac imaging, I will show examples of left ventricular function, valvular flow, shortening exam time, and the very common setting of arrhythmia. Within joint motion imaging, I will show examples assessing instability in the wrist joint and temporomandibular joint. In the upper airway, I will show examples assessing airway anatomy and function during speech production and sleep-disordered breathing. Finally, I will provide some reflections on the opportunities and barriers for increased adoption of diagnostic RT-MRI.

Highlights

• Real-time MRI provides diagnostic value when it captures the physiology (requiring adequate spatio-temporal resolution and contrast)
• Real-time MRI provides additional value when it provides the ability to interact (requiring low-latency reconstruction)
• RT-MRI has made an impact on assessment of cardiac function, joint motion, and the upper airway.

Body

What does “real-time imaging” mean? is what we use when videoconferencing with our colleagues, family, and friends. It is what we use when we watch live television. It is provided by several existing diagnostic modalities including X-ray fluoroscopy, Ultrasound, Electromagnetic Articulography, and optical imaging, which are widely available and are used thousands of time every day. Real-time imaging provides diagnostic value when it captures the content of interest (requiring spatiotemporal resolution and contrast), and when it provides the ability to interact (requiring low-latency reconstruction).

These have historically been a limitation for MRI due to the slow encoding process, need to wait for relaxation/recovery, and time-consuming reconstruction. For the past 30-years, technology (covered by the previous speaker) has been developed and translated to provide continuous improvements to RT-MRI.

This talk will summarize several diagnostic applications of RT-MRI. Within cardiac imaging, I will show examples of left ventricular function, valvular flow, shortening exam time, and the very common setting of arrhythmia. Within joint motion imaging, I will show examples assessing joint instability in the wrist and temporomandibular joint. In the upper airway, I will show examples assessing airway anatomy and function during speech production and sleep-disordered breathing.

Finally, I will provide some reflections on the opportunities and barriers for increased adoption of diagnostic RT-MRI.

Acknowledgements

References

[1] P Mansfield Real-time EPI by NMR, Br Med Bull 40(2):187-190, 1984

[2] SJ Riederer et al. MR Fluoroscopy: Technical Feasibility, Magn Reson Med 8(1):1-15. 1988

[3] AB Kerr et al. RT-MRI on a Conventional Scanner, Magn Reson Med 38(3):355-367. 1997

[4] M Uecker et al. RT-MRI at a Resolution of 20ms, NMR Biomed 23:986-994. 2010