Tijl van der Velden1, Erwin Krikken1, Catalina Arteaga1, Fredy Visser2, and Dennis Klomp1
1Radiology, University Medical Center Utrecht, Utrecht, Netherlands, 2Philips Healthcare, Best, Netherlands
Synopsis
While
substantial acceleration in MRI acquisitions have been demonstrated in the last
decades (particularly at high fields where SNR is not limited), substantial
patient and scan preparation time have been reported that seem to prohibit high
patient throughput for clinical MRI. In this study we demonstrate that robust
head MRI can be obtained at a throughput of more than 13 subjects per hour,
including patient management and scan preparations (even faster than typical
X-ray exams). Increased throughput may be an alternative way to “killer
applications” in making high field MRI economically viable.
Introduction
The
availability of MR scanners has grown enormously over the last decade.
Nevertheless, MR examinations remain expensive and take a relatively long time (20-30
minutes) when compared to other imaging modalities such as X-rays, ultrasound or
computed tomography. However, as MRI has a superior soft tissue contrast compared
to many imaging modalities, resulting in accurate diagnostic information, and does
not involve ionizing radiation, particularly important when pediatric patients
are to be scanned1 reducing acquisition times, and therefore
costs, can improve utilization of MRI. The need to improve utilization applies
even more so when high end MRI systems are being used (like 7T), where the cost
can be more than tripled compared to standard MRI systems, and its use may be
more complex. As 7T MRI systems have been CE and FDA approved, the economic
viability becomes an important aspect for clinical use, particularly for the
diagnostic exams that do not meet with the 7T specific “killer application”. The
purpose of this study was to explore the potential patient throughput in a 7T
scanner for full 3D brain MRI.Methods
26
volunteers were scanned at a 7 tesla MR scanner (Philips, Cleveland, USA) in supine
position. A head coil (NOVA medical, USA) with two transceiver channels was interfaced
to two 4kW RF amplifiers. The same protocol was used for all volunteers and
consisted on a 3D gradient echo, TE/TR=0.95/6
ms, FOV=250x250x250 or 275x275x250 mm3, resolution=1.5x1.5x0.75 mm3, 2m09
or 2m22 acquisition time. For visualization purposes, 3D renders were created. A
large field of view was chosen to avoid the necessity of planning.Results
26 volunteers
were successfully scanned consecutively in 2 hours and 3 minutes, leading to a
mean scan time of 4m44 per person, including going in and out the scanner room.
Figure 1 shows the volume rendering of the acquired images for all volunteers, demonstrating
full 3D coverage of the brain. From one subject a sagittal, transverse and coronal
view is shown (Figure 2). Figure 3 plots the distribution of the overall scan session
times. Half of all sessions took between 4m20 and 5m00. None of the volunteers
complained on the table speed used to bring the subject in or out of the
isocenter of the MRI.Discussion
The
results demonstrate that 26 subjects can get a 3D MRI of the brain at 7T within
two hours, or a throughput of 4 minutes and 44 seconds per person. Considering
an effective acquisition time of over 2 minutes, the subject handling and scan
preparation can be obtained in just over 2 minutes. While our study
incorporated only a single 3D scan, full clinical exams incorporate acquisitions
with multiple contrasts, increasing scan time. However, highly accelerated scans
have been demonstrated before using high density receiver arrays2 using SENSE3 and Caipirinha4. Further optimized acquisition schemes can
even acquire multi-contrast images in around 1 minute1. Consequently when combined with under 3
minutes of preparation time, patient throughput for clinical MRI at 7T may be
increased such that it becomes economically even more viable than traditional
MRI.Conclusion
7T MRI can be obtained with high throughput of 13 subjects per
hour for brain MRI.Acknowledgements
No acknowledgement found.References
1. Skare, S., Sprenger, T., Norbeck, O., Rydén, H., Blomberg, L., Avventi,
E. and Engström, M. (2017), A 1-minute full brain MR exam using a
multicontrast EPI sequence. Magn. Reson. Med.. doi:10.1002/mrm.26974
2. Petridou, N.,
Italiaander, M., van de Bank, B. L., Siero, J. C. W., Luijten, P. R. and
Klomp, D. W. J. (2013), Pushing the limits of high-resolution
functional MRI using a simple high-density multi-element coil design.
NMR Biomed., 26: 65–73. doi:10.1002/nbm.2820
3. Pruessmann, K. P., Weiger, M., Scheidegger, M. B. and Boesiger, P.
(1999), SENSE: Sensitivity encoding for fast MRI. Magn. Reson. Med., 42:
952–962.
doi:10.1002/(SICI)1522-2594(199911)42:5<952::AID-MRM16>3.0.CO;2-S
4. Breuer, F. A., Blaimer,
M., Mueller, M. F., Seiberlich, N., Heidemann, R. M., Griswold, M. A.
and Jakob, P. M. (2006), Controlled aliasing in volumetric parallel
imaging (2D CAIPIRINHA). Magn. Reson. Med., 55: 549–556.
doi:10.1002/mrm.20787