Wednesday, 29 July 2015

Have a more powerful tool and you see more

Dula AN, Pawate S, Dortch RD, Barry RL, George-Durrett KM, Lyttle BD, Dethrage LM, Gore JC, Smith SA. Magnetic resonance imaging of the cervical spinal cord in multiple sclerosis at 7T. Mult Scler. 2015. pii: 1352458515591070. [Epub ahead of print]

BACKGROUND: The clinical course of multiple sclerosis (MS) is mainly attributable to cervical and upper thoracic spinal cord dysfunction. High-resolution, 7T anatomical imaging of the cervical spinal cord is presented. Image contrast between gray/white matter and lesions surpasses conventional, clinical T1- and T2-weighted sequences at lower field strengths.
OBJECTIVE: To study the spinal cord of healthy controls and patients with MS using magnetic resonance imaging at 7T.
METHODS: Axial (C2-C5) T1- and T2*-weighted and sagittal T2* were acquired at 7T in 13 healthy volunteers (age 22-40 years), and 15 clinically diagnosed MS patients (age 19-53 years, Extended Disability Status Scale, (EDSS) 0-3) in addition to clinical 3T scans. Evaluation included signal and contrast to noise ratios and lesion counts for healthy and patient volunteers, respectively.
RESULTS/CONCLUSION: High-resolution images at 7T exceeded resolutions reported at lower field strengths. Gray and white matter were sharply demarcated and MS lesions were more readily visualized at 7T compared to clinical acquisitions, with lesions apparent at both fields. Nerve roots were clearly visualized. White matter lesion counts averaged 4.7 vs 3.1 (52% increase) per patient at 7T vs 3T, respectively


So all imagers will be saying "please, please, please, can we have a 7T scanner" so they can repeat the studies at 1.5T and 3T. If you have a more powerful tool is is obvious that you can see more. This study shows that  more lesions were seen...how does this compare to the gold standard, which is post-mortem histology, because the question is how much does MRI miss. 

If we are thinking of NEDA-4 and measuring atrophy it is much more precise with 7T than the blurred lines given by 3T. 

2 comments:

  1. MD, talking about MRI, have you read this one?
    "FDA Drug Safety Communication: FDA evaluating the risk of brain deposits with repeated use of gadolinium-based contrast agents for magnetic resonance imaging (MRI)"

    link:
    http://www.fda.gov/Drugs/DrugSafety/ucm455386.htm

    ReplyDelete
    Replies
    1. Radioactivity was considered safe when it was first used also but thats for the post but as it says inthe end sentence say there is no evidence of risk. This is what the study aims to find out

      Delete

Please note that all comments are moderated and any personal or marketing-related submissions will not be shown.