Analysis and predictability of technologists' perception of MR exam complexity.

INTRODUCTION: As MRI becomes a routine clinical diagnostic method, its complexity of techniques, protocols and scanning is growing. On the other hand, aggravated by the ubiquitous shortage of workforce, technologists' stress level and burnout rates are increasing. In this context, our study aims to shed light on technologists' perceived complexity of MR exams, by analyzing a multidimensional dataset composed of workflow, patient, and operational details, and further predicting perceived exam complexity. METHODS: In this IRB-approved study, data about imaging workflow, exam context, and patient characteristics were collected over one year from MR modality logfiles and from technologist questionnaires, including the perceived exam complexity. The association of individual factors with complexity was analyzed via Fisher's exact tests and Cramér's V values. Predictability of exam complexity was further evaluated via ROC analysis of three different multivariate classifiers. RESULTS: Retakes, delays, and extended exam duration are associated with perceived complexity (V ≥ 0.2). From the set of possible predictors, patient mobility and communication ability have the most influence on perceived complexity (V > 0.2), followed by special equipment needs (pulse oximetry, intubation, or ECG), protocol details and other patient characteristics. Feasibility of predicting the perceived exam complexity from a multivariate set of exam and patient details known at the time of scheduling has been demonstrated (AUC = 0.73), and suitable classification algorithms have been identified. CONCLUSION: Perceived exam complexity is associated with various factors. Our results suggest that it can be predicted sufficiently well to support early operational decision making. Some factors, however, may not be readily available in hospital IT systems and must be obtained before scheduling. IMPLICATIONS FOR PRACTICE: Results and observations of this study could be utilized to assist operational scheduling in the radiology department and reduce MR technologists' stress levels.

First experimental evidence of the feasibility of multi-color magnetic particle imaging.

Magnetic particle imaging is a new approach to visualizing magnetic nanoparticles. It is capable of 3D real-time in vivo imaging of particles injected into the blood stream and is a candidate for medical imaging applications. To date, only one particle type has been imaged at a time, however, the ability to separate signals acquired simultaneously from different particle types or from particles in different environments would substantially increase the scope of the method. Different colors could be assigned to different signal sources to allow for visualization in a single image. Successful signal separation has been reported in spectroscopic experiments, but it was unclear how well separation would work in conjunction with spatial encoding in an imaging experiment. This work presents experimental evidence of the separability of signals from different particle types and aggregation states (fluid versus powder) using a 'multi-color' reconstruction approach. Several mechanisms are discussed that may form the basis for successful signal separation.

Nanoparticle encapsulation in red blood cells enables blood-pool magnetic particle imaging hours after injection.

Magnetic particle imaging (MPI) is a new medical imaging approach that is based on the nonlinear magnetization response of super-paramagnetic iron oxide nanoparticles (SPIOs) injected into the blood stream. To date, real-time MPI of the bolus passage of an approved MRI SPIO contrast agent injected into the tail vein of living mice has been demonstrated. However, nanoparticles are rapidly removed from the blood stream by the mononuclear phagocyte system. Therefore, imaging applications for long-term monitoring require the repeated administration of bolus injections, which complicates quantitative comparisons due to the temporal variations in concentration. Encapsulation of SPIOs into red blood cells (RBCs) has been suggested to increase the blood circulation time of nanoparticles. This work presents first evidence that SPIO-loaded RBCs can be imaged in the blood pool of mice several hours after injection using MPI. This finding is supported by magnetic particle spectroscopy performed to quantify the iron concentration in blood samples extracted from the mice 3 and 24 h after injection of SPIO-loaded RBCs. Based on these results, new MPI applications can be envisioned, such as permanent 3D real-time visualization of the vessel tree during interventional procedures, bleeding monitoring after stroke, or long-term monitoring and treatment control of cardiovascular diseases.

Fast reconstruction in magnetic particle imaging.

Magnetic particle imaging (MPI) is a new tomographic imaging method which is able to capture the fast dynamic behavior of magnetic tracer material. From measured induced signals, the unknown magnetic particle concentration is reconstructed using a previously determined system function, which describes the relation between particle position and signal response. After discretization, the system function is represented by a matrix, whose size can prohibit the use of direct solvers for matrix inversion to reconstruct the image. In this paper, we present a new reconstruction approach, which combines efficient compression techniques and iterative reconstruction solvers. The data compression is based on orthogonal transforms, which extract the most relevant information from the system function matrix by thresholding, such that any iterative solver is strongly accelerated. The effect of the compression with respect to memory requirements, computational complexity and image quality is investigated. With the proposed method, it is possible to achieve real-time reconstruction with almost no loss in image quality using measured 4D MPI data.

[Magnetic particle imaging (MPI)]. / Magnetic Particle Imaging (MPI).

Magnetic particle imaging (MPI) displays the spatial distribution and concentration of superparamagnetic iron oxides (SPIOs). It is a quantitative, tomographic imaging method with high temporal and spatial resolution and allows work with high sensitivity yet without ionizing radiation. Thus, it may be a very promising tool for medical imaging. In this review, we describe the physical and technical basics and various concepts for clinical scanners. Furthermore, clinical applications such as cardiovascular imaging, interventional procedures, imaging and therapy of malignancies as well as molecular imaging are presented.

Human erythrocytes as nanoparticle carriers for magnetic particle imaging.

The potential of red blood cells (RBCs) loaded with iron oxide nanoparticles as a tracer material for magnetic particle imaging (MPI) has been investigated. MPI is an emerging, quantitative medical imaging modality which holds promise in terms of sensitivity in combination with spatial and temporal resolution. Steady-state and dynamic magnetization measurements, supported by semi-empirical modeling, were employed to analyze the MPI signal generation using RBCs as novel biomimetic constructs. Since the superparamagnetic iron oxide (SPIO) bulk material that is used in this study contains nanoparticles with different sizes, it is suggested that during the RBC loading procedure, a preferential entrapment of nanoparticles with hydrodynamic diameter ≤60 nm occurs by size-selection through the erythrocyte membrane pores. This affects the MPI signal of an erythrocyte-based tracer, compared to bulk. The reduced signal is counterbalanced by a higher in vivo stability of the SPIO-loaded RBCs constructs for MPI applications.

Weighted iterative reconstruction for magnetic particle imaging.

Magnetic particle imaging (MPI) is a new imaging technique capable of imaging the distribution of superparamagnetic particles at high spatial and temporal resolution. For the reconstruction of the particle distribution, a system of linear equations has to be solved. The mathematical solution to this linear system can be obtained using a least-squares approach. In this paper, it is shown that the quality of the least-squares solution can be improved by incorporating a weighting matrix using the reciprocal of the matrix-row energy as weights. A further benefit of this weighting is that iterative algorithms, such as the conjugate gradient method, converge rapidly yielding the same image quality as obtained by singular value decomposition in only a few iterations. Thus, the weighting strategy in combination with the conjugate gradient method improves the image quality and substantially shortens the reconstruction time. The performance of weighting strategy and reconstruction algorithms is assessed with experimental data of a 2D MPI scanner.

Three-dimensional real-time in vivo magnetic particle imaging.

Magnetic particle imaging (MPI) is a new tomographic imaging method potentially capable of rapid 3D dynamic imaging of magnetic tracer materials. Until now, only dynamic 2D phantom experiments with high tracer concentrations have been demonstrated. In this letter, first in vivo 3D real-time MPI scans are presented revealing details of a beating mouse heart using a clinically approved concentration of a commercially available MRI contrast agent. A temporal resolution of 21.5 ms is achieved at a 3D field of view of 20.4 x 12 x 16.8 mm(3) with a spatial resolution sufficient to resolve all heart chambers. With these abilities, MPI has taken a huge step toward medical application.

Trajectory analysis for magnetic particle imaging.

Recently a new imaging technique called magnetic particle imaging was proposed. The method uses the nonlinear response of magnetic nanoparticles when a time varying magnetic field is applied. Spatial encoding is achieved by moving a field-free point through an object of interest while the field strength in the vicinity of the point is high. A resolution in the submillimeter range is provided even for fast data acquisition sequences. In this paper, a simulation study is performed on different trajectories moving the field-free point through the field of view. The purpose is to provide mandatory information for the design of a magnetic particle imaging scanner. Trajectories are compared with respect to density, speed and image quality when applied in data acquisition. Since simulation of the involved physics is a time demanding task, moreover, an efficient implementation is presented utilizing caching techniques.

Experimental results on fast 2D-encoded magnetic particle imaging.

This paper presents the first experimental results on magnetic particle imaging with full 2D encoding. The encoding speed achieved was 3.88 ms for a field of view of 1x1 cm2. Small phantoms composed of several dots each filled with 200 nl undiluted Resovist (500 mmol(Fe) l(-1)) were scanned. A resolution of better than 1 mm was achieved for a frame rate of 25 frames s(-1).

A simulation study on the resolution and sensitivity of magnetic particle imaging.

This paper presents the first detailed simulation approach to evaluate the proposed imaging method called 'magnetic particle imaging' with respect to resolution and sensitivity. The simulated scanner is large enough to accept human bodies. Together with the choice of field strength and noise the setup is representative for clinical applications. Good resolution, fast image acquisition and high sensitivity are demonstrated for various tracer concentrations, acquisition times, tracer properties and fields of view. Scaling laws for the simple prediction of image quality under the variation of these parameters are derived.