RESUMO
Breast-conserving surgery (BCS) is a commonly utilized treatment for early stage breast cancers but has relatively high reexcision rates due to post-surgical identification of positive margins. A fast, specific, sensitive, easy-to-use tool for assessing margins intraoperatively could reduce the need for additional surgeries, and while many techniques have been explored, the clinical need is still unmet. We assess the potential of Magnetic Particle Imaging (MPI) for intraoperative margin assessment in BCS, using a passively or actively tumor-targeted iron oxide agent and two hardware devices: a hand-held Magnetic Particle detector for identifying residual tumor in the breast, and a small-bore MPI scanner for quickly imaging the tumor distribution in the excised specimen. Here, we present both hardware systems and demonstrate proof-of-concept detection and imaging of clinically relevant phantoms.
Assuntos
Neoplasias da Mama , Diagnóstico por Imagem/instrumentação , Campos Magnéticos , Margens de Excisão , Mastectomia Segmentar , Imagens de Fantasmas , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Estudo de Prova de ConceitoRESUMO
A low-field (80 mT), portable MRI scanner has been developed that may address barriers to MRI for people with multiple sclerosis (MS). As a proof of concept study, we imaged two participants with central nervous system demyelinating disease by both a standard 1.5 Tesla MRI and the portable MRI scanner. These images demonstrate the ability to identify a solitary demyelinating lesion in early stage disease and cortical atrophy and chronic white matter changes in late stage disease. In spite of device limitations, including border distortion and lower image quality, the portable device has important implications for addressing barriers to care in people with MS.
Assuntos
Doenças Desmielinizantes , Esclerose Múltipla , Encéfalo/diagnóstico por imagem , Doenças Desmielinizantes/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Esclerose Múltipla/diagnóstico por imagem , NeuroimagemRESUMO
While access to a laboratory MRI system is ideal for teaching MR physics as well as many aspects of signal processing, providing multiple MRI scanners can be prohibitively expensive for educational settings. To address this need, we developed a small, low-cost, open-interface tabletop MRI scanner for academic use. We constructed and tested 20 of these scanners for parallel use by teams of 2-3 students in a teaching laboratory. With simplification and down-scaling to a 1â¯cm FOV, fully-functional scanners were achieved within a budget of $10,000 USD each. The design was successful for teaching MR principles and basic signal processing skills and serves as an accessible testbed for more advanced MR research projects. Customizable GUIs, pulse sequences, and reconstruction code accessible to the students facilitated tailoring the scanner to the needs of laboratory exercise. The scanners have been used by >800 students in 6 different courses and all designs, schematics, sequences, GUIs, and reconstruction code is open-source.
Assuntos
Diagnóstico por Imagem , Imageamento por Ressonância Magnética/instrumentação , Diagnóstico por Imagem/economia , Campos Eletromagnéticos , Desenho de Equipamento , Imageamento por Ressonância Magnética/economia , Imagens de Fantasmas , Pesquisa , Processamento de Sinais Assistido por Computador , Estudantes , EnsinoRESUMO
Research in MRI technology has traditionally expanded diagnostic benefit by developing acquisition techniques and instrumentation to enable MRI scanners to "see more." This typically focuses on improving MRI's sensitivity and spatiotemporal resolution, or expanding its range of biological contrasts and targets. In complement to the clear benefits achieved in this direction, extending the reach of MRI by reducing its cost, siting, and operational burdens also directly benefits healthcare by increasing the number of patients with access to MRI examinations and tilting its cost-benefit equation to allow more frequent and varied use. The introduction of low-cost, and/or truly portable scanners, could also enable new point-of-care and monitoring applications not feasible for today's scanners in centralized settings. While cost and accessibility have always been considered, we have seen tremendous advances in the speed and spatial-temporal capabilities of general-purpose MRI scanners and quantum leaps in patient comfort (such as magnet length and bore diameter), but only modest success in the reduction of cost and siting constraints. The introduction of specialty scanners (eg, extremity, brain-only, or breast-only scanners) have not been commercially successful enough to tilt the balance away from the prevailing model: a general-purpose scanner in a centralized healthcare location. Portable MRI scanners equivalent to their counterparts in ultrasound or even computed tomography have not emerged and MR monitoring devices exist only in research laboratories. Nonetheless, recent advances in hardware and computational technology as well as burgeoning markets for MRI in the developing world has created a resurgence of interest in the topic of low-cost and accessible MRI. This review examines the technical forces and trade-offs that might facilitate a large step forward in the push to "jail-break" MRI from its centralized location in healthcare and allow it to reach larger patient populations and achieve new uses. Level of Evidence: 5 Technical Efficacy Stage: 6 J. Magn. Reson. Imaging 2019. J. Magn. Reson. Imaging 2020;52:686-696.
Assuntos
Meios de Contraste , Imageamento por Ressonância Magnética , Encéfalo , Mama , Humanos , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: The size, cost, and siting requirements of conventional MRI systems limit their availability and preclude usage as monitoring or point-of-care devices. To address this, we developed a lightweight MRI for point-of-care brain imaging over a reduced field of view (FOV). METHODS: The B0 magnet was designed with a genetic algorithm optimizing homogeneity over a 3 × 8 × 8 cm FOV and a built-in gradient for slice selection or readout encoding. An external pair of gradient coils enables phase encoding in the other two directions and a radiofrequency (RF) coil provides excitation and detection. The system was demonstrated with high-resolution 1D "depth profiling" and 3D phantom imaging. RESULTS: The lightweight B0 magnet achieved a 64-mT average field over the imaging region at a materials cost of <$450 USD. The weight of the magnet, gradient, and RF coil was 8.3 kg. Depth profiles were obtained at high resolution (0.89 mm) and multislice rapid acquisition with refocused echoes (RARE) images were obtained with a resolution ~2 mm in-plane and ~6-mm slice thickness, each in an imaging time of 11 min. CONCLUSION: The system demonstrates the feasibility of a lightweight brain MRI system capable of 1D to 3D imaging within a reduced FOV. The proposed system is low-cost and small enough to be used in point-of-care applications.
Assuntos
Imageamento por Ressonância Magnética/instrumentação , Neuroimagem/instrumentação , Sistemas Automatizados de Assistência Junto ao Leito , Desenho de Equipamento , Humanos , Ondas de RádioRESUMO
Permanent magnet arrays offer several attributes attractive for the development of a low-cost portable MRI scanner for brain imaging. They offer the potential for a relatively lightweight, low to mid-field system with no cryogenics, a small fringe field, and no electrical power requirements or heat dissipation needs. The cylindrical Halbach array, however, requires external shimming or mechanical adjustments to produce B0 fields with standard MRI homogeneity levels (e.g., 0.1 ppm over FOV), particularly when constrained or truncated geometries are needed, such as a head-only magnet where the magnet length is constrained by the shoulders. For portable scanners using rotation of the magnet for spatial encoding with generalized projections, the spatial pattern of the field is important since it acts as the encoding field. In either a static or rotating magnet, it will be important to be able to optimize the field pattern of cylindrical Halbach arrays in a way that retains construction simplicity. To achieve this, we present a method for designing an optimized cylindrical Halbach magnet using the genetic algorithm to achieve either homogeneity (for standard MRI applications) or a favorable spatial encoding field pattern (for rotational spatial encoding applications). We compare the chosen designs against a standard, fully populated sparse Halbach design, and evaluate optimized spatial encoding fields using point-spread-function and image simulations. We validate the calculations by comparing to the measured field of a constructed magnet. The experimentally implemented design produced fields in good agreement with the predicted fields, and the genetic algorithm was successful in improving the chosen metrics. For the uniform target field, an order of magnitude homogeneity improvement was achieved compared to the un-optimized, fully populated design. For the rotational encoding design the resolution uniformity is improved by 95% compared to a uniformly populated design.
RESUMO
Magnetic Particle Imaging (MPI) is a rapidly developing imaging modality that directly measures and maps the concentration of injected superparamagnetic iron oxide nanoparticles (SPIOs). Since the agent does not cross the blood-brain barrier, cerebral SPIO concentration provides a direct probe of Cerebral Blood Volume (CBV). Here we provide an initial demonstration of the ability of MPI to detect functional CBV changes (fCBV) by monitoring SPIO concentration during hypercapnic manipulation in a rat model. As a tracer detection method, MPI offers a more direct probe of agent concentration and therefore fCBV than MRI measurements in which the agent is indirectly detected through perturbation of water relaxation time constants such as T2∗. We found that MPI detection could measure CBV changes during hypercapnia with high CNR (CNRâ¯=â¯50) and potentially with high temporal resolution. Although the detection process more closely resembles a tracer method, we also identify evidence of physiological noise in the MPI time-series, with higher time-series variance at higher concentration levels. Our findings suggest that CBV-based MPI can provide a detection modality for hemodynamic changes. Further investigation with tomographic imaging is needed to assess tomographic ability of the method and further study the presence of time-series fluctuations which scale with signal level similar to physiological noise in resting fMRI time-courses.
Assuntos
Determinação do Volume Sanguíneo/métodos , Encéfalo/irrigação sanguínea , Volume Sanguíneo Cerebral , Óxido Ferroso-Férrico/farmacocinética , Neuroimagem/métodos , Animais , Determinação do Volume Sanguíneo/instrumentação , Hipercapnia/fisiopatologia , Ratos , Ratos Sprague-DawleyRESUMO
PURPOSE: As the premiere modality for brain imaging, MRI could find wider applicability if lightweight, portable systems were available for siting in unconventional locations such as intensive care units, physician offices, surgical suites, ambulances, emergency rooms, sports facilities, or rural healthcare sites. METHODS: We construct and validate a truly portable (<100 kg) and silent proof-of-concept MRI scanner which replaces conventional gradient encoding with a rotating lightweight cryogen-free, low-field magnet. When rotated about the object, the inhomogeneous field pattern is used as a rotating spatial encoding magnetic field (rSEM) to create generalized projections which encode the iteratively reconstructed two-dimensional (2D) image. Multiple receive channels are used to disambiguate the nonbijective encoding field. RESULTS: The system is validated with experimental images of 2D test phantoms. Similar to other nonlinear field encoding schemes, the spatial resolution is position dependent with blurring in the center, but is shown to be likely sufficient for many medical applications. CONCLUSION: The presented MRI scanner demonstrates the potential for portability by simultaneously relaxing the magnet homogeneity criteria and eliminating the gradient coil. This new architecture and encoding scheme shows convincing proof of concept images that are expected to be further improved with refinement of the calibration and methodology.