Faster MRI?

May 15, 2012

 

Researchers from the Children’s National Medical Center in Washington, D.C (principal researcher: Stanley Fricke) have recently published a study in Medical Physics where they show that ultra-fast magnetic gradients (pulse sequences with rise times 100 times faster than conventional MRI) do not produce nerve stimulation or muscle twitching. According to the researchers, MRI limiting speed should be revisited taking into account the new developments, and they expect MRI to allow imaging of small children in seconds rather than minutes.

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I wrote in my previous post about smart phones and how they are getting more and more common among Radiologists. Well, tablets are not far behind. Actually, the new iPad’s Retina display, which has raised the tablet’s resolution to the level of a 3-megapixel PACS monitor, is generating a lot of expectation, especially for reading Digital Radiography images. The new iPad offers 2,048 x 1,536-pixel resolution at 264 pixels per inch, up from the iPad 2’s 1,024 x 768-pixel resolution at 132 pixels per inch. This, together with the easy-to-handle features, such as zoom and scroll, make this device very suitable for checking images on the fly.

However, this increased resolution is only beneficial when the images also have a high resolution. This is not the case for tomographic images such as CT, MRI, SPECT or ultrasound, which have a much lower resolution. Nonetheless, the portability of the device, together with the new speed capabilities (e.g. the new iPad utilizes the A5X chip, with quad-core graphics processing capability), make the tablet a very attractive tool for Radiologists.

Last February, a group of Canadian researchers presented at the American Academy of Orthopeadic Surgeons (AAOS) a new study about the interpretation of MR images on the iphone.

Smartphones are becoming part of every activity of our lives, and this is also true for physicians and hospitals. The advantage is that they are portable and most of the time on the pocket or handbag, but the question is whether they are good enough for a medical diagnosis.

According to Dr. John Theodoropoulos, an orthopedic surgeon from the University of Toronto, “iPhone interpretations showed high sensitivity and specificity for medial meniscus and cruciate ligaments injuries with lower sensitivity for lateral meniscus tears and lower specificity for cartilage injuries.  And compared to much larger the PACS workstation interpretation on a flat screen, the iPhone showed excellent agreement for medial meniscus and cruciate ligament injuries and good agreement for cartilage injuries”. However, Dr. Theodoropoulos said that the iPhone app missed two cartilage tears versus the full-sized workstation.

Maybe we are not there yet, but the smartphones and tablets certainly look promising for medical image interpretation and have many features that make them very attractive, specially for emergency cases.

More info

 

Cloud-based services

February 23, 2012

Each day we are hearing more and more about cloud services. However, a critical issue comes to mind: data security.

Some are comparing this reaction to the first reactions to Internet banking, consumers being afraid of fraud, identity theft and so on. As Internet banking, cloud-based services are a reality nowadays. However, you must choose your provider wisely. Suppliers must have the optimal technologies to ensure patient data is protected at all levels.

For more information,  Carestream has created a white paper about cloud-based services.

The use of mobile medical apps on tablets and smartphones is becoming more and more common in healthcare. Therefore the U.S. Food and Drug Administration (FDA) has included medical imaging applications in a new draft guidance document. It is not yet final. Comments and suggestions may be submitted to the FDA until October.

Microsoft Research has come up with a virtual tool for physiotherapy. The idea behind it is to motivate people recovering from injuries to do their exercises. AnatOnMe is a device that projects images of the bones muscles and ligaments inside the body onto the patient’s own skin. This is a novel implementation of augmented reality as the augmented world is projected on the patient. An image of the underlying bone structure, muscle tissue, tendons, or nerves is projected onto the skin, giving patients a better understanding of the injury, and of what they need to do to help the healing process.
The device consists of two parts: the first one contains a projector, an ordinary digital camera, and an infrared camera. The second contains a laser pointer and the control buttons. The system is not meant to be very accurate, and the image of the internal injury is not precisely map onto the patient’s exterior, the therapist simply points the projector and lines it up by eye. The images displayed are not actually taken from scans of the patients but come from stock graphical images used to show one of six different types of injury. However, it works pretty well to educate patients and help them better understand their injuries.

Open or Wide Bore MR?

May 25, 2011

That’s the question researchers from Germany try to answer in the CLAUSTRO trial (start Feb 2011). According to the authors: “The goal is to analyze the rate of claustrophobic reactions and clinical utility of an open MR scanner in a randomized comparison with a recently designed short-bore but closed scanner with 97% noise reduction. This trial will be the first to appraise the potential for claustrophobia reduction and clinical relevance of open MR scanners in claustrophobic patients with a clinical indication for MR imaging. Furthermore, this trial will analyze and compare the cost-effectiveness of the two MR scanners, which is important in view of the enormous annual loss of healthcare productivity due to claustrophobia during MR imaging. Also, patient preferences and image quality will be analyzed. Thus, this randomized trial may have the potential to influence both the clinical and economical utilization of MR imaging.”
This is a very interesting trial that will yield a comparison between the two systems from a patient point of view, which is very important. The success of a good MR scan depends a lot on how comfortable the patient feels, given the fact that he/she has to lie still for quite some time.
For more information, please refer to: Reduction of claustrophobia during magnetic resonance imaging: methods and design of the “CLAUSTRO” randomized controlled trial