Low-field Magnetic Resonance Imaging Research Articles

Feasibility and efficacy of low-field magnetic resonance imaging in critically unwell children: A developing country experience

Feasibility and efficacy of low-field magnetic resonance imaging in critically unwell children: A developing country experience

Imaging without barriers

Low-field magnetic resonance imaging can be engineered for widespread point-of-care diagnostics

Magnetic Resonance Imaging, Computed Tomographic and Radiographic Findings in the Metacarpophalangeal Joints of 31 Warmblood Showjumpers in Full Work and Competing Regularly.

There is a limited description of magnetic resonance imaging (MRI) and no information on computed tomographic (CT) findings in the fetlock of non-lame, non-racing sports horses. This study aimed to document comparative CT, MRI and radiographic findings in the metacarpophalangeal joints of showjumpers in full work. Clinical and gait assessments, low-field MRI, fan-beam CT and radiographic examinations of both metacarpophalangeal joints were performed on 31 showjumpers. Images were analysed descriptively. In most limbs (53/62, 85.5%), there were CT and MRI changes consistent with densification in the sagittal ridge and/or condyles of the third metacarpal bone (McIII). Hypoattenuation (subchondral bone resorption) was seen in CT reconstructions in the metacarpal condyle dorsoproximally (n = 2) and dorsodistally (n = 1), in the sagittal groove (n = 2) and medial fovea (n = 1) of the proximal phalanx. The McIII resorptive lesions were detected on MR images but not the proximal phalanx lesions. None were identified on radiographs. In conclusion, MRI and CT abnormalities previously associated with lameness were seen in the front fetlocks of showjumpers without relevant lameness. Densification in the sagittal ridge and the metacarpal condyles likely reflects an adaptive change to exercise. Subchondral bone resorption may indicate an early stage of disease; follow-up information is needed to establish its clinical significance.

Anaesthesia-related morbidity associated with recumbent, low-field magnetic resonance imaging of horses

ABSTRACT Case history: Medical records from 2009 to 2021 from a private equine referral hospital in Rochester, NH, USA were analysed for cases that underwent general anaesthesia for low-field MRI of the distal limb. These were used to determine peri-anaesthetic morbidity and mortality. Clinical findings and outcome: Two hundred and forty-three anaesthetic episodes were recorded in horses undergoing low-field MRI. The peri-anaesthetic complication rate prior to discharge was 6.2% (15/243). No patients experienced a fatal complication. Ninety two of the 243 patients had multiple sites imaged, 90/243 received pre-anaesthetic dantrolene, 134/243 received intra-anaesthetic dobutamine, and 15/243 were positioned in dorsal recumbency. Complications included: abdominal discomfort (“colic”; 9/243), myopathy (4/243), hyphaema (1/243) and carpal fracture (1/243). At the time of discharge, 14/15 complications had resolved. Of 135 horses for which data were available 55 became hypotensive during the procedure (lowest mean arterial pressure < 65 mmHg). Median body weight was 553 (min 363, max 771) kg. Horses were anaesthetised for a median of 150 (min 45, max 210) minutes. There was no evidence of an association between higher body weight (p = 0.051) or longer duration of anaesthesia (p = 0.421) and development of an anaesthetic complication. For categorical variables (dantrolene administration pre-anaesthesia, dobutamine administration during anaesthesia, hypotension (mean < 65 mmHg) during anaesthesia, dorsal vs. lateral recumbency, and imaging of single vs. multiple sites), the 95% CI for the OR included 1, indicating a lack of effect of the variable on the odds of complication. Clinical relevance: The cases included in this series suggest that low-field MRI under general anaesthesia is a viable option for diagnostic imaging in otherwise healthy horses. Complications occur, but most resolve before discharge.

434. Improving Image Accuracy in Low-Field Magnetic Resonance Imaging to Make Accessible Biomarkers for Psychiatric Disorders

434. Improving Image Accuracy in Low-Field Magnetic Resonance Imaging to Make Accessible Biomarkers for Psychiatric Disorders

Spatiotemporal encoding MRI in a portable low-field system.

Demonstrate the potential of spatiotemporal encoding (SPEN) MRI to deliver largely undistorted 2D, 3D, and diffusion weighted images on a 110 mT portable system. SPEN's quadratic phase modulation was used to subsample the low-bandwidth dimension of echo planar acquisitions, delivering alias-free images with an enhanced immunity to image distortions in a laboratory-built, low-field, portable MRI system lacking multiple receivers. Healthy brain images with different SPEN time-bandwidth products and subsampling factors were collected. These compared favorably to EPI acquisitions including topup corrections. Robust 3D and diffusion weighted SPEN images of diagnostic value were demonstrated, with 2.5 mm isotropic resolutions achieved in 3 min scans. This performance took advantage of the low specific absorption rate and relative long TEs associated with low-field MRI. SPEN MRI provides a robust and advantageous fast acquisition approach to obtain faithful 3D images and DWI data in low-cost, portable, low-field systems without parallel acceleration.

Portable Bedside Low-Field Magnetic Resonance Imaging for Evaluation of Ischemic Strokes in Patients Admitted to Inpatient Floor Units (P3-5.012)

Portable Bedside Low-Field Magnetic Resonance Imaging for Evaluation of Ischemic Strokes in Patients Admitted to Inpatient Floor Units (P3-5.012)

Quality Improvement Review and Practical Consideration of Hyperfine Portable Bedside Low-field Magnetic Resonance Imaging in the Non-ICU Setting (P2-5.018)

Quality Improvement Review and Practical Consideration of Hyperfine Portable Bedside Low-field Magnetic Resonance Imaging in the Non-ICU Setting (P2-5.018)

Low-field magnetic resonance imaging of sagittal groove disease of the proximal phalanx in non-racing sport horses.

Injuries of the sagittal groove of the proximal phalanx (P1) in equine athletes are considered to predominantly occur due to chronic bone stress overload. To describe the range of abnormalities that is present in the sagittal groove in a large group of horses diagnosed with sagittal groove disease (SGD) on low-field MRI. Retrospective, cross-sectional. Medical records were searched to identify initial MRI images of horses diagnosed with SGD and these were blindly evaluated using a semi-quantitative grading scheme and novel SGD MRI classification system reflecting potential pathways of pathological progression and severity of stress injury. A total of 132 limbs from 111 horses were included in the study; predominantly warmbloods competing in showjumping (n = 83) and dressage (n = 18). SGD MRI classifications were: 0 (normal, n = 0), 1 (small subchondral defect, n = 2), 2 (osseous densification, n = 28), 3 (subchondral microfissure with osseous densification, n = 7), 4 (bone oedema-like signal within the subchondral ± trabecular bone and ± subchondral microfissure or demineralisation, n = 72), 5 (incomplete macrofissure/fracture, n = 23) and 6 (complete fracture, n = 0). Classification 4c (bone oedema-like signal with demineralisation) and 5 had higher proportions in the plantar third of hindlimbs (3% and 10%, respectively) compared with forelimbs (0% and 0%, respectively). SGD classification and extent of bone oedema-like signal were not significantly different between lame (n = 116) and non-lame limbs (n = 16) (both p > 0.05). Periosteal new bone and oedema-like signal were identified (either confidently or suspected) at the dorsoproximal aspect of P1 in 25% and 39% of limbs, respectively. Inclusion via diagnoses in original MRI reports, variable clinical history, small size of some classification groups. The presence or absence of lameness is not a dependable measure of the severity of SGD. The periosteal oedema-like signal of P1 has not previously been described in MRI of SGD and further supports the concept of bone stress injury.

THE ROLE OF THE LOW FIELD MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF THE COMMON SHOULDER JOINT LESIONS

This article reviews the role of the low field magnetic resonance imaging (MRI) with magnetic field strengths of 0.4 Tesla in the evaluation of the main pathologic conditions of the shoulder joint commonly encountered in clinical practice. Shoulder pain is a common clinical complaint that may be caused by abnormalities of the rotator cuff tendon, labrum and a variety of other pathological conditions. The differential diagnosis is extensive and includes tendinosis and rotator cuff pathology, instability, labral lesions, biceps disorders, radiculopathy, and thoracic outlet syndrome. In older patients, arthritis may even be a factor. The goal of this study was to evaluate the feasibility and diagnostic confidence of an open low field MRI in patients with shoulder joint pain. Our data was obtained from 40 patients: 24 Male (60%) and 16-Female (40%). Their ages ranged between 17 and 70 years. All patients were investigated by conventional X-rays and MRI in the medical diagnostic center of Aden Resonance in Al-Mansoura district in Aden city. MRI was performed at an open 0. 4 Tesla MR-unit (Hitachi - Japan-Aperto Lucent). The study protocol comprised axial, sagittal &amp; coronal STIR-T2 and T1 weighted images of 3-4 mm thickness. 55 patients (52.4%) were investigated by high field MRI 1. 5 T (Neusoft) as a reference method.

Comparison of Detomidine or Romifidine in Combination with Morphine for Standing Magnetic Resonance Imaging in Horses.

The aim of this study was to determine the most appropriate sedation protocol for a standing magnetic resonance imaging (MRI) examination in horses, comparing continuous rate infusions (CRIs) of detomidine and romifidine combined with a single bolus of morphine. Sixteen horses referred for standing low-field open-magnet MRI were randomly assigned to one of two sedation protocols. The horses were premedicated with 0.03 mg/kg of intramuscular acepromazine, and those animals belonging to Group D received an intravenous (IV) loading dose of detomidine (0.01 mg/kg) 30 min later, while those of Group R received romifidine (0.04 mg/kg). If the horses were inadequately sedated, an additional dose of IV detomidine (0.005 mg/kg) or romifidine (0.02 mg/kg) was administered, according to the animal's group. During the MRI, a single IV bolus of morphine (0.05 mg/kg) was administered, and according to which group it belonged to, the animal started the administration of detomidine (0.01 mg/kg/h) or romifidine (0.02 mg/kg/h). Heart rate (HR), respiratory rate (RR), rectal temperature (RT), depth of sedation, and degree of ataxia were evaluated every 10 min during MRI. Two horses belonging to Group D and four horses from Group R needed additional sedation before entering the MRI unit because they were unsatisfactorily sedated. No side effects were observed following morphine bolus administration. During the MRI procedure, five horses in Group R received an additional IV romifidine bolus (0.01 mg/kg) because the depth of sedation score was 1 and the ataxia score was 0. Any substantial differences were recorded between the two treatments in terms of HR, RR, and RT. In conclusion, at the doses used, a detomidine-morphine combination following a CRI of detomidine appears more suitable than a romifidine-morphine combination following a CRI of romifidine for maintaining an adequate depth of sedation and adequate immobility in horses undergoing standing MRI.

The Use of Portable, Very Low-field (0.064T) MRI to Image Cochlear Implants: Metallic Image Artifact in Comparison to Traditional, Stationary 3T MRI.

To assess image artifact when imaging a cochlear implant (CI) with a conventional 3T MRI machine compared with a very low-field (0.064T) MRI. None. Diagnostic study. Image artifact size associated with the CI affixed to an MRI phantom at very low-field 0.064T MRI versus 3T MRI. The longest diameter of the image artifact was 125 mm for the 3T MRI and 86 mm for the 0.064T MRI, representing 45% longer image artifact generated in the 3T MRI. The actual volume of the imaging phantom was 1371 cm3. The volume of the image artifact was measured as 379 cm3 in the 3T MRI, representing a loss of 27.6% of the actual volume of the imaging phantom. The volume of image artifact was measured as 170 cm3 in the 0.064T MRI, representing a loss of 12.4% of the phantom volume. 3T MRI had better image quality. This result was not surprising given that larger magnetic field strength is known to provide higher resolution. There was 15% less image artifact generated in the very low-field MRI machine compared with a conventional 3T device. And there was also subjectively increased distortion of the imaging phantom at 3T MRI compared with the 0.064T MRI. With minimized safety concerns and a much lower cost than conventional 3T machines, very low-field scanners may find expanded clinical uses. This preclinical study explores the potential utility of very low-field MRI in scanning CI recipients.

Low Field MRI Surveillance 6-24 Months Post-acute COVID-19 Pneumonia: Factors Influencing Severity and Evolution of Lung Opacities

To determine factors influencing low-field MRI lung opacity severity 6-24 months after acute Covid-19 pneumonia. 104 post-acute Covid-19 patients with 167 MRI exams were included. 32 patients had more than one exam, and 63 exams were serial exams. Pulmonary findings were graded on a scale of 0-4 by quadrant, total score ranging from 0 (no opacity) to 16 (opacity > 75%), and score >8 considered moderate and >12 severe opacity. Kruskal-Wallis, Mann-Whitney, and Spearman rank correlation was used to assess the association of clinical and demographic factors with MR opacity severity at time intervals from acute infection. Random coefficients regression was used to assess whether opacity score changed over time. Severity of initial illness was associated with increased MR opacity score at timeframes up to 24 months (p<.05). Among the 167 exams, moderate to severe MR opacities (total opacity score >8) were identified in 33% of exams beyond 6 months: 37% at 6 - <12 months (n=23/63); 31% at 12- <18 months (n=13/42); 25% at 18- <24 months (n=6/24); and 50% at >24 months (n=3/6). No significant change in total opacity score over time was identified by random coefficients regression. Among the 32 patients with serial exams, 11 demonstrated no change in opacity score from initial to final exam, 10 decrease in score (mean 2.3, stdev 1.25, range 1-4), and 11 increase in score (average 2.8, stdev 1.48, range 1-7). Initial Covid-19 disease severity was associated with increased MRI total opacity score at time intervals up to 24 months, and moderate to severe opacities were commonly identified by low-field MRI beyond 6 months from acute illness.

13C MRI of hyperpolarized pyruvate at 120 µT

Nuclear spin hyperpolarization increases the sensitivity of magnetic resonance dramatically, enabling many new applications, including real-time metabolic imaging. Parahydrogen-based signal amplification by reversible exchange (SABRE) was employed to hyperpolarize [1-13C]pyruvate and demonstrate 13C imaging in situ at 120 µT, about twice Earth’s magnetic field, with two different signal amplification by reversible exchange variants: SABRE in shield enables alignment transfer to heteronuclei (SABRE-SHEATH), where hyperpolarization is transferred from parahydrogen to [1-13C]pyruvate at a magnetic field below 1 µT, and low-irradiation generates high tesla (LIGHT-SABRE), where hyperpolarization was prepared at 120 µT, avoiding magnetic field cycling. The 3-dimensional images of a phantom were obtained using a superconducting quantum interference device (SQUID) based magnetic field detector with submillimeter resolution. These 13C images demonstrate the feasibility of low-field 13C metabolic magnetic resonance imaging (MRI) of 50 mM [1-13C]pyruvate hyperpolarized by parahydrogen in reversible exchange imaged at about twice Earth’s magnetic field. Using thermal 13C polarization available at 120 µT, the same experiment would have taken about 300 billion years.

Bridging the gap: improving correspondence between low-field and high-field magnetic resonance images in young people.

Portable low-field-strength magnetic resonance imaging (MRI) systems represent a promising alternative to traditional high-field-strength systems with the potential to make MR technology available at scale in low-resource settings. However, lower image quality and resolution may limit the research and clinical potential of these devices. We tested two super-resolution methods to enhance image quality in a low-field MR system and compared their correspondence with images acquired from a high-field system in a sample of young people. T1- and T2-weighted structural MR images were obtained from a low-field (64mT) Hyperfine and high-field (3T) Siemens system in N = 70 individuals (mean age = 20.39 years, range 9-26 years). We tested two super-resolution approaches to improve image correspondence between images acquired at high- and low-field: (1) processing via a convolutional neural network ('SynthSR'), and (2) multi-orientation image averaging. We extracted brain region volumes, cortical thickness, and cortical surface area estimates. We used Pearson correlations to test the correspondence between these measures, and Steiger Z tests to compare the difference in correspondence between standard imaging and super-resolution approaches. Single pairs of T1- and T2-weighted images acquired at low field showed high correspondence to high-field-strength images for estimates of total intracranial volume, surface area cortical volume, subcortical volume, and total brain volume (r range = 0.60-0.88). Correspondence was lower for cerebral white matter volume (r = 0.32, p = 0.007, q = 0.009) and non-significant for mean cortical thickness (r = -0.05, p = 0.664, q = 0.664). Processing images with SynthSR yielded significant improvements in correspondence for total brain volume, white matter volume, total surface area, subcortical volume, cortical volume, and total intracranial volume (r range = 0.85-0.97), with the exception of global mean cortical thickness (r = 0.14). An alternative multi-orientation image averaging approach improved correspondence for cerebral white matter and total brain volume. Processing with SynthSR also significantly improved correspondence across widespread regions for estimates of cortical volume, surface area and subcortical volume, as well as within isolated prefrontal and temporal regions for estimates of cortical thickness. Applying super-resolution approaches to low-field imaging improves regional brain volume and surface area accuracy in young people. Finer-scale brain measurements, such as cortical thickness, remain challenging with the limited resolution of low-field systems.

Modern low-field MRI.

This narrative review explores recent advancements and applications of modern low-field (≤ 1 Tesla) magnetic resonance imaging (MRI) in musculoskeletal radiology. Historically, high-field MRI systems (1.5T and 3T) have been the standard in clinical practice due to superior image resolution and signal-to-noise ratio. However, recent technological advancements in low-field MRI offer promising avenues for musculoskeletal imaging. General principles of low-field MRI systems are being introduced, highlighting their strengths and limitations compared to high-field counterparts. Emphasis is placed on advancements in hardware design, including novel magnet configurations, gradient systems, and radiofrequency coils, which have improved image quality and reduced susceptibility artifacts particularly in musculoskeletal imaging. Different clinical applications of modern low-field MRI in musculoskeletal radiology are being discussed. The diagnostic performance of low-field MRI in diagnosing various musculoskeletal pathologies, such as ligament and tendon injuries, osteoarthritis, and cartilage lesions, is being presented. Moreover, the discussion encompasses the cost-effectiveness and accessibility of low-field MRI systems, making them viable options for imaging centers with limited resources or specific patient populations. From a scientific standpoint, the amount of available data regarding musculoskeletal imaging at low-field strengths is limited and often several decades old. This review will give an insight to the existing literature and summarize our own experiences with a modern low-field MRI system over the last 3years. In conclusion, the narrative review highlights the potential clinical utility, challenges, and future directions of modern low-field MRI, offering valuable insights for radiologists and healthcare professionals seeking to leverage these advancements in their practice.

Managing hardware-related metal artifacts in MRI: current and evolving techniques.

Magnetic resonance imaging (MRI) around metal implants has been challenging due to magnetic susceptibility differences between metal implants and adjacent tissues, resulting in image signal loss, geometric distortion, and loss of fat suppression. These artifacts can compromise the diagnostic accuracy and the evaluation of surrounding anatomical structures. As the prevalence of total joint replacements continues to increase in our aging society, there is a need for proper radiological assessment of tissues around metal implants to aid clinical decision-making in the management of post-operative complaints and complications. Various techniques for reducing metal artifacts in musculoskeletal imaging have been explored in recent years. One approach focuses on improving hardware components. High-density multi-channel radiofrequency (RF) coils, parallel imaging techniques, and gradient warping correction enable signal enhancement, image acquisition acceleration, and geometric distortion minimization. In addition, the use of susceptibility-matched implants and low-field MRI helps to reduce magnetic susceptibility differences. The second approach focuses on metal artifact reduction sequences such as view-angle tilting (VAT) and slice-encoding for metal artifact correction (SEMAC). Iterative reconstruction algorithms, deep learning approaches, and post-processing techniques are used to estimate and correct artifact-related errors in reconstructed images. This article reviews recent developments in clinically applicable metal artifact reduction techniques as well as advances in MR hardware. The review provides a better understanding of the basic principles and techniques, as well as an awareness of their limitations, allowing for a more reasoned application of these methods in clinical settings.

Encoding scheme design for gradient-free, nonlinear projection imaging using Bloch-Siegert RF spatial encoding in a low-field, open MRI system

Eliminating conventional pulsed B0-gradient coils for magnetic resonance imaging (MRI) can significantly reduce the cost of and increase access to these devices. Phase shifts induced by the Bloch-Siegert shift effect have been proposed as a means for gradient-free, RF spatial encoding for low-field MR imaging. However, nonlinear phasor patterns like those generated from loop coils have not been systematically studied in the context of 2D spatial encoding. This work presents an optimization algorithm to select an efficient encoding trajectory among the nonlinear patterns achievable with a given hardware setup. Performance of encoding trajectories or projections was evaluated through simulated and experimental image reconstructions. Results show that the encodings schemes designed by this algorithm provide more efficient spatial encoding than comparison encoding sets, and the method produces images with the predicted spatial resolution and minimal artifacts. Overall, the work demonstrates the feasibility of performing 2D gradient-free, low-field imaging using the Bloch-Siegert shift which is an important step towards creating low-cost, point-of-care MR systems.

Detection of oilseed rape clubroot based on low-field nuclear magnetic resonance imaging

Plant root diseases threat plant growth and eventually cause plant death without proper treatment. It is difficult to diagnose root diseases without digging the roots from the soil, and it is late when the above-ground parts show symptoms under the stress of root diseases. This study used magnetic resonance imaging (MRI) for non-invasive root phenotyping to detect oilseed rape clubroot. MRI images of healthy oilseed rape roots and roots infected by clubroot were obtained. After image preprocessing, average sample grayscale histograms (Avg-SGH) were extracted to build classification models for disease identification using logistic regression (LR), support vector machine (SVM) and random forest (RF). Reconstruction of three-dimensional (3D) root architectures was also conducted. Root architecture parameters were extracted from the reconstructed roots. Analysis of variance (ANOVA) showed that the root architecture parameters differed significantly between healthy and infected roots. RF model using root architecture parameters showed good performances, and the feature importance for clubroot identification was also explored. The overall results showed that MRI could effectively detect clubroot diseases in a non-invasive manner, indicating significant potential for plant root phenotyping.

Abstract 89: Portable, Low-Field Magnetic Resonance Imaging: Determining Mismatch Following Acute Ischemic Stroke

Background and Aims: Treatment options for acute ischemic stroke (AIS) are uniquely dependent on the time of stroke onset. Intravenous thrombolysis must be administered within 4.5 hours of symptoms commencing, yet a subset of patients wake-up with symptoms and time of onset is unknown. Mismatch between fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) MRI can be used to qualify wake-up strokes for thrombolysis. This has been shown to lead to improved functional outcomes in multicenter trials (WAKE-UP, MR-WITNESS). However, access to MRI is a barrier to differential diagnosis and subsequent treatment. Recent advances in portable, low-field MRI (LF-MRI) offer a solution to increase access to MRI technologies and circumvent the limitations of conventional systems. As such, in this pilot study, we sought to establish the utility of portable LF-MRI to identify DWI-FLAIR mismatch following AIS. Methods: Patients with a diagnosis of AIS presenting to Emergency Department or Intensive Care Unit of the Yale New Haven Hospital or Massachusetts General Hospital from January 2020 to June 2023 underwent DWI and FLAIR acquisition on a 0.064T MRI (Hyperfine Research Inc.) at &lt;4.5 hours ( n =7), 4.5-6 hours ( n =7), and 6-48 hours ( n =110) since last known well (LKW). Conventional high-field (HF) MR images were acquired within 72 hours of LF-MRI. HF-DWI images were co-registered to LF-FLAIR and the hyperintense DWI stroke lesion segmented and superimposed on the FLAIR. The segmentation was mirrored to the contralateral hemisphere of the LF-FLAIR to establish a FLAIR signal intensity ratio (SIR). Results: The FLAIR SIR on images &lt;4.5 hours since LKW was 0.98±0.08. The SIR for cases 4.5-6 hours was 1.34±0.33. Cases 6-48 hours produced a SIR of 1.56±0.36. The SIR at &lt;4.5 hours was significantly less than that observed &gt;6 hours since LKW ( p =0.03). Conclusion: This pilot study demonstrates that a 0.064T portable MRI is capable of distinguishing hyperacute stroke from later stroke onset using FLAIR SIR. Future research is needed in a larger cohort to determine if this imaging technology can be used to guide thrombolysis in the setting of wake-up stroke.