MRI Technologists Research Articles

The perception of artificial intelligence: Insights from MRI technologists in radiology practices

ObjectiveAs artificial intelligence (AI) increasingly integrates into healthcare sectors globally, it becomes crucial to examine its impact within specific contexts. This study aims to explore MRI technologists' perceptions towards AI in radiology in Saudi Arabia and to identify the demographic factors influencing these perceptions. MethodologyA cross-sectional survey was conducted among 128 MRI technologists in Saudi Arabian healthcare facilities. The 10-question survey captured key aspects of their perceptions towards AI integration. Statistical analyses using R software included logistic regression to identify significant associations between demographic factors and AI perceptions. Odds ratios (ORs), 95% confidence intervals (CIs), and p-values were computed, with statistical significance set at an alpha level of 0.05. ResultsThe survey results indicated that a significant majority (84.4%) of technologists agree that AI will play a crucial role in the future of radiology. Higher education levels were significantly associated with positive perceptions of AI (OR 1.75, p = 0.028). Male technologists and those aged 40–49 showed more pronounced apprehensions about AI's disruptions. Specifically, the odds ratio for male technologists perceiving AI will disrupt MRI practice was 2.05 (p = 0.009), and for those aged 40–49, the odds ratio was 1.60 (p = 0.013). The odds ratio for male technologists believing AI will disrupt careers was 1.85 (p = 0.012), and for those aged 40–49, it was 1.50 (p = 0.030). Additionally, the odds of believing AI integration will not change their work were significantly higher among males (OR 2.25, p = 0.002). ConclusionThese findings highlight the need for targeted educational programs and support initiatives for MRI technologists in Saudi Arabia. Addressing the concerns of apprehensive groups, particularly older and male technologists, through continuous education and realistic information sessions can facilitate smoother AI integration. These initiatives are essential for aligning AI advancements with Saudi Arabian cultural and professional standards, ensuring a prepared and supportive workforce.

Scan With Me: A Train-the-Trainer Program to Upskill MRI Personnel in Low- and Middle-Income Countries

PurposeAccess to MRI in low- and middle-income countries (LMICs) remains among the poorest in the world. The lack of skilled MRI personnel exacerbates access gaps, reinforcing long-standing health disparities. The Scan With Me (SWiM) program aims to sustainably create a network of highly skilled MRI technologists in LMICs who will facilitate the transfer of MRI knowledge and skills to their peers and contribute to the implementation of highly valuable imaging protocols for effective clinical and research use. MethodsThe program introduces a case-based curriculum designed using a novel train-the-trainer approach, integrated with peer-collaborative learning to upskill practicing MRI technologists in LMICs. The 6-week curriculum uses the teach-try-use approach, which combines self-paced didactic lectures covering the basics of MR image acquisition (teach) with hands-on expert-guided scanning experience (try) and the implementation of protocols tailored to provide the best possible images on their infrastructures (use). Each program includes research translation skills training using an established advanced MRI technique relevant to LMICs. A pilot program focused on cardiac MRI (CMR) was conducted to assess the program’s curriculum, delivery, and evaluation methods. ResultsForty-three MRI technologists from 16 LMICs participated in the pilot CMR program and, over the course of the training, implemented optimized CMR protocols that reduced acquisition times while improving image quality. The training resources and scanner-specific standardized protocols are published openly for public use in an online repository. In general, at the end of the program, learners reported considerable improvements in CMR knowledge and skills. All respondents to the program evaluation survey agreed to recommend the program to their colleagues, while 87% indicated interest in returning to help train others. ConclusionsThe SWiM program is the first master class in MRI acquisition for practicing imaging technologists in LMICs. The program holds the potential to help reduce disparities in MRI expertise and access. The support of the MRI community, imaging societies, and funding agencies will increase its reach and further its impact in democratizing MRI.

Implementation of remote MRI scanning

The present shortage of MRI technologists continues to interfere with the delivery of care of patients. In addition, there have been limited solutions to cover disability, sickness, vacation, and personal days of that limited workforce. Our practice decided that the best way to address these coverage problems was to implement a virtual remote scanning solution. We explain the IT infrastructure, training and policies needed to implement this innovative solution safely and successfully to the MRI technologist shortage.

ECMR 4-03 - Scan with Me (SWiM): A Case-based Learning Approach to Upskill MRI Technologists in Low- and Middle- income Countries

ECMR 4-03 - Scan with Me (SWiM): A Case-based Learning Approach to Upskill MRI Technologists in Low- and Middle- income Countries

Assessment of MRI Safety Awareness and Practice Standards in Bangladesh

Objectives: The objective of this study was to evaluate the current MRI safety knowledge, awareness and practice standards among MRI technologist in Bangladesh and to perceive if the identified safety principles related to MRI management are in line with international standards. Materials and Methods: The study was carried out with consent option among MRI technologist in Bangladesh. A self-structured questionnaire was used to collect data through email, the questionnaire contained ten parts and 47 questions in all. MRI technologist voluntarily consented and filled out the questionnaire. The questions were to explore knowledge about MRI safety policy and accessories, patient screening, adverse reaction, Infection control, Device labeling, Equipment safety, signage and barriers, access and communication, and MRI safety during pregnancy generally. The collected data were analyzed with the help of Microsoft Excel. Results: Regarding knowledge of MRI equipment, 34% of respondents were unaware of the symbols or signs used to denote the various zones in your MRI suit, and 27% were unaware of the negative effects of quenching magnets. About 45% of respondents, who were asked about emergency/safety accessories’ availability, answered that crash carts and MRI-compatible anesthetic equipment aren’t present in the department. In case of awareness of different zones of the MRI suite, which is crucial for an MRI unit, 46.08% of respondents were unaware in this issue. 50% of respondents do not believe that MRI has any harmful effect to people who are pregnant. This study revealed that many MRI facilities generally are not aware of departmental/equipment safety notices & obstacles. Conclusion: The study showed that awareness about MRI safely and practice standards were not encouraging with many of the MRI technologists due to their insufficient knowledge. They need training along with other supporting staff connected to patient to enhance their knowledge in implementation of safety policy, patient screening tools and exposure of MRI during pregnancy.

New Zealand and Australian MRI technologists’ (radiographers) MRI safety knowledge and confidence levels

IntroductionThe MRI technologist (radiographer) is at the frontline of MRI safety decision-making and has the primary responsibility to provide high quality, efficient and safe patient care in the MRI environment. As MRI technology advances and new safety issues emerge, this study aimed to provide a snapshot of the preparedness of MRI technologists in New Zealand (NZ) and Australia to practise confidently and safely. MethodAn online questionnaire, administered via Qualtrics and covering a range of MRI safety topics, was distributed in 2018 via the New Zealand MR Users Group, the MRI Australia-NZ Group Facebook, and relevant professional bodies. ResultsA total of 312 MRI technologists attempted the questionnaire, with 246 surveys being fully completed. Of these, 61% (n = 149) were in Australia, 36% (n = 89) in NZ, and 3% (n = 8) from other countries. Findings indicated that current MRI education is preparing MRI technologists in NZ and Australia to practise safely. However, while these technologists are confident in their MRI safety decision-making, accuracy levels within some groups need addressing. ConclusionTo develop a consistent level of safe practice, it is proposed that a minimum level of MRI-specific education is defined and mandated to practise. Continuing professional development focussing on MRI safety must be encouraged and, if audited as part of registration, could also be mandated. Implementation of a supporting regulatory framework similar to NZ is recommended for other countries. Implications for practiceAll MRI technologists are responsible for the safety of their patients and staff. Employers must support and ensure MRI-specific education has been completed. Ongoing engagement in MRI safety events provided by MRI safety experts, professional bodies and/or universities is essential to remain up-to-date.

Automated Placement of Scan and Pre-Scan Volumes for Breast MRI Using a Convolutional Neural Network.

Graphically prescribed patient-specific imaging volumes and local pre-scan volumes are routinely placed by MRI technologists to optimize image quality. However, manual placement of these volumes by MR technologists is time-consuming, tedious, and subject to intra- and inter-operator variability. Resolving these bottlenecks is critical with the rise in abbreviated breast MRI exams for screening purposes. This work proposes an automated approach for the placement of scan and pre-scan volumes for breast MRI. Anatomic 3-plane scout image series and associated scan volumes were retrospectively collected from 333 clinical breast exams acquired on 10 individual MRI scanners. Bilateral pre-scan volumes were also generated and reviewed in consensus by three MR physicists. A deep convolutional neural network was trained to predict both the scan and pre-scan volumes from the 3-plane scout images. The agreement between the network-predicted volumes and the clinical scan volumes or physicist-placed pre-scan volumes was evaluated using the intersection over union, the absolute distance between volume centers, and the difference in volume sizes. The scan volume model achieved a median 3D intersection over union of 0.69. The median error in scan volume location was 2.7 cm and the median size error was 2%. The median 3D intersection over union for the pre-scan placement was 0.68 with no significant difference in mean value between the left and right pre-scan volumes. The median error in the pre-scan volume location was 1.3 cm and the median size error was -2%. The average estimated uncertainty in positioning or volume size for both models ranged from 0.2 to 3.4 cm. Overall, this work demonstrates the feasibility of an automated approach for the placement of scan and pre-scan volumes based on a neural network model.

Fetal MRI at 3 T: Principles to Optimize Success.

Fetal MRI has emerged as a cornerstone of prenatal imaging, helping to establish the correct diagnosis in pregnancies affected by congenital anomalies. In the past decade, 3 T imaging was introduced as an alternative to increase the signal-to-noise ratio (SNR) of the pulse sequences and improve anatomic detail. However, imaging at a higher field strength is not without challenges. Many artifacts that are barely appreciable at 1.5 T are amplified at 3 T. A systematic approach to imaging at 3 T that incorporates appropriate patient positioning, a thoughtful protocol design, and sequence optimization minimizes the impact of these artifacts and allows radiologists to reap the benefits of the increased SNR. The sequences used are the same at both field strengths and include single-shot T2-weighted, balanced steady-state free-precession, three-dimensional T1-weighted spoiled gradient-echo, and echo-planar imaging. Synergistic use of these acquisitions to sample various tissue contrasts and in various planes provides valuable information about fetal anatomy and pathologic conditions. In the authors' experience, fetal imaging at 3 T outperforms imaging at 1.5 T for most indications when performed under optimal circumstances. The authors condense the cumulative experience of fetal imaging specialists and MRI technologists who practice at a large referral center into a guideline covering all major aspects of fetal MRI at 3 T, from patient preparation to image interpretation. © RSNA, 2023 Quiz questions for this article are available in the supplemental material.

Safety Survey on Lone Working Magnetic Resonance Imaging Technologists in Saudi Arabia

The American College of Radiology (ACR) requires MR personnel not to work alone due to the increased risk of safety issues such as projectiles, aggressive patients, and technologist fatigue. As a result, we intend to assess the current safety of lone-working MRI technologists in MRI departments in Saudi Arabia. A cross-sectional study using a self-report questionnaire was conducted in 88 Saudi hospitals. A response rate of 64% (174/270) was obtained among the 270 MRI technologists which were identified. The study discovered that 86% of MRI technologists had prior experience working alone. In terms of MRI safety training, 63% of MRI technologists received such training. A question about lone MRI workers' awareness of the ACR's recommendations revealed that 38% were unaware of such recommendations. Furthermore, 22% were misinformed, believing that working alone in an MRI unit is optional or depends on the individual's desire to work alone. Working alone has the primary consequence of being statistically significantly associated with projectile/object-related accidents/mistakes (p = 0.03). Saudi Arabian MRI technologists have extensive experience working alone without supervision. Most MRI technologists are unaware of lone working regulations, which has raised concerns about accidents/mistakes. There is a need for MRI safety training and adequate practical experience to raise awareness of MRI safety regulations and policies related to lone working among departments and MRI workers.

Assessment of MRI Safety Practices in Saudi Arabia.

The aim of this study is to investigate the safety practices used by MRI departments in Saudi Arabia. A cross-sectional study across 113 private and public hospitals was conducted in Saudi Arabia. A survey questionnaire was designed and sent to 113 MRI units. The questionnaire consisted of 43 items under 14 sections for the assessment of MRI safety practices. These 14 sections are related to (i) MRI and its safety, (ii) MRI usage and its safety, and (iii) safety of the MRI technologists and reporting of adverse effects during the usage. The American College of Radiology (ACR) guidance document on MRI safety practices was used as a template for this survey. Data were analyzed using IBM SPSS Statistical software for Windows version 26.0 (IBM Corp., Armonk, NY, USA). Of the 43 items assessed, only 3 items' binary responses (Yes & No) did not differ much. A greater proportion of positive responses for 40 items (93%) regarding MRI safety practices. More than 50% of the participants claimed that their departments lacked a Magnetic Resonance Safety Officer (MRSO). Regarding regular safety training programs, less than 50% received training in MRI safety. Handheld metal detectors were found in only 39% of the MRI units. The majority of MRI units in Saudi Arabia have demonstrated compliance with majority of ACR MRI safety recommendations; nonetheless, there are two main items for which the guidelines may not be attained: MRSO and regular MRI safety training programs. By taking into account the limitations of this study, it is strongly recommended to assign MRSO and implement annual MRI safety training to improve MRI safety practices for both patients and healthcare workers.

Automated MRI Field of View Prescription from Region of Interest Prediction by Intra-Stack Attention Neural Network.

Manual prescription of the field of view (FOV) by MRI technologists is variable and prolongs the scanning process. Often, the FOV is too large or crops critical anatomy. We propose a deep learning framework, trained by radiologists' supervision, for automating FOV prescription. An intra-stack shared feature extraction network and an attention network are used to process a stack of 2D image inputs to generate scalars defining the location of a rectangular region of interest (ROI). The attention mechanism is used to make the model focus on a small number of informative slices in a stack. Then, the smallest FOV that makes the neural network predicted ROI free of aliasing is calculated by an algebraic operation derived from MR sampling theory. The framework's performance is examined quantitatively with intersection over union (IoU) and pixel error on position and qualitatively with a reader study. The proposed model achieves an average IoU of 0.867 and an average ROI position error of 9.06 out of 512 pixels on 80 test cases, significantly better than two baseline models and not significantly different from a radiologist. Finally, the FOV given by the proposed framework achieves an acceptance rate of 92% from an experienced radiologist.

Magnetic resonance imaging in neonates: a practical approach to optimize image quality and increase diagnostic yield.

Magnetic resonance imaging has emerged as a preferred modality in pediatric imaging because of its high soft-tissue contrast and the lack of ionizing radiation. It is important to recognize that despite its many advantages, several challenges to performing neonatal MRI arise from the lack of patient compliance and the small size of the anatomy. This manuscript presents the approach to patient preparation used at the authors' institution, summarizes general principles of image optimization and hardware selection, and reviews common indications across various organ systems. This manuscript also incorporates input from our pediatric-trained MRI technologists, in an attempt to compile a practical guideline covering all major aspects of neonatal MRI, from its execution to its interpretation.

Assessing Radiology Practice Patterns for Obtaining MRI in Pediatric Patients with MR-Conditional Tracheostomy Tubes.

Silicone tracheostomy tubes are a popular choice for pediatric patients with chronic tracheostomies due to their pliability and increased comfort. However, the presence of wire reinforcement causes them to be labeled "MR-conditional." The objective of this study was to understand practice patterns across radiology departments for obtaining MRI in children with MR-conditional tracheostomy tubes. A survey consisting of 7 questions aimed at determining a facility's protocol for obtaining MRI in children with tracheostomy tubes was developed and administered via telephone to MRI technologists at US children's hospitals. 182 children's hospitals were identified and 59 responses were obtained across 30 states (32.4%). 19 sites (32%) were excluded as they were unable to perform MRI. All 40 facilities reported that they have a standard questionnaire for medical implants, however only 20 reported that tracheostomy tubes are included on that questionnaire (50%). 6 (15%) reported all MR-conditional tubes are changed to MR-safe ones. Of the remaining 34, protocols were as follows: 1 (2.9%) scans patients with conditional tubes for a maximum of 15 minutes, 5 (14.7%) only use a 1.5T magnet, and 28 (82.3%) reported following the manufacturer conditions. In terms of artifact, 3 sites change MR-conditional tubes to MR-safe if scanning the head, neck, chest, or abdomen (8.8%), 6 (17.6%) change the tube if scanning the head or neck, 15 (44.1%) change the tube only if scanning the neck, and 10 (29.4%) were not aware of issues with artifact. Based on this survey of MRI technologists at US children's hospitals, there is no unified protocol for obtaining MRI in pediatric patients with MR-conditional tracheostomy tubes. A lack of standardized protocols may be contributing to unnecessary tracheostomy changes. Future research includes clearly defining the anatomical regions affected by wire-related artifact and developing a standardized MRI protocol for these patients.

Primer on Commonly Occurring MRI Artifacts and How to Overcome Them.

HomeRadioGraphicsVol. 42, No. 3 PreviousNext PhysicsRadioGraphics FundamentalsPrimer on Commonly Occurring MRI Artifacts and How to Overcome ThemChikara Noda, Bharath Ambale Venkatesh, Jennifer D. Wagner, Yoko Kato, Jason M. Ortman, João A. C. Lima Chikara Noda, Bharath Ambale Venkatesh, Jennifer D. Wagner, Yoko Kato, Jason M. Ortman, João A. C. Lima Author AffiliationsFrom the Divisions of Cardiology (C.N., Y.K., J.M.O., J.A.C.L.) and Radiology (B.A.V.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Blalock 524, Baltimore, MD 21287; and Canon Medical Research USA, Cleveland, Ohio (J.D.W.).Address correspondence to J.A.C.L. (e-mail: [email protected]).Chikara NodaBharath Ambale VenkateshJennifer D. WagnerYoko KatoJason M. OrtmanJoão A. C. Lima Published Online:Apr 22 2022https://doi.org/10.1148/rg.210021MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractVarious artifacts occur at MRI, and MRI technologists and radiologists must know how to identify and avoid these artifacts so they can consistently produce high-quality images.Suggested Readings Hirokawa Y, Isoda H, Maetani YS, Arizono S, Shimada K, Togashi K. MRI artifact reduction and quality improvement in the upper abdomen with PROPELLER and prospective acquisition correction (PACE) technique. AJR Am J Roentgenol 2008;191(4):1154–1158. Crossref, Medline, Google Scholar Huang SY, Seethamraju RT, Patel P, Hahn PF, Kirsch JE, Guimaraes AR. Body MR Imaging: Artifacts, k-Space, and Solutions. RadioGraphics 2015;35(5):1439–1460. Link, Google Scholar Runge M, Ibrahim EH, Bogun F, et al. Metal Artifact Reduction in Cardiovascular MRI for Accurate Myocardial Scar Assessment in Patients With Cardiac Implantable Electronic Devices. AJR Am J Roentgenol 2019;213(3):555–561. Crossref, Medline, Google Scholar Stadler A, Schima W, Ba-Ssalamah A, Kettenbach J, Eisenhuber E. Artifacts in body MR imaging: their appearance and how to eliminate them. Eur Radiol 2007;17(5):1242–1255. Crossref, Medline, Google Scholar Tsuchihashi T. Artifact of MRI [in Japanese]. Nippon Hoshasen Gijutsu Gakkai Zasshi 2003;59(11):1370–1377. Crossref, Medline, Google ScholarArticle HistoryReceived: Feb 1 2021Revision requested: Apr 20 2021Revision received: June 29 2021Accepted: July 9 2021Published online: Apr 22 2022Published in print: May 2022 FiguresReferencesRelatedDetailsCited ByPostsurgical Evaluation of the Pediatric Foot and AnkleMaria PilarAparisi Gómez, AlbertoBazzocchi, PaoloSimoni, Emilio J.Inarejos Clemente2022 | Seminars in Musculoskeletal Radiology, Vol. 26, No. 06Accompanying This ArticlePrimer on Commonly Occurring MRI Artifacts and How to Overcome ThemApr 22 2022Default Digital Object SeriesRecommended Articles Respiratory Motion Management in Abdominal MRI: Radiology In TrainingRadiology2022Volume: 306Issue: 1pp. 47-53Invited Commentary on “Optimizing Diffusion-Tensor Imaging Acquisition for Spinal Cord Assessment,” with Response from Dr Martín Noguerol et alRadioGraphics2020Volume: 40Issue: 2pp. 428-431Impact of Data-driven Respiratory Gating in Clinical PETRadiology2016Volume: 281Issue: 1pp. 229-238Validation of Software Gating: A Practical Technology for Respiratory Motion Correction in PETRadiology2016Volume: 281Issue: 1pp. 239-248MR Neurography of Peripheral Nerve Injury in the Presence of Orthopedic Hardware: Technical ConsiderationsRadiology2021Volume: 300Issue: 2pp. 246-259See More RSNA Education Exhibits A Primer on Commonly Occurring MRI Artifacts and How to Overcome ThemDigital Posters2020Up-to-Date Technique for Improvement of CT and MRI Imaging Quality in the Head and Neck: Theory, Clinical ApplicationsDigital Posters2019Pulse Sequences Used in Musculoskeletal MRI Exams: A Review for Residents and FellowsDigital Posters2018 RSNA Case Collection Orbital blowout fractureRSNA Case Collection2020Metastatic invasive lobular breast carcinomaRSNA Case Collection2021Pulmonary SequestrationRSNA Case Collection2022 Vol. 42, No. 3 Slide PresentationMetrics Altmetric Score PDF download

A Pilot Quality Improvement Project to Reduce Intraoperative MRI Hypothermia in Neurosurgical Patients.

Introduction:Intraoperative hypothermia increases patient morbidity, including bleeding and infection risk. Neurosurgical intraoperative magnetic resonance imaging (iMRI) can lead to hypothermia from patient exposure and low ambient temperature in the MRI suite. This quality improvement project aimed to reduce the risk of hypothermia during pediatric neurosurgery laser ablation procedures with iMRI. The primary aim was to increase the mean lowest core temperature in pediatric patients with epilepsy during iMRI procedures by 1 °C from a baseline mean lowest core temperature of 34.2 ± 1.2 °C within 10 months and sustain for 10 months.Methods:This report is a single-institution quality improvement project from March 2019 to June 2021, with 21 patients treated at a pediatric hospital. After identifying key drivers, temperature-warming interventions were instituted to decrease hypothermia among patients undergoing iMRI during neurosurgery procedures. A multidisciplinary team of physicians, nurses, and MRI technologists convened for huddles before each case. Interventions included prewarmed operating rooms (ORs), blanket coverings, MRI table and room; forced-air blanket warming, temperature monitoring in the OR and iMRI environments; and the MRI fan turned off.Results:Data were analyzed for five patients before and nine patients after the institution of the temperature-warming elements. The sustainment period included 15 patients. The mean lowest intraoperative temperature rose from 34.2 ± 1.3 °C in the preintervention period to 35.5 ± 0.6 °C in sustainment (P = 0.004).Conclusion:Hybrid OR and MRI procedures increase hypothermia risk, which increases patient morbidity. Implementation of a multidisciplinary, multi-item strategy for patient warming mitigates the risk.

Abstract WP49: Mri Based Thrombolysis For Unwitnessed Stroke Patients Is Feasible At Primary Stroke Centers

Background: The 2018 WAKE-UP Trial established the safety and efficacy of administering IV-tPA in patients who presented within 4.5 hours of symptom discovery based on specific MRI sequences. Implementation of the study results remains limited at Primary Stroke Centers (PSCs). We assessed the feasibility of a Comprehensive Stroke Center (CSC) MRI based unwitnessed thrombolysis protocol at 13 PSCs. Methods: A committee consisting of vascular neurologists, neuroradiologists and MRI technologists developed the protocol. The protocol was utilized at the CSC for one year, and subsequently expanded to the PSCs. A specific "WAKE-UP MRI”" order was created which consisted of only DWI, GRE and FLAIR sequences. MRI technologists were trained to ensure that the "WAKE-UP MRI” would take priority over other patients; eg: if there was no one in MRI, it would be held for the stroke patient, and if MRI was occupied, the stroke patient would be next. The acute stroke care was managed by an integrated telestroke system at the PSCs. All telestroke providers were educated on the protocol. Standard stroke time metrics were collected and analyzed over 2 years. Data from the CSC was compared with its 13 PSC spokes. A student’s t-test was used for data analysis. Results: A total of 190 patients who arrived with 4.5 hours of symptom discovery were screened; 62 at CSC and 128 at PSCs. Forty underwent emergent MRI at CSC and 29 at PSCs. Median door to MRI time was longer for patients presenting to PSC compared to CSC (78 vs 53.5 mins; p = 0.0002). Twenty-one vs 9 patients received tPA at CSC and PSC hospitals respectively. Median door to needle (DTN) times were longer for patients at PSC vs CSC (106 vs 67 mins; p = .018). The most common reasons for not administering IV-tPA was a negative MRI (40% at PSCs vs 47% at CSC) and a lack of DWI and FLAIR mismatch (40% at PSCs vs 42% at CSC). Conclusion: Use of emergent MRI in unwitnessed stroke for thrombolysis is feasible at PSCs. There remain barriers to implementation, with PSCs showing more delayed access to MRI and thrombolysis compared to CSC.

Low-Cost Low-Field MRI Has Arrived: What Does It Mean for Radiology?

A few years ago, one of our MRI technologists went into a supply closet in the neurosciences intensive care unit (NICU) and discovered a portable head-only 0.064-T MRI scanner that uses a resistive magnet powered by a standard power outlet. Colleagues and I in the Department of Radiology and Biomedical Imaging were not pleased that no one had told us that this novel device was being used in the NICU for an industry-sponsored institutional review board–approved protocol. It was developed by a local company, and the principal investigator was a neurologist.

Effect of uterine position and intrapelvic motions on the image quality of 3D T2-weighted MRI of the uterus: Can short prescans predict the non-diagnostic image quality?

PurposeTo evaluate prescan findings of uterine position and intrapelvic motions that predict the non-diagnostic image quality of three-dimensional T2-weighted MRI (3D-T2WI) of the uterus. MethodsThis retrospective study included 287 women who underwent pelvic MRI including 3D-T2WI and short prescans consisting of 2D-T2WI and cine imaging. One radiologist classified 3D-T2WI of the uterus as being of diagnostic or non-diagnostic image quality and evaluated the prescans regarding uterine position and intrapelvic motions. Multivariate logistic regression analysis was performed to identify predictors of non-diagnostic 3D-T2WI. The predictive ability of the prescans was verified by two independent MRI technologists. ResultsNon-diagnostic 3D T2WI was found in 42 patients (14.6 %) and was significantly associated with severe motions of urinary flow in the bladder (p < 0.001), small bowel (p = 0.039), and respiration (p < 0.001). In the multivariate analysis of uterine position and intrapelvic motions, risk factors for the non-diagnostic image quality were prominent urinary flow when the uterus contacted the bladder (p < 0.001, adjusted odds ratio = 35.1) and severe respiratory and small bowel motions when the uterus was surrounded by the bowel (p < 0.001, adjusted odds ratio = 68.4). No risk factors were found for the uterus contacting the vertebrae. With these predictors, the prescans demonstrated a sensitivity of 82.9 and 68.3 %, and specificity of 88.2 and 93.9 % for the non-diagnostic 3D-T2WI by the two technologists, respectively. ConclusionIntrapelvic motions have a different effect on the image quality of 3D-T2WI depending on the uterine position, and short prescans may be useful in predicting time-consuming non-diagnostic 3D-T2WI of the uterus.

Coronavirus Disease 2019 (COVID-19) and Your Radiology Practice: Case Triage, Staffing Strategies, and Addressing Revenue Concerns.

Coronavirus Disease 2019 (COVID-19) and Your Radiology Practice: Case Triage, Staffing Strategies, and Addressing Revenue Concerns.

Multiparametric Magnetic Resonance Imaging for the Detection of Clinically Significant Prostate Cancer: What Urologists Need to Know. Part 1: Acquisition.

Acquiring multiparametric magnetic resonance images of the prostate is not a simple "push-button" approach. To show how image acquisition of prostate multiparametric Magnetic Resonance Imaging (mpMRI) can be optimized. Image protocols, magnetic field strength choice, and the use of receiver coils are discussed. In addition, patient preparation and the recognition, prevention, and mitigation of artifacts are evaluated. Based on expert prostate MRI technologists (MRI radiographers) opinion, the optimal protocol is reviewed, and potential artifacts are determined. The entire acquisition process is presented from initial patient preparation until the end of the imaging. The choice of the used equipment, pulse sequences, and prevention of patient- and imaging-related artifacts are presented. This will be shown in individual patients. Although the Prostate Imaging Reporting and Data System guidelines (2012 and 2016) describe minimal and optimal acquisition protocols for prostate mpMRI, these standards are not always met in daily practice. A major challenge in mpMRI is to obtain high image quality and reduce its variability for radiologic interpretations. A summary of evidence and guidelines for the acquisition of mpMRI of the prostate can set a basic guideline to reduce these variabilities. This article and an accompanying video can be used as a guide by MRI technologists (MRI radiographers) to improve their image acquisitions by optimizing protocols, magnetic field strength choice, and use of receiver coils. We also discuss patient preparation and the recognition, prevention, and mitigation of artifacts. In this first surgery-in-motion contribution, we will show how optimized image acquisition is performed to detect prostate cancer. Both MRI-dependent and patient related factors are discussed.