Economic factors limit the clinical adoption of 7T MRI systems

Economic factors limit the clinical adoption of 7T MRI systems

Asked what it would take for a 7 tesla machine to become available as 3 or 1.5 tesla systems in the future, Thoralf Niendorf, PhD, said, “For now, I think it’s readily available, most protocols brain imaging are well established and can be used. “

Thoralf Niendorf, PhD, from Berlin. Image courtesy of Felix Petermann of MDC.

“In the end, I think it’s just the price that makes the difference between 3T and 7T, and not all institutions could afford a 7T system,” he noted. “But from a technical standpoint, availability isn’t a problem at all; for brain MRI, it’s all about money.”

ISMRM will hold this week’s meeting in collaboration with the European Society for Magnetic Resonance Imaging in Medicine and Biology and the International Society for Radiographers and MR Technologists.

Growing Demand for 7T MRI

Niendorf, who is Professor of Experimental Ultra High Field MRI at the Charité Berlin and Head of the Berlin Ultra High Field Facility at the Max Delbrück Center for Molecular Medicine, spoke about new frontiers and applications in high field imaging. at ISMRM 2022. It highlighted the growing demand for imaging services, particularly in addressing the global burden of neurological disorders and the challenge of integrating the findings of molecular and cellular insights from brain research.

Imaging has an important role to play in moving from late-stage treatment to early diagnosis of disease processes before symptoms occur, he said. Niendorf stressed the clinical importance and relevance of neuro MRI: examinations of the brain, spine, and head and neck typically account for more than 50% of total examinations.

“You are the experts and are used to doing it at 1.5T and 3T, and now we are trying to push the envelope and do it at 7T too,” he continued.

Niendorf described the advantages of 7 tesla MRI, such as an increase in the signal-to-noise ratio, greater spatial resolution, and the ability to produce more detailed images, citing examples in relation to multiple sclerosis (MS).

“We believe 7T MRI can really make a difference when it comes to differentiating MS lesions from other neurodegenerative diseases (such as Susac’s syndrome),” he said.

“But imaging injuries are not enough: this would limit us to being photographers, when we are researchers, scientists and radiographers who want to help people and save lives. That’s why we need to know more about the mechanisms behind neurodegenerative diseases. or neurological disorders, “added Niendorf.

Configuring a 7T service

The technological challenges of 7 tesla MRI are not to be underestimated; however, according to Philippa Bridgen, an advanced MRI research radiographer at King’s College London. You helped set up a 7 tesla service at Guy’s Hospital in central London.

“You really need a good working relationship with your team of physicists, because they are absolutely vital to your success,” he said during the same session on Saturday.

The service is part of the London Collaborative Ultra High Field System and, with several partners, including King’s College London, is involved in the work, including epilepsy research. The unit has already seen around 350 patients, including 60 children, since it opened in October 2019.

Bridgen said the main challenges for the 7 tesla MRI included the need for additional safety training for staff, preparing patients for scans, and transient side effects (such as people feeling sick or tasting). metallic in the mouth), have clear clinical and referral pathways, obtain research grants, and know what to do with images and accidental results.

“If you need a radiologist to look at it, are they used to looking at 7T images? Do they see things they’ve never seen before? ultra-high field is used to identify who could benefit from it.

Bridgen was involved in a pilot study in 20 children that compared the clinical value of 7 tesla structural MRI for lesion detection in a cohort of children with drug-resistant epilepsy undergoing presurgical evaluation. He found lesions visible on the 7 tesla MRI that weren’t evident on the 3 tesla scans, but were visible on the PET scan. This could help guide stereotaxic surgery to remove the lesions.

The reality of 11.7T

Aiming even higher in terms of field strength is Dr Denis Le Bihan, PhD, and the team from NeuroSpin, part of the French Atomic Energy Commission in Saclay, Paris.

He described how the group developed “the human brain explorer” – an all-European machine dubbed “the world’s most powerful MRI scanner”. In October 2021, it delivered its first images: a pumpkin scanned at 11.7 tesla. The plan now is to move on to patients, said Le Bihan, who came up with the idea over 20 years ago.

He spoke at ISMRM 2022 via a video link because he is currently in Germany to receive the Eduard Rhein Foundation Award for the invention of Diffusion Tensor Magnetic Resonance Imaging (DTI). He said the 11.7 tesla magnet was so large when manufactured that it had to be routed during transportation to avoid lower road bridges.

The delivery of the 11.7 T magnet posed a major logistical challenge

The delivery of the 11.7 T magnet posed a major logistical challenge. Image courtesy of Dr. Denis Lebihan, PhD.

The scanner should help researchers better explore some brain disorders and neural patterns, he told delegates at ISMRM 2022.

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