Precision health is about optimizing healthcare for diagnosis and treatment of medical conditions in a world full of variables. This initiative considers how patients' lifestyles and genetics affect diseases and disorders. As a result, there has been an increase in patient-centered testing that provides outcome-based information. Medical imaging, especially magnetic resonance (MR), has become crucial to diagnosing and monitoring diseases and disorders, because it prevents exposure to radiation and can provide additional, quantifiable and consistent data. MR has also become fast and personalized with the help of innovative technology and software.
Quantifiable MR data is extremely helpful for detecting and monitoring disease. Because MR shows structures within the body, it can be used to measure things like atrophy or tumors. This allows doctors to determine how a disease is progressing and the treatment outcomes. For example, MR can illustrate atrophy, or declining health of tissue structures in the brain to improve outcomes for patients with Alzheimer’s.1 Similarly, advanced techniques, like diffusion-weighted imaging (DWI), allow physicians to see both size and characteristic changes occurring in a tumor, showing how cancer is reacting to a treatment and whether to try a new one.2 This ensures that patients are receiving the prescriptions and procedures that are right for them at the right time.
Conventionally in MR, patients have to lay as still as possible, as motion may blur the image, and therefore the scan may have to be repeated. Additionally, children often have trouble laying still, which can lead to doctors to rely on the use of sedation to obtain a clear image. However, sedation can come with its own risks and should not be a common occurrence. New motion correction techniques and software could be an excellent replacement. Researchers at the University of Wisconsin-Madison have developed a technique to produce better quality images from both motion distorted and unobstructed images.3 Recent developments in motion detecting software has begun prospective correction of pediatric scanning and decreased the number of repeated scans. 4 This could increase the number of patients a radiology department can scan and may reduce the cost of MR.
MR has historically been associated with long scan times but they need to be shortened in order to maximize the number of scans that can be completed each day and lower costs per patient. Scanners gather a substantial amount of data from each MR scanning sequence, resulting in lengthy exams as the computer processes the information. All of the collected data leads to a higher-resolution, in-depth image. There are multiple ways to accelerate the scan that have been put into practice, including compressed sensing (CS) and parallel imaging (PI). Scientists found that they could use CS to capture images at 8-fold acceleration without sacrificing image quality in the MRI.5 PI is often used to accelerate scans to shorten breath-hold duration, reduce motion artifacts, and can be used for any sequence throughout the body.6 Both of these techniques result in less scan time per patient and optimize the number of patients per day for each scanner.
In addition to improving MR imaging to be fast, consistent and quantifiable, new machines aim to increase comfort and adapt to the needs of patients. With the shift to precision health, there has been a renewed interest in responding to patient needs. For example, a couple innovations in magnetic resonance focus on free-breathing and noise-free.
MR patient exams of the abdomen often have to hold their breath during imaging, which can be difficult. Breathing during an MR scan causes motion, which, in turn, causes motion artifacts.3 With new respiratory motion correction technology, patients can have free-breathing exams.
One of the biggest complaints about MRI is the loud noise of the machine. Scanners are generally as loud as a jackhammer at roughly 110 dB.7 MR engineers have been working to reduce this to a more comfortable level for patients.8,9 The noise comes from the coils in the machine vibrating and altering a patient's magnetic field, which is required to complete an MRI. Innovative technology allows scanners to be significantly quieter and patients to be significantly happier without sacrificing the image quality that radiologists need to confidently assess the images.
Precision medicine has led to more quantifiable, consistent, rapid and personalized MRI through the use of new technology, letting doctors focus on outcome-based observations. Because of this, MR has become a valuable tool. The outcomes of disease and treatments can be quantified and assessed by radiologists, and patients can feel more comfortable with their personalized MR experience. MR has made incredible improvements since the Precision Medicine Initiative was instituted in 2015.
- Linda K. McEvoy and James B. Brewer. "Quantitative structural MRI for early detection of Alzheimer's disease." Expert Rev Neurother. November 2010; 10(11): 1675-1688. Web. 16 November 2018. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182103/>.
- Andrew J. Degnan, Chul Y. Chung, and Amisha J. Shah. "Quantitative diffusion-weighted magnetic resonance imaging assessment of chemotherapy treatment response of pediatric osteosarcoma and Ewing sarcoma malignant bone tumors." ClinicalImaging.org. January-February 2018; 47: 9-13. Web. 16 November 2018. <https://www.clinicalimaging.org/article/S0899-7071(17)30154-7/fulltext>.
- Adityarup Chakravorty. "Researchers Unveil New Strategy to Correct for Motion During MRI Scans." Waisman Center. 23 August 2018. Web. 13 November 2018. <https://www.waisman.wisc.edu/2018/08/23/researchers-unveil-new-strategy-to-correct-for-motion-during-mri-scans/>.
- Joshua M. Kuperman, et al. “Prospective motion correction improves diagnostic utility of pediatric MRI scans.” Pediatric Radiology. December 2011; 41(12): 1578-1582. Web. 21 November 2018. <https://link.springer.com/article/10.1007/s00247-011-2205-1>.
- Michael Lustig, David Donoho and John M. Pauly. "Sparse MRI: The application of compressed sensing for rapid MR imaging." Magnetic Resonance in Medicine. 29 October 2007; 58(6): 1182-1195. Web. 14 November 2018. <https://onlinelibrary.wiley.com/doi/full/10.1002/mrm.21391>.
- Anagha Deshmane, et al. "Parallel MR imaging." JMRI. 13 June 2012; 36(1): 55-72. Web. 14 November 2018. <https://onlinelibrary.wiley.com/doi/full/10.1002/jmri.23639>.
- Leesha Lentz. "Turn Down the Volume — Vendors Pursue Quieter MRI Systems." Radiology Today. December 2013; 14(12): 12. Web. 16 November 2018. <https://www.radiologytoday.net/archive/rt1213p12.shtml>.
- Samantha J Holdsworth, et al. "Clinical Evaluation of Silent T1-Weighted MRI and Silent MR Angiography of the Brain." American Journal of Roentgenology. February 2018; 210: 404-411. Web. 14 November 2018. <https://www.ajronline.org/doi/full/10.2214/AJR.17.18247>.
- Corcuera-Solano. "Quiet Propeller MRI Techniques Match the Quality of Conventional Propeller Brain Imaging Techniques." American Journal of Neuroradiology. June 2015; 36(6): 1124-1127. Web. 14 November 2018. <http://www.ajnr.org/content/36/6/1124.full>.