No apologies are offered for potentially sending the interested and highly motivated reader down an ultimately useless sequence road. Existing literature tends to be preliminary, and reports findings in few patients. Thirdly, and as is often the case with rapidly changing technology, the sequences may be quickly put into clinical use without much support in the scientific literature. Second, the majority of sequences discussed were obtained at mid and high field (1–1.5 T) therefore, I cannot attest to their usefulness at lower field strength.
Cord and CSF motion studies will not be covered, and peripheral nerve evaluations such as the lumbar and cervical plexi have been reviewed recently (1, 2). First, a few disclaimers: this review is necessarily limited, and I do not presume to cover every conceivable pulse sequence. This review will focus on some new sequences that might have real clinical impact on spinal imaging, as well as new applications of some older techniques. Even more choices are potentially available, but have shown little clinical use. Fortunately, a convergence of these forces has also occurred, allowing for current sequences with high C/N and short examination times.Ī myriad of choices are available for spine imaging, often with a bewildering array of names, acronyms, and parameters. Many novel MR imaging techniques have been developed with one of two driving forces behind them-increased speed of acquisition or improved lesion detection. This should be in a form that is quick and easy to interpret, and eliminates tedious multiple imaging manipulation and off-line processing. From a minimalist standpoint, what is desired is enough contrast to noise (C/N) in the shortest imaging time to provide diagnostic accuracy. The goal is to provide a voxel size that provides adequate yet small enough signal-to-noise (S/N) ratios for contrast resolution that provide the necessary spatial resolution. These choices will be influenced by the anatomic area to be studied, the desired field of view (FOV), spatial resolution, and contrast needs. In the performance of any MR examination, major decisions include selection of the appropriate coil, imaging plane, slice thickness, imaging matrix, number of excitations, and pulse-sequence parameters. Nevertheless, despite being somewhat overshadowed by their flashier cephalad cousins, significant advances have been made in sequence design and implementation that will directly impact the ease and confidence of spinal disease interpretation. These optimised sequences can then be used in the patient cohort.With the tremendous technical advances in MR imaging of the brain, such as perfusion, diffusion, and blood oxygenation level-dependent (BOLD) functional imaging, and contrast-enhanced MR angiography, the continued advances in MR imaging of the spine unfortunately may be overlooked. The healthy volunteers will be scanned for no more than one hour per session for a maximum of two sessions in total. On completion of radiotherapy treatment, the participants will continue to be on standard of care follow up protocol with the treating oncologist.Ī small cohort of ten healthy volunteers will also be recruited to the study to develop and select some of the MR sequences only; they will not provide blood or urine samples. In addition, they will be requested to give weekly blood and urine samples during the course of radiotherapy and at first follow up. The study participants will receive the standard of care treatment for their disease condition. All patients undergoing treatment in the MR Linac at the Christie hospital will be considered for enrolment regardless of tumour site being treated.
This enables us to take images with high resolution and target the tumours more precisely and also reduce the dose to normal tissues. The MR Linac is a new radiotherapy machine with an on board MR scanner. The overarching hypothesis is that changes in MR imaging and biological parameters from blood, tissue, or urine biomarkers can be measured during radiotherapy and associated with clinical outcome. This is accomplished by studying the MR images taken during each treatment session on the MR Linear accelerator (MR Linac). The MR BIO study aims to understand the changes in the tumour and normal tissues during a course of radiotherapy. Why Should I Register and Submit Results?.
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