Program Information
MR Physics: Current Practice and Future Directions
K Huff1*, R Muthupillai2*, (1) Fusion Physics, LLC, Apollo Beach, FL, (2) St Luke's Episcopal Hospital, Houston, TX
Presentations
SA-C-BRC-0 (Saturday, March 7, 2015) 1:30 PM - 3:30 PM Room: Ballroom C
Essential tools for Clinical Cardiovascular MRI, Raja Muthupillai, PhD
Non-invasive imaging has played a crucial role in the diagnosis of heart disease. Echocardiography is widely used to evaluate left-ventricular function, and valvular disease. Nuclear scintigraphy is used to assess myocardial perfusion and viability, and recent advances in x-ray computed tomography have made it possible to visualize coronary artery anatomy and coronary artery calcium. In the past decade, as a non-invasive imaging option, cardiovascular MR has grown from a being a mere curiosity to becoming a widely used clinical tool for evaluating cardiovascular disease. Cardiovascular Magnetic Resonance Imaging (CMRI) is now routinely used across multiple centers to study myocardial structure, cardiac function, macro vascular blood flow, myocardial perfusion, and myocardial viability.
For someone entering the field of cardiac MR, this rapid pace of development in the field of CMRI might make it difficult to identify a cohesive starting point. In this presentation, key cardiovascular imaging techniques that have found widespread clinical acceptance will be summarized. In particular, essential cardiac and respiratory gating techniques that form the backbone of all cardiovascular imaging methods will be described. It is followed by four sections that discuss: (a) the gradient echo techniques that are used to assess ventricular function, (b) black-blood turbo spin echo methods used for morphologic assessment of the heart, (c) phase-contrast based techniques for the assessment of blood flow and valvular function, and (d) CMR methods for the assessment of myocardial ischemia and viability. In each section, we briefly summarize technical considerations relevant to the clinical use of these techniques, followed by practical information for its clinical implementation. In each of those four areas, CMRI is considered either as the benchmark imaging modality against which the diagnostic performance of other imaging modalities are compared against, or provides a complementary capability to existing imaging techniques.
Description of cutting-edge CMR imaging techniques that are practiced at few academic centers is excluded and the presentation is focused on describing methods that are widely used and are likely to be available in a clinical setting.
Learning Objectives:
1. Understand the utility of cardiac and respiratory gating techniques
2. Understand cardiovascular magnetic resonance imaging techniques
3. Understand clinical applications of cardiovascular magnetic resonance imaging
Current Practice and Future Directions (MR Testing and Quality Control)
Given that there have been relatively few changes in the current practice of MRI Physics, there will be a brief recap of basic MRI Physics, as well as the requirements of the Medical Physicist during an annual evaluation of the typical MRI Scanner. These requirements include evaluation of Magnetic Field Homogeneity, ACR phantom scanning, Technologist Quality Control, and MRI Safety, which will be discussed in a lengthier fashion. What continues to cause more strife to the practicing physicist is trouble shooting typical MRI artifacts and maintaining a working understanding of the alphabet soup that is the clinically used MRI sequence. These issues will be addressed in conjunction with the proposed changes that are on the horizon by various accrediting bodies.
Learning Objectives:
1. Understand the basics of MRI physics
2. Understand the best practices in MRI scanner evaluation
3. Understand troubleshooting methods related to artifacts and other common issues
Handouts
- 97-25808-353470-109860.pdf (R Muthupillai)
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