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Volume 2 • Issue 6 • 1000e113 J Biotechnol Biomater ISSN:2155-952X JBTBM an open access journal Editorial Open Access Stancanello, Venkateshwarlu et al., 2012, 2:6 DOI: 10.4172/2155-952X.1000e113 *Corresponding author: Joseph Stancanello, Ph.D., Director, MRI Research Europe, Middle East and Africa, GE Healthcare, France, Tel: +49 173 9655 402; E-mail: [email protected] Received October 01, 2012; Accepted October 01, 2012; Published October 03, 2012 Citation: Stancanello J (2012) Magnetic Resonance Imaging will Replace Computer Tomography. J Biotechnol Biomater 2:e113. doi:10.4172/2155- 952X.1000e113 Copyright: © 2012 Stancanello J, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Magnetic Resonance Imaging will Replace Computer Tomography Joseph Stancanello* MRI Research Europe, Middle East and Africa, GE Healthcare, France Introduction e introduction of tomographic imaging revolutionized the way we look at medical images. Compared to X-ray projective image, Computer Tomography (CT) offers the possibility of analyzing anatomical structures on a three-dimensional, slice-to-slice approach. On the other hand, limitations of CT consist of poor soſt tissue contrast and ionizing radiation [1], while the advantages are distortion-free images and fast scan times [2]. Indeed, CT has been the modality of choice in many applications, going from diagnostic imaging to image- guided therapeutic solutions [3,4]. e advent of Magnetic Resonance Imaging (MRI) represented a further quantum leap in tomographic imaging in that soſt tissue contrast was dramatically superior to CT with no radiation dose. On the other hand, MRI suffered from image distortion and long scan times, as well as limitation in scanning regions where metal implants are present. MRI offers a wide range of contrast generation, which makes it probably the modality with the highest potential in the imaging arena. is is reflected in the introduction of new MRI sequences in the range of 5-10 per year. ough MRI held significant advantages over CT, the late introduction and the complexity of the systems (and their high associated costs) have led MRI to be a follower of CT in many applications. e introduction of hardware and soſtware solutions to mitigate the traditional weakness of MRI such as image distortion (new systems are able to reach a sub-millimeter accuracy [5]) and long scan time (parallel imaging [6] and compressed sensing methods [7] have dramatically decreased the scan time down to less than 1 minute) are making MRI become the natural successor to CT in many applications at an expense comparable to that of a mid-high end CT. On top of that, the traditional advantages of MRI over CT such us huge soſt tissue contrast (see new sequence such as fat-water quantification [8]) and molecular/functional imaging (see new hyperpolarized contrast agents [9]) are even increasing in the last years. Let us have a look at some specific examples. Integration of MRI into Hybrid Medical Devices CT has been historically the modality of choice for image guided therapy such as in radiotherapy (see CT-on-rails [10] or cone-beam CT [11] associated with linear accelerators) or in surgery, including robotic applications [12]. e drivers were the distortion-free images and the low complexity of the CT systems compared to MRI, also in terms of behavior of electrons/ferromagnetic tools within a magnetic field. e capability of MRI to dramatically reduce distortion and the availability of MRI-compatible devices (e.g., waveguides to be placed in magnetic fields [13]) and tools (e.g., MRI compatible surgical tools [14]) has elevated MRI to the modality of future for image-guided solutions, such as High Focused Ultrasounds [15] (HIFU) due to the ability of MRI to create temperature maps [16] or surgical suites due to ability of MRI to accurately differentiate tumors versus healthy tissue. Another example is given by the integration of morphological into molecular imaging. Historically, CT has been the modality of choice in the integration with Positron Emission Tomography (PET) or Single MRI-guided robotic applications [18] and drug delivery [19] are the challenges of future which could enable MRI to exploit its untapped potential in a variety of different applications. Integration of MRI into First Aid Department Historically CT has been the modality of choice in first aid, as an evolution of projective x-ray images. is has been motivated by the fast CT acquisition and by the ability to accurately visualize traumatic results. In terms of MRI, the introduction of parallel imaging and new fast sequences has decreased the acquisition time to a level more suitable for first aid. Compressed sensing in a similar approach to iterative reconstruction in CT holds the potential to significantly decrease the acquisition time but, as of now, this is paid in terms of reconstruction time, which makes it not suitable for first aid purposes. In future, if the processing time will decrease, compressed sensing could play an important role also in first aid applications. Regarding the advantage of CT for traumatic events, new MRI pulse sequences makes it possible to visualize musculo-skeletal structures in greater detail as well as regions close tometallic implants [20]. is will make MRI very competitive against the high Z artifacts produced by CT images in the presence of metallic implants. In addition to all these improvements, MRI holds the potential to offer functional information (perfusion and diffusion), which may be very useful in some application like post-stroke therapy [21]. erefore, interest in the use of MRI as a substitute of CT in first aid department is growing worldwide. MRI in Cardiac Imaging Historically, CT images represented the gold standard in cardiac applications, especially aſter the introduction of ultra-fast CT. e ability to quickly image multi-phase cardiac data with high spatial resolution together with a reduction in the dose whilst maintaining reasonably image quality has supported the use of CT in an increasing number of patients being examined with cardiac pathologies [22]. e introduction of fast sequences, parallel imaging and iterative reconstruction methods are shiſting the attention of the community to cardiac MRI, especially due to no dose, when multiple acquisitions are needed. In addition to Photon Emission Tomography (SPECT) in CT-PET or CT-SPECT. It is a common belief that MRI will add additional information to PET images when acquired simultaneously. Hence, MRI-PET hybrid systems have been proposed and are currently under investigation to understand their value in clinical routine beyond research areas [17]. J o u r n a l o f B i o t e c h n o l o g y & B i o m a t e r i a l s ISSN: 2155-952X Journal of Biotechnology & Biomaterials
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Page 1: B iof o l a n maet Journal of Biotechnology & Biomaterials ... · capability of MRI to dramatically reduce distortion and the availability of MRI-compatible devices (e.g., waveguides

Volume 2 • Issue 6 • 1000e113J Biotechnol BiomaterISSN:2155-952X JBTBM an open access journal

Editorial Open Access

Stancanello, Venkateshwarlu et al., 2012, 2:6 DOI: 10.4172/2155-952X.1000e113

*Corresponding author: Joseph Stancanello, Ph.D., Director, MRI Research Europe, Middle East and Africa, GE Healthcare, France, Tel: +49 173 9655 402; E-mail: [email protected]

Received October 01, 2012; Accepted October 01, 2012; Published October 03, 2012

Citation: Stancanello J (2012) Magnetic Resonance Imaging will Replace Computer Tomography. J Biotechnol Biomater 2:e113. doi:10.4172/2155-952X.1000e113

Copyright: © 2012 Stancanello J, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Magnetic Resonance Imaging will Replace Computer TomographyJoseph Stancanello*MRI Research Europe, Middle East and Africa, GE Healthcare, France

IntroductionThe introduction of tomographic imaging revolutionized the

way we look at medical images. Compared to X-ray projective image, Computer Tomography (CT) offers the possibility of analyzing anatomical structures on a three-dimensional, slice-to-slice approach. On the other hand, limitations of CT consist of poor soft tissue contrast and ionizing radiation [1], while the advantages are distortion-free images and fast scan times [2]. Indeed, CT has been the modality of choice in many applications, going from diagnostic imaging to image-guided therapeutic solutions [3,4].

The advent of Magnetic Resonance Imaging (MRI) represented a further quantum leap in tomographic imaging in that soft tissue contrast was dramatically superior to CT with no radiation dose. On the other hand, MRI suffered from image distortion and long scan times, as well as limitation in scanning regions where metal implants are present. MRI offers a wide range of contrast generation, which makes it probably the modality with the highest potential in the imaging arena. This is reflected in the introduction of new MRI sequences in the range of 5-10 per year.

Though MRI held significant advantages over CT, the late introduction and the complexity of the systems (and their high associated costs) have led MRI to be a follower of CT in many applications. The introduction of hardware and software solutions to mitigate the traditional weakness of MRI such as image distortion (new systems are able to reach a sub-millimeter accuracy [5]) and long scan time (parallel imaging [6] and compressed sensing methods [7] have dramatically decreased the scan time down to less than 1 minute) are making MRI become the natural successor to CT in many applications at an expense comparable to that of a mid-high end CT. On top of that, the traditional advantages of MRI over CT such us huge soft tissue contrast (see new sequence such as fat-water quantification [8]) and molecular/functional imaging (see new hyperpolarized contrast agents [9]) are even increasing in the last years. Let us have a look at some specific examples.

Integration of MRI into Hybrid Medical DevicesCT has been historically the modality of choice for image guided

therapy such as in radiotherapy (see CT-on-rails [10] or cone-beam CT [11] associated with linear accelerators) or in surgery, including roboticapplications [12]. The drivers were the distortion-free images and thelow complexity of the CT systems compared to MRI, also in terms ofbehavior of electrons/ferromagnetic tools within a magnetic field. Thecapability of MRI to dramatically reduce distortion and the availabilityof MRI-compatible devices (e.g., waveguides to be placed in magneticfields [13]) and tools (e.g., MRI compatible surgical tools [14]) haselevated MRI to the modality of future for image-guided solutions, suchas High Focused Ultrasounds [15] (HIFU) due to the ability of MRI tocreate temperature maps [16] or surgical suites due to ability of MRI toaccurately differentiate tumors versus healthy tissue.

Another example is given by the integration of morphological into molecular imaging. Historically, CT has been the modality of choice in the integration with Positron Emission Tomography (PET) or Single

MRI-guided robotic applications [18] and drug delivery [19] are the challenges of future which could enable MRI to exploit its untapped potential in a variety of different applications.

Integration of MRI into First Aid DepartmentHistorically CT has been the modality of choice in first aid, as an

evolution of projective x-ray images. This has been motivated by the fast CT acquisition and by the ability to accurately visualize traumatic results. In terms of MRI, the introduction of parallel imaging and new fast sequences has decreased the acquisition time to a level more suitable for first aid. Compressed sensing in a similar approach to iterative reconstruction in CT holds the potential to significantly decrease the acquisition time but, as of now, this is paid in terms of reconstruction time, which makes it not suitable for first aid purposes. In future, if the processing time will decrease, compressed sensing could play an important role also in first aid applications. Regarding the advantage of CT for traumatic events, new MRI pulse sequences makes it possible to visualize musculo-skeletal structures in greater detail as well as regions close tometallic implants [20]. This will make MRI very competitive against the high Z artifacts produced by CT images in the presence of metallic implants. In addition to all these improvements, MRI holds the potential to offer functional information (perfusion and diffusion), which may be very useful in some application like post-stroke therapy [21]. Therefore, interest in the use of MRI as a substitute of CT in first aid department is growing worldwide.

MRI in Cardiac Imaging Historically, CT images represented the gold standard in cardiac

applications, especially after the introduction of ultra-fast CT. The ability to quickly image multi-phase cardiac data with high spatial resolution together with a reduction in the dose whilst maintaining reasonably image quality has supported the use of CT in an increasing number of patients being examined with cardiac pathologies [22]. The introduction of fast sequences, parallel imaging and iterative reconstruction methods are shifting the attention of the community to cardiac MRI, especially due to no dose, when multiple acquisitions are needed. In addition to

Photon Emission Tomography (SPECT) in CT-PET or CT-SPECT. It is a common belief that MRI will add additional information to PET images when acquired simultaneously. Hence, MRI-PET hybrid systems have been proposed and are currently under investigation to understand their value in clinical routine beyond research areas [17].

Jour

nal o

f Biot

echnology &Biomaterials

ISSN: 2155-952X

Journal of Biotechnology & Biomaterials

Page 2: B iof o l a n maet Journal of Biotechnology & Biomaterials ... · capability of MRI to dramatically reduce distortion and the availability of MRI-compatible devices (e.g., waveguides

Citation: Stancanello J (2012) Magnetic Resonance Imaging will Replace Computer Tomography. J Biotechnol Biomater 2:e113. doi:10.4172/2155-952X.1000e113

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Volume 2 • Issue 6 • 1000e113J Biotechnol BiomaterISSN:2155-952X JBTBM an open access journal

11. Jaffray DA, Siewerdsen JH, Wong JW, Martinez AA (2002) Flat-panel cone-beam computed tomography for image-guided radiation therapy. Int J Radiat Oncol Biol Phys 53: 1337-1349.

12. Maurin B, Bayle B, Piccin O, Gangloff J, de Mathelin M, et al. (2008) A patient-mounted robotic platform for CT-scan guided procedures. IEEE Trans Biomed Eng 55: 2417-2425.

13. St Aubin J, Steciw S, Fallone BG (2010) Waveguide detuning caused by transverse magnetic fields on a simulated in-line 6 MV linac. Med Phys 37: 4751-4754.

14. Hall WA, Galicich W, Bergman T, Truwit CL (2006) 3-Tesla intraoperative MR imaging for neurosurgery. J Neurooncol 77: 297-303.

15. Al-Bataineh O, Jenne J, Huber P (2012) Clinical and future applications of high intensity focused ultrasound in cancer. Cancer Treat Rev 38: 346-353.

16. Bohris C, Schreiber WG, Jenne J, Simiantonakis I, Rastert R, et al. (1999) Quantitative MR temperature monitoring of high-intensity focused ultrasound therapy. Magn Reson Imaging 17: 603-610.

17. Schwenzer NF, Stegger L, Bisdas S, Schraml C, Kolb A, et al. (2012) Simultaneous PET/MR imaging in a human brain PET/MR system in 50 patients-Current state of image quality. Eur J Radiol 81: 3472-3478.

18. Hempel E, Fischer H, Gumb L, Höhn T, Krause H, et al. (2003) An MRI-compatible surgical robot for precise radiological interventions. Comput Aided Surg 8: 180-191.

19. Sanches PG, Grüll H, Steinbach OC (2011) See, reach, treat: ultrasound-triggered image-guided drug delivery. Ther Deliv 2: 919-934.

20. Koch KM, Brau AC, Chen W, Gold GE, Hargreaves BA, et al. (2011) Imaging near metal with a MAVRIC-SEMAC hybrid. Magn Reson Med 65: 71-82.

21. Sandhu GS, Sunshine JL (2012) Advanced Neuroimaging to Guide Acute Stroke Therapy. Curr Cardiol Rep.

22. Sun Z, Choo GH, Ng KH (2012) Coronary CT angiography: current status and continuing challenges. Br J Radiol 85: 495-510.

23. Attili AK, Schuster A, Nagel E, Reiber JH, van der Geest RJ (2010) Quantification in cardiac MRI: advances in image acquisition and processing. Int J Cardiovasc Imaging 26: 27-40.

24. Florian A, Jurcut R, Ginghina C, Bogaert J (2011) Cardiac magnetic resonance imaging in ischemic heart disease: a clinical review. J Med Life 4: 330-345.

that, new acquisition and post-processing techniques hold the potential to provide information about flow [23], ischemic heart disease [24] functional information as well as morphological information of heart.

In conclusion, the aforementioned examples suggest that MRI is filling the gap compared to CT, making it potentially the future modality of choice in imaging and therapeutic applications. Also, the potential offered by functional and molecular MRI is likely to differentiate even more this modality leading to the substitution of CT with MRI in the future.

References

1. Brink JA, Amis ES Jr (2010) Image Wisely: a campaign to increase awareness about adult radiation protection. Radiology 257: 601-602.

2. Hinkmann FM, Voit HL, Anders K, Baum U, Seidensticker P, et al. (2009) Ultra-fast carotid CT-angiography: low versus standard volume contrast material protocol for a 128-slice CT-system. Invest Radiol 44: 257-264.

3. Baker GR (2006) Localization: conventional and CT simulation. Br J Radiol 79: S36-S49.

4. Bale R, Widmann G (2007) Navigated CT-guided interventions. Minim Invasive Ther Allied Technol 16: 196-204.

5. Crijns SP, Bakker CJ, Seevinck PR, de Leeuw H, Lagendijk JJ, et al. (2012) Towards inherently distortion-free MR images for image-guided radiotherapy on an MRI accelerator. Phys Med Biol 57: 1349-1358.

6. Katscher U, Bornert P (2007) Parallel magnetic resonance imaging. Neurotherapeutics 4: 499-510.

7. Miao J, Guo W, Narayan S, Wilson DL (2012) A simple application of compressed sensing to further accelerate partially parallel imaging. Magn Reson Imaging.

8. Reeder SB, Cruite I, Hamilton G, Sirlin CB (2011) Quantitative Assessment of Liver Fat with Magnetic Resonance Imaging and Spectroscopy. J Magn Reson Imaging 34: spcone.

9. Brindle KM, Bohndiek SE, Gallagher FA, Kettunen MI (2011) Tumor imaging using hyperpolarized 13C magnetic resonance spectroscopy. Magn Reson Med 66: 505-519.

10. Knight K, Touma N, Zhu L, Duchesne GM, Cox J (2009) Implementation of daily image-guided radiation therapy using an in-room CT scanner for prostate cancer isocentre localization. J Med Imaging Radiat Oncol 53: 132-138.


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