2023-09-02 02:55:25
In three decades of evolution, magnetic resonance has become a day-to-day technique and an ally with new uses and possibilities. Magnetic resonance imaging is essential in neuroscience research.
The Spanish Society of Medical Radiology (Seram) decided in 2020 to “review the role of magnetic resonance imaging (MRI), since it is a technique that has been used for 30 years but has had a very significant evolution both technically and in answers that it can give us”, explains Josep Munuera, director of the Radiodiagnosis Service of the Hospital de la Santa Creu i Sant Pau, in Barcelona, and scientific manager of the Seram.
And it is that MRI is a gold standard technique in many areas, “it is the definitive technique in some neoplasias, in prostate follow-up, in neurology, breast…”, lists Munuera. But it also “provides very valuable information on metabolites, blood flow in aneurysms, tumor composition, etc.”
Thus, a “day-to-day technique” allows very basic uses, but also very advanced ones, “such as studying what happens in the brain of psychiatric patients”, and it has a fundamental role in neuroscience research.
These new applications have been possible, above all, due to the evolution of the technique itself and of the equipment, which have gone from a magnet power of 0.7 Tesla to 3, and even 7 in research, and by “the types of sequences that can be extracted, each one on a property of the tissues that we study; their combination gives a complete diagnosis.”
The patient’s experience in the MRI has also changed a lot, much more comfortable now: “Before, it was a narrow tube that made a lot of noise for a long time. Now humanization is sought, the tubes have been expanded and noise is sought to be attenuated with distraction elements for the patient”.
Regarding the duration of the test, the main help in shortening it has come from the hand of artificial intelligence: “Thanks to acceleration and noise reduction algorithms, it is possible to obtain higher quality images in 7 or 8 minutes, compared to the 30 that it usually took”.
Another fundamental change refers to the importance given to quantitative data, in addition to qualitative data: “To use big data it is necessary to have data, and all this information can be incorporated into the rest of the clinical data.”
However, Munuera acknowledges that evolution does not depend solely on technology, since “we need people who know how to take advantage of it, exploit the results and possibilities of MRI: radiologists, technicians, engineers…”. And, of course, the lack of radiologists is an international problem, so it is essential “to be able to retain talent with the help of management and institutions.”
new uses
In order to keep up to date with MRI developments, every year since 2020 Seram organizes a conference in collaboration with the American Roentgen Ray Society (ARRS). These are some of the advances analyzed in the last one, held in La Coruña:
Cardiology: cardiomyopathy, congenital heart disease, systemic diseases, pulmonary hypertension, cardiac involvement in cancer patients, evaluation of myocardial functional alteration when the ejection fraction (value that provides information about cardiac contraction) is normal, in studies evaluating the right cavities , in myocardial deposit diseases, cardiac masses or tumors, etc. There are many situations in which cardiology can use MRI not only for diagnosis, but also for prognosis. Head and neck: in this area, MRI has the advantage, compared to other imaging techniques, of having a high contrast resolution that allows better detection and delimitation of lesions. It provides data on tumor extension by obtaining morphological sequences, but also with functional diffusion and perfusion sequences currently it is possible to obtain quantitative data that can contribute to the characterization of tumors and provide information on the prediction of response to treatment. and the forecast. There are specific behavioral characteristics of head and neck cancers that are prognostic indicators and will condition treatment, such as perineural dissemination, involvement of bone structures, intracranial invasion, invasion of laryngeal cartilages, or the presence of adenopathies. Ovarian tumors: the casual finding of an asymptomatic ovarian mass is a frequent clinical problem, and only 30% of these masses will be malignant. Transvaginal ultrasound is the technique of choice for the characterization of ovarian masses; however, up to 25-30% of ovarian tumors are classified as indeterminate by transvaginal ultrasound, with 15-30% of these masses actually of non-ovarian origin and up to 70% of those classified as high risk resulting be benign For this reason, MRI plays a fundamental role in the evaluation of adnexal tumors, both in those that are indeterminate in the ultrasound study, and in those that are initially classified as malignant with disease limited to the ovary. The latter is of special relevance in solid tumors, since many of them are initially erroneously classified as malignant by ultrasound, and MRI could correctly identify them as it has greater specificity. Rosalia Sierra
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