number 46 2003 issue 3number 46 2003 issue 3 s i g n a l s 2g editor’s letter julie strandt-peay,...

Number 46

2003 Issue 3

2 Editor’s Letter2 Meet the New SMRT President3 President’s Letter

Annual Meeting Highlights4 Education Committee Report5 SMRT Forum: MR Purchase Decisions

at the ISMRM Meeting6 2003 Oral Presentation Proffered

Paper Award Winners8 2003 Poster Presentation Winners10 2003 2nd Place Oral Presentation,

Clinical Focus11 2003 2nd Place-Tie Oral Presentation,

Research Focus12 2003 2nd Place-Tie Oral Presentation,

Research Focus13 2003 3rd Place Oral Presentation,

Clinical Focus14 2003 1st Place– Clinical Poster15 2003 1st Place– Research Poster16 2003 2nd Place– Clinical Poster17 2003 2nd Place– Research Poster18 2003 Clinical Focus and Research Focus

Oral and Poster Presenters20 Update on SMRT Educational Seminars21 SMRT Members: Remember to Vote!21 Regional Committee Update

Information for You22 Low- and Mid-field MRI– Precessing

in a Vertical Field Knee Case Study23 Institute for Magnetic Resonance

Safety, Education, and Research24 MRI Safety– Guidelines to Prevent

Excessive Heating and Burns Associatedwith Magnetic Resonance Procedures

News for You26 2004 SMRT Annual Meeting Update28 ISMRM/SMRT Calendar29 Win a Trip to Japan!

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SECTION FOR MAGNETIC RESONANCE TECHNOLO

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I S M R • • • • M

NEWSLETTER OF THE SECTION FOR MAGNETIC RESONANCE TECHNOLOGISTS

IN THIS ISSUE SMRT 12th Annual MeetingProgram ReportLaurian Z. Rohoman, A.C.R., R.T. (R)(MR), 2003 Program Committee Chair

A fter a two-month delay the SMRT 12th Annual Meeting finally became a reality on 9-11 July 2003 at the Metro Toronto

Convention Centre in Toronto, Ontario, Canada. Two hundred andforty-one technologists from 17 different countries attended the2-day educational meeting. The theme of this year’s meeting was“Excellence through World-Class Education” and it certainly was.The topics presented by the faculty speakers together with theabstract presentations by the technologists indeed promotedexcellence through world-class education.

The meeting started off with the 5th Annual Poster Exhibit and Walking TourReception on Wednesday evening. Our thanks to Mallinckrodt, Inc. for sponsoringthis event. The attendees were able to meet and interact with their peers in arelaxed and informal atmosphere. Thirty-seven poster presenters were on hand todisplay their work and share the results with the attendees. A lot of hard work goesinto putting together these poster presentations and we commend all the posterpresenters for their commitment and dedication. This year a new event was addedto the Poster Exhibit. Four poster presenters were selected to give a brief oralpresentation of their work. The oral poster presentations were well received and wehope to continue this event at future meetings, allowing more poster authors theopportunity to present their work.

The didactic portion of the meeting began very early Thursday morning, withLaurian Rohoman, 2003 Program Chair welcoming the attendees and introducingthe moderator of the morning session, Muriel Cockburn from Glasgow, Scotland.Anne Sawyer-Glover, B.S., R.T., (R)(MR) started off the program sharing herexpertise on “Basics of Functional Neuro Imaging.” Next Naeem Merchant, M.D.,

discussed “Cardiac Imaging,” which was wellappreciated by the audience. After the break,William Faulkner, B.S., R.T. (R)(MR)(CT) talkedabout “New Pulse Sequences” and kept theaudience well entertained. Next on the agendawere proffered papers.

The SMRT Business Meeting was heldduring the lunch hour. John Koveleski, Presi-dent of the SMRT called the meeting to order.The Executive Committee members wereintroduced as well as the current and new PolicyBoard members. Next the committee chairs eachgave a brief report and then it was on to theawards presentations. The Fellows Award waspresented to Robin Greene-Avison by HeidiBerns, Robin sent her regrets as she was unableto attend the rescheduled meeting. The Honor-ary Membership Award was presented to Dr.Frank Shellock and the Distinguished Service

Continued on page 7 ➠John Koveleski passes the gavel to incomingSMRT President, Maureen Ainslie.

NUMBER 46 2003 ISSUE 3 S i g n a l s 2

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Editor’s LetterJulie Strandt-Peay, B.S.M., R.T. (R)(MR)

reetings.

In this issue ofSignals you will findexpanded coverage of theSMRT 12th AnnualMeeting with ProgramChair, Laurian Rohoman

leading off. The editor would like tothank Anne Sawyer-Glover for onceagain providing most of the photographsrelating to the annual meeting. You willhear from and about our new President,Maureen Ainslie. Education Chair,Julia Lowe announces the awardwinning abstract presenters and detailsabout the educational program. Ab-stracts are printed for your educationalinformation, and more will be included inthe next issue of Signals. Nanette Keckchaired this year’s SMRT Forum at theISMRM meeting and shares that event.

Kelly Baron brings us news on thelatest offering of the SMRT EducationalSeminars Home Study program. Past-president, John Koveleski, chairs theNominating Committee and reminds usthat it is time to vote for the candidateof our choice. SMRT Regional Seminarsare an important component of theeducational offerings. Check out all theupcoming events and take note of chair,Cindy Comeau’s message about howYOU could host a seminar. Low- andMid-Field columnist, Bill Faulknershows an interesting case study. FrankShellock addresses the potential ofexcessive heating and burns in his safetycolumn. There is also information aboutthe Institute for Magnetic ResonanceSafety, Education, and Research.

Plans are already underway for theSMRT 13th Annual Meeting in Kyoto,Japan. Jim Stuppino is Program Chairand has his committee hard at work.Has your work place been featured in“Highlight Your Site”? Information isavailable for you and your colleagues tobecome world known. The SMRTcontinues to strive to increase theeducational offerings and opportunitiesfor MR professionals. Note the items inSignals and be sure to visit the SMRTWebsite often.

And, lastly, and exciting opportunityfor customers of MRI Devices!See the back cover for details! �

Meet the New SMRT President:Maureen Ainslie, M.S., R.T. (R)(MR)Julie Strandt-Peay, B.S.M., R.T. (R)(MR)

Signals: Maureen, canyou highlight for usyour career in MR?

Maureen: I wasfortunate to be one ofthe technologists chosento work on one of thefirst 1.5 Tesla magnets

installed at the Brigham and Women’sHospital in Boston, Massachusetts. Itwas quite a challenge as not only wasthe field of MR a new avenue for all ofus, the magnet was operated as aconsortium magnet with three usergroups. A large level one traumacenter, a cancer center and a pediatrichospital all shared time on the system.We prepared by visiting another MRfacility in an academic institution thathad a magnet for several years. Wethen diligently studied MR physicswhile watching the install team bringup our system. I still remember thefeeling of panic when our applicationsspecialist left after the final day of ouron-site training. I held a variety ofchallenging positions over the nextfew years in MR and eventuallymanaged the division. As my careerprogressed I had the opportunity towork on the 0.5 T open magnetspecifically designed for use in thesurgical environment. That projectbrought together two areas in whichI possessed significant interest andexperience and remains one of mycherished experiences. Throughoutmy career I have looked for additionalchallenges. This thirst for knowledgeeventually led me to pursue anadvanced degree. While working fulltime I managed to complete a Mastersof Science Program. This investmentclearly opened doors for me. Armedwith my degree, I was chosen tomanage the Duke Image Analysis Labin Durham, N.C. in 1997. My workallows me to interact with technologistson a daily basis while helping maintainthe highest standards in image qualityfor use in clinical trials. I am extremelyfortunate to be able to combine mylove of imaging with a professionalcareer that is stimulating and full ofpotential.

Signals: When did you first becomeinvolved in the SMRT?

Maureen: I was sponsored by Squibbto attend a SMRT meeting in SanFrancisco in 1991. That experiencewas so positive, I decided to become amember. I submitted my first abstractfor the SMRT Annual Meeting in 1993and was delighted to receive thePresident’s Award for best abstract.This was the first time this award hadbeen given. I was elected to the PolicyBoard in 1997 and served as chair ofthe Regionals Committee. This was arewarding experience as the Commit-tee worked to support Regionalmeetings for local technologists. I thenserved as Program Chair for theAnnual Meeting held in Denver in2000. It is truly satisfying to workwith such a dedicated group ofvolunteers who strive to providequality educational opportunities andpromote MR professionalism acrossthe globe.

Signals: What would you like to see theSMRT accomplish in this upcoming year?

Maureen: The Executive Committeeand Policy Board are committed toincreasing the educational opportuni-ties available for MR technologistsaround the world. I would like to seemore MR professionals take advantageof the educational opportunities andthe SMRT technologists’ network bybecoming a member of this uniqueorganization. Finally, along withsupport from the Berkeley office,SMRT will continue to pursue avenuesto expand our global presence.

Signals: There seems to be a lot ofSMRT educational activity in the nearfuture. How will you, as President, tryto maintain that momentum?

Maureen: There is a great deal ofexcitement stirring in the SMRTmember ranks. I believe it is importantto communicate your expectations andinspire members to contribute to theirorganization through newslettersubmissions, hosting Regional Seminarsor soliciting new membership. Eachindividual’s contribution increases theadded value SMRT membership bringsto technologists worldwide and providesa voice for MR technologists. �


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President’s LetterMaureen Ainslie, M.S., R.T. (R)(MR)

he SMRT held a successful 12th Annual Meeting in Toronto,Ontario, Canada, on 9-11 July 2003.Many thanks to Program ChairLaurian Rohoman and her committeefor their time and effort in preparingfor this meeting and handling therescheduling process with determinationand grace. Thanks also to Julia Loweand the Education Committee for theirsupport for the annual meeting. The 2ndAnnual SMRT Forum was held duringthe ISMRM 11th Scientific Meeting onSaturday, 12 July 2003. Executivemember Nanette Keck served as chairof the forum.

The Regionals Committee has sixRegional Educational Seminars sched-uled throughout North America,according to Chair, Cindy Comeau,and additional Regionals are in theplanning stages for 2004 worldwide.I would personally like to thank all theregional chairs for hosting a regional intheir area. Regional Seminars provideopportunities for technologists to benefitfrom local speakers expertise and achance to get together with your fellowMR professionals. In addition, you canearn Category A Continuing Educationcredits for attending a Regional Semi-nar. If you are interested in hosting aRegional in your area, please contactCindy for additional information.

Our focus this year is increasingour growing SMRT membership of 1500and the educational opportunities fortechnologists worldwide. Towards thisend, we have instituted a campaign toreach out to technologists around theglobe and make them aware of theeducational opportunities the SMRTprovides. Todd Richards, our newMembership Chair, is leading theseefforts. Please contact him regardingSMRT membership information.

Plans for the SMRT AnnualMeeting in Kyoto in May 2004 areunderway. Jim Stuppino, the 2004Program Chair has met with membersof the Japanese Society of RadiographicTechnologists and the ISMRM ScientificProgram Committee to design aprogram that will serve a globalaudience. Please contact Jim directlywith input or suggestions. Executive

member John Christopher along withmembers of the SMRT/ISMRM ForumSubcommittee have selected “Artifactsand Corrections” as the topic for theforum traditionally held on Mondayafternoon at the ISMRM AnnualMeeting.

The External Relations Committee,chaired by Maureen Hood continues tointeract and build relationships withother healthcare organizations. TheSMRT as part of the Associated SciencesConsortium of the Radiological Society ofNorth America (RSNA) works to produceeducational seminars of interest totechnologists and other medical scienceareas of diagnostic imaging for theRSNA meeting each year. The SMRT isalso involved with groups interested inpromoting professionalism and opportu-nities for healthcare professions such asthe Alliance for Quality Medical Imagingand Radiation Therapy, and the HealthProfessions Network. Both of theseorganizations are working to promotequality and education for allied healthprofessionals while at the same timeaddressing the current workforceshortages in certain health care fields.The SMRT is committed to promotingeducation and professional valuesglobally and has expanded its efforts toreach out to groups around the worldthrough the establishment of a GlobalRelations Subcommittee chaired byMuriel Cockburn. Two additionalLocal Chapters of the SMRT, CentralVirginia and Central Georgia have beenformed, bringing the total to ten. LocalChapters meet periodically throughoutthe year, offering additional educationalopportunities for MR technologists intheir area.

A new opportunity for MR technol-ogy students to present an abstract orlearning experience for review andposting on the SMRT Website is rollingout in September under the direction ofDenise Davis, Student Scope Subcom-mittee Chair. We anticipate thisprogram will provide SMRT exposure toMR technologists entering our field.Along these lines, the MR technologistlistserve, which has grown to 800members world wide, has proven to be apositive association as list membershave greater exposure to SMRT-sponsored activities.

The SMRT Educational Seminars“Home Study” program continues to be asuccess. These self-study articles provideCategory A Continuing Education creditsfor technologists and an opportunity toenhance their technical proficiency andbroaden their knowledge on a varietyof topics.

The SMRT looks forward to anexciting year. The Policy Board andExecutive Committee are dedicated toour goal of providing quality MReducational opportunities and promotingMR professionalism around the world.

I am excited to be working with thisexperienced team of qualified individuals.I encourage all members to offersuggestions to the members of the PolicyBoard as we work to provide member-ship benefits that will increase yourknowledge and enhance your experienceas an MR professional. Feel free tocontact me directly, or the chairs andPolicy Board Members as listed on theSMRT Website. I look forward to servingas your President this year. �

ISMRM President Michael E. Moseleyand SMRT President Maureen Ainslieat the SMRT Poster Walking Tour andReception in Toronto.


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Education Committee Report on the2003 SMRT Annual Meeting in Toronto, Ontario, CanadaJulia B. Lowe, B.S., R.T. (R)(MR), SMRT 2003 Education Committee Chair

ecause of the dedication and

hard work of everyoneinvolved with the SMRTthe 2003 Annual Meetingwas a huge success.Despite the challengeswe faced we managed topull together to make this

meeting happen. Thanks to all of theSMRT committee members, especiallythe Program Committee, and to thetechnologists that worked so hard tosubmit quality abstracts, and also to themeeting attendees and speakers. Wealso appreciate those of you that wereunable to attend but still volunteeredyour time and contributions to thismeeting.

Preparation for this meeting beganmonths ago. One of the first events wasthe Call for Papers requesting MRItechnologists to formally write upclinical or research abstracts. There wasan amazing response from technologists,which yielded a total of 64 abstractssubmitted from 17 countries.

Reviewers that were selected fromthe Education Committee workeddiligently to score the abstracts. Thereviewers score content, clinical orresearch focus criteria, and overallquality of presentation for each abstract.The scores are totaled to determine thehighest scoring abstracts in eachcategory so that the technologists can berecognized at the annual meeting. Theinitial categories are separated intoclinical and research. Technologistschoose upon submission to present theirwork orally or in a poster fashion, whichmake up the other two categories.

This year Eva Wembacher, R.T.,achieved the highest overall scoringabstract and received the President’sAward at the SMRT Business Meetingand Awards Luncheon for her workentitled “Combined Small and LargeBowel MR Imaging in Patients withInflammatory Bowel Disease.” Her workwas included in the program agenda asa proffered paper. Other technologistswith high scoring abstracts were invitedto present proffered papers as well.Mercedes Pereyra, R.T., was awardedfirst place in the clinical category for her

work titled “Quantitative Assessment ofGlobal LV Function Using SensitivityEncoding (SENSE) Accelerated BalancedFFE.” Claudio Arena, R.T. (CT)(MR),was awarded second place in the clinicalcategory for her work titled “RobustSmall Field-of-View, High ResolutionContrast Enhanced MRA (CE-MRA) ofRenal Arteries Using Sensitivity Encod-ing in Two Dimensions (2D-SENSE).”Eva Wembacher, R.T., also received thethird place clinical award for her workentitled “Comparison of DifferentTechniques for MR-Colonography.”Other proffered papers included in theprogram agenda were those awarded inthe research category for oral presenta-tion. Heather Ducie, B.Sc. (Hons) R.T.(R)(MR), was awarded first place for herwork entitled “Analysis of Perfusion MRIData in Patients with Severe Cere-brovascular Disease.” Due to tyingscores, second place was awarded toboth Jane Francis, D.C.R. (R), D.N.M.,for her work entitled “CardiovascularMagnetic Resonance in the Pre- and PostOperative Assessment of PatientsUndergoing Left Ventricular ReductionSurgery” and Wendy Strugnell, B.Sc.,R.T., for her work entitled “Cardiac MRIAnalysis of RV Function– A NewApproach.” The technologists’ presenta-tions are an important part of theagenda and provide us all with thecurrent international interests andtechniques. This year for the first timemeeting attendees acquired continuingeducation credits for the technologists’proffered paper presentations.

Also new this year was the additionof oral poster presentations. Fourtechnologists were selected to stand bytheir posters and give a brief talk to theinformal gathering during the postertour. The first presenter was Silke Boskwho gave a short presentation on“Thromboembolic Disease Assessmentwith Whole Body MR Venography.” NextSteven Williams talked about his poster“Imaging Cartilage at 1.5T Standardand Novel Techniques.” Bobby Lewisthen presented her work on “Does Anglematter in MRSI”? Our last presenterwas Susan Ryan who explained herposter “Using the Roolie for PeripheralRun Off MRAs.”

The Poster Walking Tour andReception is the first event of themeeting and began Wednesday evening.We would like to thank Mallinckrodt,Inc. for hosting the event. Attendees canbrowse the original work of technolo-gists in a relaxing and social atmo-sphere while enjoying food and drinks.Thirty-seven of the 54 accepted posterabstracts were displayed for all theattendees to view, some not making thetrip due to rescheduled meeting date.

The reviewers from the EducationCommittee completed the final posterscores during the Poster Walking Tour.The poster scores are averaged with theoriginal abstract score and the winnersare determined before the BusinessMeeting Luncheon and Awards Cer-emony. I would like to thank all of thereviewers for such dedication. Scoring64 abstracts in two weeks and reviewing37 posters in an evening is no small featand is much appreciated!

In the clinical category, the firstplace poster presentation was awardedto David Stanley, B.S., R.T. (R)(MR) forhis worked entitled “Evaluation of 3DFRFSE and 3D Fiesta MRCP.” Thesecond place award was presented toSandra Massing, R.T., for her workedentitled “Phase-Contrast Cardiac MRImaging for Absolute Quantification of

Continued on page 5 ➠

SMRT President, John Koveleski, presents thePresident’s Award to Eva Wembacher, R.T.for her work entitled “Combined Small andLarge Bowel MR Imaging in Patients withInflammatory Bowel Disease.”


he SMRT Forum is a great way tobring together peoplefrom all over theglobe and all phasesof the MR world. MRPurchase Decisionswas the topic for thisyear. We werefortunate to havethree such speakersto give us their insight.

Clare Sims, R.T., was the firstspeaker. She is the Chief MR Tech-nologist and Business Manager of theMR unit in Addenbrooke Hospital,Cambridge, UK. She has been involvedin several new MR system installationsand upgrades over the years. In herpresentation, she gave several optionstoward the analytical approach topurchasing equipment, financing,compatibility, and site preparation.

The next speaker was JamesStuppino, B.S., R.T. (R)(MR). Jim is theAdministrative Director and Co-Ownerof Valley Advanced Imaging inBethlehem, Pennsylvania, USA. In hisposition, he oversees all aspects offacility operations and has beeninvolved in start up situations forseveral years. He gave us severalreasons why we should use dedicatedversus whole body imaging. He also

The Section for Magnetic ResonanceTechnologists would like to thank the

following donors for their generous supportof the SMRT Twelfth Annual Meeting:

GOLD CORPORATE MEMBERS:Amersham Health

Berlex Imaging/Schering AG GermanyGE Medical Systems

Philips Medical SystemsSiemens Medical Solutions

BRONZE CORPORATE MEMBERS:Bracco Imaging S.p.A.

Bruker BioSpin MRI, Inc.Hitachi Medical Systems America, Inc.

Mallinckrodt, Inc.Toshiba Corporation

SMRT would like to thank:Avotec, Inc.

Amersham Health, Inc.Berlex Imaging

Bracco Diagnostics Inc.GE Medical Systems

Hitachi Medical Systems America, Inc.Magmedix, Inc.

Mallinckrodt, Inc.Medrad, Inc.

Nova Medical, Inc.Philips Medical Systems

Resonance Technology, Inc.Siemens Medical Solutions USA, Inc.

Vital Imagesfor their generous support of the

SMRT 12th Annual Meeting.

SMRT would also like to thank:MRI Devices Corporation

for its support of theSMRT Educational Seminars Home Studies.

(l. to r.) Gary H. Glover, Ph.D., Nanette Keck, R.T. (R)(MR),Clare Sims, R.T., and James Stuppino, B.S., R.T. (R)(MR)

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SMRT Forum: MR Purchase Decisionsat the ISMRM Annual MeetingNanette Keck, R.T., SMRT Forum Organizer and Moderator,SMRT Executive Committee Member

spoke about how to make decisions on1.5T versus low-field systems. Theseare all very important issues that couldbe costly if the wrong decision is made.

Gary Glover, Ph.D., Professor ofRadiology, Stanford University, was thethird speaker. Dr. Glover has beeninvolved in MR since the early 1980sand currently in research exploring therapid scanning methods using spiraland other ways to dynamically imagebrain function. His experience with3T has shown how this will be possiblenot only in the research setting, but inthe clinical setting as well.

I want to thank the above speakersfor giving their time and knowledge tothe SMRT Forum. I feel fortunate tohave been part of this group to presentoptions for MR Purchase Decisionsand thank those that asked me toparticipate. �

Mitral Valve Regurgitation.” Third placewas also awarded to David Stanley, B.S.,R.T. (R)(MR), for his work entitled“Evaluation of Abdominal Veins using2D Fiesta.” In the research category, thefirst place poster presentation wasawarded to Renee Hill, R.T. (R)(MR), forher work entitled “Optimization of HighResolution 3D Volumetric Scans toDifferentiate Gray Matter and WhiteMatter at 1.5 Tesla.” Due to tying scoressecond place was awarded to both KarenBove Bettis, R.T. (R)(MR), for her workentitled “Appearance of CalcificationArtifact in the Falx Cerebri on PhaseMaps Using a High Resolution Veno-

gram Technique at 3 Tesla” and RandyEarnest, B.S., for his work entitled“Magnetic Resonance Angiography withBlood Pool Agent MS-325: Results Froma Phase III Clinical Trial.”

The Safety Forum was extremelyhelpful and provided current andupdated information. Technologistsinteracted with the Safety Forumspeakers by asking questions andoffering comments and suggestions to usall. The information learned from theForum will be disseminated to MR sitesby the attendees that will effectivelyincrease safety awareness.

SMRT Annual Meeting continued

Once again I would like to thank allof those involved with the meeting. Thespeakers gave excellent talks on a widerange of topics and the technologistsdemonstrated efficient new MR tech-niques and ideas. The SMRT AnnualMeeting brings us together from manyplaces of the world to share ideas, toeducate, and to remind us of what animportant role we have as technologistsin caring for patients. The Torontomeeting was one of the most educationaland successful meetings to date! Please,join us next year in Kyoto, Japan tocontinue the mission of the SMRT. �


2003 Oral Presentation Award Winners at the SMRT Annual Meeting2003 President’s Award–Eva Wembacher, R.T.Department of Diagnostic and Interventional Radiology, University Hospital Essen,Essen, Germany

“Combined Small and Large Bowel MR Imaging in Patients with Inflammatory Bowel Disease”See page 5 Signals Number 44 2003 Issue 1.

1st Place Award, Oral Clinical Focus–Mercedes Pereyra, R.T.Department of Diagnostic Radiology,St. Luke’s Episcopal Hospital,Houston, Texas, USA

“Quantitative Assessment of Global LVFunction Using Sensitivity Encoding(SENSE) Accelerated Balanced FFE”See page 4 Signals Number 45 2003 Issue 2.

2nd Place Award, Oral Clinical Focus–Claudio Arena, R.T. (CT)(MR)Department of Diagnostic Radiology,St. Luke’s Episcopal Hospital,Houston, Texas, USA

“Robust Small Field-of-View, HighResolution Contrast Enhanced MRA(CE-MRA) of Renal Arteries usingSensitivity Encoding in Two Dimensions(2D-SENSE)”See page 10.

3rd Place Award, Oral Clinical Focus–Eva Wembacher, R.T.Department of Diagnostic and InterventionalRadiology, University Hospital Essen,Essen, Germany

“Comparison of Different Techniquesfor MR-Colonography”See page 13.

1st Place Award, Oral Research Focus–Heather Ducie, R.T. (MR)Institute of Child Health, and Great Ormond StreetHospital for Children, London, England, UK“Analysis of Perfusion MRI Data in Patients withSevere Cerebrovascular Disease”See page 5 Signals Number 45 2003 Issue 2.

2nd Place Award-Tie, Oral Research Focus–Wendy Strugnell, B.Sc., R.T.Cardiac MRI Centre, The Prince Charles Hospital,Brisbane, Queensland, Australia“Cardiac MRI Analysis of RV Function–A New Approach”See page 11.

2nd Place Award-Tie, Oral Research Focus–Jane Francis, D.C.R., (R)(DNM)Department of Cardiovascular Medicine,The John Radcliffe Hospital, Oxford, England, UK“Cardiovascular Magnetic Resonance in thePre- and Post-Operative Assessment of PatientsUndergoing Left Ventricular Reduction Surgery”See page 12.

Robin Greene-Avison, R.T.(N)(MR) C.N.M.T.

2003 SMRTFellows Award

Frank Shellock, Ph.D.

2003 SMRTHonorary

Membership Award

Richard Helsper, R.T.

2003 SMRTDistinguished Service

Award

Gregory Brown, R.T.

2003 SMRTCrues-Kressel Award


Invited Speakers

Award went to Richard Helsper. TheCrues-Kressel Award for outstandingcontributions to the education ofmagnetic resonance technologists wasawarded to Gregory Brown for hisdevotion to MR technologist’s educationover the years and since 1996 throughhis Adelaide MR Website. The PaperAwards for the Clinical and ResearchFocus were presented by LaurianRohoman, Program Chair. Julie LoweEducation Chair presented the PosterAwards for the Clinical and ResearchFocus.

Outgoing President John Koveleskithen passed the President’s gavel toMaureen Ainslie, SMRT President 2003-2004. Maureen Ainslie awarded JohnKoveleski the President’s Plaque for hisdedication and hard work over the pastyear as President of the SMRT.Maureen Ainslie gave her introductorytalk to the attendees. The meeting wasthen adjourned.

Incoming President MaureenAinslie moderated the afternoon session.Dr. Petrina Causer gave an excellenttalk on “Breast Imaging,” in which shediscussed the indications for breastcancer evaluation, MR technique,diagnostic criteria and breast biopsies.

Garry Gold, M.D., then presented“Pulse Sequences and Protocols inMusculoskeletal MRI,” he talked about

coil selection, described key sequencesfor MSK MR imaging and comparedthe1.5 Tesla to the 3T system.

After a short break, the afternoonprogram continued with the President’sAward winning paper by EvaWembacher, R.T., entitled “CombinedSmall and Large Bowel MR Imaging inPatients with Inflammatory BowelDisease.” Erin Simon, M.D., presented“Pre- and Postnatal PediatricNeuroimaging: How and Why.” Shediscussed techniques, safety, andcommon indications for both fetal aswell as post natal neuro imaging.

Tomas Lauenstein, M.D., ended thisfirst day of the meeting with his talk on“The Assessment of GastrointestinalDisorders,” discussing his experiencewith bowel imaging.

The sessions continued on Fridaymorning with Julie Lowe, EducationChair moderating. Lawrence Wald, Ph.D.,presented “Functional MRI: Past,Present, and Future.” Our thanks to Dr.Wald for being able to give this talk onvery short notice. Richard Frayne, Ph.D.,then spoke on “Stroke Imaging” andgave an excellent overview of modernMR techniques for stroke imaging.

The program continued with“Contrast Enhanced MR of the Abdomen:Contrast Agents, Techniques and

Findings” presented by RichardSemelka, M.D., who discussed liverimaging techniques and the use of non-specific extra cellular contrast agents aswell as hepatocyte-selective contrastagents.

The Safety Forum was held over thelunch hour, there were some speakerchanges due to the rescheduled meeting.Frank Shellock, Ph.D., moderated theforum and introduced the first speaker,Bill Faulkner, B.S., R.T. (R)(MR)(CT) whospoke on “Technologists Responsibilities.”Next Dr. Shellock presented “MR SafetyGuidelines and Recommendations.”A. Gregory Sorensen, M.D., then talkedon “MR Contrast Agent Safety,” andFrank Shellock gave the final talk on“MR Procedures: Implants and DevicesUpdate.” The audience had manyquestions for all the speakers and againthe Safety Forum proved to be a valuablepart of the meeting.

Program Chair, Laurian Rohoman,moderated the final session of themeeting. The afternoon program startedoff with proffered papers. DonaldMcRobbie, Ph.D., then explained parallelimaging with his topic “Talking Senseand Non-Sense in Parallel Imaging.”After a short break, Eric Outwater, M.D.,presented “MRI of the Female Pelvis:Emphasis on Technique” in which he


Continued on page 9 ➠

(l. to r.) Silke Bosk, R.T., Petrina Causer, M.D., William Faulkner, B.S., R.T. (R)(MR)(CT), Richard Frayne, Ph.D., Garry Gold, M.D.,Thomas Lauenstein, M.D., Donald W. McRobbie, Ph.D., and Naeem Merchant, M.D.

(l. to r.) Anne Sawyer-Glover, B.S., R.T. (R)(MR), and Eric Outwater, M.D., Richard Semelka, M.D., Frank G. Shellock, Ph.D., Erin Simon, M.D.,A. Gregory Sorensen, M.D., David Stanley, B.S., R.T. (R)(MR), and Lawrence Wald, M.D.


Award Winning Clinical Focus and Research Focus Poster Presentersat the SMRT Annual Meeting

2003 1st Place Clinical Poster– David Stanley,Applied Science Laboratory, GE Medical Systems, Milwaukee,Wisconsin, USA, “Evaluation of 3D FRFSE and 3D Fiesta forMRCP”

2003 1st Place Research Poster– Renee S. Hill,MRI Research Facility, NINDS National Institutes of Health, BethesdaMaryland, USA,“Optimization of High Resolution 3D VolumetricScans to Differentiate Gray Matter and White Matter at 1.5 Tesla”

2003 3rd Place Clinical Poster– David Stanley,Applied Science Laboratory, GE Medical Systems, Milwaukee,Wisconsin, USA, “Evaluation of Abdominal Veins Using 2D Fiesta”

2003 2nd Place Clinical Poster– Sandra Massing,University Hospital, Department of Diagnostic and InterventionalRadiology, Essen, Germany, “Phase-Contrast Cardiac MR Imagingfor Absolute Quantification of Mitral Valve Regurgitation”

2003 2nd Place-Tie Research Poster– Karen Bove Bettis,FMRI Core Facility, NIMH, NIH, Bethesda, Maryland, USA“Appearance of Calcification Artifact in the Falx Cerebri on PhaseMaps Using a High Resolution Venogram Technique at 3 Tesla”

2003 2nd Place-Tie Research Poster– Randy Earnest,EPIX Medical Inc., Cambridge, Massachusetts, USA,“Magnetic Resonance Angiography with Blood Pool Agent MS-325:Results from a Phase III Clinical Trial”



SMRT Board Members.Seated in front, l to r: Cindy Comeau, Laurian Rohoman, and Anne Sawyer-Glover. Seated l to r: Muriel Cockburn, Heidi Berns, Judy Wood,Maureen Ainslie, Denise Davis, Gina Greenwood, Bobbie Burrow, Silke Bosk, and Julia Lowe. Standing l to r: William Faulkner, MaureenHood, Marcia Gervin, Gregory Brown, Julie Strandt-Peay, Andrew Cooper, James Stuppino, Raymond Cruz, Scott Kurdilla, John Koveleski,Nanette Keck, Kelly Baron, and Cindy Hipps. (not pictured: John Christopher, Todd Frederick, and Bart Schraa).

discussed protocols and techniques usedin female pelvic imaging. The nextpresenter was David Stanley, B.S., R.T.(R)(MR) who spoke on “Why 3T?”showing the advantages and disadvan-tages of 3T systems. The program endedwith the final three proffered papers.

In closing I would like to thank allthe Program Committee members fortheir help and support in putting

together this program and making thismeeting a successful one and also thankJulia Lowe, Education Chair and hercommittee of reviewers for scoring allthe abstracts and posters. Specialthanks to Jennifer Olson and theISMRM Office staff for their support.

Again this year we had generousdonations from our sponsors and wethank them for their continued support

(Editor’s note: For those of you not able to attendthe SMRT 12th Annual Meeting, there are syllabiavailable through the SMRT Office. Call or see theSMRT Website for details).

and contribution to the MR technolo-gists continuing education (please seeacknowledgents on page 5). Door prizeswere donated by Magmedix and Dr.Frank Shellock and we thank them fortheir generosity. This meeting however,could never have been as successfulwithout you, the attendees, we thankyou for your participation and for yoursupport. The feedback and suggestionsyou have given by filling out theevaluation forms are very muchappreciated and will be taken intoconsideration when planning the 2004Annual Meeting.

For those who were unable toattend this year’s rescheduled meeting,please note that several RegionalEducational Seminars will be held thisfall (see the calendar on page 28), someperhaps in your area that you may beable to attend and obtain your CE credits.We hope you continue your activemembership and look forward to seeingyou at the next SMRT Annual Meeting,which will be held on 15-16 May 2004in Kyoto, Japan. �

2003 SMRT Poster Walking Tour and Reception. Seated l to r: Tom McKinley, Kathy Robichau,and Judy Fuller. Standing l to r: Dave Stanley, Jason Polzin, Melissa Polzin, Gina Greenwood,and Lynette Frye. More meeting photos appear on pages 15 and 20.


Robust Small Field-of-View, High Resolution Contrast EnhancedMRA (CE-MRA) of Renal arteries using Sensitivity Encodingin Two Dimensions (2D-SENSE)Claudio Arena, R.T.1, Margit Nemeth, M.D.2, Eric Douglas, R.T.1, R. Muthupillai, Ph.D.3,4, S.D. Flamm, M.D.4

1 Department of Diagnostic Radiology, St. Luke’s Episcopal Hospital, Houston, Texas, USA, 2 Department of Cardiology,St. Luke’s Episcopal Hospital, Houston, Texas, USA, 3 Philips Medical Systems, Bothell, Washington, USA, and4 Department of Radiology, St. Luke’s Episcopal Hospital, Houston, Texas, USA

2003 2nd Place Oral Presentation, Clinical Focus–

IntroductionContrast Enhanced MRA (CE-MRA) isnow routinely used in clinical practice forvascular imaging.1 Recent studies haveshown that when combined with fluoro-scopic triggering, and centric phase encodeordering schemes, CE-MRA can be used tovisualize renal arteries with good spatialresolution and minimal venous contami-nation.2,3 The highest spatial resolutionthat can be obtained is constrainedprimarily by physiologic variables such asthe arterial-to-venous transit time, andpatient breath-holding ability.2,3 In otherwords, the total number of phase encodingsteps acquired within these constraints(in-plane (ky) and through-plane (kz)),ultimately determine the maximumachievable spatial resolution for a givencoverage. Therefore, there is a need fortraversing the k-space as rapidly aspossible within these physiologic con-straints. The traditional approach totraverse k-space faster is the use of high-performance gradients to reduce the echotime (TE), and repetition time (TR). It isalso well known that such brute forcereductions in TR and TE also adverselyaffect signal-to-noise ratio (SNR), andcontrast-to-noise ratio (CNR) of CE-MRA.4In this respect, a recently described,parallel acquisition technique, SensitivityEncoding (SENSE), traverses k-space

Figure 1. 2D-SENSE accelerated 3D CE-MRA.The coronal and sagittal maximum intensityprojections are depicted above. Note the increasedvolume of coverage and high spatial resolution ofthe 2D-SENSE making it possible to visualize thefull extent of SMA and its branch vessels.

faster by skipping phase-encoding steps bya factor proportional to the SENSEacceleration factor.5 The resultingdeliberate aliasing is removed duringreconstruction with the knowledge of coilsensitivity function. To date, in CE-MRA,SENSE acceleration has been primarily inthe in-plane phase encoding direction.6,7

The purpose of this work is to describe ansmall FoV approach where SENSE wasapplied along both phase encodingdirections in a 3D CE-MRA acquisition(slice-select, and the in-plane phaseencoding) with a net acceleration factor ofthree, to acquire a large volume, withhigh-resolution isotropic voxel size.

Materials and MethodsAll images were acquired on a 1.5TPhilips Gyroscan NT-Intera scannerrunning at Release 8.1.x level. A 0.2mmol/kg of Gd-DTPA was administeredat an injection rate of 2 cc/sec. Afluoroscopic acquisition was used totrigger the high-resolution 3D acquisi-tion upon contrast bolus arrival.

Study Protocol and PatientPopulationSENSE accelerated CE-MRA protocolwas approved by our InstitutionalReview Board for the evaluation of renalartery stenosis. Conventional 3DCE-MRA was used to image 12 of 24

patients (age: 59+/-15 years, 5 male)without using SENSE. The rest of thepatients (12/24, age: 52+/-11 years,4 male) were imaged using the 2D-SENSE CE-MRA protocol. The acquisi-tion parameters in Table 1.

Image AnalysisQuantitative Analysis: The data wastransferred to EasyVision Workstation(Rel. 4.x) for image analysis. Regions ofinterest were drawn on the source imageson the aorta, and inferior vena cava. Arepresentative image is shown in Figure 1.Air space was not available for conven-tional noise measurements because of thesmall field-of-view acquisition used in the2D-SENSE protocol. As a surrogatemeasure, noise was estimated from thestandard deviation (SD) of the signalintensity in the IVC ROI. The aortic SNRwas computed as the ratio of the meansignal intensity of the aorta and noise.

Qualitative Analysis: The images wereevaluated qualitatively for the followingparameters: (i) Renal artery overall imagequality on a scale of 1 to 4 (1: Excellent,2: Good; 3: Fair, and 4: Poor); (ii) Artifactlevels were assessed for renal arteryringing (RA-Ring) and renal arteryblurring (RA-Blur), and renal parenchy-mal ringing (RP-Ring) on a scale of 1 to 4

Acquisition Parameter Conventional CE-MRA 2D-SENSE CEMRA

Technique 3D-T1FFE 3D-T1FFEField-of-View (xFOV x yFOV) (mm) 400x320 256x256Matrix 384x263 224x224Acquired slice thickness/# of slices 3.0 / 25 2.2 / 40Reconstructed slice thickness/# of slices 1.5 / 50 1.1 / 80AP volume of Coverage (mm) 75 88Fold-over suppression No YesTR (msec)/TE (msec) /Flip angle (deg) 4.6 / 1.5 / 40° 4.6 / 1.5 / 40°Bandwidth per pixel (Hz) 310 310Phase encoding order CENTRA CENTRAFluroscopic Triggering Yes YesSENSE No YesIn-plane SENSE factor (Along ky) – 1.7Through-plane SENSE factor (Along kz) – 1.7Acquired Voxel Volume (mm3) 4.8 (1x1.56x3) 2.6 (1.1x1.1x2.2)Scan Time (sec) 31 31

Table 1.


Cardiac MRI Analysis of RV Function – A New ApproachW. Strugnell, R. Slaughter, G. Javorsky, R. RileyCardiac MRI Centre, The Prince Charles Hospital, Brisbane, Queensland, Australia

2003 2nd Place-Tie Oral Presentation, Research Focus–

PurposeInherent difficulties exist in the currentstandard method of CMR analysis ofright ventricular (RV) volumes. Thecurrent accepted technique for measur-ing RV volumes uses a series of leftventricular (LV) short axis cine acquisi-tions prescribed from a vertical long axisacquisition and acquired perpendicularto a line from the centre of the mitralvalve to the apex of the left ventricle.Using this image data set for RVanalysis assumes that the tricuspidvalve lies in the same plane and positionas the mitral valve. Our experienceindicates that the use of this imagingplane makes analysis problematic as thetricuspid valve is not in-plane in theslice and the atrio-ventricular margin isdifficult to distinguish. This leads toinaccuracies in measurements at thebase of the RV and miscalculation of theRV volume. We developed a noveltechnique to improve visualisation ofthe tricuspid and pulmonary valveswith the aim of increasing the accuracyof RV analysis by CMR.

(1: none, 2:mild, 3:moderate, and4: severe); (iii) SENSE artifact affectingclinical diagnosis on a four pointscale (1: Significant and non-diagnostic,2: Moderate but diagnostic; 3: Minimaland diagnostic; 4: Insignificant and nota factor), and (iv) Reader confidence indiagnosis was assessed using a threepoint scale (1: Certain; 2: Moderate; and3: Poor). All data is presented as Mean+/-SD.

ResultsQualitative Results: A total of 57 renalartery segments were evaluated. In thecase of conventional 3D CE-MRA, 31 renalartery segments (including 7 accessoryrenal arteries) were evaluated, and 26renal artery segments (including 4accessory renal arteries) were evaluated.Differences in renal artery overall imagequality, artifact level, and reader confi-dence were not found to be statisticallysignificant. Representative images inFigure 1.

Quantitative Results: The aortic SNR forthe conventional and 2D-SENSE CE-MRA

acquisitions was: 21.4+/- 10.7 and 22.1 +/-11.1 respectively. The AVR for theconventional and 2D-SENSE acquisitionswas: 9.1 +/- 6.5, and 10.1 +/- 6 respectively.

DiscussionTo date, SENSE has been primarily usedto improve the speed of CE-MRA acquisi-tion. However, when using SENSE it isalso necessary to plan the acquisitionvolume carefully to avoid any intrinsicaliasing. For example, while in conven-tional CE-MRA some aliasing (e.g., arms)can often be tolerated, with SENSE suchaliasing should be eliminated either byrequesting the patient to keep his armsabove his/her head or by choosing a largeenough field-of-view (FOV) to avoidaliasing. In this work, we deliberatelychose a small FOV (256 x 256 mm), whichallowed us to use a smaller matrix andstill attain high spatial resolution. Thepenalty of additional scan time requiredfor oversampling to avoid foldover artifactwas minimized using an in-plane SENSEacceleration factor of 1.7. The thickerimaging volume makes it easy to plan the

volume and include the evaluation of bothrenal and mesenteric arteries. Qualitativeand quantitative results show that it ispossible to obtain a small field-of-view,high-resolution CE-MRA images using2D SENSE with the same breath-holdduration as the conventional 3D CE-MRAacquisition without any penalty. �

References1. 1. Prince M, Narasimhan D, Stanley J, et al.

J Vasc Surgery 1995; 21:656-669.2. Wilman A, Riederer S. Magn Reson Med

1997;38:793-802.3. Fain S, King B, Breen J, Kruger D,

Riederer S. Radiology 2001;218:481-490.4. Parker DL, Goodrich KC, Alexander AL,

Buswell HR, Blatter DD, Tsuruda JS.Magn Reson Med 1998;40:873-882.

5. Pruessmann K, Weiger M, Scheidegger M,Boesiger P. Magn Reson Med 1999;42:952-962.

6. Weiger M, Pruessmann K, Kassner A, et al.J Magn Reson Imag 2000;12:671-677.

7. Golay X, Brown SJ, Itoh R, Melhem ER.Am J Neuroradiol 2001; 22:1615-1619.

MethodsWe undertook a prospective study offifty post cardiac transplant patients toevaluate the new technique. A series ofLV short axis multi-slice cine acquisitionFIESTA images were acquired using thecurrent standard technique. From thisdata set, LV and RV stroke volumeswere derived on an Advantage Windowsworkstation using planimetry of theendocardial and epicardial borders inend-systole and end-diastole. Our newtechnique involved obtaining a set ofmulti-slice cine acquisition FIESTAimages in a plane perpendicular to aline from the centre of the pulmonaryvalve to the apex of the RV. Planimetryof the RV was then performed and astroke volume calculated using thesame method of analysis. Physiologicallythe left and right cardiac outputs areequal. RV stroke volumes obtained fromboth techniques were compared with LVstroke volumes.

ResultsOn the images acquired with the newtechnique, the tricuspid and pulmonaryvalves were more easily visualisedleading to more accurate and reproduc-ible planimetry of ventricular borders.RV stroke volumes using the newmethod showed a higher correlationwith LV stroke volumes (r=0.94) thanwith the current method (r=0.85). RVstroke volumes were consistently under-calculated by up to 10% using thecurrent standard method.

ConclusionsRV function is assuming greaterimportance in clinical management ofcardiac patients. Accurate reproduciblequantification of RV function willexpand treatment strategies andpotentially assist in achieving theultimate goal of improving patientmanagement. This new method im-proves visualisation of the tricuspid andpulmonary valves and makes analysiseasier and less prone to operator error.Serial RV assessments could be under-taken with greater confidence indiagnostic accuracy and reproducibility.�


Cardiovascular Magnetic Resonance in the Pre- and Post-OperativeAssessment of Patients Undergoing Left Ventricular Reduction SurgeryJane Francis1, Saul Myerson1, Joseph Selvanayagam1, Steven Westaby2, Stefan Neubauer1

1Department of Cardiovascular Medicine, 2Department of Cardiothoracic Surgery, The John Radcliffe Hospital, Oxford, England, UK

2003 2nd Place-Tie Oral Presentation, Research Focus–

PurposeMyocardial infarction can cause largeareas of akinetic, scarred myocardium(sometimes with aneurysm formation),which may result in a marked change inshape of the ventricle and reduction inejection fraction. The endoventricularpatch plasty technique was developed byDor et al 1 to improve left ventricular (LV)shape and function at the time of coronaryartery bypass surgery. It involves resectionof the akinetic segment or aneurysm andinsertion of a circular patch, which allowsa more physiologically shaped left ven-tricular cavity. Cardiovascular magneticresonance (CMR) with its multi-planarability allows accurate delineation of thecardiac anatomy and extent of the akineticsegment, both pre and post surgery.Ventricular function can be calculated andareas of infarcted myocardium delineated2 following injection of a gadoliniumchelate, thus allowing the surgeon a guideto margins of excision. We report the use ofCMR in a small group of patients referredto our centre for consideration of leftventricular reduction surgery.

MethodFour patients (2 male, 2 female) aged 62-73(mean 65.5 yrs) who were considered forLV reduction surgery had CMR prior tosurgery to assess the extent of theinfarcted tissue, accurately define LVshape and calculate left ventricularfunction, including left ventricular ejectionfraction (LVEF) and volumetric analysis.Imaging was performed on a Siemens(Erlangen, Germany) Sonata 1.5T scannerwith gradient performance 40mT/m andgradient slew rate of 200T/m/ms. All scanswere ECG gated and performed supine

using a six element spine array coilcombined with a two channel flex arrayplaced anteriorly over the chest. Localiserimages were performed in three orthogo-nal planes followed by vertical long axis(VLA), horizontal long axis (HLA) andshort axis (SA) pilots to determine theatrio-ventricular groove and the true longaxis of the ventricle. TrueFISP (Fastimaging with steady state free precession)cine images were then obtained in VLA,HLA for overall global function and SAplanes from base to apex to calculateLVEF and LV volumes. Imaging param-eters: matrix 256 x 164, TR = 45.3ms, TE1.51 ms, flip angle 60° slice thickness (ST)7mm, 15 segments, 11-17 phases percardiac cycle breathold time of 8-12seconds. Following intravenous injection of0.1mmol/kg body weight of OmniscanTM

(Nycomed Amersham, Amersham, UK),2D segmented turboflash images with anon- selective inversion pulse wereacquired in the same planes as thefunctional images to delineate the extentof infarction. Imaging parameters: matrix256 x 115, TR variable depending on heartrate- ECG triggered every second heart-beat, shifted to diastole. Flip angle 25°;inversion time (TI) 310-400 ms. Imagingstarted at 8-10mins post injection. LVEFand LV volumes were calculated usingSiemens ARGUSTM software and theamount of myocardial enhancement wasassessed qualitatively. Two patients(1 male 73 yrs and 1 female 62 yrs) haveundergone LV reduction surgery withdramatic effect and had repeat CMR.

ResultsAll patients were able to tolerate CMR.LVEF was 3-18% (mean 14%) and end

diastolic volume (EDV) 294-1425mls(mean 617mls) pre-op. LVEF increasedfrom 3-54% in one case and from 16-38%in the second post-operatively. Figure 1ashows the HLA of a 73-year-old malepatient with a huge LV aneurysm pre-op.Figure 1b shows the SA view aftercontrast showing the extend of infarctionand Figure 1c shows the HLA 12 days postop Dor procedure. The table shows the LVvolumes pre and post-op of the samepatient.

ConclusionsCMR is a valuable aid in the assessmentof patients undergoing LV reductionsurgery using the Dor procedure. It canprovide an accurate measurement ofLVEF and LV volumes both pre and postsurgery and delineate the extent ofmyocardial infarction. We are planningstudy this unique group of patients overtime to quantify changes in ventriculargeometry and function. �

References1. Left ventricular aneurysm: a new

surgical approach. Dor V et al. ThoracCardiovasc Surg. 1989; 37:11-9.

2. An improved MR imaging technique forthe visualization of myocardial infarc-tion. Simonetti OP et al Radiology 2001218(1): 215-23.

Figure 1a. Figure 1b. Figure 1c.

Pre Op Post Op

EDV (mls) 1425 167ESV (mls) 1380 77SV (mls) 43 90EF % 3 54


Comparison of Different Techniques for MR-ColonographyEva Wembacher, Silke Bosk, Waleed Ajaj, Thomas C. Lauenstein, Jörg F. Debatin, Stefan G. RühmDepartment of Diagnostic and Interventional Radiology, University Hospital Essen, Essen, Germany

2003 3rd Place Oral Presentation, Clinical Focus–

PurposeMR colonography (MRC) is an appropri-ate diagnostic tool for detectingcolorectal polyps exceeding 8mm in size.Different techniques of MRC have beendescribed. “Dark lumen” MRC is basedon the administration of a rectal water-enema combined with the intravenousinjection of paramagnetic contrast. On3D GRE data sets the colonic wall aswell as masses arising from it showbright enhancement. Thus, bowel walland colorectal masses can easily bedelineated against the background ofthe dark colonic lumen. With “brightlumen” MRC colorectal lesions arevisualized as dark filling defects withinthe bright colonic lumen. This can beachieved by administering a rectalenema containing paramagneticcontrast [1]. On 3D gradient echo datasets only the contrast-containing coloniclumen is bright whereas the surround-ing tissues including colonic wall andpolyps remain low in signal intensity. Anew approach for “bright lumen” MRC isbased on the acquisition of TrueFISPsequences. Using a rectal water-enema,the contrast mechanism is comparableto that of the approach in conjunctionwith a paramagnetic contrast enemaand the acquisition of T1-weighted GREsequences. Since the TrueFISP techniqueneither requires the administration ofintravenous nor rectal paramagneticcontrast medium, it appears economi-cally attractive. The purpose of thisstudy was to compare dark lumen MRCwith the described TrueFISP based

bright lumen technique for the detectionof colorectal masses.

Method31 patients with suspected colorectallesions were included in this study. MRexaminations were performed on a 1.5 TMR system (Magnetom Sonata, SiemensMedical Systems, Erlangen, Germany).The colon was filled with 2000ml of tapwater. The TrueFISP sequence wasacquired both in supine and proneposition (TR/TE: 4.45/2.23ms, flip angle70°, field of view (FOV) 400 x 400mm,slice thickness 3mm, acquisition time21sec). For the dark lumen technique,data acquisition was performed with thepatient in prone position only. For the3D GRE sequence the following param-eters were used: TR/TE: 1.64/0.6 ms, flipangle 15°, field of view (FOV) 400 x 400mm, effective slice thickness 1.57mm,acquisition time 23 sec. Paramagneticcontrast (Gd-BOPTA, Multihance,Bracco, Italy) was administered i.v. at adose of 0.2 mmol/kg and a flow rate of3.0 ml/s. After a delay of 75sec, the ‘pre-contrast’ 3D acquisition was repeatedwith identical imaging parameters. Inaddition to MRC all patients underwentconventional colonoscopy on the sameday of the MR examination.

ResultsConventional colonoscopy detected 20colorectal polyps in 11 patients andthree colorectal cancers in three pa-tients. Based on dark-lumen MRC, allpolyps >5mm were correctly diagnosed(Figure 1), whereas 4 polyps <5mm were

Figure 1. 3D T1w GRE scan shows 8mm polyp in the sigmoid colon.Lesion can be distinguished from residual stool due to contrastenhancement comparing native (A) and post contrast scan (B).

Figure 2. 7mm polyp (black arrow) detected on TrueFISP dataset. It is difficult to differentiate between polyps and residualstool (white arrows) due to similar contrast characteristics.

missed. Thus, sensitivity of dark-lumenMRC amounted to 83%. There were nofalse-positive results: residual stoolcould correctly be differentiated frompolyps due to the lack of contrastenhancement. TrueFISP based brightlumen MRC, however, failed to detectseven polyps (all <10mm). In addition,bright lumen MRC showed false positivefindings in 5 patients (Figure 2). Brightlumen MRC reached a sensitivity of74% for the detection of polyps/masses.

ConclusionsA particular advantage of bright-lumenMRC with TrueFISP is that no para-magnetic contrast neither for intrave-nous nor rectal administration isneeded. In addition, the sequence israther insensitive to motion artifacts.However, in this study even polypslarger than 5mm were missed, andthere was a considerable number offalse positive findings due to theproblem differentiating between re-sidual stool and colorectal masses. Thedark lumen MRC in conjunction withintravenous application of paramagneticcontrast proved to be superior for thedetection of even small polyps. Polypscould be clearly identified based on theuptake of contrast agent. Thus, falsepositive findings were not seen. How-ever, further developments such as theuse of 3D TrueFISP sequences or theemployment of potential sequencestrategies for a better differentiation ofresidual stool vs. polyps might enhancethe impact of a bright lumen imagingapproach based on TrueFISP. �

References1. Lauenstein TC.

Magnetic resonanceimaging in bowelimaging. Top. Magn.Reson. Imaging.2002 Dec;13(6):377.


Evaluation of 3D FRFSE and 3D Fiesta for MRCPDavid Stanley1, James Glockner2, JoAnn Bromley2, and Michael Wood1

1Applied Science Laboratory, GE Medical Systems; 2Mayo Clinic, Rochester, Minnesota, USA

2003 1st Place Proffered Paper– Clinical Poster

PurposeBiliary imaging has become a commonindication for abdominal MRI inrecent years. Most protocols forMRCP include thin slice SSFSE(single shot fast spin echo), thick slabSSFSE or a combination of bothtechniques that can provide diagnosticaccuracy similar to ERCP. However,SSFSE images can be limited by lowspatial resolution, low SNR, imageblurring and or image misregistrationdue to breathing artifacts. Recently,fast 3D acquisitions have been devel-oped employing Fiesta or FRFSEpulse sequences to improve overallimage quality for MRCP exams.

It is the purpose of this paper tocompare the SSFSE pulse sequence to3D Fiesta and 3D FRFSE for theMRCP exam.

Method 3D Fiesta (Fast Imaging EmployingSteady-state Acquisition) sequence isa fully balanced steady state coherentimaging pulse sequence designed toproduce high SNR images at veryshort repetition times (TR) withweighting proportional to T2/T1.Sequence parameters included:TR 4.5 ms, TE 2.1 ms, flip angle 45°,bandwidth 83 kHz, FOV 28-36, matrix256x192, slice thickness 1.6-3mm.Acquisitions times ranged from 22-30seconds.

The 3D FRFSE (Fast RecoveryFast Spin Echo) sequence is a fast spinecho sequence that utilizes a 90-degreeRF pulse at the end of the TR period tocause all of the tissues to recover tothe longitudinal plane. This allowsfor T2-weighted acquisitions withrelatively short TR. Sequence param-eters included: TR 1200 ms, TE 530

ms, bandwidth 62 kHz, FOV 26-32 cm,matrix 256x192, and a slice thicknessof 1.4-3 mm. Respiratory triggeringwas used for patients who could nothold their breath, and 5000 TR wasused for these cases. Breath holdacquisitions times ranged from 28-32seconds and respiratory-triggered scantimes range from 3-4 minutes.

Ten patients were referred forMRCP exam (Signa 1.5T, GE MedicalSystems Milwaukee, WI) using con-ventional thin and thick slab SSFSEalong with 3D Fiesta and 3D FRFSE.Sequences were evaluated by aradiologist with abdominal MRexperience and rated for perceivedCNR, perceived SNR, artifacts in theimages, and overall image quality.All sequences were evaluated on ascale of 0 (poor) -4 (excellent). Also,the images were ranked in order ofpreference 1-3 with 1 being the mostpreferred sequence to make thediagnosis.

Figure 1. Maximum intensity projection images from 3D Fiesta (left) and 3D FRFSE (right)acquisitions in a patient with hilar cholangiocarcinoma.

Results3D FRFSE was the preferred sequencewith a cumulative average of 1.6followed by 3D Fiesta, (2.0) andSSFSE, (2.3). 3D FRFSE sequencesalso had the highest image qualityrating at 3.1, followed by 3D Fiesta,(2.8) and SSFSE, (2.7). SSFSEgenerated the fewest artifacts (3.2)followed by 3D FRFSE (2.9) and 3DFiesta (2.5). Additional information(vs SSFSE) was found in 4/10 patientsusing 3D FRFSE and 3/10 Patientsusing 3D Fiesta. Additional confi-dence in interpretation (vs SSFSE)was found in 8/10 patients when using3D FRFSE and 5/10 using 3D Fiesta.

Conclusions3D FRFSE and 3D Fiesta sequencesprovided additional information inmost cases when compared to conven-tional thin and thick slab SSFSEsequences. 3D MRCP sequences werealso the sequences of choice in thisexam. 3D FRFSE and 3D Fiesta showgreat potential for improving thestandard MRCP exam. �


2003 SMRT Poster Walking Tour and Reception

This year a new event was added to the Poster Exhibit Reception, four selected poster authors gave short oral presentations of their workduring the poster exhibit. Shown above (l.) Silke Bosk describes in detail aspects of interest in her poster entitled, “ ThromboembolicDisease: Assessment with Whole-Body MR Venography.” (r.) Steven Williams discusses his poster entitled “Imaging Articular Cartilage at1.5T Standard and Novel Techniques.” The two other oral poster presentations were by Susan Ryan, “Using the Roolie for Peripheral RunOff MRAs,” and Bobbi K. Lewis, “Does Angle Matter in Acquiring MRSI?”

Optimization of High Resolution 3D Volumetric Scans toDifferentiate Gray Matter and White Matter at 1.5 TeslaRenee S. Hill, Jeanette BlackNIH MRI Research Facility, NINDS National Institutes of Health, Bethesda, Maryland, USA

2003 1st Place Proffered Paper– Research Poster

PurposeHigh-resolution MR images arecritical for accurate co-registration offunctional data. Tissue contrast andresolution vary with changes in scantiming parameters. The purpose ofthis study is to investigate the opti-mum scan parameters needed tomaximize Gray /White Matter con-trast-to-noise using 3D Inversion-prepared fast spoiled gradient echorecalled (FSPGR) sequences.

MethodThe scans were acquired on threenormal volunteers using a GE 1.5 TSIGNA (Twin Gradient Coil, 9.0software). Scan parameters were asfollows: 3D axial FSPGR -IR prep,TR12ms, TE 5.1ms, matrix 256 x 256,FOV 260, 3/4 phase FOV, slice thick-ness 1mm, 124 slices, 15.63kHzbandwidth. Data were acquired at fourinversion times (TI): TI 150 (scan time:5:53), TI 300 (scan time: 6:51), TI 450(scan time: 7:48), and TI 600 (scan

time: 8:46). For each TI, the flip anglewas changed from 15° - 55° in 5°increments. The flip angle waschanged in a random fashion to reduceany systematic error. The receiver gainwas adjusted and held constant sothat no signal over ranging occurredfor any combination of TI/flip angle.Data for each TI were obtained ondifferent sessions. The standard GEhead coil was used to acquire all data.

The slice that best visualized thebasal ganglia was selected for mea-surements. Mean signal intensity ofgray matter (left and right withinhead of caudate) and white matter(frontal white matter (left and right)and forceps major (left and right))were measured using small regions ofinterest (ROI). The standard deviation(SD) of noise was measured using twoROI’s outside the image. Contrast tonoise ratios (CNR) were calculated bydividing the difference in signalbetween GM/WM by the noise SD.

ResultsThere was a general increase in meansignal for each increase in TI and flipangle. However, an increased level ofimage blurring was observed for all TIvalues at flip angles greater than 30°.The CNR was similar for TI 450 and600 at all flip angles, and approxi-mately a factor of 2 higher than forCNR at TI 150 and 300.

ConclusionsResults indicate that optimum con-trast and image resolution is obtainedwith minimum scan time at TI 450and flip angle 25°.

With these parameters, 1.5T highresolution (1mm isotropic), wholebrain scans can be performed with aGM/WM CNR value~ 8 in ~ 8 minutes.�


Phase-contrast Cardiac MR Imaging for Absolute Quantificationof Mitral Valve RegurgitationS. Massing, S. Bosk, J. Barkhausen, P. HunoldUniversity Hospital, Department of Diagnostic and Interventional Radiology, Essen, Germany

2003 2nd Place Proffered Paper– Clinical Poster

PurposeEstimation of mitral valve regurgita-tion (MVR) severity is an importantissue in patient management in orderto meet the optimal time point forvalve replacement. Established non-invasive grading parameters fromechocardiography are differing over awide range and lack consistency withpatient prognosis. Aim of the studywas to assess accuracy and feasibilityof MVR volume estimation by phase-contrast MRI in comparison to 3Dechocardiography.

Methods and Materials18 patients with echocardiographicallyproven MVR were included into thestudy for quantification of mitralregurgitation volume. All MR examswere performed on a 1.5 T scanner(Magnetom Sonata, Siemens). The MRprotocol included TrueFISP cinestudies in standard long axes and athrough plane phase-contrast GEsequence (TR, 25 ms; TE, 4.8 ms).

Phase-contrast imaging was appliedstrictly perpendicular to the flowdirection at the level of the proximalascending aorta and above the mitralvalve to assess left ventricular stroke(LVSV) and diastolic inflow volume,respectively. The VENC was set at 250cm/s (aorta) and 150 cm/s (mitralvalve). Volumes were provided byintegrating the flow-time-curves usingthe Argus® software (Siemens). MVRvolume was calculated as the differ-ence between left ventricular inflowand LVSV (MVR volume =inflow - LVSV). MR data were com-pared to a new prototype Dopplerechocardio-graphy technique (PhaseVelocity Integral).

ResultsMR imaging was feasible for thequantification of MVR volume in allpatients. Examination durationamounted to 22±4 min. MVR volume

Figure 1. Top left: Cine four chamber view showing MVR jet(white arrow). Top right: Velocity map of MVR in early systole withaliasing artifact (black arrow). Bottom: Flow-time-curves of LVSV (left)and mitral inflow (right).

Table 1. Comparison of Phase-contrast MRI with Dopplerechocardiography shows close agreement between absolute MVRvolumes in both techniques.

in MRI ranged from 6.4 to 46 ml. MRImeasurements correlated well withDoppler echocardiography measure-ments: slope of regression line, 1.05,correlation coefficient, R=0.856(Table1).

ConclusionMR imaging allows an accurateassessment of absolute MVR volumein a non invasive way by using aphase-contrast GE sequence. MRIovercomes echocardiography difficul-ties as it is grossly independent frompatients’ body physique. Severitygrading of MVR based on the MRestimation of absolute volumes is analternative to establishedechocardiography and invasive proce-dures and might be advantageous interms of prognosis and operationplanning. �


Appearance of Calcification Artifact in the Falx Cerebri on PhaseMaps Using a High Resolution Venogram Technique at 3 TeslaBove Bettis, KE1, Bodurka, JA1, Birn, RM1, Rowser, P1, Saad, ZS2, Cox, RW2, Bandettini, PA1

1FMRI Core Facility, NIMH, NIH, 2Scientific and Statistical Computing Core, NIMH, NIH, Bethesda, Maryland, USA

2003 2nd Place-Tie Proffered Paper– Research Poster

PurposeTo understand the significance ofhypo-intensity artifacts as seen ongradient echo sequences of a particu-lar subject, not seen on T1-weighted(T1W) sequences, nor to this degree onother subjects at 3 Tesla. Thoughcalcifications within the falx cerebriwith MRI are certainly common, it hasbeen unusual at our institution to seethis degree of distortion.

Material and MethodsWe studied a healthy male volun-

teer, 49 years of age, with no knowndisease processes that would excludethe subject from IRB Approved Proto-cols. The subject is 72 inches in heightand weighed 175 lbs. Two studies wereperformed over a two-day period on a3 Tesla General Electric Signa VH/iMRI scanner (3T/90cm, whole bodygradient inset 40mT/m, slew rate 150T/m/s). The standard system transmit/receive birdcage head coil was used.On both days, the exam began with astandard 3-Plane localizer (SPGR) andall subsequent series were plannedfrom this first set of images forstandardization of slice location. TheT1W 3D Magnetization PreparedRapid Gradient Echo (MP-RAGE)sequence (Figure E) parameters wereas follows: plane orientation axial,TE: MinFull, TI: 725ms: flip angle 60,bandwidth: 31.25kHz, FOV 24cm x24cm, slice thickness 1.2mm skip0mm, 128 locations, matrix size

256 x 192, NEX =1. The High Resolu-tion MR Venogram was acquired inthe axial plane on day one and in thesagittal plane the following day.Parameters as follows: sequenceSPGR, scan modes: 3D, with gradientmoment nulling (Flow Comp), TR:50ms, TE: 30ms, flip angle 200, FOV24cm x 24cm, slice thickness 1.2mmskip 0. The slice locations in the axialplane exactly matched those of theMP-RAGE. The slice locations in thesagittal plane numbered 112, andwere the maximum number of slicesneeded to cover the brain from theinferior to superior borders. Matrixsize was 512 x 256, NEX =1. A re-search control variable that allowedboth and magnitude images phasemaps to be displayed was turned on.A quick series of single shot gradientrecalled echo-planar (GE-EPI) imageswas run to check for possible distor-tions if the subject were to be consid-ered for fMRI procedures. Parameterswere as follows: TE: 30ms, TR 2s; flipangle 90°, FOV 24cm x 24cm, matrix64x64, slice thickness 5.0, skip 0 for 18locations with 60 repetitions per slicelocation. The EPI images, magnitudeand phase images of the MRVenograms were transferred off-line toa Linux computer where the imageswere post-processed using the Analy-sis of Functional Neuro-Imaging(AFNI) software. The images were alsoanalyzed on the LX console to stan-dardize the slice location, Region ofInterest (ROI) size and ROI location.

ResultsIn the sagittal plane of the 3-planelocalizer, there appeared to be threehypo-intense regions that were seenjust superior to the corpus callosum atmidline and to the right of midline.The largest of these artifacts wasvisualized in the sagittal plane of theMR venogram (Figure 1A). The phasemap showed distortion from L2.2 toR12.2 (Figure 1B) and from S 44.5 toS 63.7 (Figure 1C) in the axial plane.Figure 1D demonstrates the EPIdistortion, which ranged from S45.5 toS65.5. This artifact is not visible onthe MP-Rage (Figure 1E).

DiscussionWhile falcine calcifications are consid-ered common, these calcificationscontain varying amount of bonemarrow and might present benignlyor to the extent as seen in this subject.If a subject is scheduled for a heavilyweighted T2W/T2*W study such asEPI, High Resolution Venogram etc.,and significant signal loss is seen onthe localizing scans, it might beprudent to run a heavily T2*Wsequence with phase maps in order toquantify and qualify possible artifactsthat could distort and even disqualifythe data. �

Figure 1a-e.


2003 Clinical Focus and Research Focus Oral and Poster PresentersSilke Bosk,Department of Diagnosticand InterventionalRadiology, UniversityHospital Essen,Essen, Germany“Thromboembolic Disease:Assessment with Whole-BodyMR Venography”

Bobbi K. Lewis,Experimental NeuroimagingSection, LDRR, NIH,Bethesda, Maryland, USA“Does Angle Matter InAcquiring MRSI?”

Karen Bove Bettis,FMRI Core Facility,NIMH, NIH, Bethesda,Maryland, USA“Demonstration of CerebralVenous Vasculature Using aHigh Resolution VenogramTechnique at 3 Tesla”

Catherine Blaesing,Department of MRIRadiology, University ofMichigan Hospital, AnnArbor, Michigan, USA“Challenging VoxelPlacement for Brain MRSpectroscopy”

Carol Awde,Department of DiagnosticImaging, St. Joseph’sHealthcare, Hamilton,Ontario, Canada“Takayasus Arteritis– TheRole of MRI in Its Diagnosis”

JoAnn Bromley,Mayo Clinic, Rochester,Minnesota, USA“Improving Efficiency inMRI by Utilizing Non-Technologist Personnel”

Filip De Ridder,Department of Radiology,Free University of Brussels,Belgium“Improvement in the Selectionof Stereotactic Biopsy Targetin Intracere-bral GliomasUsing T2* Perfusion” and“Evaluation of Crohn'sDisease Activity with MRI”

Denise Davis,MR Research Center,University of Pittsburgh,Pittsburgh, Pennsylvania, USA“Considerations forDevelopment of 3T ClincalProtocols”

Gregory Brown,Department of MRIRadiology, Royal AdelaideHospital, Adelaide, Australia“Initial Experience with R2Mapping to Measure LiverIron Concentrations:A Practical Tool for ManagingIron Overloaded Patients”

Dorothea Happ,Department of Radiology,University of MichiganHealth System, Ann Arbor,Michigan, USA“Gadolinium EnhancedT1-Weighted 3D-SPGRBreath-Hold Excretory MRUrography”

Michael Macilquham,MRI Department, CabriniHospital, Malvern,Victoria, Australia“Prostate MagneticResonance Imaging andSpectroscopy–A Clinical Review”

Sandra Massing,Dept. of Diagnostic andInterventional Radiology,University Hospital Essen,Essen, Germany“Late Enhancement inCardiac MRI of MyocardialInfarction and the Predictionof Functional Recovery afterBypass Surgery”

Andrew Cooper,MRI Unit, Queen’s MedicalCentre, Nottingham,England, UK“Imaging of Deep VeinThrombosis using MagneticResonance Direct ThrombusImaging (MRDTI),A Mobitrack Technique”

Randy Earnest,EPIX Medical, Inc.,Cambridge,Massachusetts, USA“How to Survive ClinicalTrials? A TechnologistPerspective”

Hina Jaggi,MRI Unit, Department ofRadiology, NYU MedicalCenter, New York,New York, USA, USA“Advanced Cardiac Imagingto Evaluate CardiacViability”

Susan O’Flahavan,Advanced MRI Section,LFMI, NINDS, NIH,Bethesda, Maryland, USA“SNR Improvements Usinga 16-Channel Head Coil”

Cindy ComeauAdvanced CardiovascularImaging, CardiovascularResearch Foundation, LenoxHill Hospital, New York,New York, USA“The Preoperative Assessmentof Mitral Regurgitation byMRI: A Series of Six Patients”

Jane Ho,Institute of Child Health,University College London,London, England, UK“Functional MRI in Patientswith Language Deficits: TheRole of Covert and OvertLanguage ActivationParadigms”


Susan Ryan,Department of Radiology,LaGrange Hospital,LaGrange, Illinois, USA“Using the “Roolie” forPeripheral Run Off MRAs”

Steven Williams,Mayo Clinic, Rochester,Minnesota, USA“Imaging ArticularCartilage at 1.5T Standardand Novel Techniques”

Annica Sandberg,MRI Unit Department ofNeuroradiology,Karolinska Hospital,Stockholm, Sweden“Perfusion Weighted MRIin Research and ClinicalRoutine”

Ann Sisak,Department of DiagnosticImaging, St. Joseph’sHealthcare, Hamilton,Ontario, Canada“3D Fiesta IACs–Effective Screening Tool?”

David Stanley,Applied ScienceLaboratory, GE MedicalSystems, Milwaukee,Wisconsin, USA“Dynamic Contrast-Enhanced Bilateral BreastTechnique”and “Real-Time DelayedEnhancement”

Kathryn Tyler,Walton Centre for Neurologyand Neurosurgery, Liverpool,England, UK“MRI Spin Echo Sequencefor the Demonstration of theSubthalamic Nucleus for DeepBrain Stimulation in Patientswith Parkinson’s Disease”

Paula Rowser,FMRI Core Facility,NIMH, NIH, Bethesda,Maryland, USA“Effects of SNR onIntracranial MRAngiography Images on a3T Magnet vs. 1.5T”

2003 Clinical Focus and Research Focus Oral and Poster PresentersCheryl Richardson,Royal Marsden NHS Trust,London, England, UK“Techniques and Trouble-Shooting in High SpatialResolution Thin Slice MRIfor Rectal Cancer”

Suzan Rohrer,Department of Radiology,University of MichiganHealth System, Ann Arbor,Michigan, USA“MR SpectroscopyDifferentiating BetweenRecurrent Brain Tumor andNon-Neoplastic TherapyRelated Changes”

Sue Rysted,Mayo Clinic, Rochester,Minnesota, USA“Modified SSFSE toReduce Image Blurring:Comparison with theStandard Sequence”

Photos unavailableClinical Focus authors:Teresa Almandoz, “Staging of Gastric Adenocarcinoma by MRI: Protocols, Opportunities and Limitations”Pablo Buzzi, “Cranial Trauma: Hemorrhagic Endocranial Complications”Tsukasa Doi, “Evaluation of Coronal Image Used Grappa in Parallel Imaging”Sei Young Kim, “Diffusion Tensor MRI and Fiber Tractography Using Multichannel SENSE Head Coil: Clinical Feasibility in the Evaluation of CNS Anomaly”Emil Nordby, “Functional Magnetic Resonance Imaging (fMRI) of the Brain as a Tool for Surgical Planning”Erma Owens, “Implementation of Magnetization Transfer Ratios in Characterization of Demylelinating Disease in Clinical Practice” and “Developmentand Design of Clinical Ladder for MRI Technologists”Byung-Rae Park, “Classification of Fall in Sick Times of Liver Cirrhosis using MR Images and Neural Network”George Tezapsidis, “Indirect MR Arthography: Applications in Assessing Knee Diseases” and “Direct MR Fistulography: Comparison Study with DSA”Mary Watkins, “Making Clinical Sense of Cardiac MR: A Full Functional Exam in Five Plus One Minutes”

Research Focus authors:Anne Dorte Blankholm, “Comparison of 3D SPGR (Inversion Prepared Spoiled Grass) and 3D FIESTA (TRUE FISP) at C2 Level in the Assessment ofMultiple Sclerosis”Ho Yong Jung, “A Study on the Changes of Signal Intensity of Water in Relation to TE Changes”Joji Kato, “MR Myelography Using Fast Recovery Fast Spin Echo (FRFSE)”Yong Moon Lee, “Study and Consideration of Localized in vivo 1H MR Spectroscopy (MRS) for Human Brain”Jung Woo Lee, “Four Dimensional (Time-Resolved) MRA Using SENSE Technique: Preliminary Report”Dae Keon Seo, “A Phantom Study of Image Distortion for Accuracy of Stereotactic Localization in the Magnetic Resonance Imaging”Bjarte Snekvik, “Stimulated Echo for Diffusion Imaging at 3T”Yvonne van der Meulen, “Possibility to Differentiate between Metastasis and Radiation Necrosis by MR Spectroscopic Imaging”


T he SMRT Educational Seminars group is hard at work finishing up the last

issue of the year. Enclosed with this issueof Signals you will find “Advances in Inter-ventional MRI.” The issue is composed of twoarticles, the first entitled “Transnasal andTransphenoidal MRI-Guided Biopsies of

Petroclival Tumors.” I know that sounds painful, but authorsThomas Schultz and colleagues have shown that MRI offers an“interactive, one-step method of localization, targeting, andtissue sampling and retrieval… which is minimally invasivefor the patient.” Their research reviews the set-up of theoperative suite, the procedure and instruments used for thebiopsy, clinical findings of the patients and correlating patho-logic findings.

The second article of this issue, entitled “Integration ofInterventional MRI with Computer-Assisted Surgery” revealshow computer-based techniques are enhancing the ability of

Update on SMRT Educational SeminarsKelly D. Baron B.S.R.T. (R)(MR)

Interventional MRI to detect and identify a potential abnor-mality, as well as localize and target an abnormality fortherapy purposes. This article by Dr. Jolesz and colleagues isvery cool and very techy, reviewing the latest in computertechniques to analyze imaging data. The text reviews theapplications in the fields of neurosurgery, liver cryosurgery,and ultrasound therapy. If you are not performing theseprocedures, it will give you a glimpse of things to come and tolook forward too!

The last issue of the year will be entitled “Diffusion-Weighted Imaging of the Pediatric Brain,” and will again becomposed of two articles. The first will address the changesseen in water diffusion in the brain during the 1st year of life.The second will reveal the differences in diffusion patterns inthe normal brain compared to that of brains with variouswhite matter diseases. �

Information Sharing during Breaks and at the Poster Walking Tour and Reception

There is opportunity to meet colleagues, old friends,and new friends to compare MR practices aroundthe world.

Again this year we want to thank Mallinckrodt, Inc.for their generous support in funding the SMRTPoster Walking Tour and Reception.


H

Regional Committee UpdateCindy Comeau, B.S., R.T. (R)(MR), SMRT Regionals Committee Chair

ave you been looking for a way to promote MRI education? Are you

looking for a way to network with other peoplein your field? Perhaps you attended a SMRTRegional Seminar recently and wondered howto become more involved. If you have answered“YES” to any of these questions then hosting anSMRT Regional Seminar may be the answerfor you!

In keeping with the mission of promoting technologisteducation the SMRT/ISMRM organization needs your support.The process of hosting a SMRT Regional Seminar begins withthe identification of a local chairperson who will coordinatethe local event. With support from the SMRT/ISMRMBerkeley office you select a venue and local speakers. You mayalso contact with local vendors interested in providing supportfor your local meeting. Jennifer Olson will send you a Regionalpacket and brief you on the process. In this packet you willfind a timeline and a wealth of information to get you started.Also as recognition of your efforts in hosting an SMRTRegional your SMRT membership fee is waived for one year!

The SMRT sincerely thanks all of the local chairs for thesix SMRT Regional Seminars scheduled in September andOctober 2003. So please take a moment and review SMRTCalendar on page 28. You can also visit the SMRT Website(http://www.ismrm.org/smrt) to view this information and toregister. If you would like a brochure mailed to you, pleasecontact the Berkeley office by e-mail [email protected] or call+1 510 841 1899.

Please pass this information on to your fellow MRItechnologists. We look forward to seeing you at a SMRTRegional Educational Seminar soon and perhaps hosting oneyourself! �

SMRT Members: Remember to VoteJohn A. Koveleski, R.T. (R)(MR), Past-President and Chair, Nominating Committee

I t is that time of year when you have the opportunity to participate in the future of

the SMRT. As a voting member you not onlyhave the privilege but the responsibility tovote for the individuals who will become thePresident-Elect and the new Policy BoardMembers. As your ballot arrives please takesome time to review the qualities and experi-

ence of the candidates and select those individuals whomyou think will serve you and the SMRT well.

This is your chance to determine the future leadershipof the SMRT. You will also have the occasion to select therecipient of the Crues-Kressel Award.

The President-Elect position is a three-year commit-ment, beginning as President-Elect followed by Presidentand then Past President. As a member of the ExecutiveCommittee, the President-Elect is mentored for one year andthen becomes the President. During the year as President,this leader represents the SMRT to the parent society,ISMRM, and presides over all of the business of the SMRT.This includes contact with all twelve standing committees,as well as any other pertinent issues that arise. As PastPresident this person serves on the Executive Committee toease the transition from one year to the next and is Chairof the Nominating and Awards Committees.

Policy Board members are elected for a three-year term,and are expected during that time to chair at least one ofthe standing committees and serve on others as needed.Those elected to the Policy Board are expected to be highlymotivated, concerned individuals who will complete thosetasks necessary for the SMRT to have ongoing success.Face to face meetings are rare, because members of anygiven committee may be from a variety of countries.Communication among Policy Board and committeemembers is generally conducted through electronic mail,which is both efficient and economical. It is a tribute tothose many volunteers who have already completed termson the Policy Board as well as those being considered forelection, that the SMRT continues to evolve into a recog-nized professional organization for MR technologists aroundthe world. By carefully selecting your choices, you willensure the SMRT will thrive for years to come.

You will also be asked to select a recipient of theCrues-Kressel Award. This award was established in honorof Drs. John Crues and Herbert Kressel for their support inestablishment of the SMRT. The person nominated to receivethis award is someone who is recognized “for outstandingcontributions to the education of magnetic resonancetechnologists.” For a listing of those who have received thisaward in previous years please check the SMRT Website.

Included with the ballot are brief biographical historiesfor all the candidates. Please review them and mark yourchoices. As a reminder, only those voting members in goodstanding, with annual dues paid, are eligible to vote. Followthe directions carefully to sign and mail your ballot or it may

not be counted. Ballots will be mailed 15 October 2003.The postmark deadline is 1 December 2003 and the ballotsmust be received no later than 8 December 2003. Theballots will be counted and the results announced in a futureissue of Signals. If you have any questions about the electionprocedure or your eligibility to vote, please contact me at:[email protected] or at my work telephone number of+1 717 975 0444, or the SMRT office at: +1 510 841 1899. �

Journal Subscriptions Rate IncreaseAt the ISMRM Board of Trustees meeting in Toronto thispast July it was moved, seconded, and carried that the costof journals be increased from US$90 to US$100 for SMRTmembers who choose to subscribe to a journal starting in2004. �


Figure 2.

Figure 1.

I

LOW- AND MID-FIELD MRI

Precessing in a Vertical Field: Knee Case StudyWilliam Faulkner, B.S., R.T. (R)(MR)(CT)

This article represents the views of its author only and does not reflect those of theInternational Society for Magnetic Resonance in Medicine and are not made with its authority or approval.

started this column writing on one topic

but then this interestingcase came up whileworking with a site tooptimize the knee protocolon their 0.2T system.I thought I’d do somethinga little different and just

present this as a case study to show howsome newer imaging options availableon low-field systems can be utilized.I’d like to thank Dr. Glen Strome ofAssociates in Diagnostic Radiology andthe technologists of ChattanoogaImaging for their assistance. This is a15-year-old male with knee pain(you’ll see why shortly).

The first sequence is a conventionalspin echo (please stop calling it“true spin echo”). The parameters are:TR 1050, TE 27. The sagittal imagesthrough the medial meniscus demon-strate the tear (figure 1). The midlineimages show what is often referred to asthe “double PCL sign” (figure 2). Thisindicates a bucket-handle tear and the“extra PCL” signal is really a big pieceof the torn meniscus.

The next series is a Fast Spin Echoutilizing a “driven equilibrium” option(Fast Recovery Fast Spin Echo). Addi-tionally it utilizes a fat/water separationoption and the images displayed are thewater images (figure 3). This producesProton Density weighted fat suppressedimages (yes – this is a 0.2T system).The parameters are TR 3000, TE 46.

The fat suppressed FSE sequencealso provides good contrast between thecartilage and fluid in the joint. Again,the meniscal tear is well seen.

The same sequence is repeated inthe coronal plane both with and withoutthe “fat suppression” option. The imageswithout fat suppression show the pieceof the meniscus laying in the joint spacenear the PCL (figure 4), as well asdemonstrate the meniscal tear again(figure 5).

You don’t always get lucky and geta cooperative patient with well-definedpathology when working to optimizeyour protocols. In fact, it’s usually justthe opposite. You get an uncooperativeor very sick patient with absolutely nopathology. The docs want to know whythe images look so crummy and they

doubt the changes will show the pathol-ogy as good as the old protocol sincethey don’t see any abnormalities.

Since everything worked in myfavor this time, I thought I’d use thisopportunity to show some interestingpathology and demonstrate what can bedone on a low-field system in 2003. �


Figure 3.

Low- and Mid-Field MRI continued

Figure 4.

Figure 5.

Institute for MagneticResonance Safety,Education, and ResearchThe Institute for Magnetic Resonance Safety,Education, and Research (IMRSER) is anindependent, multidisciplinary, professionalorganization devoted to promoting awareness,understanding, and communication ofmagnetic resonance (MR) safety issuesthrough education and research.

One of the functions of the Institute forMagnetic Resonance Safety, Education, andResearch is to develop MRI safety guidelinesand to disseminate this information to theMR community in order to help ensure safetyfor patients, healthcare workers, and otherindividuals in the MR environment. Thedevelopment of guidelines is achieved by theMedical, Scientific, and Technology AdvisoryBoard and the Corporate Advisory Board ofthe IMRSER utilizing pertinent peer-reviewed, evidence-based literature and byrelying on each member’s extensive clinical,research, or other appropriate experience.

The Medical, Scientific, and TechnologyAdvisory Board is comprised of recognizedleaders in the field of magnetic resonance(MR), including diagnostic radiologists,clinicians, research scientists, physicists,MRI technologists, MR facility managers, andother allied healthcare professionals involvedin MR technology and safety. In addition, theFood and Drug Administration has assigneda Federal Liaison to the IMRSER’s Medical,Scientific, and Technology Advisory Board.The Corporate Advisory Board is comprisedof representatives from the MR industryincluding MR system manufacturers, contrastagent pharmaceutical companies, RF coilmanufacturers, MR accessory vendors,medical product manufacturers, and otherrelated corporate organizations.

Notably, MRI safety guidelines developed bythe IMRSER consider and incorporateinformation provided by the InternationalSociety for Magnetic Resonance in Medicine(ISMRM), the American College of Radiology(ACR), the Food and Drug Administration(FDA), the National Electrical ManufacturersAssociation (NEMA), the Medical DevicesAgency (MDA), and the InternationalElectrotechnical Commission (IEC).

The IMRSER’s rigorous development andreview process for MRI safety guidelinesensures that authoritative and relevantinformation is produced in a timely mannerfor rapid dissemination to the MR community.

It should be noted that the MRI safetyguidelines developed by the IMRSER areeducational in nature and not specificallyintended to be legal standards of care.Accordingly, these MRI safety guidelines maybe modified as determined by individualcircumstances, currently available resources,differences or changes in technology, andother relevant information. �


I

Guidelines to Prevent Excessive Heating and BurnsAssociated with Magnetic Resonance ProceduresFrank G. Shellock, Ph.D., Adjunct Clinical Professor of Radiology, University of Southern California; Founder, Institute for MagneticResonance Safety, Education, and Research; President, Magnetic Resonance Safety Testing Services, Los Angeles, California, USAwww.MRIsafety.com www.IMRSER.orgThis article represents the views of its author only and does not reflect those of theInternational Society for Magnetic Resonance in Medicine and are not made with its authority or approval.

MRI SAFETY

n general, magneticresonance (MR)

imaging is considered tobe a relatively safediagnostic modality.However, the use ofradiofrequency coils,physiologic monitors,electronically-activated

devices, and external accessories orobjects made from conductive materialshas caused excessive heating, resultingin burn injuries to patients undergoingMR procedures. Heating of implants andsimilar devices may also occur inassociation with MR procedures, butthis tends be problematic primarily forobjects made from conductive materialsthat have elongated shapes such asleads, guidewires, and certain types ofcatheters (e.g., catheters with thermistorsor other conducting components).

Notably, more than 30 incidents ofexcessive heating have been reported inpatients undergoing MR procedures inthe United States that were unrelatedto equipment problems or the presenceof conductive external or internalimplants or materials [review of datafiles from U.S. Food and Drug Adminis-tration, Center for Devices and Radio-logical Health, Manufacturer and UserFacility Device Experience Database,MAUDE, http://www.fda.gov/cdrh/maude.html and U.S. Food and DrugAdministration, Center for Devices andRadiological Health, Medical DeviceReport, (http://www.fda.gov/CDRH/mdrfile.html)]. These incidents includedfirst, second, and third degree burnsthat were experienced by patients(Figure 1). In many of these cases, thereports indicated that the limbs or otherbody parts of the patients were in directcontact with body radiofrequency (RF)coils or other RF transmit coils of theMR systems or there were skin-to-skincontact points suspected to be respon-sible for these injuries.

MR systems require the use of RFpulses to create the MR signal. This RFenergy is transmitted readily throughfree space from the transmit RF coil tothe patient. When conducting materialsare placed within the RF field, the resultmay be a concentration of electricalcurrents sufficient to cause excessiveheating and tissue damage. The natureof high frequency electromagnetic fieldsis such that the energy can be transmit-ted across open space and throughinsulators. Therefore, only devices withcarefully designed current paths can bemade safe for use during MR proce-dures. Simply insulating conductivematerial (e.g., wire or lead) or separat-ing it from the patient may not besufficient to prevent excessive heatingor burns from occurring.

Furthermore, certain geometricalshapes exhibit the phenomenon of“resonance” which increases theirpropensity to concentrate RF currents.At the operating frequencies of presentday MR systems, conducting loops oftens of centimeters in size may createproblems and, therefore, must beavoided, unless high impedance is usedto limit RF current. Importantly, evenloops that include small gaps separatedby insulation may still conduct current.

To prevent patients from experienc-ing excessive heating and possible burnsin association with MR procedures, thefollowing guidelines are recommended:

(1) Prepare the patient for the MRprocedure by ensuring that there are nounnecessary metallic objects contactingthe patient’s skin (e.g., metallic drugdelivery patches, jewelry, necklaces,bracelets, key chains, etc.).

(2) Prepare the patient for the MRprocedure by using insulation material(i.e., appropriate padding) to preventskin-to-skin contact points and theformation of “closed-loops” from touch-ing body parts.

(3) Insulating material (minimumrecommended thickness, 1-cm) shouldbe placed between the patient’s skin andtransmit RF coil that is used for the MRprocedure (alternatively, the RF coilitself should be padded). For example,position the patient so that there is nodirect contact between the patient’s skinand the body RF coil of the MR system.This may be accomplished by having thepatient place his/her arms over his/herhead or by using elbow pads or foampadding between the patient's tissueand the body RF coil of the MR system.This is especially important for thoseMR examinations that use the body coilor other large RF coils for transmissionof RF energy.

(4) Use only electrically conductivedevices, equipment, accessories (e.g.,ECG leads, electrodes, etc.), and materi-als that have been thoroughly testedand determined to be safe and compat-ible for MR procedures.

(5) Carefully follow specific MR safetycriteria and recommendations for implantsmade from electrically-conductivematerials (e.g., bone fusion stimulators,neurostimulation systems, etc.).

(6) Before using electrical equipment,check the integrity of the insulation and/or housing of all components includingsurface RF coils, monitoring leads,cables, and wires. Preventive mainte-nance should be practiced routinely forsuch equipment.

Figure 1. Third-degree burn experienced bya patient during an MR procedure. This burnwas unrelated to equipment malfunction orthe presence of internal or external conduc-tive materials. Continued on page 25 ➠

MRI Safety Guideline Developed by the Institute for Magnetic Resonance Safety, Education, and Research.


(7) Remove all non-essential electricallyconductive materials from the MRsystem (i.e., unused surface RF coils,ECG leads, cables, wires, etc.).

(8) Keep electrically conductive materi-als that must remain in the MR systemfrom directly contacting the patient byplacing thermal and/or electricalinsulation between the conductivematerial and the patient.

(9) Keep electrically conductive materi-als that must remain within the bodyRF coil or other transmit RF coil of theMR system from forming conductiveloops. Note: The patient's tissue isconductive and, therefore, may beinvolved in the formation of a conduc-tive loop, which can be circular, U-shaped, or S-shaped.

(10) Position electrically conductivematerials to prevent “cross points.” Forexample, a cross point is the point wherea cable crosses another cable, where acable loops across itself, or where a cabletouches either the patient or sides of thetransmit RF coil more than once.Notably, even the close proximity ofconductive materials with each othershould be avoided because some cablesand RF coils can capacitively-couple(without any contact or crossover) whenplaced close together.

(11) Position electrically conductivematerials to exit down the center of theMR system (i.e., not along the side of theMR system or close to the body RF coilor other transmit RF coil).

(12) Do not position electrically conduc-tive materials across an externalmetallic prosthesis (e.g., externalfixation device, cervical fixation device,etc.) or similar device that is in directcontact with the patient.

(13) Allow only properly trainedindividuals to operate devices (e.g.,monitoring equipment) in the MRenvironment.

(14) Follow all manufacturer instruc-tions for the proper operation andmaintenance of physiologic monitoringor other similar electronic equipmentintended for use during MR procedures.

(15) Electrical devices that do notappear to be operating properly duringthe MR procedure should be removedfrom the patient immediately.

(16) Closely monitor the patient duringthe MR procedure. If the patient reportssensations of heating or other unusualsensation, discontinue the MR proce-

dure immediately and perform athorough assessment of the situation.

(17) RF surface coil decoupling failurescan cause localized RF power depositionlevels to reach excessive levels. The MRsystem operator will recognize such afailure as a set of concentric semicirclesin the tissue on the associated MRimage or as an unusual amount ofimage non-uniformity related to theposition of the RF coil.

The adoption of these guidelineswill help to ensure that patient safety ismaintained, especially as more conduc-tive materials and electronically-activated devices are used in associationwith MR procedures. �

Pertinent Reference1. Bashein G, Syrory G. Burns associated with pulse

oximetry during magnetic resonance imaging. Anes-thesiology 1991;75:382-3.

2. Brown TR, Goldstein B, Little J. Severe burns result-ing from magnetic resonance imaging with cardiopul-monary monitoring. Risks and relevant safety precau-tions. Am J Phys Med Rehabil 1993;72:166-7.

3. Chou C-K, McDougall JA, Chan KW. Absence ofradiofrequency heating from auditory implants dur-ing magnetic resonance imaging. Bioelectromagnetics1997;44:367-372.

4. Dempsey MF, Condon B. Thermal injuries associatedwith MRI. Clin Radiol 2001;56:457-65.

5. Dempsey MF, Condon B, Hadley DM. Investigation ofthe factors responsible for burns during MRI.J Magn Reson Imaging 2001;13:627-631.

6. ECRI, Health Devices Alert. A new MRI complication?Health Devices Alert. May 27, pp. 1, 1988.

7. ECRI. Thermal injuries and patient monitoring dur-ing MRI studies. Health Devices Alert. 1991;20: 362-363.

8. Finelli DA, Rezai AR, Ruggieri PM, Tkach JA,Nyenhuis JA, Hrdlicka G, Sharan A, Gonzalez-Martinez J, Stypulkowski PH, Shellock FG. MR im-aging-related heating of deep brain stimulation elec-trodes: In vitro study. Am J Neuroradiol 2002;23:1795-1802.

10. Hall SC, Stevenson GW, Suresh S. Burn associatedwith temperature monitoring during magnetic reso-nance imaging. Anesthesiology 1992;76:152.

11. Heinz W, Frohlich E, Stork T. Burns following mag-netic resonance tomography study. (German) ZGastroenterol 1999;37:31-2.

12. http://www.MRIsafety.com13. International Electrotechnical Commission (IEC),

Medical Electrical Equipment, Particular require-ments for the safety of magnetic resonance equipmentfor medical diagnosis, International Standard IEC60601-2-33, 2002.

14. Jones S, Jaffe W, Alvi R. Burns associated with elec-trocardiographic monitoring during magnetic reso-nance imaging. Burns 1996;22:420-1.

15. Kanal E, Shellock FG. Burns associated with clinicalMR examinations. Radiology 1990;175: 585.

16. Kanal E, Shellock FG. Policies, guidelines, and rec-ommendations for MR imaging safety and patientmanagement. J Magn Reson Imaging 1992;2:247-248.

17. Keens SJ, Laurence AS. Burns caused by ECG moni-toring during MRI imaging. Anaesthesia 1996;51:1188-9.

18. Knopp MV, Essig M, Debus J, Zabel HJ, van Kaick G.Unusual burns of the lower extremities caused by aclosed conducting loop in a patient at MR imaging.Radiology 1996;200:572-5.

19. Knopp MV, Metzner R, Brix G, van Kaick G. Safetyconsiderations to avoid current-induced skin burns inMRI procedures. (German) Radiologe 1998;38:759-63.

20. Kugel H, Bremer C, Puschel M, Fischbach R, LenzenH, Tombach B, Van Aken H, Heindel W. Hazardoussituation in the MR bore: induction in ECG leadscauses fire. Eur Radiol 2003;13:690-694.

21. Nakamura T, Fukuda K, Hayakawa K, Aoki I,Matsumoto K, Sekine T, Ueda H, Shimizu Y. Mecha-nism of burn injury during magnetic resonanceimaging (MRI)-simple loops can induce heat injury.Front Med Biol Eng 2001;11:117-29

22. Nyenhuis JA, Kildishev AV, Foster KS, Graber G, AtheyW. Heating near implanted medical devices by the MRIRF-magnetic field. IEEE Trans Magn 1999;35:4133-4135.

23. Rezai AR, Finelli D, Nyenhuis JA, Hrdlick G, Tkach J,Ruggieri P, Stypulkowski PH, Sharan A, Shellock FG.Neurostimulator for deep brain stimulation: Ex vivoevaluation of MRI-related heating at 1.5-Tesla. J MagnReson Imaging 2002;15: 241-250.

24. Schaefer DJ. Safety Aspects of radio-frequency powerdeposition in magnetic resonance. MRI Clinics ofNorth America 1998;6:775-789.

25. Schaefer DJ, Felmlee JP. Radio-frequency safety inMR examinations, Special Cross-Specialty Categori-cal Course in Diagnostic Radiology: Practical MRSafety Considerations for Physicians, Physicists, andTechnologists, Syllabus, 87th Scientific of the Radio-logical Society of North America, Chicago, pp 111-123,2001.

26. Shellock FG. Magnetic Resonance Procedures: HealthEffects and Safety. CRC Press, LLC, Boca Raton, FL,2001.

27. Shellock FG. MR safety update 2002: Implants anddevices. J Magn Reson Imaging 2002;16:485-496.

28. Shellock FG. Radiofrequency-induced heating duringMR procedures: A review. J Magn Reson Imaging2000;12: 30-36.

29. Shellock FG. Reference Manual for Magnetic Reso-nance Safety: 2003 Edition, Amirsys, Inc., 2003.

30. Shellock FG, Slimp G. Severe burn of the finger causedby using a pulse oximeter during MRI. American Jour-nal of Roentgenology 1989;153:1105.

31. Shellock FG, Hatfield M, Simon BJ, Block S, WamboldtJ, Starewicz PM, Punchard WFB. Implantable spinalfusion stimulator: assessment of MRI safety. J MagnReson Imaging 2000;12:214-223.

32. Smith CD, Nyenhuis JA, Kildishev AV. Health effectsof induced electrical fields: implications for metallicimplants. In: Shellock FG, ed. Magnetic resonance pro-cedure: health effects and safety. Boca Raton, FL: CRCPress, 2001; 393-414.

33. U.S. Food and Drug Administration, Center for De-vices and Radiological Health (CDRH), Medical De-vice Report (MDR) (http://www.fda.gov/CDRH/mdrfile.html). The files contain information fromCDRH’s device experience reports on devices whichmay have malfunctioned or caused a death or seriousinjury. The files contain reports received under boththe mandatory Medical Device Reporting Program(MDR) from 1984 - 1996, and the voluntary reportsup to June 1993. The database currently contains over600,000 reports.

34. U.S. Food and Drug Administration, Center for De-vices and Radiological Health (CDRH), Manufacturerand User Facility Device Experience Database,MAUDE, (http://www.fda.gov/cdrh/maude.html).MAUDE data represents reports of adverse eventsinvolving medical devices. The data consists of all vol-untary reports since June, 1993, user facility reportssince 1991, distributor reports since 1993, and manu-facturer reports since August, 1996.

MRI Safety continued

This website was created and is maintained byFrank G. Shellock, Ph.D.

For more information on safetyrelated issues, please visit:


SECTION FORMAGNETIC RESONANCE TECHNOLOGISTS

13th Annual Meeting15-16 MAY 2004, KYOTO, JAPANKyoto International Conference Hall


T

... is published by theInternational Society forMagnetic Resonance in Medicine,2118 Milvia Street, Suite 201,Berkeley, CA 94704, USA.

Signals is produced quarterly forthe benefit of the SMRT membership.In addition to this printed copy ofSignals, an electronic version isavailable to members on the SMRTWebsite. Remember to check thewebsite often for updates and featuresthat are important to you.

http://www.ismrm.org/smrt

PUBLICATIONS COMMITTEE:

Gregory Brown, R.T.,Publications Committee Chair

Julie Strandt-Peay, B.S.M., R.T. (R)(MR),Signals Newsletter Editor

Kelly Baron, B.S.R.T. (R)(MR),SMRT Educational Seminars Editor

William Faulkner, B.S., R.T. (R)(MR)(CT) C.N.M.T.

Cindy T. Hipps, B.H.S., R.T. (R)(MR)

Anne M. Sawyer-Glover, B.S., R.T. (R)(MR)

OFFICERS:

President:Maureen Ainslie, M.S., R.T. (R)(MR)

President-Elect:Cindy T. Hipps, B.H.S., R.T. (R)(MR)

Past-President:John A. Koveleski, R.T. (R)(MR)

Secretary:William Faulkner, B.S., R.T. (R)(MR) (CT)

Treasurer:Anne M. Sawyer-Glover, B.S., R.T. (R)(MR)

ISMRM Executive Director:Jane Tiemann

ISMRM Associate Executive Director:Jennifer Olson

ISMRM Publications Manager,Design and Layout:Sheryl Liebscher

© 2003 by International Society forMagnetic Resonance in MedicinePhone: +1 510 841 1899Fax: +1 510 841 2340E-mail: [email protected]

SMRT Web Page: www.ismrm.org/smrt

The SMRT Proudly Presents13th Annual Meeting of the Section forMagnetic Resonance TechnologistsJames J. Stuppino, B.S., R.T. (R)(MR), 2004 SMRT Program Committee Chair

he SMRT invites technologists from around the world to attend the ThirteenthAnnual Meeting of the Section for Magnetic Resonance Technologists. This

meeting will be held 15 to 16 May 2004 in conjunction with the Twelfth ScientificMeeting and Exhibition of the International Society for Magnetic Resonance inMedicine at the Kyoto International Conference Hall in Kyoto, Japan.

The goal of the SMRT is to provide quality educational opportunities for theMR technologist and to establish and maintain a high level of professionalism in thefield. MR technologists are faced with many challenges: keeping abreast of advanc-ing technology, implementation of new applications, and a continuously increasingworkload. We continue to strive to maintain a high standard of performance whileproviding quality patient care.

The Meeting will commence with a Poster Exhibit and Walking Tour Receptionat 18:30 on Friday evening, 14 May 2004. This will be a great way to learn aboutnew and innovative clinical and research studies that are being performed by ourcolleagues worldwide. It also provides a great opportunity to interact with the posterauthors and to meet and share ideas with fellow technologists from around theworld.

An important aspect of the meeting remains the submission of abstracts for oraland poster presentations by technologists. Proffered papers will be interlacedthroughout the sessions.

We strongly encourage all technologists to participate in the meeting bysubmitting an oral or poster abstract. For assistance, please see instructions postedon the SMRT Website. The deadline for SMRT abstract submissions will be21 January 2004. Online abstract submission will be available on the SMRTWebsite: http://www.ismrm.org/smrt. The proffered papers and posters have beenone of the highlights of past SMRT meetings.

The SMRT Annual Business Meeting will be held on Saturday, 15 May,giving members a chance to actively participate in and contribute ideas to yourprofessional MR organization.

As Chair of the 2004 Program Committee, it is my pleasure to invite you toattend this meeting and to join the SMRT in bringing to technologists, an exciting,quality educational weekend in the wonderful city of Kyoto. �

Highlight Your Site!Cindy T. Hipps, B.H.S., R.T. (R)(MR)

SMRT members: This is an opportunity to see your site highlighted on the Web!

• Are you proud of your imaging facility?

• Do you have great co-workers or dynamic staff?

• Do you have a specialty that makes your site unique?

• Is your site a great place to work with exceptional people?

• Are you looking to expand your staff?

Send in pictures of your facility, co-workers, and staff along with descriptionof your facility to: [email protected].

INTERNATIONAL SOCIETY FOR MAGNETIC RESONANCE IN MEDICINE2118 Milvia Street, Suite 201, Berkeley, California 94704 USA

ISMRM/SMRT CALENDAR

ISMRM Workshop on MR Technologyto Assess MS Pathology In Vivo9-11 October 2003San Servolo, Venice, Italy

ISMRM Workshop on MR in DrugDevelopment: From Discovery to ClinicalTherapeutic Trials2-3 April 2004Hilton McLean Tysons Corner, McLean, Virginia, USA

ISMRM 12th

Scientific Meeting& Exhibition15-21 May 2004Kyoto InternationalConference Hall,Kyoto, Japan

SMRT Northwest Regional Seminar27 September 2003Fred Hutchinson Cancer Research Center, Seattle, Washington, USA

SMRT Northeast Regional Seminar28 September 2003University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

SMRT President’s Regional Seminar18 October 2003Duke University Medical Center, Durham, North Carolina, USA

SMRT Northeast Regional Seminar25 October 2003Mariott Boston Copley Place Hotel, Boston, Massachusetts, USA

SMRT 13th Annual Meeting of theSection for Magnetic Resonance Technologists15-16 May 2004Kyoto International Conference Hall, Kyoto, Japan

For more registration information, please contact: ISMRM/SMRTPhone: +1 510 841 1899 Fax: +1 510 841 2340 E-mail: [email protected] SMRT Website: www.ismrm.org/smrt

CONTINUE YOUR EDUCATION...

ON US!

Would you like the opportunity to earn educational credits and haveMRI Devices pick up the tab?

Enter the MRI Devices Case Study Contest andhave a chance to win the Grand Prize trip to the 13th Annual SMRT meeting in Kyoto, Japan onMay 14-16, 2004. Other prizes include 3 secondplace winners to Las Vegas for a 2004 NorthwestImaging Forums conference and 10 third place winners receive a one-year membership to SMRT.

It’s simple to enter! Submit your best MRI Case Study (using any MRI Devices coil) byOctober 31, 2003. For details, visit our website atwww.mridevices.com

number 46 2003 issue 3number 46 2003 issue 3 s i g n a l s 2g editor’s letter julie strandt-peay,...

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