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Congress: ECR25
Poster Number: C-18242
Type: Poster: EPOS Radiographer (educational)
Authorblock: W. McGuire1, M. Fennessy1, K. Thakor1, D. Nickel2, E. Weiland2, A. R. R. Padhani1; 1Northwood/UK, 2Forchheim/DE
Disclosures:
Will McGuire: Nothing to disclose
Marie Fennessy: Nothing to disclose
Kirti Thakor: Nothing to disclose
Dominik Nickel: Employee: Siemens Healthineers
Elisabeth Weiland: Employee: Siemens Healthineers
Anwar R. R Padhani: Advisory Board: Siemens Healthineers Speaker: Siemens Healthineers Research/Grant Support: Siemens Healthineers
Keywords: Bones, Oncology, Radiographers, MR, Diagnostic procedure, Imaging sequences, Radiation therapy / Oncology, Cancer, Metastases
Learning objectives Accurate detection of bone lesions—including their presence, extent, and activity, is critical for cancer treatment planning and monitoring treatment response. While Magnetic Resonance Imaging (MRI) is valuable for many tissues, imaging cortical bone is challenging due to its low signal. Consequently, Computed Tomography (CT) remains the standard for visualising bone structure and integrity, particularly for surgical planning. This project aimed to develop a novel MRI-based technique to generate pseudo-CT images of cortical bone. Our approach utilises low flip angle gradient echo sequences...
Read more Background Bone-window CT (BW-CT) enhances contrast by displaying fluids and soft tissues in a narrow range of mid-grey pixel intensities. This results in dense structures like cortical and trabecular bone appearing bright against a low-contrast soft tissue background. This contrast allows for a detailed assessment of the bone mineral matrix, minimising interference from surrounding soft tissues. We employed low flip angle (3°) PD-weighted radial StarVIBE and Cartesian VIBE sequences to replicate BW-CT contrast. These low flip angles produce images where fluids and...
Read more Findings and procedure details StarVIBEStarVIBE provided a comparable image contrast to BW-CT (Figure 1). Its radial k-space sampling proved robust to patient and internal organ motion. However, stellate artefacts from the air in the bowel were frequently observed (Figure 2). While these artefacts were visually distracting, they did not significantly impede bone visualisation. The main drawback of StarVIBE was its long acquisition time (TA: 06:00 per slab). Additionally, its image resolution was inferior to that of BW-CT. The lengthy acquisition time, driven by the number...
Read more Conclusion We have demonstrated two practical MRI methods for generating BW-CT-like images that provide diagnostic-quality visualisation of the mineralised bone matrix. In some patients, DL VIBE sequences enhanced the conspicuity of lytic bone deposits compared to BW-CT. Fusing diffusion weighted images with a b-value of 900 s/mm2 (b900) and DL VIBE sequences further improved lesion conspicuity. Free-breathing DL VIBE produces sharp BW-CT-like images with good SNR and comparable resolution. While further optimisation of acquisition time is needed, it appears best suited for...
Read more References 1: Lecouvet, F. E., Zan, D., Lepot, D., Chabot, C., Vekemans, M-C., Duchêne, G., Chiabai, O., Triqueneaux, P., Kirchgesner, T., Taihi, L., Poujol, J., Gheysens, O. & Michoux, N. (2024). MRI-based Zero Echo Time and Black Bone Pseudo-CT Compared with Whole-Body CT to Detect Osteolytic Lesions in Multiple Myeloma. Radiology, 313(1). DOI: 10.1148/radiol.231817
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