The year in MR news saw new heavy-duty scanners with cutting edge capabilities, as well as smaller and more portable systems bringing MR into areas it has never been before. Here, in chronological order, are the ten most-read MR stories of the year from our Daily News online.

Hong Kong scientists develop compact ultralow-field MR brain scanner

Scientists at the University of Hong Kong announced in January they had built a prototype compact ultralow-field MR scanner designed to assess brain injuries and disorders.

The prototype is equipped with a compact two-pole 0.055T permanent samarium-cobalt (SmCo) magnet and can be plugged into a standard AC power outlet. Its dimensions are 95.2 x 70.6 x 49.7 cm, and the bore is 29 x 70 cm. Its footprint is approximately two square meters, and it is meant to be a permanent magnet-based, low-cost, low-noise, low-power and shielding-free ULF brain MR scanner, according to Physics World.

The motivation behind the design was the fact that approximately 70% of the world’s population has little or no access to high-field superconducting MRs, which are expensive not just in cost but in installation and maintenance. The team estimates that their machine can be built in quantity with material costs under $20,000.

Additionally, roughly 30% of clinical MR cases involve the brain. This also pushed the researchers to build a ULF brain MR, because there is a great need for such imaging in the diagnosis and prognosis of various neurological diseases and injuries. "The goal is to develop methodologies for such ULF scanners to perform many routine yet clinically useful neuroimaging protocols, so as to fulfill the unmet clinical needs in point-of-care situations and/or developing countries," senior author Ed X. Wu, Lam Woo Professor in the laboratory of biomedical imaging and signal processing at Hong Kong University, told HCB News.

The findings were published in Nature Communications.


MR starting in early 30s could cut breast cancer mortality by 50%

Getting an MR scan between the ages of 30 and 35 could spare women with a genetic predisposition for breast cancer from a more than 50% chance of death from the disease.

A team of researchers spread across the U.S. found in February that pathogenic variants in three genes — ATM, CHEK2 and PALB2 genes — are as prevalent as the more commonly known BRCA1 and BRCA2 gene mutations, and like them. Depending on the variant, women face a lifetime risk of developing breast cancer at 21% to 40%.

But screening these women has been challenging due to a lack of clinical trials to inform guidelines on when diagnostic exams should begin and how to screen. "The study supports the importance of testing appropriate women at a relatively young age so that they can benefit from MR screening. In general, we suggest testing women who meet NCCN criteria at around age 25-30," Dr. Mark Robson, senior author of the paper and chief of the breast medicine service at Memorial Sloan Kettering Cancer Center, told HCB News.

Robson and his colleagues evaluated risks and MR efficiency using established breast cancer simulation models. They input age-specific risk estimates provided by the Cancer Risk Estimates Related to Susceptibility (CARRIERS) consortium from more than 32,000 patients and a similar number who had no cancer. They also included recent published data for screening performance.

The findings were published in JAMA Oncology.


Portable MR almost on par with stationary systems for stroke detection

Findings published in April show that portable MR systems are nearly as efficient for diagnosing stroke as stationary MR systems.

They are also effective at differentiating ischemic strokes from ones caused by blood clots, according to Yale and Harvard researchers who used portable MR to successfully identify such cases in 90% of patients scanned.

Determining the type of stroke a patient has is crucial for choosing the right treatment, as blood thinners are essential for those with ischemic strokes but dangerous for patients with ones where the bleeding is in the brain. Portable MR can bring care right to the patient’s bedside, in ambulances or in remote clinics. It also decreases waiting for scans with stationary MR, which are in high demand and often in use.

As a result, the scientists say that it may ensure faster decision-making and delivery for treatment in remote areas where patients lack access to major hospitals with standard MR systems. “This is the first systematic evidence you can detect ischemic strokes using portable, bedside devices,” said Kevin Sheth, a professor of neurology and neurosurgery at Yale School of Medicine and co-corresponding author of the study.

Sheth and his peers used portable MR scanners on 50 patients at Yale New Haven Hospital and found they largely confirmed cases of ischemic stroke that were diagnosed by stationary MRs. For 45 of these patients, it detected blood clots as small as four millimeters in size.

The team used Swoop, a portable MR scanner developed by Yale New Haven and Hyperfine. The solution is equipped with a 0.064 magnet and is 20 times cheaper, 10 times lighter and consumes 35 times less power than fixed conventional MR solutions, according to Hyperfine.



Bruker debuts 7 Tesla and 9.4 Tesla MR and PET/MR magnets

Bruker unveiled its 7 Tesla and 9.4 Tesla conduction-cooled Maxwell magnets in May for high-field sensitivity and resolution in advanced preclinical MR and PET/MR research scanners.

Designed for its BioSpec Maxwell preclinical MR system, the magnets are follow-ups to the BioSpec Maxwell 3 Tesla model and do not require liquid helium or nitrogen refills. Bruker expects them to be valuable for producing sharp images from noninvasive in vivo imaging on small rodents in preclinical research. It says the scans will have high spatial and temporal resolution and help in assessing miniscule areas in high-resolution anatomical imaging of the mouse brains or when performing function MR.

Making their debut at the International Society for Magnetic Resonance in Medicine (ISMRM) 2022 conference, the two MR components utilize high-performance technology in easy-to-use systems to provide researchers with a range of preclinical applications. Siting, installation and maintenance is also simplified, as there is typically no building modification needed.

“The pharmaceutical industry is experiencing pressure to bring new drugs to market faster and more cost-effectively. Contract research organizations are striving for best-in-class solutions in a small footprint. Our new Biospec Maxwell MRI series does not require specialized lab infrastructure and offers compact, lightweight and easy-to-install systems for preclinical MR or PET/MR studies,” said Dr. Wulf Jung, president of Bruker BioSpin’s preclinical imaging division, in a statement.

The BioSpec Maxwell preclinical MR system is a liquid cryogen filling-free MR system that is upgradable with an MR CryoProbe, which increases sensitivity, and with a state-of-the-art PET module.

Bruker’s preclinical imaging systems are for research use only.


7T MR yields new benefits for understanding, treating Parkinson's

7T MR may help determine which patients with previously untreatable symptoms of Parkinson’s and similar conditions would benefit from new treatments, according to findings published in May.

Researchers at the University of Cambridge’s Wolfson Brain Imaging Centre used the scanner to identify Parkinson's and progressive supranuclear palsy (PSP) patients who endured damage to their locus coeruleus, a tiny part of the brain that produces noradrenaline, which helps with brain functioning such as attention, arousal, thinking and motivation.

In a study last year, they found certain PSP patients had lost as much as 90% of their locus coeruleus and surmised that noradrenaline boosters could help alleviate symptoms in these specific patients.

Many companies produce these drugs, which have been approved for similar uses. Unfortunately, 3T and lower magnetic field MR systems are unable to show the locus coeruleus of living patients on scans, making it impossible to identify patients with damage there.

Co-lead author professor James Rowe, from the university's department of clinical neurosciences, told HCB News that 7T may solve the problem because of its higher resolution. "The locus coeruleus is also the first part of the brain to be damaged by Alzheimer's disease, as well as being among the most sensitive regions to Parkinson's and PSP. So the ability to detect individual impact of the disease as a guide to treatment is of importance to many people. The locus coeruleus is also an important factor in ageing — and how to stay cognitively well as one gets older."


Siemens smallest, lowest-cost MR scanner gets FDA OK

The FDA gave clearance to the MAGNETOM Free.Star whole-body MR scanner from Siemens Healthineers in July.

The second system designed for the High-V MR platform, MAGNETOM Free.Star is the smallest, most lightweight scanner made by Siemens, as well as its most affordable MR scanner. It has a 0.55 Tesla field strength that, combined with deep learning technologies and advanced image processing, produces high-quality images.

The machine weighs 3.3 tons and is less than 80 inches high. It also requires less than one liter of liquid helium and has no quench pipe, reducing infrastructure and life cycle costs. “The MAGNETOM Free.Star is further proof of our steadfast commitment to providing customers with MR scanners that are more cost-effective, more easily operable, and more easily sited for installation at a wide variety of healthcare institutions across the United States.”

The reduced energy consumption in MAGNETOM Free.Star brings down total life cycle costs by more than 30% over conventional scanners, and its Deep Resolve algorithms perform targeted denoising and produce high-resolution images at a level only previously possible at higher field strengths.

The FDA clearance follows that of MAGNETOM Free.Max, a compact whole-body scanner weighing less than 3.5 tons, in July 2021. Like MAGNETOM Free.Star, it has a 0.55 Tesla field strength, uses less than one liter of helium and has no quench pipe.

Both also use Deep Resolve algorithms, as well as the myExam Companion workflow solution, which leverages AI to guide users of all experience levels through exams, regardless of patient or throughput. Because of their smaller infrastructures, both scanners can be installed in areas not previously accessible for MR, with minimal structural modifications required.



Masks and MR safety: researchers examine the risks

Wearing the wrong face mask in or around an MR scanner can pose serious risks, including mask displacement and face burns, as well as artifacts that make images unusable and result in repeat scans. Despite this, there is no official guidance on what masks are safe to use.

In a July study, researchers at Cardiff University found these outcomes were possible when wearing certain types of masks due to the ferromagnetic materials within them. Testing eight different types, they found that five contained magnetic components that they say are MR unsafe.

To prevent these adverse events, they recommend a color-coded system. “We suggest that where possible, surgical masks should be ordered in a separate color to distinguish between an ‘MR safe’ and an ‘MR unsafe’ surgical mask,” said lead study author Dr. Bethany Keenan, from Cardiff University’s school of engineering, in a statement.

The scientists performed three MR scans on a 3D printed model of a head and neck fitted with eight commercially available FFP3 masks. Safety was based on the presence of ferromagnetic and metallic materials, as well as a measurable deflection at the MR bore, and a temperature greater than 40°C during testing.

Two of the masks were deemed MR safe. One was labeled MR conditional because there was a potential risk of local heating under certain conditions within the MR machine. “It is extremely important to not assume that a mask is safe prior to an MR examination, and to conduct a safety evaluation to determine which components are made of ferromagnetic metals and which are non-ferromagnetic metal,” said Keenan.



Hospital not liable for neglect of patient burned during MR scan

In October, the California Court of Appeals reaffirmed a lower court ruling that a hospital was not guilty of neglect after a patient was burned during an MR procedure there.

The man, who died from unrelated circumstances, underwent an electrocardiogram and MR imaging in 2016 at Glendale Adventist Medical Center after waking up “weaker than usual,” according to the news outlet, Human Resources Director.

The man was wearing ECG pads during the scan and came out with a burn on his abdomen. The MR technologist was not trained on the dangers of ECG pads in MR machines but did check him for metal and his medical history before the exam.

The patient filed a civil complaint in 2018, alleging that the hospital failed to screen him properly. Following his death, his estate took over the suit. The case is named Kruthanooch v. Glendale Adventist Medical Center.

During the trial, a diagnostic radiology specialist representing the estate said the hospital did not abide by industry or radiology care standards during screening, and that employees lacked proper training.

A reconstructive plastic surgery specialist who spoke on behalf of the hospital said performing an MR scan with ECG pads was within the standard of care and consistent with exams in outpatient surgery centers and hospitals. They said the pads did not cause the burns; that the actual cause was unknowable; and that the plaintiff had a history of ill health, including coronary artery disease and diabetes.


Mounting helium shortages raise concerns over future MR access

Low helium levels across the globe have left healthcare stakeholders worried about the implications for MR scans, and the patients who need them.

With a boiling point of -452 degrees Fahrenheit, liquid helium is the coldest element on earth and used to keep MR magnets cool and the magnetic current superconductive. For this, MR systems require some 2,000 liters of the element.

But because helium is a nonrenewable element, the current shortage has caused suppliers to curb how they allocate its use and how much to supply each customer based on their respective needs, according to NBC News.

“Helium is on allocation for sure,” said Donna Craft, a regional construction manager for Premier Inc. who contracts with helium suppliers for some 4,000 hospitals, told NBC News in October. “We’re probably not blowing up balloons in the gift shop anymore.”

Additionally, the war in Ukraine has made the situation more challenging, as the U.S. was relying on Russia up until this year to alleviate the burden of having such a tight supply.

The Eurasian country recently constructed a new facility out east that was supposed to provide nearly one-third of the world’s helium. A fire last January halted production there, and while it could still reopen any day, the war has stopped trade for the most part between it and the U.S.

As a result, four of five major U.S. helium suppliers are prioritizing healthcare providers because of the important need for MR imaging and reducing amounts distributed to other, less essential customers.

Despite this, providers are still facing challenges with the shortage, especially from the alarming rise in the cost for helium, which has risen as much as 30%.

While they have not canceled appointments or shut down MR machines, Ioannis Panagiotelis, chief marketing officer for MR at GE Healthcare, says that "every industry and hospital with an MR system has been affected.”

The predicament has raised questions about future reliance on MR imaging, with radiology experts saying that its 3D images are irreplaceable.

“It’s central to many things we do in modern medicine,” Dr. Scott Reeder, chief of MR at the University of Wisconsin School of Medicine and Public Health, told NBC News.


11.74T MR scanner could be operational by end of 2022

Researchers at Gachon University Gil Medical Center (GUGMC) in South Korea and MR components developer ASG Superconductors in Italy announced in November they were optimistic about unveiling the world’s first simultaneous multi-channel/multi-nuclear 11.74T MR scanner before the year is out.

The solution will be used primarily for brain imaging research and is expected to be powerful enough to acquire images that are almost 10 times more detailed than those of 1.5T MR scanners.

"The ultra-high resolution brain images obtained from the 11.74T MR system are expected to provide significant clues for the early diagnosis and treatment of neuro-degenerative brain diseases such as Parkinson's disease, Alzheimer's and stroke,” said professor Woo-Kyung KIM, president of Gachon University Gil Medical Center (president of the Neuroscience Research Institute), in a statement.

Among its achievements was satisfying the three main criteria of the Site Acceptance Test in the first half of 2022. This includes having an internal temperature of <2.2 Kelvin, a magnetic field intensity of 2.2K, and magnetic field uniformity.

Technical managers of ASG and experts from Korea carried out the test. The evaluation committee confirmed the magnetic field reached the target field density and maintained stability and uniformity.

The magnet was manufactured in December 2018. The researchers plan to combine the 11.74T magnet with gradient magnetic coils, RF coils, electronic components and power supplies when they start using it.

The scanner is fully serviced by ASG technicians on site and is supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Korea.

Several MR systems more powerful than standard 1.5T and 3T scanners and even the top-end 7T scanners are in the works. In 2017, the Weizmann Institute of Science in Israel installed Bruker’s Biospec 15.2T USR preclinical ultrahigh-field MR system to give clinicians a better understanding of biomolecular processes of certain diseases, as well as advanced biomaterials that could potentially impact a variety of emerging diagnostic and therapeutic approaches.

"[This] instrument will enable new forms of multiplexed imaging not previously available to the institute, with the aim to develop, optimize and implement genetically engineered reporter systems for MR with artificial 'multicolor' characteristics," Dr. Amnon Bar-Shir of the department of organic chemistry at the institute, told HCB News at the time.