7T MRI beneficial for athlete injury requiring higher resolution image: Study
Delhi: 7-tesla MRI may be effective for sports imaging of injured athletes, according to a talk given by Reto Sutter of Balgrist University Hospital in Zürich, Switzerland at the International Society for Magnetic Resonance in Medicine (ISMRM) 2021 virtual annual meeting held on May 15.
"While lower field-strength MRI is adequate for most injured athletes 7-tesla MRI might offer some benefit from the higher spatial resolution," he told attendees. "Some technical challenges that come with using MRI at ultra-high field strength can be successfully addressed."
"7T MRI isn't easy 'out-of-the-box imaging, but if you use the right protocol, it can be very effective for sports imaging," he said.
Sutter offered an overview of using 7-tesla MRI for musculoskeletal applications, as well as tips for optimizing images and an outline of clinical implementation directions the technology could take in the future.
Standard MRI is currently used for meniscus injuries, but it can't necessarily distinguish individual components of the cartilage; 7-tesla MRI offers more detail.
Possible uses for 7-tesla MRI in lower-extremity musculoskeletal imaging include the following, according to Sutter:
· Commonly missed meniscal tears, such as posterior horn, lateral, and displaced. "If we can develop 7-tesla technology to help us diagnose meniscal tears with higher accuracy, there's additional benefit for both referring physicians and patients," he said.
· Menscopopliteal fascicles. "To diagnose this, we need very good resolution," he said. "It's another possible use case for 7T."
· Cartilage delamination in the hip. Current best practice for visualizing this condition is direct MRI arthrography with traction, Sutter said. Using 7 tesla instead would benefit patients.
· Osteochondral defects in the ankle. "Standard MRI can nicely see bone marrow edema [in these cases] but there's limited spatial resolution," Sutter noted. "CT arthrogram shows surface of the cartilage overlaying defect, but soft tissue/edema isn't visible. 7T MRI has a possible benefit here with increased spatial resolution and also [visualization of] soft tissues."
Use of 7T in clinic
Finally, Sutter throws light on a number of possible clinical implementation directions for 7-tesla MRI. He described how it improved treatment planning in a 52-year-old woman involved in a skiing accident: 1.5-tesla MRI showed an anterior cruciate ligament (ACL) tear and a nondisplaced fracture of the tibial head, and she was referred for conservative treatment. However, 7-tesla MRI revealed a more complex tear and a meniscal ramp lesion, which directed her to surgery. In another case, 7-tesla MRI identified delamination of femoral cartilage in a 41-year-old male snowboarder that 1.5-tesla MRI missed.
"[Studies have shown] that 7T MRI has higher diagnostic accuracy when it comes to visualizing low-grade meniscus and cartilage damage, and that [the technology] can be superior to 3T MRI for detecting small calcifications in articular cartilage and menisci," he said.
Not all athletes need 7-tesla MRI, but for those who could benefit from higher resolution images, it shows promise, according to Sutter. Yet implementation of the technology will take time.
