Scan faster* and have more time for advanced MRI techniques

“We used to have long examination times for certain types of patients, a few lasting more than 40 minutes,” says Dr. Savatovsky. “What is remarkable, is that now all these examinations are below 30 minutes, which opens up opportunity to add more sequences when needed. It’s really hard to keep a patient for more than 40 minutes in the scanner, but because we have now cut scan times by at least 10 minutes, we can add more sequences without making the exam too long. And this is where the new system helps us make a difference. Examples include our examinations for informing brain tumor classification or giant cell arteritis workup, or for intracranial wall imaging – so in patients where we need several advanced sequences or high resolution sequences.”

“We added three additional sequences in our brain neoplasm classification exam: a 3D SWI sequence, APT and ASL on top of 3D morphologic sequences, an isotropic DSC (dynamic susceptibility contrast) and multivoxel spectroscopy. I think that in patients that need a classification for brain mass, for example, we can provide a more detailed and confident diagnosis than before, allowing the clinicians to decide for either a medical workup if no tumor is suspected, or for neurosurgery as soon as possible if a neoplasm is suspected.”

“In multiple sclerosis patients, we increasingly include a multishot susceptibility sequence [3] in our routine cases, thanks to the shorter scan times. Our abbreviated MS protocol for brain is around 8 to 9 minutes, so we can ask for one or two additional sequences to visualize the central veins, or to get an additional contrast to better depict posterior fossa lesions. In cases of white matter lesions of unknown significance on FLAIR images, for example when we see high signal hyperintensities in the brain, we can add on more advanced sequences such as PSIR (phase sensitive inversion recovery) or susceptibility-weighted sequences to help us in distinguishing between MS and nonspecific or vascular abnormalities in these inflammatory cases.”

Dr. Savatovsky appreciates the improvements and flexibility that Elition with Compressed SENSE and MultiBand SENSE provides, particularly for stroke patients. “For stroke, it allows us to cut about 5 minutes off of our stroke protocol, or to keep the same acquisition time and get more insights.”

The ability to perform more sequences can help in making a swift and confident diagnosis. “For example, our stroke cases usually include the regular sequences that every center does (b1000 diffusion, FLAIR, time-of-flight angiography), but we also image supra aortic vessels, and we can replace a gradient echo sequence with a fast 50-second susceptibility-weighted sequence, and all of this doesn’t add much time. because all the regular sequences are accelerated on Elition.”

“The time savings with Compressed SENSE and MultiBand SENSE make it easier to add sequences to give us additional insights. Depending on the context and the first results, we might add a DSC perfusion to assess the ischemic penumbra, an ASL perfusion to help find an alternative cause in case of normal diffusion, or add a high-resolution T1 sequence for a stroke patient, to quickly assess wall imaging in emergency cases. The additional sequences can help improve patient management, because we can already consider some alternative diagnoses if the morphological MRI is normal.”