Anyone who’s ever had a MRI (magnetic resonance imaging) scan knows the daunting procedure. The patient must lie completely still in a tomb-like MRI chamber for up to 45 minutes while the head or body is scanned for medical diagnostic purposes. But what if the patient is a fidgety young child, or someone writhing in pain from an injury or disease, or an elderly person suffering from dementia? In those instances, holding completely motionless in the MRI machine—even for five minutes—is difficult if not impossible.
The challenges associated with undergoing this demanding procedure range from the medical to economic to humanistic. If a lot of movement occurs during MRI scans, the images become so blurry that they are not interpretable by radiologists, meaning patients must return the next day to undergo sedation or full anesthesia before trying the process again. With the cost of an MRI billed at approximately $1,000 an hour, all of those degraded, unacceptable images result in U.S. hospitals chalking up more than $1 billion annually in lost revenues. And families fret when their loved ones, especially keiki and the elderly, are traumatized by the claustrophobic, frightening process of an MRI, or must undergo full anesthesia and its accompanying risk of complications in order to lie completely still.
Now Dr. Thomas Ernst, a physicist at the John A. Burns School of Medicine (JABSOM) at the University of Hawai‘i at Mānoa, and his research associates in the U.S. and Germany have invented a revolutionary system to allow MRI machines to compensate for a patient’s slight movement—making the procedure less intimidating and more effective in diagnosing medical problems.
Ernst heads up JABSOM’s Neuroscience and Magnetic Resonance Imaging Research Program, whose advanced 3-Tesla MRI scanner was funded by the Office of National Drug Control Policy, a White House Office, and is located at The Queen’s Medical Center near downtown Honolulu. The prototype is eliciting impressive early results and raves, especially from the specialists charged with reading MRI scans, whose resolutions are so high at 1 millimeter or 1/20th of an inch that it takes very little motion for the images to become degraded.
“This is important to radiologists, because they say the patients who need the scans the most are the patients who move the most,” explains Ernst. “These are the young or the elderly, or those who have head trauma, dementia, Parkinson’s disease, brain tumors—so it doesn’t help to tell them not to move, because they just don’t understand the instructions or are in pain.”
Ernst’s team, part of a joint venture with The Queen’s Medical Center, has developed a novel technique in which a small, custom-developed marker is placed on the body. This marker is read by a camera that tracks movement in real time at 100 snapshots per second and then relays that information back into the scanner. “So, as you move, the scanner locks itself on the marker, and the result is that the MRI scan has no blurring,” says Ernst.
Not having to lie absolutely still is welcomed by patients, and means that tykes as young as three to four years of age can lay in the MRI scanner while watching kiddie movies through little binoculars and earphones, and may be entertained in the MRI chamber for as long as 30-45 minutes without sedation or anesthesia. “It’s a good thing, especially for the children,” says Ernst, who believes the new marker technique will be ready for commercialization within a few years. “Plus, if you can make technology less expensive, you make it more accessible—which means more people can benefit from an MRI.”
Team members include researchers from UH Mānoa (including his physician wife at JABSOM, Dr. Linda Chang), the Research Corporation of the University of Hawaii, University of Wisconsin, Medical College of Wisconsin, and Universities of Freiburg and Magdeburg in Germany. Together, they are solving an image problem that can save lives.
Top photo: Dr. Thomas Ernst of JABSOM poses with a young patient at the advanced 3-Tesla MRI scanner at The Queen’s Medical Center. Photo courtesy of The Queen’s Medical Center.