ISMRM presentations reflect MR’s varied role in practice and research

Visitors to the 2008 International Society for Magnetic Resonance in Medicine meeting in Toronto need only wait a minute for the door to swing from clinical issues to advanced research on functional and metabolic imaging.

Opportunities to learn something new fill the week staring May 3 with educational courses covering numerous aspects of scanner design, pulse sequence development, and clinical use, then continue with categorical courses, hands-on learning, technical exhibits, and scientific presentations and posters.

Plenary sessions will alternate from practice to theoretical issues, according to Kim Butts-Pauly, Ph.D, scientific program chair.

Dr. Richard Ehman, a professor of radiology at Mayo Clinic in Rochester, MN, will cover the emerging clinical use of MRI elastography, a concept he first introduced at an ISMRM conference more than 10 years ago.

Ehman will explain in his plenary lecture Tuesday how MR elastography quantifies the elastic characteristics of vibrating tissues. He will argue that MR elastrography is ready for prime-time use in diagnosing breast and liver cancers and various forms of fibrosis. In an interview, he mentioned that MR elastrography already accounts for 30% of the abdominal MR studies performed at Mayo.

MRI's growing popularity for monitoring response to thermal ablation may soon carry over to also monitoring the effects of high-intensity focused ultrasound. HIFU already plays a role in uterine fibroid treatment, but it shows potential for noninvasively eradicating tumors in the breast, liver, and other organs as well, Butts-Pauly said.

Continuing inquiries concerning the role of gadolinium-based contrast media in nephrogenic systemic fibrosis will be featured for the second straight year. A symposium on the status of the disease on Monday will be followed by a scientific session with specific abstracts on the subject on Tuesday.

Musculoskeletal MR presentations will emphasize the quantitative markers on chronic degenerative disease, said Dr. Timothy J. Mosher, an associate professor of radiology and orthopedics at Penn State University College of Medicine.

Functional imaging of articular cartilage will be a hot topic, with two cartilage sessions on Monday and Tuesday. Monday morning's session addresses translational research applications of dGEMRIC and T2 mapping as they relate to clinical trials. Tuesday's cartilage session addresses emerging cartilage imaging techniques, including T1rho imaging, UTE imaging, and faster acquisition methods for quantitative T1 and T2 mapping.

Potential MRI markers of bone physiology, osteoporosis, and degeneration of the intervertebral disc is the focus of Wednesday afternoon's scientific session. A technical session on Thursday highlights new techniques and hardware for musculoskeletal imaging, including ultrahigh-field MR (7T and above).

The 2008 ISMRM meeting may be remembered for the growing prominence of steady-state free precession sequence for functional imaging studies, Butts-Pauly said. Perfusion- and diffusion-weighted imaging have up to this point been based on echo-planar pulse sequences that are not well suited for applications that give rise to susceptibility artifacts.

SSFP overcomes that limitation, as will be seen in an excellent paper on fMRI of the olfactory bulb, she said.

Numerous talks will focus on molecular and metabolic imaging, which are helping personalize radiological practice, said Dr. John Port, a neuroradiologist at Mayo Clinic in Rochester.

Lectures will track the contributions of diffusion tensor imaging thus far to understanding of brain architecture and function. A series of plenary lectures on Friday will introduce radiologists to hyperpolarized carbon-13 imaging and its surprisingly rapid transition from research to clinical use. The 100,000-fold increase in polarization possible with hyperpolarized C-13 MRI has stunning implicatios, such as the real-time observation of sugar metabolism in the brain, he said.

Body imagers can learn about the latest developments in diffusion and multiparametric imaging of the prostate gland and dynamic contrast-enhanced MR and MR spectroscopy in the abdomen. MRI-guided interventions are advancing for radiofrequency ablation, cryoablation, and focused ultrasound treatment of lesions in the prostate, liver, and kidney.

Basic research findings and human clinical trials appear together in many scientific sessions to make them relevant to both academic and community-based MR users.

The scientific committee took care to assure that every region of the world represented in the audience was also represented among the scientific presentations, according to Dr. Clare Tempany, director of clinical MRI at Brigham and Women's Hospital in Boston.

"We want to hear from everybody," she said.