Study shows significant improvement in MRI image quality

A comparison between traditional positioning aids and the Pearltec Multipad in uncooperative patients and patients with involuntary movements.

Dr. Melanie Fukui et al, Neuroradiology, Allegheny General Hospital, Pittsburgh, December, 2013

Context

Repeat MRI examinations due to motion artifacts cost time and money. A study based on 192 examinations by Andre et al [1] found that 59% of sequences measured had visible motion artifacts, resulting in sequence repeats for almost one in five patients. Andre et al. conclude that "more attention and resources should be devoted to providing practical solutions to this dilemma". Therefore, an optimized positioning system for patients is crucial. In this study conducted at Allegheny General Hospital, the application of Pearltec's Multipad was compared with traditional positioning aids during MRI brain scans.

Objective

Evaluate the impact of Pearltec's Multipad compared to traditional positioning aids in terms of image quality during MRI examinations performed on uncooperative patients and patients with involuntary movements.

Materials and methods

To analyze the possibility of eliminating motion artifacts, a user study was carried out at Allegheny General Hospital, Pittsburgh, where brain MRI scans were performed on uncooperative patients and patients with involuntary movements (n=22 subjects). Initially, the examinations were performed using conventional positioning aids. Subsequently, the examinations were repeated using Pearltec's Multipad (Figure 1).

Fig. 1: Pearltec Multipad used in the study.

The examinations were performed on a Siemens Avanto or Symphony MRI system. Finally, Dr. Melanie Fukui, a specialist in neuroradiology and diagnostic radiology, evaluated the examinations using a 5-level scale designed to integrate the impact of motion artifacts on the diagnostic quality of the images. Ghosting artifacts, non-ghosting artifacts, brain contour sharpness and image noise, as well as overall image quality, were evaluated.

Results

The study was carried out on 22 patients. Examinations using traditional positioning aids produced images with moderate to severe artifacts, where one in four measurements was deemed non-diagnostic. In contrast, examinations using Pearltec's Multipad generated images of diagnostic quality. Overall image quality improved from an average of 1.0 (moderate to severe artifacts) to an average of 3.0 (minimal image artifacts). For 8 of the 22 patients, including one 83-year-old male patient, the images obtained were judged to be artifact-free (Figure 2).

Fig. 2: Comparison of image quality on a brain scan of an 83-year-old male patient. The first scan used conventional foam (left side), the second scan used Pearltec's Multipad (right side).

Fig. 3: Results showing almost artifact-free images thanks to Pearltec Multipads.

Overall, ghosting artifacts decreased in severity from 1.0 to 2.9. Non-ghosting artifacts decreased from 1.15 to 3.0; brain contour sharpness increased from 1.05 to 3.2, and image noise decreased from 1.0 to 3.1, where 0 corresponds to severe image artifacts and 4 to minimal artifacts.

Conclusion

Motion artifacts are the most common cause of MRI image degradation, particularly in uncooperative patients and patients with involuntary movements. Examinations using traditional positioning aids produced images containing severe motion artifacts, deemed non-diagnostic. In contrast, examinations using Pearltec's Multipad produced images of diagnostic quality, virtually free of artifacts. Pearltec's Multipad offers an opportunity to overcome motion artifacts, improve image quality and achieve a new standard of diagnostic quality.

1) Towards Quantifying the Prevalence, Severity, and Cost Associated With Patient Motion During Clinical MR Examinations. Andre, Jalal B. et al. Journal of the American College of Radiology, Volume 12, Issue 7, 689 - 695