Scott Reeder^1
1University of Wisconsin, Madison, WI, United States

Development, validation, and translation of advanced new imaging methods is an exciting and important area of scientific development and clinical medicine. The development of standardized approaches and objective measures of new imaging technologies such as SNR and CNR, and subjective ordinal metrics are extremely helpful particularly in the early stages of technical development and translation. Subsequent studies comparing new imaging techniques with accepted reference standards, is the next step to establish the diagnostic performance of a technique for the detection and staging of disease.  Ultimately, clinical effectiveness and patient outcomes are the most important metric of the impact of new technologies.  Finally, there are many practical barriers that should be considered, including work flow, post-processing, that are needed to garner acceptance by technologists, radiologists, and referring physicians.

Richard L Ehman^1
1Radiology, Mayo Clinic, Rochester, MN, United States

The ISMRM has launched the “MR Value Initiative”, to encourage innovative optimization the value of MR-based diagnostic technologies.  Both the numerator (clinical benefit) and the denominator (cost) of the value ratio can be targeted by scientific and technical innovation.  Studies have shown that investigators in medical imaging generate innovations at a high rate, and that these inventions can often be readily translated, with extraordinary impact on patient care.  This presentation focuses on identifying time-tested strategies that aspiring innovators can use to improve the chances that their work will have an impact and perhaps make the world a better place.

Hongyu An¹, Andria L Ford², Cihat Eldeniz¹, Yasheng Chen², Katie D Vo³, Hongtu Zhu⁴, William J Powers⁵, Weili Lin⁶, and Jin-Moo Lee^2
1Washington University in St. Louis, St. Louis, MO, United States, ²Neurology, Washington University in St. Louis, St. Louis, MO, United States, ³Radiology, Washington University in St. Louis, St. Louis, MO, United States, ⁴Biostatistics, University of North Carolina At Chapel Hill, Chapel Hill, NC, United States, ⁵Neurology, University of North Carolina At Chapel Hill, Chapel Hill, NC, United States, ⁶Radiology, University of North Carolina At Chapel Hill, Chapel Hill, NC, United States

The fate of mild to moderate ischemic tissue is greatly impacted by both hyperacute (3-6 hr)  and acute (6-24hr) perfusion changes. Thus, such regions could be targeted for intervention beyond current treatment windows. 

Shivani Pahwa¹, Nicholas Schiltz², Lee Ponsky³, Ziang Lu¹, Sara Dastmalchian¹, Robert Abouassaly³, Mark Griswold⁴, and Vikas Gulani^5
1Radiology, Case Western Reserve University, Cleveland, OH, United States, ²Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH, United States, ³Urology, Case Western Reserve University, Cleveland, OH, United States, ⁴Radiology and Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States, ⁵Radiology, University Hospitals Case Medical Center, Cleveland, OH, United States

The perception that MRI inflates health care costs impedes its incorporation into prostate cancer treatment algorithms, despite robust evidence of its accuracy. We evaluated the cost effectiveness of 13 different strategies using a decision tree model in which MRI is performed before non-targeted, transrectal ultrasound guided prostate (TRUS) biopsy. Our results show that MRI is cost effective in each of these strategies, and also adds incremental quality adjusted life years (QALY) to the patient over and above the standard practice of performing non-targeted TRUS biopsy. 

James Grant Pipe¹, Ashley Gould Anderson¹, Akshay Bakhru², Zhiqiang Li¹, Suthambhara Nagaraj², Melvyn B Ooi³, Ryan K Robison¹, Dinghui Wang¹, and Nicholas R Zwart^1
1Imaging Research, Barrow Neurological Institute, Phoenix, AZ, United States, ²MRI, Philips Healthcare, Bangalore, India, ³MRI, Philips Healthcare, Phoenix, AZ, United States

This work gives an overview of an effort to build the infrastructure for rapid, robust clinical Spiral MRI of the brain.  The current goal is to achieve comparable or better Image quality than conventional scans with reduced overall scan time.  A long-term (future) goal is to achieve a comprehensive high-quality brain MR exam in 5 minutes.

Pim Pullens¹, Andrew IR Maas², David Menon³, Wim van Hecke⁴, Jan Verheyden⁴, Lene Claes⁴, Paul M Parizel¹, and On behalf of CENTER-TBI participants and investigators^5
1Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium, ²Neurosurgery, Antwerp University Hospital & University of Antwerp, Antwerp, Belgium, ³Anaesthesia, University of Cambridge, Cambridge, United Kingdom, ⁴icometrix NV, Leuven, Belgium, ⁵University Hospital Antwerp, Antwerp, Belgium

Traumatic Brain Injury (TBI) is regarded as “the most complex disease in our most complex organ”. Clinical outcome is unpredictable, especially in repetitive mild TBI, in terms of behavior, cognition, emotion and associated long-term effects such as dementia. The Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study is a pan-European prospective longitudinal observational study aiming to improve care for TBI patients. One of the key goals is to improve the quality of imaging-derived data by the application of a clinical standardized MR imaging protocol including structural, SWI, DTI and rs-fMRI, across up to 25 clinical sites in a large, heterogeneous sample of TBI patients. Harmonization of these protocols has been a challenging task. As data collection is underway, 265 datasets have been inspected for quality. Data quality is variable across sites and scanners. In order for such large-scale observational studies to be really effective, sequence harmonization and standardization is of key importance, but lacking at the moment.

Marzena Wylezinska-Arridge¹, Mark J White^1,2, Indran Davagnanam¹, M Jorge Cardoso³, Sjoerd B Vos^3,4, Sebastien Ourselin³, Olga Ciccarelli⁵, Tarek Yousry¹, and John Thornton^1,2
1Neuroradiological Academic Unit, UCL Institute of Neurology, University College London, London, United Kingdom, ²Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom, ³Translation Imaging Group, Centre for Medical Imaging Computing, University College London, London, United Kingdom, ⁴MRI Unit, Epilepsy Society, Chalfont, St Peters, United Kingdom,⁵Institute of Neurology, University College London, London, United Kingdom

The huge number of hospital MRI examinations routinely obtained for clinical purposes offers a potentially valuable “big data” resource for largescale experimental neurology. However, acquisition-scheme variation may compromise the research value of clinical imaging data. A first step towards reducing variation by prospective protocol harmonization is to systematically capture sequence-use statistics. Using an in-house tool developed to automate capture of long-term, MRI sequence deployment statistics in routine practice within our neuroradiological service, we identified “core“, most used sequences and the deployment frequency of their respective variants, to enable efficient, targeted protocol harmonization.