Q&A: Leading researcher shows how 7T MRI is pushing the boundaries

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In June, Philips Medical Systems announced the opening of an ultra high field magnetic resonance imaging (MRI) research center at its Cleveland facility. The state-of-the-art Philips Achieva 7.0T (tesla) research system installed at the center is the only whole body 7.0T MRI system installed in a corporate environment. The primary objective of the research is to further MRI capabilities to better understand and treat degenerative neurological diseases such as Alzheimer's, Parkinson's and multiple sclerosis, Philips said.

The Ohio State University's Imaging Research team of the Department of Radiology collaborated with Philips on the 7.0T installation as part of the State of Ohio's Third Frontier Program, which involves a number of institutions through Ohio's Wright Center of Innovation project. Health Imaging News sat down with Professor Michael V. Knopp, MD, PhD, chairman and professor of the Department of Radiology and Principle Investigator, The Ohio State University (OSU), to get his perspective on the program.

Can you give us a brief history of your involvement with this research project?
This project, together with Philips Medical Systems, is part of an effort by the state of Ohio establishing the Wright Center of Innovation. That has been a highly competitive effort by the state of Ohio to select cutting-edge opportunities for bio-technology. I wrote a proposal to the Center to jointly develop and implement the Philips ultra-high field MR with the long-term vision of establishing this 7.0T (telsa) research system as a clinically feasible imaging methodology. The proposal was awarded an overall $17 million grant. Philips has been a commercial partner in this and has delivered on their commitment to place an MRI team at the facility outside Cleveland. It's been a wonderful collaboration so far.

How are using the system at your facility?
We have placed the [7T] system fully within the clinical facility. The Philips Achieva 3.0T is next to it and also we have put a very unique facility together which enables us to image patients, volunteers but also veterinary patients and this has been an additional collaboration with the Veterinary School which is also very important for us in some of the validation work as well as bringing this capabilities for human and other species.

Do you do comparative studies of the two systems to measure the differences?
What we will do in the future is correlative studies to compare the advantages of the 7.0T compared to the 3.0T and 1.5T. And also again along the theme of how we can translate some of the observations and capabilities we develop with the 7.0T back to the lower field strength systems.

What are the specific advantages of 7.0T MRI compared to other modalities?
There are a couple of important components which allowed this paradigm to develop. First, based on the limited work on advanced MR systems like ours it is now well established that the ultra-high fields with 7.0T are safe. The FDA declared last year that fields up to 8 Tesla are considered a non-significant risk. That is a very important milestone. And that decision was based on human data from various sites including ours. The second component is the rapid evolution of high-field and ultra high-field systems. The imaging physics and the understanding of the advantage of higher fields have evolved on a broad scale. Thirdly, in recent years the knowledge base of genetics and molecular biology is tremendously increased. We have new disciplines such as molecular imaging and nanotechnology technology that have rapidly evolved.

One of the challenges we have recognized is that we are at a cross roads as to how we translate some of the exciting work our communities can do in rodents, for example, to advanced applications in humans. When you analyze this, then the ultra-high field stretch up to 7.0T becomes a pivotal, enabling capability to bring forward new functions and molecular capabilities into non-invasive imaging and spectroscopy. We can do this with MR. The 7.0T, or ultra-high yield MR, has been the missing link in facilitating and implementing the advanced molecular imaging and assessment using nanocompounds, for example, in humans.

From a practical treatment standpoint, where will this lead?
Structural imaging means resolution and has been the basis for imaging for a long time. We are looking for what something looks like and the higher the field strength the better the resolution. So, the structural information can be optimized by going to more powerful systems. But this is just one of the components. The next is that imaging especially with MR is rapidly evolving into looking at functional processes. Not only looking at the methodology but at the paths of physiology and its changes. We are interested in looking at the function of angiogenesis or the function of metabolism.

The third aspect is molecular imaging. In this, we are basically looking at very specific targets or pathways to see what is happening with the expression of a specific molecular target or the blockage of a specific molecular target. The inherent advantage of MR compared to other modalities such as radio tracer-based modalities, for example PET, is that we have an excellent anatomic resolution, the special resolution with MR is much higher, and we have more flexibility on the methodologies used in image generation. The next one is using advanced coils and parallel processing to acquire your data faster and more efficiently to get more precise information.

Will there be benefits to lower field strength MR systems because of the work you are undertaking?
In our facility right next to the 3.0T system we have the 7.0T because I am absolutely convinced of this idea of the 'trickle down' effect. As we are evolving, detecting and validating innovative approaches to determine, characterize and monitor diseases we at the same time will take a look at how we can do certain things at lower field strengths which at that point will make it more broadly available at a lower cost, for example, than the 7.0T.

It seems that the power of the 7.0T system is that it provides images of things that are extremely minute, absolutely tiny, beyond anything most people could have imaged when these MR systems were first conceived of. Is this the main improvement?
Yes, but the system also can see things much better as in the case with multiple-sclerosis (MS). Imaging has been identified as a very good biological marker as to how active the disease is and how activity it is progressing. We anticipate that with the ultra-high field capabilities we will be able to have a much better assessment and learn much more about MS. There are always two components, one is the detection and characterization of disease and the second is to monitor changes of the disease state during therapy. Now, you can use this to evaluate with drugs to determine what drugs should be administered and in what doses and the overall effectiveness so you can discontinue ineffective therapies or increase effective ones. So, to some extent the ultra-high field allows you to do things better. It allows you to do things that you have not been able to do non-invasively before at the human scale; the other exciting aspect is that now bringing in advances on hardware side, the coil side, and software image sequencing and post-processing side we will be able to gather information which we have never been able to see before.

Will this aid in 'personalized medicine'?
Absolutely. The paradigm is the better the information we get and the more detailed is it the better we can characterize the diagnosis as well as the therapy. This is the basis for personalized care. This effort is highly linked to, for example, the efforts we are undertaking for personalized medicine. The linkage between MR and for example PET is that these are not really competing technologies. PET requires a radioactive tracer, whereas MR does not. On follow-up studies where we want to gather a lot of information consecutively over time, you don't want to do this with large doses of radiation.

How long is your partnership with Philips set to last?
The relationship will continue for the product life. This is part of a major collaborative commitment for a longer time, and as I said the joint vision is to come up with a design which is applicable as a clinical system. However, the funding we have from our grant and our operational research center is that we will go into a sustainable operation within three years.

When and if do you anticipate a real-world clinical application of this technology?
Right now I'm not saying that ultra-high field technology is going to be all over the place, but it is advancing our knowledge base. Most importantly, it is allowing us to derive information that is not available otherwise.