A New Era in Magnetic Resonance Contrast Media.

Next-generation gadolinium-based contrast agents (GBCAs), including both high relaxivity agents and targeted agents, and manganese-based agents with a high probably of commercial success are discussed in some depth. It is highly likely that gadopiclenol and gadoquatrane, both next-generation high relaxivity gadolinium-based compounds, will come in time to replace the current macrocyclic gadolinium chelates, despite the wide acceptance, very high safety profile, and high stability of the latter group. Current research has also made possible the development of 2 new targeted gadolinium chelates, which look very promising, with the potential to improve cancer detection (for both MT218 and ProCA32.

The Future Arrived: Photon-Counting Detector CT.

In the past decades, we have witnessed tremendous technical innovations in computed tomography (CT) imaging. These included improvements in temporal and spatial resolution, lowering of the radiation dose, the introduction of dual-energy and multi-energy imaging, automated image preprocessing and machine learning algorithms, and, most recently, the development and clinical introduction of photon-counting detector CT. This special issue of Investigative Radiology comprises a collection of expert summaries and reviews on this most impactful recent innovation and cutting-edge technology of photon-counting detector CT.

Scientific Advances and Technical Innovations in Musculoskeletal Radiology.

Decades of technical innovations have propelled musculoskeletal radiology through an astonishing evolution. New artificial intelligence and deep learning methods capitalize on many past innovations in magnetic resonance imaging (MRI) to reach unprecedented speed, image quality, and new contrasts. Similarly exciting developments in computed tomography (CT) include clinically applicable molecular specificity and substantially improved spatial resolution of musculoskeletal structures and diseases.

The Clinical Utility of Magnetic Resonance Imaging According to Field Strength, Specifically Addressing the Breadth of Current State-of-the-Art Systems, Which Include 0.55 T, 1.5 T, 3 T, and 7 T.

This review provides a balanced perspective regarding the clinical utility of magnetic resonance systems across the range of field strengths for which current state-of-the-art units exist (0.55 T, 1.5 T, 3 T, and 7 T).

Advocating the Development of Next-Generation, Advanced-Design Low-Field Magnetic Resonance Systems.

New next-generation low-field magnetic resonance imaging systems (operating in the range of 0.5 T) hold great potential for increasing access to clinical diagnosis and needed health care both in developed countries and worldwide. The relevant history concerning the choice of field strength, which resulted in 1.

Gadolinium-Based MRI Contrast Agents Induce Mitochondrial Toxicity and Cell Death in Human Neurons, and Toxicity Increases With Reduced Kinetic Stability of the Agent.

Objectives: This preclinical study was devised to investigate potential cellular toxicity in human neurons induced by gadolinium-based contrast agents (GBCAs) used for contrast-enhanced magnetic resonance imaging (MRI). Neurons modeling a subset of those in the basal ganglia were tested, because the basal ganglia region is 1 of 2 brain regions that displays the greatest T1-dependent signal hyperintensity changes.

Methods: Eight GBCAs were tested.

Motion in Magnetic Resonance: New Paradigms for Improved Clinical Diagnosis.

Recent innovations in magnetic resonance, involving both hardware and software, that effectively deal with motion-whether inadvertent on the part of the patient or due to respiration and cardiac contraction-are reviewed, emphasizing major current advances. New technology involving motion sensing (kinetic, respiratory, and beat) is enabling simpler, faster, and more robust monitoring of the sources of motion. This information is being integrated, with new innovative imaging approaches, to effectively manage motion and its impact on image quality.

In vitro T2 relaxivities of the Gd-based contrast agents (GBCAs) in human blood at 1.5 and 3 T.

Background: The availability of data in the medical literature for the T relaxivities of the Gd-based contrast agents (GBCAs) is limited. A comprehensive comparison between the agents available commercially (other than in Europe) is lacking, with no data available that most closely reflect the clinic, which is in human whole blood at body temperature.

Purpose: To complement the existing literature by determining T relaxivity data for eight GBCAs in vitro.

Dechelation (Transmetalation): Consequences and Safety Concerns With the Linear Gadolinium-Based Contrast Agents, In View of Recent Health Care Rulings by the EMA (Europe), FDA (United States), and PMDA (Japan).

The issue of dechelation (transmetallation) in vivo after administration of the linear gadolinium-based contrast agents, and potential safety concerns, is considered on the basis of an extensive, focused literature review. Early indications of potential problems included the high level of excess ligand used in the formulation of 2 agents (indeed the 2 least stable thermodynamically) and interference with laboratory tests when blood was drawn from patients relatively soon after administration of these same agents. The advent of nephrogenic systemic fibrosis in the late 2000s raised additional major concerns.

Advocating the Development of Next-Generation High-Relaxivity Gadolinium Chelates for Clinical Magnetic Resonance.

The question of improved relaxivity, and potential efficacy therein, for a next-generation of magnetic resonance gadolinium chelates with extracellular distribution and renal excretion, which could also be viewed from the perspective of dose, is addressed on the basis of historical development, animal experimentation, and human trials. There was no systematic evaluation that preceded the choice of 0.1 mmol/kg as the standard dose for human imaging with the gadolinium chelates.

Dynamic non-invasive ASL perfusion imaging of a normal pancreas with secretin augmented MR imaging.

Objectives: To investigate prospectively the repeatability of pancreatic perfusion measurements using arterial spin labelling (ASL) and to determine the increase in perfusion due to secretin stimulation.

Material And Methods: An (FAIR)-TrueFISP ASL sequence was applied to determine the perfusion of the pancreatic head in a 3T MRI scanner. Ten healthy volunteers (four men, six women: mean age 28.

Critical Questions Regarding Gadolinium Deposition in the Brain and Body After Injections of the Gadolinium-Based Contrast Agents, Safety, and Clinical Recommendations in Consideration of the EMA's Pharmacovigilance and Risk Assessment Committee Recommendation for Suspension of the Marketing Authorizations for 4 Linear Agents.

For magnetic resonance, the established class of intravenous contrast media is the gadolinium-based contrast agents. In the 3 decades since initial approval, these have proven in general to be very safe for human administration. However, in 2006, a devastating late adverse reaction to administration of the less stable gadolinium-based contrast agents was identified, nephrogenic systemic fibrosis.

Material-Dependent Implant Artifact Reduction Using SEMAC-VAT and MAVRIC: A Prospective MRI Phantom Study.

Objective: The aim of this study was to compare the degree of artifact reduction in magnetic resonance imaging achieved with slice encoding for metal artifact correction (SEMAC) in combination with view angle tilting (VAT) and multiacquisition variable resonance image combination (MAVRIC) for standard contrast weightings and different metallic materials.

Methods: Four identically shaped rods made of the most commonly used prosthetic materials (stainless steel, SS; titanium, Ti; cobalt-chromium-molybdenum, CoCr; and oxidized zirconium, oxZi) were scanned at 3 T. In addition to conventional fast spin-echo sequences, metal artifact reduction sequences (SEMAC-VAT and MAVRIC) with varying degrees of artifact suppression were applied at different contrast weightings (T1w, T2w, PDw).

Diagnostic Value and Interreader Agreement of the Pancreaticolienal Gap in Pancreatic Cancer on MDCT.

Objective: The aim of this retrospective study was to evaluate the diagnostic value and measure interreader agreement of the pancreaticolienal gap (PLG) in the assessment of imaging features of pancreatic carcinoma (PC) on contrast-enhanced multi-detector computed tomography (CE-MDCT).

Materials And Methods: CE-MDCT studies in the portal venous phase were retrospectively reviewed for 66 patients with PC. The age- and gender-matched control group comprised 103 healthy individuals.

Speed in Clinical Magnetic Resonance.

The relevant clinical accelerated magnetic resonance techniques that are available currently for routine patient examinations are reviewed, presenting and discussing the benefits therein when compared with more conventional scans. The focus is on clinical use and practicality, with the review divided into 3 sections. Improvements in 3-dimensional acquisition are first discussed, specifically controlled aliasing in parallel imaging results in higher acceleration, related radial techniques, and CAIPI-Dixon-TWIST-VIBE.

Safety of the Gadolinium-Based Contrast Agents for Magnetic Resonance Imaging, Focusing in Part on Their Accumulation in the Brain and Especially the Dentate Nucleus.

The established class of intravenous contrast media for magnetic resonance imaging is the gadolinium chelates, more generally referred to as the gadolinium-based contrast agents (GBCAs). These can be differentiated on the basis of stability in vivo, with safety and tolerability of the GBCAs dependent upon chemical and biologic inertness. This review discusses first the background in terms of development of these agents and safety discussions therein, and second their relative stability based both on in vitro studies and clinical observations before and including the advent of nephrogenic systemic fibrosis.

Comparing the diagnostic utility of sacroiliac spectral CT and MRI in axial spondyloarthritis.

Objective: To compare the clinical value of sacroiliac spectral CT and MRI in diagnosing axial spondyloarthritis (SpA).

Methods: 137 patients with low back pain and suspected axial SpA were recruited. 76 patients were diagnosed with axial SpA, and 49 patients were diagnosed with non-specific low back pain (nLBP).

Simultaneous multi-slice readout-segmented echo planar imaging for accelerated diffusion-weighted imaging of the breast.

Objectives: Readout-segmented echo planar imaging (rs-EPI) significantly reduces susceptibility artifacts in diffusion-weighted imaging (DWI) of the breast compared to single-shot EPI but is limited by longer scan times. To compensate for this, we tested a new simultaneous multi-slice (SMS) acquisition for accelerated rs-EPI.

Materials And Methods: After approval by the local ethics committee, eight healthy female volunteers (age, 38.

Accelerated magnetic resonance diffusion tensor imaging of the median nerve using simultaneous multi-slice echo planar imaging with blipped CAIPIRINHA.

Purpose: To investigate the feasibility of MR diffusion tensor imaging (DTI) of the median nerve using simultaneous multi-slice echo planar imaging (EPI) with blipped CAIPIRINHA.

Materials And Methods: After federal ethics board approval, MR imaging of the median nerves of eight healthy volunteers (mean age, 29.4 years; range, 25-32) was performed at 3 T using a 16-channel hand/wrist coil.

A novel diagnostic method (spectral computed tomography of sacroiliac joints) for axial spondyloarthritis.

Background/purpose: To evaluate the diagnostic value of spectral computed tomography (CT) of sacroiliac joints for axial spondyloarthritis (SpA).

Methods: We retrospectively analyzed the records of 125 patients with low back pain (LBP) suspected of having SpA. Each patient underwent sacroiliac joint spectral CT examination.

Metal Artifact Reduction in Pelvic Computed Tomography With Hip Prostheses: Comparison of Virtual Monoenergetic Extrapolations From Dual-Energy Computed Tomography and an Iterative Metal Artifact Reduction Algorithm in a Phantom Study.

Objective: The aim of this study was to directly compare metal artifact reduction (MAR) of virtual monoenergetic extrapolations (VMEs) from dual-energy computed tomography (CT) with iterative MAR (iMAR) from single energy in pelvic CT with hip prostheses.

Materials And Methods: A human pelvis phantom with unilateral or bilateral metal inserts of different material (steel and titanium) was scanned with third-generation dual-source CT using single (120 kVp) and dual-energy (100/150 kVp) at similar radiation dose (CT dose index, 7.15 mGy).