ISMRM21 - Complementary & Hybrid Musculoskeletal Imaging

Complementary & Hybrid Musculoskeletal Imaging

Sunrise Session

ORGANIZERS: Jan Fritz, Kimberly Amrami, Hiroshi Yoshioka, Xiaojuan Li, Edwin Oei

Wednesday, 19 May 2021

Concurrent 7

13:00 - 14:00

Moderators: Chiara Giraudo & Brian Hargreaves

Skill Level: Basic to Intermediate

Session Number: S-03d

Parent Session: Hot Topics in MSK MRI

Session Number: S-03d

Overview
This course offers an overview of complementary and hybrid imaging techniques to image musculoskeletal (MSK) diseases. The complementary value of CT techniques to MRI will be reviewed for specific MSK disorders. New developments in hybrid PET-MRI will be presented, focusing on the added value of functional information offered by PET over structural information derived from MRI.

Target Audience
Radiologists, clinicians, technologists, and scientists interested in learning about the complementary value of musculoskeletal imaging techniques and the role of novel hybrid MRI techniques.

Educational Objectives
As a result of attending this course, participants should be able to:
- Describe the various imaging modalities for MSK diseases and the advantages and disadvantages of each;
- Describe the complementary value of CT techniques to MRI; and
- Explain the principle of hybrid MRI and describe the added value of PET-MRI for MSK diseases.

		Complementary Modalities: DECT Watch the Video Katrina Glazebrook Dual-energy CT provides material composition information. Removal of the calcium signal (virtual non-calcium VNCa) from cancellous bone allows visualization of the marrow space. Studies have shown high sensitivity and specificity compared to MR in cases of trauma in the scaphoid, hip, knee, and ankle (fig 1,2). VNCa imaging can demonstrate marrow infiltration in cases of metastases and myeloma (fig 3). DECT allows identification of MSU crystals in cases of suspected gout with high sensitivity and specificity compared to aspiration (fig 4,5). Monoenergetic DECT with iterative metal artifact reduction can improve image quality in cases with significant metal artifact (fig 6).
		Hybrid MRI Techniques Watch the Video Feliks Kogan Hybrid MRI methods promise to combine the high-resolution multi-contrast imaging benefits of MRI with new approaches aimed at early disease detection and clinical interventions. PET-MRI systems add metabolic and functional information from PET to potentially provide a complete imaging modality for studying musculoskeletal disease while high-intensity focused-ultrasound offers therapeutic interventions for bone tumors. This educational talk will discuss emerging applications of these technologies and their comparative advantages. Technical considerations and challenges as they specifically relate to musculoskeletal disease will also be discussed.