1. F i e l d StrengthPublication for the Philips MRI Community
I s s u e 3 0 - D e c e m b e r 2 0 0 6
• RSNA 2006: new Achieva 3.0T X-series and SmartExam
• Sharp and Children’s DWI protocol improves abdominal imaging
• Rolling Oaks Radiology at imaging vanguard with Achieva 3.0T
• Apollo Hospital uses 3.0T in wide variety of abdominal studies
• Yeditepe: Achieva 3.0T neuro site with Ambient Experience
2. Johann Wolfgang von Goethe, the 18th century German poet, novelist and dramatist, said that
“knowing is not enough, we must apply, willing is not enough, we must do.” In the fast moving
world of MR technology, especially, turning technological advances into clinical applications is
key in creating value. As global director of the MR Applications and Clinical Science group at
Philips, I lead our company’s application specialists and clinical scientists as they strive to apply
technological know-how – in the development of novel coils, pulse sequences, reconstruction
techniques and analyses tools – to add clinical value for our customers. Among the key
success factors of our activities is the close collaboration with expert users of our equipment.
In this issue of Field Strength, we present examples of innovations that – by virtue of the
close collaboration of applications specialists, clinical scientists and clinicians – are making a
difference for patients and for radiologists.
Innovations are reflected in articles on diffusion-weighted imaging of the abdomen and
proton-density weighted TSE imaging in musculoskeletal applications. Increased ease-of-use is
stressed once more with high quality contributions describing efficiency improvements with
ExamCards and SmartExam. The RSNA news article presents the most recent SmartExam
extensions and introduces the new Achieva 3.0T X-series. The articles on abdominal and
neurological imaging at 3.0T nicely illustrate what advanced technology can do in a clinical
environment. Finally, the 7.0T users meeting showed us the great progress that can be
achieved when we apply know-how in its ultimate way in a group of experts.
Indeed, we must apply what we know and do what we said we would; in cooperation with our
clinical collaborators, this will make the difference in applying Philips’ advanced MR technology
for the patient’s benefit.
Good reading!
René G. Aarnink
Director, Applications and Clinical Science, MR
2 Field Strength Issue 30 - December 2006
Dear Friends,
4. 4 Field Strength Issue 30 - December 2006
Philips highlights new Achieva 3.0T
X-series and SmartExam at RSNA 2006
New Achieva 3.0T X-series offers
new levels of performance
Philips offers major performance
improvements with the new Achieva 3.0T
X-series. Through its X-series technology,
resident in the magnet, gradient and RF
subsystems, the system provides what is
necessary for advanced whole-body
3.0T imaging.
The new patient-friendly, short-bore
(1.57 m) system features a maximum
FOV of 50 cm that facilitates off-center
shoulder imaging, large FOV spine, body
imaging, peripheral and whole-body
MRA, and whole body imaging in only
a few stations. The Achieva 3.0T X-series’
new Quasar Dual gradients provide high-
performance amplitudes (max. 80 mT/m)
and slew rates (max. 200 mT/m/ms) with
improved linearity across the full FOV.
The X-series RF body coil for Achieva
3.0T delivers optimal SNR and SAR
management and is designed for dielectric-
free, whole-body imaging that requires
no saline bags.
Philips also announces the Achieva
FreeWave platform equipped with a
32-channel RF system to dramatically
improve existing studies and facilitate
emerging applications.
Achieva’s compact 3.0T X-series design has
enabled introduction of the first mobile
Achieva 3.0T X-series system. In addition,
Philips introduces a wide variety of high-
channel coils for Achieva 3.0T X-series,
Achieva 1.5T, and new ST coils for
Panorama 1.0T.
Achieva 3.0T X-series
high resolution whole
body imaging.
Achieva 3.0T X-series high resolution knee, matrix 2048x2048.
5. 5Issue 30 - December 2006 Field Strength
SmartExam for high
productivity and efficiency
At RSNA 2006, Philips continues to
promote its SmartExam automated planning,
scanning and processing technology, based on
ExamCards. New is SmartExam for spine
and knee studies. Together with brain studies,
this covers about 70% of all examinations.
SmartExam offers remarkable inter- and
intra-patient scan reproducibility and
operator efficiency, which could translate into
greater daily throughput. Users can share
ExamCards via the Philips NetForum
Community, which enables ExamCard
download directly into the scanner.
SmartExam is available for new and existing
users of Achieva 3.0T, Achieva 1.5T and
Panorama 1.0T.
Clinical leadership
The Achieva 3.0T X-series provides the
tools necessary to perform cutting edge
whole-body 3.0T imaging. The system
enables routine clinical imaging in all
applications, including best-in-class neuro,
body and musculoskeletal imaging.
The FreeWave platform is designed to
permit clinical techniques that require
higher data rates, bandwidth and resolution
(up to 2k imaging), including the latest
Philips-exclusive applications: 4D-TRAK,
k-t BLAST and SENSE performance up
to 16 times faster. Innovative applications
include DWIBS, FiberTrak, SENSE
spectroscopic imaging, VISTA,
Asymmetric TSE.
SmartExam provides consistent planning when applied in an average knee, a large knee, a knee with
a metal pin, and a pediatric knee. Courtesy Dr. Lecouvet, St. Luc University Hospital, Brussels.
T1-weighted T2-weighted
Total Neuro scanning provides high
efficiency and speed
Simultaneous brain and whole-spine
scanning is now possible with the new
33-element SENSE Head/Spine coil
combination. Complete coverage – from
the brain to the sacrum – is possible in a
few minutes without patient repositioning.
Further techniques
under development
The MultiVane technique
uses a radial acquisition
method, designed to provide
diagnostic images despite
patient motion in body
and neuro imaging.
The THRIVE sequence offers
high resolution and excellent
contrast in body imaging.
Building on this, the 4D-
THRIVE technique, a highly
accelerated 3D method, is
being developed for high
spatial resolution, isotropic
T1-weighted imaging during
contrast uptake.
6. 6 Field Strength Issue 30 - December 2006
Whole-body diffusion-weighted imaging
highlights abdominal pathology
DWI is useful tool in Sharp and Children's MRI Center's abdominal-pelvic protocol
The dynamics of water diffusion apply as much in the body as they
do in the brain; restricted diffusion arising from pathological processes
causes tissues to “light up” on diffusion-weighted images – sometimes
dramatically in comparison to normal surrounding anatomy. Dr. Russell
Low at Sharp and Children's MRI Center (San Diego, Calif.) is exploiting
this variability in the Brownian motion of water in all abdominal imaging
studies. For certain body MRI applications, whole-body DWI aids in the
detection of pathology that may be virtually invisible on T1-,T2- and
contrast-enhanced images. Technical challenges, such as susceptibility
artifacts and physiologic motion, have been addressed by implementing
an optimized rapid diffusion-weighted version of EPI that enables short
breath holds and reduced artifacts when combined with SENSE.
“Radiologists aren't using diffusion-
weighted imaging as extensively as they
should due to a lack of awareness and -
to a certain extent – DWI's technical
limitations in body imaging,” says Dr. Low,
Medical Director of Sharp and Children's
MRI Center. “Whole-body diffusion-
weighted imaging is an entirely new
way to look not only at tumors but also
inflammatory diseases in the abdomen and
pelvis. Number one, abdominal DWI is
feasible and number two, the images are
clinically very useful.”
Sharp and Children's radiologists became
familiar with whole-body DWI's potential
in abdominal and pelvic imaging in March
2004, during a visit by Philips clinical
scientist Alun Jones. Dr. Low used DWI on
the Center's Achieva 1.5T to scan a patient
who later was diagnosed with a hepatoma.
“We began seeing things on the diffusion-
weighted images, but we were initially
unsure what they represented,” he recalls.
“Finally, we realized we were looking at
enlarged lymph nodes that were so
conspicuous they stood out like light bulbs.
We had never seen anything like this before.
The contrast of the images and the
conspicuity of the nodes in this case really
were quite striking. On conventional images
we were used to seeing lymph nodes that
blended in with surrounding structures.”
A DWI image is worth 1,000 pictures
It soon became apparent to Dr. Low that
definitive whole-body DWI images might
facilitate the task of reviewing the 1,000
or more standard T1- and T2-weighted,
dynamic post-contrast and multiplanar
images in an effort to detect very subtle
contrast differences. Subsequently, Sharp
and Children's added a DWI sequence to
its abdominal and pelvic protocol and
validated this theory.
“The diffusion-weighted images really direct
my focus to the area of the abnormality,” he
observes. “Many times I'll look at the
diffusion images first to see what appears
bright – which areas have restricted diffusion
– and then go back and simultaneously
review the conventional images. This helps
me see the abnormalities more quickly –
particularly in the lymph nodes.
Unequivocally, DWI is the sequence to use
to look for suspected lymphadenopathy.”
DWI's value in helping to visualize possible
disease states in small lymph nodes is most
apparent because the anatomy can easily
Russell Low, M.D.
An artist conception of the new Sharp
Memorial Hospital, scheduled for
opening in 2008.
7. 7Field StrengthIssue 30 - December 2006
blend in with adjacent soft tissues, Dr. Low
adds, but occasionally DWI can help reveal
subtle larger nodal masses that are incon-
spicuous on conventional MR images.
While lymphadenopathy is clearly the sig-
nature application for DWI, he continues,
the technique also is quite valuable in
helping clinicians detect all types of primary
and metastatic tumors in the abdomen and
pelvis, in addition to other pathologies
associated with restricted diffusion – such as
Crohn's disease, inflammation, osteomyelitis,
abscesses and cysts.
A further benefit of the DWI sequence is
to guard against potential false-positive
interpretations, Dr. Low adds. “Sometimes
you see a suspicious finding on, say, a T2-
weighted series, and then you realize the
diffusion-weighted image is entirely
normal,” he says.
Short breath holds make DWI
addition feasible
To cope with motion, Dr. Low opted for
a breath hold strategy using a rapid DWI
pulse sequence on the Achieva 1.5T system.
Other investigators favor high-NSA (i.e. 6
to 8 per station) imaging as a way to average
out motion, but the cost-benefit of breath
hold imaging seemed substantial, he says.
“The diffusion-weighted version of single
shot EPI is extremely fast and can be
accomplished in a 20-second breath hold
for the abdomen and an additional 20-
second breath hold for the pelvis,” he
explains. “Versus high-NSA imaging,
our approach is to get the sequence done
quickly and simply as an additional
sequence added to our conventional
imaging. For the short breath holds
involved, we gain a tremendous amount
of additional information.”
Preceding the DWI sequence are a T1-
weighted dual echo FFE sequence followed
by axial T2-weighted and T1-weighted TSE
sequences with SPIR fat suppression. After
these, the breath hold DWI for abdomen
or pelvis is performed. Subsequently,
clinicians implement a dynamic contrast-
enhanced THRIVE (T1-weighted high-
Patient with lymphoma. The T1-weighted FFE image is
unremarkable. On the T2-weighted single shot TSE image with
SPIR it is difficult to distinguish small lymph nodes from iliac
vessels.The diffusion-weighted image most clearly shows
multiple bilateral pelvic lymph nodes (arrows).The marked
conspicuity of lymphadenopathy on the DW images is
characteristic.The inverted MIP generated from the DW
images shows bilateral iliac and inguinal lymphadenopathy.
Patient with rectal bleeding. The top row images show soft
tissue in the rectum that is difficult to distinguish from retained
stool.The first DW image shows a markedly hyperintense mass
(arrow) in the left anterior rectum.The adjacent DW image
depicts multiple pelvic lymph nodes (arrows). Findings represent
a Stage 3 primary rectal cancer.
T1-weighted FFE T2-weighted SPIR
DWI b=500 Inverted MIP
Single shot TSE T1-weighted
DWI b=500 DWI b=500
"DWI is the sequence to
use to look for suspected
lymphadenopathy."
8. 8 Field Strength Issue 30 - December 2006
resolution isotropic volume examination),
followed by a time-delayed T1-weighted
FFE with WATS. SENSE factor 2 is used
in all sequences.
“The beauty of this Philips body protocol
is that they're all breath hold sequences
now,” he notes. “We can easily perform an
abdominal MR exam in 15 minutes and
we have some technologists who can scan
an abdomen and pelvis in 20 minutes.”
“We're exploiting technological advances
in scanning speed in body imaging much
more so than in neuro and musculoskeletal
imaging,” he remarks. “We're imaging
probably four times faster in the abdomen
than we did five to eight years ago, while
a lot of musculoskeletal and brain MR
imaging is still being scanned at the
same pace. When I began performing body
MR 16 years ago, conventional spin echo
T2-weighted images with fat sat took 12
minutes. Now it takes just a breath hold of
20 seconds to acquire T2-weighted images
with better resolution and detail.”
To further increase SNR, Dr. Low also uses
the new 16-channel SENSE Torso coil,
which he has been using for several
months. “It's a phenomenal coil,” he says.
“It appears to be a relatively small coil, yet
the coverage is excellent. We can cover the
abdomen and pelvis very easily, up to 48
to 50 cm.
DWI as pathfinder
Although some investigators have sought
to use ADC values to characterize tumors
as benign or malignant, at Sharp and
Children's DWI is intended to serve
as a guidepost mainly, indicating where
potential problems may be. The standard
sequences in the protocol are designed to
further help characterize what is seen on
diffusion and pinpoint the pathology's
anatomical coordinates.
“One of the limitations of diffusion is that
a lot of the background features fade out,”
he explains. “You end up with a big bright
spot or black [i.e. inverted-contrast] spot,
so correlating the diffusion with the
anatomic images is necessary. We roll
through all the series simultaneously on
PACS to view DWI and the other images
concurrently.”
Instead of post-processing the DWI data
to create inverted-contrast MIP images,
Dr. Low prefers to view the source images.
“These inverted images are quite attractive
and they promote awareness of the
technique, but source images – whether
they be MRA images or DWI images –
represent the unadulterated data set,”
he says. “The MIP doesn't 'know' the
brightest signal intensity pixel is a tumor,
so if it happens to be T2 shine-through
from bowel, for example, it will still be
projected as bright signal.”
Post contrast THRIVE DWI b=500 T2-weighted DWI b=500
"We can easily perform
an abdominal MR exam
in 15 minutes"
Patient with increasing abdominal girth. The gadolinium-
enhanced THRIVE image shows peritoneal enhancement and
infiltration of the small bowel mesentery (long arrow). Omental
tumor (short arrow) is also present.The DW image shows
hyperintense masses in the small bowel mesentery and
omentum (arrows).
Patient with primary ovarian cancer. The T2-weighted
image shows pelvic ascites (A).The DW image shows markedly
hyperintense omental (long arrows) and peritoneal tumor (short
arrow).The ascites suppresses on the DW image increasing the
conspicuity of the tumor.
9. 9Issue 30 - December 2006 Field Strength
DWI encompasses wide scope of
abdominal and pelvic pathology
Some specific pathologies that DWI has
helped Dr. Low and his colleagues visualize
– in addition to lymphadenopathy –
include tumors of the peritoneum,
pancreas, liver and gastrointestinal tract.
“Contrast-enhanced imaging is very good at
helping us to detect peritoneal tumors, but
DWI sometimes helps us sort out complex
relationships – such as separating bowel
from peritoneal tumors and bowel from
mesenteric tumors,” he observes. “In
imaging rectal tumors, we would try to
make high resolution images, but if the
bowel is collapsed it's hard to distinguish
collapsed bowel from tumor. With
DWI, these tumors are exceptionally
hyperintense. And you can see the suspected
lymphadenopathy around the tumor.”
To improve hepatic imaging, Dr. Low
credits Dr. Shadid Hussain of Erasmus
University of Rotterdam, The Netherlands,
for a modification of the standard DWI
sequence. The concept is to use a b-value of
20 and replace the T2-weighted sequence,
yielding nominal diffusion weighting and
substantial T2 weighting – creating a black
blood sequence, essentially.
“All the vessels become dark, but the rest
of the image will basically be a combination
of some diffusion weighting and a lot of
T2 weighting,” Dr. Low explains. “I like
this sequence – it works well to show
small perivascular tumors.”
For all other imaging, Dr. Low prefers a
moderate diffusion sensitivity to limit
artifact, therefore he uses a b-value of 500
(versus a b-value of 1000 commonly used
in the brain). “There still is some T2 shine-
through, which may be seen as some bright
signal in the bowel; a lot of the bowel does
suppress on the DWI, but typically there
still are some remaining areas of high
intraluminal signal. However, if you
compare the diffusion image to the other
images, it's always easier to tell what's
going on.”
Greater awareness is the key to more
whole-body DWI use
Given the obvious benefits that Sharp and
Children's MRI Center has experienced
by adding whole-body DWI to their
abdominal and pelvic protocols, DWI's
use in the body should begin to increase
rapidly through increased awareness,
Dr. Low predicts.
“Clinicians will follow as they learn about
a technique's advantages,” he says. “Then,
it's a simple matter of plugging it in and
running it. Of course, after that they need
to figure out what they're looking at, since
DWI's dichotomous bright-dark contrast
scheme is different from what clinicians are
accustomed to.
Clearly, diffusion-weighted imaging is one
of the things that Philips MR does really
well,” Dr. Low adds. “It's a beautiful
sequence that Philips has optimized for
body DWI. It works very nicely and is an
important part of our abdominal and pelvic
MR protocol.”
"Clearly, diffusion-weighted
imaging is one of the
things that Philips MR
does really well"
Net Forumwww.philips.com/netforum
Visit the MRI NetForum Community
to view more contributions by
Dr. Low, Sharp and Children's
MRI Center.
T1-weighted Post-contrast keyhole THRIVE DWI b=500
Patient with metastatic prostate cancer. The T1-weighted and gadolinium-enhanced keyhole
THRIVE images show liver metastases and osseous metastases.The DW image best shows the
innumerable hyperintense liver metastases and osseous metastases in the spine (arrows).
10. Achieva 3.0T throws doors open to
spectrum of abdominal studies
After just seven months, Indraprastha Apollo Hospital has a long list of routine
3.0T body studies
The abdominal MRI practice of Indraprastha Apollo Hospital (New
Delhi, India) underwent a rapid evolution and growth – from a few
simple, anecdotal cases to 20% of the entire patient volume – in their
Achieva 3.0T system’s first seven months of operation.With fast,
advanced techniques such as THRIVE, SENSE and DWIBS and the extra
SNR that 3.0T affords, Indraprastha Apollo’s abdominal MRI options
greatly expanded to include both straightforward body examinations
such as MRCP, as well as more sophisticated studies, such as evaluation
of liver and pancreas tumors, renal donors, atherosclerotic disease,
aortic aneurysms and pelvic diseases. Applications also include follow-
up studies of post-intervention patients, according to Indraprastha
radiologist/interventionalist Dr. Harsh Rastogi.
Equipped with a 64-slice CT scanner
and limited to a 0.5T MRI system,
Indraprastha Apollo Hospital radiologists
had little motivation to perform many
abdominal MRI studies before November
2005 – when they began operating the
Achieva 3.0T system.
“The 0.5T system was the workhorse for
neuro and musculoskeletal cases for 10
years, but in abdominal imaging, we were
limited to studies of the biliary tree by
MRCP or doing a few simple pelvic
examinations,” recalls Harsh Rastogi,
M.D., senior consultant in radiology
and intervention at Indraprastha Apollo
Hospital, a 700-bed, multi-specialty,
tertiary care medical center in India’s
capital, New Delhi.
By June 2006, Indraprastha’s new Achieva
3.0T had supercharged the medical center’s
abdominal MRI service, making it a 20%
share of the total MRI volume. Today,
10 Field Strength Issue 30 - December 2006
Liver imaging after
tumor embolization
Multiphase THRIVE images of the liver
acquired 3 days after embolization of
the right hepatic artery. Intra-tumoral
necrosis can be recognized as non-
enhancing mass in the right lobe of the
liver.Viable tumor fed by the left hepatic
artery shows enhancement.
Dr. Harsh Rastogi
11. 11Issue 30 - December 2006 Field Strength
Indraprastha radiologists perform three
to four body MRI examinations per day,
encompassing routine MRCP studies and
advanced CE-MRI and CE-MRA cases
to survey for tumors and other pathology
in the abdomen and pelvis. A key to
Indraprastha’s present success in upper
abdominal imaging – beyond the obvious
benefit of doubled SNR at 3.0T – is the
THRIVE sequence, Dr. Rastogi notes.
Efficient liver coverage
“THRIVE is fast and provides great
contrast enhancement and background
suppression and superb high resolution,”
he says. THRIVE (T1 High Resolution
Isotropic Volume Examination) combines a
3D T1-weighted TFE sequence with SPAIR
fat suppression and SENSE, enabling fast,
high-resolution imaging with large FOV
coverage and excellent fat suppression –
in a single 17-20-second breath hold. For
liver, spleen, pancreas and kidney studies
at Indraprastha, clinicians use the SENSE
Torso coil and a SENSE factor of 4, a
39.5 cm FOV, two millimeter slices with
two parallel REST slabs and 2 x 2 x 2 mm3
isotropic voxels.
“THRIVE helps us pick up small mets or
evaluate the dynamics of contrast enhance-
ment per unit of time,” Dr. Rastogi
observes.
He cites the case of a 75-year-old man who
presented with a hepatic adenocarcinoma
metastasized from an unknown primary,
for which clinicians were attempting to
determine the optimal treatment. The
patient had undergone previous RF
ablation for this malignant lesion, so the
Indraprastha surgeon indicated that the
mass was inoperable. Consequently,
Dr. Rastogi suggested palliative transarterial
chemoembolization (TACE) of the tumor.
Baseline and post-interventional THRIVE
studies were able to show that TACE had
completely cut off the tumor’s blood
supply, evidenced by a non-enhancing
tumor central core in a post-therapy scan.
“We were surprised and thrilled to see
and be able to document via MRI that
embolization had definitively caused the
infarction of the tumor and that the
therapy had worked for this patient,” he
says. “Now, we can follow-up with these
"It is just amazing how
much we can do with the
THRIVE sequence alone."
THRIVE THRIVE DWIBS 3D volume rendered
Sciatic Nerve Neurofibroma
CT showed a spindle-shaped mass in the popliteal fossa. MRI was done to pre-operatively
assess the relationship of the mass to the neuro-vascular bundle. Coronal and sagittal post-
contrast THRIVE images of the popliteal fossa show multiple heterogenously enhancing
nerve sheath tumors on the sciatic nerve and its branches.The DWIBS image shows
restricted diffusion along the sciatic nerve and multiple tumors.The 3D volume rendered
images show the “snow man” sign of multiple nerve sheath tumors.
12. 12 Field Strength Issue 30 - December 2006
patients every three to six months with
MRI to monitor the outcome.”
THRIVE in the pancreas
In an acute chronic pancreatitis case, upper
and lower GI endoscopies were unsuc-
cessful in helping determine the cause
of blood in the stool, upon which the
patient was referred to Indraprastha Apollo.
“We did a THRIVE study of the upper
abdomen and to our surprise we found a
4 cm diameter pseudoaneursym in region
of the pancreatic tail,” Dr. Rastogi relates.
“The patient’s CT scan three weeks
previous was absolutely normal. The
bleeding was caused by the pseudo-
aneurysm, which I occluded by infusing
liquid embolic agent. The follow-up
THRIVE examination four days pre-
discharge showed that the aneurysm had
thrombosed. Another follow-up THRIVE
study showed us that the aneurysm had
completely disappeared. It is just amazing
how much we can do with the THRIVE
sequence alone.”
Renal applications
THRIVE has proven invaluable in renal
MRA examinations of Indraprastha’s kidney
donor patients – helping doctors account
for renal arteries pre-transplant – and those
suffering from kidney diseases.
An elderly patient suffering from acute
renal failure had a THRIVE study instead
of standard angiogram due to her kidneys’
condition as well as an allergy to iodinated
contrast. The THRIVE study enabled
doctors to detect multiple renal infarcts and
occlusion of the superior mesenteric artery.
“The diagnosis was a thrombus in the
thoracic aorta that was embolizing into the
organs of the abdomen, including the
bowel, kidneys and superior mesenteric
artery,” he reports.
Dynamic examinations
For the youngest patients, Dr. Rastogi has
discovered that he is able to forego breath
holds and scan dynamically with Achieva
3.0T. A benchmark case was an eight-
month-old boy who presented with biliary
atresia at another hospital and who had
surgery to correct the disorder with no
complications five months post-surgically.
Subsequently, the patient began
experiencing melena. Clinicians at the
aforementioned medical center prescribed a
number of tests, including upper and lower
endoscopies and nuclear medicine studies
to identify the site of the bleeding, but all
were inconclusive.
“This patient was specifically referred to
our hospital, where our primary care
physicians indicated they wanted an
MR angiogram done on his abdomen,”
Dr. Rastogi recalls. “Instead of an MR
angiogram I suggested a dynamic contrast-
enhanced MRI of his abdomen – as breath
holding wouldn’t be possible. With MRI,
we visualized venous congestion and
ectopic varices of the small intestine arising
due to portal hypertension. This finding
completely changed the management from
surgery to a more conservative medical
approach.”
Versatile THRIVE works just about
everywhere
Dr. Rastogi stresses that while THRIVE’s
value is most readily appreciated in
the abdomen, Apollo clinicians have
demonstrated the technique’s utility in
other regions as well, including the neck,
limbs and even the tongue. “THRIVE is
such a robust technique. It seems to work
well under all circumstances,” he says.
DWIBS provides large-FOV survey
Advanced, innovative techniques such as
DWIBS (diffusion-weighted whole-body
imaging with background body signal
suppression) are now available at Indra-
prastha on its Philips MRI platform.
“For visualizing neurofibromas, DWIBS
is excellent,” Dr. Rastogi says. “This
technique also is quite valuable for nerve
imaging in examinations for possible
lymphomas and for imaging the brachial
plexus as a whole.”
In a recent case, a patient presented with
a CT-confirmed neurofibroma in the
popliteal fossa. Dr. Rastogi wanted to
clarify the relationship of this nerve sheath
tumor with the popliteal arteries and veins.
A whole-body DWIBS study revealed that
the patient had not just one tumor, but
many of them “scattered all over,” he
remarks.
"For visualizing
neurofibromas, DWIBS is
excellent."
Indraprastha Apollo Hospital,
New Delhi, India
13. 13Issue 30 - December 2006 Field Strength
“This finding completely changed the
perspective of the treating surgeon – there
were far too many to treat surgically,” he
says. “Moreover, surgery would have risked
damage to one of the major leg veins and
the patient was not suffering from any
neurological or functional limitations,
anyway.
“It’s interesting that on CT, we were able to
pick up just one neurofibroma, whereas
DWIBS enabled us to visualize many,” he
adds. “In brachial plexus imaging for the
detection of neurofibromatosis, DWIBS
also helps visualize the nerve root entry
zone in the neck and assists us in
identifying the nerve roots, per se, which
can be difficult in conventional imaging
due to the brachial plexus’s oblique
angulation. DWIBS images can be post-
processed into other planes, so precise slice
positioning is less relevant.”
Prostate spectroscopy helps zero in
on target
A burgeoning pelvic application for
Indraprastha Hospital’s Achieva 3.0T is
prostate spectroscopy for pre-biopsy
characterization of prostate tumors. The
technique is valuable for patients with a large
prostate (e.g., 70-80 g), for which a more
accurate identification of the optimal biopsy
region is desired. “In these cases, prostate
spectroscopy has helped show us where the
high citrate peaks – indicating a neoplastic
process – are located in the prostate,” he says.
The 3.0T revolution in abdominal
imaging
Dr. Rastogi’s opinions about 3.0T for
abdominal imaging may be colored by
the hospital’s dramatic – and perhaps
uncommon – vault from 0.5T imaging
to 3.0T imaging, but it is equally true
that 3.0T clinical utility has increased
tremendously in recent years.
“My understanding is that the global
radiologist community is trying to
revolutionize abdominal imaging with
3.0T – and the applications are immense,”
Dr. Rastogi says. “There is no radiation
to the patient and the use of THRIVE
imaging and similar rapid imaging
sequences is significantly reducing scan
time while simultaneously decreasing
artifacts. The use of 3.0T can only become
more popular as time goes on – and it will
present a big challenge to high resolution
CT in the years to come.”
Net Forumwww.philips.com/netforum
Visit the NetForum User Community
for downloading ExamCards and
viewing application tips, clinical cases,
extended versions of FieldStrength
articles, and more.
STIR T2-weighted T2-weighted T1-weighted
Tongue AVM with bleeding
The top row images show the AVM nidus
in the left half of the tongue. Numerous
branches of the lingual artery feed the AVM.
The median raphae is displaced to the right.
MPR images of the THRIVE scan show
the dilated left lingual artery, the draining vein,
and two segments of a well-defined nidus
along the lateral border of the tongue.
The SENSE NeuroVascular coil was used.
THRIVE
14. 14 Field Strength Issue 30 - December 2006
Radiologist group begins second year
with workhorse Achieva 3.0T
California-based Rolling Oaks Radiology finds system a top performer for myriad applications
The perception of radiologists at Rolling Oaks Radiology (Thousand
Oaks, Calif. USA) that a 3.0T system would be unique in their market
and a top clinical performer in all imaging applications was well-
founded. In the summer of 2005, a major acquisition of Philips
equipment included Achieva 3.0T, PET and CT systems and nuclear
medicine, ultrasound, digital x-ray and mammography units –
transforming Rolling Oaks into a Philips luminary site. The Achieva
3.0T acquisition, in particular, highlights how a private, entrepreneurial
scanning facility such as Rolling Oaks Radiology can thrive, harnessing
an unfamiliar MR platform and turning it into their workhorse system
for all patients and applications.
Constrained by their former medical group
into accepting the bare minimum in terms
of MR technology, four radiologists founded
Rolling Oaks Radiology, a center whose
mission was to acquire only the most
advanced equipment for the benefit of their
patients. In the summer of 2005, a major,
multi-modality Philips equipment acqui-
sition, which included an Achieva 3.0T
system, marked Rolling Oaks Radiology’s
official establishment and its new status as a
Philips luminary site.
“I thought the neuro images and the
cartilage images were spectacular,” says Roy
Gottlieb, D.O., medical director at Rolling
Oaks Radiology and one of the center’s
current staff of five fellowship-trained
radiologists. “I also have a friend that works
on 3.0T systems in Florida who is happy
from a musculoskeletal standpoint. So, I
thought the future was trending toward
3.0T, and making a big investment like this
we wanted to look to the future.”
Cartilage characterization benefits
most in joint imaging
Musculoskeletal studies account for 40
percent of Rolling Oaks Radiology’s patient
volume, and the potential for major
resolution increases with Achieva 3.0T has
made a major impact, Dr. Gottlieb observes.
“One of the best things about the 3.0T is
the resolution we can get imaging the
glenoid labrum in the shoulder,” he says.
“We’re able to see labral tears, such as
Bankhardt and SLAP tears, without
intraarticular contrast. In patients with
instability in the shoulder, we see labral
tears a lot more on the non-contrast studies
than we would have on our 1.5T system.
“This seems to hold true for all the joints
and looking at the ligaments of the wrist
and the triangular fibrocartilage complex,”
Dr. Gottlieb continues. “We find that we
have a better depiction of small parts
because we’re able to increase resolution.”
In the knee, he adds, certain chondral
pathologies are better appreciated,
improving the ability to gauge the severity
of pathology. “We have been asked to
collaborate on a study testing certain drugs’
ability to improve the health of underlying
cartilage as depicted by the progression or
regression of the degree of cartilage
thinning/chrondromalacia,” he says.
“Before we had 3.0T, we could say there
was some chondromalacia – perhaps judge
more accurately between full-thickness and
non-full-thickness. But now, we feel that
we have a better depiction – within
percentages – 25 to 50 percent, or 50 to
75 percent – to more finely grade chondral
thickness changes and even early chondro-
Roy Gottlieb, D.O., medical director
at Rolling Oaks Radiology
Patella cartilage tear.
15. 15Issue 30 - December 2006
malacia changes, such as fraying. You really
need high resolution for that.”
3.0T neuro studies predictably better
Studies of the brain and spine represent
30 percent of Rolling Oaks’s patient volume
and include a range of examinations from
routine brain studies to advanced scans such
as BOLD fMRI and spectroscopy. The
increased SNR provided by the 3.0T field
strength enables clinicians to boost
resolution and acquire very thin slices.
“We obtain exceptional gray/white differen-
tiation and can see the tiny nerves that come
from the brain stem,” he says. “We also can
better visualize detailed structures, such as
potential tiny intracannilicular acoustic
neuromas involving the 7th-8th nerve
complex even without the use of contrast
agents, because of the high spatial and
contrast resolution we now obtain using
the 3.0T magnet.” As expected, MRA at 3.0T
is superb via a combination of high field
strength and the Philips 16-channel
NeuroVascular coil. “We can complete a
whole neck study and then an MR angiogram
from the circle-of-Willis to the aortic arch
without changing coils,” Dr. Gottlieb says.
Anecdotally, Rolling Oaks has had success
with BOLD fMRI and spectroscopy.
In preparation for research studies with the
University of Southern California (USC),
Rolling Oaks is gaining experience in BOLD
fMRI. One project focuses on the functional
imaging of children with sickle cell anemia
while another independent project explores
how BOLD fMRI might guide Gamma
Knife® surgery.
“Gamma Knife® surgery uses multiple
convergent beams of ionizing radiation to
treat brain tumors non-invasively, but precise
functional imaging data could help USC
neurosurgeons create even more focused
treatment isocenters, helping to further
minimize the dose to eloquent cortex,”
he says.
Like many other centers, Rolling Oaks
also is interested in investigating how MR
spectroscopy, an application that demands
high SNR, could benefit post-therapy
follow-up studies and has used the
technique in a few patient cases so far.
“Patients return for follow-up scans and
may be having some new symptoms that
could be indicative of recurrence of their
brain tumor,” Dr. Gottlieb explains.
“Sometimes it’s very difficult to
differentiate between radiation necrosis and
recurrent or residual tumor on contrast-
enhanced MRI. With MRS, we can often
distinguish these conditions. The quality of
our spectroscopy is better on our 3.0T
system than it was on our 1.5T system.”
Higher resolution helps 3.0T
abdominal studies
Rolling Oak Radiology leverages Achieva
3.0T system’s higher SNR to both increase
resolution and decrease breathhold times
in abdominal studies. This strategy has
worked well in breathhold diffusion studies
to view possible lymphadenopathy or lesions
in the abdomen and pelvis, Dr. Gottlieb
notes.
“Our breathhold diffusion sequence
provides very good contrast resolution,
making areas of restricted diffusion
appear white,” he says.
“All in all, the 3.0T field strength, and
Achieva 3.0T in particular, has proven
to be the right selection for us and
our patients.”
MRI MRI
Post-contrast CT Post-contrast CT MPR CT
Liver masses are better
visualized by 3.0T MRI
than by 64-slice CT.
Brachial plexus
neurofibromatosis
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for more 3.0T contributions.
16. 16 Field Strength Issue 30 - December 2006
Application tip
PDW TSE orthopedic imaging
The TSE PDW (proton density-weighted) sequence is widely
used for diagnostic imaging in orthopedics. This application tip
focuses on joint imaging – in particular on image contrast and
the reduction of imaging blurring, and on time-efficient PDW
imaging with asymmetric TSE.
Optimize TE/TR for good contrast
Typically, PDW contrast is characterized by intermediate articular
cartilage signal, lower meniscus, ligament and tendon signal and
high synovial fluid signal. Use a TE of about 30 ms and a TR
between 4000 ms and 5000 ms to easily achieve this contrast.
Note that a relatively short TE (TE <25ms) might increase the
risk of magic angle artifact.
When using a relatively short TR (e.g. TR <2500 ms), DRIVE
helps to maintain high fluid signal.
Contributed by Ping Yang, Philips MR
Application, Best,The Netherlands.
Optimize TSE shot length to control image blurring
In TSE imaging, tissues with shorter T2 relaxation times (such as
articular cartilage, bone marrow and muscle) produce more blurring
than those with longer T2’s. TSE shot length is the most important
parameter to control image blurring for a given TSE profile order
and TE. TSE shot length is displayed on the Info page.
Linear halfscan PDW TSE is a clinically practical sequence.
The challenge in using linear halfscan is to control TSE shot length
when modifying other parameters. In addition, the images have
relatively low SNR. Echo spacing and TSE shot length change
when the halfscan factor, TSE factor and TE are modified.
When using TE 30 ms, keep TSE shot length <100 ms to obtain
sharp PDW images. A halfscan factor >0.65 is recommended.
In low-high TSE, raising TE increases echo spacing and TSE shot
length, thereby increasing image blurring. For a TE of 20-35 ms,
typical for PDW imaging, using start-up echoes is a way to control
echo spacing and TSE shot length. Keep TSE shot length <80 ms
to minimize image blurring. Challenges include long scan time and
the time-consuming start up echoes.
Asymmetric TSE is a new functionality that provides time-efficient
PDW imaging: high TSE factors can be used. This allows selection
of echo spacing and TE independently. The TSE shot length is easy
to control via the TSE factor and echo spacing, while TE can be
freely selected. For a TE of 30 ms, keep the TSE shot length <130
ms to acquire sharp PDW images.
Asymmetric TSE with fat suppression
Fat-suppressed (STIR or SPAIR) scans are faster when combined
with asymmetric TSE. For a specified resolution, adjusting echo
spacing controls the number of packages. When TR is set as
shortest, a long echo spacing (10-14 ms) will produce a one-
package scan. Decreasing echo spacing to 6-9 ms easily provides
a two-package scan. When using TE 30 ms, keep TSE shot length
<130 ms to obtain sharp images.
TR 2500 ms, without DRIVE.
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to view more applications tips and
download ExamCards for
orthopedic imaging.
TR 2500 ms, with DRIVE.
Asymmetric TSE. Achieva 1.5T, TE 30 ms,TR 5000 ms,
voxel size 0.41 x 0.63 x 3 mm, scan time: 3 min.
17. 17Issue 30 - December 2006 Field Strength
Linear halfscan TSE
shot length 95 ms,
scan time 3 min.
Low-high TSE
2 startup echoes, shot length
80 ms, scan time 5 min.
Achieva 1.5T,
TR 5000 ms,TE 30 ms,
echo spacing 10 ms,
voxel size 0.41 x 0.63 x 3.0 mm.
PDW TSE SPAIR
Achieva 1.5T,
TE 30 ms,
TR shortest.
Asymmetric TSE
shot length 130 ms,
scan time 3 min.
Low-high, 4:30 min.
TSE factor 8, 2 startup echoes,
shot length 80 ms,
echo spacing 10 ms,
actual TR 4900 ms,
1 package.
Asymmetric, 3:20 min.
TSE factor 12,
shot length 120 ms,
echo spacing 10 ms,
actual TR 5400 ms,
1 package.
Asymmetric, 2:20 min.
TSE factor 18,
shot length 126 ms,
echo spacing 7 ms,
actual TR 2700 ms,
2 packages.
ShortTE STIR
Achieva 1.5T,
TE 30 ms,
TR shortest,
IR 135 ms.
Low-high, 4 min.
TSE factor 8, 2 startup echoes,
shot length 80 ms,
echo spacing 10 ms,
actual TR 4900 ms,
1 package.
Asymmetric, 3 min.
TSE factor 10,
shot length 100 ms,
echo spacing 10 ms,
actual TR 4900 ms,
1 package.
Asymmetric, 2 min.
TSE factor 15,
shot length 98 ms,
echo spacing 6.5 ms,
actual TR 2400 ms,
2 packages.
Asymmetric TSE with fat suppression
18. "Achieva was chosen
because we thought it had
the most sophisticated
neuro package"
18 Field Strength Issue 30 - December 2006
Turkish medical center harnesses Achieva 3.0T
for advanced neuroradiology techniques
Yeditepe University Hospital employs multiple techniques to make interventions more precise
Just over a year sinceYeditepe University Hospital (Istanbul) became
operational, the multi-specialty medical center has built a reputation as
a world-class facility. A centerpiece atYeditepe is its thriving neurological
science institute.Yeditepe acquired the Achieva 3.0T system – only the
second whole-body 3.0T in Turkey – to provide the imaging power
needed to fully characterize brain tumors pre-surgically. Using diffusion
tensor imaging, perfusion-weighted imaging, spectroscopy, BOLD fMRI
and conventional imaging techniques,Yeditepe radiologists provide
neurosurgeons with the imaging data they need to avoid eloquent cortex.
By virtue of advanced imaging techniques,
such as MR spectroscopy, BOLD fMRI,
diffusion tensor imaging and perfusion-
weighted imaging, most brain tumors leave
very little to hide in terms of composition,
vascularity, dimensions and proximity to
sensitive cortical tissues. And these methods
are even more powerful when paired with
the 3.0T field strength, which affords
maximum signal to resolve even subtle
anatomical details.
Yeditepe neuroradiologists and neuroscience
physicians appreciated this fact, and –
realizing that neuro cases would represent
about 60 percent of the hospital’s MRI
volume – lobbied the center’s funding body,
the non-profit Iztek Foundation to invest
in a 3.0T scanner. Ultimately, the
foundation chose to partner with Philips in
equipping the entire facility with not just
an MRI system, but also top-of-the-line
multi-detector CT, PET-CT, flat panel
digital subtraction angio, nuclear medicine
systems and ultrasound units.
“The Achieva 3.0T with Quasar Dual
gradients and Ambient Experience (see
page 20) was chosen because we thought
Achieva had the most sophisticated neuro
package, including multi-nuclear
spectroscopy,” says Professor Ilhami
Kovanlikaya, M.D., chief of the
department of radiology. “Philips also
offered automatic software updates and
committed to a multi-year technical
support contract.”
Optimal tumor characterization
Every brain tumor patient referred to
Yeditepe’s department of radiology receives
an advanced brain scan, which includes
MR spectroscopy, BOLD fMRI, DTI,
perfusion-weighted imaging and
conventional sequences.
“MR spectroscopy gives us information
regarding the lesion’s metabolic
composition – whether we’re dealing with
an aggressive malignant neoplasm or a
benign mass, while perfusion-weighted
imaging can help us determine the blood
supply of the mass,” Prof. Kovanlikaya
observes. “Furthermore, BOLD fMRI is an
extremely valuable technique to assist in
understanding the mass’s relationship with
the motor strip or language areas – which
are critical to avoid during surgery.”
Diffusion tensor imaging (DTI) helps
Yeditepe radiologists appreciate the
relationship between the tumor and
white matter fiber tracts – the brain’s
communication superhighway, which also
must be avoided during surgery.
“For DTI and tractography, the PRIDE
workstation has been very useful,” he says.
“I input all the raw DTI data from the
scanner and the PRIDE software
Prof. Ilhami Kovanlikaya, M.D.
19. 19Issue 30 - December 2006 Field Strength
automatically calculates and outputs
fractional anisotropy maps and tractography
for whatever fiber region I select. It’s an
excellent program for determining the
course of white matter fibers.”
Yeditepe radiologists also use their battery
of neuro techniques in assessing the post-
T2 weighted TSE T1-weighted Aggressive brain tumor
32-year-old female with loss of sensation in left lower extremity and
increased difficulty in walking for a year was examined with Achieva
3.0T. The T2W TSE axial image shows a 3.5 cm hyperintense mass
in the right frontal lobe extending to the precentral and superior
frontal gyri.The mass has minimal enhancement on the post-contrast
T1-weighted image.The perfusion MR image reveals significantly
increased perfusion within the tumor. Multi-voxel multislice PRESS
proton MRS was also obtained from the mass.The spectral voxel
obtained from the same region of interest where pMRI measurements
were done revealed a markedly increased choline/creatine ratio.
Functional MRI, DTI fiber tractography were done for surgical planning.
The FA values measured from the tumor and contralateral normal
white matter were 0.15 and 0.47 respectively.
DTI FA map
Perfusion
Spectroscopy
BOLD fMRI right and left hand motor tasks
BOLD fMRI left lower extremity
surgical and/or post-radiation treatment
follow-up of patients, Prof. Kovanlikaya
says. “We can instantly determine the
patient’s response to treatment regimes,
and also it is much easier to differentiate,
for example, possible radiation necrosis
from recurrent tumor using these advanced
neuroimaging techniques.”
Net Forumwww.philips.com/netforum
Visit the NetForum User Community
for downloading ExamCards and
viewing application tips, clinical cases,
extended versions of Field Strength
articles, and more.
20. 20 Field Strength Issue 30 - December 2006
Philips acquires leading MRI component and
accessory maker, Intermagnetics
In June 2006, Royal Philips Electronics
announced it had signed a definitive
agreement to acquire Intermagnetics
General Corporation. Intermagnetics
develops, manufactures and markets high
field superconducting MRI magnets and is
viewed as the technological innovator in
this market. Intermagnetics also provides
specialized MRI-compatible patient
monitoring devices and RF coils.
The Intermagnetics acquisition will
strengthen Philips’ position in the
MR market, allowing the company to
significantly improve its supply chain,
enhance its competitive position and
participate in the fast-growing RF
coil market.
“Intermagnetics’s leading positions in the
markets of RF coils and MRI patient
monitoring will enable us to build unique
solutions for our customers. In the long
term, we believe MRI technology will
become important in molecular imaging,
which positions us well for the future,”
said Jouko Karvinen, member of the Philips
Board of Management and CEO of
Medical Systems.
Intermagnetics headquarters in Latham,
New York will become the global
headquarters of Philips’ enlarged Magnetic
Resonance business.
Yeditepe University Hospital officials
determined to make MR scans as patient-
friendly as possible, a key component of
which was Ambient Experience. Ambient
Experience features soothing, thematic
audio-visual surroundings in the
examination room.
It empowers patients to modify their
scanning environment – thereby giving
them a feeling of control over the diagnostic
procedure. Yeditepe’s Achieva 3.0T is the
world’s first with Ambient Experience.
“Our hospital’s board of trustees’ chairman,
Mr. Bedrettin Dalan, believes it is crucial to
provide a very supportive and friendly
hospital environment for patients and their
families,” says Prof. Ilhami Kovanlikaya.
“Patients often enter hospitals under a
certain amount of stress, so we wanted to
strengthen the patient’s ties to life while in
the hospital. Ambient Experience definitely
fulfills that requirement.”
From Prof. Kovanlikaya’s point-of-view, the
idyllic scenery and lighting and the calming
sound effects that Ambient Experience
provide not only make the patient’s
experience less intimidating, but it avoids
putting patients under stress that could
result in a substandard scan.
“When patients are relaxed, everything just
goes easier,” he says. “Plus, Ambient
Experience gives the patient the ability to
choose their favorite theme. At Yeditepe, the
Sunrise theme is most popular – you get the
visual of a rising sun and audio effects, such
as birds chirping.”
Yeditepe has first Achieva 3.0T with Ambient Experience
21. Interest and enthusiasm in the Philips 7.0T
research system remain incredibly high
among both Philips and customer groups,
if the second annual Philips 7.0T user
meeting is any indication. On June 18-20,
the Philips 7.0T community gathered in
Nottingham, U.K. for the meeting,
drawing 36 customers and prospects –
representing 10 prominent MR research
institutions – in addition to 26 Philips
participants from the USA and Europe.
The Ohio State University (OSU,
Columbus, Ohio) and the University of
Notthingham (Nottingham, U.K.) are
currently operating 7.0T scanners.
Representatives of these sites presented
their first imaging and spectroscopy results.
In fact, OSU recently received approval
from its Investigational Review Board to
conduct patient/volunteer studies, and
investigators have begun planned projects
with all due speed. At Nottingham, many
studies are already underway, as was
illustrated in presentations and hands-on
scanning sessions.
The meeting agenda consisted of lectures by
Philips staff and customers, as well as
breakout “carousel” groups, which focused
on topics such as: siting, service, IRB/ethics,
safety, hands-on 7.0T scanning, technology,
design and devices and the Philips 7.0T
development roadmap and priorities.
“Ballots” gathered from users and follow-up
discussions indicated strong interest in
further 7.0T developments, such as new
technology and more applications.
New sites look into the future
Customers from the Institute of
Biomedical Engineering (IBTZ) of the
ETH/University of Zurich, Vanderbilt
University in Nashville, TN, the University
of Texas Southwestern (UTSW), Dallas,
TX, Leiden University Medical Center
(LUMC) and University of Utrecht
(UMCU) in the Netherlands, presented
their 7.0T plans and reported on the status
of preparations. Zurich, for its part, began
clinical research involving 7.0T scanning of
human subjects just one week after the
7.0T meeting ended.
Official opening of Nottingham Centre
Participants at the 2006 Philips 7.0T MR
user meeting also stayed for the official
opening of the Sir Peter Mansfield
Magnetic Resonance Centre (SPMMRC),
which houses Nottingham’s Achieva 7.0T
and other Philips systems. At the opening
Sir Peter Mansfield spoke about his early
experiments, performed in his labs on the
Nottingham campus, which led to the
founding of MRI and the 2003 Nobel Prize
for Medicine.
News
Second Philips 7.0T research meeting
indicates steady platform development
Philips 7.0T
user meeting
participants
21Issue 30 - December 2006 Field Strength
22. Calendars
Education calendar 2007
22 Field Strength Issue 30 - December 2006
Contrast-enhanced MRA in clinical practice: a hands-on course
Maastricht,The Netherlands
Date: t.b.d.
For physicians and radiographers. Includes teaching sessions and volunteer
and patient scanning.
Info: Tim Leiner, MD PhD, leiner@rad.unimaas.nl
Fetal MR course and Congress
Vienna,Austria
Date: May 15-18, 2008
For physicians and radiographers. Includes teaching sessions and volunteer
and patient scanning.
Info: www.meduniwien.ac.at/radiodiagnostik/fetal_MRI_vienna/,
iela.prayer@meduniwien.ac.at
Hands-on Clinical fMRI Course
Leuven, Belgium
Date: t.b.d.
Teaching sessions, volunteer and patient scanning, image analysis and
interpretation, and case presentations.
Info: www.kuleuven.ac.be/radiology/Research/fMRI/
stefan.sunaert@uz.kuleuven.ac.be
CVMRI Practicum: New Techniques and Better Outcomes
St. Luke’s Episcopal Hospital, Houston,Texas
Date: July 17-21, October 9-13
On principles and practical applications of Cardiac MRI.
Info: tmatthews@sleh.com,Tel. +1-832-355-4201
Cardiac MRI Training
Washington Hospital Center,Washington DC, USA
Date: Three-month fellowship
Info: www.cvmri.com, Pamela Wilson,Tel. +1-202-877-6889
Erasmus Course on Cardiovascular MRI
Leiden,The Netherlands
Date: October 4-5
Focuses on clinical applications of cardiac MR.
Info: www.emricourse.org
MRI: Musculoskeletal Structured Fellowship
University of California at San Francisco, California, USA
Date: t.b.d.
Info: www.radiology.ucsf.edu/postgrad/visit_fell_index.shtml
nancy.mutnick@radiology.ucsf.edu,Tel. +1-415-502-2984
Cardiac MR courses at CMR Academy
3-months Complete courses level II
5-days Compact courses
1-2 days modules
German Heart Institute, Berlin, Germany
All courses are for cardiologists and radiologists. Some parts will be
offered in separate groups.
Info: www.cmr-academy.com, info@cmr-academy.com,Tel. +49-30-4502 6280
Consists of three parts per course:
German English German English
Part 1:Six-week intensive course, Jan. 10- Feb. 28- May 30- Sept. 26-
including hands-on training at the Feb. 16 Apr. 4 July 6 Nov. 2
German Heart Institute.
Part 2: Reading and partially 160 hours private study (> 250 cases).
quantifying over 250 cases.The
CMR Academy provides the cases
and the necessary hardware and
software.
Part 3: Two weeks of case Apr. 16-27 Sep. 10-21 Nov. 12-23 Dec.3-14
reviews, discussion and further
hands-on training.
CMR diagnostics in theory and German English German English
practice, including performance Jan. 15-19 Mar. 5-9 Jun. 4-8 Oct. 1-5
of examinations and case
interpretation.
(e.g. Perfusion, DSMR, Infarct Imaging, Details on www.cmr-academy.com
Heart Failure, CAI, 3.0T CMR, etc).
Breast MRI and MR-guided Interventions in Clinical Practice
University of Bonn, Bonn, Germany
Date: t.b.d.
Imaging, image interpretation and MR guided interventions, including
needle localization and biopsy.
Info: christiane.sonntag@ukb.uni-bonn.de,Tel. +49-228-287-9875
International Cardiac MR course
Leeds, England
Date: October 16-20
Deals with theoretical principles and practical applications of Cardiac MRI.
Daily practical scanning and post-processing sessions in small groups.
Info: www.leedscmr.org/cardiac_course/index.htm, Mgreen@leedscmr.org
Cardiovascular MR training courses and fellowships
St. Louis, Missouri, USA
Date: March 6-9
Lecture format (2.5 days) or lecture plus hands-on (4 days).
Also offered are hands-on technologist training courses and
three-month fellowships.
Info: cmrl.wustl.edu/education, CMRL@cvu.wustl.edu,
Tel. +1-314-454-7459
Breast MRI in the Garden State
Erasmus Course on Breast MRI, Chios, Greece
Date: July 1-6
Info: www.emricourse.org, cradrew@az.vub.ac.be
23. Events calendar 2007
23Issue 30 - December 2006 Field Strength
Jan. 2-4 Society for Cardiovascular Magnetic Resonance – SCMR Rome, Italy www.scmr.org
Jan. 29-Feb. 1 Arab Health Dubai, UAE www.arabhealthonline.com
Jan. 30-Feb. 3 International MRI Symposium Garmisch, Germany www.mr2007.org
March 9-13 European Congress of Radiology – ECR Vienna,Austria www.myecr.org
Feb. 14-18 American Academy of Orthopaedic Surgeons – AAOS San Diego, CA, USA www.aaos.org
March 1-6 Society of Interventional Radiology – SIR Seattle,WA, USA www.sirweb.org
March 24-27 American College of Cardiology – ACC New Orleans, LA, USA www.acc.org
Apr. 12-15 Jornada Paulista de Radiogia – JPR Sao Paolo, Brazil www.spr.org.br
Apr. 13-15 Japan Radiology Congress – JRC Yokohama, Japan www.j-rc.org
Apr. 14-17 Charing Cross Symposium London, UK www.cxsymposium.com
Apr. 22-24 International Medical Instruments and Equipment Exhibition – China Med Beijing, China www.chinamed.net.cn
Apr. 29-May 5 American Society of Neuroradiology – ASNR San Diego, CA, USA www.asnr.org
May 19-25 International Society for Magnetic Resonance in Medicine and European Society Berlin, Germany www.ismrm.org
for Magnetic Resonance in Medecine and Biology – ISMRM – ESMRMB
May 22-25 Paris Course on Revascularization – EuroPCR Barcelona, Spain www.europcr.com
May 16-19 Deutschen Röntgenkongress Berlin, Germany www.drg.de
May 16-19 Association for European Pediatric Cardiology – AEPC Warsaw, Poland www.aepc.org
June 10-14 Human Brain Mapping – OHBM Chicago, IL, USA www.humanbrainmapping.org
June 11-13 UK Radiological Congress – UKRC Manchester, UK www.ukrc.org.uk
MR Basics
MR Essentials for Achieva Intera, Panorama 1.0T users
MR Advanced for Achieva Intera, Panorama 1.0T users
MR Spectroscopy courses (1.5T and 3.0T)
Magnetic Resonance Spectroscopy
MR Spectroscopy application course
Zurich, Switzerland
Daily practical scanning and post-processing sessions in small groups.
Date: Spring 2007
Aimed at clinicians who will use MR spectroscopy in the clinical practice.
Focuses on how to perform, interpret, quantify, and also includes advanced
methods for use in research.
Info: www.mr.ethz.ch/courses/spectro2006/
Michele.Pauwels@philips.com
Date: Fall 2007
Aimed at clinicians who will use MR spectroscopy in the clinical practice.
Focuses on how to perform, interpret, and quantify.
Info: www.gyrotools.com
Essential Guide to Philips in MRI
Different locations, UK
Date: January 15-18, June 11-14, October 22-25
Specifically designed for Philips users, past, present and future. It is designed
to provide a modular approach to accommodate all levels of knowledge.
Info: Helen.Scargill@philips.com
North American off-site training courses
Dates upon request.
Info: kristan.harrington@philips.com,Tel. +1-440-483-2471,
Fax: +1-440-483-7946
Chattanooga,TN, USA
Designed for beginner technologists with little or no previous MR
experience. Lecture covers the basic concepts and theory of MRI.
Cleveland, OH, USA
This comprehensive course for technologists covers all basic scanning
and system functionality.
Cleveland, OH, USA
Didactic and hands-on course covering advanced applications including
advanced pulse sequences, cardiac and spectroscopy.
24. 452296218711
Achieva 1.5T & 3.0T: MR with IQ
Philips Achieva MR systems revolutionize ease of use thanks to
SmartExam, a fully automated Planning, Scanning and Processing procedure
available at a single mouse click. Not only does SmartExam know how to
make the scans, it also knows where to make them and how to post-
process them.Without being told again and again. Like the scalable
32-channel FreeWave spectrometer, SENSE parallel imaging,
advanced applications... it's truly Achieva.
www.medical.philips.com/achieva
