Realising the potential of open MRI for dynamic studies of human anatomy and function

Lead Research Organisation: University of Nottingham
Department Name: Sch of Physics & Astronomy

Abstract

We use Magnetic Resonance Imaging (MRI) as a powerful, non-invasive technique for the study of human anatomy, function and physiology, for instance to investigate how different treatments work and affect different people (experimental medicine and personalised medicine).

Unfortunately standard cylindrical-bore MRI scanners force people to lie in a confined, supine position, which has several unfortunate consequences. Most importantly for the work we are focusing on here, gravity and posture have significant effects on the human body, and so forcing people to lie down can confound physiological studies. However beyond this, some patients simply cannot lie flat (for instance those with Chronic Obstructive Pulmonary Disease -COPD). Furthermore, many patients find the conventional MRI scanners claustrophobic and children often need to be sedated to stop them moving during MRI scanning.

We now have the chance to overcome these problems, since a recent major advance in magnet technology has allowed the development of new 'open MRI' systems, allowing people to sit, stand or lie down during scanning. The capabilities of the open scanners are currently limited because they cannot provide the ideal magnetic fields required for traditional MRI. However, in parallel, a revolution is occurring in MRI data acquisition and reconstruction, which can overcome the effects of these imperfect magnetic fields.

We will combine these two major innovations in MRI, to provide a paradigm shift in open MRI, allowing us to acquire both structural and functional biomedical information in dynamic, naturalistic body positions.

In this project we will focus on developing new technologies that will allow us to exploit the full capabilities of open MRI. We will design new RF coils that we use to collect the signal during MRI, we will develop a method to monitor the unintended variations in the magnetic fields that occur in the open scanner, and we will develop methods of collecting and reconstructing the imaging data to allow us to take account of these variations in field, and also subject motion.

Our goal is to acquire images at high speed to allow us to monitor the function of the body in seated or standing positions, for instance fast enough to observe the movement of the gastrointestinal tract, or to allow people to breath freely whilst we image their lungs.

We will develop generic solutions to address the challenges of open MRI, and then use them to produce tailored imaging approaches to address a series of specific biomedical questions that have been chosen as they need the advantages of open MRI. Specifically we will design solutions to study the following conditions:
- Acute Respiratory Distress Syndrome for instance after viral infection including COVID19: it is particularly difficult for some respiratory patients to lie flat.
- Gastroparesis: this is a debilitating condition which prevents normal stomach emptying, but gastric emptying can be changed by lying down.
- Painful knee osteoarthritis: the knee is best studied in a standing position, but rapid scanning is required since weight-bearing can be painful for these patients.

Publications

10 25 50
 
Description We have developed
-methods of imaging lung function and shown it changes between being upside down and the right way up.
-hardware and a new protocol for studying defecography in open MRI
-hardware and a new protocol for studying pelvimetry with open MRI
-protocols for studying upright spine
-hardware and a new protocol for studying the displacement of body organs in different positions
- methods of studying GI function in the physiologically relevant upright position using open MRI
-methods of studying children's brains in open MRI to reduce stress
We have characterised and corrected movement in Open MRI, and have accelerated imaging in the low spec Open MRI scanner.
Exploitation Route Several clinical studies being developed
Sectors Healthcare

Manufacturing

including Industrial Biotechology

Pharmaceuticals and Medical Biotechnology

 
Description Open MRI and whole body physiology is very amenable to outreach. We are undertaking work which will impact on safety guidelines.
First Year Of Impact 2023
Sector Healthcare,Manufacturing, including Industrial Biotechology
Impact Types Societal

 
Description FMHS pump priming 'Accelerator' grant Marciani and Simpson
Amount £4,900 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 04/2023 
End 05/2024
 
Description Open Magnet T2 Weighted Defaecating Proctography for Evaluation of Defaecatory disorders - a feasibility study
Amount £10,000 (GBP)
Funding ID 47/185334/CPKILV 
Organisation Nottingham University Hospitals NHS Trust 
Sector Academic/University
Country United Kingdom
Start 08/2023 
End 09/2024
 
Title Novel method for field monitoring 
Description NMR based field probe to correct field variations in open MRI 
Type Of Material Improvements to research infrastructure 
Year Produced 2022 
Provided To Others? No  
Impact Prototype exists. Abstract has been submitted to a meeting this year. 
 
Title Optical motion monitoring in open MRI 
Description This involves the repurposing of existing technology in a novel and more challenging environment of an open MRI scanner 
Type Of Material Improvements to research infrastructure 
Year Produced 2022 
Provided To Others? No  
Impact Initial system exists but is still being optimized 
 
Title Optimizing under sampling in MRI 
Description Undersampling optimized using bespoke image quality metrics and a library of MRI images 
Type Of Material Improvements to research infrastructure 
Year Produced 2021 
Provided To Others? Yes  
Impact It is being applied on the Paramed scanner 
 
Title Respiratory triggering for open MRI 
Description This is based on signal from optical camera and involves detailed analysis of optical data 
Type Of Material Improvements to research infrastructure 
Year Produced 2024 
Provided To Others? Yes  
Impact Wider user base for Open MRI 
 
Description Basic human morphology 
Organisation Ministry of Defence (MOD)
Country United Kingdom 
Sector Public 
PI Contribution We are in the process of establishing significant contract to fund this work
Collaborator Contribution So far they have motivated the reserach
Impact Ongoing
Start Year 2022
 
Description FIZZ : gas producing fizzy drinks in the stomach and small bowel) 
Organisation University of Nottingham
Department School of Biosciences
Country United Kingdom 
Sector Academic/University 
PI Contribution Expertise in GI imaging and GI function
Collaborator Contribution Expertise in food science and bioscience
Impact Multidisciplinary between biosciences and physics Work ongoing
Start Year 2023
 
Description Geoff Parker UCL 
Organisation University College London
Country United Kingdom 
Sector Academic/University 
PI Contribution Low echo time MRI
Collaborator Contribution Expertise in lung imaging
Impact An abstract was submitted to ISMRM but (probably due to an error in submission) it was rejected. Ethics written for future work
Start Year 2020
 
Description Hyperpolarized MRI for open MRI 
Organisation University of Nottingham
Country United Kingdom 
Sector Academic/University 
PI Contribution OM provided expertise on scanner hardware and software to add additional x-nuclear channel to scanner
Collaborator Contribution Meersman team (from Medical School) provided and RF coil and expertise on hyperpolarized MRI and additional expertise on NMR hardware
Impact Multidisciplinary: physics, medicine, engineering
Start Year 2023
 
Description Leo Cancer Centre 
Organisation Leo Cancer Care
Country United Kingdom 
Sector Private 
PI Contribution We are developing methods to image people upright as if prior to radiotherapy to identify how organs move relative to external landmarks
Collaborator Contribution They have brought expertise on radiotherapy and posed the problem to us.
Impact Development of imaging sequences that can be used for imaging in this problem. Protocol for ongoing scanning We are about to start a study for them
Start Year 2022
 
Description Spine imaging with Oxford 
Organisation University of Oxford
Department Oxford Hub
Country United Kingdom 
Sector Academic/University 
PI Contribution Developed concept and produced upright MRI scans in healthy people and people with scoliosis. With the input from Oxford, we aim to optimise the Scoliosis scans for (semi-)automatic analysis. With the upright open scanner, we aim to investigate the effect of different postures and load-bearing on spine morphology in Scoliosis. We hope this will provide crucial information for surgical planning and decrease the cumulative amount of ionizing radiation patients are typically exposed due to conventional CT and X-ray-based pre-surgical scans.
Collaborator Contribution The Oxford team consists of Spine Surgeon Professor Jeremy Fairbank, researcher Dr. Amir Jamaludin, and PhD Student Emmaneulle Bourigault. The Oxford team has established a pipeline (SpineNet) for automatic grading and assessment of spine disorders. We are looking into utilising or modifying their pipelines for analysing Scoliosis data collected with Upright 0.5T scanner at Nottingham.
Impact We are collaborating with University of Oxford Visual Geometry Group (Spine) for our Scoliosis study. The Oxford team consists of Spine Surgeon Professor Jeremy Fairbank, researcher Dr. Amir Jamaludin, and PhD Student Emmaneulle Bourigault. The Oxford team has established a pipeline (SpineNet) for automatic grading and assessment of spine disorders. We are looking into utilising or modifying their pipelines for analysing Scoliosis data collected with Upright 0.5T scanner at Nottingham.
Start Year 2023
 
Title Heads up 
Description Heads_Up - comparing upright open Magnetic Resonance Imaging (MRI) to conventional closed MRI for brain imaging in children -a pilot study Carolyn Costigan UKIO (United Kingdom Imaging Congress) 2023 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Refinement. Clinical
Year Development Stage Completed 2024
Development Status Actively seeking support
Impact Improving the patient experience for paediatrics in MRI through Play Therapy ISMRM 2023 Charlotte Swain Carolyn Costigan Selene Rowe 
 
Title MR Proctography in Open MRI 
Description New RF coil built in house. Imaging protocol established and tested in healthy controls. 
Type Diagnostic Tool - Imaging
Current Stage Of Development Initial development
Year Development Stage Completed 2023
Development Status Actively seeking support
Impact Investigating the Feasibility of Upright 0.5T MR Defaecating Proctography: initial results reveal potential for clinical assessments. ISMRM 2024 Annual Meeting. First Author: Dr. Rashed Sobhan. 
 
Title New approach for lung imaging 
Description Proton functional imaging of the lung in the upright position. Significant work done to show this is physiologically relevant in healthy subjects 
Type Diagnostic Tool - Imaging
Current Stage Of Development Refinement. Non-clinical
Year Development Stage Completed 2023
Development Status Actively seeking support
Impact New discoveries about effects of gravity on healthy lung physiology ISMRM abstract: Quantitative Lung T1 and T2* Mapping with Upright 0.5T MR: investigating the effect of gravity on lung regions under low-field strength. ISMRM 2024 Annual Meeting. First Author: Dr. Rashed Sobhan. 
 
Title Upright spine imaging including automatic segmentation particularly for scoliosis 
Description Development of upright imaging specifically for scoliosis 
Type Diagnostic Tool - Imaging
Current Stage Of Development Initial development
Year Development Stage Completed 2023
Development Status Actively seeking support
Impact This is at early development stage but imaging is finalized and analysis is working 
URL https://github.com/LauraBortolotti/RespGating
 
Description Medical Physics Day in NUAST 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Location: (Nottingham University Academy for Science and Technology) NUAST - https://nuast.org.uk/
When: 6th dec 2023
How many classes:
9-10, Y12 (16 & 17 year olds) around 22 students
10-11, Y11 (15 & 16 year olds) around 28 students (parallel session)
11.20-12.20, Y13 (17 & 18 year olds) around 12 students
12.20-13.20, Y12 (different students) around 44 students (parallel session)
14.00-15.00, Y13 (different students) around 24 students


Students at NUAST have the pleasure to attend a session on medical physics held by Prof. Penny Gowland and Dr. Laura Bortolotti on the 6th December. The 1-h session was planned to be 30 minute lecture on the "begin of Magnetic Resonance Image (MRI) and actual development in Nottingham" delivered by Prof. Gowland. Then, students had the choice to challenge themselves doing some activities. 5 activities were set on tables, students in group had 1 minute to working out the solution. Then, all together we gathered around each table and discuss on the scientific part of the activities. They were welcomed by being given a leaflet containing key points on MRI (definition, field strength from brain wave, passing through Earth magnetic field, to powerful MRI scanner) and 2 QR codes.
One activity was to match the light waves with the instrument uses (Figure). This allows to talk about interaction between water molecule and different light wavelength - don't put your hand in a microwave!!- and energy and the various medical physicist career as well. This has been used than to recap how the MR signal is formed.
They have a 3D foam model of a full body scan MRI to build, concession of Dr. Rebecca Dewey. This allowed to discuss how signal is collected - I have the sound of the machine recorded in my smartphone to play.
They have another three "matching" game that involves to pair the MR image of fruits, veggie and body with fruits, veg and organs names. This allow to see that is the water molecule that is often target and that "non-animated" object are easier to picture that moving organs..but also that a 3D object is virtually "sliced" using MRI! Different images were acquired ad different field strength, and so we discuss of the role of the field strength on obtaining good quality images. Also, one non-water-based image was in to show that different molecule could be seen and so (e.g.) ATP metabolism could be study - not only the anatomy but also the function. One image showed the brain veins and as expected, these were recognised as neurons instead. So, this provides me a link to talk about functional MRI, EEG and MEG.
If succeed, they will receive a "MRI champion" sticker whose reports the MRI picture of a star fruit, all happy about that!
The session closed with a question: "Do you think that the MRI scanner will make you levitate? ". Most of the students says yes - so I pointed out the QR code on the back of the leaflet has the link to the Ignobel prize on "levitating frog" to point out that 16 T were needed for a 60 g frog - so, there is no way for human to happen in the MRI scanner! The one in the front was used at the beginning as it reports the Nobel prize in Medicine for the discover of MRI. So, I suggest to them to have a look later at home to those!
Year(s) Of Engagement Activity 2023
URL https://nuast.org.uk/
 
Description Volunteering with a UK charity called MyBigCareer 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact Encouraging school pupils to consider science and engineering career paths
Year(s) Of Engagement Activity 2021,2022
URL https://www.mybigcareer.org/volunteering/being-a-volunteer/
 
Description Wollaton Park Festival of Science 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Festival of Science and curiosity:
Medical Imaging have been showcased at the Festival of Science and Curiosity between 10th and 14th February 2024 (https://twitter.com/UoN_Physics/status/1756628468152869335 ).
On the front, MRI-model and props were on display alongside with a mocap of the OPM-MEG helmet. Spiderman action figure was lying down in the MRI was catching most of the attention from kids! MRI technique and purpose for general health was widely discussing with the public including the advantages of the upright geometry.
Year(s) Of Engagement Activity 2024
URL https://wollatonhall.org.uk/festival-of-science-and-curiosity/
 
Description You tube videos 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Youtube videos on Open MRI and Physics

https://www.youtube.com/watch?v=Hd077Up3isE
https://www.youtube.com/watch?v=kfl6jEmHoNI
Year(s) Of Engagement Activity 2021,2022
URL https://www.youtube.com/watch?v=Hd077Up3isE