What’s more, they shared their views on how healthcare professionals, academia, governments, and industry can work together to foster innovation. QIBA Dynamic Contrast-Enhanced (DCE) MRI Biomarker Committee (BC) Meeting Monday, January 23, 2023, at 11 a.m. Looking ahead to the future of radiology, the panelists offered their perspectives on the potential role of artificial intelligence (AI) technology in helping to address the rising cost of healthcare spending. The group also reviewed topics such as patient safety, greater utilization of MRI contrast, and engaging with a patient population that’s increasingly educated about these contrast agents. "We need to design a system that is economically viable and, at the same time, guarantees security for our customers and, in particular, our patients.” “We need to think about redundancies in the supply chain,” said Fulvio Renoldi Bracco, vice-chairman & CEO of Bracco Imaging. They also assessed topics such as patient safety, greater utilization of MRI contrast, and how to deal with a patient population that’s increasingly educated about these contrast agents. “Implementing such tools into the routine clinical work flow will help to make the use of contrast agent dispensable in routine follow-up imaging of MS patients.Present and Future of MRI Contrast: A Roundtable Discussion Straight from RSNAĭecem- Although shortages in CT contrast agents may have generated more headlines in 2022, a recent radiologists survey conducted by Bracco found that nearly 25% of respondents have also experienced supply issues with the gadolinium-based contrast agents (GBCAs) used in MRI over the past few years.ĭuring a roundtable discussion sponsored by Bracco and moderated by at RSNA 2022, academic luminaries and Bracco executives shared the survey results and discussed steps that could be taken to solidify the supply of GBCAs for use in MRI, now and in the future. “Several vendors have made tools for generating subtraction images commercially available,” he said. This combination of 3-D sequences and subtraction techniques is key to improving sensitivity for detecting newly occurred lesions, Dr. The approach combines 3-D MRI and subtraction techniques, which cancel out unchanged areas in the follow-up image, substantially improving visualization of new or enlarging white matter lesions. Wiestler credited an image subtraction pipeline developed and researched at his facility for the powerful sensitivity of the non-contrast MRI in detecting newly occurring lesions. “Importantly, we did not miss disease activity in the non-enhanced scans in a single follow-up scan.”ĭr. “In over 500 follow-up scans, we missed only four of 1,992 new or enlarged lesions,” Dr. Contrast agents used in MR imaging are gadolinium-based, non-nephrotoxic and are safe and effective for diagnostic applications. With 3T MRI, the assessment of interval progression did not differ significantly between the contrast-enhanced and non-enhanced images. There were a total of 1,992 new or enlarged lesions. Of 507 follow-up scans, 264 showed interval progression, defined by as at least one new or unequivocally enlarged lesion on follow-up MRI scans. Wiestler and colleagues used MRI to assess new or enlarged lesions in 359 patients with MS. “These factors warrant evaluation of strategies for reducing or omitting contrast agent, especially in MS patients who often accumulate a high number of MRI scans over their lifetimes,” said study senior author Benedikt Wiestler, M.D., from the Technische Universität München in Munich, Germany.Īdvances in non-contrast MRI image acquisition and post-processing technology, along with the increasing availability of powerful 3T MRI machines, have raised the possibility that non-enhanced scans could have a role in MS follow-up imaging. There is also evidence that some of the metal remains in the body after contrast administration, although the long-term clinical impact of these deposits is unclear. Gadolinium, a heavy metal, enhances the images and helps provide important diagnostic information, but it leads to both prolonged scan times and increased costs. MRI with the administration of gadolinium-based contrast material is widely considered obligatory for follow-up scans of patients with MS.
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