A case of Multiple Sclerosis. Comparison of a (A) standard MRI and (B) MASDIR MRI image. No abnormality is seen on the standard MRI. A focal lesion is seen on the MASDIR image (long arrow) and other abnormalities are seen in the corticospinal tracts (short arrows) as well as elsewhere in the white matter. 80% or more of the white matter is abnormal on the MASDIR image. The only normal white matter appears black. High signal “etched” lines are also seen (arrowhead). These precisely define the boundaries between white matter and cortical grey matter. These boundaries are poorly seen on the standard MRI.
The telescope that Galileo used for astronomy in 1609 had an optical magnification of 8-9X. He saw craters on the moon, separate stars in the Milky Way and four of Jupiter’s moons, all for the first time. Since then we have achieved an amplification of image contrast of 5-15X on the human brain, opening a world of possibilities.
A new journal paper headed by Kiwi imaging pioneer UCSD Emeritus Professor Graeme Bydder and involving Dr Samantha Holdsworth (Associate Professor at FMHS and Principal Investigator at CBR, Mātai and others) presents a mathematical framework that changes the way clinicians can understand MR image contrast. This has the potential to transform the way neuro-inflammatory diseases of the brain and other conditions are imaged.
The proposed framework explains the dark/light image contrast seen on MRI images and makes it possible to design MRI techniques that will detect very subtle abnormalities. While there are always new MRI techniques being discussed in the literature, most depend on state-of-the-art hardware and software only available at top research institutions. However, the concepts in this paper can instead be applied to images that can be obtained on regular clinical scanners.
There is increasing evidence that neuro-inflammation could be a major contributor to a wide range of diseases in the nervous system, including Mulitple Sclerosis, Traumatic Brain Injury, Myalgic Encephalitis/Chronic Fatigue Syndrome, long COVID, Alzheimer’s disease, and Parkinson’s disease. These diseases are likely to be much more conspicuous with the techniques explored in this paper.
It is also hoped that the techniques will be useful in other parts of the body. For example, Mātai plans to see if the framework can increase the sensitivity of MRI to prostate cancer.
These ‘MASDIR’ pulse sequence techniques (which Multiply, Add, Subtract and/or Divide existing Inversion Recovery clinical images acquired by inputting certain settings) improve tissue contrast by 5-15 times compared to the current “gold standard” techniques. This makes subtle changes due to disease far easier to see. These techniques have shown a dramatical improvement when used in relation to Multiple Sclerosis, the archetypal neuro-inflammatory disease.