MR imaging near metallic implants using MAVRIC SL: initial clinical experience at 3T

Area of Science:

• Radiology and Medical Imaging
• Biomedical Engineering
• Materials Science in Medicine

Background:

• Metallic implants in patients pose significant challenges for Magnetic Resonance (MR) imaging due to artifact generation.
• Conventional 2D fast spin-echo (2D-FSE) techniques often struggle to provide clear images around metallic implants at 3T.
• Artifacts can obscure critical anatomical details, hindering accurate diagnosis and treatment planning.

Purpose of the Study:

• To compare the effectiveness of multi-acquisition with variable resonance image combination selective (MAVRIC SL) against conventional 2D-FSE MR techniques.
• To evaluate the performance of MAVRIC SL in imaging patients with various metallic implants at 3T.
• To assess the impact of MAVRIC SL on image quality and patient management.

Main Methods:

• Twenty-one 3T MR studies were performed on 19 patients with diverse metallic implants.
• Paired MAVRIC SL and 2D-FSE sequences were analyzed by two radiologists.
• Image quality metrics including artifact size, bone-implant interface visualization, soft tissue depiction, blurring, and overall quality were assessed using Wilcoxon signed rank tests.

Main Results:

• MAVRIC SL demonstrated significantly reduced in-plane and through-plane artifact compared to 2D-FSE (P = .0001).
• Improved visualization of the bone-implant interface and surrounding soft tissues was observed with MAVRIC SL.
• While MAVRIC SL showed increased blurring (P = .0016), it led to significant changes in patient management, including surgical decisions for 18 patients.

Conclusions:

• MAVRIC SL at 3T significantly enhances image quality and reduces artifact around metallic implants compared to 2D-FSE.
• The improved imaging clarity provided by MAVRIC SL directly influences clinical decision-making and patient management.
• MAVRIC SL represents a valuable advancement for MR imaging in patients with metallic implants.