Mineralized tissue visualization with MRI: Practical insights and recommendations for optimized clinical applications

Area of Science:

• Radiology
• Medical Imaging
• Biomedical Engineering

Background:

• Magnetic resonance imaging (MRI) techniques for mineralized tissues (MT-MRI) are emerging for musculoskeletal imaging.
• MT-MRI aims to combine MRI's soft tissue detail and radiation-free nature with computed tomography (CT)-like contrast for bone visualization.

Purpose of the Study:

• To provide a comprehensive review of commonly used MT-MRI techniques.
• To categorize MT-MRI methods by technical principles and clinical utility.
• To discuss the advantages, limitations, and artifacts of each MT-MRI approach.

Main Methods:

• Review of various MT-MRI techniques including 3D gradient-echo, ultra-short/zero-echo time, susceptibility-weighted imaging, and AI-generated synthetic CT.
• Categorization based on technical principles and clinical applications.
• Discussion of performance in bone morphology, fracture detection, arthropathy, and calcification evaluation.

Main Results:

• Different MT-MRI techniques possess unique strengths and weaknesses.
• Current MT-MRI methods face limitations in spatial resolution compared to CT for subtle bone abnormalities and calcifications.
• Susceptibility effects, SNR, and motion artifacts can impact diagnostic accuracy.

Conclusions:

• MT-MRI shows promise for musculoskeletal imaging but requires further development to match CT's resolution for specific applications.
• Artificial intelligence and hardware advancements like ultrahigh-field MRI are expected to enhance MT-MRI capabilities.