Research-Dedicated Magnetic Resonance Imaging at McGuire VA Medical Center

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PROJECT SUMMARY / ABSTRACT Advances in Magnetic Resonance Imaging (MRI) have become astonishing in the medical field, allowing the assessment of structural and tissue characterization of many organs and functional features of some. Thus, MRI has become a critical tool for clinical and research use in multiple disciplines including neurology, neurosurgery, psychiatry, oncology, pain management, rehabilitation, and cardiology to mention few. The limited availability of the current MRI scanners for research at the McGuire VAMC frequently results in outsourcing MRI scans to other institutions and further IRB approval for researchers, besides limiting patient enrollment and adding wait times, logistical and travel burden to our Veterans participating in research. Furthermore, the lack of an MRI scanner limits collaborations with other institutions and clinical research consortiums in multiple areas including traumatic brain injury (TBI), spinal cord injury (SCI), PTSD, Alzheimer’s and Parkinson’s disease, multiple sclerosis, liver and cardiac disease. We request the funds to acquire a 3 Tesla Magnetic Resonance Imaging (3T-MRI) designed to provide versatility to meet the increasing demands in clinical research. Its current features offer a comprehensive application portfolio with unique functions, as well as a short and open appearance to reduce patient anxiety and claustrophobia. The equipment will have multiple advanced clinical and scientific suites for research applications in multiple disciplines such as tissue characterization, Diffusion Tensor Imaging (DTI) and functional MRI (fMRI). The requested 3T-MRI will provide accessibility of all required MRI features to all our 9 major and 6 minor users. This will allow Drs. Fuchs and Pandak to perform required magnetic resonance enterography (MRE) and liver fat content; Drs. Hundley and Huizar to complete and expand their studies in heart failure and cardiomyopathy associated with ectopic beats, myocardial injury in COVID-19, cardiotoxicity, and MRI exercise testing after chemotherapy; Dr Walker (LIMIBIC consortium) and Dr. McDonald (MIRECC and ENIGMA-PTSD consortium) to perform advanced MRI with DTI and fMRI to study TBI and PTSD; Dr. Gorgey to assess body composition, adaptation of tracts to trans-spinal / epidural stimulation and exercise using DTI in SCI patients; Dr. Bjork to study mental health, depression, and substance abuse with fMRI; and Dr. Gitchel to expand his current efforts with Parkinson’s disease research (PADRECC). The McGuire VAMC has a tradition for excellence in clinical care as a tertiary referral center with 3 current state-of-the-art scanners, primarily for clinical use. Thus, the infrastructure and expertise to install, maintain and sustain the 3T MRI scanner are in place. Similarly, the McGuire VAMC has had a long tradition of basic and clinical research funding for at least 30 years supporting multiple research protocols and investigators. This application is fully supported by all our VA officials including the Medical Center Director, Chief of Staff, Chief of Bioengineering, Research Department and Radiology, providing the full infrastructure, physical space, human resources and financial commitment to install, maintain and sustain this equipment. An detailed sustainment plan with a back-fee structure and an organizational plan with an oversight mechanism and conflict resolution is in place to assure its fair use and avoid conflicts. Thus, a research-dedicated MRI scanner is feasible and will address our current limitations and allow all investigators within McGuire VAMC and other neighboring institutions to add comprehensive structural and functional assessment in their respective disciplines using state-of-the-art MRI technology. This new MRI infrastructure, if funded, is likely to change the research trajectory for multiple specialties at the McGuire VAMC and likely will attract physician scientists and researchers to join our VAMC. Most importantly, it will open new opportunities for multiple investigators to participate / collaborate in national and international research studies and consortiums.