Development of clinically translatable MRI methodologies for the thoracic spinal cord

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PROJECT SUMMARY Magnetic resonance imaging (MRI) is critical to diagnosing pathology of the human spinal cord for a wide array of diseases, conditions, and trauma. The thoracic region of the spinal cord, corresponding to vertebral levels T1-T12, is frequently involved in conditions such as cord ischemia, dural arteriovenous fistulas, and hemangioblastoma as well as inflammatory diseases such as multiple sclerosis (MS). There is a clear need for high quality, nondegraded MRI of the thoracic cord to support diagnosis and treatment planning in the clinical setting as well as to provide comprehensive evaluation of the spinal cord in translational research studies. Unfortunately, MRI methods development for this anatomy significantly lags that for the brain and cervical spinal cord. The thoracic spinal cord is especially challenging to image because, in addition to small size, physiological motion, and low intra-cord tissue contrast between gray and white matter, this region is directly adjacent to the lungs and diaphragm and suffers the most from respiration artifacts relative to the cervical and lumbar regions. Respiration artifacts are caused by the physical motion of the lungs and diaphragm as well as the temporally varying B0 field homogeneity. Conventional, clinical MRI techniques for the thoracic spinal cord are often degraded by these artifacts which can necessitate re-acquisition (lengthening scan duration) or canceling studies, which can negatively impact clinical management. The overarching goal of this project is to systematically optimize anatomical and diffusion MRI sequences for the thoracic spinal cord that employ clinically translatable techniques to mitigate these technical hurdles with specific attention to motion and respiration artifacts. This goal will be addressed in two aims: Aim 1) Optimize clinically relevant anatomical MRI sequences for the thoracic spinal cord at 3T and Aim 2) Optimize diffusion MRI sequences for the thoracic spinal cord at 3T. Completion of these aims will provide a clinically feasible protocol for improved anatomical and diffusion MRI that addresses an important gap in current spinal cord MRI coverage. Furthermore, this study will generate preliminary data and set the stage for future translational research studies that will implement comprehensive spinal cord imaging to improve our understanding of spinal cord pathologies in patient populations.