Research-Dedicated Magnetic Resonance Imaging at McGuire VA Medical Center

项目摘要/摘要 磁共振成像(MRI)的进展在医学领域已经变得令人惊讶，使得 对许多器官的结构和组织特征以及某些器官的功能特征的评估。因此， MRI已成为临床和研究使用的关键工具，包括神经学， 神经外科、精神病学、肿瘤学、疼痛管理、康复和心脏病学等等。 目前用于McGuire VAMC研究的MRI扫描仪的可用性有限 将核磁共振扫描外包给其他机构，并进一步批准研究人员的IRB，此外 限制患者登记，增加退伍军人的等待时间、后勤和旅行负担 参与研究。此外，缺乏核磁共振扫描仪限制了与其他公司的合作 多个领域的机构和临床研究联盟，包括创伤性脑损伤(TBI)、脊柱 脊髓损伤(SCI)、创伤后应激障碍、阿尔茨海默氏症和帕金森氏症、多发性硬化症、肝脏和心脏疾病。 我们请求资金购买3Tesla磁共振成像(3T-MRI)，旨在提供 多功能性，以满足临床研究中日益增长的需求。它目前的功能提供了一个全面的 具有独特功能的应用程序组合，以及简短而开放的外观，以减少患者焦虑和 幽闭恐怖症。该设备将拥有多个先进的临床和科学套件，用于研究应用 在组织定征、扩散张量成像(DTI)和功能磁共振成像(FMRI)等多个学科中得到广泛应用。 所要求的3T-MRI将为我们的所有9个主要和6个主要网站提供所有必需的MRI功能 次要用户。这将使Fuchs和Pandak博士能够进行所需的磁共振小肠造影术 (MRE)和肝脏脂肪含量；Hundley博士和Huizar博士完成并扩大他们在心力衰竭和 与异位搏动、新冠肺炎心肌损伤、心脏毒性和核磁共振运动相关的心肌病 化疗后测试；沃克博士(LIMIBIC财团)和麦克唐纳博士(MIRECC和Enigma-PTSD 财团)使用DTI和fMRI进行高级MRI，以研究创伤性脑损伤和创伤后应激障碍；Gorgey博士评估身体 脊髓损伤患者DTI的组成、束对经脊髓/硬膜外刺激的适应性和运动； 比约克用功能磁共振研究精神健康、抑郁和药物滥用；吉切尔博士扩大了他目前的研究范围 帕金森氏病研究(PADRECC)。 作为第三转诊中心，McGuire VAMC在临床护理方面有着卓越的传统，目前有3个 最先进的扫描仪，主要用于临床。因此，安装、维护和 保持3T核磁共振扫描仪已就位。同样，McGuire VAMC有着悠久的基本和 至少30年的临床研究资金，支持多种研究方案和研究人员。 这项申请得到了我们所有退伍军人管理局官员的全力支持，包括医疗中心主任、 参谋长，生物工程，研究部和放射科主任，提供完整的基础设施，物理 空间、人力资源和财政承诺，以安装、维护和维持这一设备。一个详细的 具有补缴费用结构的维持计划和具有监督机制和冲突的组织计划 已经制定了解决办法，以确保其合理使用并避免冲突。因此，一种专门用于研究的核磁共振扫描仪 可行，并将解决我们目前的限制，并允许McGuire VAMC和其他 邻近机构在各自的机构中增加全面的结构和功能评估 使用最先进的核磁共振技术的学科。这个新的核磁共振基础设施，如果获得资金，很可能会发生变化 McGuire VAMC多个专科的研究轨迹可能会吸引医生 科学家和研究人员加入我们的VAMC。最重要的是，它将为多家公司带来新的机遇 调查人员参与/合作国家和国际研究研究和财团。

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.