Comprehensive MRI near Total Joint Replacements

描述（由申请人提供）：该项目旨在通过减少金属附近的严重图像伪影，同时提供高效的患者特定扫描，可以在临床可行的扫描时间内检测植入物附近的骨丢失、感染和温度变化，为接受全关节置换术的受试者提供常规MRI。相关性：全关节置换术是最成功的骨科手术之一，每年在美国约有100万患者（预计到2030年将翻一番）用于减轻关节疾病引起的疼痛。然而，约10%的关节置换术在5-10年内由于骨丢失（骨质溶解）、感染或其他并发症而失败，通常导致翻修手术。对并发症的准确、早期非侵入性评估仍然有限，但可以提供更早、侵入性更小的治疗，减少不必要的手术，或允许更好的手术计划。方法：我们之前开发了新的MRI技术，可以可视化金属植入物附近的病理，并与其他小组一起成功地将其应用于植入器械（包括关节置换和脊柱固定硬件）的患者的成像。然而，这些方法仍然缓慢，具有有限的空间分辨率，并且难以常规使用。因此，我们的目标是（1）提供患者特异性扫描，提高不同类型植入物的成像效率，（2）通过高级采样和图像重建进一步加速扫描，（3）在MRI期间提供植入物附近的无创温度测量，以及（4）在全关节置换患者中验证3 T下的所有方法，以测量成像改善，并评估诊断准确性和我们的新方法的作用。翻修手术前患者评价中的MRI方法。总结：我们的目标是为关节置换患者提供全面的MRI技术，其扫描时间和分辨率与传统MRI相当，但可完全纠正图像伪影。这些技术将允许常规的、非侵入性的评估，以便更早、更准确地检测和治疗这些患者的并发症，以及MRI在金属植入物附近的许多其他应用。

DESCRIPTION (provided by applicant): This project aims to provide routine MRI of subjects with total joint replacements by reducing the severe image artifacts near metal, while offering highly efficient patient-specific scans that can detect bone loss, infection, and temparature changes near the implant in clinically feasible scan times. Relevance: Total joint replacements are one of the most successful orthopedic procedures, used annually to reduce pain from joint diseases in about one million patients in the United States (a number projected to double by 2030). However, about 10% of joint replacements fail in 5-10 years due to bone loss (osteolysis), infection, or other complications, often leading to revision surgery. Accurate, early non-invasive assessment of complications remains limited, but would offer earlier and less invasive treatments, reduce unnecessary surgery, or allow better surgical planning. Approach: We have previously developed novel MRI techniques that allow visualization of pathology adjacent to metallic implants, and together with other groups have successfully applied them to imaging of patients with devices including joint replacements and spinal fixation hardware. However these methods remain slow, have limited spatial resolution, and are challenging to use routinely. Therefore our aims are (1) to provide patient- specific scans that increase imaging efficiency for different types of implant, (2) to further accelerate scans with advanced sampling and image reconstruction, (3) to offer non-invasive temperature measurement near implants during MRI and (4) to validate all methods at 3T in patients with total joint replacements to measure imaging improvements as well as to assess diagnostic accuracy and the role of our new MRI methods in patient evaluation prior to revision surgery. Summary: We aim to offer comprehensive MRI techniques for patients with joint replacements with compa- rable scan times and resolution to conventional MRI, but with complete correction of image artifacts. These techniques will allow routine, non-invasive evaluation for earlier and more accurate detection and treatment of complications in these patients, as well as numerous other applications of MRI near metal implants.