Ten years ago, MedUni Vienna and Vienna General Hospital opted for 7-Tesla Ultra-High-Field MRI scanning, thereby having a decisive impact on clinical development. These 10 years will be celebrated with an Anniversary Symposium in Van Swieten Hall on 4 December (9:00 – 16:00 hrs.). Today 7-Tesla is becoming increasingly important in therapy monitoring, as the endpoint of clinical trials, as it were – that’s something quite new, points out Siegfried Trattnig, Medical Director of the Center of Excellence for High-Field MRI in Vienna: "Over the years, we have shown that, thanks to its very high spatial and spectral resolution, 7-Tesla provides detailed images of human anatomy, can accurately reveal metabolic processes in the brain, for example, and also help in the visualisation of neurological diseases, such as epilepsy or multiple sclerosis."
Because of the combination of better signal-to-noise ratio, greater tissue contrast and higher spatial resolution, 7-Tesla makes it possible to see things that could not be seen with 3-Tesla. Says Trattnig: "A good example of this is the scanning of epilepsy patients, where it is better at identifying brain areas that trigger epilepsy, because, in the case of epilepsy, every lesion counts."
People with multiple sclerosis also benefit from 7-Tesla results, because it is easier to see plaques in the grey brain matter that correlate with clinical findings. During the course of long-term check-ups, it was found that MS plaques that have an iron ring are slow-growing lesions indicating progressive MS – in this case, a 7-Tesla scan is the only imaging technique for evaluating the efficacy of newly developed drugs to combat chronically progressive MS.
Clinical sodium imaging – developed in Vienna
The "father of autologous chondrocyte implantation" is also visiting Vienna on 4 December: Lars Peterson from the University of Gothenburg in Sweden, who co-developed surgical chondrocyte transplantation in the knee and was the first to use it surgically more than 30 years ago, is giving a lecture on precisely this subject in the morning.
In 2009, MedUni Vienna and Vienna General Hospital were the first to use sodium imaging, an important biochemical method for evaluating the quality of cartilage transplants on 7-Tesla, on patients who had undergone cartilage replacement therapy. Due to the low sodium-ion concentration in the human body, sodium imaging requires high field intensities and can therefore only be done on 7-Tesla. Since there is a direct correlation between sodium and proteoglycans, a component of the cartilage structure that is responsible for the biomechanical properties of the cartilage, it is possible to assess the quality of the cartilage transplant with minimal stress to patients," explains Trattnig.
A business partner of Vienna High-Field MRI Center has now commissioned a study to validate a new drug to promote cartilage build-up following knee injuries or arthritis and only requires one injection into the joint and no surgery at all. This will consist of a Phase-II trial using 7-Tesla and sodium imaging. "Before using the drug, we would first have to conduct a pilot study to prove that 7-Tesla will provide the capability for obtaining such detailed images inside the knee joint. We are confident that it will," says Trattnig.
The same technique can be used to show possible side-effects of certain antibiotics, which can lead to Achilles tendon damage. The medication affects the tendon at a cellular level and this is associated with a provisional change in biochemical composition and, in particular, a change in proteoglycan content. Sodium imaging on the 7-Tesla Ultra-High-Field MRI scanner can be used to measure the sodium concentration in the tendon, which correlates directly with proteoglycan content, allowing the condition of the tendon to be assessed and any weakening of the tendons by the medication to be identified. At the same time, T2*-Mapping on the 7-Tesla scanner, also used clinically in Vienna, can highlight any damage to the collagen fibres in the Achilles tendon bundles.
This and other developments have meant that MedUni Vienna and Vienna General Hospital are now internationally regarded as a leading imaging centre: "The Department of Biomedical Imaging and Image-guided Therapy is ideally equipped with the very latest 3- and 7-Tesla MRI scanners, PET-MRI, CT scanners and the preclinical imaging laboratory and soon we will also have intraoperative MRI in neurosurgery. We are therefore one of the major imaging centres in the world," emphasises Trattnig. The High-Field MRI Center is part of the Department of Biomedical Imaging and Image-guided Therapy at MedUni Vienna/Vienna General Hospital and was established in 2003, along with the Center for Medical Physics and Biomedical Engineering.
A Celebration of 10 years Tesla & 15 years of High-Field MRI Center
Tuesday, 4 December 2018, 9:00 – 16:00 hrs, Van Swieten Hall of MedUni Vienna, Van-Swieten-Gasse 1a, 1090 Vienna. Markus Müller, Rector of MedUni Vienna, and Herwig Wetzlinger, Director of Vienna General Hospital, will open the anniversary event.
For programme and information: https://hfmr.meduniwien.ac.at/schnellinfo/10-jahresfeier/