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Novel imaging methods for diagnosing tobacco related cancers

Institution: Stanford University
Investigator(s): Albert Macovski, Ph.D.
Award Cycle: 1997 (Cycle 6) Grant #: 6RT-0384 Award: $629,087
Subject Area: Cancer
Award Type: Research Project Awards
Abstracts

Initial Award Abstract
In 1989, 3% of U.S. citizens had cancer of the mouth and throat. Since these cancers account for about 1.5% of all cancer deaths, about half of these patients die. These cancers are strongly linked to the use of tobacco and alcohol. Studies show that non-drinking smokers have a 4- to 13-fold increase in risk for this cancer over controls (non-drinking non-smokers). Doctors usually can see these cancers on the inside of the throat. If there is a suspicious lump, the doctor will take a tissue sample to determine if it is cancerous. If the cells appear cancerous, doctors then order a magnetic resonance image (MRI) of the neck to find out if the cancer has already spread to the lymph nodes in the neck. If the cancer has not yet spread to the lymph nodes, surgery is the best approach. Otherwise, chemotherapy is currently the best alternative.

Here we propose to design and test a radically new MRI scanner that will produce high quality scans of the neck area for much lower cost. MRI has become very popular for diagnosing diseases of the head, neck, spine, and joints. Unlike x-rays, MRI poses no health risk to the patient, but it is costly. The goal of this project is to design, build, and test new types of magnetic resonance imaging devices for ultra-low cost diagnosis of tobacco-related cancer of the neck area. Our new approach is called Prepolarized Magnetic Resonance Imaging (PMRI). A prepolarized MRI scanner could cost as little as $30,000 to manufacture. Conventional MRI scanners cost about $400,000 to manu-facture. This innovation could reduce the cost of diagnosing and treating tobacco-related tumors in the neck.

The ultimate goal for this project is to make a PMRI scanner so inexpensive that one could justify screening high-risk patients. This is done now for cancer in the colon. Doctors know that early diagnosis is the best predictor of survival, so screening with a PMRI scanner might dramatically improve the survival rate of these cancer patients. Furthermore, current surgical treatments can horribly disfigure a patient’s face and neck. If our screening test can find the tumors before metastases arise, surgeons might be able to perform much less disfiguring surgery. The screening will require a substantial initial investment, but we believe that this approach could ultimately reduce the total societal cost of treating these cancers.

Final Report
Introduction: The objective of this research project was to demonstrate the technical feasibility and low cost of a novel form of magnetic resonance imaging (MRI) for diagnosing and staging of tobacco-related cancers in the head and neck. Conventional MRI systems cost between $1M and $3M. We propose a novel Prepolarized MRI system that uses two inexpensive electromagnets rather than one expensive superconducting magnet.

Topic Addressed: We aim to demonstrate that a complete dedicated head and neck Prepolarized MRI scanner imaging can be constructed for less than $50,000 while maintaining excellent image quality.

Progress: During this grant, we have made excellent progress towards these goals. Indeed, we successfully recorded our first phantom images on September 6 on a 5 cm bore system. We then constructed a 9-cm bore system made our first human in vivo images on September 19. We are still debugging minor image artifacts, but the image quality is even better than we expected, considering 1 mm x 1mm resolution. These were wrist images with 0.4 T polarizing magnet field and 1 MHz center frequency. This is a clear and successful proof of concept of Prepolarized MRI. We are very grateful to the TRDRP for our no-cost extension which has enabled us to continue this work to its successful fruition. In the last 6 months of the grant period, we made significant progress with our scanner. We have greatly improved our image quality, and finished the construction of new shim coils, which will allow us to do volumetric imaging. We also made some basic measurements that indicate that our head scanner will have excellent image quality with a reception frequency as low as 2 MHz.

Future Directions: We have every hope that we will soon be able to image a head-sized object. We foresee no scientific obstacles. The only remaining problems are engineering issues related to scaling the size of the magnets.

Impact: Cancers of the head and neck account for about 1.5% of all cancer deaths. Studies have shown that non-drinking smokers have a 4- to 13-fold increase in risk for this cancer. MRI is currently the key clinical tool for deciding between surgery and chemotherapy treatment. Hence, our PMRI system could reduce the cost of making this decision, as well as the cost of treatment staging. Ultimately, we hope that a PMRI scanner could be inexpensive enough that society could justify screening high-risk patients. Screening is now routine for diagnosing colon cancer, and early diagnosis is the best predictor of survival. Hence, Prepolarized MRI could improve the survival rate and reduce the total societal costs of treating tobacco-related tumors of the head and neck.
Publications

A low cost prepolarized MR Imaging Prototype
Periodical: Radiological Society of North America Index to Imaging Literature Index Medicus:
Authors: Scott G, Conolly S, Morgan P, Xu H, Brosnan TJ, Macovski AE ART
Yr: 1997 Vol: 97 Nbr: 1391 Abs: Pg: 470

Minimum power homogeneous magnet design for prepolarized MRI
Periodical: Proceedings of the 39th Experimental Nuclear Magnetic Resonance Conference Index Medicus:
Authors: Zu H, Conolly SM, Scott G, Macovski A ABS
Yr: 1998 Vol: Nbr: Abs: Pg: 140

The design of a head and knee prepolarized MRI scanner
Periodical: Proceedings of the 39th Experimental Nuclear Magnetic Resonance Conference Index Medicus:
Authors: Conolly P, Scott G, Xu H, Morgan P, Macovski A ABS
Yr: 1998 Vol: Nbr: Abs: Pg: 246

Minimum-cost solenoid design for prepolarized MRI
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Conolly SM, Scott GC, Macovski A ABS
Yr: 1998 Vol: Nbr: Abs: Pg: 255

Minimum power homogeneous magnet design for prepolarized MRI
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Xu H, Conolly SM, Scott G, Macovski A ABS
Yr: 1998 Vol: Nbr: Abs: Pg: 2006

Polyphase techniques for low cost MRI receivers
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Scott G, Conolly S, Macovski A ABS
Yr: 1998 Vol: Nbr: Abs: Pg: 2020

Fundamental scaling relations for homogeneous magnets
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Xu H, Conolly S.M., Scott G.C., Macovski A ABS
Yr: 1999 Vol: Nbr: Abs: Pg: 475

Gradient design with abritrary geometrical constraints by linear programming
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Xu H, Conolly S.M., Scott G.C., Macovski A ABS
Yr: 1999 Vol: Nbr: Abs: Pg: 747

A high-power pulsing circuit for prepolarized MRI
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Conolly S.M., Matter N.I., Scott G.C., Macovski A ABS
Yr: 1999 Vol: Nbr: Abs: Pg: 473

Electromagnet current regulation with thyristor supplies
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Scott G.C., Xu H., Conolly S.M., Macovski A ABS
Yr: 1999 Vol: Nbr: Abs: Pg: 743

Design of dedicated shim fields
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Adalsteinsson E, Conolly SM, Xu H, Macovski A ABS
Yr: 0 Vol: Nbr: Abs: Pg: 477

Homogeneous magnet design using linear programming
Periodical: IEEE Transactions on Medical Imaging Index Medicus:
Authors: Xu H, Conolly S, Scott G, Macovski A ABS
Yr: 2000 Vol: 36 Nbr: 2 Abs: Pg:

Electromagnetic criteria for prepolarization coils
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Scott G, Conolly SM, Macovski A ABS
Yr: 2000 Vol: Nbr: Abs: Pg: 1373

Edge cooling for low-field homogeneous magnets
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Conolly SM, Xu H, Scott G, Macovski A ABS
Yr: 2000 Vol: Nbr: Abs: Pg: 1377

Split resistive shimming of low-field homogeneous magnets
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Conolly SM, Xu H, Scott G, Macovski A ABS
Yr: 2000 Vol: Nbr: Abs: Pg: 1376

Resistive homogeneous MRI magnet design by matrix subset selection
Periodical: Magnetic Resonance in Medicine Index Medicus:
Authors: Morgan PN, Conolly SM, Macovski A ART
Yr: 1999 Vol: 41 Nbr: 6 Abs: Pg: 1221-1229

MR imaging of articular cartilage using driven equilibrium
Periodical: Magnetic Resonance in Medicine Index Medicus:
Authors: Hargreaves BA, Gold GE, Lang PK, et al ART
Yr: 1999 Vol: 42 Nbr: 4 Abs: Pg: 695-703

A prepolarized MRI scanner
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Scott B, Chronik N, Matter H, et al ABS
Yr: 2001 Vol: Nbr: Abs: Pg: 610

Signal and contrast in prepolarized MRI: First Data
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Conolly S, Chronik B, Matter P, et al ABS
Yr: 2001 Vol: Nbr: Abs: Pg: 683

A fast recovery pulsed readout power supply for polarized MRI
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Matter N, Conolly S, Macovski A, Scott G ABS
Yr: 2001 Vol: Nbr: Abs: Pg: 1152

Linear programming based shim design for prepolarized MRI
Periodical: International Society of Magnetic Resonance in Medicine Index Medicus:
Authors: Ungersma S, Macovski A, Scott G, Conolly S ABS
Yr: 2001 Vol: Nbr: Abs: Pg: 1156