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Ingenia 3.0T meets great expectations in body imaging

Best Practice
Takahashi, Mamoru, M.D. Seirei Mikatahara General Hospital • Japan

Clinicians are impressed with the large coverage and excellent DWI on Ingenia 3.0T

Seirei Mikatahara is a prominent medical center in the region surrounding the Japanese city of Hamamatsu-shi. Last autumn an Ingenia 3.0T was installed in the Department of Radiology and it is now producing truly exquisite diagnostic images, even of the most demanding anatomies such as the liver, heart and whole body exams.

According to Seirei Mikatahara radiologist Mamoru Takahashi, MD, the Ingenia 3.0T system has more than lived up to the high expectations. “The Ingenia 3.0T is the first Philips MRI system in our hospital and we operate it in parallel with two 1.5T systems from other vendors. The Ingenia 3.0T performs well in all areas, but we use it mainly for imaging of the upper abdomen, pelvis, heart and breast. Our less challenging exams, such as head, spine and orthopedic exams are performed on our two other systems,” says Dr. Takahashi.

Mamoru Takahashi, MD, radiologist, joined the
Department of Radiology of Seirei Mikatahara
General Hospital in 2000.

Easy coverage from chest to pelvis

Dr. Takahashi is particularly impressed with the system’s homogeneity. “The excellent field homogeneity combined with the 200 cm large coverage of the posterior coil in the table is a major benefit. This allows easy and clinically useful scanning with coverage from chest to pelvis. Even in large FOVs, we obtain beautifully uniform images and great fat suppression.”
 
    
 DWI b1500
DWI b1500
Excellent breast DWI with Ingenia 3.0T.
41-year-old female with known solid tubular carcinoma
with ductal spread, G1, pT2 (2.2 x 1.7 x 1.4 cm) and
lymph node metastasis in the axilla. DWI with high
b-value (1500 mm2/s) shows high SNR and no
disturbing distortion. Also the axillary lesions are well
depicted.
 

Exquisite diffusion imaging in small and large FOV

The Seirei Mikatahara radiologists are excited about the DWI quality, which they credit to the extremely high magnetic field homogeneity and the Ingenia 3.0T’s high SNR. “Image quality in all our diffusion images is exquisite. For instance, DWI in breast with b-value 1500, in prostate with b-value 2000 and direct coronal DWI all exhibit exceptionally high SNR and are virtually free of distortion,” he says.

“We now use high-quality DWI scans on every organ, but it is also possible to perform a large FOV DWI scan with more extended coverage, for instance liver and pelvis. When we examine a patient with a tumor or inflammatory lesion, we can easily add direct coronal whole body DWI (DWIBS), as this takes only about 1 minute per stack on the Ingenia 3.0T.”
  
  
 
Multiple myeloma                                                Pancreatic cancer
Male in his 40s with known multiple myeloma.           Male in his 50s with previously diagnosed  Countless lesions with abnormal signal  are               multiple pancreatic tail cancer and liver 
seen in bones. Scan time 3 x 1:24 min.                     metastases. Scan time 3 x 1:10 min.


Using 3-station direct coronal diffusion weighted imaging provides image quality similar to conventional axial DWI, but scan time is significantly shorter.
 
 <br><br> <br><br>




Liver imaging benefits from high SNR

According to Dr. Takahashi, the high SNR provided by the 3.0T field strength and the dStream architecture is used for both shortening imaging time and improving spatial resolution. “The high SNR provides important benefits in contrast-enhanced abdominal MRI. We perform contrast-enhanced MRI of the liver with extracellular or liver-specific contrast agents. In our routine exam, we include diffusion weighted imaging, T2-weighted imaging and e-THRIVE, pre-contrast and three dynamic phases using dS-SENSE. Without such high SNR, the SNR limitations in dynamic scanning using liver-specific contrast agents make it difficult to evaluate the liver lesion. But with Ingenia 3.0T this is no problem at all,” he says.

“We use DWI in particular for visualizing lesions in the liver. The Ingenia 3.0T provides excellent DWI in the liver and this method is very robust. We can calculate ADC values and generate ADC maps to help in diagnosis. These support qualitative assessment of the cell density of the lesion as this is related to ADC.”

Ingenia’s most appreciated strengths

“With the Ingenia, we can use larger dS-SENSE factors than a default scan or lower NSA to improve temporal resolution and spatial resolution even for whole body scans without an increase in scan time. For instance, in a patient with metastases in the lumbar spine, we can easily add DWIBS to the routine exam, because imaging two or three stacks adds only about 3 minutes.

“We are also impressed with Ingenia 3.0T breast imaging, thanks to its high spatial resolution and high contrast. The high SNR allows us to obtain high-resolution images of an affected breast to evaluate a mass and we can easily use b-values as high as 1500 for DWI. Furthermore, thanks to the high homogeneity, axillary fat suppression is also excellent on Ingenia.”

Dr. Takahashi also highlights the fast imaging in cardiac MRI. “The Ingenia 3.0T allows us to scan with a low number of breath holds, which is easier for patients. In cine with Balanced FFE we have managed to shorten repetition time TR to 2.3 ms thanks to MultiTransmit 4D, and as a result banding artifacts are almost completely eliminated.”
  
 
 Phase 5 Phase 10
Phase 5
Phase 10
AVM with non-CE dynamic MRA. Male patient in his 20s. CINEMA-STAR is based on arterial spin labeling and helps to visualize a 2.5 cm AVM in the left occipital lobe (convulsions onset) without using contrast agent. Also the drainage vein is seen. No distortion is visible and there is extremely little signal drop off at the junction. 10 phases are acquired at 200 ms intervals, matrix 256, scan time 5 min. 
  

Ingenia is lowering the threshold for 3.0T MRI

In Dr. Takahashi’s view, the Ingenia 3.0T with dStream provides a major innovation, with full digitization in RF coils, combined with Xtend FOV and MultiTransmit for patient-adaptive B1 control. “We had given the move to 3.0T MRI very careful consideration, but with the Ingenia 3.0T we are able to scan in all regions of the body without any problems, and consistently generate diagnostic images of excellent quality,” he concludes.


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Best Practice
Ingenia 3.0T
AVM, Body, Brain, Breast, dStream, DWI, DWIBS, Neuro, non-CE MRA, Non-contrast MRA, Vascular, Whole body
 

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