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Thank you for your comment. We are launching a brand new cardiac MRI course which we will get that covered as well. Stay tuned and visit the Everything MRI website for more details 📣

Hello. Thank you for watching. There is a number of factors that we need to consider. First thing which is the manufacturer you are working. Different manufactures have different acceleration techniques which may have slightly dissimilar ways of filling the K-space and, therefore, also different performance. Also, we always need to consider the channels of the coil you are using. The SNR level will play a key role on this. The fact that you are working on a 0.35T may probably limit the range of adjustments that we can make on acceleration without significantly impacting the SNR. For example, on a 3T scanner, since there is an abudance of SNR, you can push the scanner using greater acceleration factors. On a 0.35T we may not have that flexibility, in this sense.

Thank you for sharing this. Would you mind sharing some additional parameters? I think 3 minutes is a great achievement!! Especially with optimal image quality

@@everything-mri just standard parameters... Phase resolution 100%, slice resolution 80% and voxel size 0,4 x 0.4 x 0,5 in 3min 15sec

Thank you so much Scott. It is amazing having someone with plenty of experience in the field sharing tips and tricks for workflow optimisation. In regards to acceleration techniques in CMR, I think that may deserve an entire separate video! That I definitely something we will consider for the future, because as you said it can have a lot of implications from the BH perspective, and as a consequence on overall scan time and image quality.

Our pleasure 🙏🏻

Thank you for watching and commenting on the video. There will definitely be a part 2. You are right; this video aims to be an introduction to the topic. It provides examples of some of the most commonly used acceleration techniques routinely. There are many others, which we will cover in future videos, along with new comparisons. Thank you also for bringing up that point. We have personally experienced aliasing-like artifacts when increasing the acceleration factor with relatively older scanners. While this doesn't happen often, we agree it's important to mention. So, thank you for adding it to the discussion. Which scanners are you using if we can ask?

@@everything-mri I’m application specialist so I have an experience with many different Siemens scanners, from Symphony/Harmony to Vida :)

@@vladimirtt7553 Oh fantastic! If you have any other useful tips or, if there are things that we did not cover that you believe it may be worth to mention, please feel free to share them here. Many people will benefit a lot from it 🙏

All good points to discuss over the meeting. These are common challenges that, unfortunately, many clinical settings tend to experience. But, kudos to you for not abandoning yourself to the classic "oh, we have always done this way", showing instead proactivity and trying to improve the workflow. Sometimes a significant improvement for everyone requires just small adjustments!

Thank you for watching and sharing your thoughts. We definitely understand your frustration! Many concerns about "shorter" scan times often come from a lack of familiarity with techniques like GRAPPA and compressed sensing. Part of our role is to help educate MR users on the benefits and limitations of these techniques. With more awareness, we hope these practices will be more widely adopted routinely!

@@everything-mri Where I work we have 13 Siemens 3T Skyra scanners. So numerous techs experiencing the same frustrations. Some know the parameters very well and some are just there for a paycheck.

@@anniesshenanigans3815 13 Skyra?!?! Where do you work if I can ask?

@@dvalled18 Radiology Regional in SWFL

@@anniesshenanigans3815 Florida?

Thank you for watching 🙏🏻

Thank you so much for watching and appreciating the content 🙏🏻

Thank you so much for the lovely comment. This is what gives strength to continue doing what we do ❤️ very glad that was helpful!

Hello Rajan. Thank you for watching. For this type of questions we recommend to reach out to the Esaote sales team so they can provide you better assistance in explaining what could be the potential advantages of the Magnfiico MR scanner. Thank you for understanding

Hello. Already dropped message before 3-4 days. But no reply as of now. Appreciated your prompt reply here.

Hi there! Great question. When using the Dixon technique on a T1w sequence, the blood should typically still appear hypointense on the water-only image, similar to how it appears on a routine T1 sequence. Essentially, the Dixon method helps in separating fat and water signals, but it doesn't inherently change the relaxation properties of the tissues. So, if blood is hypointense on a standard T1w image, it should remain hypointense on the water-only image as well. Hope this helps!

@@everything-mri thank you Sir! Really appreciate this explanation!! It’s just that when it comes to ‘water-only’, I was confused because ‘eh, does blood belong to the category of something water-based as well??’ Hence my confusion. So if everything water-based should give hyperintense signals on water-only on T1 - but blood doesn’t fall under that category? Because I was under the impression that blood was dark on routine t1 as it’s a fluid and there’s a lot of ‘free water’ in it?

If Dixon doesn’t change the inherent relaxation property, and that’s why blood is still dark - then why is water bright on IP and water-only images on T1 sequence, after we run the Dixon?

@@rachlruby You're asking really good questions. Well done for being so proactive and I am very glad to try clarifying this matter! So, blood can be tricky because it’s a complex mixture, not just free water. On a routine T1 sequence, blood is typically dark due to the relaxation properties of hemoglobin and blood flow, not just because it’s a fluid. In the Dixon technique, water-only images isolate signals from free water molecules, like in tissues, but blood’s unique composition and flow make it hypointense on T1 weighting. While water is bright on in-phase and water-only images, blood remains dark due to its specific properties, even though we can say it contains water.

@@everything-mri Thank you sir, I’m super happy that you resolve this area of confusion for me! You are awesome for giving such clear answers! And based on what you said - here’s the last thing I need clarification for. Because I’d initially assumed that on fat-only images, both water and blood signals would be suppressed? So if we inject gadolinium, then on fat-only images, there should be no enhancement in areas with bloodflow, since the blood signals are already suppressed?

My pleasure. Thank you so much for watching 🙏🏻

Absolutely. That is already on top of our priorities. We have a brand new cardiac MRI course that is going to be launch soon. Those will be some of the topics that will be discussed. You can register your interest here: shorturl.at/A7W0D

Thank you so much for your support. Nothing to worry about, a video about DWI tips and tricks is already in our to-do list. Stay tuned 😊

You have had a very similar journey to the one we had, which is in some way a little bit scary! Unfortunately, this may mean there are a lot of MR techs on the same boat. Thank you so much for watching 🙏🏻

Thank you so much for watching Scott. Your input is absolutely valuable. Completely agree with you on the fact that it's crucial to start enhancing MRI safety from an academic perspective as well, before students fully dive into the practical aspects of the job. Without a solid understanding of essential safety concepts, it's really hard to imagine a cohort of healthcare professionals ready to tackle the numerous MR safety challenges that may arise throughout their careers!

Hello. Thank you for watching. Unfortunately, it has been long time since I have manipulated the bandwidth on a GE scanner. However, I am pretty sure you will find this optimisation session, recorded directly by the manufacturer, quite useful: th-cam.com/video/xkeW8ID5_vI/w-d-xo.htmlsi=mOEtZFOYSgb3nHJY Hope this helps 🤞🏻

@@everything-mri thank you

Thank you for watching. We completely agree that collaboration with those professional profiles is essential for sharing knowledge and progressing in this field. As you said, vetMRI has indeed been neglected for many years, but with the growing interest and many unanswered questions, we believe it's an exciting time to focus our efforts on all aspects and applications of this modality. Let's work together to address these challenges critically and make significant progress!

Agree completely. It is quite astonishing! And as we have seen from this episode, this can have implications also on the MR workflow once FMDs are installed. Luckily there are services like those offered by Gio which, along with reiterating the importance of this, they also provide a list of manufacturers which supply sports bra to facilitate this "transition" .

Hello! Setting the phase partial Fourier parameter really depends on what you need from the examination. For instance, if you're after high SNR images and your patient can stay still, you might want to skip using partial Fourier. However, if you’re dealing with a patient who finds it tough to keep still or you're imaging areas like the heart that are constantly moving, adjusting the partial Fourier could really help. My advice would be to go for a higher partial Fourier ratio, like 5/8 or 6/8, when you need to speed things up. This can cut down the scan time quite a bit, though it does mean a bit of a compromise on image quality and a higher chance of artifacts popping up. The 7/8 setting is a more balanced choice; it speeds up the scan a little without sacrificing too much quality, making it a great choice for those times when you need a faster scan but still care about clarity. Hope this helps!

You are welcome 😊

You are welcome 😊

As usual, thank you so much for the support Manuel 🙏🏻

Hello. Thank you for watching. The one you mentioned is part of the topics we have on our agenda. Just be patient, we will discuss about that as well in the future 😊

Few things can feel so humbling as a tough CMR! I think a few things to try: 1. Coaching the patient again; be sure they understand the instructions. Otherwise try to decipher the cause: is the breath hold too long? is expiratory breath hold too difficult? CMR is a long study for most sites, it may also be helpful to speak with your reading cardiologist about what is the primary clinical question for the study, and re-prioritizing the sequences. If the main question is LGE, no sense in re-running Cine's over and over again when a limited number of breath holds might be better used for mapping, LGE, Flows, etc. 2. If breath holding is not going well, also consider having the patient do shallow breathing or just free breath it entirely. - Real time cine imaging is helpful in this scenario. It will sacrifice image quality and be much more work for the Drs to do analysis, but may also be the only way to achieve clear imaging. - LGE is frequently done with the MOCO technique as a freebreathing scan, with good image quality. It is important to know it's drawbacks though, MOCO only works in-plane, like propeller, so running a MOCO in 4 chamber orientation may look more reliable than it actually is. It is best kept as Short axis or 2 chamber. MOCO also uses non-rigid correction ie it warps the image to look right, so best to run it in systole so that the heart is definitely the same shape/size in each of the averages it uses so that it doesn't warp LGE to look more or less bad than it actually is. On a 3T, non MOCO single shot SSFP LGE image quality can be quite good free breathing. 3. Try a HASTE/SSFSE for dark blood over multiple heartbeats. If you're on a Siemens and really need a fast-ish T1 Darkblood, you can take the radial ssfp cine from the Siemens tree and beat it up into a gated GRE darkblood static image. Looking forward to future discussions on CMR!

@@scottgloverjohnson thank you so much for sharing these insights! I think the colleague above (and not only him) will find them extremely useful 🙏🏻

You're more than welcome. Hope you enjoyed 😊

@@everything-mri very! In fact I am a novice in MRI! Hoping to learn alot from you! They have installed it at our place so will be practicing alot!

Thank you for your comment. ISMRT / ISMRM is a fantastic opportunity for the MRI Community. We have also attended some of these events as speakers in the past. Unfortunately, attending all these community events may be challenging at times due to work related commitments. BUT, since you are there, make sure you enjoy the meeting also for us and take notes to share with the wider community 😉

Appreaciate your comment Dr. Conte 🙏🏻

Thank you Partha! Glad you like it

Thank you Maddalena. We are glad you found it interesting!

Hello. There are many books that you can purchase online regarding MRI to start from the basics. One we can reccommend is definitely this one, from our dear friend Doug Boyd: boydsimaging.com/boyds-comprehensive-guide-to-mri-book/

Hello. Thank you for watching. We have forwarded your question to Stephen. Here below is his replay: I shall stick to the everyday macrocylic contrast agents. The first clue is in the medication charts that come with the contrast media- Prohance is indicated for "use in MRI in adults to visualize lesions in the head and neck" (Bracco). Gadovist is indicated for use in MRI in adults and children of all ages to visualise lesions and MRA in all parts of the body, as is Dotarem- this is all from the manufacturers charts and FDA. From research, of the 3, Gadovist has the highest T1 relaxivity (5.2 L/mmol-s) followed by Prohance (4.1) and then Dotarem (3.6), which means that Gadovist produces the highest signal intensity (SI) for comparable dosages. As Gadovist is twice the strength of both Prohance and Dotarem, half the dose of Gadovist can be used as compared to the other 2, although 0.15 mmol/kg is recommended rather than 0.1. Additionally Gadovist has a much higher viscosity and osmolality (5cP and 1603 mOsm/kg) than both Prohance (1.3 and 630) and Dotarem (2.4 and 1350). Gadovist has higher SI at first pass perfusion and sticks around longer for tissue characterisation (LGE) than both Prohance and Dotarem (for cardiac MRI). Also from experience, for the equivalent dose of Dotarem and Prohance, Dotarem performs better both for first pass and LGE. With regards to Prohance (sticking to the question), a single dose will have left the myocardium within 3 minutes of administration; even a double dose barely allows LGE assessment at 4 minutes. If you must use Prohance, I would recommend a triple (also approved by the manufacturer & FDA) or quadruple dose for full cardiac MRI assessment; bare in mind though that you'd need to work out the appropriate split for perfusion if doing stress and rest perfusion before topping up for LGE.

@@everything-mri Thank you very much for the detailed answer! We are applying twice 0,2 mmol/kg for a total of 0,4, so we are already at the quadruple dose. Our LGEs start 8 minutes after contrast injection, which seems bit late in this context now.

Hello. Thank you so much for watching. Regarding your question, the main reason for the extended TR threshold in a 3T scanner compared to a 1.5T is the increased T1 relaxation time at higher magnetic field strengths. T1 relaxation time is the time it takes for the longitudinal magnetization to recover to 63% of its original value after being perturbed by radiofrequency pulses. At higher field strengths, like 3T for example, tissues have longer T1 relaxation times, which necessitates longer TRs to allow for sufficient recovery of longitudinal magnetization and better contrast in the resulting images. I hope this make sense!

@@everything-mri Thanks. You guys are doing a great job! Keep it up👍

Thank you so much. Very glad you found it inspirational 🙏🏻

That's a tricky question. Meaning that as usual in MRI, there is always a balance to consider. There is no "yes" or "no" answer since there are a lot of factors involved. You need to consider things like at what magnetic field strength your scanning and the potential acquisition time involved. In fact, increasing the NEX can beneficial to get some extra signal, especially if you work at low field strengths, but the patient may move as a result of a greater scan time. Find the right trade off is the key

Glad you enjoyed the episode and thank you for supporting our content 👌🏻

Manchester United has a Siemens MRI I led to believe. I can’t remember if it is a 1.5T or 3T. I suspect it is 1.5T. I think Manchester City may have onsite.

Thank you. I really appreaciate your comment. Obviously, the more feedback like this one we have the more fair and comprehensive will be the comparison. However, this will always remain quite subjective. For example, while I agree that sometimes 3D whole heart acquisition can become pretty long in Siemens, I disagree with the statement that it generally takes over 10 mins. It should really be assessed on individual cases. I have acquired plenty of 3D whole heart with Siemens scanners in less than 4 minutes. Again, I think this varies a lot according to personal experience and knowledge of the scanner. I am very happy to hear you have had a positive experience with Philips scanners though 👍🏻 my personal feeling is that they are very reliable and image quality obtained can be very impressive!

Thank you so much. Very glad you enjoyed the episode ☺️

Grazie mille per il commento davvero utile. Siamo sempre al lavoro per migliorare la qualità dei video, questi suggerimenti fanno davvero comodo. Per quanto riguarda gli spunti inerenti al voxel, essendo un argomento abbastanza corposo spero di poterci tornare su in futuro e toccare tutte quelle tematiche da te menzionate. Nel frattempo, grazie ancora per il contributo 🙏🏻

Thank you so much. I am really glad you found the video useful 🙏🏻

Thank you. Glad you found this video useful 🙏🏻

Thank you so much. Appreciate your support 🙏🏻

Glad you enjoyed. Get ready for some more to come 🙂