Getting at the Heart of MRIs
Mar 09, 2020 Cedars-Sinai Staff
Your doctor suspects you may have heart disease. When you go for a cardiac MRI, the technician asks you to lie still and repeatedly hold your breath. Any motion can distort the image. You try, but they have to do it over again anyway. You're frustrated and uncomfortable and it's taking a long time. That's the reality for many heart patients.
Cedars-Sinai researcher Anthony Christodoulou, PhD is hoping to change this often frustrating process with a groundbreaking new technology. We sat down with him to learn more about what he's working on.
"I think MRI is the most beautiful medical invention of all time, but unfortunately, imaging remains really difficult for cardiac patients."
What problem are you trying to solve?
Anthony Christodoulou: I think MRI is the most beautiful medical invention of all time, but unfortunately, imaging remains really difficult for cardiac patients. One reason is the simple fact that our hearts beat! MRI results can be impossible to read if anything is moving during the scan. Breathing can also distort the image. Right now, the best solution is to try to freeze the motion, collecting images in short bursts and having patients hold their breath. The whole process is uncomfortable and unreliable. Most importantly, it's unsuitable for patients who have irregular heartbeats or trouble holding their breath.
What's the answer?
AC: There's no way to really stop the motion that can blur images. But when I was thinking about ways to improve the process, I suddenly realized there was no need to reinvent the wheel. We could use techniques we already had and apply them in a new way in MRI machines. Enter the multitasking MRI. Rather than trying to avoid motion, multitasking MRI continuously acquires images during a scan. Then it separates the images and reconstructs them in a way that avoids the problems caused by movement. And it takes clear, specific measurements instead of relying on a subjective evaluation of the image.
The process takes 90 seconds or less and is so much easier for patients. For that reason alone, it would be worth it. But you get more accurate results, too, which is the most important thing.
It sounds like multitasking MRI is a major improvement. Why isn't it in common use?
AC: It takes about 5-10 years for an idea like this to turn into standard practice. Like pharmaceutical drugs, devices have to go through an approval process. After you come up with the idea, you need to test the device in multiple sites, get approval and find a commercial partner to build and market the technology. That involves showing hospitals and clinics why they should use it.
Multitasking MRI uses machines and techniques that already exist, so approval probably won't take as long as a completely untested device.
Eventually, I think it will be used for much more than cardiac imaging. I can see it being used for limbs, for example, as well as the brain and other organs.
Anything else you'd want patients to know?
AC: There is a legacy of groundbreaking research in cardiology at Cedars-Sinai, where the Swan-Ganz catheter—the gold standard to diagnose heart conditions—was invented decades ago.
When my colleagues and I do research, we're not just running science projects. We want cardiac patients to have access to multitasking MRI because we want to help them live well and live long.