The recent evolution of MRI is helping to better diagnose cancer while ensuring better patient follow-up. Contrast media, combined with the benefits of artificial intelligence, contribute to this progress.
A major challenge for public health, cancers represent the second biggest cause of death worldwide, with over ten million people affected in 2019*. And the global pandemic continues to grow: the number of cases is set to double by 2040, compared to 2012. The most common cancers are prostate cancer in men and breast cancer in women. Treatment is more effective if started early, sometimes even before the disease occurs, particularly in patients at risk. Imaging remains central to treatment since it enables the spread of tumors to be located, quantified and estimated and their progress to be monitored under treatment.
Several imaging techniques co-exist: the CT scanner, magnetic resonance imaging (MRI), ultrasonography but also PET (Positron Emission Tomography), alone or combined with other technologies such as the PET scanner or PET-MRI. These machines are expensive and, for the time being, hard to access, including in developed countries.
MRI Is a highly effective imaging technique...
MRI examinations are based on the use of a magnetic field induced by a powerful cylindrical magnet. Subjected to this field, the hydrogen atoms present in great numbers in the body’s tissues on the water molecule, behave like small magnets. Activated by an external electromagnetic wave, they thus emit signals, captured by a specific detector and converted into images on a computer screen.
MRI is a painless examination that provides images of the inside of the human body, in two or three dimensions. It is prescribed in particular to visualize the “soft tissue”: brain, spinal cord, internal organs, muscles, tendons, etc. This technology, which does not use X-rays, presents no risk of irradiation for patients. Non-invasive, it enables tumors inside the body to be seen without being harmful and can be repeated to monitor the tumor in the long term.
And constantly developing
The new MRI machines enable images to be produced more quickly and with better spatial resolution. New, very low magnetic field machines have come on to the market. For example, a portable 0.064 tesla device (compared with 1.5 or 3 tesla of current MRI machines) provides images of the brain of patients in their bed. Compact, it is fitted with wheels. It also consumes a low amount of electricity, the equivalent of a coffee machine.
Progress has also been made in very high magnetic field MRIs. Within the framework of the Franco-German ISEULT project, in which Guerbet has been involved, an 11.7 tesla magnet has been designed by engineers at the CEA (French Atomic Energy Commission). It is the most powerful MRI Machine in the world intended for human imaging.
Lastly, diffusion MRI, capable of detecting cellular density, is increasingly used in oncology. Developed in the 1980s in particular by Denis Le Bihan, who was thesis director, they provide information on the microstructure of tissues in addition to sequences with contrast medium.
Iseult, the most powerful MRI machine in the world, located at Saclay in France (Photo credit: AFP)
Connected injection systems for better traceability
On the injector side, the challenge is to facilitate the monitoring of injections and enhance patient safety. As with exposure to ionizing radiation, injection systems enable the dose to be tracked. Connected models collect the data from the bottles fitted with datamatrix or RFID (radio-frequency identification) labels, which notably contain data on the contrast medium (kind, dose, etc.). They enable the information to be centralized and made available to practitioners simply and effectively.
High-relaxivity contrast media
The evolution of contrast media is inseparable from progress in magnetic resonance imaging.
Macrocyclic structure media have enabled patient safety to be enhanced by reducing the risk of gadolinium retention in the body. Gadolinium is a metal, the release of which in the body must be limited as far as possible, in accordance with the recent health agency recommendations of most countries in the world[1][2].
AI, at the heart of diagnostics
Artificial intelligence (AI) contributes to visualizing cancerous tumors better and thus enhances the reliability, rapidity and sensitivity of cancer detection. Thanks to algorithms, databases and Big Data, AI enhances and accelerates the analysis of images and thus, ultimately, will enable better patient care. It thus improves radiologists’ practice by stimulating their productivity and the performance of their activity.
An AI solution currently being developed at Guerbet
* Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019)
[1] EMA’s final opinion confirms restrictions on use of linear gadolinium agents in body scans (europa.eu)
[2] FDA Drug Safety Communication: FDA warns that gadolinium-based contrast agents (GBCAs) are retained in the body; requires new class warnings | FDA
I22001758 – November 8, 2022