Quantitative MRI of the Postinjury Instrumented Spinal Cord
Abstract
This study seeks to aid individuals with severe spinal cord injuries (SCI). In many SCI cases, surgeons need to install hardware (screws, plates, rods) to stabilize the damaged spine. This study particularly targets those patients with hardware implanted to stabilize their spinal cord injuries. Physicians managing patients with SCI prefer to utilize medical imaging pictures to help guide treatment and rehabilitation processes. The most useful pictures for the physicians come from MRI machines. For the many SCI individuals with stabilization hardware, current MRI technology does not allow for adequate pictures to be captured and utilized by physicians. While metal spinal implants are typically safe to be imaged in the MRI system, they create distortions that make the pictures unclear. As a result, many SCI patients do not get the pictures they need, and furthermore do not get the best treatment and rehabilitation that might be possible. For example, without clear pictures, surgeons do not know where to inject theraputic agents when treating spinal cord injuries. In addition, many clinical trials are investigating new techniques to repair spinal cord damage. The progress of these trials is slowed by the inability to make clear MRI pictures of the spinal cord in patients with implanted hardware. This limitation slows the progress and advancement of potentially life-changing technologies for individuals with spinal cord damage. Our research group specializes in two specific areas that can help solve this problem. First, physicists in our group have a proven track record in eliminating the metal artifact issues in MRI pictures. Clinics now use technology developed by researchers in our group to make clear pictures of total hip and knee replacements. Our group also has surgeons and scientists that are experts in utilizing MRI pictures to analyze and monitor spinal cord health – particularly after injury. These specialists are actively developing mechanisms to help improve treatments and rehabilitation plans based on their analysis of MRI pictures. Together, the specialists in our group are working to remove the limitations imposed by implanted hardware on MRI pictures of SCI and other diseases that damage the spinal cord. Using the results from this study, routine monitoring and treatment of many SCI patients could be improved with new standard of care MRI pictures. The benefits from this change of SCI clinical management are substantial. First, the intended impact of surgical procedures can more easily be verified. Second, the health of the spinal cord can be carefully monitored and used to guide rehabilitation efforts. The risks introduced by this new technology are very low, as routine stabilization hardware is safe for MRI scanning. The time frame for clinical adoption of the techniques proposed in this study is relatively short. Our study team has active partnerships with MRI industry vendors and has a track record of developing technology that translates to the clinic through industry partnerships. The specific new technology used in this study is based on existing software provided by these vendors, and could easily be adopted into vendor offerings. Some of the new technology is slated to be adopted by industry and could be available within 18 months of the conclusion of this proposed study, thus making the takeaways from this study available to a wide user base. As a result, we estimate that aspects of the standards of care that could result from this study would be available for widespread use within 24 months of the study conclusion. In summary, we believe that our team of physicists, scientists, and surgeons is uniquely positioned to solve a substantial hurdle that patients with spinal cord damage, and their attending medical teams, often encounter. Solving this problem can quickly impact clinical management of these patients and will also help advance clinical trials of game-changin
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910273
Entities
People
- Kevin Koch
Organizations
- Medical College of Wisconsin
- United States Army