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Modern acceleration in musculoskeletal MRI: applications, implications, and challenges

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Abstract

Magnetic resonance imaging (MRI) is crucial for accurately diagnosing a wide spectrum of musculoskeletal conditions due to its superior soft tissue contrast resolution. However, the long acquisition times of traditional two-dimensional (2D) and three-dimensional (3D) fast and turbo spin-echo (TSE) pulse sequences can limit patient access and comfort. Recent technical advancements have introduced acceleration techniques that significantly reduce MRI times for musculoskeletal examinations. Key acceleration methods include parallel imaging (PI), simultaneous multi-slice acquisition (SMS), and compressed sensing (CS), enabling up to eightfold faster scans while maintaining image quality, resolution, and safety standards. These innovations now allow for 3- to 6-fold accelerated clinical musculoskeletal MRI exams, reducing scan times to 4 to 6 min for joints and spine imaging. Evolving deep learning-based image reconstruction promises even faster scans without compromising quality. Current research indicates that combining acceleration techniques, deep learning image reconstruction, and superresolution algorithms will eventually facilitate tenfold accelerated musculoskeletal MRI in routine clinical practice. Such rapid MRI protocols can drastically reduce scan times by 80–90% compared to conventional methods. Implementing these rapid imaging protocols does impact workflow, indirect costs, and workload for MRI technologists and radiologists, which requires careful management. However, the shift from conventional to accelerated, deep learning-based MRI enhances the value of musculoskeletal MRI by improving patient access and comfort and promoting sustainable imaging practices. This article offers a comprehensive overview of the technical aspects, benefits, and challenges of modern accelerated musculoskeletal MRI, guiding radiologists and researchers in this evolving field.

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Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

CAIPIRINHA:

Controlled aliasing in PI results in higher acceleration

CS:

Compressed sensing

DL:

Deep learning

FSE:

Fast spin-echo

PD:

Proton density

PI:

Parallel imaging

MAVRIC:

Multiacquisition variable-resonance image combination

RF:

Radiofrequency

SAR:

Specific absorption rate

SEMAC:

Slice-encoding for metal artifact correction

SMS:

Simultaneous multi-slice acquisition

SNR:

Signal-to-noise ratio

TR:

Repetition time

TSE:

Turbo spin-echo

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  1. Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA

    Jan Vosshenrich & Jan Fritz

  2. Department of Radiology, University Hospital Basel, Basel, Switzerland

    Jan Vosshenrich

  3. Siemens Medical Solutions USA Inc, Malvern, PA, USA

    Gregor Koerzdoerfer

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Vosshenrich, J., Koerzdoerfer, G. & Fritz, J. Modern acceleration in musculoskeletal MRI: applications, implications, and challenges. Skeletal Radiol (2024). https://doi.org/10.1007/s00256-024-04634-2

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