3-D-printed model of stenotic intracranial artery enables vessel-wall MRI standardization

April 14, 2017
Dr. Tanya Turan, director of the Stroke Division at the Medical University of South Carolina and senior author on the Journal of NeuroInterventional Surgery article, with her team at the scanner. Credit: Medical University of South Carolina

A collaboration between stroke neurologists at the Medical University of South Carolina (MUSC) and bioengineers at the University of Massachusetts has led to the creation of a realistic, 3D-printed phantom of a stenotic intracranial artery that is being used to standardize protocols for high-resolution MRI, also known as vessel-wall MRI, at a network of U.S. and Chinese institutions, according to an article published online March 9, 2017 by the Journal of NeuroInterventional Surgery.

High-resolution or vessel-wall MRI has been used to study the plaque components in vessels in the brain for more than ten years and has the potential to elucidate the underlying pathology of intracranial atherosclerotic disease (ICAD), the leading cause of stroke worldwide, as well as to gauge patient risk and inform clinical trials of new therapies. However, progress has been stymied by the lack of standardization in high-resolution MRI protocols, which poses an obstacle to multicenter trials.

"There is a lot of exciting research that is possible with high-resolution MRI techniques, but it has much less opportunity to affect patient care if it can't be systematically distributed to multiple sites and multiple populations," says Tanya N. Turan, M.D., director of the MUSC Stroke Division and senior author of the article.

To overcome this obstacle, Turan worked with bioengineers at the University of Massachusetts to produce a phantom of a stenotic intracranial vessel using imaging sequences obtained from a single patient with ICAD at MUSC. The 3-D printed ICAD phantom mimics both the stenotic vessel and its plaque components, including the fibrous cap and the lipid core. The phantom is being shared with collaborating institutions so that it can be used to standardize high-resolution MRI protocols. The imaging data presented in the Journal of NeuroInterventional Surgery article demonstrate the feasibility of using the phantom for standardization and were obtained from six U.S. and two Chinese sites.

Frontal maximum intensity projection image from time of flight MR showing a focal stenosis of the basilar artery (A, top panel, arrow). Single axial slice of high resolution vessel wall MRI showing intracranial atherosclerosis of the basilar artery (A, bottom panel, arrow). The resulting patient specific virtual phantom of atherosclerotic plaque (B) with fibrous cap (C, top panel) and lipid core (C, bottom panel). Credit: Reproduced from Development of a high resolution MRI intracranial atherosclerosis imaging phantom, Chueh et al, published online on March 9, 2017 by the Journal of NeuroInterventional Surgery with permission from BMJ Publishing Group Ltd.

Producing the phantom was a major step in the right direction for standardizing high-resolution MRI ICAD protocols. However, several more years may be necessary to complete the process. The next major challenge for these investigators will be establishing parameters for MRI machines from a variety of manufacturers. So far, MRI parameters have been established for Siemens and GE systems but work is still under way on Philips systems.

The phantom is also being shared with sites in China, where the burden of intracranial stenosis is especially high. Turan is collaborating with Weihai Xu, M.D., of Peking Union Medical College, the lead Chinese site, to collect additional data to assess interrater reliability among the participating institutions. Once high-resolution MRI protocols have been standardized and good interrater reliability demonstrated, the international team plans to conduct a prospective observational trial to examine risk prediction at participating centers, which would more quickly meet the required patient enrollment than would a trial conducted in the U.S. alone.

"We're only going to be able to advance the field more quickly if we work together," says Turan. "The phantom gives us the tool to be able to work together."

Explore further: First systemic evidence for safety of tPA in stroke patients with sickle cell disease

More information: Ju-Yu Chueh et al, Development of a high resolution MRI intracranial atherosclerosis imaging phantom, Journal of NeuroInterventional Surgery (2017). DOI: 10.1136/neurintsurg-2016-012974

Related Stories

First systemic evidence for safety of tPA in stroke patients with sickle cell disease

April 11, 2017
Adult patients with sickle cell disease (SCD) who experience a stroke caused by a clot (i.e., ischemic strokes or IS) can be treated safely with tissue plasminogen activator (tPA) if they qualify, report investigators at ...

NIST develops first widely useful measurement standard for breast cancer MRI

March 23, 2016
Researchers at the National Institute of Standards and Technology (NIST) have developed the first widely useful standard for magnetic resonance imaging (MRI) of the breast, a method used to identify and monitor breast cancer.

New neuroendovascular technique shows promise in stroke patients with large-vessel clots

June 29, 2016
In an article published online April 16, 2016 by the Journal of Neurointerventional Surgery, investigators at the Medical University of South Carolina (MUSC) report promising 90-day outcomes for stroke patients with large-vessel ...

Phantom movements in augmented reality helps patients with intractable phantom limb pain

December 1, 2016
Dr Max Ortiz Catalan at Chalmers University of Technology has developed a novel method of treating phantom limb pain using machine learning and augmented reality. This approach has been tested on over a dozen of amputees ...

Recommended for you

Smoking raises risk of aneurysm recurrence after endovascular treatment

August 17, 2017
In a new study, researchers report people who have experienced an aneurysm have another reason to quit smoking.

Study adds to evidence that most prescribed opioid pills go unused

August 2, 2017
In a review of half a dozen published studies in which patients self-reported use of opioids prescribed to them after surgery, researchers at Johns Hopkins report that a substantial majority of patients used only some or ...

Engineers harness the power of 3-D printing to help train surgeons, shorten surgery times

August 2, 2017
A team of engineers and pediatric orthopedic surgeons are using 3D printing to help train surgeons and shorten surgeries for the most common hip disorder found in children ages 9 to 16. In a recent study, researchers showed ...

World's first child hand transplant a 'success'

July 19, 2017
The first child in the world to undergo a double hand transplant is now able to write, feed and dress himself, doctors said Tuesday, declaring the ground-breaking operation a success after 18 months.

Knee surgery—have we been doing it wrong?

July 18, 2017
A team of University at Buffalo medical doctors have published a study that challenges a surgical practice used for decades during arthroscopic knee surgery.

New tools help surgeons find liver tumors, not nick blood vessels

July 17, 2017
The liver is a particularly squishy, slippery organ, prone to shifting both deadly tumors and life-preserving blood vessels by inches between the time they're discovered on a CT scan and when the patient is lying on an operating ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.