Development of magnetic resonance methods for functional imaging of the skeletal muscle
Dr. Francesco Santini, Division of Radiological Physics, University Hospital Basel
Abstract (Lay summary see below)
Assessing the functionality of skeletal muscle fibers is essential in the monitoring of progress of both pathological (neuro- and musculodegenerative) and physiological processes (training and rehabilitation). Although morphological information is of utmost importance and primarily used in longitudinal followup of a single patient, it is not an absolute marker of organ health. In order to obtain an absolute indication of muscle status, it is necessary to follow a functional approach, which should monitor the ability of the muscle itself to contract and gather supply of nutrients and oxygen from the blood.
In this project, we intend to develop new procedures for the imaging of muscle functionality that rely on the usage of Electrical Muscle Stimulation (EMS) during Magnetic Resonance Imaging (MRI). EMS can non-invasively induce contraction of the skeletal muscles through an electrical pulse that can be controlled in shape, intensity and duration. This allows for standardization of the displacement and level of exercise by means of quantitative parameters such as duration and frequency of contractions and current/phase charge delivered to the organ.
Our planned investigation consists of two interconnecting lines of development: on the one hand, we will develop and refine a device that synchronizes the stimulation with the image acquisition, and on the other hand, we will adapt various acquisition methodologies (velocity and oxygenation/perfusion imaging) to work in combination of the stimulation. In order to achieve accurate dynamic and functional imaging of the skeletal muscles, it is important to obtain a good (ideally sub-millisecond) synchronization between the MR acquisition and the contraction.
Our preliminary work using a trigger circuit connected at the output of a clinical EMS device and activated by the optical synchronization signal sent by the MR scanner showed very promising results in this direction. In this project, we will refine the design of the trigger circuit allowing higher control over the stimulation waveform modulation. With our proposed approach high-temporal-resolution dynamic MR imaging can be performed. Existing methods are commonly used for cardiac imaging and need to be adapted and optimized in order to image movements happening roughly 10 times faster (within 100-200ms) than the average cardiac cycle (1000ms).
Another important parameter for the assessment of muscle functionality is its metabolic response. In the frame of this project, we intend to exploit the reproducibility of muscle contractions generated by the EMS to measure oxygenation/muscle fiber activation during constant exercise. In order to achieve this goal, existing T2-, T2*- and perfusion-weighted acquisition sequences will need to be adapted to be synchronized with the stimulus. The method will be tested on healthy volunteers and a study of the muscle characteristics in multiple age groups will be performed to assess the sensitivity of the methodology to aging.
Lay summary
Sviluppo di metodi di risonanza magnetica per l'imaging funzionale dei muscoli scheletrici
La misurazione della funzionalità delle fibre dei muscoli scheletrici è essenziale per valutare l'avanzamento di processi sia patologici (patologie degenerative dei muscoli o neurali), sia fisiologici (allenamento e riabilitazione in seguito a infortuni).
Nonostante il semplice imaging morfologico fornisca già informazioni essenziali, che fanno sì che venga già utilizzato per monitorare la progressione di una malattia sul singolo paziente, non è un indicatore assoluto dello stato di salute dell'organo. Per poter ottenere una valutazione oggettiva e assoluta, è necessario seguire un approccio funzionale, che dia informazioni sulla capacità del muscolo stesso di contrarsi e di assorbire nutrimento e ossigeno dal sangue per la funzionalità del suo metabolismo.
In questo progetto, vogliamo sviluppare delle nuove procedure per l'imaging della funzionalità muscolare che utilizzano l'elettrostimolazione del muscolo durante l'imaging a risonanza magnetica (MRI). L'elettrostimolazione può, in modo non invasivo, indurre la contrazione dei muscoli in maniera controllata e riproducibile.
Intendiamo utilizzare questo metodo per ottenere immagini dinamiche del muscolo con una risoluzione temporale di pochi millisecondi, in modo da visualizzare la dinamica della contrazione muscolare. Questo approccio è simile all'imaging cardiaco, in cui la contrazione avviene naturalmente in modo periodico e riproducibile.
Un altro aspetto che considereremo sarà l'imaging metabolico. Utilizzeremo la riproducibilità dell'esercizio muscolare indotto dall'elettrostimolatore per monitorare nel tempo l'ossigenazione del muscolo tramite l'adattamento di metodi esistenti per l'analisi della perfusione.
La futura applicazione di questi metodi sarà potenzialmente sia nella ricerca preclinica sia nella ricerca clinica, per la valutazione di patologie degenerative (ad esempio malattie neurodegenerative e distrofie). Un altra applicazione possibile di questi metodi sarà la valutazione della riabilitazione dopo un trauma osseo o muscolare, anche applicato alla medicina dello sport.
Progetti
- Nuovi progetti di ricerca dal 2024
- L'importanza e i successi della ricerca
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