MRI Scanning overview

MRI scanning has been operational at Paul Strickland Scanner Centre since 1986. Our scanners have always been “best in class” machines with a regular replacement programme. For example:

  • In 2005 we installed the first UK 3T scanner for clinical use. Currently, our 3T clinical scanner has the highest gradient performance available on the market. Our other 1.5T AvantoFit scanner is regarded as the best machine ever produced by Siemens Healthineers. A third scanner also operating at 1.5T will expand our capabilities because it has a larger bore enabling larger patients and those with claustrophobia to be examined in greater comfort.
  • Our special relationship with Siemens Healthineers also allows us to stay ahead in scanner capabilities. So we can and do implement into clinical studies, new features well ahead of their appearance in the marketplace. For example multiparametric MRI, which is only now appearing in the guidelines for prostate cancer diagnosis, has been in use at PSSC for more than 10 years.
  • Whole body MRI scanning is another example of our leadership in promoting cancer care. We have examined the largest number of cases in the world, which has allowed us to define its role in cancer care, via scientific publications and contributions to cancer care guidelines.

The team

There is a very strong safety culture amongst MRI personnel because of the strength of our scanners mentioned above. This safety culture applies not only to patient matters but also to staff. We constantly monitor MRI and use safety alerts, making sure that our procedures are fully compliant with safety recommendations.

The scanning team consists of senior personnel who are specifically trained in MRI, including functional imaging. These skills are rarely found in MRI radiographers working outside teaching hospitals. Our radiographers know how to conduct perfusion, diffusion, brain activation studies and spectroscopy examinations, which are a matter of routine at Paul Strickland Scanner Centre.

We also have radiographer and physicist support to support functional imaging research studies, which enables us to participate both internally and externally funded research programmes. Such research programmes require strict quality control and quality assurance programmes which are already in place.

Our advanced radiographers are sought after for their knowledge and skills by Siemens Healthineers, allowing us to release them for technologist teaching duties, and for trying out the next generation of MRI machine, in order to improve their usability. This allows us to stay ahead with upcoming hardware and operating software developments.

Our MRI scanners

With two advanced generation scanners, and another one to follow shortly, together with appropriate supporting hardware and software, there is very little that we can’t do. We perform the full range of studies, including advanced functional imaging studies. However we do pride ourselves on being at the cutting edge for oncology studies.

We are internationally known for multiparametric prostate MRI and whole body MRI. Being the most experienced in whole body MRI globally means that our protocols are streamlined, compliant with international standards (which we help to formulate) and appropriately used. This has attracted a great deal of attention nationally and internationally, with doctors and patients coming to Paul Strickland Scanner Centre. For example, we have had teams visiting from Scotland, Denmark, USA andBrazil to learn about how we do whole body MRI scanning.

Until the new wide bore scanner is installed, we have limited ability to examine very large patients and those with severe claustrophobia but we are very happy to advise on where examinations could be undertaken should the need arise.

Why choose us

Our MRI scanners are state of the art and we endeavour to lead clinical oncologic imaging. Our radiography staff are highly trained with many years of MRI expertise. Our MRI radiologists are highly skilled and nationally known, with our lead radiologist being an international thought leader in prostate MRI and whole body scans. Our quality programmes ensure that our scanners and staff are the best they can be.

Example scan images

Comparing WB-MRI to Choline PET/CT scan in prostate cancer.

82 year old man treated for prostate cancer representing with biochemical recurrence 4 years after pelvic radiotherapy. The b900 image is a diffusion sequence which shows an area of hypercellularity in the right anterior rib which is barely perceptible on the standard of care choline PET/CT. This patient cyberknife radiotherapy for this lesion.

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Comparing WB-MRI to FDG-PET/CT scan in small cell lung cancer.

62 yo male with small cell lung cancer. Frontal projection of a whole body diffusion image and glucose PET done on consecutive days (first and second columns respectively). Grossly there is good concordance of high uptake on FDG-PET with high signal intensity on b900 MIP images. Fused PET-CT (third column) and fused b900-T2W (4th column) of the lower chest and liver. Note normal FDG uptake in the heart not seen on the fused b900 images (arrow). Liver metastases are more clearly outlined on the fused b900-T2W images (arrow). Bone deposits are also more clearly seen on fused b900-T2W images (slanting arrow).

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Imaging bone marrow tumor response in myeloma disease.

Multiple myeloma patient treatment response after one cycle of ESHAP chemotherapy. The coloured whole body images show a good response to therapy (more yellow and green colours) in the skeleton. This can be quantified using specialist software being co-developed with Siemens Healthineers; an example of the type of collaboration being PSSC and Siemens Healthineers.

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Follow-up of plasmacytoma

The baseline and serial whole body MRI follow-up of plasmacytoma is a NICE approved indication. On examination 1, a right shoulder abnormality is seen which disappears on the 2nd examination after radiotherapy (RT). By the 3rd examination multiple new lesions are seen (red arrows) indicating transformation to symptomatic myeloma and the need to start anticancer therapy.

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Multiparametric prostate cancer examination before starting active surveillance

Multiparametric prostate cancer examinations before active surveillance is a NICE approved indications. This 64 year old appeared to be well suited for active surveillance for low risk disease but we found a 1 cm tumour anteriorly in the gland (arrow) which was characterised as an aggressive lesion making the patient unsuited for active surveillance. He was treated with definitive radiotherapy using our cyberknife facilities.

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Better performance of MRI compared to CT for bone disease detection in metastatic breast cancer

Axial CT (A) and diffusion weight MRI scan (B) show a metastatic lesion in the body of L1 in a patient with breast cancer not evident on CT. In addition, the b900 signal intensity image (B) identifies another smaller lesion in the right transverse process of L1 (green arrow).

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Better performance of MRI compared to CT for liver disease detection in metastatic breast cancer

Axial CT (A) and diffusion weight MRI scan (B) show a metastatic lesion segment 5/6 of the liver not evident on CT.

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