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Development and Clinical Validation of Magnetic Resonance Methods for the Functional Imaging and Spectroscopy of Skeletal Muscles by Means of Synchronized Electrical Muscle Stimulation

English title Development and Clinical Validation of Magnetic Resonance Methods for the Functional Imaging and Spectroscopy of Skeletal Muscles by Means of Synchronized Electrical Muscle Stimulation
Applicant Santini Francesco
Number 172876
Funding scheme Project funding (Div. I-III)
Research institution Radiologische Physik Departement Radiologie Universitätsspital Basel
Institution of higher education University of Basel - BS
Main discipline Biophysics
Start/End 01.07.2017 - 30.06.2021
Approved amount 496'000.00
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Keywords (4)

Musculoskeletal imaging; MRI; Electrical Muscle Stimulation; MR Spectroscopy

Lay Summary (Italian)

Lead
La risonanza magnetica è uno strumento diagnostico molto utile per la valutazione dello stato di salute del corpo umano in generale e dei muscoli in particolare. Tuttavia, al momento essa è utilizzata principalemente per lo studio della struttura del muscolo stesso, mentre invece lo studio della funzionalità del muscolo in movimento è complicato dal fatto che l’acquisizione di un’immagine richiede tempi più lunghi rispetto ai processi fisiologici di contrazione delle fibre muscolari. Nell’imaging cardiaco si sfrutta la periodicità della contrazione per acquisire una porzione di immagine ad ogni battito; tuttavia questa tecnica non è immediatamente applicabile al muscolo scheletrico.
Lay summary

Soggetto e obiettivo

Il nostro obiettivo è quello di sfruttare l’elettrostimolazione (una pratica usata quotidianamente in fisioterapia, ed anche da atleti professionisti ed amatoriali per riabilitazione e allenamento), cioè l’utilizzo di uno strumento che, tramite una debole corrente elettrica, induce una contrazione dei muscoli scheletrici, per ottenere un movimento periodico e ripetibile del muscolo. Tramite questo approccio potremo sviluppare metodi simili all’imaging cardiaco per visualizzare la contrazione stessa dei muscoli scheletrici. Parallelamente, studieremo gli eventuali rischi associati all’utilizzo di questo strumento all’interno della risonanza magnetica e valuteremo i parameteri all’interno dei quali l’utilizzo è sicuro. Sfrutteremo poi la ripetibilità delle contrazioni per sviluppare anche metodi di spettroscopia per monitorare il metabolismo del muscolo durante l’elettrostimolazione. Infine, questi metodi verranno valutati in una popolazione di atleti durante il loro periodo di allenamento ed in pazienti affetti da malattie muscolari.

Contesto socio-scientifico

Il nostro lavoro permetterà di sviluppare un nuovo approccio all’imaging muscolare, fornendo una serie di strumenti che potranno essere utilizzati parallelamente all’imaging strutturale per la valutazione della funzionalità del muscolo.

Direct link to Lay Summary Last update: 11.04.2017

Responsible applicant and co-applicants

Employees

Project partner

Publications

Publication
Dynamic MR imaging of the skeletal muscle in young and senior volunteers during synchronized minimal neuromuscular electrical stimulation
Deligianni Xeni, Klenk Christopher, Place Nicolas, Garcia Meritxell, Pansini Michele, Hirschmann Anna, Schmidt-Trucksäss Arno, Bieri Oliver, Santini Francesco (2019), Dynamic MR imaging of the skeletal muscle in young and senior volunteers during synchronized minimal neuromuscular electrical stimulation, in Magnetic Resonance Materials in Physics, Biology and Medicine, 0.
Exploration of New Contrasts, Targets, and MR Imaging and Spectroscopy Techniques for Neuromuscular Disease – A Workshop Report of Working Group 3 of the Biomedicine and Molecular Biosciences COST Action BM1304 MYO-MRI
Strijkers Gustav J., Araujo Ericky C.A., Azzabou Noura, Bendahan David, Blamire Andrew, Burakiewicz Jedrek, Carlier Pierre G., Damon Bruce, Deligianni Xeni, Froeling Martijn, Heerschap Arend, Hollingsworth Kieren G., Hooijmans Melissa T., Karampinos Dimitrios C., Loudos George, Madelin Guillaume, Marty Benjamin, Nagel Armin M., Nederveen Aart J., Nelissen Jules L., Santini Francesco, Scheidegger Olivier, Schick Fritz, Sinclair Christopher, et al. (2019), Exploration of New Contrasts, Targets, and MR Imaging and Spectroscopy Techniques for Neuromuscular Disease – A Workshop Report of Working Group 3 of the Biomedicine and Molecular Biosciences COST Action BM1304 MYO-MRI, in Journal of Neuromuscular Diseases, 6(1), 1-30.
OpenForce MR: A low-cost open-source MR-compatible force sensor
Santini Francesco, Bieri Oliver, Deligianni Xeni (2018), OpenForce MR: A low-cost open-source MR-compatible force sensor, in Concepts in Magnetic Resonance Part B: Magnetic Resonance Engineering, 48B(4), e21404-e21404.

Collaboration

Group / person Country
Types of collaboration
IRCCS Fondazione Istituto Neurologico Nazionale C. Mondino - Pavia Italy (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
Policlinico Universitario Agostino Gemelli - Rome Italy (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
MYO-MRI 2019 Talk given at a conference Dynamic muscle MRI comparison to water T2 on facioscapulohumeral muscular dystrophy patients with phase contrast imaging of electrically stimulated quadriceps muscles 17.11.2019 Berlin, Germany Deligianni Xeni;
MYO-MRI 2019 Talk given at a conference Deep neural network with regional regularization for fat/water reconstruction of multi-echo gradient-echo images 17.11.2019 Berlin, Germany Santini Francesco;
ISMRM 27th Annual Meeting Poster Compressed-Sensing 4D Flow MRI of the Skeletal Muscle during Nerve vs Muscle Electrical Stimulation 11.05.2019 Montreal, Canada Santini Francesco; Deligianni Xeni;
ISMRM 27th Annual Meeting Talk given at a conference Pilot study on facioscapulohumeral muscular dystrophy patients with dynamic phase contrast imaging of electrically stimulated quadriceps muscles 11.05.2019 Montreal, Canada Santini Francesco; Deligianni Xeni;
Joint Annual Meeting ISMRM-ESMRMB Poster Multi-Nuclei Functional Imaging of the Skeletal Muscle during Synchronized Electrical Stimulation: Interleaving 1H Velocity Mapping with 31P Spectroscopy 16.06.2018 Paris, France Santini Francesco; Deligianni Xeni;
Joint Annual Meeting ISMRM-ESMRMB Poster OpenForce MR: A Low-Cost Open-Source MR-Compatible Force Sensor 16.06.2018 Paris, France Deligianni Xeni; Santini Francesco;


Abstract

Assessing the functionality of skeletal muscle fibers is essential in the progress monitoring of both pathological (neuro- and musculodegenerative) and physiological processes (training and rehabilitation). While morphological information is mostly important in the longitudinal follow-up 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 would monitor the ability of the muscle to contract and to gather supplies of nutrients and oxygen from the blood. This approach can follow two paths: the first is the studying of the muscular kinematics using gated or real-time sequences during muscle movement; the second is metabolic assessment, which can either be measured directly (through 31P spectroscopy of muscle metabolites) or indirectly (for example by T2- or T2*-weighted imaging).In the last two years, our group has been developing a novel approach to acquire high-temporal-resolution images of the contraction of the skeletal muscle by inducing a reproducible movement by means of electrical muscle stimulation (EMS). With this method, contraction speed, strain, and strain rate were measured in a consistent and controlled way.This approach revealed itself promising for the purpose of observing the functionality of the muscles. However, so far it has been only developed for the study of kinematics, thus missing the metabolic information, and while further studies are ongoing, a clinical validation of the method is still needed. In addition, quantitative evaluation of the safety of the hardware setup connected to the subject has so far limited the acquisition to low-power sequences.Ideally, one would extend this approach to a more general “toolbox” consisting of methods that can give a broader view on the muscle functionality, coupling contractility and metabolism in the same kind of setup.In the first part of this project, we propose to continue the development of the synchronized imaging method, also by objectively evaluating its safety limits, and to extend it to spectroscopy, for which our group has access to the appropriate hardware, exploiting the same characteristics of repeatability and controllability of the electrical muscle stimulation. The velocity imaging sequence will be optimized by including the modern concept of simultaneous multislice imaging, in order to obtain volumetric coverage in reasonable scan time, and relaxometry methods currently used for the heart will be adapted to work in the muscle, in order to monitor changes in T1 and T2 during exercise.Once these steps are completed, we will focus on the development of interleaved imaging/spectroscopy methods, a concept which has been recently proposed, which would fuse the two main instruments of muscle functional imaging into a single acquisition.The second part of the project will be dedicated to the validation of the methods in a clinical setting on two different subject populations: on the one side, they will be used to objectively monitor the training of athletes (in collaboration with the Department of Sport, Exercise and Health (DSBG), Division Sports and Exercise Medicine of the University of Basel) and on the other side, they will be applied to the diagnosis and to the severity assessment of patients suffering from Becker muscular dystrophy (in collaboration with the Department of Neurology of the University Children's Hospital of Basel).In addition to the immediate scientific output, the outcome of this project will be a set of imaging and spectroscopy tools to be used in a clinical setting for the evaluation of the condition of muscles in different contexts, both pathological and physiological. The attractiveness of this setup is its ease of deployment and its low cost, which would make it implementable in a large number of clinics and hospitals equipped with a standard clinical MRI system.
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