4 Quantitative MRI of the Brain
Concepts of measurement in MRI – an
overview
• qMR uses the paradigms of a scientific
instrument
• measurement traditions have a long history,
from astronomy and watchmaking
• good study design often gives results worth
publishing
again, and also to be comparable with measure-
ments made by others in other locations. In the
human body we expect to measure some param-
eters (height, weight, blood pressure) ourselves,
recognizing that some of these parameters may
have genuine biological variation with time. More
invasive measurements (e.g. blood alcohol level
or blood sugar level) are also expected to have a
well-defined normal range, and to be reproducible.
In physics, chemistry, electrical engineering and
manufacturing there is a strong tradition of mea-
surement, international agreements on standards,
and training courses for laboratory practitioners.
International standards of mass, length and time
have been in existence for many years. Secondary
standards have been produced which can be traced
back to the primary standards. National and inter-
national bodies provide coordination.
As individual scientists we may have a pas-
sionate desire to use our talents for the benefit of
mankind, preferring to devote our energy to find-
ing better ways of helping our fellow humans to
be healthy than to improving weapons for their
destruction. In this context, developing measure-
ment techniques in MRI constitutes a perfect appli-
cation of traditional scientific skills to a mod-
ern problem.
MRI is now widespread, and accepted as the
imaging method of choice for the brain (and
for many body studies). It is generally used in
a qualitative way, with a radiologist interpreting
(reporting) film hardcopy on a light box.
3
Many
3
A light box illuminates from behind a film (size approx-
imately 14 × 17 inches, or 35 × 43 cm), which may contain
MRI machines now have independent workstations
connected to the scanner and the database of MR
images, which enable and encourage simple quan-
titative analysis of the images in their numerical
(i.e. digital) form. However the data collection pro-
cedure often prevents proper quantification being
carried out; machine parameters such as transmit-
ter gain, flip angle value (and its spatial variation),
receiver gain and image scaling may all be accept-
able for qualitative analysis, but cause irreversible
confusion in images to be quantified. Researchers
may be unaware of good practice in quantification,
and collect or analyse data in an unsuitable way,
even though the MRI machine is capable of more.
The process of quantifying, or measuring,
parameters in the brain necessarily takes more
time and effort than a straightforward qualitative
study. More MRI scanner time is needed, and
considerable physics development effort and
computing resources may be needed to set up
the procedure. In addition, analysis can be very
time-consuming, and support of the procedure is
required to measure and maintain its reliability
over time. Procedures have to be found
4
which
are insensitive to operator influence (whether in
the data collection or image analysis) and to
scanner imperfections (such as radiofrequency
nonuniformity from a particular head coil), which
provide good coverage of the brain in a reasonable
time, and which are stable over study times which
may extend to decades.
The benefits of quantification are that funda-
mental research into biological changes in disease,
and their response to potential treatments, can pro-
ceed in a more satisfactory way. Problems of bias,
reproducibility and interpretation are substantially
reduced. MRI can move from a process of picture-
taking, where reports are made on the basis of
unusually bright, dark, small or large objects, to
traditional X-ray images or several MR images. As MRI pro-
duces progressively more slices per study (a three-dimensional
image dataset may contain 128 slices), the desire to print
these all onto a few films has resulted in progressively smaller
images, in which the relevant detail cannot be seen without
using a magnifier.
4
The author’s website (www.qmri.org) contains more links
and references to qMR.