Kia ora

Welcome to our newly  formatted quarterly update! We're thrilled to share some great news and  updates with our CAMRI community.

Firstly, we are excited to share that we  have recently upgraded our 3T MRI scanner from the Skyra to the Vida with a  whole suite of new clinical and research capabilities, continuing our strong  relationship with Siemens. 

In this issue, we spotlight Anna Lydon,  CAMRI's charge tech, and her journey in the industry, her passion for  cardiovascular imaging, and her valuable contributions to CAMRI's success.

We're also delighted to report on  our recent successful hosting of the 2023 Diffusion MRI Neuroanatomy and  Tractography Workshop. The event spanned three days, and attendees had the  opportunity to learn from some of the scientific leaders in the field. We  capped off the event with a wine and cheese networking evening held in our  facilities.

Finally, we want to regularly update you on  some of the ongoing research studies at CAMRI. One project we're particularly  excited to highlight in this issue is the COOLHEAD study which explored  whether brain cooling can delay or prevent is chaemic damage before clot  retrieval in stroke. The study was led by Dr  Will Diprose and Professor Alan Barber, using novel MRI methods   available at CAMRI.

Dr David  Dubowitz |  Director 

A Successful Upgrade: Celebrating CAMRI's New 3T Vida Scanner

The 3T Vida scanner is a high-performance machine that will continue to keep us at the forefront of clinical and research work. It offers improved capabilities, including a new look and operating system. CAMRI was first in New Zealand to receive the latest XA50 software from Siemens. This new software opens up a world of possibilities for advanced imaging solutions to clinical and research problems, allowing us to also offer work-in-progress imaging packages developed by Siemens scientists and imaging software created by research collaborators around the world for advanced research and clinical MRI. 

Our updated infrastructure has allowed for the improvement of our imaging capabilities, ensuring our clients receive faster and higher-quality images. We have also invested in new RF coils that allow us to do a whole array for specialist imaging. Additionally, we have updated essential equipment for our clinical work and improved the look and feel of the whole facility.

3T scanner gets installed by the New Zealand Siemens team.

When it  comes to medical procedures, anxiety can be a major concern. However, at  CAMRI, our upgraded facility provides comfort and ease as the focal points of  the patient experience. A local artist, Lucy G, was commissioned by CAMRI to  create backlit panels featuring New Zealand flora and fauna, immersing  patients into a relaxing and inviting environment. On top of the latest MRI  improvements our facility continues to offer movie  and audio entertainment  in the scanner. This is a popular option among patients, especially children,  as it provides a source of distraction and enjoyment while receiving the MRI.

As a part of our ongoing  effort to provide a smooth and seamless patient experience, we are currently  working on upgrading our branded wayfinding to make navigating to our  facility, whether from the hospital or from outside, an easy and hassle-free  process.

Artificial Intelligence  (AI) plays a big role in the new scanner, allowing for faster imaging with  better resolution. This is especially valuable in the paediatric setting,  where children have a limited tolerance for longer scans. 

Unique artwork produced by New Zealand artist Lucy G fitted to backlit panels on side wall and ceiling

Thanks to the support of Siemens Health Science engineers and application specialists, along with the CAMRI team and Uniservices, the upgrade to the 3T Vida MRI machine was successfully achieved despite many challenges from COVID and delays in the global supply chain. 

Welcoming ceremony of the new 3T scanner led by Michael Steedman

A welcoming ceremony was held, led by Rangatira Michael Steedman, Pro Vice Chancellor (Maori) at WaipapaTaumata Rau - University of Auckland, to celebrate the completion of theupgrade and the hard work of all involved. The ceremony was attended by the CAMRI team, senior Uniservices, and Auckland University leadership.

As we continue to utilize the upgraded scanner, we are dedicated to keeping our community informed and updated on our capabilities and research directions.

Staff spotlight

Anna Lydon is CAMRI's charge medical imaging  technologist who also leads much of CAMRI's advanced research implementation  too. As a medical imaging professional, she began her career as a  radiographer in angiography but found her passion in MRI. Her journey to  CAMRI started when she was introduced to cardiac MRI at Manukau Radiology in  Middlemore, where she became excited with the non- invasive and  detailed imaging of the heart. This led her to join the University of  Auckland's new MRI Centre (CAMRI), which had a focus on cardiovascular  imaging, in 2004. Anna's initial role at CAMRI was to promote the research  use of MRI, and CAMRI has retained this dual focus on advanced clinical work  and advanced research work since then.   

Anna enjoys working with  the team at CAMRI and retains her special interest in cardiovascular imaging,  one of the Centre’s specialties. She has contributed to scientific research  and advancements in cardiac and vascular imaging. Anna's proudest achievement  is her contribution to advancements in non-contrast vascular imaging. This  has led to positive outcomes for patients who previously could not have  imaging due to poor renal function. 

Anna works closely with  the ANZ chapter of SMRT as their Secretary to promote MRI education  throughout Australia and New Zealand. She has presented at conferences  overseas with the latest advancements in her field and has collaborated with  Siemens to bring new technology to CAMRI.

Anna has been contributing  to various more unusual projects too. She has been involved in a study of a  mummified Moa head and neck conducted by Professor Martin Wild at Auckland  University. Furthermore, she has also been involved in the imaging of  meerkats for the Auckland Zoo.

Since joining CAMRI,  Anna's role has evolved from managing research to becoming the Charge  Technologist. She has gained new insights and expanded her skill set, making  her a valuable asset to the team and to researchers. She finds it remarkable  how quickly technology has advanced since she joined the team, and she  embraces the challenges and opportunities to learn and grow.

Diffusion MRI Neuroanatomy and Tractography 2023 Workshop

CAMRI, in collaboration withWaipapa Taumata Rau, University of Auckland, and Natbrain Lab at the Universityof London, recently hosted a three-day Diffusion MRI Neuroanatomy andTractography workshop. The practical workshop took place from 22nd-24th Februaryand was attended by 30 participants from around New Zealand andAustralia. It was facilitated by distinguished guest speakers Dr AhmadBeyh and Dr Flavio Dell'Acqua, both of whom travelled from King's College London to teach the workshop, and was supported by a Catalyst Fund Leadersgrant from Royal Society NZ.

In addition to the workshop, the Catalyst grant funding awarded for Dr Dell’Acqua’s visit, aims to catalyse scientific interactions between overseas experts and New Zealand researchers, as well as promoting the establishment of a network of researchers both within New Zealand and overseas. 

Dr.Ahmad Beyh teaching attendees at workshop

The workshop was designed for research students, postdoctoral fellows, research scientists and clinicians to learn how to use tractography and to analyse brain connections using diffusion MRI. It also featured hands-on sessions where participants were able to apply the techniques they learned to analyse the irown diffusion MRI data with the instructors.

Attendees were joined by Dr. Ahmad Beyh and Dr. Flavio Dell 'Aqua as well as CAMRI's Director Dr David Dubowitz for this post-workshop group photo.

The first evening of the workshop included a wine and cheese networking event hosted at CAMRI. This provided an opportunity for participants to network and interact with one another in a more relaxed setting. CAMRI also held tours of their facility, showcasing their state-of-the-art equipment and facilities.

 Dr David Dubowitz taking the workshop attendees on a tour through CAMRI, including the mock scanner above, during the networking evening. 

Overall, the Diffusion MRI Neuroanatomy and Tractography workshop was a resounding success with a 95percent recommendation rate. 

This inaugural workshop by CAMRI marks the beginning of a new initiative to showcase the advanced capabilities of CAMRI through live events.

Looking forward, CAMRI has further symposia planned including a 2024 Diffusion Neuroanatomy MRI and Tractography workshop.

Keeping a Cool Head: An Innovative Approach to Post-Stroke Outcomes

Volunteer wearing cooling cap for the COOLHEAD research study.

Endovascular clot retrieval(ECR) dramatically improves outcomes in patients with an ischaemic stroke. This minimally invasive procedure involves inserting a tube through an artery in the groin and positioning it in the affected arteries of the brain to remove the clot following a stroke.

The brain is highly sensitive to progressive damage during a stroke, and immediate restoration of the impacted blood supply is critical. Delaying treatment may result in worse outcomes. However, the clot retrieval procedure for stroke treatment is only currently available at three centres throughout New Zealand. For patients outside the catchment area, inter-hospital transfer can increase the time it takes to receive treatment.

Cooling the brain, shows promise as an effective neuroprotective strategy to slow the progression of the infarcted region while awaiting treatment. A pragmatic approach is non-invasive head cooling that could be initiated before arrival at the hospital, such as in a helicopter, and maintained during transfer until the clot can be removed.

The COOLHEAD research study, led by Dr Will Diprose and Professor Alan Barber(Professor of Clinical Neurology and Clinical Lead for stroke at Te Whatu Ora,Auckland) investigated whether a “cooling cap”, could cool the brain over typical hospital transport times. The first step was to verify that the cooling cap was able to cool deeper brain structures, beyond the scalp. Measuring the internal temperature of the brain itself is challenging, and even with MRI it is not a routine practice. However, CAMRI were able to come up with some innovative MRI solutions for this.

For this study, a novel method known as Echo-Planar Spectroscopic Imaging (EPSI) was employed for temperature mapping. This spectroscopic technique relies on measuring changes to the characteristic properties of water and other chemicals. In MR spectroscopy, water has a unique resonance frequency in the MRI scanner that is temperature dependent. This differs from other metabolite chemicals in the brain, which have resonance frequencies that are not impacted by temperature. By measuring the frequency difference between water and other brain metabolites through MR spectroscopy, temperature changes can be determined.

Dr. Catherine Morgan, CAMRI's MRI physicist, worked with developers of the imaging sequence at the University of Miami to facilitate brain temperature measurements specifically for this project. This generated 3D temperature maps of the brain at 8-minuteintervals. Implementing these types of novel MRI techniques is one of the unique resources that CAMRI offers to support researchers. 

The cooling cap was tested in healthy participants and recovered stroke patients.

Six healthy volunteers hadthe head cooling device applied for 120 minutes to test the tolerability of the cooling cap. Brain temperature was measured via MRI both before and during the head cooling. Regular blood pressure and body temperature were also measured.

In a second study, six stroke survivors were enrolled in a trial to evaluate the effectiveness of the cooling cap. Participants underwent a baseline MRI scan and were then seated outside the MRI scanner as the cooling cap was applied for up to an hour. Following this, a post-cooling EPSI scan was conducted while the head cooling was maintained.

Both healthy volunteers and stroke patients reported that the cooling cap was well tolerated, and it resulted in a significant decrease in brain temperature, of approximately 1°C in both groups. While this is a relatively modest temperature change, this may be sufficient to help reduce the metabolic demands of the brain and potentially delay brain damage prior to stroke treatment. Further investigation of its efficacy in an acute clinical setting is now planned.

Figure showing temperature measurements beforeand after the cooling process.

Want to find out more? Here's some further reading

More details on the “COOLHEAD” study can be found in the recently published article here.

A review of MRI thermometry methods can be found here.