This chapter is available as free (personal) off-print from the new book version.

20-06 Clinical Applications

At about this time, MR imaging started being clinically evaluated. One of the most admirable research groups worked at Hammersmith Hospital in London. The head of the group was Robert E. Steiner, but Ian R. Young and Graeme M. Bydder were the moving forces. Among others, Frank H. Doyle and Jacqueline M. Pennock supplemented this group.

Because MR imaging is at the crossroads between medicine, biology and che­mis­try, physics, and computer science, research groups with strong in­ter­dis­ci­pli­nary relationships and cross-fertilization became scientifically extremely fruit­ful, …

… which led to the 'odd couple' system, involving one phy­si­cian and one scientist. At congresses, you would always see Graeme Bydder (Figure 20-34) together with Ian Young (Figure 20-35), a seemingly ideal combination. Figure 20-34: Graeme Bydder.

There were other couples like them (e.g., Rinck and Mul­ler), but apparently such an in­ter­dis­ci­pli­nary re­la­tion­ship between radiologists and physicists or chemists does not fit into all European academic systems. Figure 20-35: Ian Young.

Early clinical imaging was extremely difficult, time-consuming, and often dis­ap­point­ing. Just taken as oan example: spin-echo imaging, for instance, was a bigger step than many would imagine. Today it is taken for granted and mostly replaced by faster echo techniques; but it has helped MR imaging immensely to become a routine technique.

The first MR images were based upon proton-density differences, later upon differences in T1-weighting. By 1982-1983, the Hammersmith and Wiesbaden groups pointed out that long heavily T2-weighted multiecho SE se­quen­ces were better at highlighting pathology (Figure 20-36) [⇒ Bydder; ⇒ Rinck 1983].

Figure 20-36: Images of a recurrent brain tumor taken on a 0.15 Tesla system; TEs (a-d) between 20 and 300 ms. Long echo times in multiecho CPMG se­quen­ces were a major leap forward in the first half of the 1980s. It took some years until T2-weighted images were generally accepted, mostly because many com­pa­nies claimed that long TE was neither pos­sib­le nor necessary. Illustration from: Rinck PA, Bydder GM, and Harms SE. Magnetic resonance imaging of the brain. Published in the first (book) edi­tion of this introduction to MR imaging in 1985.

There were similar groups in the United States, mostly in New England and California.

Unfortunately it is beyond the scope of this short introduction to mention all of them – which is not meant to belittle their contributions to clinical MR imaging.