C9812 - RM Avanzata nella Pratica Clinica: Setup, Monitoring and Application (RN)

Learning outcomes

The course aims to provide an in-depth understanding of advanced technical and operational skills in magnetic resonance imaging (MRI), with particular emphasis on examination setup, patient monitoring, and the implementation of complex clinical protocols, in order to ensure high standards of quality, safety, and diagnostic effic

Course contents

BODY MRI

• Cardiac MRI (Whole Heart, Kellman, specific sequences)
• MRI Mapping
• Knee Mapping
• Three-point Dixon – Fat Fraction
• UTE/ZTE (Ultrashort Echo Time / Zero Echo Time)

NEURO MRI

• Synthetic MRI
• Functional MRI (conventional task-based paradigms and resting-state fMRI)
• MR Spectroscopy (conventional metabolites and 2-HG)
• DTI Tractography
• ASL (Arterial Spin Labelling)

Readings/Bibliography

BODY MRI 1. Cardiac MRI – Whole Heart, sequenze specifiche e tecniche di acquisizione

1. Kramer CM, Barkhausen J, Bucciarelli-Ducci C, Flamm SD, Kim RJ, Nagel E. Standardized cardiovascular magnetic resonance imaging (CMR) protocols: 2020 update. Journal of Cardiovascular Magnetic Resonance. 2020;22:17.

5. UTE / ZTE

1. Gatehouse PD, Bydder GM. Magnetic resonance imaging of short T2 components in tissue. Clinical Radiology. 2003;58(1):1-19.
2. Robson MD, Gatehouse PD, Bydder M, Bydder GM. Magnetic resonance: an introduction to ultrashort TE (UTE) imaging. Journal of Computer Assisted Tomography. 2003;27(5):825-846.
3. Du J, Bydder M, Takahashi AM, et al. Short T2 imaging using ultrashort echo time MRI. Magnetic Resonance in Medicine. 2010.
4. Weiger M, Pruessmann KP. MRI with zero echo time: principles and applications. Journal of Magnetic Resonance Imaging. 2019.
5. More SS, Zhang X. Ultrashort Echo Time and Zero Echo Time MRI and Their Applications at High Magnetic Fields: A Literature Survey. Investigative Magnetic Resonance Imaging. 2024;28(4):153-173. doi:10.13104/imri.2024.0009.
6. Ferrari L, Bianchi T, Champendal M, et al. Ultra-short and zero echo time MRI sequences for MSK investigation: a scoping review. Radiography. 2026;32(3):103334. doi:10.1016/j.radi.2026.103334.

Questo è un settore in rapida evoluzione: UTE/ZTE sono particolarmente interessanti per osso corticale, tendini, legamenti, menischi, fibrocartilagine, polmone e strutture a T2 estremamente breve.

NEURO MRI 6. Synthetic MRI / SyMRI

1. Warntjes JBM, Dahlqvist O, Lundberg P. Novel method for rapid, simultaneous acquisition of quantitative MRI parameters and synthetic contrasts. Magnetic Resonance in Medicine. 2007;57(3):528-537.
2. Krauss W, Gunnarsson M, Andersson T, Thunberg P. Automatic brain tissue classification using multi-parametric MRI. Magnetic Resonance in Medicine. 2015.
3. Blystad I, Warntjes JBM, Smedby Ö, Lundberg P, Larsson EM, Tisell A. Synthetic MRI of the brain in a clinical setting. Acta Radiologica. 2012;53(10):1158-1163.
4. Granberg T, Uppman M, Hashim F, et al. Clinical feasibility of synthetic MRI in multiple sclerosis: a diagnostic and volumetric study. American Journal of Neuroradiology. 2016.
5. Tanenbaum LN, Tsiouris AJ, Johnson AN, et al. Synthetic MRI for clinical neuroimaging: results of the Magnetic Resonance Image Compilation (MAGiC) study. AJNR American Journal of Neuroradiology. 2017.
6. Hagiwara A, Hori M, Yokoyama K, et al. Synthetic MRI in the detection of brain metastases. Journal of Magnetic Resonance Imaging. 2017.

La review di Katsuki e Sato è particolarmente utile per una trattazione didattica complessiva di SyMRI, perché comprende quantificazione di T1, T2 e proton density, sintesi delle immagini, segmentazione automatica e applicazioni cliniche.

7. fMRI – Task-based e Resting State

1. Ogawa S, Lee TM, Kay AR, Tank DW. Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proceedings of the National Academy of Sciences USA. 1990;87(24):9868-9872.
2. Kwong KK, Belliveau JW, Chesler DA, et al. Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation. Proceedings of the National Academy of Sciences USA. 1992;89(12):5675-5679.
3. Logothetis NK. What we can do and what we cannot do with fMRI. Nature. 2008;453:869-878.
4. Friston KJ, Jezzard P, Turner R. Analysis of functional MRI time-series. Human Brain Mapping. 1994;1:153-171.
5. Fox MD, Raichle ME. Spontaneous fluctuations in brain activity observed with functional magnetic resonance imaging. Nature Reviews Neuroscience. 2007;8:700-711.
6. Biswal B, Yetkin FZ, Haughton VM, Hyde JS. Functional connectivity in the motor cortex of resting human brain using echo-planar MRI. Magnetic Resonance in Medicine. 1995;34(4):537-541.
7. Murphy K, Fox MD. Towards a consensus regarding global signal regression for resting state functional connectivity MRI. NeuroImage. 2017;154:169-173.
8. The OHBM Working Group. Consensus recommendations for clinical functional MRI applied to language mapping. Aperture Neuro. 2025. doi:10.52294/001c.128149.

8. MR Spectroscopy – metaboliti classici e 2-HG

1. Wilson M, Andronesi O, Barker PB, et al. Methodological consensus on clinical proton MR spectroscopy of the brain: review and recommendations. Magnetic Resonance in Medicine. 2019;82(2):527-550. doi:10.1002/mrm.27742.
2. Maudsley AA, Andronesi OC, Barker PB, et al. Advanced magnetic resonance spectroscopic neuroimaging: Experts' consensus recommendations. NMR in Biomedicine. 2021;34(5):e4309. doi:10.1002/nbm.4309.
3. Öz G, Alger JR, Barker PB, et al. Clinical proton MR spectroscopy in central nervous system disorders. Radiology. 2014;270(3):658-679.
4. Choi C, Ganji SK, DeBerardinis RJ, et al. 2-hydroxyglutarate detection by magnetic resonance spectroscopy in IDH-mutated gliomas. Nature Medicine. 2012;18:624-629.
5. Andronesi OC, Loebel F, Bogner W, et al. Treatment-induced changes in the glioma metabolic profile measured by proton magnetic resonance spectroscopic imaging. Journal of Clinical Oncology.
6. Elkhaled A, Jalbert LE, Phillips JJ, et al. Magnetic resonance of 2-hydroxyglutarate in glioma. Journal of Magnetic Resonance Imaging.

9. DTI / Diffusion MRI / Tractography

1. Basser PJ, Mattiello J, LeBihan D. MR diffusion tensor spectroscopy and imaging. Biophysical Journal. 1994;66(1):259-267.
2. Basser PJ, Pajevic S, Pierpaoli C, Duda J, Aldroubi A. In vivo fiber tractography using DT-MRI data. Magnetic Resonance in Medicine. 2000;44(4):625-632.
3. Mori S, van Zijl PCM. Fiber tracking: principles and strategies—a technical review. NMR in Biomedicine. 2002;15(7-8):468-480.
4. Behrens TEJ, Berg HJ, Jbabdi S, Rushworth MFS, Woolrich MW. Probabilistic diffusion tractography with multiple fibre orientations: what can we gain? NeuroImage. 2007;34(1):144-155.
5. Tournier JD, Calamante F, Connelly A. Robust determination of the fibre orientation distribution in diffusion MRI: non-negativity constrained super-resolved spherical deconvolution. NeuroImage. 2007;35(4):1459-1472.
6. Schilling KG, Yeh FC, et al. Quantitative mapping of the brain's structural connectivity using diffusion MRI tractography: a review. NeuroImage. 2022;249:118830.
7. Schilling KG, Cieslak M, Descoteaux M, et al. What needs to be standardized for reliable, reproducible, and robust tractography? GigaScience. 2026.
8. Schilling KG, Cieslak M, Descoteaux M, et al. Did you know? State-of-the-art preprocessing diffusion MRI data can improve tractography. Brain Structure and Function. 2026. doi:10.1007/s00429-026-03107-7.
9. 1. Elementi di Risonanza Magnetica, M. Coriasco
   2. - Introduction of Resting State fMRI functional Connectivity, J. Bijsterbpsch
      - Diagnostic accuracy of 2-hydroxyglutarate magnetic resonance spectroscopy in newly diagnosed brain mass and suspects recurrent gliomas, M. Zhou
   3. - Synthetic MRI for Clinicl Neuroimaging: Result of the Magnetic Resonance Image Compilation (MAGiC) Prospective, Multicenter, Multireader Trial, LN Tanenbaum
   4. - Risonanza Magnetico Testo Atlante Cardiologia, P. Pedrotti

Teaching methods

Interactive lectures with the participation of Subject Matter Experts:

Radiographer Paolo Morgagni

Radiographer Gianmarco Donati

Radiographer Davide Lelli

During the lectures, technical and clinical cases will be presented and discussed, with particular emphasis on the in-depth analysis of imaging protocols.

Assessment methods

The final assessment is aimed at evaluating the knowledge and understanding of the topics covered, with the objective of consolidating theoretical competencies and translating them into practical technical skills. The assessment may be conducted in written and/or oral form.

Office hours

See the website of Gioele Santucci