Advances in imaging technology have opened up new frontiers at Einstein, as researchers can now view, with exquisite detail, the growth of tumors over time, the effect malaria has on the brain, and the proliferation of stem cells transplanted in an irradiated liver. Physicians benefit as well, with neurosurgeons sending patients for pre-surgery imaging and cardiac specialists discerning vascular abnormalities with non-invasive techniques.

MRRC co-directors Drs. Michael Lipton (left) and Craig Branch discuss facility business with Dr. Evelyn Gruss-Lipper, benefactor of the MRRCThese are among scores of research projects and clinical interventions underway at the Gruss Magnetic Resonance Research Center (MRRC), located on Einstein's Jack and Pearl Resnick campus, where researchers and clinicians are using state-of-the-art imaging machines that are unmatched in the metropolitan region, and the first of their kind in the Northeast.

Installed during 2009 and 2010, the MRRC's new equipment represents the latest developments in the field of magnetic resonance imaging, a relatively new diagnostic tool, which produced its first image in the 1970s (with Einstein alumnus Dr. Raymond Damadian, Class of 1960, the first to use the technology with humans).

Magnetic resonance imaging, called MRI, became widespread in the 1990s. Einstein's equipment for humans has magnet strength of 3 Tesla – or 3T – which is the strongest MRI magnet approved for use in scanning humans. This high magnetic field strength, combined with other technologic features of the scanner, allow Einstein scientists and physicians to produce exquisitely detailed images of the human body, aiding both research and diagnosis. In addition, the equipment for small-animal subjects is more than three times as powerful, at 9.4T, and allows non-invasive examination of animal without the need to euthanize them. In addition, a mock scanner introduces patients and study participants to the experience of being inside the machine before they undergo their actual imaging sessions.

This image depicts a functional MRI imaging study in a transgenic mouse model of sickle-cell disease, before (top series) and after (bottom series) treatment with an experimental blood substitute. The images demonstrate that prior to treatment, high oxygen extraction is observed consistent with poor oxygen delivery due to the disease. After treatment, a normal response is observed. (Courtesy of Dr. Mary Fabry, Medicine/hematology)"The improvements to our facility have been a real boon for Einstein," said Dr. Craig Branch, the center's director. "In addition to boosting our competitiveness in pursuing grants, we've been able to demonstrate to faculty how our equipment can benefit their research efforts with animals or humans."

Research activity at the MRRC has picked up significantly since the installations. Currently, more than 40 projects are underway or in the pipeline, by researchers whose studies range from understanding the role of neuro-peptides in eating disorders to tracking cognitive decline among aging Americans.

Dr. Chandan Guha, professor of radiation oncology and director of the Einstein Oncophysics Institute, collaborates with the Gruss MRRC in his studies with liver stem cells, which are transplanted after a preparative regimen of liver irradiation, resulting in extensive proliferation of the transplanted cells in the irradiated portions of the diseased organ. Magnetic resonance spectroscopy is then used to detect the extent of liver-cell repopulation.

"The MRRC is a huge resource for Einstein," said Dr. Guha. "It offers tremendous application in understanding the metabolism of tumors as well as the process of repair of radiation injury to normal tissues."

The MRI's diffusion tensor imaging (DTI) capabilities are aiding Dr. Branch and MRRC associate director Dr. Michael Lipton in their study of mild traumatic brain injury, otherwise known as concussion. The precise images afforded by DTI help them in detecting subtle degrees of injury, which may have important implications for predicting a patient's prognosis – such as will the patient recover on his own, or might he incur permanent damage?

In this image, the use of diffusion tensor imaging (DTI) shows degeneration of nerve fibers that connect the two sides of the brain. This particular brain injury resulted in significant problems with the speed that the patient could process information. Without DTI, the patient would be told that his/her brain looks normal and would likely be extremely distressed by the fact that he/she knows that things are not normal even though no injury could be seen. (Courtesy of Dr. Michael Lipton, MMRC)Dr. Lipton also is promoting the use of the MRRC to physicians at Einstein's university hospital, Montefiore. Neurosurgeons have used the facility to prepare patients for the operating room by asking patients to read, speak, or move their limbs while inside the scanner and thus map brain regions important for normal function.

"The MRI can detect activity in certain regions of the brain as the patient performs the actions," explained Dr. Lipton. "So when the neurosurgeon goes in to remove a tumor, he can remove as much as possible but avoid damaging these functionally critical brain regions."

Neurosurgeons also use the images to map metabolic function in the brain. For example, the imaging helps identify the foci of epileptic activity, which can then be treated surgically to stop the seizures.

Other physicians use the Einstein imaging system to perform real-time magnetic resonance angiography, which offers detailed imaging of blood flow throughout the vascular system without the need for inserting a catheter, as is required with traditional angiograms. The MRRC recently began offering breast imaging, as well, making use of revolutionary multi-transmit technology that produces much clearer and higher quality breast images than traditional MRIs. These images offer complimentary information that can be useful in conjunction with mammography.

Readying a patient for imagingThe versatility of the machines' powerful magnets continues to expand. As the manufacturer develops new technologies, they share them with Einstein researchers, who can employ them in their research and clinical exams. In return, as Einstein researchers and MRRC staff scientists develop new methodologies for using the technologies, they share their novel approaches with the manufacturer, who adapts the machines for these new uses.

"It's a collaboration designed to move the science forward," said Dr. Branch. "We want to better understand disease and pathology, and the technology can help us uncover new ways to attack the underlying problem behind the disease. Our ultimate goal is to make discoveries that lead to improved patient care."