Invention: Improved magnetic resonance imaging (MRI)
Magnetic resonance imaging (MRI) is one of the world's most widely used diagnostic tools. The road to success was paved by a revolutionary scanning technique known as fast low angle shot (FLASH). Perfected by German physical chemist Jens Frahm in 1985, FLASH accelerated MRI scans by a factor of 100. Reducing scanning time from half a day to a few minutes, it soon became the clinical standard. The inventor's follow-up, FLASH 2, delivers the first moving MRI images in real time at up to 100 frames per second
Before Frahm's game-changing invention, MRI was still unsuitable
as a diagnostic tool. When the first human MRI scan was conducted in 1977, it
took four hours and 45 minutes to create a three-dimensional image - much
too slow for medical practice.
Providing the speed boost, Jens Frahm at the Max Planck
Institute for Biophysical Chemistry in Göttingen devised an ingenious principle
in the early 1980s: FLASH flips the atoms that are aligned with the magnetic
field at a shallower angle, thus allowing for ultra-short signal pulses fired
in rapid succession and hence faster scans. As a result, MRI scanners can
collect all necessary exposures for a three-dimensional image in just a few
minutes, and two-dimensional images within seconds.
The rest is history. Leading manufacturers adopted the
patented technology within months of publication and the number of installed
MRI scanners grew significantly worldwide.
"The imaging method we developed at the time has formed
the basis for all clinical magnetic resonance applications worldwide,"
says the inventor. In 2010, Frahm presented the follow-up invention: FLASH 2
pairs the FLASH principle with modern-day computer image reconstruction to
achieve recording speeds of up to 100 frames per second, moving MRI from
photography to video.
Societal benefit
Accelerated by FLASH technology, MRI scanners quickly became
the new status quo in medical imaging by delivering high-resolution,
three-dimensional images of sensitive areas such as the brain, heart and
abdomen without the harmful radiation associated with X-rays.
Today, more than 100 million MRI procedures, all using
the FLASH method, are performed every year around the world. That is three MRI
scans every second. In global healthcare ratings, the availability of MRI
procedures is an important benchmark of quality care. Worldwide, there are 36 000
MRI machines. In Germany alone, the number of MRI procedures in ambulatory care
almost tripled from 38 procedures performed per 1 000 inhabitants in 2000
to 108 procedures in 2014.
Patients also stand to benefit from FLASH 2, which is
currently undergoing clinical tests in Germany, the UK and the United States. It
provides the first-ever three-dimensional videos of pumping hearts, moving
joints and complex processes like swallowing or speech formation. "We can
now visualise physiological processes that we have never seen before,"
says Frahm. FLASH 2 has already yielded 50 doctoral theses along with
fresh diagnostic insights.
Economic benefit
Frahm's discoveries resulted in key patents for the FLASH
method, granted in 1987 in the United States and in 1989 in Europe. But the
patents initially yielded no profits, because three of the largest
manufacturers used the technology without a licence. By 1993, the Max Planck
Society had spent nearly EUR 1.5 million in a successful seven-year legal
battle on all continents.
Today, the FLASH platform is the Max Planck Society's most
profitable patent asset and has generated a reported EUR 155 million
in licensing revenue to date. Royalties from both FLASH and FLASH 2 go
straight into research, funding a not-for-profit organisation specifically created
for Frahm's research in 1993 at the Max Planck Institute for Biophysical
Chemistry in Göttingen.
Analysts at MarketsandMarkets estimated the global market
for MRI systems at EUR 4.7 billion in 2016. The market is projected
to reach EUR 6 billion in 2021 at a compound annual growth rate of
5.1%.
-
Jens Frahm
-
Faster, real-time MRI, Jens Frahm
-
Faster, real-time MRI, Jens Frahm
-
Jens Frahm
-
Jens Frahm
How it works
Water is found throughout the body (e.g. in tissue, organs
and fat), and MRI relies on the properties of the hydrogen nuclei in water. The
patient is put in the MRI scanner's strong magnetic field and the hydrogen
atoms in the body's water molecules align with the field. These atoms are then "flipped"
out of alignment by a radio frequency pulse.
After the pulse, the hydrogen atoms "relax" back
into the magnetic field, emitting radio waves that are picked up by the MRI
scanner and rendered into images by a mathematical transformation. The first
MRI devices required over 200 individual data recordings - meaning exposures
to the magnetic field - to fully render one cross-section of a patient's body.
The lengthy procedure also required a delay of several seconds between each
radio pulse to allow the nuclei to recover.
Radically shortening imaging times, Frahm's FLASH technique uses only a
small portion of the MRI signal for each of the many individual measurements. The
concept eliminates long delays between pulses, enabling repetitive measurements
every 2 to 10 milliseconds, with pulses flipping atoms through a
shallower angle of just 5 to 15 degrees instead of 90 before they relax to magnetic
alignment.
Frahm's "fast low angle shot" completes cross-sectional images in about one
second, and reduced the measuring times of three-dimensional image recordings
from at least half a day to a few minutes.
For the world's first moving MRI images, FLASH 2 uses an ingenious
trick: because differences between individual frames are minimal, it records
only a small number of images - around 5 to 15 instead of 200 exposures.
Reconstruction algorithms then "fill
in the blanks" to create seamlessly moving pictures.
The inventor
Jens Frahm embarked on his lifelong path of integrating
chemical and physical research as a physics student at the Georg August University
of Göttingen, Germany. For his 1977 PhD thesis in physical chemistry, he
explored the medical uses of a then brand-new concept called nuclear magnetic
resonance (NMR) spectroscopy, the core technology behind MRI.
Today, Frahm heads
his own MRI research laboratory as Director of Biomedizinische NMR Forschungs
GmbH at the Max Planck Institute for Biophysical Chemistry in Göttingen, a position
he has held since 1993. A current -
perhaps surprising - project studies sound
formation in brass instruments, such as the horn, using FLASH 2. Musical
education textbooks are already being
rewritten as a result of the findings. MRI films have revealed the active role
of the human tongue in what have always
been referred to as "lip-vibrated" instruments. A footnote should
include that Frahm is an avid clarinet player, and at one time received
training from the Staatstheater Oldenburg.
Regarded as an
institution in his field, the prolific Frahm is the author of over 470 scientific publications, including papers
detailing fundamental principles behind FLASH and FLASH 2. He holds an h-index score of 87 and is
listed as the inventor on four granted European patents.
Frahm's honours
include the Gold Medal Award of the International Society for Magnetic
Resonance in Medicine (1991), European MRI Award of the German Roentgen Society
(1989) and Jacob Henle Medal (2016). In 2016, Frahm was inducted into the
German Research Hall of Fame, an honour which has been conferred on only 20 scientists.
"I've worked
all my life on MRI. For me as a physicist, this is a fascinating opportunity to
do something useful, something meaningful, that benefits millions of people,"
Frahm says.
Did you know?
It's a little-known fact that some of today's most
widely used medical diagnostic tools owe their existence to space programmes.
Both computer-aided tomography and MRI are based on digital image processing technologies
developed and refined by NASA to survey the surface of the moon in preparation for
the Apollo lunar landing.
These technologies from space exploration were later
successfully converted into terrestrial uses thanks to spin-off innovations
like Frahm's FLASH imaging principle. The impact of out-of-this-world
inventions extends far beyond medicine. The European Space Agency (ESA) has
brought organic membranes for water recycling, remote-controlled emergency
response robots and image analysis software for the repair of wind turbines
back to Earth. Even bathing has become more eco-friendly as a result of space
water conservation studies. In Sweden, Mehrdad Mahdjoubi has created a new shower
technology that uses only five litres of water per use while continuously
filtering the water to make it even cleaner than from the tap.
Landing space technologies on Earth is also big
business. According to the ESA, technology transfer from space inventions creates
1 500 jobs and revenues of EUR 80 million per year. This is between
15 and 20 times the amount spent by ESA member states on the space
programme.