Press release | 24.4.2018
Munich, 24 April 2018 - Magnetic Resonance Imaging (MRI) is one of the safest medical diagnostic procedures today, and MRI scans are performed more than 100 million times per year worldwide. But when MRI scanners first emerged in the late 1970s, patients needed to lie still for several minutes for a single image; a major drawback - and barrier to market success - compared with X-ray or ultrasound. The crucial step that accelerated the process and established MRI in clinical practice was developed by German biophysicist Jens Frahm at the Max Planck Institute for Biophysical Chemistry in Göttingen. Perfected in 1985, the inventor's Fast Low Angle Shot (FLASH) technique reduced MRI imaging times from minutes to a matter of seconds, while his follow-up advancements made it possible to produce the first-ever MRI "films" of human physiology in real time.
For these contributions, Jens Frahm has been nominated for the European Inventor Award 2018 as one of three finalists in the category "Research". The winners of this year's edition of the EPO's annual innovation prize will be announced at a ceremony in Paris, Saint-Germain-en-Laye, on 7 June 2018.
"Jens Frahm's work has unlocked the diagnostic potential of Magnetic Resonance Imaging in public healthcare and benefitted millions of patients over the past decades," said EPO President Benoît Battistelli, announcing the European Inventor Award 2018 finalists. "This invention underlines the leading role of European scientists and inventors in the field of medical technology, to which research institutes strongly contribute."
MRI relies on measuring the response of hydrogen nuclei found in water molecules throughout the human body to a magnetic field. The first human MRI scan was conducted in 1977, but took four hours and 45 minutes to create a picture - much too slow for medical practice. The reason: a single, two-dimensional MRI image requires about 200 individual data recordings - or exposures to the magnetic field - to fully render a section of a patient's body and initially required waiting periods in between to allow the nuclei recover.
Working as part of an MRI research team at the Max Planck Institute (MPI) for Biophysical Chemistry in Göttingen in the early 1980s, Jens Frahm devised a method to speed up the process: By sending ultra-short signal pulses at only 2 to 10 millisecond intervals, fired at a reduced angle, he was able to collect all the necessary exposures for a three-dimensional MRI image in a few minutes. This radical speed increase, aptly named FLASH (Fast Low Angle Shot), completely eliminated recovery breaks and still delivered high-resolution images. Frahm had his invention patented and published his findings in The Lancet in 1985. Leading manufacturers adopted FLASH within months of publication and the numbers of installed MRI scanners grew significantly worldwide.
Another advancement, known as FLASH 2, is a further reason for Frahm's nomination for the European Inventor Award. Completed in 2010, the method pairs the FLASH principle with modern-day computer image reconstruction to achieve recording speeds of up to 100 frames per second. 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 measurements. Image reconstruction algorithms then calculate the differences between images and fill in the missing information to create seamlessly moving pictures.
"We're shifting magnetic resonance imaging from a photographic state to one that is filmed. We've developed a new method that makes it possible for the first time to directly depict and film the physiological processes of any kind of human bodily function," says Jens Frahm.
Currently undergoing clinical tests in Germany, the UK and the United States, FLASH 2 can generate up to 6 000 images in one minute. It unlocks the first-ever MRI films of beating hearts, moving joints and complex processes like swallowing and speech formation.
Powered 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. "We eliminated waiting times with FLASH technology ... basically, it initiated the modern MRI," says Frahm.
Today, MRI usage is considered an indicator of quality healthcare in global ratings and has risen in all countries over the past decades. In Frahm's native Germany, the number of MRI exams in ambulatory care has increased from 38.4 per 1 000 inhabitants in 2000 to 108.2 in 2014, while the number of installed MRI scanners per 100 000 inhabitants increased from 2.7 units in 2010 to 3.4 in 2015.
According to Frahm, patients will also stand to benefit from FLASH 2. It opens up detailed studies of articulation and speaking disorders such as stuttering, and swallowing problems in real time and without discomfort to the patient. In cardiac MRI procedures, doctors can have a view of the beating heart for a new kind of comprehensive cardiac examination in much less time. "The patients we want to study are primarily those with arrhythmias - those who currently have totally irregular heartbeats that cannot be properly examined using conventional technology," says the inventor. FLASH 2 is currently being tested for clinical use at universities in Germany, the UK and the US.
The global market for MRI systems was estimated to be worth EUR 4.7 billion in 2016 and is projected to reach EUR 6 billion in 2021. The FLASH platform is now the Max Planck Society's most profitable patent asset and has generated a reported EUR 155 million in licensing revenue to date. Royalties from patents on both FLASH and FLASH 2 have been used to fund the research activities of Biomedizinische NMR Forschungs GmbH, the not-for-profit organisation Frahm established in 1993 at the Göttingen MPI for Biophysical Chemistry to scale up FLASH research.
Jens Frahm embarked on his path of integrating chemical and physical research to reveal processes inside the human body as a young physics student at the Georg-August-University of Göttingen. For his 1977 PhD thesis in physical chemistry, he explored the medical uses of a brand-new concept called nuclear magnetic resonance (NMR) spectroscopy, the core technology behind MRI. In his free time, he played the clarinet, drawing on training he received from the State Theatre in the town of Oldenburg.
Four decades later, Frahm's musical passion and curiosity are as keen as ever: The inventor is using FLASH 2 technology to explore the biomechanics behind sound formation in brass instruments such as the horn. He captures live MRI films of professional musicians, including members of the Berlin Philharmonic Orchestra. The first surprising take-away: Contrary to time-honoured teaching, the human tongue is not passive in playing what are referred to as "lip-vibrated instruments". Frahm's MRI films revealed the tongue's active role in producing the quality of sound and modulating speed of air streams. Musical education text books are being rewritten as a result.
Today, Jens 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. His current research focus lies with diagnostic applications of real-time MRI images created via FLASH 2 in detecting heart disease, speech impediments and swallowing disorders.
He is credited as the author of four European patents and over 470 scientific publications, including papers detailing fundamental principles behind FLASH and FLASH 2. An authority in his field, 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, Jens Frahm was inducted into the German Research Hall of Fame - an honour he shares with only 20 other scientists, half of whom are Nobel laureates - for his for pioneering work on MRI.
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 Topography (CAT) and Magnetic Resonance Imaging (MRI) were developed and refined by NASA to survey the surface of the moon. Thanks to spin-off innovations, the fundamental principles were expanded - for instance by Jens Frahm's FLASH method - into medical practice.
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