A Norwegian medical research laboratory is making advances in imaging techniques for both ultrasound and magnetic resonance imaging (MRI). One benefit will be an enhanced ability to better identify heart defects in newborns.

"Making the correct diagnosis is the greatest challenge facing pediatric cardiologists," explained Dr. Siri-Ann Nyrnes, consultant in the pediatric department of St. Olav's Hospital Trondheim University Hospital (Norway). "The organs are so small, and current ultrasound imaging can only provide limited information. A cardiologist needs many years of experience to be able to make a diagnosis with any certainty." Dr. Nyrnes is part of the Medical Imaging Laboratory (MI Lab; Trondheim, Norway), whose host institution is the Norwegian University of Science and Technology (NTNU).

MI Lab is one of Norway's 14 original Centers for Research-based Innovation (SFI), which have received funding from the Research Council of Norway since 2007. Color Doppler imaging has been the standard in ultrasound since the late 1980s. MI Lab's new method, called blood flow imaging (BFI), provides two-dimensional blood flow information by visualizing blood speckle movement superimposed on color Doppler images. The resulting pattern displays blood flow regardless of the ultrasound beam orientation providing greater information about flow direction as well as a more intuitive visualization. Blood flow rate can also be measured, and clinicians will soon be able to determine the actual volume of blood flowing through normal and pathologic openings.
In a pilot study, researchers examined 13 children with ventricular septal defect (a hole in the wall between the right and left ventricles of the heart, the most common heart defect in newborns). Using both new and traditional blood flow imaging methods, the researchers concluded that compared to the color Doppler, the new method provides a significantly more detailed image of blood flow.

"The images in this study were created by the physician and technician working together, so the latter could see first-hand what we physicians are contending with, and what we need in order to improve our diagnostics," remarked Dr. Nyrnes. "The method is being refined with each patient."

The MI Lab is now taking the method an additional step by using plane wave imaging, which can generate an image more quickly. A pilot study of five newborns indicated that plane wave imaging yielded 5-10 times more images per second, with a considerably higher image quality.

"Quantifying the blood flow is our next objective," said engineer and research fellow Lasse Løvstakken. "Ultimately we want to develop this method to provide blood flow information in 3D [three-dimensions]."

Olav Haraldseth, a professor of medicine at NTNU, is also the director of MI Lab. "We are focusing our research on ultrasound and MR because these will most likely be the most important methods in future healthcare," he asserted.

The goal of MI Lab is to establish a major interdisciplinary research group involving relevant participants from the entire research community in the Trondheim area. The group is to integrate fields such as medicine, ICT [information and communication technology], physics, mathematics, cybernetics, electronics, physiology, molecular biology, neuroscience, and psychology. "I believe that this collaborative effort between the university, hospital, and industry will prove very fruitful, yielding high-quality research and innovation that are useful to our industry partners and to society as a whole. Our objective must be to encourage medical research that makes Norwegian industry more competitive. Medicine is a knowledge-based industry, and the whole world is our market," said Prof. Haraldseth.

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