This section describes some of our main areas of research.
In each case examples of work presented at the International Society for Magnetic Resonance in Medicine (ISMRM) conference are given.
These can be viewed by clicking the corresponding pdf files.

Breast Research Programme
MRI has a high sensitivity for breast lesion detection and has established a role in equivocal mammography cases. Dynamic contrast enhanced (DCE) data is often used to improve specificity. Post-contrast high-resolution images are also used to provide morphological information.

• Enhancement profiles
  DCE data may be quantitatively interrogated to examine temporal chracteristics of enhancing lesions. We are using both empirical methods and pharmacokintic methods of analysis.
  
  Other work involves using neural-networks for pattern recognition of lesion enhancement profiles.
• Shape analysis
  Typically maligant lesions have an irregular border whereas benign lesions tend to be more round. Determination of shape characteristics such as convexity and complexity may improve differentiation.
• Textural analysis
  We are working on understanding the subjective interpretation of a lesion by analysing characteristics of pixel intensity and distribution.
  
• MR Spectroscopy
  We are currently using single voxel methods to demonstrate the presence of choline in malignant tumours.
• Other novel breast techniques
  Other MR techniques we are applying to the breast to provide complimentary information include ADC mapping and R2* measurement to probe tumour hypoxia.
  

Brain Research Programme
The brain is a large and relatively immobile organ, and was the first structure to be routinely imaged in the early 1980s. MRI has been shown to be the most sensitive technique for the vast majority of intra-cranial disease. MRI can provide important pre-surgical information in tumours, that is not apparent with CT.
We are working in the following areas:

• MR Spectroscopic Imaging
  MRSI allows us to probe the metabolic environment of tumours using multiple spectroscopic voxels. We are developing the methodology for analysing and displaying abnormal volumes based on the ratio of the NAA to choline levels. These data are being used in the evaluation of pre and post radiotherapy and surgical patients.
• functional MRI
  fMRI permits the non-invasive study of brain activation via the haemodynamic response. fMRI is now finding a clinical use in the pre-surgical evaluation of cancer patients allowing the surgeon to minimise post-operative functional deficits. Similarly, the functional data can be incorporated into a radiotherapy plan to permit a conformal avoidance strategy (see below). The picture on the right illustrates this with the motor cortex identified in green and the tumour in red.
  
• Other work
  Our fMRI research programme is expanding into other applications. For example we are currently embarking on a collaboration with Dr Colin Robertson (University of Lincoln) using fMRI to monitor and improve the targetting of treatment of depression using Transcranial Magnetic Stimulation (TMS).
  
  To see a video example of TMS at work, click here, which shows how stimualtion over the Broca area, interupts speech.
  
  In temporal lobe epilespsy patients We are also using fMRI for pre-surgical language lateralisation pre-surgery as an alternative to the invasive WADA test.

Radiotherapy Planning
State-of-the-art radiotherpay delivery methods such as Intensity Modulated Radiotherapy (IMRT) permit the use of extremely conformal dose distributions. We are using MRI to provide detailed anatomical and functional images that allow better delineate tumour targets and surrounding normal tissues.

• Head & Neck RT
  In this YCR funded project we are evaluating the efficacy of incorporating DCE-MRI into treatment plans in order to identify regions within the tumour which would receive dose escalation.
• Conformal avoidance
  We are using fMRI (described above) to highlight regions of the sensorimotor cortex in order to adopt a conformal avoidance strategy in the radiotherpay of brain tumours, thereby improving outcome.
• Gel dosimetry
  IMRT requires high-resoltuon dose verification in three dimensions, which is not possible with conventional film dosimetry. In collaboration with the University of Hull Chemistry department we are manufacturing and developing novel gel material in which radiation-induced changes may be calibrated with MRI to verify radiation delivery.

Bone Marrow Imaging
Bone marrow consists of red (water) and yellow (fat) components, the proportions of which are thought to be related to the remodelling capacity of bone with implications for the late treatment effects in cancer patients. We are presently undertaking a series of projects in collaboration with the Centre for Metabolic Bone Disease to investigate the normal variation of bone marrow composition throughout the axial and peripheral skeleton. This data will help us in future clinical studies.

• MRS investigations
  We have used non water suppressed spectroscopy to demonstrate normal bone marrow composition in terms of age, gender and skeletal site variation. The increased chemical shift dispersion at 3.0 Tesla provides information on other lipid peaks which may be clinically useful.
• Fat imaging
  We have developed novel fat-water phanoms of known fat content from 0-100%. These have been imaged using three techniques and correlated with MRS determined values. The results have enabled us to replace MRS for high resolution fat quantification of the main lipid resonance.