Cryogenic Preamplifiers for Magnetic Resonance Imaging.

Pursuing the ultimate limit of detection in magnetic resonance imaging (MRI) requires cryogenics to decrease the thermal noise of the electronic circuits. As cryogenic coils for MRI are slowly emerging cryogenic preamplifiers are required to fully exploit their potential. A cryogenic preamplifier operated at 77 K is designed and implemented for C imaging at 3 T (32.13 MHz), using off-the-shelves components. The design is based on a high electron mobility transistor (ATF54143) in a common source configuration. Required auxiliary circuitry for optimal cryogenic preamplifier performance is also presented consisting of a voltage regulator (noise free supply voltage and optimal power consumption), switch, and trigger (for active detuning during transmission to protect the preamplifier). A gain of 18 dB with a noise temperature of 13.7 K is achieved. Performing imaging experiments in a 3 T scanner showed an 8% increased signal-to-noise ratio from 365 to 399 when lowering the temperature of the preamplifier from 296 to 77 K while keeping the coil at room temperature. This paper thus enables the merger of cryogenic coils and preamplifiers in the hopes of reaching the ultimate limit of detection for MRI.

Myocardial perfusion 320-row multidetector computed tomography-guided treatment strategy for the clinical management of patients with recent acute-onset chest pain: Design of the CArdiac cT in the treatment of acute CHest pain (CATCH)-2 randomized controlled trial.

AIMS: Patients admitted with chest pain are a diagnostic challenge because the majority does not have coronary artery disease (CAD). Assessment of CAD with coronary computed tomography angiography (CCTA) is safe, cost-effective, and accurate, albeit with a modest specificity. Stress myocardial computed tomography perfusion (CTP) has been shown to increase the specificity when added to CCTA, without lowering the sensitivity. This article describes the design of a randomized controlled trial, CATCH-2, comparing a clinical diagnostic management strategy of CCTA alone against CCTA in combination with CTP. METHODS: Patients with acute-onset chest pain older than 50 years and with at least one cardiovascular risk factor for CAD are being prospectively enrolled to this study from 6 different clinical sites since October 2013. A total of 600 patients will be included. Patients are randomized 1:1 to clinical management based on CCTA or on CCTA in combination with CTP, determining the need for further testing with invasive coronary angiography including measurement of the fractional flow reserve in vessels with coronary artery lesions. Patients are scanned with a 320-row multidetector computed tomography scanner. Decisions to revascularize the patients are taken by the invasive cardiologist independently of the study allocation. The primary end point is the frequency of revascularization. Secondary end points of clinical outcome are also recorded. DISCUSSION: The CATCH-2 will determine whether CCTA in combination with CTP is diagnostically superior to CCTA alone in the management of patients with acute-onset chest pain.