Advanced MR: a roadmap for return to play

by Michael A. McCrea, PhD, ABPP, Professor and Vice Chair of Research in the Department of Neurosurgery, the Shekar N. Kurpad, MD, PhD Chair in Neurosurgery, Co-Director, Center for Neurotrauma Research (CNTR), Medical College of Wisconsin, Milwaukee, WI

Michael A. McCrea, PhD, ABPP

Medical College of Wisconsin

Milwaukee, WI

As we emerge from the COVID-19 pandemic, the idea of "return to play" resonates with all of us. Whether it is returning to in-person work or school, playing professional or collegiate sports in front of fans, the resumption of youth sports or, more simply, getting together with friends and family whom we haven’t seen for some time, we can all appreciate the need to return to what we were doing before the pandemic. For me, return to play also means resuming the important research being conducted by our team at the Medical College of Wisconsin in the field of concussion and traumatic brain injury (TBI).

As you will read in the following pages of SIGNA™ Pulse of MR, MR imaging can play an important role in determining when an athlete’s level of recovery and fitness allow for a return to play after various forms of injury in sport. First, MR provides clinical utility in terms of making the diagnosis. Second, MR informs treatment decisions, whether it be rest, rehabilitative therapies or surgery. Third, MR may have some prognostic utility in helping predict an athlete’s expected course of recovery, outcome and return to play.

Together, these benefits of MR have one central theme: leveraging advanced technology toward more objective biomarkers of injury and recovery, consistent with our collective interest in moving toward a model of precision medicine.

Take for example the role of MR in neuroimaging as an objective assessment of concussion and mild TBI (mTBI). Advanced MR techniques, such as diffusion tensor imaging (DTI), quantitative susceptibility mapping (QSM)‡ and others, are designed to help detect subtle abnormalities associated with concussion that may not be readily evident on a routine clinical exam or conventional assessment methods.

Over the past 10 years, GE Healthcare and researchers have leveraged modern MR to accelerate the science of sport-related concussion, MSK injury and return to play. While we often think of MR as a diagnostic tool, it can help identify specific treatment modalities for individual patients or athletes and is prognostic in predicting an individual athlete’s likely course of recovery and return to play.

As MR technology continues to advance, we’ll improve its diagnostic, therapeutic and prognostic capabilities to provide a direct benefit to our patients. By continuing to provide the clinical evidence that MR is a valuable component that informs clinicians throughout a patients’ care pathway — from diagnosis to recovery — it will have a meaningful impact in routine care as we all return to play.