From NMR to Clinical Breast MRI

Abstract

This chapter gives a short historical overview of the process that transformed the physical phenomenon of nuclear magnetic resonance (NMR) into magnetic resonance imaging (MRI), the most powerful and versatile medical imaging modality, with relevant application to breast cancer screening and diagnostics. This long way was a constellation of Nobel laureates who contributed to: establish the physical principles of the phenomenon (W. E. Pauli); provide the first description of a resonance method for recording the magnetic properties of atomic nuclei (I. I. Rabi) and the first demonstration of NMR in condensed matter (F. Bloch and E.M. Purcell); develop high-resolution NMR spectroscopy (R. R. Ernst) and its use for investigations on the structure of biological macromolecules in solution (K. Wüthrich); and allow NMR to produce images of the human body through the introduction of magnetic field gradients for signal spatial localization (P. C. Lauterbur and P. Mansfield). We also underline the role of N. Tesla in understanding the physics of magnetic fields and radio waves (since 1957, we measure the magnetic field intensity in tesla, T) and that of R. V. Damadian in pioneering the application of NMR relaxometry to cancer, in particular to breast cancer. In addition, we summarize the first experiences on unenhanced breast MRI during the first half of the 1980s up to the first reports on gadolinium-based contrast-enhanced breast MRI (1986), with the relevant contributions given by S. Heywang and W. A. Kaiser. Finally, we highlight the prominent role of high-risk screening as the application which mainly supported the acceptance of breast MRI worldwide.