AUTHORS' REPLY

Abstract

<h3>Abstract</h3> <h3>Purpose</h3> Quantitative susceptibility mapping (QSM) is increasingly used for clinical research where oblique image acquisition is commonplace but its effects on QSM accuracy are not well understood. <h3>Theory and Methods</h3> The QSM processing pipeline involves defining the unit magnetic dipole kernel, which requires knowledge of the direction of the main magnetic field with respect to the acquired image volume axes. The direction of is dependent upon the axis and angle of rotation in oblique acquisition. Using both a numerical brain phantom and in-vivo acquisitions in five healthy volunteers, we analysed the effects of oblique acquisition on magnetic susceptibility maps. We compared three tilt correction schemes at each step in the QSM pipeline: phase unwrapping, background field removal and susceptibility calculation, using the root-mean-squared error and QSM-tuned structural similarity index (XSIM). <h3>Results</h3> Rotation of wrapped phase images gave severe artefacts. Background field removal with PDF gave the most accurate susceptibilities when the field map was first rotated into alignment with . LBV and V-SHARP background field removal methods gave accurate results without tilt correction. For susceptibility calculation, thresholded <i>k</i>-space division, iterative Tikhonov regularisation and weighted linear total variation regularisation all performed most accurately when local field maps were rotated into alignment with before susceptibility calculation. <h3>Conclusion</h3> For accurate QSM, oblique acquisition must be taken into account. Rotation of images into alignment with should be carried out after phase unwrapping and before background field removal. We provide open-source tilt-correction code to incorporate easily into existing pipelines: https://github.com/o-snow/QSM_TiltCorrection.git.