3D Gradient Echo Sequence Research Articles

Movement assessment of breast and organ-at-risks using free-breathing, self-gating 4D magnetic resonance imaging workflow for breast cancer radiation therapy.

Motion management is essential in treatment planning of radiotherapy for breast cancer. This study assessed the movement of organs-at-risk and the breast using 4D magnetic resonance imaging (MRI). A self-gating respiration-resolved radial 3D gradient echo sequence was used. Five healthy volunteers were imaged at 1.5 T during free-breathing in supine position making use of a breast board. Median distances between heart and chest wall in axial views were 2.4 cm (range: 1.5 cm) and 3.0 cm (range: 1.7 cm) for end-of-exhale and end-of-inhale. 4D-MRI allowed organ delineation and might be a promising addition to novel RT planning for breast cancer patients.

Pituitary MRI in Cushing's disease - an update.

Pituitary MRI is essential in the diagnosis of ACTH-dependent Cushing's syndrome, but its results are inconsistent. The demonstration of a sellar image compatible with the diagnosis of corticotropinoma varies from 40% to 90%, depending on the centre where the imaging is performed. In fact, the expertise of the neuroradiologist, use of a Tesla 3.0 MRI and choice of sequences are fundamental. The T2 and 3D gradient echo sequences after gadolinium injection are the most informative and today allow the detection of macro- and microadenomas in almost all cases. The diagnosis of numerous picoadenomas (<3-4 mm) is more challenging. The 2D and 3D spin echo or delayed T1 SE or FLAIR sequences after gadolinium can be used as a complement or to confirm a suspicious image. Characterization of corticotropinomas remains problematic. However, the correct assessment of so-called incidentalomas by recognizing artifacts, anatomical variants and frequent Rathke's cleft cysts eliminates around 90% of the incidentalomas that mimic pituitary adenomas, as repetitively reported in the literature. For the time being, there is reason to believe that hybrid imaging combining PET and MRI such as 11C-methionine PET coregistered with volumetric MRI will solve the diagnosis of corticotropinomas in the near future.

Highly accelerated 3D MPRAGE using deep neural network-based reconstruction for brain imaging in children and young adults.

This study aimed to accelerate the 3D magnetization-prepared rapid gradient-echo (MPRAGE) sequence for brain imaging through the deep neural network (DNN). This retrospective study used the k-space data of 240 scans (160 for the training set, mean ± standard deviation age, 93 ± 80 months, 94 males; 80 for the test set, 106 ± 83 months, 44 males) of conventional MPRAGE (C-MPRAGE) and 102 scans (77 ± 74 months, 52 males) of both C-MPRAGE and accelerated MPRAGE. All scans were acquired with 3T scanners. DNN was developed with simulated-acceleration data generated by under-sampling. Quantitative error metrics were compared between images reconstructed with DNN, GRAPPA, and E-SPIRIT using the paired t-test. Qualitative image quality was compared between C-MPRAGE and accelerated MPRAGE reconstructed with DNN (DNN-MPRAGE) by two readers. Lesions were segmented and the agreement between C-MPRAGE and DNN-MPRAGE was assessed using linear regression. Accelerated MPRAGE reduced scan times by 38% compared to C-MPRAGE (142 s vs. 320 s). For quantitative error metrics, DNN showed better performance than GRAPPA and E-SPIRIT (p < 0.001). For qualitative evaluation, overall image quality of DNN-MPRAGE was comparable (p > 0.999) or better (p = 0.025) than C-MPRAGE, depending on the reader. Pixelation was reduced in DNN-MPRAGE (p < 0.001). Other qualitative parameters were comparable (p > 0.05). Lesions in C-MPRAGE and DNN-MPRAGE showed good agreement for the dice similarity coefficient (= 0.68) and linear regression (R2 = 0.97; p < 0.001). DNN-MPRAGE reduced acquisition time by 38% and revealed comparable image quality to C-MPRAGE. • DNN-MPRAGE reduced acquisition times by 38%. • DNN-MPRAGE outperformed conventional reconstruction on accelerated scans (SSIM of DNN-MPRAGE = 0.96, GRAPPA = 0.43, E-SPIRIT = 0.88; p < 0.001). • Compared to C-MPRAGE scans, DNN-MPRAGE showed improved mean scores for overall image quality (2.46 vs. 2.52; p < 0.001) or comparable perceived SNR (2.56 vs. 2.58; p = 0.08).

MR and fluorescence imaging of gadobutrol-induced optical clearing of red fluorescent protein signal in an in vivo cancer model.

Multimodality registration of optical and MR images in the same tissue volume in vivo may be enabled by MR contrast agents with an optical clearing (OC) effect. The goals of this study were to (a) investigate the effects of clinical MR contrast agent gadobutrol (GB) and its combinations as a potential OC agent assisting in fluorescence intensity (FI) imaging in vivo and (b) evaluate MRI as a tool for imaging of topical or systemic application of GB for the purpose of OC. Subcutaneous tumor xenografts expressing red fluorescent marker protein were used as disease models. MRI was performed at 1 T 1 H MRI using T1 -weighted 3D gradient-echo (T1w-3D GRE) sequences to measure time-dependent MR signal intensity changes by region of interest analysis after image segmentation. Topical application of 1.0 M or 0.7 M GB-containing OC mixture with water and dimethyl sulfoxide showed similar 30-40% increases of tumor FI during the initial 15 min. Afterwards, the OC effect of GB on FI and tumor/background FI ratio showed a decrease over time in the case of 1.0 M GB, unlike the 0.7 M GB mixture, which resulted in a steady increase of FI and tumor/background ratio for 15-60 min. The use of T1w-3D GRE MR pulse sequences showed that concentrated 1.0 M GB resulted in MR signal loss of the skin due to high magnetic susceptibility and that signal loss coincided with the OC effect. Intravenous injection of 0.3 mmol GB/kg resulted in a rapid but transient 40% increase of FI of the tumors. Overall, 1 T MRI enabled tracking of GB-containing OC compositions on the skin surface and tumor tissue, supporting the observation of a time-dependent FI increase in vivo.

Evaluation of MR-derived simulated CT-like images and simulated radiographs compared to conventional radiography in patients with shoulder pain: a proof-of-concept study

BackgroundTo evaluate the diagnostic value of MR-derived CT-like images and simulated radiographs compared with conventional radiographs in patients with suspected shoulder pathology.Methods3 T MRI of the shoulder including a 3D T1-weighted gradient echo sequence was performed in 25 patients (mean age 52.4 ± 18 years, 13 women) with suspected shoulder pathology. Subsequently a cone-beam forward projection algorithm was used to obtain intensity-inverted CT-like images and simulated radiographs. Two radiologists evaluated the simulated images separately and independently using the conventional radiographs as the standard of reference, including measurements of the image quality, acromiohumeral distance, critical shoulder angle, degenerative joint changes and the acromial type. Additionally, the CT-like MR images were evaluated for glenoid defects, subcortical cysts and calcifications. Agreement between the MR-derived simulated radiographs and conventional radiographs was calculated using Cohen’s Kappa.ResultsMeasurements on simulated radiographs and conventional radiographs overall showed a substantial to almost perfect inter- and intra-rater agreement (κ = 0.69–1.00 and κ = 0.65–0.85, respectively). Image quality of the simulated radiographs was rated good to excellent (1.6 ± 0.7 and 1.8 ± 0.6, respectively) by the radiologists. A substantial agreement was found regarding diagnostically relevant features, assessed on Y- and anteroposterior projections (κ = 0.84 and κ = 0.69 for the measurement of the CSA; κ = 0.95 and κ = 0.60 for the measurement of the AHD; κ = 0.77 and κ = 0.77 for grading of the Samilson-Prieto classification; κ = 0.83 and κ = 0.67 for the grading of the Bigliani classification, respectively).ConclusionIn this proof-of-concept study, clinically relevant features of the shoulder joint were assessed reliably using MR-derived CT-like images and simulated radiographs with an image quality equivalent to conventional radiographs. MR-derived CT-like images and simulated radiographs may provide useful diagnostic information while reducing the amount of radiation exposure.

Generative adversarial network-based post-processed image super-resolution technology for accelerating brain MRI: comparison with compressed sensing.

It is unclear whether deep-learning-based super-resolution technology (SR) or compressed sensing technology (CS) can accelerate magnetic resonance imaging (MRI) . To compare SR accelerated images with CS images regarding the image similarity to reference 2D- and 3D gradient-echo sequence (GRE) brain MRI. We prospectively acquired 1.3× and 2.0× faster 2D and 3D GRE images of 20 volunteers from the reference time by reducing the matrix size or increasing the CS factor. For SR, we trained the generative adversarial network (GAN), upscaling the low-resolution images to the reference images with twofold cross-validation. We compared the structural similarity (SSIM) index of accelerated images to the reference image. The rate of incorrect answers of a radiologist discriminating faster and reference image was used as a subjective image similarity (ISM) index. The SR demonstrated significantly higher SSIM than the CS (SSIM=0.9993-0.999 vs. 0.9947-0.9986; P < 0.001). In 2D GRE, it was challenging to discriminate the SR image from the reference image, compared to the CS (ISM index 40% vs. 17.5% in 1.3×; P = 0.039 and 17.5% vs. 2.5% in 2.0×; P = 0.034). In 3D GRE, the CS revealed a significantly higher ISM index than the SR (22.5% vs. 2.5%; P = 0.011) in 2.0 × faster images. However, the ISM index was identical for the 2.0× CS and 1.3× SR (22.5% vs. 27.5%; P = 0.62) with comparable time costs. The GAN-based SR outperformed CS in image similarity with 2D GRE for MRI acceleration. In addition, CS was more advantageous in 3D GRE than SR.

CT-like images in MRI improve specificity of erosion detection in patients with hand arthritis: a diagnostic accuracy study with CT as standard of reference

ObjectiveTo compare the diagnostic accuracy of susceptibility-weighted imaging (SWI), standard T1-weighted (T1w) images and high-resolution 3D-gradient echo sequences (volumetric interpolated breath-hold examination (VIBE)) for detection of erosions in patients with...

Cerebral Microbleeds Are Associated With Increased Brain Iron and Cognitive Impairment in Patients With Cerebral Small Vessel Disease: A Quantitative Susceptibility Mapping Study.

Cerebral microbleeds (CMBs) have been recognized to play an important role in cognitive impairment of cerebral small vessel disease (CSVD) patients. However, the mechanism of this effect is still unclear. Comparing the susceptibility values in the selected subcortical gray matter structures of CSVD patients without CMBs (CSVD-N) and with CMBs (CSVD-C) as well as healthy controls (HCs). Prospective. Sixty-nine CSVD patients and 28 HCs were included; 24 CSVD patients (34.78%) had CMBs and 45 CSVD patients (65.22%) had no CMBs. All subjects were imaged on a 3.0 T MR scanner. The protocol consisted of a three-dimensional (3D) T1-weighted sequence and a 3D multi-echo gradient echo (mGRE) sequence. Brain QSM maps were computed from mGRE data using the morphology-enabled dipole inversion with automatic uniform cerebrospinal fluid zero reference algorithm (MEDI+0). The mean susceptibility value within each region of interest was recorded. All participants underwent the cognitive assessment. Brain iron deposition burden of CMB lesions of every CSVD-C patient was computed. One-way analysis of variance test followed by Tukey's honest significance test and Kruskal-Wallis test were used with significance level of 0.05. Stepwise multivariate linear analysis was used to explore the factors influencing cognitive scores. Montreal cognitive assessment (MoCA), trail-making test (TMT)-A and TMT-B scores in the three groups were significantly different (all P < 0.05). Stepwise multivariate linear regression analysis revealed that the factors influenced MoCA scores were having CMBs (P < 0.05), white matter hyperintensities (P < 0.05), lacunes (P < 0.05) in brain, and the brain iron deposition burden of CMB lesions (P < 0.05) and for TMT scores (TMT-A + TMT-B), the influencing factors were age (P < 0.05), education years (P < 0.05), and the brain iron deposition burden of CMB lesions (P < 0.05). The higher iron deposition burden of CMB lesions in brain may be an imaging quantitative marker of cognitive decline in patients with CSVD-C. 1 TECHNICAL EFFICACY: Stage 2.

Radial spoiled gradient T1 weighted imaging of the internal auditory canal: Is Scarpa's ganglion now an expected finding and source of fundal enhancement?

StarVIBE is a 3D gradient-echo sequence with a radial, stack-of-stars acquisition having spatial resolution and tissue contrast. With newer sequences, it is important to be familiar with sequence tissue contrasts and appearance of anatomical variants. We evaluated 450 patients utilizing this sequence; 35 patients demonstrated fluffy "cotton wool" enhancement at the internal auditory canal fundus without clear pathology. We favor this represents anatomic neurovascular enhancement that StarVIBE is sensitive to and is a touch-me-not finding.

T1D -weighted ihMT imaging - Part II. Investigating the long- and short-T1D components correlation with myelin content. Comparison with R1 and the macromolecular proton fraction.

To investigate the long- and short-T1D components correlation with myelin content using inhomogeneous magnetization transfer (ihMT) high-pass and band-pass T1D -filters and to compare ihMT, R1 , and the macromolecular proton fraction (MPF) for myelin specific imaging. The 3D ihMT rapid gradient echo (ihMTRAGE) sequences with increasing switching times (Δt) were used to derive ihMT high-pass T1D -filters with increasing T1D cutoff values and an ihMT band-pass T1D -filter for components in the 100 µs to 1 ms range. 3D spoiled gradient echo quantitative MT (SPGR-qMT) protocols were used to derive R1 and MPF maps. The specificity of R1 , MPF, and ihMT T1D -filters was evaluated by comparison with two histological reference techniques for myelin imaging. The higher contribution of long-T1D s as compared to the short components as Δt got longer led to an increase in the specificity to myelination. In contrast, focusing on the signal originating from a narrow range of short-T1D s (< 1 ms) as isolated by the band-pass T1D -filter led to lower specificity. In addition, the significantly lower r2 correlation coefficient of the band-pass T1D -filter suggests that the origin of short-T1D components is mostly associated with non-myelin protons. Also, the important contribution of short-T1D s to the estimated MPF, explains its low specificity to myelination as compared to the ihMT high-pass T1D -filters. Long-T1D components imaging by means of ihMT high-pass T1D -filters is proposed as an MRI biomarker for myelin content. Future studies should enable the investigation of the sensitivity of ihMT T1D -filters for demyelinating processes.

Free-breathing radial 3D fat-suppressed T1-weighted gradient echo (r-VIBE) sequence for assessment of pulmonary lesions: a prospective comparison of CT and MRI

PurposeTo determine whether the pulmonary MR imaging with free-breathing radial 3D fat-suppressed T1-weighted gradient echo (r-VIBE) sequence can detect lung lesions and display lesion profiles with an accuracy comparable to that of computed tomography (CT), which is the reference standard in this study.PopulationSixty-three consecutive patients were prospectively enrolled between October, 2016 and March, 2017. All the patients received both 3T MRI scanning with a free-breathing r-VIBE sequence and chest standard CT. Morphologic features of lesions were evaluated by two radiologists with a 5-point system. Chest standard CT were used as reference standard. Weighted kappa analysis and chi-squared test were used to determine both inter-observer agreement and inter-method agreement.ResultsA total of 210 solid pulmonary nodules or masses and 1 ground-glass nodule were detected by CT. Compared to CT, r-VIBE correctly detected 95.7% of pulmonary nodules, including 100% of detection rate with diameter greater than 6 mm, 92.3% of pulmonary nodules with diameter between 4 and 6 mm, and 83.3% of pulmonary nodules with diameter less than 4 mm The inter-method agreements between r-VIBE and standard-dose CT were either “substantial” or “excellent” in the evaluation of following features of pulmonary nodules with diameter more than 10mm: including lobulation, spiculation, convergence of vessels, bubble-like attenuation, cavitation and mediastinal lymph node enlargement (0.605≤K≤1.000; P<0.0001). However, K values for inter-method agreements were significant but “moderate” or “poor” for evaluating pleural tag, halo, and calcification (0.355≤ K≤0.451; P<0.0001).ConclusionThe use of pulmonary MR imaging with r-VIBE showed high detection rate of pulmonary nodules and inter-method agreement with CT. It is also useful for nodule morphologic assessment.

NIMG-12. MR SUSCEPTIBILITY IMAGING FOR DETECTION OF TUMOR-ASSOCIATED MACROPHAGES IN GLIOBLASTOMA

Abstract BACKGROUND Tumor-associated macrophages (TAMs) are a key component of glioblastoma (GBM) tumor microenvironment. Considering the differential role of different TAM phenotypes in iron metabolism with the M1 phenotype storing intracellular iron, and M2 phenotype releasing iron in the tumor microenvironment, here we investigated non-invasive quantitative susceptibility mapping (QSM) and T2* MRI relaxometry to quantify iron as imaging biomarkers for TAMs in adult patients with GBM. METHODS In this prospective study, 21 adult patients with GBM were enrolled between 2016 to 2019. Patients underwent a 3D single echo gradient echo sequence in addition to standard anatomical sequences on a 3 Tesla MRI. QSM images were reconstructed using the morphology-enabled dipole inversion (MEDI) algorithm. In 3 subjects, ex vivo imaging of surgical specimens was performed on a Bruker 9.4 Tesla 8.9 cm vertical bore MR using 3D multi-echo GRE scans, and R2* (1/T2*) maps were generated by a pixel-wise monoexponential fitting. Each specimen was stained with hematoxylin and eosin, as well as with CD68, CD86, CD206, and L-Ferritin. RESULTS Significant positive correlation was observed between mean susceptibility for the tumor enhancing zone and the L-ferritin positivity percent (r =0.56, p=0.018) and the combination of tumor’s enhancing zone and necrotic core and the L-Ferritin positivity percent (r=0.72; p=0.001). Moreover, the mean susceptibility significantly correlated with positivity percent for CD68 (ρ=0.52, p=0.034) and CD86 (r=0.7 p=0.001), but not for CD206 (ρ=0.09; p=0.7). There was a positive correlation between mean R2* values and CD68 positive cell counts (r =0.6, p=0.016). Similarly, mean R2* values significantly correlated with CD86 (r=0.54, p=0.03) but not with CD206 (r=0.15, p=0.5). High mean susceptibility in the necrotic core was associated with inferior PFS (hazard ratio,4.5, p=0.016). CONCLUSION MR Susceptibility Imaging can quantify the iron content of GBM and provide a non-invasive method for TAM quantification and phenotyping.

Spiral gradient echo versus cartesian turbo spin echo imaging for sagittal contrast-enhanced fat-suppressed T1 weighted spine MRI: an inter-individual comparison study.

To compare a novel 3D spiral gradient echo (GRE) sequence with a conventional 2D cartesian turbo spin echo (TSE) sequence for sagittal contrast-enhanced (CE) fat-suppressed (FS) T1 weighted (T1W) spine MRI. In this inter-individual comparison study, 128 patients prospectively underwent sagittal CE FS T1W spine MRI with either a 2D cartesian TSE ("TSE", 285 s, 64 patients) or a 3D spiral GRE sequence ("Spiral", 93 s, 64 patients). Between both groups, patients were matched in terms of anatomical region (cervical/thoracic/lumbar spine and sacrum). Three readers used 4-point Likert scales to assess images qualitatively in terms of overall image quality, presence of artifacts, spinal cord visualization, lesion conspicuity and quality of fat suppression. Spiral achieved a 67.4% scan time reduction compared to TSE. Interreader agreement was high (alpha=0.868-1). Overall image quality (4;[3,4] vs 3;[3,4], p<0.001 - p=0.002 for all readers), presence of artifacts (4;[3,4] vs 3;[3,4] p=0.027 - p=0.046 for all readers), spinal cord visualization (4;[4,4] vs 4;[3,4], p<0.001 for all readers), lesion conspicuity (4;[4,4] vs 4;[4,4], p=0.016 for all readers) and quality of fat suppression (4;[4,4] vs 4;[4,4], p=0.027 - p=0.033 for all readers), were all deemed significantly improved by all three readers on Spiral images as compared to TSE images. We demonstrate the feasibility of a novel 3D spiral GRE sequence for improved and rapid sagittal CE FS T1W spine MRI. A 3D spiral GRE sequence allows for improved sagittal CE FS T1W spine MRI at very short scan times.

Rim lesions are demonstrated in early relapsing\u2013remitting multiple sclerosis using 3\xa0T-based susceptibility-weighted imaging in a multi-institutional setting

PurposeRim lesions, characterised by a paramagnetic rim on susceptibility-based MRI, have been suggested to reflect chronic inflammatory demyelination in multiple sclerosis (MS) patients. Here, we assess, through susceptibility-weighted imaging (SWI), the prevalence, longitudinal volume evolution and clinical associations of rim lesions in subjects with early relapsing–remitting MS (RRMS).MethodsSubjects (n = 44) with recently diagnosed RRMS underwent 3 T MRI at baseline (M0) and 1 year (M12) as part of a multi-centre study. SWI was acquired at M12 using a 3D segmented gradient-echo echo-planar imaging sequence. Rim lesions identified on SWI were manually segmented on FLAIR images at both time points for volumetric analysis.ResultsTwelve subjects (27%) had at least one rim lesion at M12. A linear mixed-effects model, with ‘subject’ as a random factor, revealed mixed evidence for the difference in longitudinal volume change between rim lesions and non-rim lesions (p = 0.0350 and p = 0.0556 for subjects with and without rim lesions, respectively). All 25 rim lesions identified showed T1-weighted hypointense signal. Subjects with and without rim lesions did not differ significantly with respect to age, disease duration or clinical measures of disability (p > 0.05).ConclusionWe demonstrate that rim lesions are detectable in early-stage RRMS on 3 T MRI across multiple centres, although their relationship to lesion enlargement is equivocal in this small cohort. Identification of SWI rims was subjective. Agreed criteria for defining rim lesions and their further validation as a biomarker of chronic inflammation are required for translation of SWI into routine MS clinical practice.

Improved Assessment of Longitudinal Spinal Cord Atrophy in Multiple Sclerosis Using a Registration-Based Approach: Relevance for Clinical Studies.

Reliable measurements of cervical cord atrophy progression may be useful for monitoring neurodegeneration in multiple sclerosis (MS). To compare a new, registration-based (Reg) method with two existing methods (active surface [AS] and propagation segmentation [PropSeg]) to measure cord atrophy changes over time in MS. Retrospective. Cohort I: Eight healthy controls (HC) and 28 MS patients enrolled at a single institution, and cohort II: 25 HC and 63 MS patients enrolled at three European sites. 3D T1-weighted gradient echo sequence, acquired at 1.5 T (cohort I) and 3.0 T (cohort II). Percentage cord area changes (PCACs) between baseline and follow-up (cohort I: 2.34 years [interquartile range=2.00-2.55 years], cohort II: 1.05 years [interquartile range=1.01-1.18 years]) were evaluated for all subjects using Reg, AS, and PropSeg. Reg included an accurate registration of baseline and follow-up straightened cord images, followed by AS-based optimized cord segmentation. A subset of studies was analyzed twice by two observers. Linear regression models were used to estimate annualized PCAC, and effect sizes expressed as the ratio between the estimated differences and HC error term (P < 0.05). Reproducibility was assessed by linear mixed-effect models. Annualized PCACs were used for sample size calculations (significance: α=0.05, power: 1 - β=0.80). Annualized PCACs and related standard errors (SEs) were lower with Reg than with other methods: PCAC in MS patients at 1.5 T was -1.12% (SE=0.22) with Reg, -1.32% (SE=0.30) with AS, and -1.40% (SE=0.33) with PropSeg, while at 3.0 T PCAC was -0.83% (SE=0.25) with Reg, -0.92% (SE=0.32) with AS, and -1.18 (SE=0.53) with PropSeg. This was reflected in larger effect sizes and lower sample sizes. Intra- and inter-observer agreement range was 0.72-0.91 with AS, and it was >0.96 with Reg. The results support the use of the registration method to measure cervical cord atrophy progression in future MS clinical studies. 3 TECHNICAL EFFICACY STAGE: 2.

A silent gradient axis for soundless spatial encoding to enable fast and quiet brain imaging.

PurposeA novel silent imaging method is proposed that combines a gradient insert oscillating at the inaudible frequency 20 kHz with slew rate‐limited gradient waveforms to form a silent gradient axis that enable quiet and fast imaging.MethodsThe gradient insert consisted of a plug‐and‐play (45 kg) single axis z‐gradient, which operated as an additional fourth gradient axis. This insert was made resonant using capacitors and combined with an audio amplifier to allow for operation at 20 kHz. The gradient field was characterized using field measurements and the physiological effects of operating a gradient field at 20 kHz were explored using peripheral nerve stimulation experiments, tissue heating simulations and sound measurements. The imaging sequence consisted of a modified gradient‐echo sequence which fills k‐space in readout lanes with a width proportional to the oscillating gradient amplitude. The feasibility of the method was demonstrated in‐vivo using 2D and 3D gradient echo (GRE) sequences which were reconstructed using a conjugate‐gradient SENSE reconstruction.ResultsField measurements yielded a maximum gradient amplitude and slew rate of 40.8 mT/m and 5178T/m/s at 20 kHz. Physiological effects such as peripheral nerve stimulation and tissue heating were found not to be limiting at this amplitude and slew rate. For a 3D GRE sequence, a maximum sound level of 85 db(A) was measured during scanning. Imaging experiments using the silent gradient axis produced artifact free images while also featuring a 5.3‐fold shorter scan time than a fully sampled acquisition.ConclusionA silent gradient axis provides a novel pathway to fast and quiet brain imaging.

Control of a wireless sensor using the pulse sequence for prospective motion correction in brain MRI.

To synchronize and pass information between a wireless motion-tracking device and a pulse sequence and show how this can be used to implement customizable navigator interleaving schemes that are part of the pulse sequence design. The device tracks motion by sampling the voltages induced in 3 orthogonal pickup coils by the changing gradient fields. These coils were modified to also detect RF-transmit events using a 3D RF-detection circuit. The device could then detect and decode a set RF signatures while ignoring excitations in the parent pulse sequence. A set of unique RF signatures were then paired with a collection of navigators and used to trigger readouts on the wireless device synchronous to the pulse sequence execution. Navigator interleaving schemes were then demonstrated in 3D RF-spoiled gradient echo, T1 -FLAIR (fluid-attenuated inversion recovery) PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction), and T2 -FLAIR PROPELLER pulse sequences. Excitations in the parent pulse sequences were successfully rejected and the RF signatures successfully decoded. For the 3D gradient echo sequence, distortions were removed by interleaving flipped polarity navigators and taking the difference between consecutive readouts. The impact on scan duration was reduced by 54% by breaking up the navigators into smaller parts. Successful motion correction was performed using the PROPELLER pulse sequences in 3 Tesla and 1.5 Tesla MRI scanners without modifications to the device hardware or software. The proposed RF signature-based triggering scheme enables complex interactions between the pulse sequence and a wireless device. Thus, enabling prospective motion correction that is repeatable, versatile, and minimally invasive with respect to hardware setup.

Fast magnetic resonance arthrography of the labrum

Research question: Short volumetric interpolated breath hold exam (VIBE) 3D gradient echo sequences are comparable to T1 spin echo (SE) sequences for evaluating the shoulder labrum using arthroscopy as a gold standard. Methods: 24 patients with suspected labral tears had magnetic resonance (MR) arthrography of the shoulder using 1.5T MR scanner. Coronal oblique 3D VIBE FS sequences were performed and reconstructed in axial and sagittal oblique planes and compared with standard T1 SE sequences. Presence and location of labral tear and rotator cuff tears were noted. Findings were correlated with surgery where available. Time to obtain T1 SE sequences versus 3D VIBE acquisition was recorded. Results: Of 24 patients, 54% had arthroscopy. Sensitivity and positive predictive value (PPV) of both T1 SE and VIBE sequences for labral tears was 92%. 100% agreement for diagnosis of labral tear by readers between both sequences was noted. Specific labral tear location was accurate in 75% for both sequences. The mean time to obtain T1 SE sequences was 13.5 mins and 7.5 minutes for 3D VIBE sequences. Conclusion: Fast MR arthrography using 3D VIBE sequences shows excellent concordance with standard T1-FS sequence for diagnosis of labral tears. With shorter acquisition time and high diagnostic sensitivity 3D VIBE sequences maybe used as an alternative to standard sequences. Level of evidence: Level III retrospective diagnostic study.

Feasibility of using a single MRI acquisition for fiducial marker localization and synthetic CT generation towards MRI-only prostate radiation therapy treatment planning

Purpose. To investigate the feasibility of using a single MRI acquisition for fiducial marker identification and synthetic CT (sCT) generation towards MRI-only treatment planning for prostate external beam radiation therapy (EBRT). Methods. Seven prostate cancer patients undergoing EBRT, each with three implanted gold fiducial markers, participated in this study. In addition to the planning CT scan, all patients were scanned on a 3 T MR scanner with a 3D double-echo gradient echo (GRE) sequence. Quantitative susceptibility mapping (QSM) was performed for marker localization. QSM-derived marker positions were compared to those from CT. The bulk density assignment technique for sCT generation was adopted. The magnitude GRE images were segmented into muscle, bone, fat, and air using a combination of unsupervised intensity-based classification of soft tissue and convolutional neural networks (CNN) for bone segmentation. Results. All implanted markers were visualized and accurately identified (average error: 0.7 ± 0.5 mm). QSM generated distinctive contrast for hemorrhage, calcifications, and gold fiducial markers. The estimated susceptibility/HU values on QSM/CT for gold and calcifications were 31.5 ± 2.9 ppm/1220 ± 100 HU and 14.6 ± 0.9 ppm/440 ± 100 HU, respectively. The intensity-based soft tissue classification resulted in an average Dice score of 0.97 ± 0.02; bone segmentation using CNN resulted in an average Dice score of 0.93 ± 0.03. Conclusion. This work indicates the feasibility of simultaneous fiducial marker identification and sCT generation using a single MRI acquisition. Future works includes evaluation of the proposed method in a large cohort of patients with optimized acquisition parameters as well as dosimetric evaluations.

Fractional calculus tracer kinetic compartment model for quantification of microvascular perfusion

Objective. We evaluate a tracer kinetic model for quantification of physiological perfusion and microvascular residue time kurtosis (RTK) in skeletal muscle vasculature with first pass bolus experiments in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Approach. A decreasing stretched Mittag-Leffler function (f1C model) was obtained as the impulse response solution of a rate equation of real-valued (‘fractional’) derivation order. The method was validated in skeletal muscle in the lower limb of seven female pigs examined by DCE-MRI. Dynamic imaging during blood pool contrast agent elimination was performed using a 3D gradient echo sequence with k-space sharing. Blood flow was augmented by continuous infusion of the vasodilator adenosine into the femoral artery increasing blood flow up to four times. Blood flow measured by a Doppler flow probe placed at the femoral artery served as ground truth. Main results. Goodness of fit and correlation with the Doppler measurements, r = 0.80 (P < 0.001), of the 4-parameter f1C model was comparable with the results obtained with a previously tested 6-parameter two-compartment (2C) model. The derivation order α of the f1C model can be interpreted as a measure of microvascular RTK. With increasing blood flow, α dropped significantly, leading to an increase in RTK. Significance. The f1C model is a practical approach based on hemodynamic principles to quantify physiological microvascular perfusion but it is impaired due to its compartmental nature.