3D Magnetic Resonance Elastography Research Articles

Fast abdominal magnetic resonance elastography with simultaneous encoding of three-dimensional displacements

Three-dimensional (3D) magnetic resonance elastography (MRE) is more accurate than two-dimensional (2D) MRE; however, it requires long-term acquisition. This study aimed to reduce the acquisition time of abdominal 3D MRE using a new sample interval modulation (short-SLIM) approach that can acquire all three motions faster while reducing the prolongation of echo time and flow compensation.To this end, two types of phantom studies and an in vivo test of the liver in three healthy volunteers were performed to compare the performances of conventional spin-echo echo-planar (SE-EPI) MRE, conventional SLIM and short-SLIM. One phantom study measured the mean amplitude and shear modulus within the overall region of a homogeneous phantom by changing the mechanical vibration power to assess the robustness to the lowered phase-to-noise ratio in short-SLIM. The other measured the mean shear modulus in the stiff and background materials of a phantom with an embedded stiffer rod to assess the performance of short-SLIM for complex wave patterns with wave interference. The Spearman's rank correlation coefficient was used to assess similarity of elastograms in the rod-embedded phantom and liver between methods.The results of the phantom study changing the vibration power indicated that there was little difference between conventional MRE and short-SLIM. Moreover, the elastogram pattern and the mean shear modulus in the rod-embedded phantom in conventional SLIM and short-SLIM did not change for conventional MRE; the liver test also showed a small difference between the acquisition techniques.This study demonstrates that short-SLIM can provide MRE results comparable to those of conventional MRE. Short-SLIM can reduce the total acquisition time by a factor of 2.25 compared to conventional 3D MRE time, leading to an improvement in the accuracy of shear modulus estimation by suppressing the patient movements.

Multi-Frequency 3D Shear Wave Absolute Vibro-Elastography (S-WAVE) System for the Prostate.

This article describes a novel system for quantitative and volumetric measurement of tissue elasticity in the prostate using simultaneous multi-frequency tissue excitation. Elasticity is computed by using a local frequency estimator to measure the three-dimensional local wavelengths of steady-state shear waves within the prostate gland. The shear wave is created using a mechanical voice coil shaker which transmits simultaneous multi-frequency vibrations transperineally. Radio frequency data is streamed directly from a BK Medical 8848 transrectal ultrasound transducer to an external computer where tissue displacement due to the excitation is measured using a speckle tracking algorithm. Bandpass sampling is used that eliminates the need for an ultra-fast frame rate to track the tissue motion and allows for accurate reconstruction at a sampling frequency that is below the Nyquist rate. A roll motor with computer control is used to rotate the transducer and obtain 3D data. Two commercially available phantoms were used to validate both the accuracy of the elasticity measurements as well as the functional feasibility of using the system for in vivo prostate imaging. The phantom measurements were compared with 3D Magnetic Resonance Elastography (MRE), where a high correlation of 96% was achieved. In addition, the system has been used in two separate clinical studies as a method for cancer identification. Qualitative and quantitative results of 11 patients from these clinical studies are presented here. Furthermore, an AUC of 0.87±0.12 was achieved for malignant vs. benign classification using a binary support vector machine classifier trained with data from the latest clinical study with leave one patient out cross-validation.

Magnetic resonance elastography fornoninvasive detection of liver fibrosis: is there an added value of 3D acquisition?

(1) Assess the diagnostic performance of liver 3D magnetic resonance elastography (MRE) parameters (including stiffness, storage/loss modulus and damping ratio) compared to liver stiffness measured with 2D MRE for noninvasive detection of advanced liver fibrosis (F3-F4) and cirrhosis (F4) in patients with chronic liver disease. (2) Assess the value of serum markers (FIB-4) in detecting advanced liver fibrosis and cirrhosis in the same patients. This was a single center, prospective IRB-approved cross-sectional study that included 49 patients (M/F: 23/26, mean age 50.8 y) with chronic liver disease and concomitant liver biopsy. MRE was acquired at 1.5T using a spin echo-EPI sequence. The following parameters were measured: liver stiffness using 2D MRE (LS-2D) and 3D MRE parameters (LS-3D, liver storage, loss modulus and damping ratio). The Mann-Whitney U test, ROC curve analysis, Spearman correlation and logistic regression were performed to evaluate diagnostic performance of MRE parameters and FIB-4. LS-2D and LS-3D had similar diagnostic performance for diagnosis of F3-F4, with AUCs of 0.87 and 0.88, sensitivity of 0.71 and 0.81, specificity of 0.89 for both. For diagnosis of F4, LS-2D and LS-3D had similar performance with AUCs of 0.81 for both, sensitivity of 0.75 and 0.83, and specificity of 0.84 and 0.73, respectively. Additional 3D parameters (storage modulus, loss modulus, damping ratio) had variable performance, with AUC range of 0.59-0.78 for F3-F4; and 0.52-0.70 for F4. FIB-4 had lower diagnostic performance, with AUCs of 0.66 for F3-F4, and 0.68 for F4. Our study shows no added value of 3D MRE compared to 2D MRE for detection of advanced fibrosis and cirrhosis, while FIB-4 had lower diagnostic performance.

A Three-Dimensional Digital Model for Early Diagnosis of Hepatic Fibrosis Based on Magnetic Resonance Elastography.

Hepatic fibrosis is an early stage of liver cirrhosis, and there are no better non-invasive and convenient methods for the detection and evaluation of the disease. Despite the good progress made with the liver stiffness map (LSM) based on magnetic resonance elastography (MRE), there are still some limitations that need to be overcome, including manual focus determination, manual selection of regions of interest (ROIs), and discontinuous LSM data without structural information, which makes it impossible to evaluate the liver as a whole. In this study, we propose a novel three-dimensional (3D) digital model for the early diagnosis of hepatic fibrosis based on MRE. MRE is a non-invasive imaging technique that employs magnetic resonance imaging (MRI) to measure the liver stiffness at the scanning site through human-computer interaction. Studies have indicated a significant positive correlation between the LSM obtained through MRE and the degree of hepatic fibrosis. However, for clinical purposes, a comprehensive and precise quantification of the degree of hepatic fibrosis is necessary. To address this, the concept of Liver Stiffness Distribution (LSD) was proposed in this study, which refers to the 3D stiffness volume of each liver voxel obtained by the alignment of 3D liver tissue images and MRE indicators. This provides a more effective clinical tool for the diagnosis and treatment of hepatic fibrosis.

A diagnostic test of three-dimensional magnetic resonance elastography imaging for preoperative prediction of microvascular invasion in patients with T1 stage clear cell renal carcinoma.

Detection of microvascular invasion (MVI) of kidney tumors is important for selecting the optimal therapeutic strategy. Currently, the prediction of MVI lacks an accurate imaging biomarker. This study evaluated the performance of three-dimensional (3D) magnetic resonance elastography (MRE) imaging in predicting microvascular invasion (MVI) of T1 stage clear cell renal carcinoma (ccRCC). In this prospective study, we conducted pre-surgical imaging with a clinical 3.0 T magnetic resonance imaging (MRI) system. Firstly, 83 consecutive patients were enrolled in this study. A 3D MRE stiffness map was generated and transferred to a post-processing workstation. Contrast-enhanced computed tomography (CT) was conducted to calculate the tumor enhancement ratio. The presence of MVI was evaluated by histopathological analysis and graded according to the risk stratification based upon the number and distribution. The mean stiffness and CT tumor enhancement ratio was calculated for tumors with or without MVI. The diagnostic performance [sensitivity, specificity, positive predictive value, negative predictive value, area under the curve (AUC)] and independent predicting factors for MVI were investigated. Finally, A total of 80 patients (aged 46.7±13.2 years) were enrolled, including 22 cases of tumors with MVI. The mean MRE stiffness of kidney parenchyma and kidney tumors was 4.8±0.2 and 4.5±0.7 kPa, respectively. There was significant difference in the mean MRE stiffness between tumors with MVI (5.4±0.6 kPa) and tumors without MVI (4.1±0.3 kPa) (P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and the AUC for mean stiffness in the prediction of MVI were 100%, 75%, 63%, 96%, and 0.87 [95% confidence interval (CI): 0.72, 0.94], respectively. The corresponding values for the CT tumor enhancement ratio were 90%, 80%, 63%, 96%, and 0.88 (95% CI: 0.71, 0.93), respectively. The odds ratio (OR) value for MRE tumor stiffness and CT kidney tumor enhancement ratio in the prediction of MVI was 2.9 (95% CI: 1.8, 3.7) and 1.2 (95% CI: 1.0, 1.7), respectively (P>0.05). 3D MRE imaging has promising diagnostic performance for predicting MVI in T1 stage ccRCC, which may improve the reliability of surgical strategy selection with T1 stage ccRCC.

MR elastography of soft porous tissue phantoms with varying macrostructure and pore pressure

Tissue porosity pressure mechanics play a vital role in the physiological workings and anatomical structures of soft tissue. Further understanding relationships between the pressurized state of the tissue and its function by noninvasive measurements may lead to new diagnostic methods for identifying early stages of disease pathology. The purpose of this study was to investigate the ability of Magnetic Resonance Elastography (MRE) to identify mechanics related to different pressurized states of porous soft tissue-like media. Phantoms with variations in stiffness and porous network geometries are scanned with MRE at 9.4 Tesla while pore pressure is quasi-statically loaded with 0, 50, 100, 150 mmHg gauge using air and liquid pressure. The MRE-derived shear modulus of tissue around isolated pores correlates with pore pressure. However, this was not observed for interconnected porous systems, in which the shear wavelength is much larger than the distance between neighboring pore branches. In these systems, the presented experimental results highlight the importance of a compressibility marker derived from 3D MRE acquisitions, which may be sensitive to pore pressure and pore network geometry.

Single Breath-Hold 3-Dimensional Magnetic Resonance Elastography Depicts Liver Fibrosis and Inflammation in Obese Patients.

Three-dimensional (3D) magnetic resonance elastography (MRE) measures liver fibrosis and inflammation but requires several breath-holds that hamper clinical acceptance. The aim of this study was to evaluate the technical and clinical feasibility of a single breath-hold 3D MRE sequence as a means of measuring liver fibrosis and inflammation in obese patients. From November 2020 to December 2021, subjects were prospectively enrolled and divided into 2 groups. Group 1 included healthy volunteers (n = 10) who served as controls to compare the single breath-hold 3D MRE sequence with a multiple-breath-hold 3D MRE sequence. Group 2 included liver patients (n = 10) who served as participants to evaluate the clinical feasibility of the single breath-hold 3D MRE sequence in measuring liver fibrosis and inflammation. Controls and participants were scanned at 60 Hz mechanical excitation with the single breath-hold 3D MRE sequence to retrieve the magnitude of the complex-valued shear modulus (|G*| [kPa]), the shear wave speed (Cs [m/s]), and the loss modulus (G" [kPa]). The controls were also scanned with a multiple-breath-hold 3D MRE sequence for comparison, and the participants had histopathology (Ishak scores) for correlation with Cs and G". For the 10 controls, 5 were female, and the mean age and body mass index were 33.1 ± 9.5 years and 23.0 ± 2.1 kg/m 2 , respectively. For the 10 participants, 8 were female, and the mean age and body mass index were 45.1 ± 16.5 years and 33.1 ± 4.0 kg/m 2 (obese range), respectively. All participants were suspected of having nonalcoholic fatty liver disease. Bland-Altman analysis of the comparison in controls shows there are nonsignificant differences in |G*|, Cs, and G" below 6.5%, suggesting good consensus between the 2 sequences. For the participants, Cs and G" correlated significantly with Ishak fibrosis and inflammation grades, respectively ( ρ = 0.95, P < 0.001, and ρ = 0.84, P = 0.002). The single breath-hold 3D MRE sequence may be effective in measuring liver fibrosis and inflammation in obese patients.

Comparison of inversion methods in MR elastography: An open-access pipeline for processing multifrequency shear-wave data and demonstration in a phantom, human kidneys, and brain.

Magnetic resonance elastography (MRE) maps the viscoelastic properties of soft tissues for diagnostic purposes. However, different MRE inversion methods yield different results, which hinder comparison of values, standardization, and establishment of quantitative MRE markers. Here, we introduce an expandable, open-access, webserver-based platform that offers multiple inversion techniques for multifrequency, 3D MRE data. The platform comprises a data repository and standard MRE inversion methods including local frequency estimation (LFE), direct-inversion based multifrequency dual elasto-visco (MDEV) inversion, and wavenumber-based (k-) MDEV. The use of the platform is demonstrated in phantom data and in vivo multifrequency MRE data of the kidneys and brains of healthy volunteers. Detailed maps of stiffness were generated by all inversion methods showing similar detail of anatomy. Specifically, the inner renal cortex had higher shear wave speed (SWS) than renal medulla and outer cortex without lateral differences. k-MDEV yielded higher SWS values than MDEV or LFE (full kidney/brain k-MDEV: 2.71 ± 0.19/1.45 ± 0.14 m/s, MDEV: 2.14 ± 0.16/0.99 ± 0.11 m/s, LFE: 2.12 ± 0.15/0.89 ± 0.06 m/s). The freely accessible platform supports the comparison of MRE results obtained with different inversion methods, filter thresholds, or excitation frequencies, promoting reproducibility in MRE across community-developed methods.

Intra-patient comparison of 3D and 2D magnetic resonance elastography techniques for assessment of liver stiffness.

To evaluate performance of 3D magnetic resonance elastography (MRE) using spin-echo echo-planar imaging (seEPI) for assessment of hepatic stiffness compared with 2D gradient-recalled echo (GRE) and 2D seEPI sequences. Fifty-seven liver MRE examinations including 2D GRE, 2D seEPI, and 3D seEPI sequences were retrospectively evaluated. Elastograms were analyzed by 2 radiologists and polygonal regions of interests (ROIs) were drawn in 2 different fashions: "curated" ROI (avoiding liver edge, major vessels, and areas of wave interferences) and "non-curated" ROI (including largest cross section of liver, to assess the contribution of artifacts). Liver stiffness measurement (LSM) was calculated as the arithmetic mean of individual stiffness values for each technique. For 3D MRE, LSMs were also calculated based on 4 slices ("abbreviated LSM"). Intra-patient variations in LSMs and different methods of ROI placement were assessed by univariate tests. A p-value of < 0.05 was set as a statistically significant difference. Mean surface areas of the ROIs were 50,723 mm2, 12,669 mm2, 5814 mm2, and 10,642 mm2 for 3D MRE, abbreviated 3D MRE, 2D GRE, and 2D seEPI, respectively. 3D LSMs based on curated and non-curated ROIs showed no clinically significant difference, with a mean difference less than 0.1kPa. Abbreviated 3D LSMs had excellent correlation with 3D LSMs based on all slices (r = 0.9; p < 0.001) and were not significantly different (p = 0.927). 3D MRE allows more reproducible measurements due to its lower susceptibility to artifacts and provides larger areas of parenchyma, enabling a more comprehensive evaluation of the liver.

Tumor stiffness measured by 3D magnetic resonance elastography can help predict the aggressiveness of endometrial carcinoma: preliminary findings

BackgroundPreoperative evaluation of aggressiveness, including tumor histological subtype, grade of differentiation, Federation International of Gynecology and Obstetrics (FIGO) stage, and depth of myometrial invasion, is significant for treatment planning and prognosis in endometrial carcinoma (EC). The purpose of this study was to evaluate whether three-dimensional (3D) magnetic resonance elastography (MRE) can help predict the aggressiveness of EC.MethodsFrom August 2015 to January 2019, 82 consecutive patients with suspected uterine tumors underwent pelvic MRI and MRE scans, and 15 patients with confirmed EC after surgical resection were enrolled. According to pathological results (tumor grade, histological subtype, FIGO stage, and myometrial invasiveness), the patients were divided into two subgroups. The independent-samples t-test or Mann-Whitney U test was used to compare the stiffness between different groups. The diagnostic performance was determined with receiver operating characteristic (ROC) curve analysis.ResultsThe stiffness of EC with ≥ 50 % (n = 6) myometrial invasion was significantly higher than that with < 50 % (n = 9) myometrial invasion (3.68 ± 0.59 kPa vs. 2.61 ± 0.72 kPa, p = 0.009). Using a stiffness of 3.04 kPa as a cutoff value resulted in 100 % sensitivity and 77.8 % specificity for differentiating ≥ 50 % myometrial invasion from < 50 % myometrial invasion of EC. The stiffness of poorly differentiated EC (n = 8) was significantly higher than that of well/moderately differentiated EC (n = 7) (3.47 ± 0.64 kPa vs. 2.55 ± 0.82 kPa, p = 0.028). Using a stiffness of 3.04 kPa as a cutoff value resulted in 75 % sensitivity and 71.4 % specificity for differentiating poorly differentiated from well/moderately differentiated EC. The stiffness of FIGO stage II/III EC was significantly higher than that of FIGO stage I EC (3.69 ± 0.65 kPa vs. 2.72 ± 0.76 kPa, p = 0.030). Using a stiffness of 3.04 kPa as a cutoff value resulted in 100 % sensitivity and 70 % specificity for differentiating FIGO stage I EC from FIGO stage II/III EC. The tumor stiffness value in type II (n = 3) EC was higher than that in type I (n = 12) EC (3.67 ± 0.59 kPa vs. 2.88 ± 0.85 kPa), but the difference was not significant (p = 0.136).ConclusionsTumor stiffness measured by 3D MRE may be potentially useful for predicting tumor grade, FIGO stage and myometrial invasion of EC and can aid in the preoperative risk stratification of EC.

Reduced vessel tone leads to vasodilation and decreased cerebral rigidity

Magnetic Resonance Elastography (MRE) measures elastic shear wave propagation in vivo to infer biomechanical properties non-invasively [Muthupillai, et al. (1995) Science;269:1854-1857.]. Models predict that tissue stiffness is influenced by changes of vascular properties [Parker, et al. (2016) PhysMedBiol;61:4890-4903.]. Cerebral blood supply is closely regulated by diameter changes of blood vessels. We here investigated the influence of vasodilation on cerebral brain stiffness with MRE. A healthy C57BL/6 mouse was anesthetized with isoflurane mixed in 100% O2. Vasodilation was induced by a hypercapnic challenge (isoflurane mixed in 95% O2 + 5% CO2). Brain stiffness was measured with a 3D spin-echo MRE sequence in a 7T animal MRI scanner under normocapnic and hypercapnic conditions. Vibration frequency was 1 kHz. Wave length and wave speed was observed to decrease significantly under hypercapnic conditions across the whole brain when compared to baseline. These changes correspond to a decrease in tissue rigidity. We conclude, therefore, that vasodilation via reducing vessel tone leads to a significant decrease in brain rigidity. Therefore, potential changes in cerebral blood flow due to physiological or pathological conditions should be considered when studying brain rigidity.

Regional assessment of in vivo myocardial stiffness using 3D magnetic resonance elastography in a porcine model of myocardial infarction.

The stiffness of a myocardial infarct affects the left ventricular pump function and remodeling. Magnetic resonance elastography (MRE) is a noninvasive imaging technique for measuring soft-tissue stiffness in vivo. The purpose of this study was to investigate the feasibility of assessing in vivo regional myocardial stiffness with high-frequency 3D cardiac MRE in a porcine model of myocardial infarction, and compare the results with ex vivo uniaxial tensile testing. Myocardial infarct was induced in a porcine model by embolizing the left circumflex artery. Fourteen days postinfarction, MRE imaging was performed in diastole using an echocardiogram-gated spin-echo echo-planar-imaging sequence with 140-Hz vibrations and 3D MRE processing. The MRE stiffness and tensile modulus from uniaxial testing were compared between the remote and infarcted myocardium. Myocardial infarcts showed increased in vivo MRE stiffness compared with remote myocardium (4.6 ± 0.7 kPa versus 3.0 ± 0.6 kPa, P = 0.02) within the same pig. Ex vivo uniaxial mechanical testing confirmed the in vivo MRE results, showing that myocardial infarcts were stiffer than remote myocardium (650 ± 80 kPa versus 110 ± 20 kPa, P = 0.01). These results demonstrate the feasibility of assessing in vivo regional myocardial stiffness with high-frequency 3D cardiac MRE. Magn Reson Med 79:361-369, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Automated Liver Elasticity Calculation for 3D MRE.

Magnetic Resonance Elastography (MRE) is a phase-contrast MRI technique which calculates quantitative stiffness images, called elastograms, by imaging the propagation of acoustic waves in tissues. It is used clinically to diagnose liver fibrosis. Automated analysis of MRE is difficult as the corresponding MRI magnitude images (which contain anatomical information) are affected by intensity inhomogeneity, motion artifact, and poor tissue- and edge-contrast. Additionally, areas with low wave amplitude must be excluded. An automated algorithm has already been successfully developed and validated for clinical 2D MRE. 3D MRE acquires substantially more data and, due to accelerated acquisition, has exacerbated image artifacts. Also, the current 3D MRE processing does not yield a confidence map to indicate MRE wave quality and guide ROI selection, as is the case in 2D. In this study, extension of the 2D automated method, with a simple wave-amplitude metric, was developed and validated against an expert reader in a set of 57 patient exams with both 2D and 3D MRE. The stiffness discrepancy with the expert for 3D MRE was -0.8% ± 9.45% and was better than discrepancy with the same reader for 2D MRE (-3.2% ± 10.43%), and better than the inter-reader discrepancy observed in previous studies. There were no automated processing failures in this dataset. Thus, the automated liver elasticity calculation (ALEC) algorithm is able to calculate stiffness from 3D MRE data with minimal bias and good precision, while enabling stiffness measurements to be fully reproducible and to be easily performed on the large 3D MRE datasets.

Cardiac MR elastography for quantitative assessment of elevated myocardial stiffness in cardiac amyloidosis.

PurposeTo evaluate if cardiac magnetic resonance elastography (MRE) can measure increased stiffness in patients with cardiac amyloidosis. Myocardial tissue stiffness plays an important role in cardiac function. A noninvasive quantitative imaging technique capable of measuring myocardial stiffness could aid in disease diagnosis, therapy monitoring, and disease prognostic strategies. We recently developed a high‐frequency cardiac MRE technique capable of making noninvasive stiffness measurements.Materials and MethodsIn all, 16 volunteers and 22 patients with cardiac amyloidosis were enrolled in this study after Institutional Review Board approval and obtaining formal written consent. All subjects were imaged head‐first in the supine position in a 1.5T closed‐bore MR imager. 3D MRE was performed using 5 mm isotropic resolution oblique short‐axis slices and a vibration frequency of 140 Hz to obtain global quantitative in vivo left ventricular stiffness measurements. The median stiffness was compared between the two cohorts. An octahedral shear strain signal‐to‐noise ratio (OSS‐SNR) threshold of 1.17 was used to exclude exams with insufficient motion amplitude.ResultsFive volunteers and six patients had to be excluded from the study because they fell below the 1.17 OSS‐SNR threshold. The myocardial stiffness of cardiac amyloid patients (median: 11.4 kPa, min: 9.2, max: 15.7) was significantly higher (P = 0.0008) than normal controls (median: 8.2 kPa, min: 7.2, max: 11.8).ConclusionThis study demonstrates the feasibility of 3D high‐frequency cardiac MRE as a contrast‐agent‐free diagnostic imaging technique for cardiac amyloidosis. Level of Evidence: 2 Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2017;46:1361–1367.

Demonstration of concurrent tensile testing and magnetic resonance elastography

Magnetic Resonance Elastography (MRE) is a technique used to measure the mechanical properties of soft tissues and has already shown its diagnostic potential for pathologies involving fibrogenesis and neurodegeneration. Experimental investigation of loading during MRE is fairly unexplored and may help to better understand changing mechanical properties in relation to organ function. Tensile testing is a common technique for examining mechanical properties of materials and is used as the simultaneous comparison method with MRE in this study. 3D MRE data was acquired during quasistatic uniaxial tensile loading of an Ecoflex 0010 cylindrical specimen. Individual MRE scans at 1.5, 2.0, and 2.5kHz where performed on engineering strain increments of 20% from 0% to 140% while tensile reaction force was recorded using a load cell attached to an adjustable elongation slide. Tensile stress-strain relation resembled the Fung hyperelastic strain energy model. We observe that the MRE shear storage modulus is related to the state of tensile deformation. This study demonstrates the feasibility of simultaneous tensile testing during MRE and the new design can potentially be used for MRE calibration using pre-tension.

Comparing hepatic 2D and 3D magnetic resonance elastography methods in a clinical setting – Initial experiences

PurposeContinuous monitoring of liver fibrosis progression in patients is not feasible with the current diagnostic golden standard (needle biopsy). Recently, magnetic resonance elastography (MRE) has emerged as a promising method for such continuous monitoring. Since there are different MRE methods that could be used in a clinical setting there is a need to investigate whether measurements produced by these MRE methods are comparable. Hence, the purpose of this pilot study was to evaluate whether the measurements of the viscoelastic properties produced by 2D (stiffness) and 3D (elasticity and ‘Gabs,Elastic’) MRE are comparable. Materials and methodsSeven patients with diffuse or suspect diffuse liver disease were examined in the same day with the two MRE methods. 2D MRE was performed using an acoustic passive transducer, with a 1.5T GE 450W MR system. 3D MRE was performed using an electromagnetic active transducer, with a 1.5T Philips Achieva MR system. Finally, mean viscoelastic values were extracted from the same anatomical region for both methods by an experienced radiologist. ResultsStiffness correlated well with the elasticity, R2=0.96 (P<0.001; slope=1.08, intercept=0.61kPa), as well as with ‘Gabs,Elastic’ R2=0.96 (P<0.001; slope=0.95, intercept=0.28kPa). ConclusionThis pilot study shows that different MRE methods can produce comparable measurements of the viscoelastic properties of the liver. The existence of such comparable measurements is important, both from a clinical as well as a research perspective, since it allows for equipment-independent monitoring of disease progression.

High-resolution mechanical imaging of the human brain by three-dimensional multifrequency magnetic resonance elastography at 7T

Magnetic resonance elastography (MRE) is capable of measuring the viscoelastic properties of brain tissue in vivo. However, MRE is still limited in providing high-resolution maps of mechanical constants. We therefore introduce 3D multifrequency MRE (3DMMRE) at 7T magnetic field strength combined with enhanced multifrequency dual elasto-visco (MDEV) inversion in order to achieve high-resolution elastographic maps of in vivo brain tissue with 1mm3 resolution. As demonstrated by phantom data, the new MDEV-inversion method provides two high resolution parameter maps of the magnitude (|G*|) and the phase angle (ϕ) of the complex shear modulus. MDEV inversion applied to cerebral 7T-3DMMRE data of five healthy volunteers revealed structures of brain tissue in greater anatomical details than previous work. The viscoelastic properties of cortical gray matter (GM) and white matter (WM) could be differentiated by significantly lower values of |G*| and ϕ in GM (21% [P<0.01]; 8%, [P<0.01], respectively) suggesting that GM is significantly softer and less viscous than WM.In conclusion, 3DMMRE at ultrahigh magnetic fields and MDEV inversion open a new window into characterizing the mechanical structure of in vivo brain tissue and may aid the detection of various neurological disorders based on their effects to mechanical tissue properties.

Hepatic and splenic stiffness augmentation assessed with MR elastography in an in vivo porcine portal hypertension model

To investigate the influence of portal pressure on the shear stiffness of the liver and spleen in a well-controlled in vivo porcine model with magnetic resonance elastography (MRE). A significant correlation between portal pressure and tissue stiffness could be used to noninvasively assess increased portal venous pressure (portal hypertension), which is a frequent clinical condition caused by cirrhosis of the liver and is responsible for the development of many lethal complications. During multiple intraarterial infusions of Dextran-40 in three adult domestic pigs in vivo, 3D abdominal MRE was performed with left ventricle and portal catheters measuring blood pressure simultaneously. Least-squares linear regressions were used to analyze the relationship between tissue stiffness and portal pressure. Liver and spleen stiffness have a dynamic component that increases significantly following an increase in portal or left ventricular pressure. Correlation coefficients with the linear regressions between stiffness and pressure exceeded 0.8 in most cases. The observed stiffness-pressure relationship of the liver and spleen could provide a promising noninvasive method for assessing portal pressure. Using MRE to study the tissue mechanics associated with portal pressure may provide new insights into the natural history and pathophysiology of hepatic diseases and may have significant diagnostic value in the future.

Preoperative assessment of meningioma stiffness using magnetic resonance elastography

The object of this study was to determine the potential of magnetic resonance elastography (MRE) to preoperatively assess the stiffness of meningiomas. Thirteen patients with meningiomas underwent 3D brain MRE examination to measure stiffness in the tumor as well as in surrounding brain tissue. Blinded to the MRE results, neurosurgeons made a qualitative assessment of tumor stiffness at the time of resection. The ability of MRE to predict the surgical assessment of stiffness was tested using a Spearman rank correlation. One case was excluded due to a small tumor size. In the remaining 12 cases, both tumor stiffness alone (p = 0.023) and the ratio of tumor stiffness to surrounding brain tissue stiffness (p = 0.0032) significantly correlated with the surgeons' qualitative assessment of tumor stiffness. Results of the MRE examination provided a stronger correlation with the surgical assessment of stiffness compared with traditional T1- and T2-weighted imaging (p = 0.089), particularly when considering meningiomas of intermediate stiffness. In this cohort, preoperative MRE predicted tumor consistency at the time of surgery. Tumor stiffness as measured using MRE outperformed conventional MRI because tumor appearance on T1- and T2-weighted images could only accurately predict the softest and hardest meningiomas.

Su1240 Magnetic Resonance Elastography (MRE) of the Pancreas, a Feasibility Study in Healthy Volunteers

Background: MRE is a non-invasive advanced imaging technique utilizing wave propagation to characterize the In Vivo mechanical properties of tissue, including stiffness, in organs such as the liver. MRE of the pancreas has not been thoroughly studied, but could provide a non-invasive tool for assessing pancreatic pathology such as pancreatitis, solid and cystic pancreatic masses. Aims: To determine the feasibility of MRE of the pancreas and establish normal ranges for tissue density of the normal pancreas. Methods: IRB approval was obtained. Stage 1: MRE of the pancreas was performed in 12 healthy volunteers with a 2-D gradientecho (GRE) sequence. An acoustic driver (AD) system delivered 40 HZ vibrations into the abdomen via a plastic drum secured via an elastic belt and powered pneumatically by a speaker located outside of the scan room. In an attempt to optimize wave propagation, the AD was placed over the liver, pancreas and left flank with the patient supine, and over the mid back with patient prone. MR elastograms were generated using an inversion algorithm to yield quantitative images of tissue stiffness in kilopascals (kPa). Stage 2: 3-D MRE was performed in 12 healthy volunteers using a flow-compensated single-shot spin-echo planar imaging (EPI) acquisition with motion encoding performed sequentially in the X, Y, and Z directions. Processing of the measured 3D displacement field was performed by first calculating the 3D vector curl of the displacement field and then using a 3D local frequency estimation (LFE) algorithm to calculate the tissue stiffness from the curl data. The pancreas was manually segmented using the MRE magnitude images and the mean stiffness in kilopascals (kPa) was recorded. Results: Stage 1: With the 2D MRE technique, there was poor pancreatic wave propagation at all AD locations including patient supine and prone for all 12 volunteers. This precluded accurate mean shear pancreatic stiffness calculation. Stage 2: With 3D MRE technique (image 1), 10 of 12 volunteers had adequate pancreatic wave propagation, with calculated mean shear hepatic stiffness of 1.04 ± 0.25 kPa (range 0.861.25 kPa). Of the 2 with poor wave propagation, one had BMI >30 kg/m2, and one had an atrophic pancreas. Conclusions: MRE of the pancreas is feasible, but requires 3D image sequencing to obtain adequate elastograms to calculate tissue stiffness. Further refinements in the technology are required to obtain consistent elastograms, including for patients with obesity or pancreatic atrophy. Ongoing investigations include determining the variation in stiffness within regions of the pancreas and to compare the normal pancreas with the spectrum of pancreatic diseases including pancreatic cancer, pancreatic cysts, acute and chronic pancreatitis.