Echo Time Magnetic Resonance Imaging Research Articles

Ultrashort echo time T2∗ values decrease in tendons with application of static tensile loads

In early stages of tendon disease, mechanical properties may become altered prior to changes in morphological anatomy. Ultrashort echo time (UTE) magnetic resonance imaging (MRI) can be used to directly detect signal from tissues with very short T2 values, including unique viscoelastic tissues such as tendons. The purpose of this study was to use UTE sequences to measure T2∗, T1 and magnetization transfer ratio (MTR) variations of tendon samples under static tensile loads. Six human peroneal tendons were imaged before and under static loading using UTE sequences on a clinical 3T MRI scanner. Tendons were divided into two static tensile loading groups: group A that underwent one-step loading (15N) and group B that underwent two-step loading (15 and 30N). The T2∗, T1 and MTR variations were investigated in two selected section regions of interest (ROIs), including whole and core sections. Mean T2∗ values for the first step of loading (groups A and B) in both whole section and core section ROIs were significantly decreased by 13±7% (P=0.028) and 16±5% (P=0.017), respectively. For the second loading step (group B), there was a consistent, but non-significant reduction in T2∗ value by 9±2% (P=0.059) and 7±5% (P=0.121) for whole and core sections, respectively. Mean T1 did not show any consistent changes for either loading steps (P>0.05). Mean MTR increased slightly, but not significantly for both loading steps (P>0.05). Significant differences were found only in T2∗ values of tendons by static tensile load application. Therefore, T2∗ monitoring during loading is suggested for quantitative investigation of the tendons biomechanics.

Study of bubble dynamics in gas-solid fluidized beds using ultrashort echo time (UTE) magnetic resonance imaging (MRI)

A narrow column, gas-solid fluidized bed was studied using ultrashort echo time (UTE) magnetic resonance imaging (MRI) for particles of diameter 0.44mm, 0.72mm, and 1.5mm. UTE enables 1D and 2D images to be acquired of an individual bubble as it rises through the sample with higher spatial resolution than has previously been possible with MRI. One-dimensional images allow calculations of bubble rise velocity and bubble frequency. They also show leading-trailing bubble coalescence. Images of bubbles in the axial plane were obtained in 2D, with the location of images adjusted to track bubbles as they rise. These measurements were used to observe the wake region of a bubble, lateral drift as the bubble rises, and in-plane bubble coalescence. Images in the vertical plane were used to study the stability of a 1D perturbation in voidage. The perturbation collapsed rapidly with particles <1mm in diameter, but for the 1.5mm diameter particles the perturbation was often stable throughout the imaging region.

Non-destructive NIR spectral imaging assessment of bone water: Comparison to MRI measurements

Bone fracture risk increases with age, disease states, and with use of certain therapeutics, such as acid-suppressive drugs, steroids and high-dose bisphosphonates. Historically, investigations into factors that underlie bone fracture risk have focused on evaluation of bone mineral density (BMD). However, numerous studies have pointed to factors other than BMD that contribute to fragility, including changes in bone collagen and water. The goal of this study is to investigate the feasibility of using near infrared spectral imaging (NIRSI) to determine the spatial distribution and relative amount of water and organic components in whole cross-sections of bone, and to compare those results to those obtained using magnetic resonance imaging (MRI) methods. Cadaver human whole-section tibiae samples harvested from 18 donors of ages 27–97years underwent NIRSI and ultrashort echo time (UTE) MRI. As NIRSI data is comprised of broad absorbances, second derivative processing was evaluated as a means to narrow peaks and obtain compositional information. The (inverted) second derivative peak heights of the NIRSI absorbances correlated significantly with the mean peak integration of the water, collagen and fat NIR absorbances, respectively, indicating that either processing method could be used for compositional assessment. The 5797cm−1 absorbance was validated as arising from the fat present in bone marrow, as it completely disappeared after ultrasonication. The MRI UTE-determined bound water content in tibial cortical bone samples ranged from 62 to 91%. The NIRSI water peaks at 5152cm−1 and at 7008cm−1 correlated significantly with the UTE data, with r=0.735, p=0.016, and r=0.71, p=0.0096, respectively. There was also a strong correlation between the intensity of the NIRSI water peak at 7008cm−1 and the intensity of the collagen peak at 4608cm−1 (r=0.69, p=0.004). Since NIRSI requires minimal to no sample preparation, this approach has great potential to become a gold standard modality for the investigation of changes in water content, distribution, and environment in pre-clinical studies of bone pathology and therapeutics.

Quantification of Human Cortical Bone Bound and Free Water in Vivo with Ultrashort Echo Time MR Imaging: A Model-based Approach.

Purpose To quantify free and bound water components of cortical bone with a model-based numeric approach with use of ultrashort echo time (UTE) magnetic resonance (MR) imaging in vivo in order to introduce a new predictor for age-related deterioration of cortical bone structure. Materials and Methods Human studies were compliant with HIPAA and approved by the institutional review board. Dual-repetition time three-dimensional hybrid-radial UTE imaging was performed, followed by the application of postprocessing algorithms, to quantify free and bound water parameters (concentration [ρ] and longitudinal relaxation time [T1]) of human cortical bone in vivo. The postprocessing algorithms included the decomposition of bulk equations into free- and bound-associated equations and solving resulted inverse problem by using evolutionary strategy methods. To test the validity of the introduced biomarker, it was measured in 40 healthy women by using the proposed method, and associations among parameters were evaluated with the Pearson correlation coefficient. Results The mean free water concentration, bound water concentration, free water T1, and bound water T1 in the recruited population were 5.9%, 19.6%, 306.79 msec, and 162.47 msec, respectively. All reported values were in good agreement with those in the literature. Cortical bone free water T1 (R2 = 0.72) and cortical bone free water concentration (R2 = 0.62) showed strong positive correlations with age. Conclusion The cortical bone free water concentration and free water T1 derived with UTE imaging are good predictors of age-related deterioration of cortical bone structure and are potentially superior to previously introduced measures such as bone water concentration and suppression ratio. © RSNA, 2017.

Inversion recovery ultrashort echo time magnetic resonance imaging: A method for simultaneous direct detection of myelin and high signal demonstration of iron deposition in the brain – A feasibility study

Multiple sclerosis (MS) causes demyelinating lesions in the white matter and increased iron deposition in the subcortical gray matter. Myelin protons have an extremely short T2* (<1ms) and are not directly detected with conventional clinical magnetic resonance (MR) imaging sequences. Iron deposition also reduces T2*, leading to reduced signal on clinical sequences. In this study we tested the hypothesis that the inversion recovery ultrashort echo time (IR-UTE) pulse sequence can directly and simultaneously image myelin and iron deposition using a clinical 3T scanner. The technique was first validated on a synthetic myelin phantom (myelin powder in D2O) and a Feridex iron phantom. This was followed by studies of cadaveric MS specimens, healthy volunteers and MS patients. UTE imaging of the synthetic myelin phantom showed an excellent bi-component signal decay with two populations of protons, one with a T2* of 1.2ms (residual water protons) and the other with a T2* of 290μs (myelin protons). IR-UTE imaging shows sensitivity to a wide range of iron concentrations from 0.5 to ~30mM. The IR-UTE signal from white matter of the brain of healthy volunteers shows a rapid signal decay with a short T2* of ~300μs, consistent with the T2* values of myelin protons in the synthetic myelin phantom. IR-UTE imaging in MS brain specimens and patients showed multiple white matter lesions as well as areas of high signal in subcortical gray matter. This in specimens corresponded in position to Perl's diaminobenzide staining results, consistent with increased iron deposition. IR-UTE imaging simultaneously detects lesions with myelin loss in the white matter and iron deposition in the gray matter.

A non-ionizing technique for three-dimensional measurement of the lumbar spine

Comprehensive assessments of scoliotic deformity and spinal instability require repetitive three-dimensional (3D) measurements of motion segments at different functional postures. However, accurate 3D measurement of the spine is a challenging task. In this paper, we present a novel, non-invasive, non-ionizing technique to quantify 3D poses of lumbar motion segments in terms of clinically meaningful anatomical coordinates. The technique used ultra-short echo time (UTE) magnetic resonance (MR) images to construct subject-specific geometrical models of individual vertebrae and registered them with 3D ultrasound dataset acquired during pose measurements. A hierarchical registration approach was used to minimize the detrimental effects of speckle noise and artifacts within soft tissues on registration accuracy. The technique was validated using a human dry bone specimen as well as a fresh porcine cadaver. Registration errors were determined by comparing with a gold standard fiducial-based registration. Results showed that the technique is accurate and reliable with bias in sub-degree and sub-millimeter level (except for the flexion–extension of the porcine cadaver experiment, which was −1.74°), and average precision of 1.11° in rotation and 0.86mm in position for the human dry bone experiment, and 1.26° and 1.23mm for the porcine cadaver experiment. Given its non-ionizing nature, the UTE MR–ultrasound registration technique is particularly useful for repeated measurements and longitudinal follow-up. With further refinement and validation, it could be a powerful tool for 3D spinal assessment.

Visualization of Middle Ear Ossicles in Elder Subjects with Ultra-short Echo Time MR Imaging.

Purpose:To evaluate the visualization of middle ear ossicles by ultra-short echo time magnetic resonance (MR) imaging at 3T in subjects over 50 years old.Materials and Methods:Sixty ears from 30 elder patients that underwent surgical or interventional treatment for neurovascular diseases were included (ages: 50–82, median age: 65; 10 men, 20 women). Patients received follow-up MR imaging including routine T1- and T2-weighted images, time-of-flight MR angiography, and ultra-short echo time imaging (PETRA, pointwise encoding time reduction with radial acquisition). All patients underwent computed tomography (CT) angiography before treatment. Thin-section source CT images were correlated with PETRA images. Scan parameters for PETRA were: TR 3.13, TE 0.07, flip angle 6 degrees, 0.83 × 0.83 × 0.83 mm resolution, 3 min 43 s scan time. Two radiologists retrospectively evaluated the visibility of each ossicular structure as positive or negative using PETRA images. The structures evaluated included the head of the malleus, manubrium of the malleus, body of the incus, long process of the incus, and the stapes. Signal intensity of the ossicles was classified as: between labyrinthine fluid and air, similar to labyrinthine fluid, between labyrinthine fluid and cerebellar parenchyma, or higher than cerebellar parenchyma.Results:In all ears, the body of the incus was visible. The head of the malleus was visualized in 36/60 ears. The manubrium of the malleus and long process of the incus was visualized in 1/60 and 4/60 ears, respectively. The stapes were not visualized in any ear. Signal intensity of the visible structures was between labyrinthine fluid and air in all ears.Conclusion:The body of the incus was consistently visualized with intensity between air and labyrinthine fluid on PETRA images in aged subjects. Poor visualization of the manubrium of the malleus, long process of the incus, and the stapes limits clinical significance of middle ear imaging with current PETRA methods.

MRI-derived bound and pore water concentrations as predictors of fracture resistance

Accurately predicting fracture risk in the clinic is challenging because the determinants are multi-factorial. A common approach to fracture risk assessment is to combine X-ray-based imaging methods such as dual-energy X-ray absorptiometry (DXA) with an online Fracture Risk Assessment Tool (FRAX) that includes additional risk factors such as age, family history, and prior fracture incidents. This approach still does not adequately diagnose many individuals at risk, especially those with certain diseases like type 2 diabetes. As such, this study investigated bound water and pore water concentrations (Cbw and Cpw) from ultra-short echo time (UTE) magnetic resonance imaging (MRI) as new predictors of fracture risk. Ex vivo cadaveric arms were imaged with UTE MRI as well as with DXA and high-resolution micro-computed tomography (μCT), and imaging measures were compared to both whole-bone structural and material properties as determined by three-point bending tests of the distal-third radius. While DXA-derived areal bone mineral density (aBMD) and μCT-derived volumetric BMD correlated well with structural strength, they moderately correlated with the estimate material strength with gender being a significant covariate for aBMD. MRI-derived measures of Cbw and Cpw had a similar predictive ability of material strength as aBMD but did so independently of gender. In addition, Cbw was the only imaging parameter to significantly correlate with toughness, the energy dissipated during fracture. Notably, the strength of the correlations with the material properties of bone tended to be higher when a larger endosteal region was used to determine Cbw and Cpw. These results indicate that MRI measures of Cbw and Cpw have the ability to probe bone material properties independent of bone structure or subject gender. In particular, toughness is a property of fracture resistance that is not explained by X-ray based methods. Thus, these MRI-derived measures of Cbw and Cpw in cortical bone have the potential to be useful in clinical populations for evaluating fracture risk, especially involving diseases that affect material properties of the bone beyond its strength.

Gradient-Modulated PETRA MRI.

Image blurring that results from off-resonance and fast T2* signal decay is a common issue in radial ultrashort echo time magnetic resonance imaging (MRI) sequences. One solution is to use a higher readout bandwidth, but this may be impractical for some techniques such as pointwise-encoding time reduction with radial acquisition (PETRA), which is a hybrid method of zero echo time and single-point imaging techniques. Specifically, PETRA has severe specific absorption rate (SAR) and radiofrequency (RF) pulse peak power limitations when using higher bandwidths in human measurements. In this study, we introduce gradient modulation (GM) to PETRA to reduce image-blurring artifacts while keeping SAR and RF peak power low. GM-PETRA tolerance to image blurring was evaluated in simulations and experiments by comparison with the conventional PETRA technique. We performed inner ear imaging of a healthy subject at 7 T. GM-PETRA showed significantly less image blurring as a result of off-resonance and fast T2* signal decay compared to PETRA. In in vivo imaging, GM-PETRA nicely captured complex structures of the inner ear such as the cochlea and semicircular canals. GM can improve PETRA image quality and mitigate SAR and RF peak power limitations without special hardware modification in clinical scanners.

Functional Proton MRI in Emphysematous Rats.

To demonstrate the feasibility of proton magnetic resonance imaging (MRI) ventilation-related maps in rodents for the evaluation of lung function in the presence of pancreatic porcine elastase (PPE)-induced emphysema. Twelve rats were equally divided into 3 groups: group 1 (no administration of PPE); group 2 (PPE selectively only in the left lung); and group 3 (PPE administered in both lungs). Magnetic resonance imaging (MRI) and computed tomographic (CT) data were acquired at baseline, at 2 weeks and 4 weeks after administration, after which the animals were euthanized. The MRI protocol comprised a golden angle 2-dimensional ultrashort echo time MRI sequence [echo time, 0.343 millisecond (ms); repetition time, 120 ms; 12 slides with thickness, 1 mm; acquisition time, 30 minutes], from which inspiration and expiration images were reconstructed after the extraction of a self-gating signal. Inspiration images were registered to images at expiration, and expansion maps were created by calculating the specific difference in signal intensity. The lungs were segmented, and the mean specific expansion (MSE) calculated as an established surrogate for fractional ventilation. Computed tomographic data provided lung density (peak of the Hounsfield unit histogram, HU_P), whereas histology provided the mean linear intercept for each lung. Two weeks after administration, the control group had a mean MSE in both lungs corresponding to 96% of the baseline. Group 2 had 85% of the baseline, and group 3 had 57%. Considering the PPE-treated lungs alone, a significant reduction in MSE of 27% at 2 weeks and 40% at 4 weeks was found with respect to nontreated lungs. Significant correlations between HU_P and MSE were found at all time points (baseline: r = 0.606, P = 0.0017; 2 weeks: r = 0.837, P ≤ 0.0001; 4 weeks: r = 0.765, P < 0.0001; all time points: r = 0.739, P < 0.0001). Mean linear intercept values significantly correlated both with MRI MSE (r = -0.770, P < 0.0001) and with CT HU_P (r = -0.882, P < 0.0001). The calculated ventilation-related maps showed a reduction of function in the PPE-treated lungs, both compared to the nontreated lungs and to the baseline values. Moreover, a good agreement between MRI-measured MSE, CT, and histology data quantitatively supports the presence of ventilation deficit in emphysematous lungs.In this work, we have demonstrated the feasibility of ventilation-related maps from non-contrast-enhanced H lung MRI, which were capable of tracking changes in lung function over time in emphysematous rats.

Advances in Imaging Cystic Fibrosis Lung Disease.

Cystic fibrosis (CF) is a life shortening, multiorgan disease, in which morbidity and mortality are dominated by pulmonary pathologies, including mucous obstruction, chronic lung infections, progressive bronchiectasis, and declining lung function. Promising new therapies, including those that target the cystic fibrosis transmembrane conductance regulator (CFTR) protein, have shown impressive efficacy in treating CF patients with specific genotypes. While spirometry is the clinical gold standard for evaluating CF lung disease, it has known insensitivities to mild lung disease and statistical weaknesses in small cohorts. Imaging has begun to play an important role in evaluating the structural abnormalities associated with CF lung disease progression. X-ray computed tomography (CT) has been established as a modality with validated metrics to evaluate disease severity, even in young patients with mild disease. Magnetic resonance imaging (MRI), as a nonionizing alternative, has very strong potential for similar metrics and longitudinal use through the lifespan. In this brief review, recent advancements in imaging CF lung disease in pediatrics are discussed, specifically in the contexts of X-ray CT, ultra-short echo time MRI, and hyperpolarized-gas MRI, with an emphasis on how emerging techniques will likely impact the management of CF lung disease in the era of CFTR-modulator therapies, targeted at smaller subpopulations of CF with specific genotypes. In the future, techniques that provide sensitive, quantitative measurements of regional lung structure and function longitudinally will become increasingly important as outcome measures for clinical trials and for monitoring individual CF patients.

Modular Coils with Low Hydrogen Content Especially for MRI of Dry Solids.

IntroductionRecent advances have enabled fast magnetic resonance imaging (MRI) of solid materials. This development has opened up new applications for MRI, but, at the same time, uncovered new challenges. Previously, MRI-invisible materials like the housing of MRI detection coils are now readily depicted and either cause artifacts or lead to a decreased image resolution. In this contribution, we present versatile, multi-nuclear single and dual-tune MRI coils that stand out by (1) a low hydrogen content for high-resolution MRI of dry solids without artifacts; (2) a modular approach with exchangeable inductors of variable volumes to optimally enclose the given object; (3) low cost and low manufacturing effort that is associated with the modular approach; (4) accurate sample placement in the coil outside of the bore, and (5) a wide, single- or dual-tune frequency range that covers several nuclei and enables multinuclear MRI without moving the sample.Materials and MethodsThe inductors of the coils were constructed from self-supporting copper sheets to avoid all plastic materials within or around the resonator. The components that were mounted at a distance from the inductor, including the circuit board, coaxial cable and holder were manufactured from polytetrafluoroethylene.Results and ConclusionResidual hydrogen signal was sufficiently well suppressed to allow 1H-MRI of dry solids with a minimum field of view that was smaller than the sensitive volume of the coil. The SNR was found to be comparable but somewhat lower with respect to commercial, proton-rich quadrature coils, and higher with respect to a linearly-polarized commercial coil. The potential of the setup presented was exemplified by 1H / 23Na high-resolution zero echo time (ZTE) MRI of a model solution and a dried human molar at 9.4 T. A full 3D image dataset of the tooth was obtained, rich in contrast and similar to the resolution of standard cone-beam computed tomography.

Detection of different kidney stone types: an ex vivo comparison of ultrashort echo time MRI to reference standard CT

Background and purposeWith the development of ultrashort echo time (UTE) sequences, it may now be possible to detect kidney stones by using magnetic resonance imaging (MRI). In this study, kidney stones of varying composition and sizes were imaged using both UTE MRI as well as the reference standard of computed tomography (CT), with different surrounding materials and scan setups. MethodsOne hundred and fourteen kidney stones were inserted into agarose and urine phantoms and imaged both on a dual-energy CT (DECT) scanner using a standard renal stone imaging protocol and on an MRI scanner using the UTE sequence with both head and body surface coils. A subset of the stones representing all composition types and sizes was then inserted into the collecting system of porcine kidneys and imaged in vitro with both CT and MRI. ResultsAll of the stones were visible on both CT and MRI imaging. DECT was capable of differentiating between uric acid and nonuric acid stones. In MRI imaging, the choice of coil and large field of view (FOV) did not affect stone detection or image quality. The MRI images showed good visualization of the stones’ shapes, and the stones’ dimensions measured from MRI were in good agreement with the actual values (R2=0.886, 0.895, and 0.81 in the agarose phantom, urine phantom, and pig kidneys, respectively). The measured T2 relaxation times ranged from 4.2 to 7.5ms, but did not show significant differences among different stone composition types. ConclusionsUTE MRI compared favorably with the reference standard CT for imaging stones of different composition types and sizes using body surface coil and large FOV, which suggests potential usefulness of UTE MRI in imaging kidney stones in vivo.

Determination of blood circulation times of superparamagnetic iron oxide nanoparticles by T2* relaxometry using ultrashort echo time (UTE) MRI

Blood circulation is an important determinant of the biodistribution of superparamagnetic iron oxide nanoparticles. Here we present a magnetic resonance imaging (MRI) technique based on the use of ultrafast echo times (UTE) for the noninvasive determination of blood half-lives at high particle concentrations, when conventional pulse sequences fail to produce a useful MR signal.Four differently coated iron oxide nanoparticles were administered intravenously at a dose of 500μmol Fe/kg bodyweight and UTE images of C57BL/6 mice were acquired on a 1-T ICON scanner (Bruker). T2* relaxometry was done by acquiring UTE images with echo times of 0.1, 0.8 and 1.6ms. Blood circulation time was then determined by fitting an exponential curve to the time course of the measured relaxation rates. Circulation time was shortest for particles coated with malic acid (t1/2=23min) and longest for particles coated with tartaric acid (t1/2=63min).UTE-based T2* relaxometry allows noninvasive determination of blood circulation time and is especially useful when high particle concentrations are present.

Feasibility of three-dimensional ultrashort echo time magnetic resonance imaging at 1.5 T for the diagnosis of skull fractures

To investigate the feasibility of ultrashort echo time (UTE) magnetic resonance imaging (MRI) for the diagnosis of skull fractures. The skull fracture models of ten Bama pigs and 364 patients with craniocerebral trauma were subjected to computed tomography (CT), UTE and conventional MRI sequences. The accuracy of UTE imaging in skull fracture diagnosis was analysed using receiver operating characteristic (ROC) curve analysis, McNemar's test and Kappa values. Differences among CT, UTE imaging and anatomical measurement (AM) values for linear fractures (LFs) and depressed fractures (DFs) were compared using one-way ANOVA and a paired-samples t-test. UTE imaging clearly demonstrated skull structures and fractures. The accuracy, validity and reliability of UTE MRI were excellent, with no significant differences between expert readings (P > 0.05; Kappa, 0.899). The values obtained for 42 LFs and 13 DFs in the ten specimens were not significantly different among CT, UTE MRI and AMs, while those obtained for 55 LFs and ten DFs in 44 patients were not significantly different between CT and UTE MRI (P > 0.05). UTE MRI sequences are feasible for the evaluation of skull structures and fractures, with no radiation exposure, particularly for paediatric and pregnant patients. Despite ionising radiation, CT is standard for skull fracture assessment. Conventional MRI cannot depict skull structures. 3D-UTE sequences clearly demonstrate skull structures and fractures. UTE plus conventional MRI are superior to CT in craniocerebral trauma assessment. Paediatric and pregnant patients will benefit from this imaging modality.

Advanced magnetic resonance spectroscopy and imaging techniques applied to brain development and animal models of perinatal injury

Magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) are widely used in the field of brain development and perinatal brain injury. Due to technical progress the magnetic field strength (B0) of MR systems has continuously increased, favoring 1H-MRS with quantification of up to 18 metabolites in the brain and short echo time (TE) MRI sequences including phase and susceptibility imaging. For longer TE techniques including diffusion imaging modalities, the benefits of higher B0 have not been clearly established. Nevertheless, progress has also been made in new advanced diffusion models that have been developed to enhance the accuracy and specificity of the derived diffusion parameters. In this review, we will describe the latest developments in MRS and MRI techniques, including high-field 1H-MRS, phase and susceptibility imaging, and diffusion imaging, and discuss their application in the study of cerebral development and perinatal brain injury.

Imaging tooth enamel using zero echo time (ZTE) magnetic resonance imaging.

In an event where many thousands of people may have been exposed to levels of radiation that are sufficient to cause the acute radiation syndrome, we need technology that can estimate the absorbed dose on an individual basis for triage and meaningful medical decision making. Such dose estimates may be achieved using in vivo electron paramagnetic resonance (EPR) tooth biodosimetry, which measures the number of persistent free radicals that are generated in tooth enamel following irradiation. However, the accuracy of dose estimates may be impacted by individual variations in teeth, especially the amount and distribution of enamel in the inhomogeneous sensitive volume of the resonator used to detect the radicals. In order to study the relationship between interpersonal variations in enamel and EPR-based dose estimates, it is desirable to estimate these parameters nondestructively and without adding radiation to the teeth. Magnetic Resonance Imaging (MRI) is capable of acquiring structural and biochemical information without imparting additional radiation, which may be beneficial for many EPR dosimetry studies. However, the extremely short T2 relaxation time in tooth structures precludes tooth imaging using conventional MRI methods. Therefore, we used zero echo time (ZTE) MRI to image teeth ex vivo to assess enamel volumes and spatial distributions. Using these data in combination with the data on the distribution of the transverse radio frequency magnetic field from electromagnetic simulations, we then can identify possible sources of variations in radiation-induced signals detectable by EPR. Unlike conventional MRI, ZTE applies spatial encoding gradients during the RF excitation pulse, thereby facilitating signal acquisition almost immediately after excitation, minimizing signal loss from short T2 relaxation times. ZTE successfully provided volumetric measures of tooth enamel that may be related to variations that impact EPR dosimetry and facilitate the development of analytical procedures for individual dose estimates.

Patch‐based generation of a pseudo CT from conventional MRI sequences for MRI‐only radiotherapy of the brain

In radiotherapy (RT) based on magnetic resonance imaging (MRI) as the only modality, the information on electron density must be derived from the MRI scan by creating a so-called pseudo computed tomography (pCT). This is a nontrivial task, since the voxel-intensities in an MRI scan are not uniquely related to electron density. To solve the task, voxel-based or atlas-based models have typically been used. The voxel-based models require a specialized dual ultrashort echo time MRI sequence for bone visualization and the atlas-based models require deformable registrations of conventional MRI scans. In this study, we investigate the potential of a patch-based method for creating a pCT based on conventional T1-weighted MRI scans without using deformable registrations. We compare this method against two state-of-the-art methods within the voxel-based and atlas-based categories. The data consisted of CT and MRI scans of five cranial RT patients. To compare the performance of the different methods, a nested cross validation was done to find optimal model parameters for all the methods. Voxel-wise and geometric evaluations of the pCTs were done. Furthermore, a radiologic evaluation based on water equivalent path lengths was carried out, comparing the upper hemisphere of the head in the pCT and the real CT. Finally, the dosimetric accuracy was tested and compared for a photon treatment plan. The pCTs produced with the patch-based method had the best voxel-wise, geometric, and radiologic agreement with the real CT, closely followed by the atlas-based method. In terms of the dosimetric accuracy, the patch-based method had average deviations of less than 0.5% in measures related to target coverage. We showed that a patch-based method could generate an accurate pCT based on conventional T1-weighted MRI sequences and without deformable registrations. In our evaluations, the method performed better than existing voxel-based and atlas-based methods and showed a promising potential for RT of the brain based only on MRI.

Identifying Novel Clinical Surrogates to Assess Human Bone Fracture Toughness.

Fracture risk does not solely depend on strength but also on fracture toughness; ie, the ability of bone material to resist crack initiation and propagation. Because resistance to crack growth largely depends on bone properties at the tissue level, including collagen characteristics, current X-ray based assessment tools may not be suitable to identify age-related, disease-related, or treatment-related changes in fracture toughness. To identify useful clinical surrogates that could improve the assessment of fracture resistance, we investigated the potential of (1)H nuclear magnetic resonance spectroscopy (NMR) and reference point indentation (RPI) to explain age-related variance in fracture toughness. Harvested from cadaveric femurs (62 human donors), single-edge notched beam (SENB) specimens of cortical bone underwent fracture toughness testing (R-curve method). NMR-derived bound water showed the strongest correlation with fracture toughness properties (r = 0.63 for crack initiation, r = 0.35 for crack growth, and r = 0.45 for overall fracture toughness; p < 0.01). Multivariate analyses indicated that the age-related decrease in different fracture toughness properties were best explained by a combination of NMR properties including pore water and RPI-derived tissue stiffness with age as a significant covariate (adjusted R(2) = 53.3%, 23.9%, and 35.2% for crack initiation, crack growth, and overall toughness, respectively; p < 0.001). These findings reflect the existence of many contributors to fracture toughness and emphasize the utility of a multimodal assessment of fracture resistance. Exploring the mechanistic origin of fracture toughness, glycation-mediated nonenzymatic collagen crosslinks and intracortical porosity are possible determinants of bone fracture toughness and could explain the sensitivity of NMR to changes in fracture toughness. Assuming fracture toughness is clinically important to the ability of bone to resist fracture, our results suggest that improvements in fracture risk assessment could potentially be achieved by accounting for water distribution (quantitative ultrashort echo time magnetic resonance imaging) and by a local measure of tissue resistance to indentation, RPI.

Quantitative Ultrashort Echo Time Magnetic Resonance Imaging Evaluation of Postoperative Menisci: a Pilot Study.

Magnetic resonance imaging (MRI) visualization of meniscal signal is particularly challenging as the highly organized ultrastructure of meniscal fibrocartilage yields very short T2 values (∼6ms) and a paucity of signal intensity during conventional image acquisition. The purpose of this study was to evaluate the feasibility of imaging postoperative menisci using an experimental, quantitative ultrashort echo time (UTE) MRI pulse sequence. This sequence acquires short echo images (echo time (TE) ∼0.3ms) to produce multi-echo images for quantitative T2* calculations that provide an objective measure of collagen organization. MRI scans of the knee were acquired at 6- and 12-month intervals on a clinical 3.0T scanner following meniscal surgery in eight patients (ages 13-41), four of whom underwent repair and the other four partial meniscectomy. Conventional MRI sequences were qualitatively evaluated for meniscal morphology and signal and correlated with quantitative UTE results. A wide range of mean T2* values for both postsurgical groups was measured, and these values changed for each patient between the 6- and 12-month intervals. In many instances, the UTE sequence demonstrated quantitative differences between the two time intervals that were not detected with conventional sequences. This pilot study presents preliminary, observational data to be used as a baseline for future studies. Although the T2* values did not reveal a trend in either group or correlate with expected signal changes on conventional MRI, we speculate that the UTE sequence may detect ultrastructural alterations in meniscal composition that are otherwise not perceived with routine fast spin echo (FSE) sequences.