Fast Spoiled Gradient Echo Sequence Research Articles

The comparison of the efficacy of 3D fast spoiled gradient echo sequence and steady state free precession sequence in imaging vascular compression in patients with trigeminal neuralgia

Aims: Trigeminal neuralgia is a condition characterized by sudden and intense pain in the face, affecting the fifth cranial nerve. While it can occur for various reasons, vascular compression is a well-known cause. Additionally, conditions such as tumors, arachnoid cysts, idiopathic inflammation, damage, or demyelination can result in trigeminal neuralgia, extending to the distal branches of the trigeminal nerve from the pons. We aimed to investigate the diagnostic efectiveness of post-contrast three-dimensional fast spoiled gradient echo images (3D-FSPGR) in addition to steady-state free precession (SSFP) images in the imaging of trigeminal neuralgia. Methods: A total of 33 patients with a preliminary diagnosis of trigeminal neuralgia between May 2022 and October 2023 were investigated and five individuals were excluded. Among the remaining 28 patients, vascular compression was observed in only 14 patients. Trigeminal nerve thickness on both side, the distance between trigeminal nerve and superior cerebellar artery on both side, presence of vascular compression, level of the compression, presence or absence of displacement and atrophy were reported for each sequences. The findings and results were compared using independent sample T-test and paired T-test. Results: The mean age of the patient group was calculated to be 56.29 ± 4.5, while for the control group, it was 52.07 ± 3.09. Trigeminal nerve thickness wasn’t different between patient with or without vascular compression (p=0.874 for right side on SSFP, p=0.804 for left side on SSFP, p=0.667 for right side on 3D-FSPGR and 0.769 for left side on 3D-FSPGR). In 10 patients, unilateral compression of the trigeminal nerve was observed, while in 4 patients, it was bilateral. In the right trigeminal nerve, vascular compression was observed in SSFP images in 5 cases in the transitional zone, 2 cases in the nerve root entry zone, and 1 case distally. In 3D-FSPGR images, it was interpreted as being in the transitional zone in 4 cases, in the NR entry zone in 3 cases, and distally in 1 case. On the other hand, for the left trigeminal nerve, vascular compression was observed in both SSFP and 3D FSGPR images in 5 cases in the nerve root entry zone, 3 cases in the distal zone, and 2 cases in the transitional zone. Conclusion: Both SSFP and 3D-FSPGR images can provide comparable information regarding the spatial relationship between the trigeminal nerve and vascular structures. Contrast enhanced imaging allows us diferentiate the tumoral and infammatory demyelinating processes from vascular compression, we recommended to continue with SSFP images in cases where contrast enhanced 3D FSGPR images are inconclusive.

Single-point macromolecular proton fraction mapping using a 0.3T permanent magnet MRI system: phantom and healthy volunteer study.

In a 0.3T permanent-magnet magnetic resonance imaging (MRI) system, quantifying myelin content is challenging owing to long imaging times and low signal-to-noise ratio. macromolecular proton fraction (MPF) offers a quantitative assessment of myelin in the nervous system. We aimed to demonstrate the practical feasibility of MPF mapping in the brain using a 0.3T MRI. Both 0.3T and 3.0T MRI systems were used. The MPF-mapping protocol used a standard 3D fast spoiled gradient-echo sequence based on the single-point reference method. Proton density, T1, and magnetization transfer-weighted images were obtained from a protein phantom at 0.3T and 3.0T to calculate MPF maps. MPF was measured in all phantom sections to assess its relationship to protein concentration. We acquired MPF maps for 16 and 8 healthy individuals at 0.3T and 3.0T, respectively, measuring MPF in nine brain tissues. Differences in MPF between 0.3T and 3.0T, and between 0.3T and previously reported MPF at 0.5T, were investigated. Pearson's correlation coefficient between protein concentration and MPF at 0.3T and 3.0T was 0.92 and 0.90, respectively. The 0.3T MPF of brain tissue strongly correlated with 3.0T MPF and literature values measured at 0.5T. The absolute mean differences in MPF between 0.3T and 0.5T were 0.42% and 1.70% in white and gray matter, respectively. Single-point MPF mapping using 0.3T permanent-magnet MRI can effectively assess myelin content in neural tissue.

Detection of pathological contrast enhancement with synthetic brain imaging from quantitative multiparametric MRI.

We aimed to test whether synthetic T1-weighted imaging derived from a post-contrast Quantitative Transient-state Imaging (QTI) acquisition enabled revealing pathological contrast enhancement in intracranial lesions. The analysis included 141 patients who underwent a 3 Tesla-MRI brain exam with intravenous contrast media administration, with the post-contrast acquisition protocol comprising a three-dimensional fast spoiled gradient echo (FSPGR) sequence and a QTI acquisition. Synthetic T1-weighted images were generated from QTI-derived quantitative maps of relaxation times and proton density. Two neuroradiologists assessed synthetic and conventional post-contrast T1-weighted images for the presence and pattern of pathological contrast enhancement in intracranial lesions. Enhancement volumes were quantitatively compared. Using conventional imaging as a reference, synthetic T1-weighted imaging was 93% sensitive in revealing the presence of contrast enhancing lesions. The agreement for the presence/absence of contrast enhancement was almost perfect both between readers (k = 1 for both conventional and synthetic imaging) and between sequences (k = 0.98 for both readers). In 91% of lesions, synthetic T1-weighted imaging showed the same pattern of contrast enhancement visible in conventional imaging. Differences in enhancement pattern in the remaining lesions can be due to the lower spatial resolution and the longer acquisition delay from contrast media administration of QTI compared to FSPGR. Overall, enhancement volumes appeared larger in synthetic imaging. QTI-derived post-contrast synthetic T1-weighted imaging captures pathological contrast enhancement in most intracranial enhancing lesions. Further comparative studies employing quantitative imaging with higher spatial resolution is needed to support our data and explore possible future applications in clinical trials.

Lumbar dorsal root ganglion displacement between supine and prone positions evaluated with 3D MRI

ObjectivePre-operative lumbar spine MRI is usually acquired with the patient supine, whereas lumbar spine surgery is most commonly performed prone. For MRI to be used reliably and safely for intra-operative navigation for foraminal and extraforaminal decompression, the magnitude of dorsal root ganglion (DRG) displacement between supine and prone positions needs to be understood. MethodsA prospective study of a degenerative lumbar spine cohort of 18 subjects indicated for lumbar spine surgery. Three-dimensional T2-weighted fast spin echo and T1-weighted spoiled gradient echo sequences were acquired at 3 T. Displacement and cross-sectional area (CSA) of the bilateral DRGs at 5 motion levels (L1–2 to L5-S1) were determined via 3D segmentation by 2 independent evaluators. Wilcoxon rank-sum tests without correction for multiple comparison were performed against hypothesized 1-mm absolute displacement and corresponding 24% CSA change. ResultsDRG mean absolute displacement was <1 mm (p > 0.99, mean = 0.707 mm, 95% confidence interval (CI) = 0.659 to 0.755 mm), with the largest directional displacement in the dorsal-to-ventral direction from supine to prone (mean = 0.141 mm, 95% CI = 0.082 to 0.200 mm). Directional displacements caudal-to-cephalad were 0.087 mm (95% CI = 0.022 to 0.151 mm), and left-right were −0.030 mm (95%CI = −0.059 to −0.001 mm). Mean CSA change was within 24% (p > 0.99, mean = −8.30%, 95% CI = −10.5 to −6.09%). Mean absolute displacement was largest for the L1 (mean = 0.811 mm) and L2 (mean = 0.829 mm) DRGs. ConclusionsMinimal, non-statistically significant soft tissue displacement and morphological area differences were demonstrated between supine and prone positions during 3D lumbar spine MRI.

Feasibility of Quantitative MRI Using 3D-QALAS for Discriminating Immunohistochemical Status in Invasive Ductal Carcinoma of the Breast.

Two-dimensional synthetic MRI of the breast has limited spatial coverage. Three-dimensional (3D) synthetic MRI could provide volumetric quantitative parameters that may reflect the immunohistochemical (IHC) status in invasive ductal carcinoma (IDC) of the breast. To evaluate the feasibility of 3D synthetic MRI using an interleaved Look-Locker acquisition sequence with a T2 preparation pulse (QALAS) for discriminating the IHC status, including hormone receptor (HR), human epidermal growth factor receptor 2 (HER 2), and Ki-67 expression in IDC. Prospective observational study. A total of 33 females with IDC of the breast (mean, 52.3 years). A 3-T, 3D-QALAS gradient-echo and fat-suppressed T1-weighted 3D fast spoiled gradient-echo sequences. Two radiologists semiautomatically delineated 3D regions of interest (ROIs) of the whole tumors on the dynamic MRI that was registered to the synthetic T1-weighted images acquired from 3D-QALAS. The mean T1 and T2 were measured for each IDC. Intraclass correlation coefficient for assessing interobserver agreement. Mann-Whitney U test to determine the relationship between the mean T1 or T2 and the IHC status. Multivariate logistic regression analysis followed by receiver operating characteristics (ROC) analysis for discriminating IHC status. A P value <0.05 was considered statistically significant. The interobserver agreement was good to excellent. There was a significant difference in the mean T1 between HR-positive and HR-negative lesions, while the mean T2 value differed between HR-positive and HR-negative lesions, between the triple-negative and HR-positive or HER2-positive lesions, and between the Ki-67 level > 14% and ≤ 14%. Multivariate analysis showed that the mean T2 was higher in HR-negative IDC than in HR-positive IDC. ROC analysis revealed that the mean T2 was predictive for discriminating HR status, triple-negative status, and Ki-67 level. 3D synthetic MRI using QALAS may be useful for discriminating IHC status in IDC of the breast. 1. Stage 2.

Can magnetic resonance imaging after cranioplasty using titanium mesh detect brain tumors?

This study determined the dependence of the concentration and position of contrast-enhanced tumors on the radio frequency (RF)-shielding effect of titanium mesh using the contrast-to-noise ratio (CNR) in magnetic resonance imaging (MRI). A phantom was constructed by filling a plastic container with manganese chloride tetrahydrate and agar. Four cellophane cylindrical containers were arranged from the end of the plastic container, and the brain tumor model was filled with gadobutrol diluted with NaCl, with molarity values of 0.2-1.0mmol/L. The titanium mesh board was set on the left side of the phantom. Images were acquired using a 1.5-T MRI as well as two-dimensional spin-echo (2D SE) and three-dimensional fast spoiled gradient echo (3D FSPGR) sequences. CNR was calculated using the signal intensity values of the tumor model, surrounding area of the brain model, and background noise. Furthermore, the fractional change in CNR was calculated using values of CNR with and without the mesh. Moreover, a profile of CNR was created. The fractional change in CNR decreased at the brain tumor positions present near the mesh and at a contrast medium concentration of approximately ≤ 0.5mmol/L in 2D SE and ≤ 0.25mmol/L in 3D FSPGR. According to the CNR profiles, directly under the mesh, almost all contrast concentrations in 2D SE was unrecognizable; however, at a concentration of ≥ 0.5 mmol/L in 3D FSPGR was recognizable.

The Evaluation of the Maculopathy Using Dynamic Contrast-enhanced MRI in Patients with Proliferative Diabetic Retinopathy.

Dynamic Contrast-enhanced Magnetic Resonance Imaging (DCE-MRI) technique could not only quantify blood-retinal barrier (BRB) breakdown leading to macular edema associated with diabetes, but also provide a two-dimensional imaging method that is not interfered by refracting media. The current study was aimed to evaluate the macular change in the patients with diabetic retinopathy using DCE-MRI technique. Twenty patients with Diabetic Retinopathy (DR) and 20 Normal Controls (NC) were included. The fast spoiled gradient echo sequence was used to perform dynamic contrast T1WI enhancement on 3.0T MR system. The macular region, optic papila and nasal retina were performed with quantitative DCE-MRI evaluation using Omni-Kinetics software. The maximal concentration, the area under the concentration-time curve (AUCconcentration-time) and maximal slope of macular region were significantly higher in DR [0.270(0.03,1.20)mmol/ 100ml, 2.71(0.04,9.91) mmol*min and 0.38(0.06,3.18) mmol/min, respectively] than that [0.169(0.03,0.72) mmol/1.25(0.13,10.41) mmol*min and 0.245(0.06,1.34) mmol/min] in NC (U value = 515.00 and P value = 0.080, U value = 433.00 and P value = 0.000, and U value = 563.00 and P value = 0.023, respectively). The receiver operating characteristic curve (ROC) analysis demonstrated that the area under AUCconcentration-time was 0.729±0.058 with the cut-off value 1.479 mmol*min (sensitivity 80.00% and specificity 62.50%) for macular region. The quantitative DCE-MRI technique could be used to evaluate the maculopathy associated with diabetic retinopathy.

Two Classes of T1 Hypointense Lesions in Multiple Sclerosis With Different Clinical Relevance.

Background: Hypointense lesions on T1-weighted images have important clinical relevance in multiple sclerosis patients. Traditionally, spin-echo (SE) sequences are used to assess these lesions (termed black holes), but Fast Spoiled Gradient-Echo (FSPGR) sequences provide an excellent alternative.Objective: To determine whether the contrast difference between T1 hypointense lesions and the surrounding normal white matter is similar on the two sequences, whether different lesion types could be identified, and whether the clinical relevance of these lesions types are different.Methods: Seventy-nine multiple sclerosis patients' lesions were manually segmented, then registered to T1 sequences. Median intensity values of lesions were identified on all sequences, then K-means clustering was applied to assess whether distinct clusters of lesions can be defined based on intensity values on SE, FSPGR, and FLAIR sequences. The standardized intensity of the lesions in each cluster was compared to the intensity of the normal appearing white matter in order to see if lesions stand out from the white matter on a given sequence.Results: 100% of lesions on FSPGR images and 69% on SE sequence in cluster #1 exceeded a standardized lesion distance of Z = 2.3 (p < 0.05). In cluster #2, 78.7% of lesions on FSPGR and only 17.7% of lesions on SE sequence were above this cutoff value, meaning that these lesions were not easily seen on SE images. Lesion count in the second cluster (lesions less identifiable on SE) significantly correlated with the Expanded Disability Status Scale (EDSS) (R: 0.30, p ≤ 0.006) and with disease duration (R: 0.33, p ≤ 0.002).Conclusion: We showed that black holes can be separated into two distinct clusters based on their intensity values on various sequences, only one of which is related to clinical parameters. This emphasizes the joint role of FSPGR and SE sequences in the monitoring of MS patients and provides insight into the role of black holes in MS.

Multimodal MRI Assessment of Thalamic Structural Changes in Earthquake Survivors.

Moving from the central role of the thalamus in the integration of inner and external stimuli and in the implementation of a stress-related response, the objective of the present study was to investigate the presence of any MRI structural and volumetric changes of the thalamic structures in earthquake witnesses. Forty-one subjects were included, namely 18 university students belonging to the experimental earthquake-exposed group (8 males and 10 females, mean age 24.5 ± 1.8 years) and a control group of 23 students not living in any earthquake-affected areas at the time of the earthquake (14 males and 9 females, mean age 23.7 ± 2.0 years). Instrumental MRI evaluation was performed using a 3-Tesla scanner, by acquiring a three-dimensional fast spoiled gradient-echo (FSPGR) sequence for volumetric analysis and an EPI (echoplanar imaging) sequence to extract fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values. As compared to the control one, the experimental group showed significantly lower gray matter volume in the mediodorsal nucleus of the left thalamus (p < 0.001). The dominant hemisphere thalamus in the experimental group showed higher mean ADC values and lower mean FA values as compared to the control group.

Resting-State Functional MRI Study: Connection Strength of Brain Networks in DR Patients.

PurposeTo explore the functional connection strength (FCS) changes of brain networks in diabetic retinopathy (DR) patients and uncover the underlying mechanism.Methods and MaterialsTwenty-one patients with DR and 21 age- and sex-matched healthy controls were enrolled from August 2012 to September 2014. Subjects were scanned using 3T MR with blood-oxygen-level dependent (BOLD) and 3-dimension fast spoiled gradient echo (3D-FSPGR) sequences. MR data was analyzed via preprocessing and functional network construction. After a group comparison, components of brain networks with significant group differences were extracted and the FCS of the brain network was evaluated. The brain areas were compared between patients and controls. P-values less than 0.05 were considered statistically significant. Connection strength was evaluated with alphasim, P<0.01.ResultsThe component maps of altered brain networks with quantified FCS were obtained in DR patients, demonstrating more disconnections mainly in the bilateral Heschl's gyrus, left cuneus, left occipital lobe, bilateral amygdala, left parahippocampal, bilateral fusiform, and left superior parietal in the patients group compared to the healthy controls (P<0.01), while compensations may occur in the frontal-cingulum region, as well as among the right caudate, left thalamus, left inferior temporal lobe, and middle orbital frontal lobe.ConclusionBrain network connections, decreased in the brain areas of which in charging with cognition and visual function, suggests that DR patients might have cognitive decline and visual function loss. However, there might be a frontal compensatory circle in patients with DR.

Feasibility Study of Simultaneous MR and 4D Ultrasound Imaging for IGRT

This work aimed to assess the feasibility of simultaneous MR and ultrasound image acquisition of healthy volunteers as part of a cost-effective and non-invasive real-time motion management solution for liver image-guided radiotherapy (IGRT). Pre-treatment simultaneous ultrasound and MR image datasets will be used to characterize respiratory motion states of salient features during free-breathing image acquisitions. These features will be tracked during treatment using ultrasound and mapped to the pre-treatment dataset to provide real-time motion management. While other motion management solutions exist, many have one or more drawbacks such as employing a high cost system, requiring invasive implants for imaging, adding dose to the patient, or potentially compromising on accuracy by utilizing optical tracking of external motion. Nine healthy volunteers were included in this study. For this IGRT project, we developed the first hands-free, MR-compatible, and real-time e4D ultrasound probe. The maximum depth is 18 cm with 2 mm lateral resolution at 7 cm depth. In 3D mode at 18 cm depth, the frame rate is 4 fps. The ultrasound was positioned either sub- or intercostally in order to view vasculature in the liver and a strap technique was utilized for probe stabilization. For this study, the harmonic mode (1.7/3.3 MHz) was employed. A fast spoiled gradient echo sequence (FSPGR) was used to obtain multi-phase 2D sagittal image slices. Nine consecutive sagittal slices were acquired for each volunteer. During acquisition, both datasets were streamed to an external machine for processing and analysis. After the scan, the data was synchronized using temporal image information. The image data was then analyzed using ITK-Snap and DICOM Slicer. Simultaneous ultrasound and MR images were successfully acquired and synchronized from nine volunteers. There were no major artifacts in either the ultrasound or MR images. Minor low level susceptibility artifacts within 1-2 cm of the ultrasound probe position were visible in the MR for some of the images acquired; such artifacts have not inhibited image analysis nor have they impacted overall image quality. Preliminary analyses do not provide evidence of drift over the course of ultrasound data acquisition, implying the position of the ultrasound is stable over the course of imaging. Limitations with internal over-heating of the ultrasound were experienced. We found that heating is mediated by lowering the acoustic power and allowing cooling time between slices of MR data. This study demonstrates the feasibility of simultaneous ultrasound and MR image acquisition using a hands-free, MR-compatible, 4D ultrasound transducer. While the current project looks to apply this technology specifically to liver IGRT, there may be opportunities for more broad application in IGRT as well as other image guidance procedures.

Common and Uncommon Artifacts in T1 FLAIR SAG Sequences of MRI Brain

ObjectiveThis study aims at identifying, classifying, and measuring the frequency the different artifacts that show up in the images of the Sagittal T1 Fluid Attenuated Inversion Recovery (FLAIR) sequence. Materials and MethodsA total of 101 subjects underwent brain magnetic resonance imaging examination with the following sequences: Axial T1 FLAIR, Axial T2-weighted imaging, Diffusion Weighted Imaging, 2D Multiple Echo Recombined Gradient Echo, Sagittal T1 FLAIR, Coronal T2 Turbo Spin Echo, Spin Echo T1-weighted imaging, and 3D Fast Spoiled Gradient-echo. In these images, we observed the following categories of artifacts: (a) ghost artifacts, (b) aliasing behind the occipital bone, (c) aliasing inside the sphenoid cavity, (d) susceptibility artifacts, and (e) pulsation artifacts. In order to recognize and verify the artifacts, we used not only the Sagittal T1 FLAIR sequence, but also Sagittal reconstructions from the 3-dimensional Fast Spoiled Gradient-echo sequence and the other routine sequences. ResultsAliasing artifacts and especially aliasing of nose are present in 41% of the cases. In 45% of these cases the uncommon aliasing artifacts, which took place into the brain parenchyma (sphenoid cavity, subarachnoid bay, or pituitary) originated from nose. In 33% of the subjects, ghost artifacts are presented, which stem from the nose, the orbits, or other pulsating structures (pulsation artifacts) or even from fat tissue. Moreover, susceptibility artifacts comprise 8% of all the artifacts. Finally, 19% of brains were presented without artifact. ConclusionsWe suggest in addition to T1 FLAIR, the application of Sagittal SE or TSE sequences in magnetic resonance imaging examination of brain, trying to include the nose in the square of FOV.

Differences in Intrinsic Brain Abnormalities Between Patients With Left- and Right-Sided Long-Term Hearing Impairment.

Unilateral hearing impairment is characterized by asymmetric hearing input, which causes bilateral unbalanced auditory afferents and tinnitus of varying degrees. Long-term hearing imbalance can cause functional reorganization in the brain. However, differences between intrinsic functional changes in the brains of patients with left- and those with right-sided long-term hearing impairments are incompletely understood. This study included 67 patients with unilateral hearing impairments (left-sided, 33 patients; right-sided, 34 patients) and 32 healthy controls. All study participants underwent blood oxygenation level dependent resting-state functional magnetic resonance imaging and T1-weighted imaging with three-dimensional fast spoiled gradient-echo sequences. After data preprocessing, fractional amplitude of low frequency (fALFF) and functional connectivity (FC) analyses were used to evaluate differences between patients and healthy controls. When compared with the right-sided hearing impairment group, the left-sided hearing impairment group showed significantly higher fALFF values in the left superior parietal gyrus, right inferior parietal lobule, and right superior frontal gyrus, whereas it showed significantly lower fALFF values in the left Heschl’s gyrus, right supramarginal gyrus, and left superior frontal gyrus. In the left-sided hearing impairment group, paired brain regions with enhanced FC were the left Heschl’s gyrus and right supramarginal gyrus, left Heschl’s gyrus and left superior parietal gyrus, left superior parietal gyrus and right inferior parietal lobule, right inferior parietal lobule and right superior frontal gyrus, and left and right superior frontal gyri. In the left-sided hearing impairment group, the FC of the paired brain regions correlated negatively with the duration and pure tone audiometry were in the left Heschl’s gyrus and right supramarginal gyrus. In the right-sided hearing impairment group, the FC of the paired brain regions correlated negatively with the duration was in the left Heschl’s gyrus and superior parietal gyrus, and with pure tone audiometry was right inferior parietal lobule and superior frontal gyrus. The intrinsic reintegration mechanisms of the brain appeared to differ between patients with left-sided hearing impairment and those with right-sided hearing impairment, and the severity of hearing impairment was associated with differences in functional integration in certain brain regions.

Detecting perfusion deficit in Alzheimer's disease and mild cognitive impairment patients by resting-state fMRI.

Vascular factors contributing to cerebral hypoperfusion are implicated in the risk of developing Alzheimer's disease (AD). To investigate the time-shift mapping created time-shift value of the brain by resting-state functional magnetic resonance imaging (rs-fMRI), and to determine the differences in time-shift value among AD, mild cognitive impairment (MCI), and normal control (NC) groups to better understand the disease. Prospective. Twenty-four AD, 24 MCI, and 24 age-matched NC participants. T2 *-weighted single-shot echo-planar imaging sequence was performed at 3T. In addition, a T1 -weighted fast spoiled gradient-echo sequence was acquired for coregistration. The brain time-shift value was determined from rs-fMRI-based blood oxygenation level-dependent (BOLD) signal in the three groups by time-shift mapping. The perfusion patterns were also investigated in the NC group. One-way analysis of variance and chi-squared tests were used to compare demographic information. The normalized time-shift maps were analyzed in a second-level test using SPM8. All analyses were evaluated with a significance level of P < 0.05 after false discovery rate (FDR) correction. The time-shift maps obtained from rs-fMRI are consistent with the cerebral blood supply atlas. Compared with NC, both MCI and AD groups had less early perfusion arrival areas among the whole brain. In the delayed time-shift value for the AD group, the areas were located in the bilateral precuneus, the sensory-motor cortex in the left hemisphere, and the bilateral calcarine sulcus, which were different from the MCI group (both P < 0.05, FDR corrected). The time-shift mapping method could detect perfusion deficits in AD and MCI noninvasively. The perfusion deficits detected by rs-fMRI may provide new insight for understanding the mechanism of neurodegeneration. Level of Evidence 2 Technical Efficacy Stage 3 J. Magn. Reson. Imaging 2019;49:1099-1104.

T2-weighted spoiled gradient echo sequence (MERGE): A different perspective on the forensic age estimation

Introduction Age estimation methods using MRI are dependent on staging systems used in T1, T2 and fast spin-echo proton density-weighted sequences. The staging system created by Dedouit [1] from images obtained by fast spin-echo proton density-weighted MRI sequences depends on the assessment of horizontal cartilage hyperintensity. Images obtained by this method, detecting 1.5 mm hyperintensity thickness, and in some cases, detecting continuity of hyperintensity could be challenging. The purpose of this preliminary study was to investigate the utility of T2-weighted spoiled gradient echo sequence in determining the degree of ossification of epiphyses. Material and methods In this study, fast spin-echo proton density-weighted and MERGE T2-weighted spoiled gradient echo sequences of the knee of 25 patients (10–30 years, 10 female and 15 male) were evaluated using Dedouit et al.’s [1] five-stage method. Results The horizontal cartilages assessed with MERGE exhibited hyperintensity and clearly visible borders ( Fig. 1 ). Stage 2 and 3 were easily distinguishable and the epiphyseal scar line observed in stage 5 (complete fusion) was easily observed in contrast to the fast spin-echo proton density-weighted sequence. The hyperintense line that was assessed in fast spin-echo proton density-weighted sequence in stage 3 cases was seen as continuous and intermittent hypointense line in MERGE sequence. It was suggested that substages may be necessary for the distinction of stage 3 and 4. Discussion At present, due to the ethical concerns, non-ionized methods (ultrasound and MRI) are more frequently used in living individuals’ age estimations. MRI assessments in spoiled T2-weighted spoiled gradient echo sequence for age determination may be advantageous in the examination of epiphyseal lines and may produce different options in staging.

Pulse sequence considerations for simulation and postimplant dosimetry of prostate brachytherapy

PurposeThe purpose of this work is to present a brief review of MRI physics principles pertinent to prostate brachytherapy, and a summary of our experience in optimizing protocols for prostate brachytherapy applications. Methods and MaterialsWe summarized essential MR imaging characteristics and their interplays that need to be considered for prostate brachytherapy applications. These include spatial resolution, signal-to-noise ratio, image contrast, artifacts, geometric distortion, specific absorption rate, and total scan time. We further described the optimization of the protocols for three pulse sequences: three-dimensional (3D) fast-spoiled gradient echo sequence for T1-weighted imaging, 3D fast-spin echo sequence for T2-weighted imaging, and 3D fast imaging in steady-state precession sequence for combined T1 and T2-weighed imaging. The utilization of an endorectal coil was also described. ResultsUsing the optimized protocols, we acquired high-quality images of the entire prostate within 3–5 minutes for each sequence. These images display the desired image contrasts and a spatial resolution that is equal to or better than 0.59 mm × 0.73 mm × 1.2 mm. While 3D fast-spoiled gradient echo sequence and 3D fast-spin echo sequence depict radioactive seed markers and anatomic structures separately, 3D fast imaging in steady-state precession sequence demonstrates great promise for imaging both seed markers and prostate anatomy simultaneously in a single acquisition. ConclusionsWe have optimized current MRI protocols and demonstrated that the anatomic structures and positive contrast radioactive seed markers for prostate post-implant dosimetry can be adequately imaged either separately or simultaneously using different pulse sequences within a total scan time of 3–5 minutes each.

Systematic Evaluation of Amide Proton Chemical Exchange Saturation Transfer at 3 T: Effects of Protein Concentration, pH, and Acquisition Parameters.

The goal of this work was to systematically evaluate the reproducibility of amide proton transfer chemical exchange saturation transfer (APT-CEST) at 3 T and its signal dependence on pH, protein concentration, and acquisition parameters. An in vitro system based on bovine serum albumin (BSA) was used, and its limitations were tested by comparing it to in vivo measurements. The contribution of small endogenous metabolites on the APT-CEST signal at 3 T was also investigated. In addition, the reliability of different z-spectrum interpolations as well as the use of only a few frequency offset data points instead of a whole z-spectrum were tested. We created both a BSA phantom at different concentrations and pH values and a metabolite phantom with different small molecules. Chemical exchange saturation transfer data were acquired using a 2-dimensional fast spoiled gradient-echo sequence with pulsed CEST preparation at different saturation durations and power levels. Healthy volunteer measurements were taken for comparison. Z-spectra were interpolated using a 24th-order polynomial (Poly), an eighth-order Fourier series (Fourier), and a smoothing Spline (sSpline) algorithm. To evaluate reduced data sets, only 6 to 14 frequency offsets of the z-spectrum were used and interpolated via a cubic Spline. Region of interest (ROI) evaluations were used to investigate the reproducibility of amide magnetization transfer ratio asymmetry [MTRasym(3.5 ppm)] and to analyze the MTRasym and z-spectra. Interscan standard deviations of MTRasym(3.5 ppm) were always below 0.3%. MTRasym(3.5 ppm) increased when the BSA concentrations increased and decreased when the pH increased. The amine MTRasym signal of small molecules was very small compared with BSA and was only detectable using short saturation times and higher power levels. The MTRasym(3.5 ppm) between BSA concentration steps and between nearly all pH steps was significantly different for all 3 fitting methods. The Fourier and sSpline methods showed no statistically significant differences; however, the results for the Poly method were significantly higher at some concentrations and pH values. Using only few frequency offsets resulted in less significant differences compared with fitting the complete z-spectrum. In general, MTRasym(3.5 ppm) of gray matter, white matter, and ventricle ROIs from volunteer scans increased with an increase in saturation power and partially decreased with an increase in saturation duration. Intra-ROI covariances of MTRasym(3.5 ppm) revealed the highest variations for Poly, whereas using reduced spectral data resulted in an increased signal variation. Amide proton transfer-CEST imaging is a highly reproducible method in which absolute signal differences of approximately 0.5% are detectable in principle. For in vivo applications, Fourier or sSpline interpolations of z-spectra are preferable. Using reduced data sets delivers similar results but with increased variation and therefore decreased (pH/concentration) differentiation capability. Differentiation capability increases with increases in the saturation duration and power level. The results from the in vitro BSA system cannot be directly transferred to the in vivo situation due to different chemical environments resulting in, for example, higher asymmetric macromolecular cMT effects in vivo. Amine signals from small molecules are unlikely to contribute to APT-CEST at 3 T (except for creatine); however, signals can be enhanced by using short saturation times and higher power levels.

Segmentation of solid subregion of high grade gliomas in MRI images based on active contour model (ACM)

Gliomas are tumours arising from the interstitial tissue of the brain which are heterogeneous, infiltrative and possess ill-defined borders. Tumour subregions (e.g. solid enhancing part, edema and necrosis) are often used for tumour characterisation. Tumour demarcation into substructures facilitates glioma staging and provides essential information. Manual segmentation had several drawbacks that include laborious, time consuming, subjected to intra and inter-rater variability and hindered by diversity in the appearance of tumour tissues. In this work, active contour model (ACM) was used to segment the solid enhancing subregion of the tumour. 2D brain image acquisition data using 3T MRI fast spoiled gradient echo sequence in post gadolinium of four histologically proven high-grade glioma patients were obtained. Preprocessing of the images which includes subtraction and skull stripping were performed and then followed by ACM segmentation. The results of the automatic segmentation method were compared against the manual delineation of the tumour by a trainee radiologist. Both results were further validated by an experienced neuroradiologist and a brief quantitative evaluations (pixel area and difference ratio) were performed. Preliminary results of the clinical data showed the potential of ACM model in the application of fast and large scale tumour segmentation in medical imaging.

The Posterior Limb of the Internal Capsule as the Subcortical Transitional Zone of the Anterior and Posterior Circulations: Insights from Human 7T MRI

Background: In patients with cerebral infarction, identifying the distribution of infarction and the relevant artery is essential for ascertaining the underlying vascular pathophysiological mechanisms and preventing subsequent stroke. However, visualization of the basal perforating arteries (BPAs) has had limited success, and simultaneous viewing of background anatomical structures has only rarely been attempted in living human brains. Our study aimed at identifying the BPAs with 7T MRI and evaluating their distribution in the subcortical structures, thereby showing the clinical significance of the technique. Methods: Twenty healthy subjects and 1 patient with cerebral infarction involving the posterior limb of the internal capsule (ICpost) and thalamus underwent 3-dimensional fast spoiled gradient-echo sequence as time-of-flight magnetic resonance angiography (MRA) at 7T with a submillimeter resolution. The MRA was modified to detect inflow signals from BPAs, while preserving the background anatomical signals. BPA stems and branches in the subcortical structures and their origins were identified on images, using partial maximum intensity projection in 3 dimensions. Results: A branch of the left posterior cerebral artery (PCA) in the patient ran through both the infarcted thalamus and ICpost and was clearly the relevant artery. In 40 intact hemispheres in healthy subjects, 571 stems and 1,421 branches of BPAs were detected in the subcortical structures. No significant differences in the numbers of stems and branches were observed between the intact hemispheres. The numbers deviated even less across subjects. The distribution analysis showed that the subcortical structures of the telencephalon, such as the caudate nucleus, anterior limb of the internal capsule, and lenticular nucleus, were predominantly supplied by BPAs from the anterior circulation. In contrast, the thalamus, belonging to the diencephalon, was mostly fed by BPAs from the posterior circulation. However, compared with other subcortical structures, the ICpost, which marks the anatomical boundary between the telencephalon and the diencephalon, was supplied by BPAs with significantly more diverse origins. These BPAs originated from the internal carotid artery (23.1%), middle cerebral artery (38.5%), PCA (17.3%), and the posterior communicating artery (21.1%). Conclusions: The modified MRI method allowed the detection of the relevant BPA within the infarcted area in the stroke survivor as well as the BPAs in the subcortical structures of living human brains. Based on in vivo BPA distribution analyses, the ICpost is the transitional zone of the anterior and posterior cerebral circulations.

Abstract B51: Metabolic imaging with hyperpolarized [1-13C]-pyruvate and DCE-MRI

Abstract Purpose: To improve the quality and specificity of metabolic imaging with hyperpolarized pyruvate using prior information from dynamic contrast-enhanced MRI (DCE-MRI). Background: Dynamic nuclear polarization (DNP) and MR spectroscopic imaging of [1-13C]-pyruvate shows tremendous promise for imaging aerobic glycolysis with sensitivity, specificity, and resolution that was previously impossible. Exogeneous, enriched hyperpolarized (HP) pyruvate is injected as a bolus and traverses multiple biological barriers before it is exposed to intracellular enzymes that mediate its fate. Preservation of the spin label through chemical reaction allows visualization of pyruvate and its chemical endpoints (lactate, alanine, and carbon dioxide/bicarbonate). We have previously observed a strong correlation between tumor perfusion and the normalized area under the curve for HP lactate, the chemical endpoint associated with aerobic glycolysis. A pharmacokinetic model of HP substrate evolution that balances physiological accuracy and computational burden includes two physical pools (intravascular/extravascular) and two chemical pools (pyruvate/lactate). In the analytical solution for this model, terms for substrate extravasation and the fractional intravascular volume can be recognized as analogues for KTRANS and Vb that are derived from analysis of DCE-MRI data using the extended Tofts model. Use of these DCE-MRI parameters as prior information could eliminate unknowns in the measurement of HP agents and improve the specificity of quantitative estimates for kPL, the apparent conversion rate for HP pyruvate into lactate. Experimental Procedures: Athymic nude mice bearing orthotopic anaplastic thyroid cancer tumors were anesthetized and scanned using a 7T Biospec small animal MR system (Bruker Biospin Corp.). A dual-tuned 1H/13C volume resonator was used for anatomic imaging and for 13C excitation, and a surface coil was used for 13C detection. HP pyruvate was prepared using a HyperSense DNP system (Oxford Instruments). Dynamic 13C spectroscopic imaging data was acquired using a radial multi-band frequency encoding sequence beginning prior to intravascular administration of HP pyruvate via tail-vein catheter. DCE-MRI data was acquired after HP measurements, using a fast spoiled gradient echo sequence. DCE-MRI data was fit to the extended Tofts model on a pixel-by-pixel basis using software developed in Matlab (The Mathworks). Parametric maps for perfusion and vascular blood volume fraction were resampled to the resolution of HP 13C scans and used as priors in a constrained reconstruction algorithm that enforces consistency between undersampled 13C projection data, the kinetic model, and prior information from 1H MRI. Results: With prior information about extravasation and fractional intravascular blood volume, the constrained reconstruction algorithm needs only solve for a global parameterized vascular input function and values for chemical conversion (kPL) and signal relaxation/loss for each voxel in the imaging volume. Elimination of nuisance parameters with strongly correlated effects reduces the computational burden of constrained reconstruction and clarifies interpretation of changes in biomarkers due to disease progression or response to therapy. Conclusions: The combination of DCE-MRI with constrained reconstruction reduces the number of unknowns in quantitative metabolic imaging using HP pyruvate, eases the computational burden, and decouples correlated effects of perfusion and chemical exchange. Citation Format: James A. Bankson, Christopher M. Walker, Yunyun Chen, Stephen Y. Lai, John D. Hazle. Metabolic imaging with hyperpolarized [1-13C]-pyruvate and DCE-MRI. [abstract]. In: Proceedings of the AACR Special Conference: Metabolism and Cancer; Jun 7-10, 2015; Bellevue, WA. Philadelphia (PA): AACR; Mol Cancer Res 2016;14(1_Suppl):Abstract nr B51.