Fat Signal Research Articles

Radiomics Based on Adapted Diffusion Kurtosis Imaging Helps to Clarify Most Mammographic Findings Suspicious for Cancer.

Purpose To evaluate a radiomics model of Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 breast lesions extracted from breast-tissue-optimized kurtosis magnetic resonance (MR) imaging for lesion characterization by using a sensitivity threshold similar to that of biopsy. Materials and Methods This institutional study included 222 women at two independent study sites (site 1: training set of 95 patients; mean age ± standard deviation, 58.6 years ± 6.6; 61 malignant and 34 benign lesions; site 2: independent test set of 127 patients; mean age, 58.2 years ± 6.8; 61 malignant and 66 benign lesions). All women presented with a finding suspicious for cancer at x-ray mammography (BI-RADS 4 or 5) and an indication for biopsy. Before biopsy, diffusion-weighted MR imaging (b values, 0-1500 sec/mm2) was performed by using 1.5-T imagers from different MR imaging vendors. Lesions were segmented and voxel-based kurtosis fitting adapted to account for fat signal contamination was performed. A radiomics feature model was developed by using a random forest regressor. The fixed model was tested on an independent test set. Conventional interpretations of MR imaging were also assessed for comparison. Results The radiomics feature model reduced false-positive results from 66 to 20 (specificity 70.0% [46 of 66]) at the predefined sensitivity of greater than 98.0% [60 of 61] in the independent test set, with BI-RADS 4a and 4b lesions benefiting from the analysis (specificity 74.0%, [37 of 50]; 60.0% [nine of 15]) and BI-RADS 5 lesions showing no added benefit. The model significantly improved specificity compared with the median apparent diffusion coefficient (P < .001) and apparent kurtosis coefficient (P = .02) alone. Conventional reading of dynamic contrast material-enhanced MR imaging provided sensitivity of 91.8% (56 of 61) and a specificity of 74.2% (49 of 66). Accounting for fat signal intensity during fitting significantly improved the area under the curve of the model (P = .001). Conclusion A radiomics model based on kurtosis diffusion-weighted imaging performed by using MR imaging machines from different vendors allowed for reliable differentiation between malignant and benign breast lesions in both a training and an independent test data set. © RSNA, 2018 Online supplemental material is available for this article.

Fat Necrosis of the Breast: Magnetic Resonance Imaging Characteristics and Pathologic Correlation

This study aims to describe the magnetic resonance imaging (MRI) features of fat necrosis on magnetic resonance mammography, which may downstage a suspicious lesion to a merely benign finding. This prospective study included 82 female patients (mean age 50 years) who were diagnosed to have suspicious lesions by mammography, ultrasonography or both. All patients underwent MRI including diffusion-weighted imaging and spectroscopy. Image postprocessing and analysis included signal intensity, enhancement characteristics, diffusion restriction, and spectroscopic analysis. All patients underwent histopathological analysis for confirmation. Sensitivity, specificity, positive predictive value (PPV), and negative (NPV) predictive value were calculated. To label a lesion as fat necrosis on MRI analysis, presence of fat signal in a lesion revealed sensitivity of 98.04%, specificity of 100%, PPV of 100%, and NPP of 96.88%, whereas nonenhancement of the lesion itself revealed sensitivity of 96.08%, specificity of 100%, PPV of 100%, and NPP of 93.94%. However, adding both the nonrestriction on diffusion analysis and the lack of tCholine at 3.22 ppm increased the sensitivity and specificity to 100%, as well as PPV of 100% for fat necrosis and hence a NPV for malignancy of 100%. MRI proved to be of value in differentiating fat necrosis from malignancy based on the molecular composition of fat necrosis, clearly depicted by MRI without the need for invasive confirmation by biopsy.

Referenced MR thermometry using three-echo phase-based fat water separation method

A three-point image reconstruction method for internally referenced MR thermometry was developed. The technique exploits the fact that temperature-induced changes in the water resonance frequency are small relative to the chemical shift difference between water and fat signals. This property enabled the use of small angle approximations to derive an analytic phase-based fat-water separation method for MR thermometry. Ethylene glycol and cream cool-down experiments were performed to validate measurement technique. Over a cool-down temperature range of 20 °C, maximum deviation between probe and MR measurement (averaged over 1.3 cm3 region surrounding probe) was 0.6 °C and 1.1 °C for ethylene glycol and cream samples, respectively.

Cardiovascular cine imaging and flow evaluation using Fast Interrupted Steady-State (FISS) magnetic resonance

BackgroundExisting cine imaging techniques rely on balanced steady-state free precession (bSSFP) or spoiled gradient-echo readouts, each of which has limitations. For instance, with bSSFP, artifacts occur from rapid through-plane flow and off-resonance effects. We hypothesized that a prototype cine technique, radial fast interrupted steady-state (FISS), could overcome these limitations. The technique was compared with standard cine bSSFP for cardiac function, coronary artery conspicuity, and aortic valve morphology. Given its advantageous properties, we further hypothesized that the cine FISS technique, in combination with arterial spin labeling (ASL), could provide an alternative to phase contrast for visualizing in-plane flow patterns within the aorta and branch vessels.Main bodyThe study was IRB-approved and subjects provided consent. Breath-hold cine FISS and bSSFP were acquired using similar imaging parameters. There was no significant difference in biplane left ventricular ejection fraction or cardiac image quality between the two techniques. Compared with cine bSSFP, cine FISS demonstrated a marked decrease in fat signal which improved conspicuity of the coronary arteries, while suppression of through-plane flow artifact on thin-slice cine FISS images improved visualization of the aortic valve. Banding artifacts in the subcutaneous tissues were reduced. In healthy subjects, dynamic flow patterns were well visualized in the aorta, coronary and renal arteries using cine FISS ASL, even when the slice was substantially thicker than the vessel diameter.ConclusionCine FISS demonstrates several benefits for cardiovascular imaging compared with cine bSSFP, including better suppression of fat signal and reduced artifacts from through-plane flow and off-resonance effects. The main drawback is a slight (~ 20%) decrease in temporal resolution. In addition, preliminary results suggest that cine FISS ASL provides a potential alternative to phase contrast techniques for in-plane flow quantification, while enabling an efficient, visually-appealing, semi-projective display of blood flow patterns throughout the course of an artery and its branches.

Magnetic Resonance Sialography and Salivary Gland Scintigraphy of Parotid Glands in Sjögren's Syndrome.

To assess the correlation between conventional magnetic resonance (MR) imaging and MR sialography of parotid glands with salivary gland scintigraphy in patients with Sjögren's syndrome. A retrospective study was conducted on eight patients with Sjögren's syndrome who underwent MR imaging and salivary gland scintigraphy. Conventional MR imaging techniques, such as T1-weighted images (T1WI), T2-weighted images (T2WI), and short TI inversion recovery images (STIR) were used for changes of fat signal in the parotid gland, while the MR sialography were used for ducts dilation of the parotid gland. Regarding scintigraphy, time-activity curves of each parotid gland were analysed. The salivary gland excretion fraction was defined as A (before stimulation test (counts/20 s)) and B (after stimulation test (counts/20 s)). Regarding characteristic appearances of fat signal, the A/B of parotid gland with homogeneous intensity distribution (3.51 ± 0.75) was higher than that with heterogeneous intensity distribution (1.56 ± 0.66, P = 0.001). Regarding MR sialographic stages, the A/B of parotid gland with stage 0 (3.51 ± 0.75) was higher than that with stage 1 (2.03 ± 0.86, P = 0.009) and with stage 2 (1.26 ± 0.25, P = 0.000). The results suggest that MR sialography of the parotid glands is a useful noninvasive tool for evaluating the decrease of salivary gland excretion in patients with Sjögren's syndrome.

Lumbar paraspinal muscle fat infiltration is independently associated with sex, age, and inter-vertebral disc degeneration in symptomatic patients.

To determine the association of paraspinal muscles and psoas relative cross-sectional area (RCSA) and fat signal fraction (FSF) with sex, age, and intervertebral disc degeneration (IDD) in symptomatic patients. We retrospectively evaluated 80 adult patients with spinal symptoms using T2-weighted magnetic resonance images. We determined RCSA and FSF of the paraspinal muscles (erector spinae and multifidus) and psoas from L1-L2 to L5-S1; we determined IDD using the Pfirrmann classification. We compared differences in muscle RCSA and FSF based on sex and IDD, and we correlated age and IDD with RCSA and FSF. Using multivariate linear regression analyses, we determined the impact of sex, age, and IDD on RCSA and FSF. Men exhibited larger psoas RCSA but not larger paraspinal muscles RCSA than women. Women had larger FSF in the paraspinal muscles and psoas. Increasing IDD was associated with larger FSF if ≥2 Pfirrmann grades were observed. IDD correlated with FSF of the paraspinal muscles, and age correlated with FSF of the paraspinal muscles and psoas. IDD was less consistently correlated with RCSA, but age correlated negatively with RCSA of all three muscles. Linear regression analyses demonstrated that sex, age, and IDD were each independently associated with FSF of the paraspinal muscles; additionally, sex and age, but not IDD, were associated with psoas FSF. RCSA was less consistently influenced by these three variables. Sex, age, and IDD are independently associated with paraspinal muscles FSF; only sex and age influence psoas FSF.

Optimal Conditions for 3D Non-contrast T1-weighted Magnetic Resonance Imaging Segmented Turbo Fast Low-angle Shot for Tissue Characterization of Coronary Plaques

In three-dimensional (3D) T1-weighted magnetic resonance imaging used for tissue characterization of coronary plaques, the contrast for electrocardiographic synchronization may vary according to the R-R interval (RR). The coronary artery plaque image shows suppression of the fluid compartment signal for the coronary artery luminal blood as well as the fat signal in the region of interest; in addition, it is necessary to ensure that the value of the plaque-to-muscle signal intensity ratio (PMR) does not change according to the difference in RR. In the current study, the phantom review and clinical data suggested that the PMR changes that occur due to the differences in RR can be minimized by adjusting the inversion time (TI) in the range of the required black blood effect. Moreover, the signal-to-noise ratio (SNR), which varies according to the difference between the RR and the TI, was determined to identify the maximum value flip angle (FA) value that would lead to improvement in the SNR. Thus, signal suppression of the PMR, SNR, and the fluid compartment of the coronary artery luminal blood can be controlled using different RRs with the relational expressions for calculating optimal TI and FA.

Developmental patterns of fetal fat and corresponding signal on T1-weighted magnetic resonance imaging.

Evaluation of subcutaneous fetal fat layer thickness on T1-weighted sequences can be used to predict birth weight. Little is known about normal MR signal patterns of subcutaneous tissue throughout pregnancy. To establish developmental patterns of subcutaneous fetal fat signal on T1-weighted sequences during the 2nd and 3rd trimesters. We retrospectively examined T1-weighted images of 110 fetal MRI scans. We measured signal intensity of subcutaneous fat on thighs, buttocks, trunk, nuchal region, chin and scalp. We then calculated the ratios of the obtained values with fetal muscle, amnios and maternal fat signal, and compared the results with those of immunohistochemical examination of adipose tissue extracted from the abdominal wall of fetuses as part of standard autopsy protocol. We included 60 MRI scans in fetuses without intra-uterine growth restriction or macrosomia of non-diabetic mothers (range 23-37weeks of gestation). Fat T1 intensity of all anatomical regions was low in all fetuses before 26weeks of gestation. It became more hyperintense with increasing gestational age, in the following order: chin and nuchal region, then buttocks, thighs and trunk, and eventually the scalp at 33weeks of gestation. After 33weeks of gestation, all fetal subcutaneous tissues demonstrated overall hyperintense signal. This progression followed the conversion at immunohistochemistry of fetal adipose tissue composition from predominant brown to white adipose cells in 19 fetuses (19-41weeks of gestation). Between 26weeks and 33weeks of gestation, subcutaneous fetal fat signal changed in an orderly pattern from chin to buttocks and scalp. This may reflect the conversion from predominant brown to white adipose tissues in subcutaneous fetal fat.

Flexible water excitation for fat-free MRI at 3T using lipid insensitive binomial off-resonant RF excitation (LIBRE) pulses.

To develop a robust and flexible low power water excitation pulse that enables effective fat suppression at high magnetic field strength. A water excitation method that uses spatially non-selective pulses was optimized in numerical simulations, and implemented and tested in phantoms and healthy volunteers at 3T. The lipid insensitive binomial off-resonant excitation (LIBRE) pulse comprises two low power rectangular subpulses that have a variable frequency offset, phase offset and duration. The capability and extent of LIBRE fat suppression was quantitatively compared with conventional fat saturation (FS) and water excitation (WE) techniques. LIBRE enables simultaneous water excitation and near complete fat suppression in large volumes at 3T as demonstrated by numerical simulations, and experiments. In phantoms and in human subjects, the frequency responses matched well with those from the numerical simulation. Comparing FS and WE, LIBRE demonstrated an improved robustness to magnetic field inhomogeneities, and a much more effectively suppressed fat signal. This applied for a range of pulse durations and pulses as short as 1.4 ms. A flexible water excitation method was developed that shows robust, near complete fat suppression at 3T. Magn Reson Med 79:3007-3017, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Abnormal High Signal Intensity Discovered in Eye Lenses in Routine Brain MRI; Correlation with Ophthalmologist Examination

Objectives: The aim of this study was to determine the possible role of brain magnetic resonance imaging (MRI) in cataract detection. Patients and Methods: This study was performed on patients who were referred to Shahid Faghihi hospital with a known disease for brain MRI. Patients were classified in two groups of case and controls. Cases were 44 eyes with abnormal signal of the lens and controls were 88 eyes with normal signal intensity of the lens. All patients underwent an ophthalmological examination and the presence of cataract and intraocular lens (IOL) was assessed in these patients. Average lens signal, average muscle signal, average fat signal, lens to muscle signal ratio, and average lens signal to average fat signal ratio were recorded. Results: The mean of the average lens signal in the case group was significantly higher than controls (370 versus 161, respectively) (P value < 0.0001). Sixteen (36.4%) out of 44 eyes in the case group had cataract, but 48 (54.5%) of 88 eyes in the control group had cataract (P value = 0.049). In the case group, 18.2% had IOL, and this was 6.8% in the controls (P value = 0.046). The mean of the average lens signal in eyes with cataract was 218.5 and in normal eyes, it was 249.1 (P value = 0.36). In eyes with IOL, the mean of the average lens signal was 347.5 and in normal eyes, this was 223.1 (P value = 0.036). Conclusion: Cataract in eyes with abnormal lens signal was significantly lower than eyes with normal lens average signal. The lens signal in eyes with cataract was similar to eyes without cataract. So, average lens signal in brain MRI does not lead to early detection of cataract.

Renal Adiposity Confounds Quantitative Assessment of Markers of Renal Diffusion With MRI: A Proposed Correction Method.

Recent studies have indicated that excessive fat may confound assessment of diffusion in organs with high fat content, such as the liver and breast. However, the extent of this effect in the kidney, which is not considered a major fat deposition site, remains unclear. This study tested the hypothesis that renal fat may impact diffusion-weighted imaging (DWI) parameters, and proposes a 3-compartment model (TCM) to circumvent this effect. Using computer simulations, we investigated the effect of fat on assessment of apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM), and TCM-derived pure-diffusivity. We also investigated the influence of magnetic resonance repetition (TR) and echo time (TE) on DWI parameters as a result of variation in the relative contribution of the fat signal. Apparent diffusion coefficient, IVIM and TCM DWI parameters were calculated in domestic pigs fed a high-cholesterol (obese group) or normal diet (lean group), and correlated to renal histology. Intravoxel incoherent motion-derived pure-diffusivity was also compared among 15 essential hypertension patients classified by body mass index (BMI) (high vs normal). Finally, pure-diffusivity was calculated and compared in 8 patients with atherosclerotic renal artery stenosis (ARAS) and 5 healthy subjects using IVIM and TCM. Simulations showed that unaccounted fat results in the underestimation of IVIM-derived pure diffusivity. The underestimation increases as the fat fraction increases, with higher pace at lower fat contents. The underestimation was larger for shorter TR and longer TE values due to the enhancement of the relative contribution of the fat signal. Moreover, TCM, which incorporates highly diffusion-weighted images (b > 2500 s/mm), could correct for fat-dependent underestimation. Animal studies in the lean and obese groups confirmed lower ADC and IVIM pure-diffusivity in obese versus lean pigs with otherwise healthy kidneys, whereas pure-diffusivity calculated using TCM were not different between the 2 groups. Similarly, essential hypertension patients with high BMI had lower ADC (1.9 vs 2.1 × 10 mm/s) and pure-diffusivity (1.7 vs 1.9 × 10 mm/s) than those with normal BMI. Pure-diffusivity calculated using IVIM was not different between the ARAS and healthy subjects, but TCM revealed significantly lower diffusivity in ARAS. Excessive renal fat may cause underestimation of renal ADC and IVIM-derived pure-diffusivity, which may hinder detection of renal pathology. Models accounting for fat contribution may help reduce the variability of diffusivity calculated using DWI.

MRI assessed pancreatic morphology and exocrine function are associated with disease burden in chronic pancreatitis.

The aim of this study was to explore the association between morphological and functional secretin-stimulated MRI parameters with hospitalization, quality of life (QOL), and pain in patients with chronic pancreatitis (CP). This prospective cohort study included 82 patients with CP. Data were obtained from clinical information, QOL, and pain as assessed by questionnaires (The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and modified Brief Pain Inventory short form). Secretin-stimulated MRI morphological parameters included pancreatic gland volume, main pancreatic duct diameter, the modified Cambridge Classification of Duct Abnormality, apparent diffusion coefficient, fat signal fraction, and the pancreatic secretion volume as a functional parameter. The primary outcomes were time to first hospitalization related to the CP, as well as annual hospitalization frequency and duration. The secondary outcomes were pain severity, QOL, and pain interference scores. A main pancreatic duct diameter below 5 mm was associated with reduced time to first hospitalization (hazard ratio=2.06; 95% confidence interval: 1.02-4.17; P=0.043). Pancreatic secretion volume was correlated with QOL (r=0.31; P=0.0072) and pain interference score (r=-0.27; P=0.032), and fecal elastase was also correlated with QOL (r=0.28; P=0.017). However, functional and morphological findings were not related to pain intensity. Advanced pancreatic imaging techniques may be a highly sensitive tool for prognostication and monitoring of disease activity and its consequences.

Leaps in Technology: Advanced MR Imaging after Total Hip Arthroplasty.

The vast majority of the metal-related artifacts in magnetic resonance imaging (MRI) arise from B0 inhomogeneity. These artifacts include failed fat suppression, signal loss, signal pileup, and image distortions. Metal artifact reduction sequence MRI has been used to mitigate these artifacts via optimization of the scan parameters and exploiting new techniques such as fully phase-encoded imaging and multispectral imaging including multi-acquisition variable-resonance image combination and slice encoding for metal artifact correction. Applicability of MRI in the vicinity of metal implants has been revolutionized by these new techniques at the expense of longer acquisition times. To reach clinically viable scan times, these novel techniques have been successfully coupled with various acceleration paradigms such as parallel imaging and compressed sensing.

Lack of NLRP3-inflammasome leads to gut-liver axis derangement, gut dysbiosis and a worsened phenotype in a mouse model of NAFLD

Non-Alcoholic Fatty Liver Disease (NAFLD) represents the most common form of chronic liver injury and can progress to cirrhosis and hepatocellular carcinoma. A “multi-hit” theory, involving high fat diet and signals from the gut-liver axis, has been hypothesized. The role of the NLRP3-inflammasome, which senses dangerous signals, is controversial. Nlrp3−/− and wild-type mice were fed a Western-lifestyle diet with fructose in drinking water (HFHC) or a chow diet. Nlrp3−/−-HFHC showed higher hepatic expression of PPAR γ2 (that regulates lipid uptake and storage) and triglyceride content, histological score of liver injury and greater adipose tissue inflammation. In Nlrp3−/−-HFHC, dysregulation of gut immune response with impaired antimicrobial peptides expression, increased intestinal permeability and the occurrence of a dysbiotic microbiota led to bacterial translocation, associated with higher hepatic expression of TLR4 (an LPS receptor) and TLR9 (a receptor for double-stranded bacterial DNA). After antibiotic treatment, gram-negative species and bacterial translocation were reduced, and adverse effects restored both in liver and adipose tissue. In conclusion, the combination of a Western-lifestyle diet with innate immune dysfunction leads to NAFLD progression, mediated at least in part by dysbiosis and bacterial translocation, thus identifying new specific targets for NAFLD therapy.

P.94 - Stimulated echo DTI of skeletal muscle in Becker muscular dystrophy: a pilot study

Diffusion tensor imaging (DTI) is an MRI technique that aims to probe muscle architecture. The technique could be relevant in neuromuscular disorders (NMDs) where differences in fiber size and increased membrane permeability occur. Two approaches are relevant, spin-echo (SE-)DTI and stimulated-echo (STE-)DTI. While STE-DTI has a lower signal to noise ratio (SNR), it allows probing of the long diffusion distances present in skeletal muscle, which SE-DTI cannot. STE-DTI may thus be more sensitive, but has not been applied in NMD, as fat reduces the amount of water signal per voxel, and thus water SNR. We evaluated the feasibility of STE-DTI with fat suppression and signal denoising in Becker muscular dystrophy (BMD) patients. BMD patients (n = 7, age 21–58) and controls (n = 6, age 33–60) were scanned at 3T. Fat suppressed STE-DTI images, (resolution = 2x2x6 mm3) water/fat images (3-point Dixon, resolution = 1x1x10mm3), and noise maps were acquired. DTI data was denoised before computation of fractional anisotropy (FA) and mean diffusivity (MD) maps. FA, MD, fat fraction (FF), and SNR were measured in 6 muscles of the lower leg. In controls, at low SNR < 7, FA values were overestimated. Therefore, data sets with an SNR < 7 (24/42 BMD muscles) were excluded, which corresponded to muscles with significantly higher FF (41 ± 26% vs 10 ± 8 %, p = 0.001). The tibialis anterior (TA) had the highest SNR, allowing the comparison of 7 BMD and 4 controls. FA was higher in BMD (0.30 ± 0.05) than in controls (0.24 ± 0.02, p = 0.016). Sample size was insufficient for group comparison in other muscles. While STE-DTI MRI can be promising, maintaining sufficient SNR is of high importance, especially when imaging muscles with high FF. We were able to use STE and long diffusion time in low fat BMD muscles, likely owing to the use of signal denoising. High FA in the TA could be due to smaller fiber size or fibrosis. Future studies should focus on increasing the SNR, and exploring multiple diffusion times.

Radial fast interrupted steady-state (FISS) magnetic resonance imaging.

To report a highly interrupted radial variant of balanced steady-state free precession (bSSFP) imaging, termed fast interrupted steady-state (FISS), for decreasing flow artifact as well as fat signal conspicuity with respect to bSSFP, and saturation effects vis-à-vis fast low-angle shot (FLASH) imaging. Numerical simulations, phantom studies, and human studies were conducted to examine the imaging contrast, off-resonance behavior, and flow properties of FISS. Human studies applied FISS for cine cardiac imaging and ungated nonenhanced MR angiography (MRA) of the legs, neck, and brain. Comparisons were made with bSSFP and FLASH imaging. Simulations revealed that FISS retains the high signal levels of bSSFP for stationary on-resonant spins, while reducing undesirable signal heterogeneity from flowing spins. Phantom studies agreed with the simulations, and showed that FISS reduces fat signal and flow artifact with respect to bSSFP imaging. FISS imaging in human subjects agreed with the simulations and phantom studies, and showed reduced saturation artifact compared with FLASH imaging. FISS imaging reduces flow artifact and fat signal conspicuity with respect to bSSFP imaging, and ameliorates arterial signal saturation observed with FLASH imaging. Potential clinical applications include fat-suppressed cine imaging and ungated nonenhanced MRA. Magn Reson Med 79:2077-2086, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Characterizing and eliminating errors in enhancement and subtraction artifacts in dynamic contrast-enhanced breast MRI: Chemical shift artifact of the third kind.

To characterize errors in enhancement in breast dynamic contrast-enhanced (DCE) MRI studies as a function of echo time and determine the source of dark band artifacts in clinical subtraction images. Computer simulations, oil and water substitute (methylene chloride), as well as an American College of Radiology quality control phantom were tested. Routine clinical DCE breast MRI study was bracketed with (accelerated) in-phase DCE acquisitions in five patients. Simulation results demonstrated up to -160% suppression of the expected enhancement caused by differential enhancement of fat and water. Two-dimensional gradient-recalled echo and fat-suppressed 3D GRE phantom imaging confirmed the simulation results and showed that fat suppression does not eliminate the artifact. In vivo in-phase DCE images showed increased enhancement consistent with predictions and also confirmed increased spatial blurring on in-phase 3D gradient-recalled echo images. Combined multi-dimensional partial Fourier and parallel imaging provided a time-equivalent in-phase DCE MRI acquisition. Errors in expected enhancement occur in DCE breast MRI subtraction images because of differential enhancement of fat and water and incomplete fat signal suppression. These errors can lead to artificial suppression of enhancement as well as dark band artifacts on subtraction images. These artifacts can be eliminated with a time-equivalent in-phase fat-suppressed 3D gradient-recalled echo sequence. Understanding chemical shift artifact of the third kind, a unique artifact of artificial enhancement suppression in the presence of intravoxel fat and water signal, will aid DCE breast MRI image interpretation. In-phase acquisitions (combined with simultaneous minimum echo time or opposed-phase echoes) may facilitate qualitative, quantitative and longitudinal analysis of contrast enhancement. Magn Reson Med 79:2277-2289, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Tissue oxygenation mapping by combined chemical shift and T1 magnetic resonance imaging.

To propose a method for determining tissue oxygenation via the measurement of fat T1 . The method is based on a 2D fat/water chemical shift-encoded and T1 -weighted acquisition. A 2D data set was acquired with a fast spin echo sequence with several echo asymmetries and repetition times, wherein one dimension is related to the fat/water phase modulation and the other to the T1 saturation recovery. A joint magnitude-based process of phase modulation and T1 evolution allowed for the collection of the fat fraction and T1 maps with resolved fat or water dominance ambiguity while avoiding the phased error problem. In vitro imaging allowed for the attribution of fat content for different water/oil emulsions that demonstrated longitudinal relaxation rate (R1 ) sensitivity to the oxygenated emulsion environment. The fat R1 values were subsequently compared to reference values, which were measured using low receiver bandwidth acquisition to enhance water and fat signal separations. In vivo feasibility of tissue oxygenation assessment was demonstrated by investigating interscapular brown adipose tissue modifications during an air/carbogen challenge in rats. The proposed method offers a precise and robust estimate of tissue oxygenation illustrated by the method's ability to detect-brown adipose tissue oxygenation modifications. Magn Reson Med 79:1981-1991, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Reciprocal Inflammatory Signaling Between Intestinal Epithelial Cells and Adipocytes in the Absence of Immune Cells

Visceral fat accumulation as observed in Crohn's disease and obesity is linked to chronic gut inflammation, suggesting that accumulation of gut adipocytes can trigger local inflammatory signaling. However, direct interactions between intestinal epithelial cells (IECs) and adipocytes have not been investigated, in part because IEC physiology is difficult to replicate in culture. In this study, we originally prepared intact, polarized, and cytokine responsive IEC monolayers from primary or induced pluripotent stem cell-derived intestinal organoids by simple and repeatable methods. When these physiological IECs were co-cultured with differentiated adipocytes in Transwell, pro-inflammatory genes were induced in both cell types, suggesting reciprocal inflammatory activation in the absence of immunocompetent cells. These inflammatory responses were blocked by nuclear factor-κB or signal transducer and activator of transcription 3 inhibition and by anti-tumor necrosis factor- or anti-interleukin-6-neutralizing antibodies. Our results highlight the utility of these monolayers for investigating IEC biology. Furthermore, this system recapitulates the intestinal epithelium–mesenteric fat signals that potentially trigger or worsen inflammatory disorders such as Crohn's disease and obesity-related enterocolitis.

Fat-based registration of breast dynamic contrast enhanced water images.

In this study, a 3D fat-based deformable registration algorithm was developed for registering dynamic contrast-enhanced breast images. The mutual information similarity measure with free-form deformation motion correction in rapidly enhancing lesions can introduce motion. However, in Dixon-based fat-water separated acquisitions, the nonenhancing fat signal can directly be used to estimate deformable motion, which can be later used to deform the water images. Qualitative comparison of the fat-based registration method to a water-based registration method, and to the unregistered images, was performed by two experienced readers. Quantitative analysis of the registration was evaluated by estimating the mean-squared signal difference on the fat images. Using a scale of 0 (no motion) to 2 ( > 4 voxels of motion), the average image quality score of the fat-based registered images was 0.5 ± 0.6, water-based registration was 0.8 ± 0.8, and the unregistered dataset was 1.6 ± 0.6. The mean-squared-signal-difference metric on the fat images was significantly lower for fat-based registered images compared with both water-based registered and unregistered images. Fat-based registration of breast dynamic contrast-enhanced images is a promising technique for performing deformable motion correction of breast without introducing new motion. Magn Reson Med 79:2408-2414, 2018. © 2017 International Society for Magnetic Resonance in Medicine.