Spin-echo Research Articles

Unmet Needs in Spondyloarthritis: Imaging in Axial Spondyloarthritis.

Imaging biomarkers in axial spondyloarthritis (axSpA) are currently the most specific biomarkers for the diagnosis of this condition. Despite advances in imaging, from plain radiographs-which detect only damage-to magnetic resonance imaging (MRI)-which identifies disease activity and structural change-there are still many challenges that remain. Imaging in sacroiliitis is characterized by active and structural changes. Current classification criteria stress the importance of bone marrow edema (BME); however, BME can occur in various diseases, mechanical conditions, and healthy individuals. Thus, the identification of structural lesions such as erosion, subchondral fat, backfill, and ankylosis is important to distinguish from mimics on differential diagnosis. Various imaging modalities are available to examine structural lesions, but computed tomography (CT) is considered the current reference standard. Nonetheless, recent advances in MRI allow for direct bone imaging and the reconstruction of CT-like images that can provide similar information. Therefore, the ability of MRI to detect and measure structural lesions is strengthened. Here, we present an overview of the spectrum of current and cutting-edge techniques for SpA imaging in clinical practice; namely, we discuss the advantages, disadvantages, and usefulness of imaging in SpA through radiography, low-dose and dual-energy CT, and MRI. Cutting-edge MRI sequences including volumetric interpolated breath-hold examination, ultrashort echo time, zero echo time, and deep learning-based synthetic CT that creates CT-like images without ionizing radiation, are discussed. Imaging techniques allow for quantification of inflammatory and structural lesions, which is important in the assessment of treatment response and disease progression. Radiographic damage is poorly sensitive to change. Artificial intelligence has already revolutionized radiology practice, including protocolization, image quality, and image interpretation.

Development of a 31P magnetic resonance spectroscopy technique to quantify NADH and NAD+ at 3 T

NADH and NAD+ act as electron donors and acceptors and NAD+ was shown to stimulate mitochondrial biogenesis and metabolic health. We here develop a non-invasive Phosphorous Magnetic Resonance Spectroscopy (31P-MRS) method to quantify these metabolites in human skeletal muscle on a clinical 3 T MRI scanner. This new MR-sequence enables NADH and NAD+ quantification by suppressing α-ATP signal, normally overlapping with NADH and NAD+. The sequence is based on a double spin echo in combination with a modified z-Filter achieving strong α-ATP suppression with little effect on NAD+ and NADH. Here we test and validate it in phantoms and in humans by measuring reproducibility and detecting a physiological decrease in NAD+ and increase in NADH induced by ischemia. Furthermore, the 31P-MRS outcomes are compared to analysis in biopsies. Additionally, we show higher NAD+ and lower NADH content in physically active older adults compared to sedentary individuals, reflecting increased metabolic health.

Repeatability and Reproducibility of pseudo-Continuous Arterial Spin Labeling Measured Brain Perfusion in Healthy Volunteers and Glioblastoma Patients.

Arterial spin labeled (ASL) MRI has gained recognition as a quantitative perfusion imaging method for managing patients with brain tumors. Limited studies have so far investigated the reproducibility of ASL-derived perfusion in patients with brain tumors. This study aims to evaluate intrasession repeatability and intersession reproducibility of perfusion measurements using 3D pseudo-continuous ASL (pCASL) with Cartesian TSE (TSE-CASPR) in healthy volunteers (HV) and glioblastoma (GBM) patients at 3 Tesla and compare against 3D pCASL with GRASE. This prospective study (NCT03922984) was approved by the institutional review board and written informed consent was obtained from all subjects. HV underwent repeated pCASL evaluations 2-4 weeks apart between November 2021 and October 2022. GBM patients were recruited for longitudinal MRI from September 2019 to February 2023. Intrasession repeatability (HV and GBM) and intersession reproducibility (HV only) of pCASL were assessed using linear regression, Bland-Altman analyses, intraclass correlation coefficient (ICC) with 95% confidence interval (CI), and within-subject coefficients of variation (wsCV). Twenty HV (9 men, age: 25.1±1.7 years, range 23-30 years) and 21 GBM patients (15 men; age: 59.8±14.3 years, range 28-81 years) were enrolled. Within imaging session, 3D pCASL measured perfusion with TSE-CASPR and GRASE respectively achieved high R2 values (0.88-0.95; 0.93-0.96), minimal biases (-0.46 to 0.81; -0.08 to 0.35 mL/100g/min), high ICC [95% CI] (0.96-0.98 [0.94-0.98]; 0.96-0.98 [0.92-0.99]), and low wsCV (6.64%-9.07%; 5.20%-8.16%) in HV (N=20) and GBM patients (N=21). Across imaging session, 3D pCASL in HV (N=20) achieved high R2 values (0.71; 0.82), minimal biases (-1.2; -0.90 mL/100g/min), high ICC [95% CI] values (0.85 [0.81-0.89]; 0.90 [0.87-0.93]), and low wsCV values (13.82%; 9.98%). Our study demonstrated excellent intrasession repeatability of 3D pCASL measured cerebral perfusion in HV and GBM patients and good to excellent intersession reproducibility in HV. 3D pCASL with GRASE performed slightly better than 3D pCASL with TSE-CASPR in HV; however, in GBM patients, 3D pCASL with TSE-CASPR showed better performance in tumor regions with nearly twofold higher SNR. ASL measured perfusion could serve as a non-contrast quantitative imaging biomarker to facilitate the management of GBM patients. ASL = arterial spin labeling; pCASL = pseudo-continuous arterial spin labeling; GBM = glioblastoma; CBF = cerebral blood flow; CASPR = Cartesian acquisition with spiral profile reordering; GRASE = gradient and spin echo; NAGM = normal-appearing gray matter.

Integrating standard epilepsy protocol, ASL-perfusion, MP2RAGE/EDGE and the MELD-FCD classifier in the detection of subtle epileptogenic lesions: a 3 Tesla MRI pilot study.

Malformations of cortical development (MCDs) in children with focal epilepsy pose significant diagnostic challenges, and a precise radiological diagnosis is crucial for surgical planning. New MRI sequences and the use of artificial intelligence (AI) algorithms are considered very promising in this regard, yet studies evaluating the relative contribution of each diagnostic technique are lacking. The study was conducted using a dedicated "EPI-MCD MR protocol" with a 3 Tesla MRI scanner in patients with focal epilepsy and previously negative MRI. MRI sequences evaluated included 3D FLAIR, 3D T1 MPRAGE, T2 Turbo Spin Echo (TSE), 3D T1 MP2RAGE, and Arterial Spin Labelling (ASL). Two paediatric neuroradiologists scored each sequence for localisation and extension of the lesion. The MELD-FCD AI classifier's performance in identifying pathological findings was also assessed. We only included patients where a diagnosis of MCD was subsequently confirmed on histology and/or sEEG. The 3D FLAIR sequence showed the highest yield in detecting epileptogenic lesions, with 3D T1 MPRAGE, T2 TSE, and 3D T1 MP2RAGE sequences showing moderate to low yield. ASL was the least useful. The MELD-FCD classifier achieved a 69.2% true positive rate. In one case, MELD identified a subtle area of cortical dysplasia overlooked by the neuroradiologists, changing the management of the patient. The 3D FLAIR sequence is the most effective in the MRI-based diagnosis of subtle epileptogenic lesions, outperforming other sequences in localisation and extension. This pilot study emphasizes the importance of careful assessment of the value of additional sequences.

Magnetic resonance imaging tracing of superparamagnetic iron oxide nanoparticle-labeled mesenchymal stromal cells for repairing spinal cord injury.

Mesenchymal stromal cell transplantation Is an effective and promising approach for treating various systemic and diffuse diseases. However, the biological characteristics of transplanted mesenchymal stromal cells in humans remain unclear, including cell viability, distribution, migration, and fate. Conventional cell tracing methods cannot be used in the clinic. The use of superparamagnetic iron oxide nanoparticles as contrast agents allows for the observation of transplanted cells using magnetic resonance imaging. In 2016, the National Medical Products Administration of China approved a new superparamagnetic iron oxide nanoparticle, Ruicun, for use as a contrast agent in clinical trials.In the present study, an acute hemi-transection spinal cord injury model was established in beagle dogs. The injury was then treated by transplantation of Ruicun-labeled mesenchymal stromal cells. The results indicated that Ruicun-labeled mesenchymal stromal cells repaired damaged spinal cord fibers and partially restored neurological function in animals with acute spinal cord injury. T2*-weighted imaging revealed low signal areas on both sides of the injured spinal cord. The results of quantitative susceptibility mapping with ultrashort echo time sequences indicated that Ruicun-labeled mesenchymal stromal cells persisted stably within the injured spinal cord for over 4 weeks. These findings suggest that magnetic resonance imaging has the potential to effectively track the migration of Ruicun-labeled mesenchymal stromal cells and assess their ability to repair spinal cord injury.

Age- and sex-related variations of normal spleen T1rho and the more stable liver T1rho to spleen T1rho ratio.

We aim to evaluate the potential age- and sex-related variations of normative values of spleen T1rho.Two T1rho sequences were used, with one based on fast spin echo sequence (FSE) and the other based on gradient echo sequence (GRE). Spleen and liver FSE T1rho values were measured in 52 healthy volunteers (36 females, 16 males), and spleen and liver GRE T1rho values were measured in 14 healthy volunteers (6 females, 8 males).For FSE data, an age-related decreasing trend of spleen T1rho was noted for both females and males. This trend was consistent with female liver T1rho values, while such a trend was not noted for male liver T1rho. Females had a higher T1rho than males, both for the spleen (92.8 vs 77.3 ms, p<0.0001) and for the liver (44.2 vs. 38.9 ms, p<0.0001, FSE data). The spleen T1rho value was approximately double the liver T1rho value. The spleen T1rho and liver T1rho were positively correlated, both for FSE data (r=0.611) and GRE data (r=0.541). When the spleen T1rho was used to normalize the liver T1rho, the ratio of T1rholiver/T1rhospleen largely removed the sex and age effect. The spleen T1rho in menstrual phase women was 10.7% lower (p=0.012) than that of non-menstrual phase women, while the liver T1rho in menstrual phase women was 3.8% lower than that of non-menstrual phase women.Since women in the menstrual phase tend to have lower body iron, the fact that both liver T1rho and spleen T1rho are shorter among women in the menstrual phase than women in the non-menstrual phase indicates that liver and spleen T1rho physiological variations may not be dominantly affected by the iron content of the tissue. If a pathology has only affected the liver while the spleen is normal, there is a possibility the ratio T1rholiver/T1rhospleen may offer better characterization of liver pathologies. · There is an age-related decreasing trend of spleen T1rho.. · Females have a higher spleen T1rho than males.. · The spleen T1rho value is approximately double the liver T1rho value.. · Spleen T1rho and liver T1rho are positively correlated.. · Wáng YXJ, Yu W-L, Deng M. Age- and sex-related variations of normal spleen T1rho and the more stable liver T1rho to spleen T1rho ratio. Fortschr Röntgenstr 2024; DOI 10.1055/a-2428-7409.

Mitochondrial oxidative phosphorylation capacity in skeletal muscle measured by ultrafast Z-spectroscopy (UFZ) MRI at 3T.

To investigate the feasibility of rapid CEST MRI acquisition for evaluating oxidative phosphorylation (OXPHOS) in human skeletal muscle at 3T, utilizing ultrafast Z-spectroscopy (UFZ) combined with MRI and the Polynomial and Lorentzian line-shape Fitting (PLOF) technique. UFZ MRI on muscle was evaluated with turbo spin echo (TSE) and 3D EPI readouts. Five healthy subjects performed in-magnet plantar flexion exercise (PFE) and subsequent changes of amide, PCr, and partial PCr mixed Cr (Cr+) CEST dynamic signals post-exercise were enabled by PLOF fitting. PCr/Cr CEST signal was further refined through pH correction by using the ratios between PCr/Cr and amide signals, named PCAR/CAR, respectively. UFZ MRI with TSE readout significantly reduces acquisition time, achieving a temporal resolution of <50 s for collecting high-resolution Z-spectra. Following PFE, the recovery/decay times (τ) for both PCr and Cr in the gastrocnemius muscle of the calf were notably longer when determined using PCr/Cr CEST compared to those after pH correction with amideCEST, namely = 87.1 ± 15.8 s and = 98.1 ± 20.4 s versus = 32.9 ± 19.7 s and = 43.0 ± 13.0 s, respectively. obtained via 31P MRS ( = 50.3 ± 6.2 s) closely resemble those obtained from pH-corrected PCr/Cr CEST signals. The outcomes suggest potential of UFZ MRI as a robust tool for non-invasive assessment of mitochondrial function in skeletal muscles. pH correction is critical for the reliable OXPHOS measurement by CEST.

Determination of the shape and dimensions of the polymer molecules in solutions using diffusional NMR relaxation

A new method of determining the dimensions and shapes of polymer molecules in solutions is proposed and verified in experiments. The method is based on the measurements of the relaxation of the transverse magnetization intensity of nuclei. It is established that the decaying signal of the spin echo from elongated molecules contains two terms exponentially decaying with time, which correspond to two diffusion coefficients differing by a factor of about two. The signal from molecules with a near-spherical shape contain only one exponent.

Effect of metallic materials on magnetic resonance image uniformity: a quantitative experimental study.

To assess quantitatively the effect of metallic materials on MR image uniformity using a standardized method. Six types of 1cm cubic metallic materials (i.e., Au, Ag, Al, Au-Ag-Pd alloy, Ti, and Co-Cr alloy) embedded in a glass phantom filled were examined and compared with no metal condition inserted as a reference. The phantom was scanned five times under each condition using a 1.5-T MR superconducting magnet scanner with an 8-channel phased-array brain coil and head and neck coil. For each examination, the phantom was scanned in three planes: axial, coronal, and sagittal using T1-weighted spin echo (SE) and gradient echo (GRE) sequences in accordance with the American Society for Testing and Materials (ASTM) F2119-07 standard. Image uniformity was assessed using the non-uniformity index (NUI), which was developed by the National Electrical Manufacturers Association (NEMA), as an appropriate standardized measure for investigating magnetic field uniformity. T1-GRE images with Co-Cr typically elicited the lowest uniformity, followed by T1-GRE images with Ti, while all other metallic materials did not affect image uniformity. In particular, T1-GRE images with Co-Cr showed significantly higher NUI values as far as 6.6cm at maximum equivalent to 11 slices centering around it in comparison with the measurement uncertainty from images without metallic materials. We found that MR image uniformity was influenced by the scanning sequence and coil type when Co-Cr and Ti were present. It is assumed that the image non-uniformity in Co-Cr and Ti is caused by their high magnetic susceptibility.

A dynamic approach for MR T2-weighted pelvic imaging

T2-weighted 2D fast spin echo sequence serves as the standard sequence in&#xD;clinical pelvic MR imaging protocols. However, motion artifacts and blurring caused&#xD;by peristalsis present significant challenges. Patient preparation such as administering&#xD;antiperistaltic agents is often required before examination to reduce artifacts, which&#xD;discomfort the patients. This work introduce a novel dynamic approach for T2&#xD;weighted pelvic imaging to address peristalsis-induced motion issue without any patient&#xD;preparation.&#xD;Approach: A rapid dynamic data acquisition strategy with complementary sampling&#xD;trajectory is designed to enable highly undersampled motion-resistant data sampling,&#xD;and an unrolling method based on deep equilibrium model is leveraged to reconstruct&#xD;images from the dynamic sampled k-space data. Moreover, the fix-point convergence of&#xD;the equilibrium model ensures the stability of the reconstruction. The high acceleration&#xD;factor in each temporal phase, which is much higher than that in traditional static&#xD;imaging, has the potential to effectively freeze pelvic motion, thereby transforming&#xD;the imaging problem from conventional motion prevention or removal to motion&#xD;reconstruction.&#xD;Main results: Experiments on both retrospective and prospective data have&#xD;demonstrated the superior performance of the proposed dynamic approach in reducing&#xD;motion artifacts and accurately depicting structural details compared to standard static&#xD;imaging.&#xD;Significance: The proposed dynamic approach effectively captures motion states&#xD;through dynamic data acquisition and deep learning-based reconstruction, addressing&#xD;motion-related challenges in pelvic imaging.

An open-access lumbosacral spine MRI dataset with enhanced spinal nerve root structure resolution

Spinal cord injury (SCI) profoundly affects an individual’s ability to move. Fortunately, recent advancements in neuromodulation, particularly the spatio-temporal epidural electrical stimulation (EES) targeting the spinal nerve roots, promoted rapid rehabilitation of SCI patients. Such neuromodulation techniques require precise anatomical modelling of spinal cord. However, the lack of spine imaging datasets, especially high-quality magnetic resonance imaging (MRI) datasets highlighting nerve roots, hinders the translation of EES into medical practice. To address this problem, we introduce an open-access lumbosacral spine MRI dataset acquired in 14 healthy adults, using constructive interference in steady state (CISS) sequence, double echo steady state (DESS) sequence, and T2-weight turbo spin echo (T2-TSE) sequence, with enhanced nerve root resolution. The dataset also includes the corresponding anatomical annotations of nerve roots and the final reconstructed 3D spinal cord models. The quality of our dataset is assessed using image quality metrics implemented in MRI quality control tool (MRIQC). Our dataset provides a valuable platform to promote a wide range of spinal cord neuromodulation research and collaboration among neurorehabilitation engineers.

Photon echo on excitons for the development of nanoelectronic devices based on a quantum-size structures in a thin zinc oxide films

The relaxation decays of photon echo signals in thin zinc oxide films produced by magnetron sputtering have been studied. Echo signals are excited at a wavelength of 800 nm at transitions between quantum levels that arise when excitonic states are localized in quantum-sized structures in the two-photon absorption mode of laser pulses with a wavelength of 800 nm.

Asymmetric spin echo multi-echo echo planar imaging (ASEME-EPI) sequence for pre-clinical high-field fMRI.

In functional magnetic resonance imaging (fMRI) of the blood oxygen level-dependent (BOLD) contrast, gradient-recalled echo (GRE) acquisitions offer high sensitivity but suffer from susceptibility-induced signal loss and lack specificity to microvasculature. In contrast, spin echo (SE) acquisitions provide improved specificity at the cost of reduced sensitivity. This study introduces Asymmetric Spin Echo Multi-Echo Echo Planar Imaging (ASEME-EPI), a technique designed to combine the benefits of both GRE and SE for high-field preclinical fMRI. ASEME-EPI employs a spin echo readout followed by two asymmetric spin echo (ASE) GRE readouts, providing an initial T2-weighted SE image and subsequent T2 * -weighted ASE images. A feasibility study for the technique was implemented on a 9.4 T pre-clinical MRI system and tested using a visual stimulation in northern tree shrews. Comparing ASEME-EPI with conventional GRE echo planar imaging (GRE-EPI) and SE echo planar imaging (SE-EPI) acquisitions, results showed that ASEME-EPI achieved BOLD contrast-to-noise ratio (CNR) comparable to GRE-EPI while offering improved specificity in activation maps. ASEME-EPI activation was more confined to the primary visual cortex (V1), unlike GRE-EPI which showed activation extending beyond anatomical boundaries. Additionally, ASEME-EPI demonstrated the ability to recover signal in areas of severe field inhomogeneity where GRE-EPI suffered from signal loss. The performance of ASEME-EPI is attributed to its multi-echo nature, allowing for SNR-optimized combination of echoes, effectively denoising the data. The inclusion of the initial SE also contributes to signal recovery in areas prone to susceptibility artifacts. This feasibility study demonstrates the potential of ASEME-EPI for high-field pre-clinical fMRI, offering a promising compromise between GRE sensitivity and SE specificity while addressing challenges of T2 * decay at high field strengths.

Prediction of MRI relaxometry in the presence of hepatic steatosis by Monte Carlo simulations.

To develop Monte Carlo simulations to predict the relationship of with liver fat content at 1.5T and 3.0T. For various fat fractions (FFs) from 1% to 25%, four types of virtual liver models were developed by incorporating the size and spatial distribution of fat droplets. Magnetic fields were then generated under different fat susceptibilities at 1.5T and 3.0T, and proton movement was simulated for phase accrual and MRI signal synthesis. The synthesized signal was fit to single-peak and multi-peak fat signal models for and proton density fat fraction (PDFF) predictions. In addition, the relationships between and PDFF predictions were compared with in vivo calibrations and Bland-Altman analysis was performed to quantitatively evaluate the effects of these components (type of virtual liver model, fat susceptibility, and fat signal model) on predictions. A virtual liver model with realistic morphology of fat droplets was demonstrated, and and PDFF values were predicted by Monte Carlo simulations at 1.5T and 3.0T. predictions were linearly correlated with PDFF, while the slope was unaffected by the type of virtual liver model and increased as fat susceptibility increased. Compared with in vivo calibrations, the multi-peak fat signal model showed superior performance to the single-peak fat signal model, which yielded an underestimation of liver fat. The -PDFF relationships by simulations with fat susceptibility of 0.6ppm and the multi-peak fat signal model were ( , ) at 1.5T and ( , ) at 3.0T. Monte Carlo simulations provide a new means for -PDFF prediction, which is primarily determined by fat susceptibility, fat signal model, and magnetic field strength. Accurate -PDFF calibration has the potential to correct the effect of fat on quantification, and may be helpful for accurate measurements in liver iron overload. In this study, a Monte Carlo simulation of hepatic steatosis was developed to predict the relationship between and PDFF. Furthermore, the effects of fat droplet morphology, fat susceptibility, fat signal model, and magnetic field strength were evaluated for the -PDFF calibration. Our results suggest that Monte Carlo simulations provide a new means for -PDFF prediction and this means can be easily generated for various regimes, such as simulations with higher fields and different echo times, as well as correction of magnetic susceptibility measurements for liver iron quantification.

Comparisons of MR and EM inferred tissue microstructure properties using a human autopsy corpus callosum sample

Degeneration of white matter (WM) microstructure in the central nervous system is characteristic of many neurodegenerative conditions. Previous research indicates that axonal degeneration visible in ex vivo electron microscopy (EM) photomicrographs precede the onset of clinical symptoms. Measuring WM microstructural features, such as axon diameter and packing fraction, currently require these highly invasive methods of analysis and it is therefore of great importance to develop methods for in vivo measurements. Diffusion weighted Magnetic Resonance Imaging (MRI) is a non-invasive method which can be used in conjunction with temporal diffusion spectroscopy (TDS) and an oscillating gradient spin echo (OGSE) pulse sequence to probe micron-scale structures within neural tissue. The current experiment aims to compare axon diameter measurements, mean effective axon diameter (AxD¯), and packing fractions calculated from EM histopathological analysis and inferred values from MR images. Mathematical models of axon diameters used for analysis include the ActiveAx Frequency-Dependent Extra-Axonal Diffusion (AAD) model and the AxCaliber Frequency-Dependent Extra-Axonal Diffusion (ACD) model using ROI (Region of Interest) based analysis (RBA) and voxel-based analysis (VBA), respectively. Overall, it was observed that MRI inferred WM microstructural parameters overestimate those calculated from EM. This may be attributable to tissue shrinkage during EM dehydration, the sensitivity of MR pulse sequences to larger diameter axons, and/or inaccurate model assumptions. The results of the current study provide a means to characterize the precision and accuracy of RBA-ACD and VBA-AAD OGSE-TDS and highlight the need for further research investigating the relationship between ex vivo MRI and EM, with the goal of reaching in vivo MRI.

Investigating the effective temporal resolution in a task-based functional MRI experiment at 7 T MRI using a dynamic phantom

Abstract An increasing number of human fMRI studies aim to discern the time delays between evoked responses under different stimuli conditions in different brain regions. To achieve that, a primary goal is to acquire fMRI data with high sampling rates. This task is now possible with ultra-high field (≥7 T) MRI and the advancement of imaging acceleration methods. Consequently, it becomes imperative to understand what is the actual or effective temporal resolution (ETR) that is realized in given settings of an fMRI experiment. In this study, we utilized a dynamic phantom to reliably repeat a set of scans, generating a “ground truth” signal with controllable onset delays mimicking fMRI responses in a task-based block-designed fMRI. Here, we define the ETR and quantify a scan’s ETR using the dynamic phantom. The quantification was performed for various scanning parameters, including echo time (TE), repetition time (TR), voxel size, and contrast-to-noise ratio (CNR). We further show that combining data from multi-echo EPI can improve the ETR (i.e., reduce it). In addition, parameters of the fMRI paradigm were examined, including the blocks’ length and density. As tissue properties (e.g., level of iron deposition) affect the CNR and thus change the ETR, we examined the signal rise mimicking not only the cortex, but also the basal ganglia (known for its high iron deposition). Combining multi-echo data, the estimated ETR for the examined scans was 151 ms for a cortex-mimicking setup and 248 ms for a basal ganglia-mimicking setup, when scanning with a sampling time (i.e., TR) of 600 ms. Yet, a substantial penalty was paid when the CNR was low, in which case the ETR was even larger than the TR. A feasibility set of experiments was also designed to evaluate how the ETR is affected by physiological signal fluctuations and the variability of the hemodynamic response. This study shows the viability of studying time responses with fMRI, by demonstrating that a very short ETR can be achieved. However, it also emphasizes the need to examine the attainable ETR for a particular experiment.

Assessing tumor microstructure with time-dependent diffusion imaging: Considerations and feasibility on clinical MRI and MRI-Linac.

Quantitative imaging biomarkers (QIBs) can characterize tumor heterogeneity and provide information for biological guidance in radiotherapy (RT). Time-dependent diffusion MRI (TDD-MRI) derived parameters are promising QIBs, as they describe tissue microstructure with more specificity than traditional diffusion-weighted MRI (DW-MRI). Specifically, TDD-MRI can provide information about both restricted diffusion and diffusional exchange, which are the two time-dependent effects affecting diffusion in tissue, and relevant in tumors. However, exhaustive modeling of both effects can require long acquisitions and complex model fitting. Furthermore, several introduced TDD-MRI measurements can require high gradient strengths and/or complex gradient waveforms that are possibly not available in RT settings. In this study, we investigated the feasibility of a simple analysis framework for the detection of restricted diffusion and diffusional exchange effects in the TDD-MRI signal. To promote the clinical applicability, we use standard gradient waveforms on a conventional 1.5 T MRI system with moderate gradient strength (Gmax=45 mT/m), and on a hybrid 1.5 T MRI-Linac system with low gradient strength (Gmax=15 mT/m). Restricted diffusion and diffusional exchange were simulated in geometries mimicking tumor microstructure to investigate the DW-MRI signal behavior and to determine optimal experimental parameters. TDD-MRI was implemented using pulsed field gradient spin echo with the optimized parameters on a conventional MRI system and a MRI-Linac. Experiments in green asparagus and 10 patients with brain lesions were performed to evaluate the time-dependent diffusion (TDD) contrast in the source DW-images. Simulations demonstrated how the TDD contrast was able to differentiate only dominating diffusional exchange in smaller cells from dominating restricted diffusion in larger cells. The maximal TDD contrast in simulations with typical cancer cell sizes and in asparagus measurements exceeded 5% on the conventional MRI but remained below 5% on the MRI-Linac. In particular, the simulated TDD contrast in typical cancer cell sizes (r=5-10µm) remained below or around 2% with the MRI-Linac gradient strength. In patients measured with the conventional MRI, we found sub-regions reflecting either dominating restricted diffusion or dominating diffusional exchange in and around brain lesions compared to the noisy appearing white matter. On the conventional MRI system, the TDD contrast maps showed consistent tumor sub-regions indicating different dominating TDD effects, potentially providing information on the spatial tumor heterogeneity. On the MRI-Linac, the available TDD contrast measured in asparagus showed the same trends as with the conventional MRI but remained close to typical measurement noise levels when simulated in common cancer cell sizes. On conventional MRI systems with moderate gradient strengths, the TDD contrast could potentially be used as a tool to identify which time-dependent effects to include when choosing a biophysical model for more specific tumor characterization.

Comparison of Echo Planar and Turbo Spin Echo Diffusion-Weighted Imaging in Intraoperative MRI.

Diffusion-weighted imaging (DWI) is routinely used in brain tumor surgery guided by intraoperative MRI (IoMRI). However, conventional echo planar imaging DWI (EPI-DWI) is susceptible to distortion and artifacts that affect image quality. Turbo spin echo DWI (TSE-DWI) is an alternative technique with minimal spatial distortions that has the potential to be the radiologically preferred sequence. To compare via single- and multisequence assessment EPI-DWI and TSE-DWI in the IoMRI setting to determine whether there is a radiological preference for either sequence. Retrospective. Thirty-four patients (22 female) aged 2-61 years (24 under 18 years) undergoing IoMRI during surgical resection of intracranial tumors. 3-T, EPI-DWI, and TSE-DWI. Patients were scanned with EPI- and TSE-DWI as part of the standard IoMRI scanning protocol. A single-sequence assessment of spatial distortion and image artifact was performed by three neuroradiologists blinded to the sequence type. Images were scored regarding distortion and artifacts, around and remote to the resection cavity. A multisequence radiological assessment was performed by three neuroradiologists in full radiological context including all other IoMRI sequences from each case. The DWI images were directly compared with scorings of the radiologists on which they preferred with respect to anatomy, abnormality, artifact, and overall preference. Wilcoxon signed-rank tests for single-sequence assessment, weighted kappa for single and multisequence assessment. A P-value <0.001 was considered statistically significant. For the blinded single-sequence assessment, the TSE-DWI sequence was scored equal to or superior to the EPI-DWI sequence for distortion and artifacts, around and remote to the resection cavity for every case. In the multisequence assessment, all radiologists independently expressed a preference for TSE-DWI over EPI-DWI sequences on viewing brain anatomy, abnormalities, and artifacts. The TSE-DWI sequences may be favored over EPI-DWI for IoMRI in patients with intracranial tumors. 2 TECHNICAL EFFICACY: Stage 5.

Comparison of Diffusion-weighted MRI using Singe-Shot Echo-planar Imaging (SS-EPI) and Split Acquisition of Fast Spin Echo Signal (SPLICE) Imaging, a non-EPI technique, in Tumors of the Head and Neck.

Diffusion-weighted imaging (DWI) using single-shot echo planar imaging (DW-EPI) is susceptible to distortions around air-filled cavities and dental fillings, typical for the head and neck area. Non-EPI, Split acquisition of fast spin echo signals for diffusion imaging (DWSPLICE) could reduce these distortions and enhance image quality, thereby potentially improving recurrence assessment in squamous cell carcinoma (SCC) of the head and neck region. This study evaluated whether DW-SPLICE is a viable alternative to DW-EPI through quantitative and qualitative analyses. The DW-SPLICE sequence was incorporated into the standard 3.0T head and neck MRI protocol with DW-EPI. Retrospective analysis was conducted on two subgroups: firstly benign or malignant lesions, and secondly post-treatment SCC recurrence. In both subgroups Image quality and distortion were scored by two independent radiologists, blinded for DW-technique, and evaluated using mixed-effect linear models. Lesion apparent diffusion coefficient (ADC) values were assessed with inter-class correlation (ICC) and Bland-Altman analyses. DWI's delineation geometric similarity to T1-weighted post-contrast (T1Wc) MRI was evaluated using the Dice Similarity Coefficient (DSC) before and after registration. Recurrence in post-treatment SCC scans was evaluated by the same two radiologists blinded for DW-technique. Recurrence detection rates were then compared between DW-SPLICE and DW-EPI using mixed logistic regression at six months and at one-year post-scan follow-up data. From August 2020 to January 2022, 55 benign or malignant lesion scans (55 patients) and 74 post-treatment SCC scans (66 patients) were analyzed. DW-SPLICE scored better on image quality and showed less overall distortion than DW-EPI (0.04<p<0.001). There was high ADC measurement reliability (ICC=0.93, p<0.001), though a proportional bias was also observed (β=0.11, p=0.03), indicating the bias increases as ADC values rise. DWSPLICE exhibited greater geometric similarity to T1Wc before registration (DSC 0.63 vs 0.47, p<0.001) and outperformed DW-EPI by more accurately identifying recurrences after one year (OR=0.96, p=0.05) but not after six months (OR=0.72, p=0.13). DW-SPLICE surpasses DW-EPI on image distortion and quality and improves diagnostic reliability for detecting recurrent or residual SCC on 3T MRI of the HN. Consistent use of one method for follow-up is advised, as ADC values are not completely interchangeable. Integrating DW-SPLICE can significantly improve tumor assessments in clinical practice. ANTs = Advanced Normalization Tools; DSC = Dice Similarity Coefficient; DW-EPI = Diffusion-weighted single-shot echo planar imaging; DW-MS-EPI = Diffusion-weighted multi-shot echo planar imaging; DW-SPLICE = Diffusion-weighted split acquisition of fast spin echo signals for diffusion imaging; DW-TSE = Diffusion-weighted Turbo Spin Echo; ICC = Intraclass Correlation Coefficient; ROC = Receiver Operating Characteristic; SCC = Squamous cell carcinoma; T1WIc = T1 weighted imaging with gadolinium contrast.

Enhancement of the lymphatic system following intravenous administration of ferumoxytol.

Lymphatic imaging is becoming increasingly important in the management of patients with congenital heart disease. However, the influence of the intravenous contrast agent ferumoxytol on lymphatic imaging is not well understood. To evaluate the impact of intravenous ferumoxytol on T1-weighted and T2-weighted lymphatic imaging in patients with congenital heart disease. We included consecutive patients receiving ferumoxytol-enhanced 3D angiography for congenital heart disease evaluation. The visibility of the thoracic duct was reviewed on the T1-weighted 3D inversion recovery balanced-steady-state free precession (SSFP) with respiratory navigator gating sequence which is routinely used for angiography and the heavily T2-weighted turbo spin echo sequence which is employed for lymphatic imaging. Data on demographics and time interval between contrast administration and imaging were collected. Statistical analyses were performed using t-tests for continuous variables and chi-squared tests for categorical variables. One hundred nineteen consecutive patients with a mean age of 12.46 years±7.7 years were included. Of these, 45 cases underwent both T1-weighted and T2-weighted imaging; the other 74 underwent only T1-weighted imaging. Of the 45 patients, 20 had thoracic duct enhancement on T1-weighted imaging; among the 26 sedated, only 2 showed enhancement, while 18 of 19 non-sedated patients showed enhancement (P<0.001), indicating a strong association between sedation and reduced thoracic duct visibility. If T2-weighted imaging was performed after contrast administration, the thoracic duct was not visible on those images. For all 45 cases of visible thoracic duct in the entire cohort, the time from contrast administration to imaging ranged from 8 min up to 75 min. The enhancement of the thoracic lymphatic duct on T1-weighted imaging, coupled with degradation observed on T2-weighted imaging, suggests that intravenously administered ferumoxytol rapidly enters the lymphatic fluid. To prevent T2 shortening from degrading the imaging results, T2-weighted imaging for lymphatic evaluation should be performed prior to the administration of ferumoxytol. Sedation and, by inference, fasting may influence this property and warrant further investigation in future studies.