Multi-echo Spin-echo Sequence Research Articles

Brain arteriolosclerosis is linked to lower gray matter volume in community‐based older adults

AbstractBackgroundBrain arteriolosclerosis is characterized by the thickening of vessel walls and arteriolar stenosis and is one of the primary pathologies of cerebral small vessel disease. Arteriolosclerosis is linked to lower cognitive and motor function, as well as an elevated risk of dementia. This study aimed to investigate the association of brain arteriolosclerosis with regional gray matter volumes in a large number of community‐based older adults.MethodData from ex‐vivo MRI and detailed neuropathological evaluation were collected from older adults (N = 882) participating in four longitudinal, clinical‐pathologic cohort studies of aging (Rush Memory and Aging Project, Religious Orders Study, Minority Aging Research Study, and Clinical Core of the Rush Alzheimer’s Disease Research Center) (Fig. 1A). Cerebral hemispheres from all participants were obtained at autopsy and imaged ex‐vivo with a multi‐echo spin‐echo sequence (ME‐SE) on 3T clinical MRI scanners approximately one month postmortem. The acquired voxel size was 0.6mm × 0.6mm × 1.5mm, and the scan time was approximately 30 minutes. The gray and white matter were segmented in the ex‐vivo MRI data. Subsequently, the gray matter underwent further division into 42 cortical and subcortical regions using multi‐atlas segmentation. The volume of each region was measured and normalized by the participant’s cerebral hemisphere volume. Following ex‐vivo MRI, a detailed neuropathologic assessment was performed on pathologies including arteriolosclerosis, atherosclerosis, cerebral amyloid angiopathy, gross and microscopic infarcts, Alzheimer’s pathology, Lewy bodies, limbic‐predominant age‐related TDP‐43 encephalopathy neuropathological change (LATE‐NC), and hippocampal sclerosis (Fig. 1B). For statistical analysis, linear regression was employed to explore the association of brain arteriolosclerosis with regional gray matter volumes (normalized by cerebral hemisphere volume) controlling for all other neuropathologies (Fig. 1B), demographics (age at death, sex, years of education), postmortem intervals, and scanner (Fig. 1A).ResultMore severe brain arteriolosclerosis was associated with lower volume in several gray matter regions, including medial orbitofrontal, superior frontal, pericalcarine, cuneus, and lateral occipital areas, independently of the effects of other neuropathologies (Figs. 2, 3).ConclusionThis study demonstrated that brain arteriolosclerosis is associated with lower volume in multiple gray matter regions independently of the effects of other vascular or neurodegenerative pathologies.

Improving Accuracy and Reproducibility of Cartilage T2 Mapping in the OAI Dataset Through Extended Phase Graph Modeling.

The Osteoarthritis Initiative (OAI) collected extensive imaging data, including Multi-Echo Spin-Echo (MESE) sequences for measuring knee cartilage T2 relaxation times. Mono-exponential models are used in the OAI for T2 fitting, which neglects stimulated echoes and B1 inhomogeneities. Extended Phase Graph (EPG) modeling addresses these limitations but has not been applied to the OAI dataset. To assess how different fitting methods, including EPG-based and exponential-based approaches, affect the accuracy and reproducibility of cartilage T2 in the OAI dataset. Retrospective. From OAI dataset, 50 subjects, stratified by osteoarthritis (OA) severity using Kellgren-Lawrence grades (KLG), and 50 subjects without OA diagnosis during OAI duration were selected (each group: 25 females, mean ages ~61 years). 3-T, two-dimensional (2D) MESE sequence. Femoral and tibial cartilages were segmented from DESS images, subdivided into seven sub-regions, and co-registered to MESE. T2 maps were obtained using three EPG-based methods (nonlinear least squares, dictionary matching, and deep learning) and three mono-exponential approaches (linear least squares, nonlinear least squares, and noise-corrected exponential). Average T2 values within sub-regions were obtained. Pair-wise agreement among fitting methods was evaluated using the stratified subjects, while reproducibility using healthy subjects. Each method's T2 accuracy and repeatability varying signal-to-noise ratio (SNR) were assessed with simulations. Bland-Altman analysis, Lin's concordance coefficient, and coefficient of variation assessed agreement, repeatability, and reproducibility. Statistical significance was set at P-value <0.05. EPG-based methods demonstrated superior T2 accuracy (mean absolute error below 0.5 msec at SNR > 100) compared to mono-exponential methods (error > 7 msec). EPG-based approaches had better reproducibility, with limits of agreement 1.5-5 msec narrower than exponential-based methods. T2 values from EPG methods were systematically 10-17 msec lower than those from mono-exponential fitting. EPG modeling improved agreement and reproducibility of cartilage T2 mapping in subjects from the OAI dataset. 3 TECHNICAL EFFICACY: Stage 1.

Whole-brain T2 mapping with radial sampling and retrospective motion correction at 3T.

Several barriers prevent the use of whole-brain T2 mapping in routine use despite increasing interest in this parameter. One of the main barriers is the long scan time resulting in patient discomfort and motion corrupted data. To address this challenge, a method for accurate whole-brain T2 mapping with a limited acquisition time and motion correction capabilities is investigated. A 3D radial multi-echo spin-echo sequence was implemented with optimized sampling trajectory enabling the estimation of intra-scan motion, subsequently used to correct the raw data. Motion corrected echo images are then reconstructed with linear subspace constrained reconstruction. Experiments were carried out on phantom and volunteers at 3T to evaluate the accuracy of the T2 estimation, the sensitivity to lesions and the efficiency of the correction on motion corrupted data. Whole-brain T2 mapping acquired in less than 7 min enabled the depiction of lesions in the white matter with longer T2. Data retrospectively corrupted with typical motion traces of pediatric patients highly benefited from the motion correction by reducing the error in T2 estimates within the lesions. All datasets acquired on seven volunteers, with deliberate motion, also showed that motion corrupted T2 maps could be improved with the retrospective motion correction both at the voxel level and the structure level. A whole-brain T2 mapping sequence with retrospective intra-scan motion correction and reasonable acquisition time is proposed. The method necessitates advanced iterative reconstruction strategies but no additional navigator, external device, or increased scan time is required.

Prospective longitudinal cohort study of quantitative muscle magnetic resonance imaging in a healthy control population.

Quantitative muscle magnetic resonance imaging (qMRI) is a valuable methodology for assessing muscular injuries and neuromuscular disorders. Notably, muscle diffusion tensor imaging (DTI) gives insights into muscle microstructural and macrostructural characteristics. However, the long-term reproducibility and robustness of these measurements remain relatively unexplored. The purpose of this prospective longitudinal cohort study was to assess the long-term robustness and range of variation of qMRI parameters, especially DTI metrics, in the lower extremity muscles of healthy controls under real-life conditions. Twelve volunteers (seven females, age 44.1 ± 12.1 years, body mass index 23.3 ± 2.0 kg/m2) underwent five leg muscle MRI sessions every 20 ± 4 weeks over a total period of 1.5 years. A multiecho gradient-echo Dixon-based sequence, a multiecho spin-echo T2-mapping sequence, and a spin-echo echo planar imaging diffusion-weighted sequence were acquired bilaterally with a Philips 3-T Achieva MR System using a 16-channel torso coil. Fifteen leg muscles were segmented in both lower extremities. qMRI parameters, including fat fraction (FF), water T2 relaxation time, and the diffusion metrics fractional anisotropy (FA) and mean diffusivity (MD), were evaluated. Coefficients of variance (wsCV) and intraclass correlation coefficients (ICCs) were calculated to assess the reproducibility of qMRI parameters. The standard error of measurement (SEM) and the minimal detectable change (MDC) were calculated to determine the range of variation. All tests were applied to all muscles and, subsequently, to each muscle separately. wsCV showed good reproducibility (≤ 10%) for all qMRI parameters in all muscles. The ICCs revealed excellent agreement between time points (FF = 0.980, water T2 = 0.941, FA = 0.952, MD = 0.948). Random measurement errors assessed by SEM and the MDC were low (< 12%). In conclusion, in this study, we showed that qMRI parameters in healthy volunteers living normal lives are stable over 18 months, thereby defining a benchmark for the expected range of variation over time.

Sodium quantification in skeletal muscle: comparison between Cartesian gradient-echo and radial ultra-short echo time 23Na MRI techniques

BackgroundClinical magnetic resonance imaging (MRI) studies often use Cartesian gradient-echo (GRE) sequences with ~2-ms echo times (TEs) to monitor apparent total sodium concentration (aTSC). We compared Cartesian GRE and ultra-short echo time three-dimensional (3D) radial-readout sequences for measuring skeletal muscle aTSC.MethodsWe retrospectively evaluated 211 datasets from 112 volunteers aged 62.3 ± 12.1 years (mean ± standard deviation), acquired at 3 T from the lower leg. For 23Na MRI acquisitions, we used a two-dimensional Cartesian GRE sequence and a density-adapted 3D radial readout sequence with cuboid field-of-view (DA-3D-RAD-C). We calibrated the 23Na MR signal using reference tubes either with or without agarose and subsequently performed a relaxation correction. Additionally, we employed a six-echo 1H GRE sequence and a multi-echo spin-echo sequence to calculate proton density fat fraction (PDFF) and water T2. Paired Wilcoxon signed-rank test, Cohen dz for paired samples, and Spearman correlation were used.ResultsRelaxation correction effectively reduced the differences in muscle aTSC between the two acquisition and calibration methods (DA-3D-RAD-C using NaCl/agarose references: 20.05 versus 19.14 mM; dz = 0.395; Cartesian GRE using NaCl/agarose references: 19.50 versus 18.82 mM; dz = 0.427).Both aTSC of the DA-3D-RAD-C and Cartesian GRE acquisitions showed a small but significant correlation with PDFF as well as with water T2.ConclusionsDifferent 23Na MRI acquisition and calibration approaches affect aTSC values. Applying relaxation correction is advised to minimize the impact of sequence parameters on quantification, and considering additional fat correction is advisable for patients with increased fat fractions.Relevance statementThis study highlights relaxation correction’s role in improving sodium MRI accuracy, paving the way for better disease assessment and comparability of measured sodium signal in patients.Key points• Differences in MRI acquisition methods hamper the comparability of sodium MRI measurements.• Measured sodium values depend on used MRI sequences and calibration method.• Relaxation correction during postprocessing mitigates these discrepancies.• Thus, relaxation correction enhances accuracy of sodium MRI, aiding its clinical use.Graphical

Accelerated 3D multi-echo spin-echo sequence with a subspace constrained reconstruction for whole mouse brain mapping.

To accelerate whole-brain quantitative mapping in preclinical imaging setting. A three-dimensional (3D) multi-echo spin echo sequence was highly undersampled with a variable density Poisson distribution to reduce the acquisition time. Advanced iterative reconstruction based on linear subspace constraints was employed to recover high-quality raw images. Different subspaces, generated using exponential or extended-phase graph (EPG) simulations or from low-resolution calibration images, were compared. The subspace dimension was investigated in terms of precision. The method was validated on a phantom containing a wide range of and was then applied to monitor metastasis growth in the mouse brain at 4.7T. Image quality and estimation were assessed for 3 acceleration factors (6/8/10). The EPG-based dictionary gave robust estimations of a large range of . A subspace dimension of 6 was the best compromise between precision and image quality. Combining the subspace constrained reconstruction with a highly undersampled dataset enabled the acquisition of whole-brain maps, the detection and the monitoring of metastasis growth of less than 500 . Subspace-based reconstruction is suitable for 3D mapping. This method can be used to reach an acceleration factor up to 8, corresponding to an acquisition time of 25 min for an isotropic 3D acquisition of 156 m on the mouse brain, used here for monitoring metastases growth.

Effects of Bariatric Surgery on Knee Articular Cartilage and Osteoarthritis Symptoms-A 12-Month Follow-Up Using T2 Relaxation Time and WOMAC Osteoarthritis Index.

Obesity is a significant risk factor for osteoarthritis (OA). The most effective treatment for morbid obesity is bariatric surgery. To study the effects of potential surgically induced weight loss on knee articular cartilage and OA symptoms of obese patients over a 12-month follow-up. Prospective longitudinal cohort study. 45 obese patients (38 female, BMI = 42.3 ± 6.5 kg/m2) who underwent gastric bypass (intervention group), and 46 age-matched conservative-care controls (37 female, BMI = 39.8 ± 4.6 kg/m2). Multiecho spin echo sequence at 3 T. Knee cartilage T2 measurements and WOMAC Indices were measured presurgery and after 12 months. The intervention group was split into successful (≥20% total weight loss (TWL)) and unsuccessful (<20% TWL) weight loss groups. T2 and WOMAC indices were also measured in controls at baseline and after 12 months. Changes among the three groups were analyzed. Analysis of variance (significance level 0.05). Twenty-six (58%) intervention patients achieved ≥20% TWL. The <20% TWL group demonstrated significantly more T2 reduction in the deep lateral femur over 12 months compared with the ≥20% TWL group (-3.83 ± 8.18 msec vs. 2.47 ± 6.54 msec, respectively), whereas no significant differences were observed on the medial femoral compartment (P = 0.385, P = 0.551, and P = 0.511 for bulk, superficial and deep regions, respectively). Changes in WOMAC indices over 12 months were significantly greater in the ≥20% TWL group compared with controls. In the <20% TWL group, pain significantly improved over 12 months compared with controls, while stiffness and function changes were not statistically significant (P = 0.063 and P = 0.051, respectively). Cartilage matrix, measured by T2, showed improvement on lateral femoral cartilage with <20% TWL compared with ≥20% TWL. Bariatric surgery provided significant improvements in knee symptoms with ≥20% TWL compared with conservative WL. This effect is also seen to some extent with <20% TWL compared with conservative WL. 2 TECHNICAL EFFICACY: Stage 4.

Quantitative T2 Mapping of Acute Pancreatitis.

Quantification of the T2 signal by means of T2 mapping in acute pancreatitis (AP) has the potential to quantify the parenchymal edema. Quantitative T2 mapping may overcome the limitations of previously reported scoring systems for reliable assessment of AP. To evaluate MR-derived pancreatic T2 mapping values in AP and correlate them with markers of disease severity. Prospective single-center study. 76 adults with AP (20-91 years, females/males: 39/37). Fat suppressed multiecho spin-echo prototype sequence to quantify T2 signal at 3T MRI. The severity of AP was assessed clinically, biologically, and by contrast-enhanced CT (CECT) performed 48-72 hours after symptom onset. MRI was then performed ≤24 hours after CT. Two readers blinded to any clinical information independently evaluated the T2 values by placing three regions of interest inside the pancreatic head, body, and tail on the T2 mapping MR sequence. Results were compared with corresponding CECT images as the standard and clinical severity parameters, using the length of hospital stay as our primary endpoint. Continuous variables were compared using the Spearman's rank correlation coefficient, analysis of variance (ANOVA) or Student's t-test. T2 values significantly correlated with the length of hospital stay (rs(74) = 0.29), CT severity index (CTSI) (rs(73) = 0.61; CTSI 0-3: 72 ± 14 msec, CTSI 4-10: 88 ± 15), intensive care unit (ICU) admission (t(2.77) = -3.41) and presence of organ failure (t(6.72) = -3.42), whereas the CTSI and Ranson score were not significantly related with ICU admission (CTSI: P = 0.24; Ranson score: P = 0.24) and organ failure (CTSI: P = 0.11; Ranson score P = 0.11). T2 mapping correlates with AP severity parameters and is useful for assessing the severity of AP with higher sensitivity than the usual clinical and radiological scoring systems. 1 TECHNICAL EFFICACY: Stage 2.

Improvements in Between-Vendor MRI Harmonization of Renal T2 Mapping using Stimulated Echo Compensation.

T2 mapping is valuable to evaluate pathophysiology in kidney disease. However, variations in T2 relaxation time measurements across MR scanners and vendors may occur requiring additional correction. To harmonize renal T2 measurements between MR vendor platforms, and use an extended-phase-graph-based fitting method ("StimFit") to correct stimulated echoes and reduce between-vendor variations. Prospective. 8 healthy "travelling" volunteers (37.5% female, 32 ± 6 years) imaged on four MRI systems across three vendors at four sites, 10 healthy volunteers (50% female, 32 ± 8 years) scanned multiple times on a given MR scanner for repeatability evaluation. ISMRM/NIST system phantom scanned for evaluation of T2 accuracy. 3T, multiecho spin-echo sequence. T2 images fit using conventional monoexponential fitting and "StimFit." Mean absolute percentage error (MAPE) of phantom measurements with reference T2 values. Average cortex and medulla T2 values compared between MR vendors, with masks obtained from T2-weighted images and T1 maps. Full-width-at-half-maximum (FWHM) T2 distributions to evaluate local homogeneity of measurements. Coefficient of variation (CV), linear mixed-effects model, analysis of variance, student's t-tests, Bland-Altman plots, P-value <0.05 considered statistically significant. In the ISMRM/NIST phantom, "StimFit" reduced the MAPE from 4.9%, 9.1%, 24.4%, and 18.1% for the four sites (three vendors) to 3.3%, 3.0%, 6.6%, and 4.1%, respectively. In vivo, there was a significant difference in kidney T2 measurements between vendors using a monoexponential fit, but not with "StimFit" (P = 0.86 and 0.92, cortex and medulla, respectively). The intervendor CVs of T2 measures were reduced from 8.0% to 2.6% (cortex) and 7.1% to 2.8% (medulla) with StimFit, resulting in no significant differences for the CVs of intravendor repeat acquisitions (P = 0.13 and 0.05). "StimFit" significantly reduced the FWHM of T2 distributions in the cortex and whole kidney. Stimulated-echo correction reduces renal T2 variation across MR vendor platforms. 2 TECHNICAL EFFICACY: Stage 1.

Comparison of driven equilibrium and standard spin-echo sequence in MR microscopy: Analysis of signal dependence on RF pulse imperfection and diffusion

Rapid MR imaging of slowly relaxing samples is often challenging. The most commonly used solutions are found in multi spin-echo (RARE) sequences or gradient-echo (GE) sequences, which allow faster imaging of such samples with multiple acquisitions of k-space lines per excitation or imaging with very short repetition times (TRs). Another solution is the use of a spin-echo (SE) sequence superimposed with a driven equilibrium Fourier transform (DEFT) method. Such a (DE-SE) imaging sequence has two refocusing RF pulses that produce two spin-echoes. In the first echo, the signal is acquired from the k-space line, and in the second echo, a 90° RF pulse is applied, typically 180° out of phase with respect to the excitation RF pulse. This last RF pulse allows almost complete magnetization reversal back to the longitudinal orientation with minimal magnetization loss. The DE-SE sequence and its RARE variant are widely used in clinical imaging, but its use in MR microscopy has some peculiarities related to the usually less perfect RF pulse flip angles and diffusion. In this study, their effects are first theoretically analyzed and later verified by experiments on test samples performed on a 9.4 T system for MR microscopy. Experiments on a water-filled tube for TE = 3.4 ms and TR = 25–200 ms showed that the DE-SE sequence produces about 10 times more signal than the SE sequence in this TR range. Finally, the performance of the DE-SE sequence compared to the SE sequence was demonstrated on a biological sample. The presented DE-SE sequence has been shown to be effective for rapid imaging of samples with long T1 relaxation times in MR microscopy and can also be considered as a suitable method for rapid proton density weighed imaging of materials.

Mitigating slice cross-talk in multi-slice multi-echo spin echo T2 mapping.

To investigate whether a T2 inter-slice variation could occur when a multi-slice multi-echo spin echo (MESE) sequence is used for image acquisition and to propose an enhanced method for reconstructing T2 maps that can effectively address and correct these variations. Bloch simulations were performed accounting for the direct saturation effect to evaluate magnetization changes in multi-slice 2D MESE sequence. Experimental phantom scans were performed to validate these simulations. An improved version of the dictionary-based reconstruction approach was proposed, enabling the creation of a multi-slice dictionary of echo modulation curves (EMC). The corresponding method has been assayed considering inter-slice T2 variation with phantoms and in lower leg. Experimental and numerical study illustrate that direct saturation leads to a bias of EMCs. This bias during the T2 maps reconstructions using original single-slice EMC-dictionary method led to inter-slice T2 variation of 2.03% in average coefficient of variation (CV) in agarose phantoms, and up to 2.8% in vivo (for TR = 2 s, slice gap = 0%). A reduction of CV was observed when increasing the gap up to 100% (0.36% in phantoms, and up to 1.5% in vivo) or increasing TR up to 4 s (0.76% in phantoms, and up to 1.9% in vivo). Matching the multi-slice experimental data with multi-slice dictionaries provided a reduced CV of 0.54% in phantoms and up to 2.3% in vivo. T2 values quantified from multi-slice MESE images using single-slice dictionaries are biased. A dedicated multi-slice EMC method providing the appropriate dictionaries can reduce the inter-slice T2 variation.

Retrospective T2 quantification from conventional weighted MRI of the prostate based on deep learning.

To develop a deep learning-based method to retrospectively quantify T2 from conventional T1- and T2-weighted images. Twenty-five subjects were imaged using a multi-echo spin-echo sequence to estimate reference prostate T2 maps. Conventional T1- and T2-weighted images were acquired as the input images. A U-Net based neural network was developed to directly estimate T2 maps from the weighted images using a four-fold cross-validation training strategy. The structural similarity index (SSIM), peak signal-to-noise ratio (PSNR), mean percentage error (MPE), and Pearson correlation coefficient were calculated to evaluate the quality of network-estimated T2 maps. To explore the potential of this approach in clinical practice, a retrospective T2 quantification was performed on a high-risk prostate cancer cohort (Group 1) and a low-risk active surveillance cohort (Group 2). Tumor and non-tumor T2 values were evaluated by an experienced radiologist based on region of interest (ROI) analysis. The T2 maps generated by the trained network were consistent with the corresponding reference. Prostate tissue structures and contrast were well preserved, with a PSNR of 26.41 ± 1.17 dB, an SSIM of 0.85 ± 0.02, and a Pearson correlation coefficient of 0.86. Quantitative ROI analyses performed on 38 prostate cancer patients revealed estimated T2 values of 80.4 ± 14.4 ms and 106.8 ± 16.3 ms for tumor and non-tumor regions, respectively. ROI measurements showed a significant difference between tumor and non-tumor regions of the estimated T2 maps (P < 0.001). In the two-timepoints active surveillance cohort, patients defined as progressors exhibited lower estimated T2 values of the tumor ROIs at the second time point compared to the first time point. Additionally, the T2 difference between two time points for progressors was significantly greater than that for non-progressors (P = 0.010). A deep learning method was developed to estimate prostate T2 maps retrospectively from clinically acquired T1- and T2-weighted images, which has the potential to improve prostate cancer diagnosis and characterization without requiring extra scans.

Evaluation of finger cartilage composition in recreational climbers with 7Tesla T2 mapping magnetic resonance imaging.

Sport climbing may lead to tissue adaptation including finger cartilage before apparent surface damage is detectable. The main aim was to assess finger cartilage composition with T2 mapping in young, active climbers and to compare the results to a non-climbers' collective. A secondary aim was to compare whether differences in cartilage T2 times are observed between older vs. younger volunteers. 7 Tesla MRI of the fingers Dig.2-4 was performed using a multi-echo spin echo sequence. Manual segmentation of 3 ROIs at the metacarpal heads, 1 ROI at the base phalanx and 1 ROI at the proximal interphalangeal joint was performed. Included were 13 volunteers without history of trauma who are regularly performing climbing activities as a recreational sport (>20 h/month). These were age-matched with 10 control subjects not performing climbing activities. Mean age was 32.4 years for the climbing group and 25.8 years for the controls. Mean T2 values for the 5 different ROIs were 42.2 ± 7.8 msec for climbers and 41.4 ± 6.8 msec for non-climbers. No significant differences were observed for T2 values between both groups. However, higher age had a significant impact on T2 values for all assessed ROIs (higher age 44.2 ± 9.5, younger age 32.9 ± 5.7, p = 0.001). This study evaluated the cartilage composition of young, engaged climbers with a T2 mapping MRI technique with the purpose to depict early onset joint changes. No negative impact on cartilage composition due to the sport activity was found, whereas age-related effects on the cartilage seemed to be more prominent.

T2 mapping magnetic resonance imaging of cartilage in hemophilia

BackgroundIn hemophilia, recurrent hemarthrosis may lead to irreversible arthropathy. T2 mapping MRI may reflect cartilage changes at an earlier reversible stage of arthropathy as opposed to structural MRI. ObjectivesTo evaluate interval changes of T2 mapping compared with the International Prophylaxis Study Group (IPSG) structural MRI scores of ankle cartilage in boys with hemophilia receiving prophylaxis. MethodsEight boys with hemophilia A (median age, 13; range, 9-17 years), 7 age- and sex-matched healthy boys (controls, median age, 15; range, 7-16 years). A multiecho spin-echo T2-weighted MRI sequence at 3.0T was used to obtain T2 maps of cartilage of boys with hemophilia and controls. Structural joint status was evaluated using the IPSG MRI score. ResultsT2 relaxation times of ankle cartilage increased significantly over time in both persons with hemophilia and controls (P = .002 and P = .00009, respectively). Changes in T2 relaxation time strongly correlated with changes in IPSG cartilage scores (rs = 0.93 to rs = 0.78 [P = .0007 to P = .023]), but not with changes in age (P = .304 to P = .840). Responsiveness of T2 relaxation times were higher than that of IPSG cartilage scores, with standardized response means >1.4 for T2 mapping in all regions-of-interest compared with 0.84 for IPSG cartilage scores. Baseline T2 relaxation time strongly correlated with timepoint 2 IPSG cartilage score (rs = 0.93 to rs = 0.82 [P = .001 to P = .012]) and T2 relaxation time (rs = 0.98 to rs = 0.88 [P = .00003 to P = .004]) changes in most regions-of-interest. ConclusionT2 mapping shows sensitivity to biochemical changes in cartilage prior to detectable damage using conventional MRI, offering potential for early detection of bleed-related cartilage damage in boys with hemophilia.

Grading Clear Cell Renal Cell Carcinoma Grade Using Diffusion Relaxation Correlated MR Spectroscopic Imaging.

Clear cell renal cell carcinoma (ccRCC) is the most common subtype of RCC, and accurate grading is crucial for prognosis and treatment selection. Biopsy is the reference standard for grading, but MRI methods can improve and complement the grading procedure. Assess the performance of diffusion relaxation correlation spectroscopic imaging (DR-CSI) in grading ccRCC. Prospective. 79 patients (age: 58.1 +/- 11.5 years; 55 male) with ccRCC confirmed by histopathology (grade 1, 7; grade 2, 45; grade 3, 18; grade 4, 9) following surgery. 3.0 T MRI scanner. DR-CSI with a diffusion-weighted echo-planar imaging sequence and T2-mapping with a multi-echo spin echo sequence. DR-CSI results were analyzed for the solid tumor regions of interest using spectrum segmentation with five sub-region volume fraction metrics (VA , VB , VC , VD , and VE ). The regulations for spectrum segmentation were determined based on the D-T2 spectra of distinct macro-components. Tumor size, voxel-wise T2, and apparent diffusion coefficient (ADC) values were obtained. Histopathology assessed tumor grade (G1-G4) for each case. One-way ANOVA or Kruskal-Wallis test, Spearman's correlation (coefficient, rho), multivariable logistic regression analysis, receiver operating characteristic curve analysis, and DeLong's test. Significance criteria: P < 0.05. Significant differences were found in ADC, T2, DR-CSI VB , and VD among the ccRCC grades. Correlations were found for ccRCC grade to tumor size (rho = 0.419), age (rho = 0.253), VB (rho = 0.553) and VD (rho = -0.378). AUC of VB was slightly larger than ADC in distinguishing low-grade (G1-G2) from high-grade (G3-G4) ccRCC (0.801 vs. 0.762, P = 0.406) and G1 from G2 to G4 (0.796 vs. 0.647, P = 0.175), although not significant. Combining VB , VD , and VE had better diagnostic performance than combining ADC and T2 for differentiating G1 from G2-G4 (AUC: 0.814 vs 0.643). DR-CSI parameters are correlated with ccRCC grades, and may help to differentiate ccRCC grades. 2 TECHNICAL EFFICACY STAGE: 2.

3D magnetic resonance fingerprinting on a low-field 50 mT point-of-care system prototype: evaluation of muscle and lipid relaxation time mapping and comparison with standard techniques

ObjectiveTo implement magnetic resonance fingerprinting (MRF) on a permanent magnet 50 mT low-field system deployable as a future point-of-care (POC) unit and explore the quality of the parameter maps.Materials and methods3D MRF was implemented on a custom-built Halbach array using a slab-selective spoiled steady-state free precession sequence with 3D Cartesian readout. Undersampled scans were acquired with different MRF flip angle patterns and reconstructed using matrix completion and matched to the simulated dictionary, taking excitation profile and coil ringing into account. MRF relaxation times were compared to that of inversion recovery (IR) and multi-echo spin echo (MESE) experiments in phantom and in vivo. Furthermore, B0 inhomogeneities were encoded in the MRF sequence using an alternating TE pattern, and the estimated map was used to correct for image distortions in the MRF images using a model-based reconstruction.ResultsPhantom relaxation times measured with an optimized MRF sequence for low field were in better agreement with reference techniques than for a standard MRF sequence. In vivo muscle relaxation times measured with MRF were longer than those obtained with an IR sequence (T1: 182 ± 21.5 vs 168 ± 9.89 ms) and with an MESE sequence (T2: 69.8 ± 19.7 vs 46.1 ± 9.65 ms). In vivo lipid MRF relaxation times were also longer compared with IR (T1: 165 ± 15.1 ms vs 127 ± 8.28 ms) and with MESE (T2: 160 ± 15.0 ms vs 124 ± 4.27 ms). Integrated ΔB0 estimation and correction resulted in parameter maps with reduced distortions.DiscussionIt is possible to measure volumetric relaxation times with MRF at 2.5 × 2.5 × 3.0 mm3 resolution in a 13 min scan time on a 50 mT permanent magnet system. The measured MRF relaxation times are longer compared to those measured with reference techniques, especially for T2. This discrepancy can potentially be addressed by hardware, reconstruction and sequence design, but long-term reproducibility needs to be further improved.

Assessing within-subject rates of change of placental MRI diffusion metrics in normal pregnancy.

Studying placental development informs when development is abnormal. Most placental MRI studies are cross-sectional and do not study the extent of individual variability throughout pregnancy. We aimed to explore how diffusion MRI measures of placental function and microstructure vary in individual healthy pregnancies throughout gestation. Seventy-nine pregnant, low-risk participants (17 scanned twice and 62 scanned once) were included. T2 -weighted anatomical imaging and a combined multi-echo spin-echo diffusion-weighted sequence were acquired at 3 T. Combined diffusion-relaxometry models were performed using both a -ADC and a bicompartmental -intravoxel-incoherent-motion ( ) model fit. There was a significant decline in placental and ADC (both P < 0.01) over gestation. These declines are consistent in individuals for (covariance = -0.47), but not ADC (covariance = -1.04). The model identified a consistent decline in individuals over gestation in from both the perfusing and diffusing placental compartments, but not in ADC values from either. The placental perfusing compartment fraction increased over gestation (P = 0.0017), but this increase was not consistent in individuals (covariance = 2.57). Whole placental and ADC values decrease over gestation, although only values showed consistent trends within subjects. There was minimal individual variation in rates of change of values from perfusing and diffusing placental compartments, whereas trends in ADC values from these compartments were less consistent. These findings probably relate to the increased complexity of the bicompartmental model, and differences in how different placental regions evolve at a microstructural level. These placental MRI metrics from low-risk pregnancies provide a useful benchmark for clinical cohorts.

The Impact of Fatty Infiltration on MRI Segmentation of Lower Limb Muscles in Neuromuscular Diseases: A Comparative Study of Deep Learning Approaches.

Deep learning methods have been shown to be useful for segmentation of lower limb muscle MRIs of healthy subjects but, have not been sufficiently evaluated on neuromuscular disease (NDM) patients. Evaluate the influence of fat infiltration on convolutional neural network (CNN) segmentation of MRIs from NMD patients. Retrospective study. Data were collected from a hospital database of 67 patients with NMDs and 14 controls (age: 53 ± 17 years, sex: 48 M, 33 F). Ten individual muscles were segmented from the thigh and six from the calf (20 slices, 200 cm section). A 1.5 T. Sequences: 2D T1 -weighted fast spin echo. Fat fraction (FF): three-point Dixon 3D GRE, magnetization transfer ratio (MTR): 3D MT-prepared GRE, T2: 2D multispin-echo sequence. U-Net 2D, U-Net 3D, TransUNet, and HRNet were trained to segment thigh and leg muscles (101/11 and 95/11 training/validation images, 10-fold cross-validation). Automatic and manual segmentations were compared based on geometric criteria (Dice coefficient [DSC], outlier rate, absence rate) and reliability of measured MRI quantities (FF, MTR, T2, volume). Bland-Altman plots were chosen to describe agreement between manual vs. automatic estimated FF, MTR, T2 and volume. Comparisons were made between muscle populations with an FF greater than 20% (G20+) and lower than 20% (G20-). The CNNs achieved equivalent results, yet only HRNet recognized every muscle in the database, with a DSC of 0.91 ± 0.08, and measurement biases reaching -0.32% ± 0.92% for FF, 0.19 ± 0.77 for MTR, -0.55 ± 1.95 msec for T2, and - 0.38 ± 3.67 cm3 for volume. The performances of HRNet, between G20- and G20+ decreased significantly. HRNet was the most appropriate network, as it did not omit any muscle. The accuracy obtained shows that CNNs could provide fully automated methods for studying NMDs. However, the accuracy of the methods may be degraded on the most infiltrated muscles (>20%). 4. Stage 1.

Quantitative muscle magnetic resonance imaging depicts microstructural abnormalities but no signs of inflammation or dystrophy in post-COVID-19 condition.

Post-COVID-19 condition (PCC) has high impact on quality of life, with myalgia and fatigue affecting at least 25% of PCC patients. This case-control study aims to noninvasively assess muscular alterations via quantitative muscle magnetic resonance imaging (MRI) as possible mechanisms for ongoing musculoskeletal complaints and premature exhaustion in PCC. Quantitative muscle MRI was performed on a 3 Tesla MRI scanner of the whole legs in PCC patients compared to age- and sex-matched healthy controls, including a Dixon sequence to determine muscle fat fraction (FF), a multi-echo spin-echo sequence for quantitative water mapping reflecting putative edema, and a diffusion-weighted spin-echo echo-planar imaging sequence to assess microstructural alterations. Clinical examination, nerve conduction studies, and serum creatine kinase were performed in all patients. Quantitative muscle MRI results were correlated to the results of the 6-min walk test and standardized questionnaires assessing quality of life, fatigue, and depression. Twenty PCC patients (female: n= 15, age=48.8±10.1 years, symptoms duration=13.4± 4.2months, body mass index [BMI] = 28.8±4.7kg/m2 ) were compared to 20 healthy controls (female: n= 15, age=48.1± 11.1 years, BMI=22.9± 2.2kg/m2 ). Neither FF nor T2 revealed signs of muscle degeneration or inflammation in either study groups. Diffusion tensor imaging (DTI) revealed reduced mean, axial, and radial diffusivity in the PCC group. Quantitative muscle MRI did not depict any signs of ongoing inflammation or dystrophic process in the skeletal muscles in PCC patients. However, differences observed in muscle DTI depict microstructural abnormalities, which may reflect potentially reversible fiber hypotrophy due to deconditioning. Further longitudinal and interventional studies should prove this hypothesis.

Dose sensitivity of MAGIC-f polymer gel using different MRI sequences

This study aims to evaluate the dose sensitivity of MAGIC-f gel irradiated by high-energy photon beams, comparing quantification using different MRI sequences. Irradiation was performed using 6 MV photons with 600 cGy/min dose rate, field size of 20x20 cm², and 94 cm source-to-surface distance. Two gel batches were produced on different days and placed in vials. In the first batch, doses of 0, 2, 4, 6, 8, 10, 20, and 40 Gy were planned. The second batch was irradiated with doses of 0, 2, 4, 6, 10, 12, 14, and 16 Gy. MR images were acquired with Spin Echo (SE, TR=3 s) and Multi Spin Echo (MSE, TR = 3s or 10s, turbo factor 24) sequences. The dose is assessed via changes in the transverse relaxation time in the irradiated gel. In MSE, dose sensitivity in the first batch was 0.27 (TR=3 s) and 0.28 Gy-1s-1 (TR=10 s) and in the second batch, 0.31 and 0.31 Gy-1s-1 (TR = 3 s and TR = 10 s, respectively). In the SE sequence, dose sensitivity was 0.42 for the first batch and 0.43 Gy-1s-1 for the second batch. Linearity of dose-response was only obtained for doses below 10 Gy. Comparing the dose sensitivity extracted from MSE and SE sequences using TR= 3s, differences around 30% were found. Thus, although MSE-MRI offers a faster protocol of imaging acquisition it is less precise for quantification of relaxation times, as TE is not a well-defined quantity. The performance of the gel as a dosimeter is consequently sequence dependent.