Zero Echo Time Research Articles

Correlation of zero echo time functional MRI with neuronal activity in rats.

Zero echo time (zero-TE) pulse sequences provide a quiet and artifact-free alternative to conventional functional magnetic resonance imaging (fMRI) pulse sequences. The fast readouts (<1 ms) utilized in zero-TE fMRI produce an image contrast with negligible contributions from blood oxygenation level-dependent (BOLD) mechanisms, yet the zero-TE contrast is highly sensitive to brain function. However, the precise relationship between the zero-TE contrast and neuronal activity has not been determined. Therefore, we aimed to derive a function to model the temporal dynamics of the zero-TE fMRI signal in response to neuronal activity. Furthermore, we examined the correlation of zero-TE fMRI with neuronal activity across stimulation frequencies. To these ends, we performed simultaneous electrophysiological recordings and zero-TE fMRI in rats subjected to whisker stimulation. The presented impulse response function provides a basis for the statistical modeling of neuronal activity-induced changes in the zero-TE fMRI signal. The temporal characteristics of the zero-TE fMRI response were found to be consistent with the previously postulated non-BOLD hemodynamic origin of the functional contrast. The zero-TE fMRI signal was well predicted by electrophysiological recordings, although systematic stimulation-dependent residuals were also observed, suggesting nonlinearities in neurovascular coupling. We conclude that zero-TE fMRI provides a robust proxy for neuronal activity.

Zero-echo time imaging achieves whole brain activity mapping without ventral signal loss in mice.

Functional MRI (fMRI) is an important tool for investigating functional networks. However, the widely used fMRI with T2*-weighted imaging in rodents has the problem of signal lack in the lateral ventral area of forebrain including the amygdala, which is essential for not only emotion but also noxious pain. Here, we scouted the zero-echo time (ZTE) sequence, which is robust to magnetic susceptibility and motion-derived artifacts, to image activation in the whole brain including the amygdala following the noxious stimulation to the hind paw. ZTE exhibited higher spatial and temporal signal-to-noise ratios than conventional fMRI sequences. Electrical sensory stimulation of the hind paw evoked ZTE signal increase in the primary somatosensory cortex. Formalin injection into the hind paw evoked early and latent change of ZTE signals throughout the whole brain including the subregions of amygdala. Furthermore, resting-state fMRI using ZTE demonstrated the functional connectivity, including that of the amygdala. These results indicate the feasibility of ZTE for whole brain fMRI including the amygdala and we first show acute and latent activity in different subnuclei of the amygdala complex after nociceptive stimulation.

Re: Utility of zero echo time (ZTE) sequence for assessing bony lesions of skull base and calvarium

Re: Utility of zero echo time (ZTE) sequence for assessing bony lesions of skull base and calvarium

Are Collagen Protons Visible with the Zero Echo Time (ZTE) Magnetic Resonance Imaging Sequence: A D2O Exchange and Freeze-Drying Study.

It is known that ultrashort echo time (UTE) magnetic resonance imaging (MRI) sequences can detect signals from water protons but not collagen protons in short T2 species such as cortical bone and tendons. However, whether collagen protons are visible with the zero echo time (ZTE) MRI sequence is still unclear. In this study, we investigated the potential of the ZTE MRI sequence on a clinical 3T scanner to directly image collagen protons via D2O exchange and freeze-drying experiments. ZTE and UTE MRI sequences were employed to image fully hydrated bovine cortical bone (n = 10) and human patellar tendon (n = 1) specimens. Then, each specimen was kept in a 30 mL syringe filled with D2O solution for two days. Fresh D2O was flushed every 2 h to reach a more complete D2O-H2O exchange. Later, the samples were lyophilized for over 40 h and then sealed in tubes. Finally, the samples were brought to room temperature and visualized using the identical 3D ZTE and UTE sequences. All hydrated bone and tendon specimens showed high signals with ZTE and UTE sequences. However, all specimens showed zero signal after the D2O exchange and freeze-drying procedures. Therefore, similar to UTE imaging, the signal source in ZTE imaging is water. The ZTE sequence cannot directly detect signals from collagen protons in bone and tendons.

Whole-brain responses to visual and auditory stimuli in anesthetized and minimally restrained awake mice using quiet zero echo time fMRI

Abstract Functional MRI (fMRI) is a flexible tool for sensory perception studies in animal models. However, animal fMRI studies are generally performed under anesthesia. Unfortunately, anesthesia affects brain function and sensory processing, complicating the interpretation of the findings. Since there is a growing need for fMRI protocols applicable for awake animals, we optimized a zero echo time Multi-Band Sweep Imaging with a Fourier Transformation (MB-SWIFT) fMRI approach for imaging awake mice. We implemented a 14-day habituation protocol that resulted in merely moderate motion of the mice while being head-fixed with the animals’ body and limbs being free to move. The sensory responsiveness between different states of consciousness was compared by imaging mice with visual and auditory stimulation schemes in the awake state and under ketamine–xylazine anesthesia. In awake mice, we observed a robust whole-brain activation of the ascending auditory and visual pathways, as well as higher sensory processing areas. Under ketamine–xylazine anesthesia, auditory responses were suppressed, and the temporal shapes of fMRI responses were different from those obtained in awake mice. Our results suggest that the quiet and motion-tolerant zero echo time MB-SWIFT approach allows complex behavioral fMRI designs in the awake state that promise to improve our understanding of the underlying mechanisms of perception.

Comparing three-dimensional zero echo time (3D-ZTE) lung MRI and chest CT in the evaluation of systemic sclerosis-related interstitial lung disease.

Systemic sclerosis (SSc) is a chronic disease that can cause interstitial lung disease (ILD), a poor prognostic factor in SSc patients. Given the concerns over radiation exposure from repeated CT scans, there is a growing interest in exploring radiation-free imaging alternatives like MRI for ILD evaluation. The aim of this study is to assess the efficacy of three-dimensional zero echo time (3D-ZTE) MRI in assessing SSc-related ILD compared to the thin-slice chest CT. This prospective single-center study investigated 65 SSc patients. SSc patients underwent CT, 3D-ZTE lung MRI, and pulmonary function tests (PFTs) within a week. Three independent reviews visually quantified ILD extent on ZTE and CT imaging and the correlation of ILD extent with PFTs was analyzed. Statistical analyses were performed, including the intraclass correlation coefficient (ICC), Kruskal-Wallis tests, Bland-Altmann analysis, and correlation analyses between imaging results and PFTs. ILD was detected in 45 patients via CT. 3D-ZTE MRI identified ILD in 41 (91.1%) of these cases, demonstrating a strong correlation with CT in assessing ILD severity (r = 0.986, p < 0.001). The median ILD extent scores were 5% for CT and 6% for 3D-ZTE MRI. Interobserver reliability for 3D-ZTE MRI was excellent, with ICC values ranging from 0.853 to 0.969. The analysis also revealed significant negative correlations between ILD extent on ZTE MRI and lung function, particularly FVC. 3D-ZTE lung MRI is a reliable and radiation-free alternative to chest CT for evaluating SSc-related ILD, with a strong correlation in assessing total fibrosis and ground-glass opacities, though limitations remain in detecting fine reticulations and coarseness. Question Can 3D-ZTE MRI replace thin-slice chest CT as a radiation-free method for assessing SSc-related ILD? Findings 3D-ZTE lung MRI showed an excellent agreement with thin-slice CT in evaluating ILD extent in SSc patients (r = 0.986, p < 0.001). Clinical relevance 3D-ZTE lung MRI provides a reliable, radiation-free alternative to CT for assessing ILD extent in SSc patients, ensuring safer longitudinal monitoring and management.

Diagnosis and evaluation of cervical ossification of the posterior longitudinal ligament on Zero-Echo Time Magnetic Resonance Imaging: an illustrative case series.

Computed tomography (CT) scans are widely used clinically in the diagnosis of ossification of the posterior longitudinal ligament (OPLL). Conventionally acquired magnetic resonance imaging (MRI) is limited by insufficient signal intensity within bone tissue. Osseus conspicuity may be enhanced by applying sequences with "CT-like" bone contrast zero-echo time (ZTE) MRI. This is a case series aimed to understand if ZTE-MRI is sensitive in detecting cervical OPLL and if this modality is suitable for evaluating OPLL morphology. A retrospective review was performed to identify adult patients with available cervical ZTE-MRI and CT scans. ZTE-MRI and CT were evaluated for their ability to detect OPLL by 2 attending spine surgeons, 1 spine surgery clinical fellow, and 1 senior orthopedic resident. The phenotype of OPLL was then described and compared between the two modalities. A total of 50 patients were reviewed. All clinicians detected 4 cases of OPLL on CT, and the same cases were independently found on ZTE-MRI. The modalities were then compared to assess the phenotype of OPLL. ZTE-MRI may have the potential to obviate the need for concurrent CT scans in diagnosing OPLL. When OPLL was suspected on MRI, ZTE-MRI could confirm the OPLL diagnosis. With conventional MRI sequences that include additional post-processed ZTE-MRI, clinicians can also assess OPLL morphology and the resulting spinal cord change to make a complete diagnosis and identify patients at higher risk for progression or complications. ZTE-MRI avoids CT-related radiation, can improve diagnosis, and decrease health costs.

3D printing of the brachial plexus and its osseous landmarks using magnetic resonance neurography for thoracic outlet syndrome evaluation

BackgroundPatient-specific three-dimensional (3D) printed anatomic models are valuable clinical tools that facilitate enhanced visualization of pertinent anatomic structures and have demonstrated benefits of reduced surgical times, increased surgeon confidence, and improved operative results and subsequent patient outcomes. Medical image-based 3D printed anatomic models are generally created from computed tomography (CT), however magnetic resonance imaging (MRI), which offers exquisite soft tissue characterization and flexible contrast avoiding the use of ionizing radiation, is an attractive alternative. Herein, the application of 3D printing incorporating both MR neurography and zero-echo time (ZTE) MRI for visualization of the brachial plexus anatomy in a subject with thoracic outlet syndrome (TOS) is described.MethodsA 28-year-old man presented with chronic right upper limb discomfort and paresthesias extending from the shoulder region to the third and fourth digits. The subject underwent evaluation with a unilateral brachial plexus MR neurography protocol at 3.0 Tesla for suspicion of TOS. The protocol included T2-weighted, 3D fast spin echo short-tau inversion recovery (STIR-FSE) and 3D radial ZTE sequences for depiction of the nerves and bones, respectively. The first rib and its synostosis impinged upon the inferior aspect of the T1 nerve root (T1NR), with accompanying mild enlargement of the T1NR. A 3D printed anatomic model was created and included: (1) bone (spine, ribs, clavicle, scapula, and humerus), (2) brachial plexus, and (3) costal cartilage.ResultsThe 3D printed model clearly demonstrated a T1NR impingement from the synostosis, confirming the diagnosis of neurologic thoracic outlet syndrome (TOS) and guided the treatment approach in prescribing TOS-specific physical therapy, which led to significant improvements in the patient’s condition.ConclusionTo our knowledge, this is the first in-vivo human 3D printed case for TOS using MRI-only data. The 3D printed model allowed for improved visualization and understanding of the spatial relationships between the nerves of the brachial plexus and surrounding osseous structures responsible for the patient’s symptoms.Clinical trial numberNot applicable.

Whisker stimulation with different frequencies reveals non-uniform modulation of functional magnetic resonance imaging signal across sensory systems in awake rats.

Primary sensory systems are classically considered to be separate units, however there is current evidence that there are notable interactions between them. We examined the cross-sensory interplay by applying a quiet and motion-tolerant zero echo time functional magnetic resonance imaging (fMRI) technique to elucidate the evoked brain-wide responses to whisker pad stimulation in awake and anesthetized rats. Specifically, characterized the brain-wide responses in core and non-core regions to whisker pad stimulation by the varying stimulation-frequency, and determined whether isoflurane-medetomidine anesthesia, traditionally used in preclinical imaging, confounded investigations related to sensory integration. We demonstrated that unilateral whisker pad stimulation not only elicited robust activity along the whisker-mediated tactile system, but also in auditory, visual, high-order, and cerebellar regions, indicative of brain-wide cross-sensory and associative activity. By inspecting the response profiles to different stimulation frequencies and temporal signal characteristics, we observed that the non-core regions responded to stimulation in a very different way compared to the primary sensory system, likely reflecting different encoding modes between the primary sensory, cross-sensory, and integrative processing. Lastly, while the activity evoked in low-order sensory structures could be reliably detected under anesthesia, the activity in high-order processing and the complex differences between primary, cross-sensory, and associative systems were visible only in the awake state. We conclude that our study reveals novel aspects of the cross-sensory interplay of whisker-mediated tactile system, and importantly, that these would be difficult to observe in anesthetized rats.

Low-rank iterative infilling for zero echo-time (ZTE) imaging.

A new referenceless low-rank reconstruction technique has been introduced to address the issue of missing samples within the Zero Echo Time (ZTE) dead-time gap. The proposed method reformulates the in-filling of the missing samples as an inverse problem subject to low-rank constraints. Its performance and robustness are evaluated through a comparative analysis that combines Monte Carlo computational simulations and data obtained from in vivo experiments. The proposed method is tested for dead-time gaps ranging up to 4.5 Nyquist dwells, across signal-to-noise ratio levels of 5, 10, 15, and 20 dB. Consistently superior performance is observed across all cases compared to algebraic and parallel imaging methods. The speed for convergence decreases exponentially as the dead-time gap expands. The proposed method enables artifact-free reconstruction up to dead-time gap of 4 Nyquist dwells and thereby supports ZTE imaging up to an imaging bandwidth of kHz (assuming transmit and receive switching less than 30 s). It demonstrates superior performance compared to algebraic and parallel imaging methods.

Zero-echo-time sequences in highly inhomogeneous fields.

Zero-echo-time (ZTE) sequences have proven a powerful tool for MRI of ultrashort tissues, but they fail to produce useful images in the presence of strong field inhomogeneities (14 000 ppm). Here we seek a method to correct reconstruction artifacts from non-Cartesian acquisitions in highly inhomogeneous , where the standard double-shot gradient-echo approach to field mapping fails. We present a technique based on magnetic field maps obtained from two geometric distortion-free point-wise (SPRITE) acquisitions. To this end, we employ three scanners with varying field homogeneities. These maps are used for model-based image reconstruction with iterative algebraic techniques (ART). For comparison, the same prior information is fed also to widely used Conjugate Phase (CP) algorithms. Distortions and artifacts coming from severe inhomogeneities, at the level of the encoding gradient, are largely reverted by our method, as opposed to CP reconstructions. This holds even close to the limit where intra-voxel bandwidths (determined by inhomogeneities, up to 1.2 kHz) are comparable to the encoding inter-voxel bandwidth (determined by the gradient fields, 625 Hz in this work). We have benchmarked the performance of a new method for ZTE imaging in highly inhomogeneous magnetic fields. For example, this can be exploited for dental imaging in affordable low-field MRI systems, and can be expanded for arbitrary pulse sequences and extreme magnet geometries, as in, for example, single-sided MRI.

MRI-based Zero Echo Time and Black Bone Pseudo-CT Compared with Whole-Body CT to Detect Osteolytic Lesions in Multiple Myeloma.

Background MRI is highly sensitive for assessing bone marrow involvement in multiple myeloma (MM) but does not enable detection of osteolysis. Purpose To assess the diagnostic accuracy, repeatability, and reproducibility of pseudo-CT MRI sequences (zero echo time [ZTE], gradient-echo black bone [BB]) in detecting osteolytic lesions in MM using whole-body CT as the reference standard. Materials and Methods In this prospective study, consecutive patients were enrolled in our academic hospital between June 2021 and December 2022. Inclusion criteria were newly diagnosed MM, monoclonal gammopathy of undetermined significance at high risk for MM, or suspicion of progressive MM. Participants underwent ZTE and BB sequences covering the lumbar spine, pelvis, and proximal femurs as part of 3-T whole-body MRI examinations, as well as clinically indicated fluorine 18 fluorodeoxyglucose PET/CT examination within 1 month that included optimized whole-body CT. Ten bone regions and two scores (categorical score = presence/absence of osteolytic lesion; semiquantitative score = osteolytic lesion count) were assessed by three radiologists (two experienced and one unfamiliar with pseudo-CT reading) on the ZTE, BB, and whole-body CT images. The accuracy, repeatability, and reproducibility of categorical scores (according to Gwet agreement coefficients AC1 and AC2) and differences in semiquantitative scores were assessed at the per-sequence, per-region, and per-patient levels. Results A total of 47 participants (mean age, 67 years ± 11 [SD]; 27 male) were included. In experienced readers, BB and ZTE had the same high accuracy (98%) in the per-patient analysis, while BB accuracy ranged 83%-100% and ZTE accuracy ranged 74%-94% in the per-region analysis. An increase of false-negative (FN) findings in the spine ranging from +17% up to +23%, according to the lumbar vertebra, was observed using ZTE (P < .013). Regardless of the region (except coxal bones), differences in the BB score minus the ZTE score were positively skewed (P < .021). Regardless of the sequence or region, repeatability was very good (AC1 ≥0.87 for all), while reproducibility was at least good (AC2 ≥0.63 for all). Conclusion Both MRI-based ZTE and BB pseudo-CT sequences of the lumbar spine, pelvis, and femurs demonstrated high diagnostic accuracy in detecting osteolytic lesions in MM. Compared with BB, the ZTE sequence yielded more FN findings in the spine. ClinicalTrials.gov Identifier: NCT05381077 Published under a CC BY 4.0 license. Supplemental material is available for this article.

Image quality and detection efficacy of zero echo time magnetic resonance imaging on Lung-RADS 2 pulmonary ground-glass nodules in comparison to thin-slice fat-saturated T2-weighted imaging.

Widely used computed tomography (CT) screening increases the detection of pulmonary pure ground-glass nodules (pGGNs), often classified as the second category of Lung Imaging Reporting and Data System (Lung-RADS 2). Despite their low malignancy risk, these nodules pose significant challenges and necessitate accurate assessment to minimize the risk of long-term follow-ups. This study investigated the detection efficacy of zero echo time (ZTE) magnetic resonance imaging (MRI) and thin-slice fat-saturated T2-weighted imaging (T2WI-FS) on 3.0 T MRI on the predictive accuracy of invasiveness for Lung-RADS 2 pGGNs. This prospective study enrolled 83 consecutive patients with 110 pGGNs who underwent preoperative CT and MRI scans. All CT images were assessed by artificial intelligence (AI) software and confirmed by a thoracic radiologist. Another two radiologists blind to pathology results assessed MRI for image quality (objective and subjective evaluations) and detection of pGGNs. Differences in nodule diameter, CT density and detection rate were compared within different pathological groups. The objective and subjective image quality scores were compared using the Wilcoxon signed rank test between ZTE and T2WI-FS. Interobserver agreement was calculated using the kappa coefficient. Receiver operating characteristic (ROC) curve analysis evaluated the diagnostic accuracy for distinguishing invasiveness. Among the 110 pGGNs evaluated, T2WI-FS demonstrated a higher detection rate (80.0%) compared to ZTE (51.8%). ZTE showed a superior signal-to-noise ratio (SNR) in the lung parenchyma, aorta, and peripheral lung structures, whereas T2WI-FS more effectively delineated tracheal walls and pulmonary nodules. Both observers rated ZTE higher for vascular and bronchial visibility, while T2WI-FS was better in terms of lower noise and fewer artifacts. Notably, ZTE visibility varied with pathological results, exhibiting a range from 0% in atypical adenomatous hyperplasia (AAH) to 94.1% in invasive adenocarcinoma (IAC). The key indicators for distinguishing invasive pGGNs from non-invasive ones were nodule diameter [area under the curve (AUC) =0.874], ZTE visibility (AUC =0.740), followed by CT values (AUC =0.682) and T2WI-FS visibility (AUC =0.678). MRI has the potential to detect and predict the invasiveness of pGGN. Both T2WI-FS and ZTE demonstrate reliable image quality in pulmonary imaging, each displaying strengths in visualizing pGGN. Thin-slice T2WI-FS has a superior detection rate, while ZTE better predicts histological invasiveness.

Utility of zero echo time (ZTE) sequence for assessing bony lesions of skull base and calvarium

The emergence of zero echo time (ZTE) imaging has transformed bone imaging, overcoming historical limitations in capturing detailed bone structures. By minimizing the time gap between radiofrequency excitation and data acquisition, ZTE generates CT-like images. While ZTE has shown promise in various applications, its potential in assessing skull base and calvarium lesions remains unexplored. Hence we aim to introduce a novel perspective by investigating the utility of inverted ZTE images (iZTE) and pseudoCT (pCT) images for studying lesions in the skull base and calvarium. A total of 35 eligible patients, with an average age of 42 years and a male/female ratio of 1:4, underwent ZTE MRI and images are processed to generate iZTE and pCT images were generated through a series of steps including intensity equalization, thresholding, and deep learning-based pCT generation. These images were then compared to CT scans using a rating scale; inter-rater kappa coefficient evaluated observer consensus while statistical metrics like sensitivity and specificity assessed their performance in capturing bone-related characteristics. The study revealed excellent interobserver agreement for lesion assessment using both pCT and iZTE imaging modalities, with kappa coefficient of 0.91 (P < 0.0001) and 0.92 respectively (P < 0.0001). Also, pCT and iZTE accurately predicted various lesion characteristics with sensitivity ranging from 84.3% to 95.1% and 82.6%-94.2% (95% CI) with a diagnostic accuracy of 95.56% and 94.44% respectively. Although both of them encountered challenges with ground glassing, hyperostosis, and intralesional bony fragments, they showed good performance in other bony lesion assessments. The pilot study suggests strong potential for integrating the ZTE imaging into standard care for skull base and calvarial bony lesions assessment. Additionally, larger-scale studies are needed for comprehensive assessment of its efficacy.

Deep learning-based pseudo-CT synthesis from zero echo time MR sequences of the pelvis

ObjectivesTo generate pseudo-CT (pCT) images of the pelvis from zero echo time (ZTE) MR sequences and compare them to conventional CT.MethodsNinety-one patients were prospectively scanned with CT and MRI including ZTE sequences of the pelvis. Eleven ZTE image volumes were excluded due to implants and severe B1 field inhomogeneity. Out of the 80 data sets, 60 were used to train and update a deep learning (DL) model for pCT image synthesis from ZTE sequences while the remaining 20 cases were selected as an evaluation cohort. CT and pCT images were assessed qualitatively and quantitatively by two readers.ResultsMean pCT ratings of qualitative parameters were good to perfect (2–3 on a 4-point scale). Overall intermodality agreement between CT and pCT was good (ICC = 0.88 (95% CI: 0.85–0.90); p < 0.001) with excellent interreader agreements for pCT (ICC = 0.91 (95% CI: 0.88–0.93); p < 0.001). Most geometrical measurements did not show any significant difference between CT and pCT measurements (p > 0.05) with the exception of transverse pelvic diameter measurements and lateral center-edge angle measurements (p = 0.001 and p = 0.002, respectively). Image quality and tissue differentiation in CT and pCT were similar without significant differences between CT and pCT CNRs (all p > 0.05).ConclusionsUsing a DL-based algorithm, it is possible to synthesize pCT images of the pelvis from ZTE sequences. The pCT images showed high bone depiction quality and accurate geometrical measurements compared to conventional CT.Critical relevance statementpCT images generated from MR sequences allow for high accuracy in evaluating bone without the need for radiation exposure. Radiological applications are broad and include assessment of inflammatory and degenerative bone disease or preoperative planning studies.Key PointspCT, based on DL-reconstructed ZTE MR images, may be comparable with true CT images.Overall, the intermodality agreement between CT and pCT was good with excellent interreader agreements for pCT.Geometrical measurements and tissue differentiation were similar in CT and pCT images.Graphical

Deep learning reconstruction for optimized bone assessment in zero echo time MR imaging of the knee

PurposeTo evaluate the impact of deep learning-based reconstruction (DLRecon) on bone assessment in zero echo-time (ZTE) MRI of the knee at 1.5 Tesla. MethodsThis retrospective study included 48 consecutive exams of 46 patients (23 females) who underwent clinically indicated knee MRI at 1.5 Tesla. Standard imaging protocol comprised a sagittal prescribed, isotropic ZTE sequence. ZTE image reconstruction was performed with a standard-of-care (non-DL) and prototype DLRecon method. Exams were divided into subsets with and without osseous pathology based on the radiology report. Using a 4-point scale, two blinded readers qualitatively graded features of bone depiction including artifacts and conspicuity of pathology including diagnostic certainty in the respective subsets. Quantitatively, one reader measured signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of bone. Comparative analyses were conducted to assess the differences between the reconstruction methods. In addition, interreader agreement was calculated for the qualitative gradings. ResultsDLRecon significantly improved gradings for bone depiction relative to non-DL reconstruction (all, p < 0.05), while there was no significant difference with regards to artifacts (both, median score of 0; p = 0.058). In the subset with pathologies, conspicuity of pathology and diagnostic confidence were also scored significantly higher in DLRecon compared to non-DL (median 3 vs 2; p ≤ 0.03). Interreader agreement ranged from moderate to almost-perfect (κ = 0.54–0.88). Quantitatively, DLRecon demonstrated significantly enhanced CNR and SNR of bone compared to non-DL (p < 0.001). ConclusionZTE MRI with DLRecon improved bone depiction in the knee, compared to non-DL. Additionally, DLRecon increased conspicuity of osseous findings together with diagnostic certainty.

Radiation-free and injection-free imaging of the paediatric chest using a magnetic resonance imaging protocol including zero time echo sequence (3D-ZTE).

Despite its overall lower image quality compared to CT, and the additional years of experience required for accurate interpretation, the 3D-ZTE MRI sequence demonstrated excellent sensitivity for several lesions, making it an appropriate imaging method in certain indications. • Chest radiography and CT are the main imaging modalities for paediatric thoracic diseases but involve radiation exposure and CT often requires IV contrast. • MRI is promising for radiation-free lung imaging in children but faces challenges of low signal-to-noise ratio and motion artefacts. • An MRI protocol including a 3D zero echo time (ZTE) sequence allows satisfactory visualisation of lung parenchyma in 82% of children. • Despite overall inferior image quality compared to CT, MRI demonstrated excellent sensitivity for several lesions, making it an appropriate imaging method in certain indications.

Zero-echo time MRI: an alternative method for the diagnosis of urinary stones in children

ObjectivesTo evaluate the potential of zero-echo time-magnetic resonance imaging (ZTE-MRI) in the assessment of urolithiasis and compare ZTE-MRI with computed tomography (CT) in pediatric patients.Materials and methodsThis was a single-center, prospective cross-sectional study conducted between April 2023 and December 2023. 23 patients (12 girls, 11 boys; mean age: 12.3, range 1–18) with urinary tract stones detected on non-enhanced abdominal CT were enrolled. The images were evaluated independently by two radiologists for the presence, and number of stones in the kidneys, ureters, and bladder. In the second session, two radiologists evaluated whether urinary tract stones could be detected by MRI compared to CT, and the maximum diameter of the stones was measured. The CT and MRI results were compared with the Wilcoxon test. The agreement between the results of the observers was examined using Spearman’s rho correlation coefficient and the intraclass correlation coefficient.ResultsA total of 58 urinary tract stones were detected by CT and 39 of these were detected by MRI. Most of the stones that MRI could not detect were < 5 mm and the detection sensitivity of MRI increased in correlation with stone size (p < 0.001). There was poor intermodality agreement for stones < 5 mm, substantial agreement for stones 5–10 mm, and almost perfect agreement for stones > 10 mm. Interobserver agreement for stone detection on MRI was almost perfect for stones > 10 mm and 5–10 mm and was substantial for stones < 5 mm.ConclusionZTE-MRI is a promising modality for detecting urinary stones without radiation exposure in children.Clinical relevance statementZero-echo time-magnetic resonance imaging is a potential method for identifying urinary stones in children and other populations who are particularly sensitive to radiation.Key PointsUrinary system stone disease in children is increasing and imaging is needed for managing urolithiasis.Zero-echo time-magnetic resonance imaging (ZTE-MRI) had an accuracy of 81.8% and 93.7% for stones larger than 5 mm and 10 mm, respectively.ZTE-MRI is a potential non-irradiating method for the diagnosis and management of urolithiasis.

A clinically-recommended MR whole lung imaging protocol using free-breathing 3D isotropic zero echo time sequence

Rationale and objectivesThis study aimed to assess the feasibility and image quality of free-breathing 3D isotropic zero echo time (ZTE) whole-lung imaging and explore a clinically appropriate protocol for MR lung imaging. Materials and methodsThe study was approved by the local ethics committee. A total of thirty healthy volunteers were enrolled in this study from October 2022 to May 2023. Free-breathing pulmonary 3D isotropic ZTE scans were implemented with various acquisition planes and the number of excitations (NEX). ZTE images were evaluated by two radiologists for the overall Image quality and visibility of intrapulmonary structures as well as the signal-to-noise ratio (SNR) of the lung parenchyma. ZTE images with different acquisition parameters were compared. For preliminary clinical visual assessment, three patients with interstitial lung disease underwent both ZTE imaging and computed tomography (CT). ResultsThe overall image quality of the lung in healthy subjects was good to excellent. The visibilities of pulmonary arteries and bronchus were up to the 7th and 5th generation, respectively. The display of lung fissures was poor. The overall image quality, the visibility of the pulmonary artery, and lung fissures in the axial acquisition were better than in the coronal acquisition (P = 0.011, 0.008, 0.010, respectively) but not statistically different from those in the sagittal acquisition (all P > 0.05). ConclusionThe free-breathing pulmonary ZTE is feasible and may serve as an alternative method in chest imaging. Either axial or sagittal ZTE image acquisition would be preferred in clinical practice.

Shoulder Bone Segmentation with DeepLab and U-Net.

Evaluation of 3D bone morphology of the glenohumeral joint is necessary for pre-surgical planning. Zero echo time (ZTE) magnetic resonance imaging (MRI) provides excellent bone contrast and can potentially be used in place of computed tomography. Segmentation of shoulder anatomy, particularly humeral head and acetabulum, is needed for detailed assessment of each anatomy and for pre-surgical preparation. In this study we compared performance of two popular deep learning models based on Google's DeepLab and U-Net to perform automated segmentation on ZTE MRI of human shoulders. Axial ZTE images of normal shoulders (n=31) acquired at 3-Tesla were annotated for training with a DeepLab and 2D U-Net, and the trained model was validated with testing data (n=13). While both models showed visually satisfactory results for segmenting the humeral bone, U-Net slightly over-estimated while DeepLab under-estimated the segmented area compared to the ground truth. Testing accuracy quantified by Dice score was significantly higher (p<0.05) for U-Net (88%) than DeepLab (81%) for the humeral segmentation. We have also implemented the U-Net model onto an MRI console for a push-button DL segmentation processing. Although this is an early work with limitations, our approach has the potential to improve shoulder MR evaluation hindered by manual post-processing and may provide clinical benefit for quickly visualizing bones of the glenohumeral joint.