Correlation between Hepatic Fat Content Using 3-Echo 3-D Dixon Method and Intravoxel Incoherent Motion (IVIM) Perfusion MR Imaging

Fat accumulates as droplets in the hepatocyte swelling, distortion of microcirculatory anatomy and compression of sinus. This study aims to investigate the correlation between the T2*-corrected fat fraction (FF) value acquired via gradient echo with a low flip angle and parenchymal pseudorandom blood perfusion (P _fraction), microcirculation (D _fast), and slow component of diffusion (D _slow), acquired via intravoxel incoherent motion (IVIM), and to investigate the blood microcirculation and diffusion components of liver parenchyma, according to fat deposition. A total of 126 patients underwent 3-T magnetic resonance imaging, including a 3-echo three-dimensional (3-D) gradient echo sequence with T2*-corrected Dixon reconstruction and IVIM sequence. Pearson’s correlation analysis was conducted to investigate the correlation of the FF obtained via the Dixon method with the apparent diffusion coefficient (ADC), D _slow, P _fraction, and D _fast obtained via IVIM. Correlation analysis was also conducted for the IVIM mapping images. A confidence level of p < 0.05 was set. A negative correlation was found between the T2*-corrected FF acquired using the 3-echo 3-D Dixon method and D _slow acquired via IVIM (r = ?0.181, p < 0.05). It was likely due to the increased extracellular collagen deposition and increased intracellular fat droplets during the progression of liver fibrosis.     

Noninvasive assessment of abdominal adipose tissues and quantification of hepatic and pancreatic fat fractions in type 2 diabetes mellitus

The purpose of this study was to evaluate adipose tissue distributions and hepatic and pancreatic fat contents using a 6-point Dixon MRI technique in type 2 diabetes mellitus (T2DM), and to assess associations between fat distributions and biochemical markers of insulin resistance. Intra-abdominal MRI was investigated in 14 T2DM patients, 13 age- and sex-matched healthy controls (HC) and 11 young HC using a 3 T Prisma MRI scanner. All T2DM subjects completed a fasting comprehensive metabolic panel, and demographic measurements were taken according to standardized methodologies. We observed excellent correlation (R² = 0.94) between hepatic fat fraction quantified using 6-point Dixon MRI and gold standard MRS, establishing the accuracy and reliability of the Dixon technique. Significantly increased visceral adipose tissue (VAT) volumes were found in T2DM patients compared to age-matched HC (1569.81 ± 670.62 cm³ vs. 1106.60 ± 566.85 cm³, p = .04). We also observed a trend of increasing subcutaneous adipose tissues (SAT), and total abdominal fat (TAT) volumes in T2DM compared to age-matched HC. Hepatic fat fraction percentage (HFF%) was 44.6% higher in T2DM compared to age-matched HC and 64.4% higher compared to young HC. Pancreatic fat fractions in the head and body/tail were higher in T2DM patients compared to both healthy cohorts. We also observed correlations between fat contents of the liver and pancreas in T2DM patients, and association between biochemical markers of T2DM with HFF, indicating a risk for non-alcoholic fatty liver disease among T2DM. In summary, this study provides evidence of T2DM patients having increased liver and pancreatic fat, as well as increased adipose tissues.     

Comparison between multi-echo T2* with and without fat saturation pulse for quantification of liver iron overload

Purpose

To test a magnetic resonance image (MRI) technique that uses an additional pulse in multi-echo T2* sequence that works to suppress the fat signal, in subjects with liver iron overload and concomitant presence of fat in the liver, which have been revealed as a major drawback that compromises the correct iron quantification by MRI.

Materials and Methods

Fifty magnetic resonance images of the liver (1.5 T scanner) of individuals with blood ferritin increases were retrospectively reviewed for the presence of steatosis, using the sequence in and out of phase, and iron overloading, using two sequences T2 * multi-echo: one standard and other with additional fat suppression pulse. T2 * values and their standard deviations were analyzed statistically.

Results

Our results showed that a significantly lower standard deviation of T2* values is obtained when the fat saturation pulse is applied in patients with steatosis. We found that modulation of fat signal on liver iron overload resulted in a different categorization of some patients. In one case, the patient was re-classified within normal levels of liver iron.

Conclusion

Our findings may contribute to a better measure of liver iron overload with relevant implications for patient treatment and care.     

Automated analysis of immediate reliability of T2 and T2* relaxation times of hip joint cartilage from 3 T MR examinations

BackgroundMagnetic resonance (MR) T2 and T2* mapping sequences allow in vivo quantification of biochemical characteristics within joint cartilage of relevance to clinical assessment of conditions such as hip osteoarthritis (OA).PurposeTo evaluate an automated immediate reliability analysis of T2 and T2* mapping from MR examinations of hip joint cartilage using a bone and cartilage segmentation pipeline based around focused shape modelling.Study typeTechnical validation.Subjects17 asymptomatic volunteers (M: F 7:10, aged 22–47 years, mass 50–90 kg, height 163-189 cm) underwent unilateral hip joint MR examinations. Automated analysis of cartilage T2 and T2* data immediate reliability was evaluated in 9 subjects (M: F 4: 5) for each sequence.Field strength/sequenceA 3 T MR system with a body matrix flex-coil was used to acquire images with the following sequences: T2 weighted 3D-trueFast Imaging with Steady-State Precession (water excitation; 10.18 ms repetition time (TR); 4.3 ms echo time (TE); Voxel Size (VS): 0.625 × 0.625 × 0.65 mm; 160 mm field of view (FOV); Flip Angle (FA): 30 degrees; Pixel Bandwidth (PB): 140 Hz/pixel); a multi-echo spin echo (MESE) T2 mapping sequence (TR/TE: 2080/18–90 ms (5 echoes); VS: 4 × 0.78 × 0.78 mm; FOV: 200 mm; FA: 180 degrees; PB: 230 Hz/pixel) and a MESE T2* mapping sequence (TR/TE: 873/3.82–19.1 ms (5 echoes); VS: 3 × 0.625 × 0.625 mm; FOV: 160 mm; FA: 25 degrees; PB: 250 Hz/pixel).AssessmentAutomated cartilage segmentation and quantitative analysis provided T2 and T2* data from test-retest MR examinations to assess immediate reliability.Statistical testsCoefficient of variation (CV) and intraclass correlations (ICC_{2, 1}) to analyse automated T2 and T2* mapping reliability focusing on the clinically important superior cartilage regions of the hip joint.ResultsComparisons between test-retest T2 and (T2*) data revealed mean CV's of 3.385% (1.25%), mean ICC_{2, 1}′s of 0.871 (0.984) and median mean differences of −1.139ms (+0.195ms).ConclusionThe T2 and T2* times from automated analyses of hip cartilage from test-retest MR examinations had high (T2) and excellent (T2*) immediate reliability.     

Effect of Gd-EOB-DTPA on hepatic fat quantification using high-speed T2-corrected multi-echo acquisition in H MR spectroscopy

Purpose

To determine whether gadolinium ethoxybenzyldiethylenetriaminepentaacetic acid (Gd-EOB-DTPA) administration affects hepatic fat quantification by magnetic resonance spectroscopy (MRS) using the fast breath-hold high-speed T2-corrected multiecho (HISTO) technique.

Materials and Methods

Seventy-six patients underwent Gd-EOB-DTPA-enhanced liver MR and 15 sec breath-hold HISTO MRS (4 times), twice before and twice after Gd-EOB-DTPA administration. Two consecutive MRSs were performed immediately before the dynamic study. Post-contrast MRS was performed twice continuously, approximately 15 min after contrast injection, prior to obtaining 20-min hepatobiliary phase images. We used paired t-test and intraclass correlation coefficient (ICC) to evaluate the variability of the mean fat fraction (FF) on pre-contrast MRS and post-contrast MRS and the effect of the contrast agent on the mean FF.

Results

The mean FFs were not significantly different between pre-contrast MRS and post-contrast MRS (6.50% ± 6.54 versus 6.70% ± 6.61, P = 0.15). The ICC of FF calculation between pre- and post-contrast MRS was 0.984. The ICCs for the FF magnitude between pre- and post-contrast MRS were 0.452, 0.771, and 0.995 for FF < 5%, FF 5–10%, and FF ≥ 10%, respectively.

Conclusion

Gd-EOB-DTPA does not appear to influence hepatic fat quantification, especially for patients with hepatic steatosis.     

Effect of hepatic steatosis on native T1 mapping of 3T magnetic resonance imaging in the assessment of T1 values for patients with non-alcoholic fatty liver disease

PurposeThis study investigated whether T1 values in native T1 mapping of 3T magnetic resonance imaging (MRI) of the liver were affected by the fatty component.MethodsThis prospective study involved 340 participants from a population-based cohort study between May 8, 2018 and August 8, 2019. Data obtained included: (1) hepatic stiffness according to magnetic resonance elastography (MRE); (2) T1 value according to T1 mapping; (3) fat fraction and iron concentration from multi-echo Dixon; and (4) clinical indices of hepatic steatosis including body mass index, waist circumference, history of diabetes, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transpeptidase, and triglycerides. The correlations between T1 value and fat fraction, and between T1 value and liver stiffness were assessed using Pearson's correlation coefficient. The independent two-sample t-test was used to evaluate the differences in T1 values according to the presence or absence of hepatic steatosis, and the one-way analysis of variance was used to evaluate the difference in T1 value by grading of hepatic steatosis according to MRI-based proton density fat fraction (PDFF). In addition, univariate and multivariate linear regression analyses were performed to determine whether other variables influenced the T1 value.ResultsT1 value showed a positive correlation with the fat fraction obtained from PDFF (r = 0.615, P < 0.001) and with the liver stiffness obtained from MRE (r = 0.370, P < 0.001). Regardless of the evaluation method, the T1 value was significantly increased in subjects with hepatic steatosis (P < 0.001). When comparing hepatic steatosis grades based on MRI-PDFF, the mean T1 values were significantly different in all grades, and the T1 value tended to increase as the grade increased (P < 0.001, P for trend <0.001). On multiple linear regression analysis, the T1 value was influenced by MRI-PDFF, calculated liver iron concentration, liver stiffness, and serum aspartate aminotransferase level.ConclusionThe T1 value obtained by current T1 mapping of 3T MRI was affected by the liver fat component and several other factors such as liver stiffness, iron concentration, and inflammation.     

Quantitative Dixon MRI sequences to relate muscle atrophy and fatty degeneration with range of motion and muscle force in brachial plexus injury

BackgroundAssessment of muscle atrophy and fatty degeneration in brachial plexus injury (BPI) could yield valuable insight into pathophysiology and could be used to predict clinical outcome. The objective of this study was to quantify and relate fat percentage and cross-sectional area (CSA) of the biceps to range of motion and muscle force of traumatic brachial plexus injury (BPI) patients.MethodsT1-weighted TSE sequence and three-point Dixon images of the affected and non-affected biceps brachii were acquired on a 3 Tesla magnetic resonance scanner to determine the fat percentage, total and contractile CSA of 20 adult BPI patients. Regions of interest were drawn by two independent investigators to determine the inter-observer reliability. Paired Students' t-test and multivariate analysis were used to relate fat percentage, total and contractile CSA to active flexion and biceps muscle force.ResultsThe mean fat percentage 12 ± 5.1% of affected biceps was higher than 6 ± 1.0% of the non-affected biceps (p < 0.001). The mean contractile CSA 8.1 ± 5.1 cm² of the affected biceps was lower than 19.4 ± 4.9 cm² of the non-affected biceps (p < 0.001). The inter-observer reliability was excellent (ICC 0.82 to 0.96). The contractile CSA contributed most to the reduction in active flexion and muscle force.ConclusionQuantitative measurement of fat percentage, total and contractile CSA using three-point Dixon sequences provides an excellent reliability and relates with active flexion and muscle force in BPI.     

Improved nerve conspicuity with water-weighting and denoising in two-point Dixon magnetic resonance neurography

BackgroundT₂-weighted, two-point Dixon fast-spin-echo (FSE) is an effective technique for magnetic resonance neurography (MRN) that can provide quantitative assessment of muscle denervation. Low signal-to-noise ratio and inadequate fat suppression, however, can impede accurate interpretation.PurposeTo quantify effects of principal component analysis (PCA) denoising on tissue signal intensities and fat fraction (FF) and to determine qualitative image quality improvements from both denoising and water-weighting (WW) algorithms to improve nerve conspicuity and fat suppression.Study typeProspective.SubjectsTwenty-one subjects undergoing MR neurography evaluation (11/10 male/female, mean age = 46.3±13.7 years) with 60 image volumes. Twelve subjects (23 image volumes) were determined to have muscle denervation based on diffusely elevated T₂ signal intensity.Field strength/sequence3 T, 2D, two-point Dixon FSE.AssessmentQualitative assessment included overall image quality, nerve conspicuity, fat suppression, pulsation and ringing artifacts by 3 radiologists separately on a three-point scale (1 = poor, 2 = average, 3 = excellent). Quantitative measurements for FF and signal intensity relative to normal muscle were made for nerve, abnormal muscle and subcutaneous fat.Statistical testsLinear and ordinal regression models were used for quantitative and qualitative comparisons, respectively; 95% confidence intervals (CIs) and p-values for pairwise comparisons were adjusted using the Holm-Bonferroni method. Inter-rater agreement was assessed using Gwet's agreement coefficient (AC₂).ResultsSimulations showed PCA-denoising reduced FF error from 2.0% to 1.0%, and from 7.6% to 3.1% at noise levels of 10% and 30%, respectively. In human subjects, PCA-denoising did not change signal levels and FF quantitatively. WW decreased fat signal significantly (−83.6%, p < 0.001). Nerve conspicuity was improved by WW (odds ratio, OR = 5.8, p < 0.001). Fat suppression was improved by both PCA (OR = 3.6, p < 0.001) and WW (OR = 2.2, p < 0.001). Overall image quality was improved by PCA + WW (OR = 1.7, p = 0.04).ConclusionsWW and PCA-denoising improved nerve conspicuity and fat suppression in MR neurography. Denoising can potentially provide improved accuracy of FF maps for assessing fat-infiltrated muscle.     

Black-blood T2* mapping with delay alternating with nutation for tailored excitation

PurposeTo develop a black-blood T2* mapping method using a Delay Alternating with Nutation for Tailored Excitation (DANTE) preparation combined with a multi-echo gradient echo (GRE) readout (DANTE-GRE).Materials and methodsSimulations of the Bloch equation for DANTE-GRE were performed to optimize sequence parameters. After optimization, the sequence was applied to a phantom scan and to neck and lower extremity scans conducted on 12 volunteers at 3 T using DANTE-GRE, Motion-Sensitized Driven Equilibrium (MSDE)-GRE, and multi-echo GRE. T2* values were measured using an offset model. Statistical analyses were conducted to compare the T2* values between the three sequences.ResultsSimulation results showed that blood suppression can be achieved with various DANTE parameter adjustments. T2* maps acquired by DANTE-GRE were consistent and comparable to those acquired with multi-echo GRE in phantom experiments. In the in vivo experiments, DANTE-GRE was more comparable to multi-echo GRE than MSDE-GRE regarding the measurement of muscle T2* values.ConclusionDue to its high signal intensity retention and effective blood signal suppression, DANTE-GRE allows for robust and accurate T2* quantification, superior to that of MSDE-GRE, while overcoming blood flow artifacts associated with traditional multi-echo GRE.     

The use of T2*-weighted multi-echo GRE imaging as a novel method to diagnose hepatocellular carcinoma compared with gadolinium-enhanced MRI: a feasibility study

Background

The goal of the study was to assess a T2*-weighted MRI sequence for the ability to identify hepatocellular carcinoma (HCC).

Methods

Hepatic iron deposition, which is common in chronic liver disease (CLD), may increase the conspicuity of HCC on GRE imaging due to increased T2* signal decay in liver parenchyma. In this study, a breath-hold T2*-weighted MRI sequence was evaluated by a blinded observer for HCC and the results compared to a reference standard of gadolinium-enhanced MRI in these same patients. Forty-one patients (mean age 56.2 years; 17 females) were included in this approved, retrospective study.

Results

By the reference standard, 14 of 41 patients had a total of 25 HCCs. The sensitivity of the T2*-weighted MR sequence for identifying HCC, per lesion, was 60%, while the specificity was 100%. There was a significantly lower T2* value of liver parenchyma in patients with HCC identified by the T2*-weighted sequence than in those with HCCs which were not identified by the T2*-weighted sequence (27.8±2.2 vs. 21.9±2.1 ms; P=.02).

Conclusions

A T2*-weighted MRI sequence can identify HCC in patients with CLD. This technique may be beneficial for imaging of patients contraindicated for gadolinium.     

Evaluation of MRI fat fraction in the liver and spine pre and post SPIO infusion

This study evaluates the robustness of a magnetic resonance (MR) fat quantification method to changes in R2* caused by an intravenous infusion of superparamagnetic iron oxide (SPIO) contrast agent. The R2* and proton density fat fraction (PDFF) were measured in liver and spine in 14 subjects using an investigational sequence (IDEAL IQ) provided by the MR scanner vendor. Measurements were made before and after SPIO infusion. Results showed SPIO significantly increased R2* in both liver (p = 8.8 × 10^− 8) and spine (p =1.3 × 10^− 2) but PDFFs were not significantly different in either the liver (p = 5.5 × 10^− 1) or the spine (p = 5.6 × 10^− 1). These results confirm that the IDEAL IQ method of fat quantification is robust to changes in R2*.     

Detection of fatty acid composition of trabecular bone marrow by localized iDQC MRS at 3 T: A pilot study in healthy volunteers

BackgroundAlthough a growing body of research shows that the bone marrow adipose tissue (BMAT) may play an essential role in bone inflammation and energy metabolism, available noninvasive methods for distinguishing different fatty acids in BMAT are still limited, in spite of their potential to provide novel biomarkers for bone related diseases.PurposeTo assess the ability of a localized intermolecular double quantum coherence (iDQC) spectroscopy sequence to resolve more fatty acid peaks than conventional MR spectroscopy (MRS), like polyunsaturated fatty acids (PUFA), from the human BMAT in the presence of trabecular bone; To preliminarily investigate whether the fatty acids composition is different between different regions and groups.ResultsCompared with conventional MRS results, additional four fatty acids peaks were well resolved using the proposed method in human BMAT in the presence of trabecular bone. In addition, a different fat composition was found between distal femur and proximal tibia: fat was more unsaturated (vinyl, *p < 0.01; diallylic, *p < 0.01) in distal femur bone marrow than in proximal tibia, and this higher unsaturation level was caused by PUFA (r = 0.67, diallylic, *p < 0.01). No significant difference in fatty acid composition were found either between left and right legs, or between female and male in the healthy young subjects studied.ConclusionThis study demonstrated that the unsaturated fatty acids information of human BMAT in the presence of trabecular bone can be clearly identified with the localized iDQC at 3 T. The resolved peaks, especially PUFA, may serve as additional diagnostic biomarkers for BMAT related diseases in the future.     

Fast triple-spin-echo Dixon (FTSED) sequence for water and fat imaging

A number of ‘Dixon’ techniques based on fast spin echo (FSE) sequence have been proposed and successfully used in many branches of medicine. Some require only one scan, but most of them need multiple scans and long scan times. This article describes a new fast triple-spin-echo Dixon (FTSED) technique suitable for ultra-high field MRI, in which three specific time shifts are introduced in the echo train; thus, three images with defined water-fat phase-differences (0, π, 2π) are encoded in the phase of the acquired images without extreme restrictions upon the echo duration. The water and fat images are then calculated by iterative least-squares estimation method. The sequence was successfully implemented at a 9.4 T ultra-high field MRI system and tested on a phantom and a rat.     

Automated measurement of fat infiltration in the hip abductors from Dixon magnetic resonance imaging

PurposeIntramuscular fat infiltration is a dynamic process, in response to exercise and muscle health, which can be quantified by estimating fat fraction (FF) from Dixon MRI. Healthy hip abductor muscles are a good indicator of a healthy hip and an active lifestyle as they have a fundamental role in walking. The automated measurement of the abductors' FF requires the challenging task of segmenting them. We aimed to design, develop and evaluate a multi-atlas based method for automated measurement of fat fraction in the main hip abductor muscles: gluteus maximus (GMAX), gluteus medius (GMED), gluteus minimus (GMIN) and tensor fasciae latae (TFL).MethodWe collected and manually segmented Dixon MR images of 10 healthy individuals and 7 patients who underwent MRI for hip problems. Twelve of them were selected to build an atlas library used to implement the automated multi-atlas segmentation method. We compared the FF in the hip abductor muscles for the automated and manual segmentations for both healthy and patients groups. Measures of average and spread were reported for FF for both methods. We used the root mean square error (RMSE) to quantify the method accuracy. A linear regression model was used to explain the relationship between FF for automated and manual segmentations.ResultsThe automated median (IQR) FF was 20.0(16.0–26.4) %, 14.3(10.9–16.5) %, 15.5(13.9–18.6) % and 16.2(13.5–25.6) % for GMAX, GMED, GMIN and TFL respectively, with a FF RMSE of 1.6%, 0.8%, 2.1%, 2.7%. A strong linear correlation (R² = 0.93, p < .001, m = 0.99) was found between the FF from automated and manual segmentations. The mean FF was higher in patients than in healthy subjects.ConclusionThe automated measurement of FF of hip abductor muscles from Dixon MRI had good agreement with FF measurements from manually segmented images. The method was accurate for both healthy and patients groups.     

Breath-held MR Cholangiopancreatography (MRCP) using a 3D Dixon fat–water separated balanced steady state free precession sequence

A novel 3D breath-held Dixon fat–water separated balanced steady state free precession (b-SSFP) sequence for MR cholangiopancreatography (MRCP) is described and its potential clinical utility assessed in a series of patients. The main motivation is to develop a robust breath-held alternative to the respiratory gated 3D Fast Spin Echo (FSE) sequence, the current clinical sequence of choice for MRCP. Respiratory gated acquisitions are susceptible to motion artifacts and blurring in patients with significant diaphragmatic drift, erratic respiratory rhythms or sleep apnea. A two point Dixon fat–water separation scheme was developed which eliminates signal loss arising from B₀ inhomogeneity effects and minimizes artifacts from perturbation of the b-SSFP steady state. Preliminary results from qualitative analysis of 49 patients demonstrate robust performance of the 3D Dixon b-SSFP sequence with diagnostic image quality acquired in a 20–24 s breath-hold.     

Assessment of liver fat quantification in the presence of iron

This study assesses the stability of magnetic resonance liver fat measurements against changes in T2* due to the presence of iron, which is a confound for accurate quantification. The liver T2* was experimentally shortened by intravenous infusion of a super paramagnetic iron oxide contrast agent. Low flip angle multiecho gradient echo sequences were performed before, during and after infusion. The liver fat fraction (FF) was calculated in co-localized regions-of-interest using T2* models that assumed no decay, monoexponential decay and biexponential decay. Results show that, when T2* was neglected, there was a strong underestimation of FF and with monoexponential decay there was a weak overestimation of FF. Curve-fitting using the biexponential decay was found to be problematic. The overestimation of FF may be due to remaining deficiencies in the model, although is unlikely to be important for clinical diagnosis of steatosis.     

Measurement of in vivo multi-component T2 relaxation times for brain tissue using multi-slice T2 prep at 1.5 and 3 T

The objective of this study was to implement a clinically relevant multi-slice multi-echo imaging sequence in order to quantify multi-component T2 relaxation times for normal volunteers at both 1.5 and 3 T. Multi-echo data were fitted using a nonnegative least square algorithm. Twelve echo data with nonlinear echo sampling were acquired using a receive-only eight-channel phased array coil and volume head coil for phantoms and normal volunteers, and compared to 32-echo data with linear echo sampling. It was observed that the performance of the 180 degrees refocusing trains was more spatially uniform for the receive-only eight-channel phased array coil than for the head coil, particularly at 3 T. The phantom study showed that the estimated T2 relaxation times were accurate and reproducible for both single- and multi-slice acquisition from a commercial phantom with known T2 relaxation times. Short T2 components (T2 <50 ms) were mainly observed within the white matter for normal volunteers, and the fraction of short T2 water components (i.e., myelin water) was 7-12% of total water. It was observed that the calculated myelin water fraction map from the nonlinearly sampled 12-echo data was comparable with that from the linearly sampled 32-echo data. Quantification of T2 relaxation times from multi-slice images was accomplished with a clinically acceptable scan times (16 min) for normal volunteers by using a nonselective T2 prep imaging sequence. The use of the eight-channel head coil involved more accurate quantification of T2 relaxation times particularly when the number of echoes was limited.     

Validation of an adapted MRI pulse sequence for quantification of fatty infiltration in muscle

Purpose

The long-term goal of our research is to develop a patient-specific biomechanical model of the supraspinatus muscle and tendon for analyzing the effects of fatty infiltration and pennation angle changes. One input of the model will be the amount and distribution of fat within the muscle. Therefore, the objective of this project was to adapt and validate a novel magnetic resonance imaging pulse sequence for quantifying the extent of fatty infiltration for the supraspinatus muscle.

Methods

Samples of incremental combinations of muscle and fat from a cow were prepared and scanned with our quantitative MR technique. The MR results were compared to actual fat measurements taken using a Soxtec extraction analyzer.

Results

The MR fat quantification results closely match those values determined by Soxtec analysis (R²=.98, root mean square deviation=4.9).

Conclusions

Our MR fat quantification protocol can be used to accurately quantify fatty infiltration in skeletal muscle. This ability to evaluate skeletal muscle tissue noninvasively will improve the efficacy of evaluation of fatty degeneration in assessing tissue quality preoperatively. This can be important in surgical planning of any musculoskeletal repairs, particularly rotator cuff tears.     

Combined modified-Dixon and PROPELLER method with low refocusing flip angle for contrast-enhanced fat-suppressed T1-weighted MRI: A prospective cross-sectional study

PurposeTo propose the combined modified-Dixon and PROPELLER sequence with low refocusing flip angle (RFA) and investigate whether this sequence can acquire clinical contrast-enhanced (CE), fat-suppressed T1-weighted (T1W) images of the head and neck.MethodsThe optimal RFA for T1W imaging was investigated in the brain of a healthy volunteer. The motion artifacts, water–fat separation error, contrast ratio (CR), and comprehensive quality were evaluated through comparison with a standard Cartesian modified-Dixon sequence in 50 patients. Two radiologists independently scored motion artifacts and water–fat separation error using a 4-point scale (1, unacceptable; 4, excellent) and comprehensive quality using a 5-point scale (1, substantially inferior; 5, substantially superior). The CR between CE lesions and non-CE muscle was calculated.ResultsThe optimal RFA of 40° was determined. In the motion artifact assessment, ratings of 3 or 4 points were assigned to 83% (observer-1, 42/50; observer-2, 41/50) and 99% (50/50; 49/50) of cases for the standard and proposed sequences, respectively (p < 0.001; p < 0.001). For the water–fat separation error assessment, ratings of 3 or 4 points were assigned to 100% (50/50; 50/50) and 97% (48/50; 49/50) of cases, respectively (p < 0.001; p = 0.02). In comprehensive evaluation, the proposed sequence was equal, slightly superior, or substantially superior to the standard sequence in 85% (39/50; 46/50). The CR was significantly higher with the proposed sequence [2.27 (1.99–2.97) vs. 2.08 (1.88–2.42), p < 0.001].ConclusionThe proposed sequence acquired stable fat-suppressed CE T1W images without motion artifacts and yielded superior overall image quality compared with the standard sequence.     

Quantitative MR imaging of targeted SPIO particles on the cell surface and comparison to flow cytometry

Purpose

To detect anti-CEACAM5 targeted superparamagnetic iron oxide (SPIO) particles in vitro on the cell surface by quantitative magnetic resonance (MR) imaging and to compare with flow cytometry.

Materials and Methods

The monoclonal mouse antibody T84.1 and an appropriate IgG isotype antibody were conjugated to dextran-coated SPIO particles. HT29 cells expressing carcinoembryonic antigen (CEACAM5) were treated with antibody-conjugated SPIO particles. Purified cell samples were examined on a 3.0-T MR scanner using a multi-echo spin-echo sequence for MR relaxometry. Aliquots of the cell samples were further treated with a fluorescein isothiocyanate (FITC) anti-dextran antibody and an Alexa Fluor 488 anti-mouse antibody for the corresponding flow cytometry.

Results

MR relaxometry revealed a dose-dependent binding of T84.1-conjugated SPIO particles with a positive correlation between R₂ relaxation rate of cell samples and SPIO particle concentration during incubation (r=0.993, P<.01). Positive correlations were also observed between R₂ relaxation rate and flow cytometry (geometric mean) with both fluorescent antibodies (r=0.972 and r=0.953, both P<.01), respectively.

Conclusion

The study revealed the feasibility of quantitative MR imaging of targeted SPIO particles on the cell surface comparable to flow cytometry.