3D sensitivity encoded ellipsoidal MR spectroscopic imaging of gliomas at 3T

Purpose

The goal of this study was to implement time efficient data acquisition and reconstruction methods for 3D magnetic resonance spectroscopic imaging (MRSI) of gliomas at a field strength of 3T using parallel imaging techniques.

Methods

The point spread functions, signal to noise ratio (SNR), spatial resolution, metabolite intensity distributions and Cho:NAA ratio of 3D ellipsoidal, 3D sensitivity encoding (SENSE) and 3D combined ellipsoidal and SENSE (e-SENSE) k-space sampling schemes were compared with conventional k-space data acquisition methods.

Results

The 3D SENSE and e-SENSE methods resulted in similar spectral patterns as the conventional MRSI methods. The Cho:NAA ratios were highly correlated (P<.05 for SENSE and P<.001 for e-SENSE) with the ellipsoidal method and all methods exhibited significantly different spectral patterns in tumor regions compared to normal appearing white matter. The geometry factors ranged between 1.2 and 1.3 for both the SENSE and e-SENSE spectra. When corrected for these factors and for differences in data acquisition times, the empirical SNRs were similar to values expected based upon theoretical grounds. The effective spatial resolution of the SENSE spectra was estimated to be same as the corresponding fully sampled k-space data, while the spectra acquired with ellipsoidal and e-SENSE k-space samplings were estimated to have a 2.36–2.47-fold loss in spatial resolution due to the differences in their point spread functions.

Conclusion

The 3D SENSE method retained the same spatial resolution as full k-space sampling but with a 4-fold reduction in scan time and an acquisition time of 9.28 min. The 3D e-SENSE method had a similar spatial resolution as the corresponding ellipsoidal sampling with a scan time of 4:36 min. Both parallel imaging methods provided clinically interpretable spectra with volumetric coverage and adequate SNR for evaluating Cho, Cr and NAA.     

Time-resolved and high-resolution MRA in a rabbit model of pulmonary embolism at 7 T: preliminary results

Purpose

Evaluate feasibility of using time-resolved and high-resolution, contrast-enhanced magnetic resonance angiography (MRA) at 7 T for characterization of an animal model of pulmonary embolism.

Methods

MRAs were performed in five rabbits using a 7-T MR scanner. Preceding the MR studies, each rabbit underwent a pulmonary artery catheterization with balloon placement. Two doses of gadodiamide were injected: first during a time-resolved MRA, immediately followed by a high-resolution acquisition. Balloon was then deflated, permitting reperfusion for 5 min. A second dose was then injected and another high-resolution MRA acquired. Measurements of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and vessel cross-sections down to fourth-order branches were made, among other parameters.

Results

Occlusion was detected in all rabbits. Despite a TE of 0.58 ms for the time-resolved MRA, regions of nonuniform enhancement attributed to susceptibility effects at the 7-T field were observed in perfused lung. Mean SNR=7.5±3.3 and 134.2±46.5 for the lung and aorta, respectively, and mean CNR=126.7±46.4 for aorta versus lung were obtained. Diameters of vessels in lung that was never occluded were not statistically different from those in reperfused lung.

Conclusion

Results show that time-resolved and high-resolution MRA of the lung are feasible at 7 T and provide high SNR, CNR and resolution, but TEs smaller than 0.58 ms are required to avoid susceptibility artifacts in time-resolved MRAs.     

Dynamic magnetic resonance imaging of swallowing and laryngeal motion using parallel imaging at 3 T

Object

To evaluate the feasibility of an optimized MRI protocol based on high field imaging at 3 T in combination with accelerated data acquisition by parallel imaging for the analysis of oropharyngeal and laryngeal function.

Materials and Methods

Fast 2D gradient echo (GRE) MRI with different spatial resolutions (1.7×2.7 and 1.1×1.5 mm²) and image update rates (4 and 10 frames per second) was employed to assess pharyngeal movements and visualize swallowing via tracking of an oral contrast bolus (blueberry juice). In a study with 10 normal volunteers, image quality was semi-quantitatively graded by three independent observers with respect to the delineation of anatomical detail and depiction of oropharynx and larynx function. Additionally, the feasibility of the technique for the visualization of pathological pre- and post-surgical oropharynx and larynx function was evaluated in a patient with inspiratory stridor.

Results

Image grading demonstrated the feasibility of dynamic MRI for the assessment of normal oropharynx and larynx anatomy and function. Superior image quality (P<.05) was found for data acquisition with four frames per second and higher spatial resolution. In the patient, dynamic MRI detected pathological hypermobility of the epiglottis resulting in airway obstruction. Additional post-surgical MRI for one clinical case revealed morphological changes of the epiglottis and improved function, i.e., absence of airway obstruction and normal swallowing.

Conclusion

Results of the volunteer study demonstrated the feasibility of dynamic MRI at 3 T for the visualization of the oropharynx and larynx function during breathing, movements of the tongue and swallowing. Future studies are necessary to evaluate its clinical value compared to existing modalities based on endoscopy or radiographic techniques.     

3D high-resolution contrast enhanced MRI of carotid atheroma — a technical update

Objective

Development of a fast 3D high-resolution magnetic resonance imaging (MRI) protocol for improved carotid artery plaque imaging.

Methods

Two patients with carotid atherosclerosis disease underwent 3D high-resolution MRI which included time-of-flight and T₁-weighted variable flip angle, fast-spin-echo (FSE) imaging, pre- and post-intravenous gadolinium-based contrast agent administration.

Results

Good quality images with intrinsic blood suppression were obtained pre- and post-contrast administration using a 3D FSE sequence. The plaque burden, lipid core volume, hemorrhage volume and fibrous cap thickness were well determined.

Conclusions

3D high-resolution MR imaging of carotid plaque using TOF and 3D FSE can achieve high isotropic resolution, large coverage, and excellent image quality within a short acquisition time.     

Highly accelerated aortic 4D flow MR imaging with variable-density random undersampling

Purpose

To investigate an effective time-resolved variable-density random undersampling scheme combined with an efficient parallel image reconstruction method for highly accelerated aortic 4D flow MR imaging with high reconstruction accuracy.

Materials and Methods

Variable-density Poisson-disk sampling (vPDS) was applied in both the phase-slice encoding plane and the temporal domain to accelerate the time-resolved 3D Cartesian acquisition of flow imaging. In order to generate an improved initial solution for the iterative self-consistent parallel imaging method (SPIRiT), a sample-selective view sharing reconstruction for time-resolved random undersampling (STIRRUP) was introduced. The performance of different undersampling and image reconstruction schemes were evaluated by retrospectively applying those to fully sampled data sets obtained from three healthy subjects and a flow phantom.

Results

Undersampling pattern based on the combination of time-resolved vPDS, the temporal sharing scheme STIRRUP, and parallel imaging SPIRiT, were able to achieve 6-fold accelerated 4D flow MRI with high accuracy using a small number of coils (N = 5). The normalized root mean square error between aorta flow waveforms obtained with the acceleration method and the fully sampled data in three healthy subjects was 0.04 ± 0.02, and the difference in peak-systolic mean velocity was − 0.29 ± 2.56 cm/s.

Conclusion

Qualitative and quantitative evaluation of our preliminary results demonstrate that time-resolved variable-density random sampling is efficient for highly accelerating 4D flow imaging while maintaining image reconstruction accuracy.     

Accelerated passive MR catheter tracking into the carotid artery of canines

Background

Using magnetic resonance (MR) imaging for navigating catheters has several advantages when compared with the current “gold standard” modality of X-ray imaging. A significant drawback to interventional MR is inferior temporal and spatial resolutions, as high spatial resolution images cannot be collected and displayed at rates equal to X-ray imaging. In particular, passive MR catheter tracking experiments that use positive contrast mechanisms have poor temporal imaging rates and signal-to-noise ratio. As a result, with passive methods, it is often difficult to reconstruct motion artifact-free tracking images from areas with motion, such as the thoracic cavity.

Methods

In this study, several accelerated MR acquisition strategies, including parallel imaging and compressed sensing (CS), were evaluated to determine which method is most effective at improving the frame rate and passive detection of catheters in regions of physiological motion. Device navigation was performed both in vitro, through the aortic arch of an anthropomorphic chest phantom, and in vivo from the femoral artery, up the descending aorta into the supra-aortic branching vessels in canines.

Results and Discussion

The different parallel imaging methods produced images of low quality. CS with a two-fold acceleration was found to be the most effective method for generating tracking images, improving the image frame rate to 5.2 Hz, while maintaining a relatively high in-plane resolution. Using CS, motion artifact was decreased and the catheters were visualized with good conspicuity near the heart.

Conclusions

The improvement in the imaging frame rate by image acceleration was sufficient to overcome motion artifacts and to better visualize catheters in the thoracic cavity with passive tracking. CS preformed best at tracking. Navigation with passive MR catheter tracking was demonstrated from the femoral artery to the carotid artery in canines.     

Detection of focal liver lesions in unenhanced and ferucarbotran-enhanced magnetic resonance imaging: a comparison of T2-weighted breath-hold and respiratory-triggered sequences

Purpose

To investigate the image quality and detection rate of focal liver lesions by comparing a T2-weighted breath-hold single-shot sequence and a T2-weighted high spatial resolution fast spin-echo sequence with respiratory triggering via unenhanced and superparamagnetic iron oxide (SPIO)-enhanced liver imaging.

Materials and Methods

The study was approved by the local ethical review board; informed consent was waived. Liver-lesion contrast was measured and a qualitative consensus evaluation of image quality and lesion detection was performed in 42 consecutive patients using a 1.5-T MR system.

Results

The liver-lesion contrast was significantly higher (P<.05) for the respiratory-triggered sequence compared to the breath-hold sequence regarding unenhanced and SPIO-enhanced imaging. The respiratory-triggered sequences revealed significantly higher image quality scores as well as higher numbers of detected liver lesions compared to the breath-hold sequence on unenhanced and SPIO-enhanced imaging. The SPIO contrast did not significantly improve the number of detected lesions on the respective sequences (P>.05).

Conclusion

We find that respiratory-triggered fast spin-echo sequences produce a higher image quality and a more precise liver-lesion detection rate thereby justifying the increased acquisition time necessary for this method.     

Fast volumetric spatial-spectral MR imaging of hyperpolarized C-labeled compounds using multiple echo 3D bSSFP

Purpose

The goal of this work was to develop a fast 3D chemical shift imaging technique for the noninvasive measurement of hyperpolarized ¹³C-labeled substrates and metabolic products at low concentration.

Materials and Methods

Multiple echo 3D balanced steady state magnetic resonance imaging (ME-3DbSSFP) was performed in vitro on a syringe containing hyperpolarized [1,3,3-2H3; 1-¹³C]2-hydroxyethylpropionate (HEP) adjacent to a ¹³C-enriched acetate phantom, and in vivo on a rat before and after intravenous injection of hyperpolarized HEP at 1.5 T. Chemical shift images of the hyperpolarized HEP were derived from the multiple echo data by Fourier transformation along the echoes on a voxel by voxel basis for each slice of the 3D data set.

Results

ME-3DbSSFP imaging was able to provide chemical shift images of hyperpolarized HEP in vitro, and in a rat with isotropic 7-mm spatial resolution, 93 Hz spectral resolution and 16-s temporal resolution for a period greater than 45 s.

Conclusion

Multiple echo 3D bSSFP imaging can provide chemical shift images of hyperpolarized ¹³C-labeled compounds in vivo with relatively high spatial resolution and moderate spectral resolution. The increased signal-to-noise ratio of this 3D technique will enable the detection of hyperpolarized ¹³C-labeled metabolites at lower concentrations as compared to a 2D technique.     

Intracranial microvascular imaging at 7 T MRI with transceiver RF coils

Purpose

To investigate intracranial microvascular images with transceiver radio-frequency (RF) coils at ultra-high field 7 T magnetic resonance imaging (MRI).

Materials and methods

We designed several types of RF coils for the study of 7 T magnetic resonance angiography and analyzed quantitatively each coil's performance in terms of the signal-to-noise ratio (SNR) profiles to evaluate the usefulness of RF coils for microvascular imaging applications. We also obtained the microvascular images with different resolutions and parallel imaging technique.

Results

The overlapped 6-channel (ch) transceiver coil exhibited the highest performance for angiographic imaging. Although other multi-channel coils, such as 4- or 8-ch, were also suitable for fast imaging, these coils performed poorly in homogeneity or SNR for angiographic imaging. Furthermore, the 8-ch coil was poor in SNR at the center of the brain, while it had the highest SNR at the periphery.

Conclusion

The present study has demonstrated that the overlapped 6-ch coil with large-size loop coils provided the best performance for microvascular imaging or angiography with the ultra-high-field 7 T MRI, mainly because of its long penetration depth together with high SNR.     

Intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist: comparison of isovolumetric 3D-THRIVE sequence MR arthrography and conventional MR image at 3 T

Purpose

The purpose of the study was to validate the diagnostic performance of high-resolution isovolumetric magnetic resonance arthrography (MRA) for intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist as compared to conventional MR imaging (MRI).

Materials and methods

Forty-eight patients with traumatic TFCC tears at arthroscopy were enrolled. All patients had underwent proton-density- and T2-weighted MRI before arthrography and three-dimensional T1 high-resolution isovolumetric examination (3D-THRIVE) MRA on a 3-T MR. We assessed the presence of scapholunate interosseous ligament (SLIL)/lunotriquetral interosseous ligament (LTIL) or TFCC tears using the arthroscopy as a gold standard.

Results

Arthroscopy revealed 37 TFCC central tears, 15 TFCC peripheral tears, 20 SLIL tears and 13 LTIL tears. Sensitivities of MRI and MRA were 70.3% and 94.6% for detection of TFCC central tears, 60.0% and 93.3% for detection of TFCC peripheral tears, 65.0% and 85.0% for SLIL tears, and 61.5% and 84.6% for LTIL tears. The specificity of the MRI was 100% for the detection of ligaments and TFCC tears. The specificities of the MRA for detection of TFCC central tears, TFCC peripheral tears, SLIL tears and LTIL tears were 100%, 97%, 96.4% and 100%, respectively.

Conclusion

Isovolumetric 3D-THRIVE wrist MRA provided better results for depiction of intrinsic ligament and TFCC tears than wrist MRI.     

Optimal techniques for magnetic resonance imaging of the liver using a respiratory navigator-gated three-dimensional spoiled gradient-recalled echo sequence

Purpose

To optimize the navigator-gating technique for the acquisition of high-quality three-dimensional spoiled gradient-recalled echo (3D SPGR) images of the liver during free breathing.

Materials and methods

Ten healthy volunteers underwent 3D SPGR magnetic resonance imaging of the liver using a conventional navigator-gated 3D SPGR (cNAV-3D-SPGR) sequence or an enhanced navigator-gated 3D SPGR (eNAV-3D-SPGR) sequence. No exogenous contrast agent was used. A 20-ms wait period was inserted between the 3D SPGR acquisition component and navigator component of the eNAV-3D-SPGR sequence to allow T1 recovery. Visual evaluation and calculation of the signal-to-noise ratio were performed to compare image quality between the imaging techniques.

Result

The eNAV-3D-SPGR sequence provided better noise properties than the cNAV-3D-SPGR sequence visually and quantitatively. Navigator gating with an acceptance window of 2 mm effectively inhibited respiratory motion artifacts. The widening of the window to 6 mm shortened the acquisition time but increased motion artifacts, resulting in degradation of overall image quality. Neither slice tracking nor incorporation of short breath holding successfully compensated for the widening of the window.

Conclusion

The eNAV-3D-SPGR sequence with an acceptance window of 2 mm provides high-quality 3D SPGR images of the liver.     

Phase contrast and time-of-flight magnetic resonance angiography of the intracerebral arteries at 1.5, 3 and 7 T

Purpose

Time-of-flight (ToF) and phase contrast (PC) magnetic resonance angiographies (MRAs) are noninvasive applications to depict the cerebral arteries. Both approaches can image the cerebral vasculature without the administration of intravenous contrast. Therefore, it is used in routine clinical evaluation of cerebrovascular diseases, e.g., aneurysm and arteriovenous malformations. However, subtle microvascular disease usually cannot be resolved with standard, clinical-field-strength MRA. The purpose of this study was to compare the ability of ToF and PC MRA to visualize the cerebral arteries at increasing field strengths.

Materials and Methods

The Institutional Review Board-approved study included eight healthy volunteers (age: 36±10 years; three female, five male). All subjects provided written informed consent. ToF and PC MRAs were obtained at 1.5, 3 and 7 T. Signal intensities of the large, primary vessels of the Circle of Willis were measured, and signal-to-noise ratios were calculated. Visualization of smaller first- and second-order branch arteries of the Circle of Willis was also evaluated.

Results

The results show that both ToF and PC MRAs allow the depiction of the large primary vessels of the Circle of Willis at all field strengths. Ultrahigh field (7 T) provides only small increases in the signal-to-noise ratio in these primary vessels due to the smaller voxel size acquired. However, ultrahigh-field MRA provides better visualization of the first- and second-order branch arteries with both ToF and PC approaches. Therefore, ultrahigh-field MRA may become an important tool in future neuroradiology research and clinical care.     

Correction strategy for diffusion-weighted images corrupted with motion: application to the DTI evaluation of infants' white matter

Objective

Diffusion imaging techniques such as DTI and HARDI are difficult to implement in infants because of their sensitivity to subject motion. A short acquisition time is generally preferred, at the expense of spatial resolution and signal-to-noise ratio. Before estimating the local diffusion model, most pre-processing techniques only register diffusion-weighted volumes, without correcting for intra-slice artifacts due to motion or technical problems. Here, we propose a fully automated strategy, which takes advantage of a high orientation number and is based on spherical-harmonics decomposition of the diffusion signal.

Material and methods

The correction strategy is based on two successive steps: 1) automated detection and resampling of corrupted slices; 2) correction for eddy current distortions and realignment of misregistered volumes. It was tested on DTI data from adults and non-sedated healthy infants.

Results

The methodology was validated through simulated motions applied to an uncorrupted dataset and through comparisons with an unmoved reference. Second, we showed that the correction applied to an infant group enabled to improve DTI maps and to increase the reliability of DTI quantification in the immature cortico-spinal tract.

Conclusion

This automated strategy performed reliably on DTI datasets and can be applied to spherical single- and multiple-shell diffusion imaging.     

Assessment of data acquisition parameters,and analysis techniques for noise reduction in spinal cord fMRI data

Purpose

The purpose of this work is to characterize the noise in spinal cord functional MRI, assess current methods aimed at reducing noise, and optimize imaging parameters.

Methods

Functional MRI data were acquired at multiple echo times and the contrast-to-noise ratio (CNR) was calculated. Independently, the repetition time was systematically varied with and without parallel imaging, to maximize BOLD sensitivity and minimize type I errors. Noise in the images was characterized by examining the frequency spectrum, and investigating whether autocorrelations exist. The efficacy of several physiological noise reduction methods in both null (no stimuli) and task (thermal pain paradigm) data was also assessed. Finally, our previous normalization methods were extended.

Results

The echo time with the highest functional CNR at 3 Tesla is at roughly 75 msec. Parallel imaging reduced the variance and the presence of autocorrelations, however the BOLD response in task data was more robust in data acquired without parallel imaging. Model-free based approaches further increased the detection of active voxels in the task data. Finally, inter-subject registration was improved.

Conclusions

Results from this study provide a rigorous characterization of the properties of the noise and assessment of data acquisition and analysis methods for spinal cord and brainstem fMRI.     

Simultaneous 3D localization of multiple MR-visible markers in fully reconstructed MR images: proof-of-concept for subsecond position tracking

Purpose

To determine whether a greatly reduced spatial resolution of fully reconstructed projection MR images can be used for the simultaneous 3D localization of multiple MR-visible markers and to assess the feasibility of a subsecond position tracking for clinical purposes.

Materials and Methods

Miniature, inductively coupled RF coils were imaged in three orthogonal planes with a balanced steady-state free precession (SSFP) sequence and automatically localized using a two-dimensional template fitting and a subsequent three-dimensional (3D) matching of the coordinates. Precision, accuracy, speed and robustness of 3D localization were assessed for decreasing in-plane resolutions (0.6–4.7 mm). The feasibility of marker tracking was evaluated at the lowest resolution by following a robotically driven needle on a complex 3D trajectory.

Results

Average 3D precision and accuracy, sensitivity and specificity of localization ranged between 0.1 and 0.4 mm, 0.5 and 1.0 mm, 100% and 95%, and 100% and 96%, respectively. At the lowest resolution, imaging and localization took ≈350 ms and provided an accuracy of ≈1.0 mm. In the tracking experiment, the needle was clearly depicted on the oblique scan planes defined by the markers.

Conclusion

Image-based marker localization at a greatly reduced spatial resolution is considered a feasible approach to monitor reference points or rigid instruments at subsecond update rates.     

Analysis of the mandibular movement by simultaneous multisection continuous ultrafast MRI

Purpose

Using simultaneous multiple cross-sectional imaging, we imaged four cross sections, including the mandibular midline and the right and left temporomandibular joints, to observe one movement of mouth opening and closing and analyze the movement of the mandible and temporomandibular joints.

Materials and Methods

Four cross sections, including the midsagittal section of the mandible, the sagittal sections of the right and left temporomandibular joints and the horizontal section containing the heads of right and left temporomandibular joints, were imaged simultaneously. The imaging was conducted in 10 male and female volunteers.

Results

In all volunteers, the relationship of the mandibular movement on the median line with the right and left temporomandibular joints was observed. Images of the volunteers with trismus indicated the condition in which the right and left temporomandibular joints did not move in keeping with each other but moved independently from each other.

Conclusion

Complex movement of the temporomandibular joint was first evaluated by simultaneous multiple cross-sectional MRI for the movement of mandible and temporomandibular joints.     

SPatial REgression Analysis of Diffusion tensor imaging (SPREAD) for longitudinal progression of neurodegenerative disease in individual subjects

Objectives

To develop a novel statistical method for analysis of longitudinal DTI data in individual subjects.

Materials and Methods

The proposed SPatial REgression Analysis of Diffusion tensor imaging (SPREAD) method incorporates a spatial regression fitting of DTI data among neighboring voxels and a resampling method among data at different times. Both numerical simulations and real DTI data from healthy volunteers and multiple sclerosis (MS) patients were used in the study to evaluate this method.

Results

Statistical inference based on SPREAD was shown to perform well through both group comparisons among simulated DTI data of individuals (especially when the group size is smaller than 5) and longitudinal comparisons of human DTI data within the same individual.

Conclusions

When pathological changes of neurodegenerative diseases are heterogeneous in a population, SPREAD provides a unique way to assess abnormality during disease progression at the individual level. Consequently, it has the potential to shed light on how the brain has changed as a result of disease or injury.     

Assessment of the internal craniocervical ligaments with a new magnetic resonance imaging sequence: three-dimensional turbo spin echo with variable flip-angle distribution (SPACE)

Purpose

Lesions close to the internal craniocervical ligaments are a common problem in patients with whiplash injuries. The aim of this study was to evaluate the morphology and visibility of these ligamentous structures with a new isotropic three-dimensional (3D) turbo-spin-echo (TSE) technique.

Materials and Methods

MR (MR) images of the cervical spine of 52 healthy subjects (27 women and 25 men; mean age=29 years; age range=18–40 years) were taken with a T2-weighted 3D TSE sequence with variable flip-angle distribution [SPACE (Sampling Perfection with Application optimized Contrasts using different flip-angle Evolution)] at 1.5 T (Magnetom Avanto, Siemens Erlangen, Germany). Two experienced musculoskeletal radiologists read the images independently on a 3D imaging and postprocessing workstation. The visibility and morphology of the alar ligaments were evaluated on a five-point scale, and inter-reader correlation was assessed with kappa statistics.

Results

Both alar ligaments were detected in all subjects. Twenty-eight (53.8%) of the alar ligaments could not be seen within one slice of the standard coronal imaging plane but could adequately be visualized in an oblique reconstruction adapted to the orientation of the ligaments on the axial slices. Inter-reader correlation for visibility on MR imaging (MRI) of the internal craniocervical ligaments was high (left+right side, kappa=0.95). Most (94%) alar ligaments presented symmetrically. In the axial plane, 60% were oriented neutral and 40% had a backward orientation. In the coronal plane, 67% were oriented caudocranially and 33% were oriented horizontally. The shape of the ligaments was parallel in half and was V-shaped in the other half. The alar ligaments had homogeneous low-signal intensity in 56% and heterogeneous low-signal intensity in 44%. The apical ligament of the dens was seen (excellent–good–moderate) in 61% (reader 1) and 52% (reader 2). The tectorial membranes and the transverse ligament of the atlas were shown (excellent–good) in all subjects.

Conclusions

MRI with acquisition of an isotropic SPACE technique allows high-resolution imaging of the craniocervical ligaments in all orientations. Reconstruction of the image data in the variable orientation of the alar ligaments allowed for excellent depiction within one slice such that partial volume artifacts that hamper image analysis can be eliminated.     

Intravoxel incoherent motion (IVIM) imaging at different magnetic field strengths: What is feasible?

Background

Due to limited SNR the cerebral applications of the intravoxel incoherent motion (IVIM) concept have been sparse. MRI hardware developments have resulted in improved SNR and this may justify a reassessment of IVIM imaging for non-invasive quantification of the cerebral blood volume (CBV) as a first step toward determining the optimal field strength.

Purpose

To investigate intravoxel incoherent motion imaging for its potential to assess cerebral blood volume (CBV) at three different MRI field strengths.

Materials and methods

Four volunteers were scanned twice at 1.5 T, 3 T as well as 7 T. By correcting for field-strength-dependent effects of relaxation, estimates of corrected CBV (cCBV) were obtained in deep gray matter (DGM), frontal gray matter (FGM) and frontal white matter (FWM), using Bayesian analysis. In addition, simulations were performed to facilitate the interpretation of experimental data.

Results

In DGM, FGM and FWM we obtained cCBV estimates of 2.2 ml/100 ml, 2.7 ml/100 ml, 1.4 ml/100 ml at 1.5 T; 3.7 ml/100 ml, 5.0 ml/100 ml, 3.2 ml/100 ml at 3 T and 15.5 ml/100 ml, 20.3 ml/100 ml, 7.0 ml/100 ml at 7 T.

Conclusion

Quantitative cCBV values obtained at 1.5 T and 3 T corresponded better to physiological reference values, while 7 T showed the largest deviation from expected values. Simulations of synthetic tissue voxels indicated that the discrepancy at 7 T can partly be explained by SNR issues. Results were generally more repeatable at 7 T (intraclass correlation coefficient, ICC = 0.84) than at 1.5 T (ICC = 0.68) and 3 T (ICC = 0.46).     

Early assessment of breast cancer response to neoadjuvant chemotherapy by semi-quantitative analysis of high-temporal resolution DCE-MRI: Preliminary results

Purpose

To evaluate whether semi-quantitative analysis of high temporal resolution dynamic contrast-enhanced MRI (DCE-MRI) acquired early in treatment can predict the response of locally advanced breast cancer (LABC) to neoadjuvant chemotherapy (NAC).

Materials and Methods

As part of an IRB-approved prospective study, 21 patients with LABC provided informed consent and underwent high temporal resolution 3 T DCE-MRI before and after 1 cycle of NAC. Using measurements performed by two radiologists, the following parameters were extracted for lesions at both examinations: lesion size (short and long axes, in both early and late phases of enhancement), radiologist's subjective assessment of lesion enhancement, and percentages of voxels within the lesion demonstrating progressive, plateau, or washout kinetics. The latter data were calculated using two filters, one selecting for voxels enhancing ≥ 50% over baseline and one for voxels enhancing ≥ 100% over baseline. Pretreatment imaging parameters and parameter changes following cycle 1 of NAC were evaluated for their ability to discriminate patients with an eventual pathological complete response (pCR).

Results

All 21 patients completed NAC followed by surgery, with 9 patients achieving a pCR. No pretreatment imaging parameters were predictive of pCR. However, change after cycle 1 of NAC in percentage of voxels demonstrating washout kinetics with a 100% enhancement filter discriminated patients with an eventual pCR with an area under the receiver operating characteristic curve (AUC) of 0.77. Changes in other parameters, including lesion size, did not predict pCR.

Conclusion

Semi-quantitative analysis of high temporal resolution DCE-MRI in patients with LABC can discriminate patients with an eventual pCR after one cycle of NAC.