Pilot study of Iopamidol-based quantitative pH imaging on a clinical 3T MR scanner.

OBJECTIVE: The objective of this study was to show the feasibility to perform Iopamidol-based pH imaging via clinical 3T magnetic resonance imaging (MRI) using chemical exchange saturation transfer (CEST) imaging with pulse train presaturation. MATERIALS AND METHODS: The pulse train presaturation scheme of a CEST sequence was investigated for Iopamidol-based pH measurements using a 3T magnetic resonance (MR) scanner. The CEST sequence was applied to eight tubes filled with 100-mM Iopamidol solutions with pH values ranging from 5.6 to 7.0. Calibration curves for pH quantification were determined. The dependence of pH values on the concentration of Iopamidol was investigated. An in vivo measurement was performed in one patient who had undergone a previous contrast-enhanced computed tomography (CT) scan with Iopamidol. The pH values of urine measured with CEST MRI and with a pH meter were compared. RESULTS: In the measured pH range, pH imaging using CEST imaging with pulse train presaturation was possible. Dependence between the pH value and the concentration of Iopamidol was not observed. In the in vivo investigation, the pH values in the human bladder measured by the Iopamidol CEST sequence and in urine were consistent. CONCLUSION: Our study shows the feasibility of using CEST imaging with Iopamidol for quantitative pH mapping in vitro and in vivo on a 3T MR scanner.

Fatigue-induced changes in longitudinal relaxation time determined by magnetic resonance imaging.

Longitudinal relaxation time (T(1)) determined by 3.0-T magnetic resonance imaging of the tibialis anterior and extensor digitorum longus muscles increased gradually with muscle fatigue caused by three 120-s periods of repeated ankle dorsiflexion separated by 5-min rest periods. T(1) values decreased in the recovery period, although they remained higher than the preexercise values. T(1) values for the soleus muscle were unchanged throughout the experiment. Results suggest that muscle T(1) values increase with increasing muscle fatigue.

Reduction of metal artifacts in patients with total hip arthroplasty with slice-encoding metal artifact correction and view-angle tilting MR imaging.

PURPOSE: To compare the new "warp" sequence (slice-encoding metal artifact correction [SEMAC], view-angle tilting [VAT], and increased bandwidth) for the reduction of both through-plane and in-plane magnetic resonance (MR) artifacts with current optimized MR sequences in patients with total hip arthroplasty (THA). MATERIALS AND METHODS: The institutional review board issued a waiver for this study. Forty patients with THA were prospectively included. SEMAC, VAT, and increased bandwidth were applied by using the warp turbo-spin-echo sequence at 1.5 T. Coronal short tau inversion-recovery (STIR)-warp and transverse T1-weighted warp (hereafter, T1-warp) images, as well as standard coronal STIR and transverse T1-weighted sequence images optimized with high bandwidth (STIR-hiBW and T1-hiBW), were acquired. Fifteen additional patients were examined to compare the T1-warp and T1-hiBW sequence with an identical matrix size. Signal void was quantified. Qualitative criteria (distinction of anatomic structures, blurring, and noise) were assessed on a five-point scale (1, no artifacts; 5, not visible due to severe artifacts) by two readers. Abnormal imaging findings were recorded. Quantitative data were analyzed with a t test and qualitative data with a Wilcoxon signed rank test. RESULTS: Signal void around the acetabular component was smaller for STIR-warp than STIR-hiBW images (21.6 cm2 vs 42.4 cm2; P=.0001), and for T1-warp than T1-hiBW images (17.6 cm2 vs 20.2 cm2; P=.0001). Anatomic distinction was better on STIR-warp compared with STIR-hiBW images (1.9-2.8 vs 3.6-4.6; P=.0001), and on T1-warp compared with T1-hiBW images (1.3-2.8 vs 1.8-3.2; P<.002). Distortion, blurring, and noise were lower with warp sequences than with the standard sequences (P=.0001). Almost half of the abnormal imaging findings were missed on STIR-hiBW compared with STIR-warp images (55 vs 105 findings; P=.0001), while T1-hiBW was similar to T1-warp imaging (50 vs 55 findings; P=.06). CONCLUSION: STIR-warp and T1-warp sequences were significantly better according to quantitative and qualitative image criteria, but a clinically relevant artifact reduction was only present for STIR images.

Comparison of two ultrashort echo time sequences for the quantification of T1 within phantom and human Achilles tendon at 3 T.

Ultrashort echo time (UTE) techniques enable direct imaging of musculoskeletal tissues with short T2 allowing measurement of T1 relaxation times. This article presents comparison of optimized 3D variable flip angle UTE (VFA-UTE) and 2D saturation recovery UTE (SR-UTE) sequences to quantify T1 in agar phantoms and human Achilles tendon. Achilles tendon T1 values for asymptomatic volunteers were compared to Achilles tendon T1 values calculated from patients with clinical diagnoses of spondyloarthritis (SpA) and Achilles tendinopathy using an optimized VFA-UTE sequence. T1 values from phantom data for VFA- and SR-UTE compare well against calculated T1 values from an assumed gold standard inversion recovery spin echo sequence. Mean T1 values in asymptomatic Achilles tendon were found to be 725±42 ms and 698±54 ms for SR- and VFA-UTE, respectively. The patient group mean T1 value for Achilles tendon was found to be 957±173 ms (P<0.05) using an optimized VFA-UTE sequence with pulse repetition time of 6 ms and flip angles 4, 19, and 24°, taking a total 9 min acquisition time. The VFA-UTE technique appears clinically feasible for quantifying T1 in Achilles tendon. T1 measurements offer potential for detecting changes in Achilles tendon due to SpA without need for intravenous contrast agents.

Effects of B1 inhomogeneity correction for three-dimensional variable flip angle T1 measurements in hip dGEMRIC at 3 T and 1.5 T.

Delayed gadolinium-enhanced MRI of cartilage is a technique for studying the development of osteoarthritis using quantitative T(1) measurements. Three-dimensional variable flip angle is a promising method for performing such measurements rapidly, by using two successive spoiled gradient echo sequences with different excitation pulse flip angles. However, the three-dimensional variable flip angle method is very sensitive to inhomogeneities in the transmitted B(1) field in vivo. In this study, a method for correcting for such inhomogeneities, using an additional B(1) mapping spin-echo sequence, was evaluated. Phantom studies concluded that three-dimensional variable flip angle with B(1) correction calculates accurate T(1) values also in areas with high B(1) deviation. Retrospective analysis of in vivo hip delayed gadolinium-enhanced MRI of cartilage data from 40 subjects showed the difference between three-dimensional variable flip angle with and without B(1) correction to be generally two to three times higher at 3 T than at 1.5 T. In conclusion, the B(1) variations should always be taken into account, both at 1.5 T and at 3 T.

Variable flip angle-based fast three-dimensional T1 mapping for delayed gadolinium-enhanced MRI of cartilage of the knee: need for B1 correction.

Delayed gadolinium-enhanced MRI of cartilage is a technique, which involves T(1) mapping to identify changes in the structural integrity of cartilage associated with osteoarthritis. Currently, the gold standard is 2D inversion recovery turbo spin echo, which suffers from long acquisition times and limited coverage. Three-dimensional variable flip angle (VFA) is an alternate technique, which has been shown to be accurate when an estimate of T(1) is available a priori. This study validates the variable flip angle method for delayed gadolinium-enhanced MRI of cartilage of the femoro-tibial knee cartilage. When amplitude of (excitation) radiofrequency field inhomogeneities were minimized using nonselective pulses and amplitude of (excitation) radiofrequency field correction using an additional acquisition of a amplitude of (excitation) radiofrequency field map, the accuracy of T(1) measurements were improved, and slice-to-slice variations over the 3D volume were minimized. In conclusion, fast 3D T(1) mapping using the variable flip angle method with amplitude of (excitation) radiofrequency field correction appears to be an efficient and accurate method for delayed gadolinium-enhanced MRI of cartilage of the knee.

Cartilage quality assessment by using glycosaminoglycan chemical exchange saturation transfer and (23)Na MR imaging at 7 T.

PURPOSE: To compare a glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging method, which enables sampling of the water signal as a function of the presaturation offset (z-spectrum) at 13 points in clinically feasible imaging times, with sodium 23 ((23)Na) magnetic resonance (MR) imaging in patients after cartilage repair surgery (matrix-associated autologous chondrocyte transplantation and microfracture therapy). MATERIALS AND METHODS: One female patient (67.3 years), and 11 male patients (median age, 28.8 years; interquartile range [IQR], 24.6-32.3 years) were examined with a 7-T whole-body system, with approval of the local ethics committee after written informed consent was obtained. A modified three-dimensional gradient-echo sequence and a 28-channel knee coil were used for gagCEST imaging. (23)Na imaging was performed with a circularly polarized knee coil by using a modified gradient-echo sequence. Statistical analysis of differences and Spearman correlation were applied. RESULTS: The median of asymmetries in gagCEST z-spectra summed over all offsets from 0 to 1.3 ppm was 7.99% (IQR, 6.33%-8.79%) in native cartilage and 5.13% (IQR, 2.64%-6.34%) in repair tissue. A strong correlation (r = 0.701; 95% confidence interval: 0.21, 0.91) was found between ratios of signal intensity from native cartilage to signal intensity from repair tissue obtained with gagCEST or (23)Na imaging. The median of dimensionless ratios between native cartilage and repair tissue was 1.28 (IQR, 1.20-1.58) for gagCEST and 1.26 (IQR, 1.21-1.48) for (23)Na MR imaging. CONCLUSION: The high correlation between the introduced gagCEST method and (23)Na imaging implies that gagCEST is a potentially useful biomarker for glycosaminoglycans.

Motion correction improves image quality of dGEMRIC in finger joints.

PURPOSE: To assess motion artifacts in dGEMRIC of finger joints and to evaluate the effectiveness of motion correction. MATERIALS AND METHODS: In 40 subjects (26 patients with finger arthritis and 14 healthy volunteers) dGEMRIC of metacarpophalangeal joint II was performed. Imaging used a dual flip angle approach (TE 3.72 ms, TR 15 ms, flip angles 5° and 26°). Two sets of T1 maps were calculated for dGEMRIC analysis from the imaging data for each subject: one with and one without motion correction. To compare image quality, visual grading analysis and precision of dGEMRIC measurement of both dGEMRIC maps for each case were evaluated. RESULTS: Motion artifacts were present in 82% (33/40) of uncorrected dGEMRIC maps. Motion artifacts were graded as severe or as rendering evaluation impossible in 43% (17/40) of uncorrected dGEMRIC maps. Motion corrected maps showed significantly less motion artifacts (P<0.001) and were graded as evaluable in 97% (39/40) of cases. Precision was significantly higher in motion corrected images (coefficient of variation (CV=.176±.077), compared to uncorrected images (CV .445±.347) (P<.001). Motion corrected dGERMIC was different in volunteers and patients (P=.044), whereas uncorrected dGEMRIC was not (P=.234). CONCLUSION: Motion correction improves image quality, dGEMRIC measurement precision and diagnostic performance in dGEMRIC of finger joints.

High-resolution cartilage imaging of the knee at 3T: basic evaluation of modern isotropic 3D MR-sequences.

PURPOSE: To evaluate qualitative and quantitative image quality parameters of isotropic three-dimensional (3D) cartilage-imaging magnetic resonance (MR)-sequences at 3T. MATERIALS AND METHODS: The knees of 10 healthy volunteers (mean age, 24.4±5.6 years) were scanned at a 3T MR scanner with water-excited 3D Fast-Low Angle Shot (FLASH), True Fast Imaging with Steady-state Precession (TrueFISP), Sampling Perfection with Application-optimized Contrast using different flip-angle Evolutions (SPACE) as well as conventional and two individually weighted Double-Echo Steady-State (DESS) sequences. The MR images were evaluated qualitatively and quantitatively (signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), SNR efficiency, CNR efficiency). Quantitative parameters were compared by means of a Tukey-test and sequences were ranked according to SNR/CNR, SNR/CNR efficiency and qualitative image grading. RESULTS: The highest SNR was measured for SPACE (34.0±5.6), the highest CNR/CNR efficiency (cartilage/fluid) for the individually weighted DESS (46.9±18.0/2.18±0.84). SPACE, individually weighted and conventional DESS were ranked best with respect to SNR/CNR and SNR/CNR efficiency. The DESS sequences also performed best in the qualitative evaluation. TrueFISP performed worse, FLASH worst. The individually weighted DESS sequences were generally better than the conventional DESS with the significant increase of cartilage-fluid contrast (46.9±18.0/31.9±11.4 versus 22.0±7.3) as main advantage. CONCLUSION: Individually weighted DESS is the most promising candidate; all tested sequences performed better than FLASH.

Bloch simulations with intra-voxel spin dephasing.

A common problem in simulations of MRI-experiments based on the numerical solution of the Bloch equations is the finite number of isochromats used in the calculations. This usually results in false or spurious signals and is a source of various differences between calculated and experimentally obtained data. In this paper, we are proposing a technique representing each sample voxel by a central and three additional isochromats, slightly shifted in orthogonal directions from center, thus providing a linear approximation of intra-voxel dephasing. This approach allows for further improvement and precision of the calculated NMR signal and virtually avoids the problem related to an finite set of isochromats. Here we provide details of the algorithm together with examples of simulations which prove the efficiency of this approach.

Non-contrast-enhanced perfusion and ventilation assessment of the human lung by means of fourier decomposition in proton MRI.

Assessment of regional lung perfusion and ventilation has significant clinical value for the diagnosis and follow-up of pulmonary diseases. In this work a new method of non-contrast-enhanced functional lung MRI (not dependent on intravenous or inhalative contrast agents) is proposed. A two-dimensional (2D) true fast imaging with steady precession (TrueFISP) pulse sequence (TR/TE = 1.9 ms/0.8 ms, acquisition time [TA] = 112 ms/image) was implemented on a 1.5T whole-body MR scanner. The imaging protocol comprised sets of 198 lung images acquired with an imaging rate of 3.33 images/s in coronal and sagittal view. No electrocardiogram (ECG) or respiratory triggering was used. A nonrigid image registration algorithm was applied to compensate for respiratory motion. Rapid data acquisition allowed observing intensity changes in corresponding lung areas with respect to the cardiac and respiratory frequencies. After a Fourier analysis along the time domain, two spectral lines corresponding to both frequencies were used to calculate the perfusion- and ventilation-weighted images. The described method was applied in preliminary studies on volunteers and patients showing clinical relevance to obtain non-contrast-enhanced perfusion and ventilation data.

Accelerated volumetric MRI with a SENSE/GRAPPA combination.

PURPOSE: To combine the specific advantages of the generalized autocalibrating partially parallel acquisitions (GRAPPA) technique and sensitivity encoding (SENSE) with two-dimensional (2D) undersampling. MATERIALS AND METHODS: By splitting the 2D reconstruction process into multiple one-dimensional (1D) reconstructions, the normal 1D GRAPPA method can be used for image reconstruction. Due to this data-handling process, a GRAPPA reconstruction is performed along the phase-encoding (PE) direction and effectively a SENSE reconstruction is performed along the partition-encoding (PAE) direction. RESULTS: In vivo experiments demonstrate the successful implementation of the SENSE/GRAPPA combination. Experimental results with up to 9.6-fold acceleration using a prototype 32-channel receiver head coil array are presented. CONCLUSION: The proposed SENSE/GRAPPA combination for 3D imaging allows the GRAPPA method to be applied in combination with 2D undersampling. Because the SENSE/GRAPPA combination is not based on knowledge of spatial coil sensitivities, it should be the method of choice whenever it is difficult to extract the sensitivity information.

Autocalibrated coil sensitivity estimation for parallel imaging.

Parallel imaging has proven to be a robust solution to the problem of acquisition speed in MRI. These methods are based on extracting spatial information from an array of multiple surface coils in order to speed up image acquisition. One of the most essential elements of any parallel imaging method is the information describing the coil sensitivity distribution throughout the sample. This paper covers some of the advanced methods to obtain coil sensitivity-related information, focusing particularly on the class of methods referred to as autocalibrating. These methods all acquire the data for coil sensitivity estimation directly before, during or directly after the reduced data acquisition. After a review of standard methods for coil sensitivity estimation, some of the basic and advanced autocalibrating methods are reviewed, and some example applications shown.

Artifact and noise suppression in GRAPPA imaging using improved k-space coil calibration and variable density sampling.

A parallel imaging technique, GRAPPA (GeneRalized Auto-calibrating Partially Parallel Acquisitions), has been used to improve temporal or spatial resolution. Coil calibration in GRAPPA is performed in central k-space by fitting a target signal using its adjacent signals. Missing signals in outer k-space are reconstructed. However, coil calibration operates with signals that exhibit large amplitude variation while reconstruction is performed using signals with small amplitude variation. Different signal variations in coil calibration and reconstruction may result in residual image artifact and noise. The purpose of this work was to improve GRAPPA coil calibration and variable density (VD) sampling for suppressing residual artifact and noise. The proposed coil calibration was performed in local k-space along both the phase and frequency encoding directions. Outer k-space was acquired with two different reduction factors. Phantom data were reconstructed by both the conventional GRAPPA and the improved technique for comparison at an acceleration of two. Under the same acceleration, optimal sampling and calibration parameters were determined. An in vivo image was reconstructed in the same way using the predetermined optimal parameters. The performance of GRAPPA was improved by the localized coil calibration and VD sampling scheme.

Parallel acquisition techniques in cardiac cine magnetic resonance imaging using TrueFISP sequences: comparison of image quality and artifacts.

PURPOSE: To compare image quality, artifacts, and signal-to-noise ratio (SNR) in cardiac cine TrueFISP magnetic resonance imaging (MRI) with and without parallel acquisition techniques (PAT). MATERIALS AND METHODS: MRI was performed in 16 subjects with a TrueFISP sequence (1.5 T; Magnetom Sonata, Siemens): TR, 3.0 msec; TE, 1.5 msec; flip angle (FA), 60 degrees. Three axes were scanned without PAT (no PAT) and using the generalized autocalibrating partially parallel acquisition (GRAPPA) and modified sensitivity encoding (mSENSE) reconstruction algorithms with an autocalibration mode to reduce scan time. A conventional spine array and a body flex array were used. Artifacts, image noise, and overall image quality were classified on a 4-point scale by an observer blinded to the implemented technique; for quantitative comparison, SNR was measured. RESULTS: With a PAT factor of two, acquisition time could be reduced by 39%. No PAT did not show artifacts, and GRAPPA revealed fewer artifacts than mSENSE. PAT provided inferior-quality scores concerning image noise and overall image quality. In quantitative measurements, GRAPPA and mSENSE (20.1 +/- 6.2 and 15.6 +/- 6.2, respectively) yielded lower SNR than no PAT (30.6 +/- 20.1; P < 0.05) and P < 0.001). CONCLUSION: Time savings in PAT are accompanied by artifacts and an increase in image noise. The GRAPPA algorithm was superior to mSENSE concerning image quality, noise, and SNR.

A brief review of parallel magnetic resonance imaging.

Since the 1980s, the implementation of fast imaging methods and dedicated hardware for MRI scanners has reduced the image acquisition time from nearly an hour down to several seconds and has therefore enabled a widespread use of MRI in clinical diagnosis. Since this development, the greatest incremental gain in imaging speed has been provided by the development of parallel MRI (pMRI) techniques in late 1990s. Within the past 2 years, parallel imaging methods have become commercially available, which means that pMRI is now available for broad clinical use. In the clinical routine, virtually any MRI method can be enhanced by pMRI, allowing faster image acquisitions without any increased gradient system performance. In some cases pMRI can even result in a significant gain in image quality due to this faster acquisition. In this review article, the advantages and the disadvantages of pMRI in clinical applications are discussed and examples from many different daily applications are given.

Ex vivo assessment of trabecular bone structure from three-dimensional projection reconstruction MR micro-images.

Magnetic resonance (MR) imaging has recently been proposed for assessing osteoporosis and predicting fracture risks. However, accurate acquisition techniques and image analysis protocols for the determination of the trabecular bone structure are yet to be defined. The aim of this study was to assess the potential of projection reconstruction (PR) MR microscopy in the analysis of the three-dimensional (3-D) architecture of trabecular bone and in the prediction of its biomechanical properties. High-resolution 3-D PR images (41 x 41 x 82 microm3 voxels) of 15 porcine trabecular bone explants were analyzed to determine the trabecular bone volume fraction (Vv), the mean trabecular thickness (Tb.Th), and the mean trabecular separation (Tb.Sp) using the method of directed secants. These parameters were then compared with those derived from 3-D conventional spin-echo microimages. In both cases, segmentation of the high-resolution images into bone and bone marrow was obtained using a spatial adaptive threshold. The contemporary inclusion of Vv, Tb.Th and 1/Tb.Sp in a multiple regression analysis significantly improved the prediction of Young's modulus (YM). The parameters derived from the PR spin-echo images were found to be stronger predictors of YM (R2 = 0.94, p = 0.004) than those derived from conventional spin-echo images (R2 = 0.79, p = 0.051). Our study indicates that projection reconstruction MR microscopy appears to be more accurate than the conventional Fourier transform method in the quantification of trabecular bone structure and in the prediction of its bioimechanical properties. The proposed PR approach should be readily adaptable to the in vivo MRI studies of osteoporosis.

An NMR technique for measurement of magnetic field gradient waveforms.

Almost all NMR imaging and localized spectroscopic methods fundamentally rely on the use of magnetic field gradients. It follows that precise information on gradient waveform shape and rise-times is often most useful in experimental MRI. We present a very simple and robust method for measuring the time evolution of a magnetic field gradient. The method is based on the analysis of the NMR signal in the time domain, and requires no specialized field measurement probes for its implementation. The technique makes use of the principal that for small flip angles the excitation profile is a good approximation to the Fourier transform of the radio frequency pulse shape. Creation of the NMR signal can be considered as an inverse Fourier transform and thus variation of the gradient strength during the excitation pulse influences the shape of the NMR signal. Although originally designed for measurement of the rise time only, we have now extended the technique to measure the exact time course of the gradient. The theory is confirmed by experimental results for gradient waveform field measurements in a high-field vertical bore system.

Generalized autocalibrating partially parallel acquisitions (GRAPPA).

In this study, a novel partially parallel acquisition (PPA) method is presented which can be used to accelerate image acquisition using an RF coil array for spatial encoding. This technique, GeneRalized Autocalibrating Partially Parallel Acquisitions (GRAPPA) is an extension of both the PILS and VD-AUTO-SMASH reconstruction techniques. As in those previous methods, a detailed, highly accurate RF field map is not needed prior to reconstruction in GRAPPA. This information is obtained from several k-space lines which are acquired in addition to the normal image acquisition. As in PILS, the GRAPPA reconstruction algorithm provides unaliased images from each component coil prior to image combination. This results in even higher SNR and better image quality since the steps of image reconstruction and image combination are performed in separate steps. After introducing the GRAPPA technique, primary focus is given to issues related to the practical implementation of GRAPPA, including the reconstruction algorithm as well as analysis of SNR in the resulting images. Finally, in vivo GRAPPA images are shown which demonstrate the utility of the technique.