Region of interest focused MRI to synthetic CT translation using regression and segmentation multi-task network.

Objective. In MR-only clinical workflow, replacing CT with MR image is of advantage for workflow efficiency and reduces radiation to the patient. An important step required to eliminate CT scan from the workflow is to generate the information provided by CT via an MR image. In this work, we aim to demonstrate a method to generate accurate synthetic CT (sCT) from an MR image to suit the radiation therapy (RT) treatment planning workflow. We show the feasibility of the method and make way for a broader clinical evaluation.Approach. We present a machine learning method for sCT generation from zero-echo-time (ZTE) MRI aimed at structural and quantitative accuracies of the image, with a particular focus on the accurate bone density value prediction. The misestimation of bone density in the radiation path could lead to unintended dose delivery to the target volume and results in suboptimal treatment outcome. We propose a loss function that favors a spatially sparse bone region in the image. We harness the ability of the multi-task network to produce correlated outputs as a framework to enable localization of region of interest (RoI) via segmentation, emphasize regression of values within RoI and still retain the overall accuracy via global regression. The network is optimized by a composite loss function that combines a dedicated loss from each task.Main results. We have included 54 brain patient images in this study and tested the sCT images against reference CT on a subset of 20 cases. A pilot dose evaluation was performed on 9 of the 20 test cases to demonstrate the viability of the generated sCT in RT planning. The average quantitative metrics produced by the proposed method over the test set were-(a) mean absolute error (MAE) of 70 ± 8.6 HU; (b) peak signal-to-noise ratio (PSNR) of 29.4 ± 2.8 dB; structural similarity metric (SSIM) of 0.95 ± 0.02; and (d) Dice coefficient of the body region of 0.984 ± 0.Significance. We demonstrate that the proposed method generates sCT images that resemble visual characteristics of a real CT image and has a quantitative accuracy that suits RT dose planning application. We compare the dose calculation from the proposed sCT and the real CT in a radiation therapy treatment planning setup and show that sCT based planning falls within 0.5% target dose error. The method presented here with an initial dose evaluation makes an encouraging precursor to a broader clinical evaluation of sCT based RT planning on different anatomical regions.

Magnetic resonance fingerprinting: a technical review.

Multiparametric quantitative imaging is gaining increasing interest due to its widespread advantages in clinical applications. Magnetic resonance fingerprinting is a recently introduced approach of fast multiparametric quantitative imaging. In this article, magnetic resonance fingerprinting acquisition, dictionary generation, reconstruction, and validation are reviewed.

Magnetic resonance fingerprinting with quadratic RF phase for measurement of T2* simultaneously with δf , T1 , and T2.

PURPOSE: This study explores the possibility of using a gradient moment balanced sequence with a quadratically varied RF excitation phase in the magnetic resonance fingerprinting (MRF) framework to quantify T2* in addition to δf , T1 , and T2 tissue properties. METHODS: The proposed quadratic RF phase-based MRF method (qRF-MRF) combined a varied RF excitation phase with the existing balanced SSFP (bSSFP)-based MRF method to generate signals that were uniquely sensitive to δf , T1 , T2 , as well as the distribution width of intravoxel frequency dispersion, Γ . A dictionary, generated through Bloch simulation, containing possible signal evolutions within the physiological range of δf , T1 , T2 , and Γ , was used to perform parameter estimation. The estimated T2 and Γ were subsequently used to estimate T2* . The proposed method was evaluated in phantom experiments and healthy volunteers (N = 5). RESULTS: The T1 and T2 values from the phantom by qRF-MRF demonstrated good agreement with values obtained by traditional gold standard methods (r2 = 0.995 and 0.997, respectively; concordance correlation coefficient = 0.978 and 0.995, respectively). The T2* values from the phantom demonstrated good agreement with values obtained through the multi-echo gradient-echo method (r2 = 0.972, concordance correlation coefficient = 0.983). In vivo qRF-MRF-measured T1 , T2 , and T2* values were compared with measurements by existing methods and literature values. CONCLUSION: The proposed qRF-MRF method demonstrated the potential for simultaneous quantification of δf , T1 , T2 , and T2* tissue properties.

Image reconstruction algorithm for motion insensitive MR Fingerprinting (MRF): MORF.

PURPOSE: The purpose of this study is to increase the robustness of MR fingerprinting (MRF) toward subject motion. METHODS: A novel reconstruction algorithm, MOtion insensitive MRF (MORF), was developed, which uses an iterative reconstruction based retrospective motion correction approach. Each iteration loops through the following steps: pattern recognition, metric based identification of motion corrupted frames, registration based motion estimation, and motion compensated data consistency verification. The proposed algorithm was validated using in vivo 2D brain MRF data with retrospective in-plane motion introduced at different stages of the acquisition. The validation was performed using qualitative and quantitative comparisons between results from MORF, the iterative multi-scale (IMS) algorithm, and with the IMS results using data without motion for a ground truth comparison. Additionally, the MORF algorithm was evaluated in prospectively motion corrupted in vivo 2D brain MRF datasets. RESULTS: For datasets corrupted by in-plane motion both prospectively and retrospectively, MORF noticeably reduced motion artifacts compared with iterative multi-scale and closely resembled the results from data without motion, even when ∼54% of data was motion corrupted during different parts of the acquisition. CONCLUSIONS: MORF improves the insensitivity of MRF toward rigid-body motion occurring during any part of the MRF acquisition.

Fast 3D magnetic resonance fingerprinting for a whole-brain coverage.

PURPOSE: The purpose of this study was to accelerate the acquisition and reconstruction time of 3D magnetic resonance fingerprinting scans. METHODS: A 3D magnetic resonance fingerprinting scan was accelerated by using a single-shot spiral trajectory with an undersampling factor of 48 in the x-y plane, and an interleaved sampling pattern with an undersampling factor of 3 through plane. Further acceleration came from reducing the waiting time between neighboring partitions. The reconstruction time was accelerated by applying singular value decomposition compression in k-space. Finally, a 3D premeasured B1 map was used to correct for the B1 inhomogeneity. RESULTS: The T1 and T2 values of the International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology MRI phantom showed a good agreement with the standard values, with an average concordance correlation coefficient of 0.99, and coefficient of variation of 7% in the repeatability scans. The results from in vivo scans also showed high image quality in both transverse and coronal views. CONCLUSIONS: This study applied a fast acquisition scheme for a fully quantitative 3D magnetic resonance fingerprinting scan with a total acceleration factor of 144 as compared with the Nyquist rate, such that 3D T1 , T2 , and proton density maps can be acquired with whole-brain coverage at clinical resolution in less than 5 min. Magn Reson Med 79:2190-2197, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Magnetic Resonance Fingerprinting-An Overview.

Magnetic Resonance Fingerprinting (MRF) is a new approach to quantitative magnetic resonance imaging that allows simultaneous measurement of multiple tissue properties in a single, time-efficient acquisition. The ability to reproducibly and quantitatively measure tissue properties could enable more objective tissue diagnosis, comparisons of scans acquired at different locations and time points, longitudinal follow-up of individual patients and development of imaging biomarkers. This review provides a general overview of MRF technology, current preclinical and clinical applications and potential future directions. MRF has been initially evaluated in brain, prostate, liver, cardiac, musculoskeletal imaging, and measurement of perfusion and microvascular properties through MR vascular fingerprinting.

Detection of elevated right ventricular extracellular volume in pulmonary hypertension using Accelerated and Navigator-Gated Look-Locker Imaging for Cardiac T1 Estimation (ANGIE) cardiovascular magnetic resonance.

BACKGROUND: Assessment of diffuse right ventricular (RV) fibrosis is of particular interest in pulmonary hypertension (PH) and heart failure (HF). Current cardiovascular magnetic resonance (CMR) T1 mapping techniques such as Modified Look-Locker inversion recovery (MOLLI) imaging have limited resolution, but accelerated and navigator-gated Look-Locker imaging for cardiac T1 estimation (ANGIE) is a novel CMR sequence with spatial resolution suitable for T1 mapping of the RV. We tested the hypothesis that patients with PH would have significantly more RV fibrosis detected with MRI ANGIE compared with normal volunteers and patients having HF with reduced (LV) ejection fraction (HFrEF) without co-existing PH, independent of RV dilitation and dysfunction. METHODS: Patients with World Health Organization group 1 or group 4 PH, patients with HFrEF without PH, and normal volunteers were recruited to undergo contrast-enhanced CMR. RV and LV extracellular volume fractions (RV-ECV and LV-ECV) were determined using pre-contrast and post-contrast T1 mapping using ANGIE (RV and LV) and MOLLI (LV only). RESULTS: Thirty-two participants (53.1% female, median age 52 years, IQR 26-65 years) were enrolled, including n = 12 with PH, n = 10 having HFrEF without co-existing PH, and n = 10 normal volunteers. ANGIE ECV imaging was of high quality, and ANGIE measurements of LV-ECV were highly correlated with those of MOLLI (r = 0.91; p < 0.001). The RV-ECV in PH patients was 27.2% greater than the RV-ECV in normal volunteers (0.341 v. 0.268; p < 0.0001) and 18.9% greater than the RV-ECV in HFrEF patients without PH (0.341 v. 0.287; p < 0.0001). RV-ECV was greater than LV-ECV in PH (RV-LV difference = 0.04), but RV-ECV was nearly equivalent to LV-ECV in normal volunteers (RV-LV difference = 0.002) (p < 0.0001 for RV-LV difference in PH versus normal volunteers). RV-ECV was linearly associated with both increasing RVEDVI (p = 0.049) and decreasing RVEF (p = 0.04) in a multivariable linear model, but PH was still associated with greater RV-ECV even after adjustment for RVEDVI and RVEF. CONCLUSIONS: Pre- and post-contrast ANGIE imaging provides high-resolution ECV determination for the RV. PH is independently associated with increased RV-ECV even after adjustment for RV dilatation and dysfunction, consistent with an independent effect of PH on fibrosis. ANGIE RV imaging merits further clinical evaluation in PH.

Accelerated and navigator-gated look-locker imaging for cardiac T1 estimation (ANGIE): Development and application to T1 mapping of the right ventricle.

PURPOSE: To develop a method for high-resolution cardiac T1 mapping. METHODS: A new method, accelerated and navigator-gated look-locker imaging for cardiac T1 estimation (ANGIE), was developed. An adaptive acquisition algorithm that accounts for the interplay between navigator gating and undersampling patterns well-suited for compressed sensing was used to minimize scan time. Computer simulations, phantom experiments, and imaging of the left ventricle (LV) were used to optimize and evaluate ANGIE. ANGIE's high spatial resolution was demonstrated by T1 mapping of the right ventricle (RV). Comparisons were made to modified Look-Locker imaging (MOLLI). RESULTS: Retrospective reconstruction of fully sampled datasets demonstrated the advantages of the adaptive algorithm. For the LV, ANGIE measurements of T1 were in good agreement with MOLLI. For the RV, ANGIE achieved a spatial resolution of 1.2 × 1.2 mm(2) with a scan time of 157 ± 53 s per slice, and measured RV T1 values of 980 ± 96 ms versus 1076 ± 157 ms for lower-resolution MOLLI. ANGIE provided lower intrascan variation in the RV T1 estimate compared with MOLLI (P < 0.05). CONCLUSION: ANGIE enables high-resolution cardiac T1 mapping in clinically reasonable scan times. ANGIE opens the prospect of quantitative T1 mapping of thin cardiovascular structures such as the RV wall.

Comparison of methods for determining the partition coefficient of gadolinium in the myocardium using T1 mapping.

PURPOSE: To develop and validate modified Look-Locker (MOLLI) protocols to generate myocardial T1 maps within clinically acceptable breath-hold durations and to compare partition coefficients (λ) of gadolinium (Gd)-DTPA determined from either bolus injection (BI) or continuous infusion (CI) techniques. MATERIALS AND METHODS: T1 mapping was performed in phantoms and in 10 volunteers on a 1.5T scanner using the standard (3-3-5) MOLLI technique and two MOLLI schemes with shorter breath-hold durations. Imaging was performed precontrast and every 5 minutes following a bolus of 0.1 mmol/kg Gd-DTPA and a 15-minute delayed continuous infusion of 0.001 mmol/kg Gd-DTPA until equilibrium T1 in the myocardium was achieved to enable direct comparison of T1 relaxation times between techniques and λ's between the BI and CI methods. RESULTS: There was good agreement of T1 values between the 3-3-5 standard MOLLI protocol and the modified 3-5 MOLLI protocol in both phantom studies over a range of heart rates and in human subjects. Both MOLLI protocols produced similar measurements of λ using both the BI and CI methods. CONCLUSION: A reduced breath-hold MOLLI T1 mapping protocol combined with the BI method can accurately characterize T1 and λ in clinically applicable breath-hold durations without requiring a long equilibrium phase infusion.