From Phantoms to Patients: Improved Fusion and Voxel-Wise Analysis of Diffusion-Weighted Imaging and FDG-Positron Emission Tomography in Positron Emission Tomography/Magnetic Resonance Imaging for Combined Metabolic-Diffusivity Index (cDMI).

Hybrid positron emission tomography/magnetic resonance imaging (PET/MR) opens new possibilities in multimodal multiparametric (m2p) image analyses. But even the simultaneous acquisition of positron emission tomography (PET) and magnetic resonance imaging (MRI) does not guarantee perfect voxel-by-voxel co-registration due to organs and distortions, especially in diffusion-weighted imaging (DWI), which would be, however, crucial to derive biologically meaningful information. Thus, our aim was to optimize fusion and voxel-wise analyses of DWI and standardized uptake values (SUVs) using a novel software for m2p analyses. Using research software, we evaluated the precision of image co-registration and voxel-wise analyses including the rigid and elastic 3D registration of DWI and [18F]-Fluorodeoxyglucose (FDG)-PET from an integrated PET/MR system. We analyzed DWI distortions with a volume-preserving constraint in three different 3D-printed phantom models. A total of 12 PET/MR-DWI clinical datasets (bronchial carcinoma patients) were referenced to the T1 weighted-DIXON sequence. Back mapping of scatterplots and voxel-wise registration was performed and compared to the non-optimized datasets. Fusion was rated using a 5-point Likert scale. Using the 3D-elastic co-registration algorithm, geometric shapes were restored in phantom measurements; the measured ADC values did not change significantly (F = 1.12, p = 0.34). Reader assessment showed a significant improvement in fusion precision for DWI and morphological landmarks in the 3D-registered datasets (4.3 ± 0.2 vs. 4.6 ± 0.2, p = 0.009). Most pronounced differences were noted for the chest wall (p = 0.006), tumor (p = 0.007), and skin contour (p = 0.014). Co-registration increased the number of plausible ADC and SUV combinations by 25%. The volume-preserving elastic 3D registration of DWI significantly improved the precision of fusion with anatomical sequences in phantom and clinical datasets. The research software allowed for a voxel-wise analysis and visualization of [18F]FDG-PET/MR data as a "combined diffusivity-metabolic index" (cDMI). The clinical value of the optimized PET/MR biomarker can thus be tested in future PET/MR studies.

Parahydrogen-Polarized Fumarate for Preclinical in Vivo Metabolic Magnetic Resonance Imaging.

We present a versatile method for the preparation of hyperpolarized [1-13C]fumarate as a contrast agent for preclinical in vivo MRI, using parahydrogen-induced polarization (PHIP). To benchmark this process, we compared a prototype PHIP polarizer to a state-of-the-art dissolution dynamic nuclear polarization (d-DNP) system. We found comparable polarization, volume, and concentration levels of the prepared solutions, while the preparation effort is significantly lower for the PHIP process, which can provide a preclinical dose every 10 min, opposed to around 90 min for d-DNP systems. With our approach, a 100 mM [1-13C]-fumarate solution of volumes up to 3 mL with 13-20% 13C-hyperpolarization after purification can be produced. The purified solution has a physiological pH, while the catalyst, the reaction side products, and the precursor material concentrations are reduced to nontoxic levels, as confirmed in a panel of cytotoxicity studies. The in vivo usage of the hyperpolarized fumarate as a perfusion agent in healthy mice and the metabolic conversion of fumarate to malate in tumor-bearing mice developing regions with necrotic cell death is demonstrated. Furthermore, we present a one-step synthesis to produce the 13C-labeled precursor for the hydrogenation reaction with high yield, starting from 13CO2 as a cost-effective source for 13C-labeled compounds.

2D Ultrashort Echo-Time Functional Lung Imaging.

BACKGROUND: Imaging of the lung by MRI is challenging due to the intrinsic low proton density and rapid T2 * relaxation. MRI methods providing lung parenchyma and function are in demand. PURPOSE: To investigate the feasibility of two-dimensional ultrashort echo-time (2D UTE) imaging for lung function assessment. STUDY TYPE: Prospective. POPULATION: Eleven healthy volunteers. FIELD STRENGTH/SEQUENCE: 3T, 2D tiny golden angle UTE (2D-tyUTE). ASSESSMENT: The applicability of breath-hold (BH) and self-gated (SG) 2D-tyUTE for quantification of the lung parenchyma signal-to-noise ratio (SNR), proton fraction (fP ), fractional ventilation (FV), and perfusion (f) was investigated. Dependencies on repetition time (BHS/I1/I2 ) and respiratory phase (expiration [EX], inspiration [IN]) were investigated and compared between smokers and nonsmokers. STATISTICAL TESTS: Analysis of variance (ANOVA), Kendell's W. RESULTS: Significant differences of SNR (EX: 10.98 ± 3.19(BHS ), 14.58 ± 3.89(BHI1 ), 17.59 ± 4.92(BHI2 ), 11.00 ± 5.42(SG); IN: 7.17 ± 2.07(BHS ), 9.51 ± 2.37(BHI1 ), 10.49 ± 2.33(BHI2 ), 10.00 ± 4.14(SG)) (P < 0.05 for all cases) were observed between the different approaches. Where fP in expiration (0.41 ± 0.13) was independent of the BH imaging technique, it was slightly higher in SG (0.44 ± 0.06). FV was reproducible among the BH techniques (0.41 ± 0.10), but significantly lower in SG (0.21 ± 0.06) (P < 0.05). A moderate correlation (R2 = 0.47, P < 0.01) was observed between the breathing amplitude and FV. No significant differences between BH and SG were observed for the perfusion analysis (EX: 3.50 ± 1.29 mL/min/mL [BHS ]; IN: 2.36 ± 1.05 mL/min/mL [BHS ]). Significant differences in fP were found between smokers (0.48 ± 0.11 BH) and nonsmokers (0.37 ± 0.12 BH) in expiration. DATA CONCLUSION: This study demonstrates the feasibility of 2D-tyUTE for successful quantification of relevant lung function parameters at 3T within clinically attractive acquisition times. The low spatial resolution into the slice selection direction may limit the final sensitivity and needs further clinical evaluation. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 1 J. MAGN. RESON. IMAGING 2020;52:1637-1644.

Sliding window reduced FOV reconstruction for real-time cardiac imaging.

BACKGROUND: Current functional cardiovascular imaging protocols mostly rely on electrocardiogram (ECG) gating and breathholding. The resulting image quality can substantially suffer from insufficient patient cooperation or severe arrhythmia. Real-time imaging can mitigate these effects but requires highly accelerated techniques, usually relying on non-cartesian trajectories and Compressed Sensing (CS). METHODS: We investigate a sliding window reduced field of view (FOV) Echo Planar Imaging (EPI) technique for real-time cardiac MRI. Segmented EPI has been combined with a subtraction technique for reducing the FOV in cardiac applications to the region of the beating heart. Residual respiratory motion, potentially impairing the image quality, has been addressed by continuous update of the static image fraction, which is derived from a low-temporal resolution sliding window reconstruction. For further acceleration, the proposed technique was combined with parallel imaging. RESULTS: The sliding window reduced FOV technique was proven feasible to reconstruct images of diagnostic image quality at a temporal resolution of 36.5ms per image. Semi-quantitative evaluation of image quality showed significant improvement over the existing rFOV method (p=0.039). Derived functional parameters show comparable results as with the BH-CINE reference. However, a trend to a slight underestimation of the largest and smallest in-plane volumes is observed. CONCLUSION: The proposed technique is feasible of providing real-time cardiac MRI with a temporal resolution better than 40ms without the need of computably complex reconstruction techniques.

Quasi-Random Single-Point Imaging Using Low-Discrepancy $k$ -Space Sampling.

Magnetic resonance imaging of short relaxation time spin systems has been a widely discussed topic with serious clinical applications and led to the emergence of fast imaging ultra-short echo-time sequences. Nevertheless, these sequences suffer from image blurring, due to the related sampling point spread function and are highly prone to imaging artefacts arising from, e.g., chemical shifts or magnetic susceptibilities. In this paper, we present a concept of spherical quasi-random single-point imaging. The approach is highly accelerateable, due to intrinsic undersampling properties and capable of strong metal artefact suppression. Imaging acceleration is achieved by sampling of quasi-random points in -space, based on a low-discrepancy sequence, and a combination with non-linear optimization reconstruction techniques [compressed sensing (CS)]. The presented low-discrepancy trajectory shows ideal noise like undersampling properties for the combination with CS, leading to denoised images with excellent metal artefact reduction. Using eightfold undersampling, acquisition time of a few minutes can be achieved for volume acquisitions.