High-resolution myelin-water fraction and quantitative relaxation mapping using 3D ViSTa-MR fingerprinting.

Purpose: This study aims to develop a high-resolution whole-brain multi-parametric quantitative MRI approach for simultaneous mapping of myelin-water fraction (MWF), T1, T2, and proton-density (PD), all within a clinically feasible scan time. Methods: We developed 3D ViSTa-MRF, which combined Visualization of Short Transverse relaxation time component (ViSTa) technique with MR Fingerprinting (MRF), to achieve high-fidelity whole-brain MWF and T1/T2/PD mapping on a clinical 3T scanner. To achieve fast acquisition and memory-efficient reconstruction, the ViSTa-MRF sequence leverages an optimized 3D tiny-golden-angle-shuffling spiral-projection acquisition and joint spatial-temporal subspace reconstruction with optimized preconditioning algorithm. With the proposed ViSTa-MRF approach, high-fidelity direct MWF mapping was achieved without a need for multi-compartment fitting that could introduce bias and/or noise from additional assumptions or priors. Results: The in-vivo results demonstrate the effectiveness of the proposed acquisition and reconstruction framework to provide fast multi-parametric mapping with high SNR and good quality. The in-vivo results of 1mm- and 0.66mm-iso datasets indicate that the MWF values measured by the proposed method are consistent with standard ViSTa results that are 30x slower with lower SNR. Furthermore, we applied the proposed method to enable 5-minute whole-brain 1mm-iso assessment of MWF and T1/T2/PD mappings for infant brain development and for post-mortem brain samples. Conclusions: In this work, we have developed a 3D ViSTa-MRF technique that enables the acquisition of whole-brain MWF, quantitative T1, T2, and PD maps at 1mm and 0.66mm isotropic resolution in 5 and 15 minutes, respectively. This advancement allows for quantitative investigations of myelination changes in the brain.

Efficient T2 mapping with blip-up/down EPI and gSlider-SMS (T2 -BUDA-gSlider).

PURPOSE: To rapidly obtain high isotropic-resolution T2 maps with whole-brain coverage and high geometric fidelity. METHODS: A T2 blip-up/down EPI acquisition with generalized slice-dithered enhanced resolution (T2 -BUDA-gSlider) is proposed. A RF-encoded multi-slab spin-echo (SE) EPI acquisition with multiple TEs was developed to obtain high SNR efficiency with reduced TR. This was combined with an interleaved 2-shot EPI acquisition using blip-up/down phase encoding. An estimated field map was incorporated into the joint multi-shot EPI reconstruction with a structured low rank constraint to achieve distortion-free and robust reconstruction for each slab without navigation. A Bloch simulated subspace model was integrated into gSlider reconstruction and used for T2 quantification. RESULTS: In vivo results demonstrated that the T2 values estimated by the proposed method were consistent with gold standard spin-echo acquisition. Compared to the reference 3D fast spin echo (FSE) images, distortion caused by off-resonance and eddy current effects were effectively mitigated. CONCLUSION: BUDA-gSlider SE-EPI acquisition and gSlider-subspace joint reconstruction enabled distortion-free whole-brain T2 mapping in 2 min at ~1 mm3 isotropic resolution, which could bring significant benefits to related clinical and neuroscience applications.

Assessment methods in surgical training in the United Kingdom / 보건의료교육평가

A career in surgery in the United Kingdom demands a commitment to a long journey of assessment. The assessment methods used must ensure that the appropriate candidates are selected into a programme of study or a job and must guarantee public safety by regulating the progression of surgical trainees and the certification of trained surgeons. This review attempts to analyse the psychometric properties of various assessment methods used in the selection of candidates to medical school, job selection, progression in training, and certification. Validity is an indicator of how well an assessment measures what it is designed to measure. Reliability informs us whether a test is consistent in its outcome by measuring the reproducibility and discriminating ability of the test. In the long journey of assessment in surgical training, the same assessment formats are frequently being used for selection into a programme of study, job selection, progression, and certification. Although similar assessment methods are being used for different purposes in surgical training, the psychometric properties of these assessment methods have not been examined separately for each purpose. Because of the significance of these assessments for trainees and patients, their reliability and validity should be examined thoroughly in every context where the assessment method is being used.