Investigation of combined kV/MV CBCT imaging with a high-DQE MV detector.

PURPOSE: Combined kV-MV cone-beam tomography (CBCT) imaging has been proposed for two potentially important image-guided radiotherapy applications: (a) scan time reduction (STR) and (b) metal artifact reduction (MAR). However, the feasibility of these techniques has been in question due to the low detective quantum efficiencies (DQEs) of commercially available electronic portal imagers (EPIDs). The goal of the work was to test whether a prototype high DQE MV detector can be used to generate acceptable quality pretreatment CBCT images at acceptable dose levels. METHODS: 6MV and 100 kVp projection data were acquired on a Truebeam system (Varian, Palo Alto, CA). The MV data were acquired using a prototype EPID containing two scintillators (a) a standard copper-gadolinium oxysulfide (Cu-GOS) screen having a zero-frequency DQE (DQE(0)) value of 1.4%, and (b) a prototype-focused cadmium tungstate (CWO) pixelated "strip" with a DQE(0) = 22%. The kV data were acquired using the standard onboard imager (DQE(0) = 70%). The angular spacing of the MV projections was 0.81° and the source output was 0.03 MU/projection while the kV projections were acquired with an angular spacing of 0.4° at 0.3 mAs/projection. Image quality was evaluated using (a) an 18-cm diameter electron density phantom (CIRS, Norfolk, VA) with nine contrast inserts and (b) the resolution section of the 20-cm diameter Catphan phantom (The Phantom Laboratory, Greenwich, NY). For the MAR studies, two opposing CIRS phantom inserts were replaced by steel rods. The reconstruction methods were based on combining MV and kV data into one sinogram. The MAR reconstruction utilized mostly kV raw data with only those rays corrupted by metal requiring replacement with MV data (total absorbed dose = 0.7 cGy). For the STR study, projections from partially overlapping 105°kV and MV acquisitions were combined to create a complete dataset that could have been acquired in 18 sec (absorbed dose = 2.5 cGy). MV-only (4.3 cGy) and kV-only (0.3 cGy) images were also reconstructed. RESULTS: The average signal-to-noise ratio (SNR) of the inserts in the MV-only CWO and GOS CIRS phantom images were 0.62× and 0.12× the SNR of the inserts in kV-only image, respectively. The limiting spatial resolutions in the MV-only GOS, MV-only CWO, and kV-only Catphan images were 3, 6, and 8 lp/cm, respectively. In the combined kV/CWO STR reconstruction, all contrast inserts were visible while only two were detectable in the kV/Cu-GOS image due to high levels of noise (average SNRs of kV/CWO and kV/GOS inserts were 0.97× and 0.18× the SNR of the kV-only inserts, respectively). In the kV-MV MAR reconstructions, streaking artifacts were substantially reduced with all inserts becoming clearly visible in the kV/CWO image while only two were visible in the kV/Cu-GOS image (average SNRs of the kV/CWO and kV/Cu-GOS CIRS with metal inserts were 0.94× and 0.35× the SNRs of the kV-only CIRS without metal inserts). CONCLUSIONS: We have demonstrated that a high-DQE MV detector can be applied to generating high-quality combined kV-MV images for SRT and MAR. Clinically acceptable doses were utilized.

TU-E-BRA-05: Reverse Geometry Imaging with MV Detector for Improved Image Resolution.

PURPOSE: Thick pixilated scintillators can offer significant improvements in quantum efficiency over phosphor screen megavoltage (MV) detectors. However spatial resolution can be compromised due to the spreading of light across pixels within septa. Of particular interest are the lower energy x-ray photons and associated light photons that produce higher image contrast but are stopped near the scintillator entrance surface. They suffer the most scattering in the scintillator prior to detection in the photodiodes. Reversing the detector geometry, so that the incident x-ray beam passes through the photodiode array into the scintillator, allows the light to scatter less prior to detection. This also reduces the Swank noise since now higher and lower energy x-ray photons tend to produce similar electronic signals. In this work, we present simulations and measurements of detector MTF for the conventional/forward and reverse geometries to demonstrate this phenomenon. METHODS: A tabletop system consisting of a Varian CX1 1MeV linear accelerator and a modified Varian Paxscan4030 with the readout electronics moved away from the incident the beam was used. A special holder was used to press a 2.5W×5.0L×2.0Hcm3 pixellated Cesium Iodide (CsI:Tl) scintillator array on to the detector glass. The CsI array had a pitch of 0.784mm with plastic septa between pixels and the photodiode array pitch was 0.192 mm. The MTF in the forward and reverse geometries was measured using a 0.5mm thick Tantalum slanted edge. Geant4-based Monte Carlo simulations were performed for comparison. RESULTS: The measured and simulated MTFs matched to within 3.4(±3.7)% in the forward and 4.4(±1.5)% in reverse geometries. The reverse geometry MTF was higher than the forward geometry MTF at all spatial frequencies and doubled to .25 at 0.3lp/mm. CONCLUSIONS: A novel method of improving the image resolution at MV energies was demonstrated. The improvements should be more pronounced with increased scintillator thickness. Funding support provided by NIH (grant number NIH R01 CA138426).

SU-E-I-15: Comparison of State-Of-The-Art Interpolation-Based Metal Artifact Reduction (MAR) Algorithms for Cone-Beam Computed Tomography (CBCT).

PURPOSE: To compare four metal-artifact-reduction (MAR) algorithms in their ability to correct the typical streaking artifacts that appear in cone- beam computed tomography (CBCT) images. METHODS: The goal was to compare the strengths and weaknesses of four MAR algorithms, Basic; Wei; Mazin and Meyer, using typical clinical situations where metal is present. Three clinical situations were evaluated: fiducial markers in the abdomen; hip implants and multiple dental fillings. The algorithms take original CBCT projections as input and produce a corrected image. The location of the metal is identified in the CBCT images and a forward projection identifies which pixels in the projections need to be replaced by interpolation of neighboring pixels. The three advanced algorithms extend the Basic technique with more sophisticated interpolation schemes. Wei and Meyer identify the high contrast structures using image segmentation in order to reduce their appearance in the projections before interpolation. Mazin corrects the original projections using a forward projection of the Basic correction. RESULTS: All the algorithms reduced the streak artifacts typical of metal structures. Nevertheless, depending upon the clinical task, the algorithms also added shading and streaks which reduced the overall visual impression. Images containing fiducial markers in the abdomen showed obvious improvements; images containing hip implants were improved but also showed distracting shading artifacts; and, images with multiple dental fillings all appeared visually worse than the uncorrected images. In almost all cases, Mazin outperformed the other approaches and introduced the fewest additional streaks and shading artifacts. CONCLUSIONS: This work indicates that the Mazin algorithm is best suited for clinical usage of MAR. Furthermore the algorithm is fairly simple and can be computational very efficient making it well suited for clinical use. Nevertheless, the overall improvement is highly dependent on the individual characteristics of the original image. For dental implants no correction is recommended.

SU-E-I-22: Metal Artifact Correction Using KV and Selective MV Imaging.

PURPOSE: To improve the image quality of radiotherapy planning CTs for patients with metal implants or fillings by completing the missing kV projection data with selectively acquired MV data that does not suffer from photon starvation. Using both imaging systems that are available on current radiotherapy devices, streaking artifacts are avoided and the soft tissue contrast is restored, even in areas where the kV photons do not contribute any information. This enables a better delineation of structures of interest in planning CT images for patients with metal objects. METHODS: An algorithm for combining kV and MV projection data from the two on-board imagers of a radiotherapy device is presented in this work. It only requires selective MV imaging with the high energy X-rays being collimated onto the metal implants, ensuring that the patient dose does not increase significantly. The algorithm can cope with non-identical geometries of the two imagers and is based on stitching together kV and MV sinograms by estimating a ratio between them. A numerical head phantom with two dental fillings and two soft tissue patterns was used to quantitatively evaluate the proposed hybrid reconstruction algorithm. A structural similarity index (SSIM) with respect to the ground truth data was computed for two ROIs. Realistic, polychromatic spectra were used for both imagers with 120 keV(p) and 6 MeV(p). The patient dose was limited to about 6 cGy for both acquisitions combined. RESULTS: The reconstruction results yield visually as well as objectively better results (SSIM=74.8%) than a simple sinogram interpolation of the kV data (SSIM=69.7%) or a reconstruction from the original data (SSIM=17.9%). CONCLUSIONS: We have successfully implemented a new reconstruction method for hybrid kV-MV cone beam CT reconstruction that enables a better planning of radiotherapy treatments for patients with metal implants without compromising their safety. This work was funded by NIH grant 1R01CA138426-01A1.

WE-C-217BCD-08: Rapid Monte Carlo Simulations of DQE(f) of Scintillator-Based Detectors.

PURPOSE: Monte Carlo simulations of DQE(f) can greatly aid in the design of scintillator-based detectors by helping optimize key parameters including scintillator material and thickness, pixel size, surface finish, and septa reflectivity. However, the additional optical transport significantly increases simulation times, necessitating a large number of parallel processors to adequately explore the parameter space. To address this limitation, we have optimized the DQE(f) algorithm, reducing simulation times per design iteration to 10 minutes on a single CPU. METHODS: DQE(f) is proportional to the ratio, MTF(f)̂2 /NPS(f). The LSF-MTF simulation uses a slanted line source and is rapidly performed with relatively few gammas launched. However, the conventional NPS simulation for standard radiation exposure levels requires the acquisition of multiple flood fields (nRun), each requiring billions of input gamma photons (nGamma), many of which will scintillate, thereby producing thousands of optical photons (nOpt) per deposited MeV. The resulting execution time is proportional to the product nRun x nGamma x nOpt. In this investigation, we revisit the theoretical derivation of DQE(f), and reveal significant computation time savings through the optimization of nRun, nGamma, and nOpt. Using GEANT4, we determine optimal values for these three variables for a GOS scintillator-amorphous silicon portal imager. Both isotropic and Mie optical scattering processes were modeled. Simulation results were validated against the literature. RESULTS: We found that, depending on the radiative and optical attenuation properties of the scintillator, the NPS can be accurately computed using values for nGamma below 1000, and values for nOpt below 500/MeV. nRun should remain above 200. Using these parameters, typical computation times for a complete NPS ranged from 2-10 minutes on a single CPU. CONCLUSIONS: The number of launched particles and corresponding execution times for a DQE simulation can be dramatically reduced allowing for accurate computation with modest computer hardware. NIHRO1 CA138426. Several authors work for Varian Medical Systems.

WE-C-217BCD-11: Coupled Radiative and Optical Geant4 Simulation of MV EPIDs Based on Thick Pixelated Scintillating Crystals.

PURPOSE: One way to greatly reduce the incidence of metal artifacts produced in kilovoltage (kV) CT images is by using megavoltage (MV) photons that penetrate high-Z objects, thus providing a measurable signal. For do se-efficient imaging, a high detective quantum efficiency (DQE) MV detector is desired. This study validates the coupled radiation and optical Geant4 simulation results against experimental data from various prototype pixelated scintillator MV detectors and determines the essential optical parameters which control the detector performance. METHODS: Experimental data obtained with a 6MV radiation source from 8 different detectors was considered. The detectors used CsI, CdW and BGO as scintillating crystals and polystyrene septal wall material. Accurate Geant4 models of the detectors were implemented and coupled radiation and optical simulations were performed. The unknown optical properties of the models were determined by minimizing the difference between the modulation transfer functions (MTF) of the simulated data obtained with the slanted slit technique and the experimental MTFs. With the set of optical properties fixed, further simulation validation was performed against the experimental normalized noise power spectrum (NNPS(f)) and the experimental DQE(f) curves for each detector. All the simulations were performed on a computer cluster deployed on the Amazon EC2 platform. RESULTS: The optimal values for the free optical parameters are 10%, 95% and 90% for the top surface reflectivity, the crystal-sept a surface reflectivity, and the Lambertian component contribution to the reflected beam from the crystal-septa interface respectively. The absolute difference between experimental and simulated data was below 10% for all the data sets. CONCLUSIONS: To our knowledge this study is the first to present a full optical and radiative DQE(f) model using Geant4 that shows an excellent match with experimental data. The model indicates that improved performance can be obtained using more specular septa which are optically opaque. Support: NIH-T32-CA09695, NIH-1R01CA138426 NIH T32-CA09695, NIH R01- CA138426, Several authors work for Varian Medical Systems.

Improved scatter correction using adaptive scatter kernel superposition.

Accurate scatter correction is required to produce high-quality reconstructions of x-ray cone-beam computed tomography (CBCT) scans. This paper describes new scatter kernel superposition (SKS) algorithms for deconvolving scatter from projection data. The algorithms are designed to improve upon the conventional approach whose accuracy is limited by the use of symmetric kernels that characterize the scatter properties of uniform slabs. To model scatter transport in more realistic objects, nonstationary kernels, whose shapes adapt to local thickness variations in the projection data, are proposed. Two methods are introduced: (1) adaptive scatter kernel superposition (ASKS) requiring spatial domain convolutions and (2) fast adaptive scatter kernel superposition (fASKS) where, through a linearity approximation, convolution is efficiently performed in Fourier space. The conventional SKS algorithm, ASKS, and fASKS, were tested with Monte Carlo simulations and with phantom data acquired on a table-top CBCT system matching the Varian On-Board Imager (OBI). All three models accounted for scatter point-spread broadening due to object thickening, object edge effects, detector scatter properties and an anti-scatter grid. Hounsfield unit (HU) errors in reconstructions of a large pelvis phantom with a measured maximum scatter-to-primary ratio over 200% were reduced from -90 ± 58 HU (mean ± standard deviation) with no scatter correction to 53 ± 82 HU with SKS, to 19 ± 25 HU with fASKS and to 13 ± 21 HU with ASKS. HU accuracies and measured contrast were similarly improved in reconstructions of a body-sized elliptical Catphan phantom. The results show that the adaptive SKS methods offer significant advantages over the conventional scatter deconvolution technique.

Zero-quantum filter offering single-shot lipid suppression and simultaneous detection of lactate, choline, and creatine resonances.

A zero-quantum (ZQ) filter offering single-shot lipid suppression and providing for simultaneous detection of the lactate methyl doublet (1.3 ppm) and nonoverlapping singlets including choline (Cho, 3.2 ppm) and creatine (Cr, 3.0 ppm) is described. Filtering is provided by soft mixing and reading pulses (RF(mix), RF(rd)) that are selective for the lactate methine quartet (4.1 ppm), Cho, and Cr resonances but exclude the 1.3 ppm lactate component and overlapping lipids. Surrounding RF(mix) and RF(rd) are magnetic field gradient pulses of equal magnitude but opposite signs to enable the rephasing of the zero-quantum lactate coherence and the creation of a stimulated echo for singlets within the pulse passbands. The sequence is designed to retain half the original lactate and singlet signal intensities. Theoretical predictions were confirmed experimentally at 1.5T using phantom acquisitions. The lipid suppression factor was measured to be over 10(3).

Comparison of relative cerebral blood volume and proton spectroscopy in patients with treated gliomas.

BACKGROUND AND PURPOSE: Elevated relative regional cerebral blood volume (rCBV) reflects the increased microvascularity that is associated with brain tumors. The purpose of this study was to investigate the potential role of rCBV in the determination of recurrent/residual disease in patients with treated gliomas. METHODS: Thirty-one rCBV studies were performed in 19 patients with treated gliomas. All patients also had proton MR spectroscopy and conventional MR imaging. Regions of abnormality were identified on conventional MR images by two neuroradiologists and compared with rCBV and MR spectroscopic data. Metabolites and rCBV were quantified and compared in abnormal regions. RESULTS: In high-grade tumors, rCBV values were proportional to choline in regions of tumor and nonviable tissue. Although the presence of residual/recurrent disease was often ambiguous on conventional MR images, the rCBV maps indicated regions of elevated vascularity in all low-grade tumors and in 12 of 17 grade IV lesions. Regions of elevated and low rCBV corresponded well with spectra, indicating tumor and nonviable tissue, respectively. CONCLUSION: This study suggests that rCBV maps and MR spectroscopy are complementary techniques that may improve the detection of residual/recurrent tumor in patients with treated gliomas. Compared with the spectra, the rCBV maps may better reflect the heterogeneity of the tumor regions because of their higher resolution. The multiple markers of MR spectroscopy enable better discrimination between normal and abnormal tissue than do the rCBV maps.

Motion correction and lipid suppression for 1H magnetic resonance spectroscopy.

Spectral/spatial spin-echo pulses with asymmetric excitation profiles were incorporated into a PRESS-based localization sequence to provide lipid suppression while retaining a sufficient amount of water to allow for correction of motion-induced shot-to-shot phase variations. 1H magnetic resonance spectroscopy data were acquired at 1.5 Tesla from a motion phantom and in vivo from the human liver, kidney, and breast. The results demonstrated that lipids in the chemical shift stopband were completely suppressed and that full metabolite signal intensity was maintained after implementation of a regularization algorithm based on phasing the residual water signal. Liver and kidney spectra contained a large resonance at 3.2 ppm that was ascribed to trimethylammonium moieties (betaine plus choline) and a weaker signal at 3.7 ppm that may result from glycogen. A breast spectrum from a histologically proven invasive ductal carcinoma displayed a highly elevated choline signal (3.2 ppm) relative to that from a normal volunteer.

In vivo 1H MR spectroscopy of human head and neck lymph node metastasis and comparison with oxygen tension measurements.

BACKGROUND AND PURPOSE: Current diagnostic methods for head and neck metastasis are limited for monitoring recurrence and assessing oxygenation. 1H MR spectroscopy (1H MRS) provides a noninvasive means of determining the chemical composition of tissue and thus has a unique potential as a method for localizing and characterizing cancer. The purposes of this investigation were to measure 1H spectral intensities of total choline (Cho), creatine (Cr), and lactate (Lac) in vivo in human lymph node metastases of head and neck cancer for comparison with normal muscle tissue and to examine relationships between metabolite signal intensities and tissue oxygenation status. METHODS: Volume-localized Lac-edited MRS at 1.5 T was performed in vivo on the lymph node metastases of 14 patients whose conditions were untreated and who had primary occurrences of squamous cell carcinoma. MRS measurements were acquired also from the neck muscle tissue of six healthy volunteers and a subset of the patients. Peak areas of Cho, Cr, and Lac were calculated. Tissue oxygenation (pO2) within the abnormal lymph nodes was measured independently using an Eppendorf polarographic oxygen electrode. RESULTS: Cho:Cr ratios were significantly higher in the nodes than in muscle tissue (node Cho:Cr = 2.9 +/- 1.6, muscle Cho:Cr = 0.55 +/- 0.21, P = .0006). Lac was significantly higher in cancer tissue than in muscle (P = .01) and, in the nodes, showed a moderately negative correlation with median pO2 (r = -.76) over a range of approximately 0 to 30 mm Hg. Nodes with oxygenation values less than 10 mm Hg had approximately twice the Lac signal intensity as did nodes with oxygenation values greater than 10 mm Hg (P = .01). Cho signal intensity was not well correlated with pO2 (r = -.46) but seemed to decrease at higher oxygenation levels (>20 mm Hg). CONCLUSION: 1H MRS may be useful for differentiating metastatic head and neck cancer from normal muscular tissue and may allow for the possibility of assessing oxygenation. Potential clinical applications include the staging and monitoring of treatment.

Clinical application of BASING and spectral/spatial water and lipid suppression pulses for prostate cancer staging and localization by in vivo 3D 1H magnetic resonance spectroscopic imaging.

In previous in situ point-resolved spectroscopy (PRESS) three-dimensional (3D) 1H magnetic resonance (MR) spectroscopic imaging studies, it has been demonstrated that the ratio of prostatic metabolites can noninvasively discriminate prostate cancer from surrounding normal tissue. However, in these studies, conventional chemical shift selective suppression (CHESS) and short-time inversion recovery (STIR) techniques often resulted in inadequate water and lipid suppression. To improve suppression and spatial coverage, the newly developed T1 insensitive dual band selective inversion with gradient dephasing (BASING) Bandstop Filter and dual phase-compensating spectral/spatial spin-echo pulses have been implemented in a clinical setting. In phantom studies, no change in metabolic profiles was observed with application of either BASING or spectral/spatial pulses. In a study of 17 prostate cancer patients, the use of either BASING or spectral/spatial pulses allowed for suppression of water (BASING 99.80 +/- 0.14% and spectral/spatial 99.73 +/- 0.47%) and lipid (BASING 98.56 +/- 1.03% and spectral/spatial 98.44 +/- 1.90%) without a significant difference in the prostatic metabolite ratios. Spectral/spatial suppression has the added advantage of reducing the chemical shift dependence of the PRESS volume, but optimal performance requires high-speed gradients with negligible eddy current effects. BASING suppression is less reliant on accurate pulse and gradient timings and can be implemented easily with no loss in performance on clinical MR scanners with conventional gradients.

Reduced spatial side lobes in chemical-shift imaging.

Density-weighted k-space sampling with spiral trajectories is used to reduce spatial side lobes in chemical-shift imaging (CSI). In this method, more time is spent collecting data at the center of k space and less time at the edges of k space in order to make the sampling density proportional to a given apodization function, subject to constraints imposed by gradient performance and Nyquist sampling. The efficient k-space coverage of spiral-based trajectories enables good control over the sampling density within practical in vivo scan times. The density-weighted acquisition is compared to a conventional, nonweighted spiral sampling without the application of a window function. For a fixed voxel size and imaging time, the noise variance is observed to be the same for both cases, while spatial side lobes are greatly reduced with the variable-density sampling. This method is demonstrated on a normal volunteer by imaging of brain metabolites at 1.5 T with both single slice CSI and volumetric CSI. Magn Reson Med 42:314-323, 1999.

Lactate detection at 3T: compensating J coupling effects with BASING.

Detection of lactate by in vivo 1H magnetic resonance spectroscopy may provide a means of identifying regions of metabolic stress in brain and other human tissue, potentially identifying regional ischemia in stroke or necrosis in tumors. At higher field strengths (3 and 4 T), which have recently become available for whole-body human studies, the chemical shift difference between the doublet from the methyl protons and the quartet from the methine proton becomes comparable to the available radiofrequency (RF) pulse bandwidth. In this case "anomalous" J modulation occurs in PRESS and STEAM because the coupling partner of the observed resonance may or may not be refocused by the RF pulses depending on the position of the molecule within the voxel and the size of the chemical shift misregistration artifact. These anomalies lead to signal cancellation for echo times near odd multiples of 1/J (often used to highlight the inverted lactate doublet against nearby lipid peaks) in single voxel studies, and spatial variation of the doublet lineshape in chemical shift imaging studies, producing erroneous determination of relative lactate concentrations. While increasing the band-width of the RF pulses can reduce this effect by reducing the signal cancellation, some cancellation will always remain. A means of eliminating this effect using BASING/ MEGA (Mescher M et al. Solvent suppression using selective echo dephasing J Magn Reson A 1996;123:226-229; Star-Lack J et al. Improved water and lipid suppression for 3D PRESS CSI using RF band selective inversion with gradient dephasing (BASING). Magn Reson Med 1997;38: 311-321) water suppression pulses will be described, along with some of its limitations.

Optimal gradient waveform design for projection imaging and projection reconstruction echoplanar spectroscopic imaging.

The use of modulated B0 projection gradient waveforms is proposed for magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI) to shape the k-space sampling density function to match the profile of an applied reconstruction window function. This allows for a time-efficient means of maximizing the signal-to-noise ratio when, for example, a low-pass spatial filter, designed to reduce k-space truncation artifacts and corresponding point-spread function sidelobe energies, is implemented. Both the two-dimensional (2D) and 3D cases are investigated. To create the projection gradient waveforms, a design method is developed that uses nonlinear constrained optimization (NLCO) to minimize the variance of the reconstruction noise. The design is subject to both equality and inequality constraints, which include the maximum gradient magnitude and slew rate. It is shown that NLCO can also be applied to twisting the projection trajectories for purposes of reducing the data acquisition time while still maintaining the desired sampling density. Applications to 1H MRSI are investigated via simulations. Advantages and limitations of the new sampling schemes are discussed.

High spatial resolution 1H-MRSI and segmented MRI of cortical gray matter and subcortical white matter in three regions of the human brain.

High-resolution MR imaging and spectroscopic imaging were used to study differences in proton spectra between cortical gray matter and subcortical white matter in 23 normal volunteers using a 1.5 T scanner and surface coil receivers. A point-resolved spectroscopy (PRESS) volume with an 8 x 8 x 8 phase-encoding matrix was used to acquire over 1900 0.09-0.2 cc spectral voxels. The high-resolution (0.7 x 0.7 x 0.8 mm3 or 0.8 x 0.8 x 1 mm3) images were corrected for the surface coil reception profile and segmented into cerebrospinal fluid (CSF) and gray and white matter to correlate with the spectra. The data showed that N-acetyl aspartate (NAA) and creatine (Cr) were higher in the gray matter than in the white matter (NAA(g/w) = 1.4+/-0.36, Cr(g/w) = 1.4+/-0.41). Choline was significantly lower in the gray matter of the occipital lobe than in the white matter (0.73+/-0.19), but not significantly different in the other regions. NAA/Cho was found to be significantly higher in the occipital lobe than in the left frontal or vertex regions.

In vivo lactate editing with simultaneous detection of choline, creatine, NAA, and lipid singlets at 1.5 T using PRESS excitation with applications to the study of brain and head and neck tumors.

Two T2-independent J-difference lactate editing schemes for the PRESS magnetic resonance spectroscopy localization sequence are introduced. The techniques, which allow for simultaneous acquisition of the lactate doublet (1.3 ppm) and edited singlets upfield of and including choline (3.2 ppm), exploit the dependence of the in-phase intensity of the methyl doublet upon the time interval separating two inversion (BASING) pulses applied to its coupling partner after initial excitation. Editing method 1, which allows for echo times TE = n/J (n = 1, 2, 3, . . . . ), alters the BASING carrier frequency for each of two cycles so that, for one cycle, the quartet is inverted, whereas, for the other cycle, the quartet is unaffected. Method 2, which also provides water suppression, allows for editing for TE > 1/J by alternating, between cycles, the time interval separating the inversion pulses. Experimental results were obtained at 1.5 T using a Shinnar Le-Roux-designed maximum phase inversion pulse with a filter transition bandwidth of 55 Hz. Spectra were acquired from phantoms and in vivo from the human brain and neck. In a neck muscle study, the lipid suppression factor, achieved partly through the use of a novel phase regularization algorithm, was measured to be over 10(3). Spectra acquired from a primary brain and a metastatic neck tumor demonstrated the presence of lactate and choline signals consistent with abnormal spectral patterns. The advantages and limitations of the methods are analyzed theoretically and experimentally, and significance of the results is discussed.

Improved water and lipid suppression for 3D PRESS CSI using RF band selective inversion with gradient dephasing (BASING).

A T1 insensitive solvent suppression technique-band selective inversion with gradient dephasing (BASING)-was developed to suppress water and lipids for 1H magnetic resonance spectroscopy (MRS). BASING, which consists of a frequency selective RF inversion pulse surrounded by spoiler gradient pulses of opposite signs, was used to dephase stopband resonances and minimally impact passband metabolites. Passband phase linearity was achieved with a dual BASING scheme. Using the Shinnar-Le Roux algorithm, a highpass filter was designed to suppress water and rephase the lactate methyl doublet independently of TE, and water/lipid bandstop filters were designed for the brain and prostate. Phantom and in vivo experimental 3D PRESS CSI data were acquired at 1.5 T to compare BASING with CHESS and STIR suppression. With BASING, the measured suppression factor was over 100 times higher than with CHESS or STIR causing baseline distortions to be removed. It was shown that BASING can be incorporated into a variety of sequences to offer improved suppression in the presence of B1 and T1 inhomogeneites.

Improved solvent suppression and increased spatial excitation bandwidths for three-dimensional PRESS CSI using phase-compensating spectral/spatial spin-echo pulses.

Dual phase-compensating spectral/spatial echo-planar (EP) spin-echo (SE) pulses were incorporated into the point resolved spectroscopy (PRESS) excitation sequence to improve water and lipid suppression for 1H chemical shift imaging (CSI) and to decrease the dependence of the PRESS box location upon chemical shift. The asymmetric EPSE pulses (either minimum or maximum phase in the chemical shift domain) were substituted for the two PRESS SE pulses to yield zero phase spectra. Three different pulses were designed and tested at 1.5 T. Pulse 1, targeted for brain CSI (TE > 85 msec), passed choline to lipid resonances, suppressed water, and rephased the methyl lactate doublet independently of TE. Pulse 2, targeted for general purpose shorter TE PRESS, possessed both high chemical shift and spatial domain bandwidths. Pulse 3, designed for prostate CSI, passed choline to citrate resonances while suppressing lipids and water. The three pulses possessed spatial bandwidths ranging between 3.3 and 5.0 kHz, more than three times higher than that offered by one-dimensional SE pulses of equivalent maximum B1 amplitude. Phantom and in vivo experimental results demonstrated that, for EPSE pulses 1 and 2, suppression factors higher than 10(4) were achieved. The increased spatial bandwidths resulted in less contamination by signals from outside the designated PRESS excited region and a significant improvement in the uniformity of metabolite intensities for voxels located near edges of the PRESS box.

Four-dimensional 1H and 23Na imaging using continuously oscillating gradients.

A class of fast magnetic spectroscopic imaging methods using continuously oscillating gradients for four-dimensional (three spatial and one spectral) localization is introduced. Sampling may start immediately following the application of an RF excitation pulse, thus enabling measurement of spin density, chemical shift, and relaxation rates of short-T2 species. For spatial localization, steady-state sinusoidal gradient waveforms are used to sample a ball in k space. The two types of trajectories presented include: (1) continuously oscillating gradients with continuously rotating direction used for steady-state free-precession imaging and (2) continuously oscillating gradients followed by a spoiler directed along discrete projections. Design criteria are given and spatial-spectral and spatial-temporal reconstruction methods are developed. Theoretical point-spread functions and signal-to-noise ratios are derived while considering T2*, off-resonance effects, and RF excitation options. Experimental phantom, in vivo, and in vitro 1H and 23Na images collected at 2.35 T are presented. The 1H images were acquired with isotropic spatial resolution ranging from 0.03 to 0.27 cm3 and gradient-oscillation frequencies ranging from 600 to 700 Hz, thus allowing for the separation of water and lipid signals within a voxel. The 23Na images, acquired with 500 and 800 Hz gradient waveforms and 0.70 cm3 isotropic resolution, were resolved in the time domain, yielding spatially localized FIDs.