Evaluation of attenuation correction in cardiac PET using PET/MR.

BACKGROUND: Simultaneous acquisition Positron emission tomography/magnetic resonance (PET/MR) is a new technology that has potential as a tool both in research and clinical diagnosis. However, cardiac PET acquisition has not yet been validated using MR imaging for attenuation correction (AC). The goal of this study is to evaluate the feasibility of PET imaging using a standard 2-point Dixon volume interpolated breathhold examination (VIBE) MR sequence for AC. METHODS AND RESULTS: Evaluation was performed in both phantom and patient data. A chest phantom containing heart, lungs, and a lesion insert was scanned by both PET/MR and PET/CT. In addition, 30 patients underwent whole-body 18F-fluorodeoxyglucose PET/CT followed by simultaneous cardiac PET/MR. Phantom study showed 3% reduction of activity values in the myocardium due to the non-inclusion of the phased array coil in the AC. In patient scans, average standardized uptake values (SUVs) obtained by PET/CT and PET/MR showed no significant difference (n = 30, 4.6 ± 3.5 vs 4.7 ± 2.8, P = 0.47). There was excellent per patient correlation between the values acquired by PET/CT and PET/MR (R 2 = 0.97). CONCLUSIONS: Myocardial SUVs PET imaging using MR for AC shows excellent correlation with myocardial SUVs obtained by standard PET/CT imaging. The 2-point Dixon VIBE MR technique can be used for AC in simultaneous PET/MR data acquisition.

Changes in intrarenal oxygenation as evaluated by BOLD MRI in a rat kidney model for radiocontrast nephropathy.

The pathogenesis of radiocontrast nephropathy is poorly understood. In an animal model, inhibition of the synthesis of nitric oxide and prostaglandins appears to predispose rats to severe renal injury following the administration of radiocontrast. Here we have investigated whether administration of radiocontrast, as well as changes in renal medullary oxygenation following pharmacologic inhibition of nitric oxide and prostaglandin synthesis, might be evaluated by blood oxygenation level-dependent (BOLD) MRI. Nineteen anesthetized (Inactin 100 mg/kg) rats were studied. BOLD MRI measurements were performed following administration of L-NAME (N-nitro-L-arginine methyl ester, 10 mg/kg), Indomethacin (10 mg/kg), and a radiocontrast agent (sodium iothalamate 60%, 6 mL/kg). Marked sequential changes in medullary R(*)(2), presumably reflecting decline in medullary pO(2), were noted after each of the pharmacological interventions employed. These results, obtained by noninvasive MRI, are consistent with prior direct recordings of pO(2) and doppler flow in the rat renal medulla after administration of L-NAME, Indomethacin and iothalamate. Medullary oxygenation in rats was reduced by inhibition of the synthesis of prostaglandins and nitric oxide, as well as by intravenous injection of radiocontrast agents. BOLD MRI can noninvasively evaluate changes in medullary oxygenation in rats that appear to predispose acute renal failure. J. Magn. Reson. Imaging 2001;13:744-747.

Captopril MR renography in a swine model: toward a comprehensive evaluation of renal arterial stenosis.

PURPOSE: To test the feasibility of captopril magnetic resonance (MR) renography and to validate the technique in an animal model of renal arterial stenosis. MATERIALS AND METHODS: Seven pigs with induced renal arterial stenosis were studied. MR renography was performed with a T1-weighted approach by using three-dimensional fast imaging with steady-state precession, or FISP, sequences after administration of a bolus of 0.1 mmol of gadopentetate dimeglumine per kilogram of body weight. Captopril was administered to improve the specificity. RESULTS: The results demonstrate that differences in renographic curves and indices are observed only if an anatomically substantial stenosis, typically a diameter reduction of more than 70%, is present and captopril is administered. CONCLUSION: In this preliminary experience in an animal model, captopril MR renography provided data consistent with expectations based on conventional renographic results.

Protective effect of aminophylline on renal perfusion changes induced by high-energy shockwaves identified by Gd-DTPA-enhanced first-pass perfusion MRI.

PURPOSE: The purpose of this study was to evaluate regional renal hemodynamics in a noninvasive manner using gadolinium-DPTA magnetic resonance imaging (MRI) before and after extracorporeal shockwave lithotripsy (SWL). In addition, the renoprotective effect of intravenous aminophylline was evaluated on the perfusion on kidneys undergoing SWL. PATIENTS AND METHODS: Ten randomly selected patients were evaluated for regional renal blood flow in the cortex and medulla with Gd-DTPA MRI studies within 2 weeks before and 4 hours after SWL. Five of these patients were treated with 500 mg of intravenous aminophylline 45 minutes prior to SWL. Renal hemodynamics were assessed utilizing relative perfusion indices (PI) calculated from signal intensity-v-time curves obtained from regions of interest (ROI). The ROI choice was based on the contrast-enhanced MRI images. Relative PIs of pre-SWL and post-SWL studies were compared in the first group of patients. Relative PIs of the treated kidney were compared with those of the contralateral kidney in the second group of patients, who received aminophylline. RESULTS: In the group not treated with aminophylline, there was no significant difference in cortical perfusion before SWL (average PI -7+/-3%). However, after lithotripsy, there was a reduction of cortical flow (average PI 31+/-12%) in the treated kidney. In the group treated with aminophylline, renal hemodynamics study after SWL revealed no significant difference in relative perfusion (average PI -8+/-6%). Relative PIs of the medulla were small for all patients, but standard errors were large, indicating a wide range of values. CONCLUSIONS: This study helps to establish reduced cortical flow after SWL and demonstrates that aminophylline attenuated this response in the kidneys subjected to lithotripsy. It appears that aminophylline administration causes no alteration in medullary blood flow.

Evaluation of linear diaphragm-chest expansion models for magnetic resonance imaging motion artifact correction.

The efficacy of Fourier analysis, autoregressive with exogenous input (ARX) and adaptive models to estimate diaphragm position from respiratory belt signal (a measure of chest expansion) was evaluated for the purpose of correcting respiratory motion artifacts in magnetic resonance imaging (MRI). Respiratory belt signal and diaphragm position data were obtained simultaneously during one-dimensional MRI scans with sampling intervals of 100 ms for 128 s (1280 samples). The models were trained using the first 512 data samples for the Fourier method and the first 640 samples for the ARX and adaptive methods. The remaining samples were used as a test set for evaluating the models. Both ARX and adaptive methods produced more accurate results than the Fourier method as reflected by the normalized mean square error (NMSE) and correlation coefficient (R) between the estimated and actual diaphragm position during normal breathing (P < 0.05). However, all three models had difficulty modeling diaphragm positions during breathing plateaus.

Evaluation of changes in intrarenal oxygenation in rats using multiple gradient-recalled echo (mGRE) sequence.

Changes in intrarenal oxygenation in rats during pharmacological stimuli were evaluated with a multiple gradient-recalled echo (mGRE) sequence. With administration of the loop diuretic furosemide, oxygenation in the medulla improved; acetazolamide, a proximal tubular diuretic, produced no significant change. These results are consistent with our previous studies in humans and resemble earlier studies of medullary oxygenation using oxygen microelectrodes in anesthetized rats. The technique may be useful in the evaluation of therapeutic strategies in animal models of pathophysiological states such as acute renal failure.

Functional imaging of the kidneys with fast MRI techniques.

Availability of faster and stronger gradient systems have given rise to a multitude of fast MRI data acquisition strategies which have tremendously increased the scope of MRI applications. These have led to the realization of long desired comprehensive approaches to evaluate anatomy and function using a single modality. In this work, we describe some of our own experiences with functional evaluation of the kidneys using MRI. Examples that suggest the feasibility of comprehensive approaches for evaluation of renal disease are also provided. We also introduce BOLD renal MRI, a method that may allow basic understanding of human renal physiology and pathophysiology in a way that has not been previously possible.

Variable-angle uniform signal excitation (VUSE) for three-dimensional time-of-flight MR angiography.

A spatially asymmetric RF pulse that improves the uniformity of blood signal intensity and vascular contrast in three-dimensional (3D) MR angiography (MRA) is presented. The pulse, called variable-angle uniform signal excitation (VUSE), was designed to provide uniform signal response and improved contrast for blood flowing through a 3D imaging volume during a FLASH sequence. The VUSE excitation profile was optimized on the basis of the number of pulses seen by the blood, which varied with the velocity of through-plane flow, repetition time, and slab thickness with the maximum flip angle at the flow exit constrained at 90 degrees. The theoretical results show that the optimal RF pulse gives more uniformity for flow signal than does a linear ramp excitation profile or a Gaussian pulse combined with a presaturation pulse. After truncation and filtering of the VUSE pulse in the time domain, the general shape of the VUSE RF excitation profile is maintained, but the maximum flip angle is reduced. The arteries of the neck in a healthy volunteer were imaged with the VUSE pulse, a constant flip angle (flat) pulse, and a linear ramp pulse in flow-compensated 3D MRA sequences. The VUSE pulse produced the most uniform signal as evidenced by the lowest relative dispersion of signal along the left vertebral artery (18.0 versus 26.4 to 23.6 for the other studies). F-distribution tests also showed that the signal distribution obtained with the VUSE pulse in a 3D FLASH sequence was statistically different from that for the flat and the linear ramp pulses.