Managing Patients With Unlabeled Passive Implants on MR Systems Operating Below 1.5 T.

The standard of care for managing a patient with an implant is to identify the item and to assess the relative safety of scanning the patient. Because the 1.5 T MR system is the most prevalent scanner in the world and 3 T is the highest field strength in widespread use, implants typically have "MR Conditional" (i.e., an item with demonstrated safety in the MR environment within defined conditions) labeling at 1.5 and/or 3 T only. This presents challenges for a facility that has a scanner operating at a field strength below 1.5 T when encountering a patient with an implant, because scanning the patient is considered "off-label." In this case, the supervising physician is responsible for deciding whether to scan the patient based on the risks associated with the implant and the benefit of magnetic resonance imaging (MRI). For a passive implant, the MRI safety-related concerns are static magnetic field interactions (i.e., force and torque) and radiofrequency (RF) field-induced heating. The worldwide utilization of scanners operating below 1.5 T combined with the increasing incidence of patients with implants that need MRI creates circumstances that include patients potentially being subjected to unsafe imaging conditions or being denied access to MRI because physicians often lack the knowledge to perform an assessment of risk vs. benefit. Thus, physicians must have a complete understanding of the MRI-related safety issues that impact passive implants when managing patients with these products on scanners operating below 1.5 T. This monograph provides an overview of the various clinical MR systems operating below 1.5 T and discusses the MRI-related factors that influence safety for passive implants. Suggestions are provided for the management of patients with passive implants labeled MR Conditional at 1.5 and/or 3 T, referred to scanners operating below 1.5 T. The purpose of this information is to empower supervising physicians with the essential knowledge to perform MRI exams confidently and safely in patients with passive implants. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 3.

A new method to improve RF safety of implantable medical devices using inductive coupling at 3.0 T MRI.

OBJECTIVE: To enhance RF safety when implantable medical devices are located within the body coil but outside the imaging region by using a secondary resonator (SR) to reduce electric fields, the corresponding specific absorption rate (SAR), and temperature change during MRI. MATERIALS AND METHODS: This study was conducted using numerical simulations with an American Society for Testing and Materials (ASTM) phantom and adult human models of Ella and Duke from Virtual Family Models, along with corresponding experimental results of temperature change obtained using the ASTM phantom. The circular SR was designed with an inner diameter of 150 mm and a width of 6 mm. Experimental measurements were carried out using a 3 T Medical Implant Test System (MITS) body coil, electromagnetic (EM) field mapping probes, and an ASTM phantom. RESULTS: The magnitudes of B1+ (|B1+|) and SAR1g were reduced by 15.2% and 5.85% within the volume of interest (VoI) of an ASTM phantom, when a SR that generates opposing electromagnetic fields was utilized. Likewise, the Δ|B1+| and ΔSAR1g were reduced by up to 56.7% and 57.5% within the VoI of an Ella model containing a copper rod when an opposing SR was used. CONCLUSION: A novel method employing the designed SR, which generates opposing magnetic fields to partially shield a sample, has been proposed to mitigate the risk of induced-RF heating at the VoI through numerical simulations and corresponding experiments under various conditions at 3.0 T.

Comparison of SAR distribution of hip and knee implantable devices in 1.5T conventional cylindrical-bore and 1.2T open-bore vertical MRI systems.

PURPOSE: There is increasing use of open-bore vertical MR systems that consist of two planar RF coils. A recent study showed that the RF-induced heating of a neuromodulation device was much lower in the open-bore system at the brain and the chest imaging landmarks. This study focused on the hip and knee implants and compared the specific absorption rate (SAR) distribution in human models in a 1.2T open-bore coil with that of a 1.5T conventional birdcage coil. METHODS: Computational modeling results were compared against the measurement values using a saline phantom. The differences in RF exposure were examined between a 1.2T open-bore coil and a 1.5T conventional birdcage coil using SAR in an anatomical human model. RESULTS: Modeling setups were validated. The body placed closed to the coil elements led to high SAR values in the birdcage system compared with the open-bore system. CONCLUSION: Our computational modeling showed that the 1.2T planar system demonstrated a lower intensity of SAR distribution adjacent to hip and knee implants compared with the 1.5T conventional birdcage system.

Survey of Acoustic Output in Neonatal Brain Protocols.

BACKGROUND: Auditory and non-auditory safety concerns associated with the appreciable sound levels inherent to magnetic resonance imaging (MRI) procedures exist for neonates. However, current gaps in knowledge preclude making an adequate risk assessment. PURPOSE: To measure acoustic exposure (duration, intensity, and frequency) during neonatal brain MRI and compare these values to existing hearing safety limits and data. STUDY TYPE: Phantom. PHANTOM: Cylindrical doped water phantom. FIELD STRENGTH/SEQUENCE: Neonatal brain protocols acquired at 1-3 T. Scans in the model protocol included a diffusion tensor imaging scan, a gradient echo, a three-dimensional (3D) fast spin echo, 3D fast spin-echo single-shots, a spin echo, a turbo spin echo, a 3D arterial spin labeling scan, and a susceptibility-weighted fast spin-echo scan. ASSESSMENT: The sound pressure levels (SPLs), frequency profile, and durations of five neonatal brain protocols on five MR scanners (scanner A [3 T, whole-body], scanner B [1.5 T, whole-body], scanner C [1 T, dedicated neonatal], scanner D [1.5 T, whole-body], and scanner E [3 T, whole-body]) located at three different sites were recorded. The SPLs were then compared to the International Electrotechnical Commission (IEC) hearing safety limit and existing data of infant non-auditory responses to loud sounds to assess risk. STATISTICAL TESTS: Mann-Whitney U test to assess whether the dedicated neonatal scanner was quieter than the other machines. RESULTS: The average level A-weighted equivalent value (LAEQ) across all five MR scanners and scans was 92.88 dBA and the range of LAEQs across all five MR scanners and scans was 80.8-105.31 dBA. The duration of the recorded neonatal protocols maintained by neonatal scanning facilities (from scanners A, B, and C) ranged from 27:33 to 37:06 minutes. DATA CONCLUSION: Neonatal protocol sound levels straddled existing notions of risk, exceeding sound levels known to cause non-auditory responses in neonates but not exceeding the IEC MRI SPL safety limit. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 5.

Heating of Hip Arthroplasty Implants During Metal Artifact Reduction MRI at 1.5- and 3.0-T Field Strengths.

OBJECTIVES: The aim of this study was to quantify the spatial temperature rises that occur during 1.5- and 3.0-T magnetic resonance imaging (MRI) of different types of hip arthroplasty implants using different metal artifact reduction techniques. MATERIALS AND METHODS: Using a prospective in vitro study design, we evaluated the spatial temperature rises of 4 different total hip arthroplasty constructs using clinical metal artifact reduction techniques including high-bandwidth turbo spin echo (HBW-TSE), slice encoding for metal artifact correction (SEMAC), and compressed sensing SEMAC at 1.5 and 3.0 T. Each MRI protocol included 6 pulse sequences, with imaging planes, parameters, and coverage identical to those in patients. Implants were immersed in standard American Society for Testing and Materials phantoms, and fiber optic sensors were used for temperature measurement. Effects of field strength, radiofrequency pulse polarization at 3.0 T, pulse protocol, and gradient coil switching on heating were assessed using nonparametric Friedman and Wilcoxon signed-rank tests. RESULTS: Across all implant constructs and MRI protocols, the maximum heating at any single point reached 13.1°C at 1.5 T and 1.9°C at 3.0 T. The temperature rises at 3.0 T were similar to that of background in the absence of implants (P = 1). Higher temperature rises occurred at 1.5 T compared with 3.0 T (P < 0.0001), and circular compared with elliptical radiofrequency pulse polarization (P < 0.0001). Compressed sensing SEMAC generated equal or lower degrees of heating compared with HBW-TSE at both field strengths (P < 0.0001). CONCLUSIONS: Magnetic resonance imaging of commonly used total hip arthroplasty implants is associated with variable degrees of periprosthetic tissue heating. In the absence of any perfusion effects, the maximum temperature rises fall within the physiological range at 3.0 T and within the supraphysiologic range at 1.5 T. However, with the simulation of tissue perfusion effects, the heating at 1.5 T also reduces to the upper physiologic range. Compressed sensing SEMAC metal artifact reduction MRI is not associated with higher degrees of heating than the HBW-TSE technique.

Sensitivity and uniformity improvement of phased array MR images using inductive coupling and RF detuning circuits.

OBJECTIVE: To improve sensitivity and uniformity of MR images obtained using a phased array RF coil, an inductively coupled secondary resonator with RF detuning circuits at 300 MHz was designed. MATERIALS AND METHODS: A secondary resonator having detuning circuits to turn off the resonator during the transmit mode was constructed. The secondary resonator was located at the opposite side of the four-channel phased array to improve sensitivity and uniformity of the acquired MR images. Numerical simulations along with phantom and in vivo experiments were conducted to evaluate the designed secondary resonator. RESULTS: The numerical simulation results of |B1+| in a transmit mode showed that magnetic field uniformity would be decreased with a secondary resonator having no detuning circuits because of unwanted interferences between the transmit birdcage coil and the secondary resonator. The standard deviation (SD) of |B1+| was decreased 57% with a secondary resonator containing detuning circuits. The sensitivity and uniformity of |B1-| in the receive mode using a four-channel phased array were improved with the secondary resonator. Phantom experiments using a uniform saline phantom had 20% improvement of the mean signal intensity and 50% decrease in the SD with the secondary resonator. Mice with excess adipose tissue were imaged to demonstrate the utility of the secondary resonator. CONCLUSION: The designed secondary resonator having detuning circuits improved sensitivity and uniformity of mouse MR images acquired using the four-channel phased array.

Reconfigurable MRI technology for low-SAR imaging of deep brain stimulation at 3T: Application in bilateral leads, fully-implanted systems, and surgically modified lead trajectories.

Patients with deep brain stimulation devices highly benefit from postoperative MRI exams, however MRI is not readily accessible to these patients due to safety risks associated with RF heating of the implants. Recently we introduced a patient-adjustable reconfigurable coil technology that substantially reduced local SAR at tips of single isolated DBS leads during MRI at 1.5 T in 9 realistic patient models. This contribution extends our work to higher fields by demonstrating the feasibility of scaling the technology to 3T and assessing its performance in patients with bilateral leads as well as fully implanted systems. We developed patient-derived models of bilateral DBS leads and fully implanted DBS systems from postoperative CT images of 13 patients and performed finite element simulations to calculate SAR amplification at electrode contacts during MRI with a reconfigurable rotating coil at 3T. Compared to a conventional quadrature body coil, the reconfigurable coil system reduced the SAR on average by 83% for unilateral leads and by 59% for bilateral leads. A simple surgical modification in trajectory of implanted leads was demonstrated to increase the SAR reduction efficiency of the rotating coil to >90% in a patient with a fully implanted bilateral DBS system. Thermal analysis of temperature-rise around electrode contacts during typical brain exams showed a 15-fold heating reduction using the rotating coil, generating <1°C temperature rise during ∼4-min imaging with high-SAR sequences where a conventional CP coil generated >10°C temperature rise in the tissue for the same flip angle.

Hyperpolarized 13C MRI: Path to Clinical Translation in Oncology.

This white paper discusses prospects for advancing hyperpolarization technology to better understand cancer metabolism, identify current obstacles to HP (hyperpolarized) 13C magnetic resonance imaging's (MRI's) widespread clinical use, and provide recommendations for overcoming them. Since the publication of the first NIH white paper on hyperpolarized 13C MRI in 2011, preclinical studies involving [1-13C]pyruvate as well a number of other 13C labeled metabolic substrates have demonstrated this technology's capacity to provide unique metabolic information. A dose-ranging study of HP [1-13C]pyruvate in patients with prostate cancer established safety and feasibility of this technique. Additional studies are ongoing in prostate, brain, breast, liver, cervical, and ovarian cancer. Technology for generating and delivering hyperpolarized agents has evolved, and new MR data acquisition sequences and improved MRI hardware have been developed. It will be important to continue investigation and development of existing and new probes in animal models. Improved polarization technology, efficient radiofrequency coils, and reliable pulse sequences are all important objectives to enable exploration of the technology in healthy control subjects and patient populations. It will be critical to determine how HP 13C MRI might fill existing needs in current clinical research and practice, and complement existing metabolic imaging modalities. Financial sponsorship and integration of academia, industry, and government efforts will be important factors in translating the technology for clinical research in oncology. This white paper is intended to provide recommendations with this goal in mind.

Improvement of 19F MR image uniformity in a mouse model of cellular therapy using inductive coupling.

OBJECTIVE: Improve 19F magnetic resonance imaging uniformity of perfluorocarbon (PFC)-labeled cells by using a secondary inductive resonator tuned to 287 MHz to enhance the induced radio frequency (RF) magnetic field (B1) at 7.05 T. MATERIALS AND METHODS: Following Faraday's induction law, the sign of induced B1 made by the secondary resonator can be changed depending on the tuning of the resonator. A secondary resonator located on the opposite side of the phantom of the 19F surface coil can be shown to enhance or subtract the induced B1 field, depending upon its tuning. RESULTS: The numerical simulation results of rotating transmit B1 magnitude (|B 1 + |) and corresponding experimental 19F images were compared without and with the secondary resonator. With the secondary resonator tuned to 287 MHz, improvements of |B 1 + | and 19F image uniformity were demonstrated. The use of the secondary resonator improved our ability to visualize transplanted cell location non-invasively over a period of 6 weeks. CONCLUSION: The secondary resonator tuned to enhance the induced B1 results in improved image uniformity in a pre-clinical application, enabling cell tracking of PFC-labeled cells with the secondary resonator.

Radio-Frequency Safety Assessment of Stents in Blood Vessels During Magnetic Resonance Imaging.

Purpose: The purpose of this study was to investigate the need for high-resolution detailed anatomical modeling to correctly estimate radio-frequency (RF) safety during magnetic resonance imaging (MRI). RF-induced heating near metallic implanted devices depends on the electric field tangential to the device (Etan ). Etan and specific absorption rate (SAR) were analyzed in blood vessels of an anatomical model to understand if a standard gel phantom accurately represents the potential heating in tissues due to passive vascular implants such as stents. Methods: A numerical model of an RF birdcage body coil and an anatomically realistic virtual patient with a native spatial resolution of 1 mm3 were used to simulate the in vivo electric field at 64 MHz (1.5 T MRI system). Maximum values of SAR inside the blood vessels were calculated and compared with peaks in a numerical model of the ASTM gel phantom to see if the results from the simplified and homogeneous gel phantom were comparable to the results from the anatomical model. Etan values were also calculated in selected stent trajectories inside blood vessels and compared with the ASTM result. Results: Peak SAR values in blood vessels were up to ten times higher than those found in the ASTM standard gel phantom. Peaks were found in clinically significant anatomical locations, where stents are implanted as per intended use. Furthermore, Etan results showed that volume-averaged SAR values might not be sufficient to assess RF safety. Conclusion: Computational modeling with a high-resolution anatomical model indicated higher values of the incident electric field compared to the standard testing approach. Further investigation will help develop a robust safety testing method which reflects clinically realistic conditions.

Retrospective analysis of RF heating measurements of passive medical implants.

PURPOSE: The test reports for the RF-induced heating of metallic devices of hundreds of medical implants have been provided to the U.S. Food and Drug Administration as a part of premarket submissions. The main purpose of this study is to perform a retrospective analysis of the RF-induced heating data provided in the reports to analyze the trends and correlate them with implant geometric characteristics. METHODS: The ASTM-based RF heating test reports from 86 premarket U.S. Food and Drug Administration submissions were reviewed by three U.S. Food and Drug Administration reviewers. From each test report, the dimensions and RF-induced heating values for a given whole-body (WB) specific absorption rate (SAR) and local background (LB) SAR were extracted and analyzed. The data from 56 stents were analyzed as a subset to further understand heating trends and length dependence. RESULTS: For a given WB SAR, the LB/WB SAR ratio varied significantly across the test labs, from 2.3 to 11.3. There was an increasing trend on the temperature change per LB SAR with device length. The maximum heating for stents occurred at lengths of approximately 100 mm at 3 T, and beyond 150 mm at 1.5 T. CONCLUSIONS: Differences in the LB/WB SAR ratios across testing labs and various MRI scanners could lead to inconsistent WB SAR labeling. Magnetic resonance (MR) conditional labeling based on WB SAR should be derived from a conservative estimate of global LB/WB ratios.

Improvement of Electromagnetic Field Distributions Using High Dielectric Constant (HDC) Materials for CTL-Spine MRI: Numerical Simulations and Experiments.

This study investigates the use of pads with high dielectric constant (HDC) materials to alter electromagnetic field distributions in patients during magnetic resonance imaging (MRI). The study was performed with numerical simulations and phantom measurements. An initial proof-of-concept and validation was performed using a phantom at 64 MHz, showing increases of up to 10% in electromagnetic field when using distilled water as the high dielectric material. Additionally, numerical simulations with computational models of human anatomy were performed at 128 MHz. Results of these simulations using barium titanate (BaTiO3) beads showed a 61% increase of [Formula: see text] with a quadrature driven RF coil and a 64% increase with a dual-transmit array. The presence of the HDC material also allowed for a decrease of SAR up to twofold (e.g., peak 10 g-averaged SAR from 54 to 22 W/kg with a quadrature driven RF coil and from 27 to 22 W/kg with a dual-transmit array using CaTiO3 powder at 128 MHz). The results of this study show that the use of HDC pads at 128 MHz for MRI spine applications could result in improved magnetic fields within the region of interest, while decreasing SAR outside the region.

RF Safety Evaluation of a Breast Tissue Expander Device for MRI: Numerical Simulation and Experiment.

This study describes the MRI-related radio frequency (RF) safety evaluation of breast tissue expander devices to establish safety criteria. Numerical simulations and experimental measurements were performed at 64 MHz with a gel phantom containing a breast expander. Additionally, computational modeling was performed (64 and 128 MHz) with an adult female model, containing a virtually implanted breast tissue expander device for four imaging landmark positions. The presence of the breast tissue expander device led to significant alterations in specific absorption rate (SAR) and|B1+|distributions. The main source of SAR alterations with the use of the breast expander device was the saline-filled pouch of the expander. Conversely, the variation of RF magnetic field (B1+) was mainly caused by the metallic port. The measured values of electric field magnitude did not increase significantly due to the introduction of the expander device. The maximum 1g- or 10g-averaged SAR values in tissues near the implant were lower than those expected in other regions of the patient body with normalization of both|B1+|equal to 2 µT at the coil isocenter and whole body averaged SAR equal to 4W/kg.

Effects of iron oxide nanoparticles on biological responses and MR imaging properties in human mammary healthy and breast cancer epithelial cells.

Superparamagnetic iron oxide nanoparticles (SPIONs, diameters >50 nm) have received great attention due to their promising use as magnetic resonance imaging (MRI) contrast agents. In this study, we evaluated the cellular uptake and biological responses in vitro of ultrasmall SPIONs (USPIONs, diameters < 50 nm). We compared the cellular responses between breast epithelia isolated from healthy and breast cancer donors after exposure to carboxy-terminated USPIONs (10 and 30 nm PEG-coated, 10 and 30 nm non-PEG-coated). The particles were characterized using transmission electron microscopy (TEM), dynamic light scattering (DLS) and gel electrophoresis. Cellular interactions with USPIONs were assessed by confocal microscopy and TEM. Cellular uptake of USPIONs was quantified using ICP-MS. Cell viability was measured by MTT and neutral red uptake assays. T2* weighted MRI scans were performed using a 7T scanner. Results demonstrated that cell association/internalization of USPIONs was size- and surface coating-dependent (PEG vs. non-PEG), and higher cellular uptake of 10 and 30 nm non-coated particles was observed in both cell types compared with PEG-coated particles. Cell uptake for 10 and 30 nm non-coated particles was higher in cancer cells from two of three tested donors compared to healthy cells from three donors. There was no significant cytotoxicity observed for all tested particles. Significantly enhanced MRI contrast was observed following exposure to 10 and 30 nm non-coated particles compared to PEG-coated particles in both cell types. In comparison, cancer cells showed more enhanced MRI signals when compared to normal cells. The data indicate that cell responses following exposure to USPIONs are dependent on particle properties. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1032-1042, 2016.

A Rotational Cylindrical fMRI Phantom for Image Quality Control.

PURPOSE: A novel phantom for image quality testing for functional magnetic resonance imaging (fMRI) scans is described. METHODS: The cylindrical, rotatable, ~4.5L phantom, with eight wedge-shaped compartments, is used to simulate rest and activated states. The compartments contain NiCl2 doped agar gel with alternating concentrations of agar (1.4%, 1.6%) to produce T1 and T2 values approximating brain grey matter. The Jacard index was used to compare the image distortions for echo planar imaging (EPI) and gradient recalled echo (GRE) scans. Contrast to noise ratio (CNR) was compared across the imaging volume for GRE and EPI. RESULTS: The mean T2 for the two agar concentrations were found to be 106.5±4.8, 94.5±4.7 ms, and T1 of 1500±40 and 1485±30 ms, respectively. The Jacard index for GRE was generally found to be higher than for EPI (0.95 versus 0.8). The CNR varied from 20 to 50 across the slices and echo times used for EPI scans, and from 20 to 40 across the slices for the GRE scans. The phantom provided a reproducible CNR over 25 days. CONCLUSIONS: The phantom provides a quantifiable signal change over a head-size imaging volume with EPI and GRE sequences, which was used for image quality assessment.

A novel method to decrease electric field and SAR using an external high dielectric sleeve at 3 T head MRI: numerical and experimental results.

Materials with high dielectric constant (HDC) have been used in high field MRI to decrease specific absorption rate (SAR), increase magnetic field intensity, and increase signal-to-noise ratio. In previous studies, the HDC materials were placed inside the RF coil decreasing the space available. This study describes an alternative approach that considers an HDC-based sleeve placed outside the RF coil. The effects of an HDC on the electromagnetic (EM) field were studied using numerical simulations with a coil unloaded and loaded with a human head model. In addition, experimental EM measurements at 128 MHz were performed inside a custom-made head coil, fitted with a distilled water sleeve. The numerical simulations showed up to 40% decrease in maximum 10 g-avg. SAR on the surface of the head model with an HDC material of barium titanate. Experimental measurements also showed up to 20% decrease of maximum electric field using an HDC material of distilled water. The proposed method can be incorporated in the design of high field transmit RF coils.

Improving the use of principal component analysis to reduce physiological noise and motion artifacts to increase the sensitivity of task-based fMRI.

BACKGROUND: Functional magnetic resonance imaging (fMRI) time series are subject to corruption by many noise sources, especially physiological noise and motion. Researchers have developed many methods to reduce physiological noise, including RETROICOR, which retroactively removes cardiac and respiratory waveforms collected during the scan, and CompCor, which applies principal components analysis (PCA) to remove physiological noise components without any physiological monitoring during the scan. NEW METHOD: We developed four variants of the CompCor method. The optimized CompCor method applies PCA to time series in a noise mask, but orthogonalizes each component to the BOLD response waveform and uses an algorithm to determine a favorable number of components to use as "nuisance regressors." Whole brain component correction (WCompCor) is similar, except that it applies PCA to time-series throughout the whole brain. Low-pass component correction (LCompCor) identifies low-pass filtered components throughout the brain, while high-pass component correction (HCompCor) identifies high-pass filtered components. COMPARISON WITH EXISTING METHOD: We compared the new methods with the original CompCor method by examining the resulting functional contrast-to-noise ratio (CNR), sensitivity, and specificity. RESULTS: (1) The optimized CompCor method increased the CNR and sensitivity compared to the original CompCor method and (2) the application of WCompCor yielded the best improvement in the CNR and sensitivity. CONCLUSIONS: The sensitivity of the optimized CompCor, WCompCor, and LCompCor methods exceeded that of the original CompCor method. However, regressing noise signals showed a paradoxical consequence of reducing specificity for all noise reduction methods attempted.

Diffusion-weighted imaging (DWI) of adenomyosis and fibroids of the uterus.

PURPOSE: Although magnetic resonance imaging is often able to distinguish between adenomyosis and fibroids, occasionally the imaging features of focal adenomyosis and fibroids overlap. Diffusion-weighted imaging (DWI) may provide useful information in differentiating pathologies. Therefore, the purpose of our study was to evaluate differences, if any, in the apparent diffusion coefficient (ADC) values of fibroids and adenomyosis. MATERIAL AND METHODS: Patients (n = 50) with uterine fibroids and adenomyosis (n = 43), who underwent pelvic MR imaging including DWI, were included in this IRB approved HIPPA compliant retrospective study. DWI was performed with b factors of 50, 400, and 800 s/mm using a 1.5 T scanner. ADC ROI measurements were placed over a fibroid, an area of adenomyosis, unaffected normal myometrium, skeletal muscle, and urine. Histogram analysis of ADC maps in 20 cases each of adenomyosis and fibroids was evaluated to assess the degree of tissue heterogeneity. RESULTS: The ADC values of adenomyosis and fibroids were compared using Student's t test. The mean and the standard deviation of the ADC values of the control group were as follows: fibroid 0.64 ± 0.29, adenomyosis 0.86 ± 0.30, myometrium 1.39 ± 0.36, and urine 3.01 ± 0.2 × 10(-3) mm(2)/s. There was a statistically significant difference among the ADC values of normal myometrium and fibroids (p < 0.0001), normal myometrium and adenomyosis (p < 0.0001), and fibroids and adenomyosis (p < 0.001). Histogram analysis demonstrates less heterogeneity of adenomyosis as compared to fibroids. CONCLUSION: The present study shows that ADC measurements have the potential to quantitatively differentiate between fibroids and adenomyosis.

A dialyzer-based flow system for validating dynamic contrast enhanced MR image acquisition.

PURPOSE: Dynamic contrast enhanced magnetic resonance imaging (MRI) has proven to be quite sensitive for the characterization of masses and early response to therapy. However, it is fraught with a number of procedural challenges as well as a lack of standardization. In this article, we describe the use of a simple dialyzer-based flow system to evaluate reproducibility of dynamic contrast enhanced MRI under active flow conditions. METHODS: The MR signal during a bolus injection of Gd-DTPA was analyzed to test the precision and variability of contrast agent kinetics during a typical dynamic contrast enhanced MRI sequence. A simple model allows an estimation of the washout rate constant of Gd-DTPA through the polysulfone tubules of the dialyzer. RESULTS: The simple flow phantom described here provided reproducible measurements of the washout rate constants. The washout rate increased from 0.20 ± 0.005 min(-1) to 0.25 ± 0.008 min(-1) over 32 weeks. Measurements were also made at week 24 using dynamic computed tomography and found to be 0.27 ± 0.006 min(-1) . Overall, the computed tomography derived rate constants results were found be ∼12% higher than the corresponding MRI values. CONCLUSION: In this study, we show that a simple dialyzer-based flow phantom can be used for testing dynamic contrast enhanced MRI pulse sequences and also allows for short-term reproducibility testing of rate constants.

Head-repositioning does not reduce the reproducibility of fMRI activation in a block-design motor task.

It is hypothesized that, based upon partial volume effects and spatial non-uniformities of the scanning environment, repositioning a subject's head inside the head coil between separate functional MRI scans will reduce the reproducibility of fMRI activation compared to a series of functional runs where the subject's head remains in the same position. Nine subjects underwent fMRI scanning where they performed a sequential, oppositional finger-tapping task. The first five runs were conducted with the subject's head remaining stable inside the head coil. Following this, four more runs were collected after the subject removed and replaced his/her head inside the head coil before each run. The coefficient of variation was calculated for four metrics: the distance from the anterior commisure to the center of mass of sensorimotor activation, maximum t-statistic, activation volume, and average percent signal change. These values were compared for five head-stabilization runs and five head-repositioning runs. Voxelwise intraclass correlation coefficients were also calculated to assess the spatial distribution of sources of variance. Interestingly, head repositioning was not seen to significantly affect the reproducibility of fMRI activation (p<0.05). In addition, the threshold level affected the reproducibility of activation volume and percent signal change.