High-resolution 3D radial bSSFP with IDEAL.

Radial trajectories facilitate high-resolution balanced steady state free precession (bSSFP) because the efficient gradients provide more time to extend the trajectory in k-space. A number of radial bSSFP methods that support fat-water separation have been developed; however, most of these methods require an environment with limited B0 inhomogeneity. In this work, high-resolution bSSFP with fat-water separation is achieved in more challenging B0 environments by combining a 3D radial trajectory with the IDEAL chemical species separation method. A method to maintain very high resolution within the timing constraints of bSSFP and IDEAL is described using a dual-pass pulse sequence. The sampling of a unique set of radial lines at each echo time is investigated as a means to circumvent the longer scan time that IDEAL incurs as a multiecho acquisition. The manifestation of undersampling artifacts in this trajectory and their effect on chemical species separation are investigated in comparison to the case in which each echo samples the same set of radial lines. This new bSSFP method achieves 0.63 mm isotropic resolution in a 5-min scan and is demonstrated in difficult in vivo imaging environments, including the breast and a knee with ACL reconstruction hardware at 1.5 T.

Subject-specific models of susceptibility-induced B0 field variations in breast MRI.

PURPOSE: To rapidly calculate and validate subject-specific field maps based on the three-dimensional shape of the bilateral breast volume. MATERIALS AND METHODS: Ten healthy female volunteers were scanned at 3 Tesla using a multi-echo sequence that provides water, fat, in-phase, out-of-phase, and field map images. A shape-specific binary mask was automatically generated to calculate a computed field map using a dipole field model. The measured and computed field maps were compared by visualizing the spatial distribution of the difference field map, the mean absolute error, and the 80% distribution widths of frequency histograms. RESULTS: The 10 computed field maps had a mean absolute error of 38 Hz (0.29 ppm) compared with the measured field maps. The average 80% distribution widths for the histograms of all of the computed, measured, and difference field maps are 205 Hz, 233 Hz, and 120 Hz, respectively. CONCLUSION: The computed field maps had substantial overall agreement with the measured field maps, indicating that breast MRI field maps can be computed based on the air-tissue interfaces. These estimates may provide a predictive model for field variations and thus have the potential to improve applications in breast MRI.

Chemical shift-based water/fat separation in the presence of susceptibility-induced fat resonance shift.

Chemical shift-based water/fat separation methods have been emerging due to the growing clinical need for fat quantification in different body organs. Accurate quantification of proton-density fat fraction requires the assessment of many confounding factors, including the need of modeling the presence of multiple peaks in the fat spectrum. Most recent quantitative chemical shift-based water/fat separation approaches rely on a multipeak fat spectrum with precalibrated peak locations and precalibrated or self-calibrated peak relative amplitudes. However, water/fat susceptibility differences can induce fat spectrum resonance shifts depending on the shape and orientation of the fatty inclusions. The effect is of particular interest in the skeletal muscle due to the anisotropic arrangement of extracellular lipids. In this work, the effect of susceptibility-induced fat resonance shift on the fat fraction is characterized in a conventional complex-based chemical shift-based water/fat separation approach that does not model the susceptibility-induced fat resonance shift. A novel algorithm is then proposed to quantify the resonance shift in a complex-based chemical shift-based water/fat separation approach that considers the fat resonance shift in the signal model, aiming to extract information about the orientation/geometry of lipids. The technique is validated in a phantom and preliminary in vivo results are shown in the calf musculature of healthy and diabetic subjects.

Water-silicone separated volumetric MR acquisition for rapid assessment of breast implants.

PURPOSE: To develop a robust T(2) -weighted volumetric imaging technique with uniform water-silicone separation and simultaneous fat suppression for rapid assessment of breast implants in a single acquisition. MATERIALS AND METHODS: A three-dimensional (3D) fast spin echo sequence that uses variable refocusing flip angles was combined with a three-point chemical-shift technique (IDEAL) and short tau inversion recovery (STIR). Phase shifts of -π/6, +π/2, and +7π/6 between water and silicone were used for IDEAL processing. For comparison, two-dimensional images using 2D-FSE-IDEAL with STIR were also acquired in axial, coronal, and sagittal orientations. RESULTS: Near-isotropic (true spatial resolution-0.9 × 1.3 × 2.0 mm(3) ) volumetric breast images with uniform water-silicone separation and simultaneous fat suppression were acquired successfully in clinically feasible scan times (7:00-10:00 min). The 2D images were acquired with the same in-plane resolution (0.9 × 1.3 mm(2) ), but the slice thickness was increased to 6 mm with a slice gap of 1 mm for complete coverage of the implants in a reasonable scan time, which varied between 18:00 and 22:30 min. CONCLUSION: The single volumetric acquisition with uniform water and silicone separation enables images to be reformatted into any orientation. This allows comprehensive assessment of breast implant integrity in less than 10 min of total examination time.

Estimation of liver T2 in transfusion-related iron overload in patients with weighted least squares T2 IDEAL.

MRI imaging of hepatic iron overload can be achieved by estimating T(2) values using multiple-echo sequences. The purpose of this work is to develop and clinically evaluate a weighted least squares algorithm based on T(2) Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation (IDEAL) technique for volumetric estimation of hepatic T(2) in the setting of iron overload. The weighted least squares T(2) IDEAL technique improves T(2) estimation by automatically decreasing the impact of later, noise-dominated echoes. The technique was evaluated in 37 patients with iron overload. Each patient underwent (i) a standard 2D multiple-echo gradient echo sequence for T(2) assessment with nonlinear exponential fitting, and (ii) a 3D T(2) IDEAL technique, with and without a weighted least squares fit. Regression and Bland-Altman analysis demonstrated strong correlation between conventional 2D and T(2) IDEAL estimation. In cases of severe iron overload, T(2) IDEAL without weighted least squares reconstruction resulted in a relative overestimation of T(2) compared with weighted least squares.

Robust multipoint water-fat separation using fat likelihood analysis.

Fat suppression is an essential part of routine MRI scanning. Multiecho chemical-shift based water-fat separation methods estimate and correct for Bo field inhomogeneity. However, they must contend with the intrinsic challenge of water-fat ambiguity that can result in water-fat swapping. This problem arises because the signals from two chemical species, when both are modeled as a single discrete spectral peak, may appear indistinguishable in the presence of Bo off-resonance. In conventional methods, the water-fat ambiguity is typically removed by enforcing field map smoothness using region growing based algorithms. In reality, the fat spectrum has multiple spectral peaks. Using this spectral complexity, we introduce a novel concept that identifies water and fat for multiecho acquisitions by exploiting the spectral differences between water and fat. A fat likelihood map is produced to indicate if a pixel is likely to be water-dominant or fat-dominant by comparing the fitting residuals of two different signal models. The fat likelihood analysis and field map smoothness provide complementary information, and we designed an algorithm (Fat Likelihood Analysis for Multiecho Signals) to exploit both mechanisms. It is demonstrated in a wide variety of data that the Fat Likelihood Analysis for Multiecho Signals algorithm offers highly robust water-fat separation for 6-echo acquisitions, particularly in some previously challenging applications.

On the performance of T2* correction methods for quantification of hepatic fat content.

Nonalcoholic fatty liver disease is the most prevalent chronic liver disease in Western societies. MRI can quantify liver fat, the hallmark feature of nonalcoholic fatty liver disease, so long as multiple confounding factors including T(2)* decay are addressed. Recently developed MRI methods that correct for T(2)* to improve the accuracy of fat quantification either assume a common T(2)* (single-T(2)*) for better stability and noise performance or independently estimate the T(2)* for water and fat (dual-T(2)*) for reduced bias, but with noise performance penalty. In this study, the tradeoff between bias and variance for different T(2)* correction methods is analyzed using the Cramér-Rao bound analysis for biased estimators and is validated using Monte Carlo experiments. A noise performance metric for estimation of fat fraction is proposed. Cramér-Rao bound analysis for biased estimators was used to compute the metric at different echo combinations. Optimization was performed for six echoes and typical T(2)* values. This analysis showed that all methods have better noise performance with very short first echo times and echo spacing of ∼π/2 for single-T(2)* correction, and ∼2π/3 for dual-T(2)* correction. Interestingly, when an echo spacing and first echo shift of ∼π/2 are used, methods without T(2)* correction have less than 5% bias in the estimates of fat fraction.

Validation of MRI biomarkers of hepatic steatosis in the presence of iron overload in the ob/ob mouse.

PURPOSE: To validate the utility and performance of a T 2 correction method for hepatic fat quantification in an animal model of both steatosis and iron overload. MATERIALS AND METHODS: Mice with low (n = 6), medium (n = 6), and high (n = 8) levels of steatosis were sedated and imaged using a chemical shift-based fat-water separation method to obtain magnetic resonance imaging (MRI) fat-fraction measurements. Imaging was performed before and after each of two superparamagnetic iron oxide (SPIO) injections to create hepatic iron overload. Fat-fraction maps were reconstructed with and without T 2 correction. Fat-fraction with and without T 2 correction and T 2 measurements were compared after each injection. Liver tissue was harvested and imaging results were compared to triglyceride extraction and histology grading. RESULTS: Excellent correlation was seen between MRI fat-fraction and tissue-based fat quantification. Injections of SPIOs led to increases in R 2 (=1/T 2). Measured fat-fraction was unaffected by the presence of iron when T 2 correction was used, whereas measured fat-fraction dramatically increased without T 2 correction. CONCLUSION: Hepatic fat-fraction measured using a T 2-corrected chemical shift-based fat-water separation method was validated in an animal model of steatosis and iron overload. T 2 correction enables robust fat-fraction estimation in both the presence and absence of iron, and is necessary for accurate hepatic fat quantification.

Characterization of the regional distribution of skeletal muscle adipose tissue in type 2 diabetes using chemical shift-based water/fat separation.

PURPOSE: To show the feasibility of assessing the spatial distribution of skeletal muscle adipose tissue using chemical shift-based water/fat separation and to characterize differences in calf intermuscular adipose tissue (IMAT) compartmentalization in patients with type 2 diabetes mellitus (T2DM) compared to healthy age-matched controls. MATERIALS AND METHODS: A chemical shift-based water/fat separation approach using a multiecho 3D spoiled gradient echo sequence was applied in a study of 64 patients, including 35 healthy controls and 29 subjects with T2DM. Masks were defined based on manual segmentations to compute fat volume within different compartments, including regions of subcutaneous adipose tissue (SAT) and six muscular regions. IMAT was divided into two compartments representing fat within the muscular regions (intraMF) and fat between the muscular regions (interMF). Two-sample Student's t-tests were used to compare fat volumes between the two groups. RESULTS: The subjects with T2DM had a lower volume of SAT compared to the healthy controls (P = 4 × 10(-5) ). There was no statistically significant difference in the IMAT volume between the two groups. However, the intraMF volume normalized by the IMAT volume was higher in the diabetics compared to the controls (P = 0.006). CONCLUSION: Chemical shift-based water/fat separation enables the quantification of fat volume within localized muscle regions, showing that the IMAT regional distribution is significantly different in T2DM compared to normal controls.

Combination of complex-based and magnitude-based multiecho water-fat separation for accurate quantification of fat-fraction.

Multipoint water-fat separation techniques rely on different water-fat phase shifts generated at multiple echo times to decompose water and fat. Therefore, these methods require complex source images and allow unambiguous separation of water and fat signals. However, complex-based water-fat separation methods are sensitive to phase errors in the source images, which may lead to clinically important errors. An alternative approach to quantify fat is through "magnitude-based" methods that acquire multiecho magnitude images. Magnitude-based methods are insensitive to phase errors, but cannot estimate fat-fraction greater than 50%. In this work, we introduce a water-fat separation approach that combines the strengths of both complex and magnitude reconstruction algorithms. A magnitude-based reconstruction is applied after complex-based water-fat separation to removes the effect of phase errors. The results from the two reconstructions are then combined. We demonstrate that using this hybrid method, 0-100% fat-fraction can be estimated with improved accuracy at low fat-fractions.

T1-corrected fat quantification using chemical shift-based water/fat separation: application to skeletal muscle.

Chemical shift-based water/fat separation, like iterative decomposition of water and fat with echo asymmetry and least-squares estimation, has been proposed for quantifying intermuscular adipose tissue. An important confounding factor in iterative decomposition of water and fat with echo asymmetry and least-squares estimation-based intermuscular adipose tissue quantification is the large difference in T(1) between muscle and fat, which can cause significant overestimation in the fat fraction. This T(1) bias effect is usually reduced by using small flip angles. T(1) -correction can be performed by using at least two different flip angles and fitting for T(1) of water and fat. In this work, a novel approach for the water/fat separation problem in a dual flip angle experiment is introduced and a new approach for the selection of the two flip angles, labeled as the unequal small flip angle approach, is developed, aiming to improve the noise efficiency of the T(1) -correction step relative to existing approaches. It is shown that the use of flip angles, selected such the muscle water signal is assumed to be T(1) -independent for the first flip angle and the fat signal is assumed to be T(1) -independent for the second flip angle, has superior noise performance to the use of equal small flip angles (no T(1) estimation required) and the use of large flip angles (T(1) estimation required).

T(1) independent, T(2) (*) corrected chemical shift based fat-water separation with multi-peak fat spectral modeling is an accurate and precise measure of hepatic steatosis.

PURPOSE: To determine the precision and accuracy of hepatic fat-fraction measured with a chemical shift-based MRI fat-water separation method, using single-voxel MR spectroscopy (MRS) as a reference standard. MATERIALS AND METHODS: In 42 patients, two repeated measurements were made using a T(1) -independent, T 2*-corrected chemical shift-based fat-water separation method with multi-peak spectral modeling of fat, and T(2) -corrected single voxel MR spectroscopy. Precision was assessed through calculation of Bland-Altman plots and concordance correlation intervals. Accuracy was assessed through linear regression between MRI and MRS. Sensitivity and specificity of MRI fat-fractions for diagnosis of steatosis using MRS as a reference standard were also calculated. RESULTS: Statistical analysis demonstrated excellent precision of MRI and MRS fat-fractions, indicated by 95% confidence intervals (units of absolute percent) of [-2.66%,2.64%] for single MRI ROI measurements, [-0.81%,0.80%] for averaged MRI ROI, and [-2.70%,2.87%] for single-voxel MRS. Linear regression between MRI and MRS indicated that the MRI method is highly accurate. Sensitivity and specificity for detection of steatosis using averaged MRI ROI were 100% and 94%, respectively. The relationship between hepatic fat-fraction and body mass index was examined. CONCLUSION: Fat-fraction measured with T(1) -independent T 2*-corrected MRI and multi-peak spectral modeling of fat is a highly precise and accurate method of quantifying hepatic steatosis.

Magnetization-prepared IDEAL bSSFP: a flow-independent technique for noncontrast-enhanced peripheral angiography.

PURPOSE: To propose a new noncontrast-enhanced flow-independent angiography sequence based on balanced steady-state free precession (bSSFP) that produces reliable vessel contrast despite the reduced blood flow in the extremities. MATERIALS AND METHODS: The proposed technique addresses a variety of factors that can compromise the exam success including insufficient background suppression, field inhomogeneity, and large volumetric coverage requirements. A bSSFP sequence yields reduced signal from venous blood when long repetition times are used. Complex-sum bSSFP acquisitions decrease the sensitivity to field inhomogeneity but retain phase information, so that data can be processed with the Iterative Decomposition of Water and Fat with Echo Asymmetry and Least-Squares Estimation (IDEAL) method for robust fat suppression. Meanwhile, frequent magnetization preparation coupled with parallel imaging reduces the muscle and long-T(1) fluid signals without compromising scan efficiency. RESULTS: In vivo flow-independent peripheral angiograms with reliable background suppression and high spatial resolution are produced. Comparisons with phase-sensitive bSSFP angiograms (that yield out-of-phase fat and water signals, and exploit this phase difference to suppress fat) demonstrate enhanced vessel depiction with the proposed technique due to reduced partial-volume effects and improved venous suppression. CONCLUSION: Magnetization-prepared complex-sum bSSFP with IDEAL fat/water separation can create reliable flow-independent angiographic contrast in the lower extremities.

Quantification of hepatic steatosis with T1-independent, T2-corrected MR imaging with spectral modeling of fat: blinded comparison with MR spectroscopy.

PURPOSE: To prospectively compare an investigational version of a complex-based chemical shift-based fat fraction magnetic resonance (MR) imaging method with MR spectroscopy for the quantification of hepatic steatosis. MATERIALS AND METHODS: This study was approved by the institutional review board and was HIPAA compliant. Written informed consent was obtained before all studies. Fifty-five patients (31 women, 24 men; age range, 24-71 years) were prospectively imaged at 1.5 T with quantitative MR imaging and single-voxel MR spectroscopy, each within a single breath hold. The effects of T2 correction, spectral modeling of fat, and magnitude fitting for eddy current correction on fat quantification with MR imaging were investigated by reconstructing fat fraction images from the same source data with different combinations of error correction. Single-voxel T2-corrected MR spectroscopy was used to measure fat fraction and served as the reference standard. All MR spectroscopy data were postprocessed at a separate institution by an MR physicist who was blinded to MR imaging results. Fat fractions measured with MR imaging and MR spectroscopy were compared statistically to determine the correlation (r(2)), and the slope and intercept as measures of agreement between MR imaging and MR spectroscopy fat fraction measurements, to determine whether MR imaging can help quantify fat, and examine the importance of T2 correction, spectral modeling of fat, and eddy current correction. Two-sided t tests (significance level, P = .05) were used to determine whether estimated slopes and intercepts were significantly different from 1.0 and 0.0, respectively. Sensitivity and specificity for the classification of clinically significant steatosis were evaluated. RESULTS: Overall, there was excellent correlation between MR imaging and MR spectroscopy for all reconstruction combinations. However, agreement was only achieved when T2 correction, spectral modeling of fat, and magnitude fitting for eddy current correction were used (r(2) = 0.99; slope ± standard deviation = 1.00 ± 0.01, P = .77; intercept ± standard deviation = 0.2% ± 0.1, P = .19). CONCLUSION: T1-independent chemical shift-based water-fat separation MR imaging methods can accurately quantify fat over the entire liver, by using MR spectroscopy as the reference standard, when T2 correction, spectral modeling of fat, and eddy current correction methods are used.

Constraining the initial phase in water-fat separation.

An algorithm is described for use in chemical shift-based water-fat separation to constrain the phase of both species to be equal at an echo time of zero. This constraint is physically reasonable since the initial phase should be a property of the excitation pulse and receiver coil only. The advantages of phase constrained water-fat separation, namely, improved noise performance and/or reduced data requirements (fewer echos), are demonstrated in simulations and experiments.

T(2)-weighted 3D fast spin echo imaging with water-fat separation in a single acquisition.

PURPOSE: To develop a robust 3D fast spin echo (FSE) T(2)-weighted imaging method with uniform water and fat separation in a single acquisition, amenable to high-quality multiplanar reformations. MATERIALS AND METHODS: The Iterative Decomposition of water and fat with Echo Asymmetry and Least squares estimation (IDEAL) method was integrated with modulated refocusing flip angle 3D-FSE. Echoes required for IDEAL processing were acquired by shifting the readout gradient with respect to the Carr-Purcell-Meiboom-Gill echo. To reduce the scan time, an alternative data acquisition using two gradient echoes per repetition was implemented. Using the latter approach, a total of four gradient echoes were acquired in two repetitions and used in the modified IDEAL reconstruction. RESULTS: 3D-FSE T(2)-weighted images with uniform water-fat separation were successfully acquired in various anatomies including breast, abdomen, knee, and ankle in clinically feasible scan times, ranging from 5:30-8:30 minutes. Using water-only and fat-only images, in-phase and out-of-phase images were reconstructed. CONCLUSION: 3D-FSE-IDEAL provides volumetric T(2)-weighted images with uniform water and fat separation in a single acquisition. High-resolution images with multiple contrasts can be reformatted to any orientation from a single acquisition. This could potentially replace 2D-FSE acquisitions with and without fat suppression and in multiple planes, thus improving overall imaging efficiency.

Adrenal and renal corticomedullary junction iron deposition in red cell aplasia.

Iron deposition can occur in the kidneys as a result of hemolysis or extensive iron overload from transfusions. With T2* MRI, renal iron deposition can be visualized. In this report, renal corticomedullary junction iron deposition is noted using T2* MRI in a boy with red cell aplasia. The renal corticomedullary junction iron deposition is an indication of the severity of his iron overload. This is an unusual finding and brings clinical attention to the boy's renal function for further evaluation.

Noise analysis for 3-point chemical shift-based water-fat separation with spectral modeling of fat.

PURPOSE: To model the theoretical signal-to-noise ratio (SNR) behavior of 3-point chemical shift-based water-fat separation, using spectral modeling of fat, with experimental validation for spin-echo and gradient-echo imaging. The echo combination that achieves the best SNR performance for a given spectral model of fat was also investigated. MATERIALS AND METHODS: Cramér-Rao bound analysis was used to calculate the best possible SNR performance for a given echo combination. Experimental validation in a fat-water phantom was performed and compared with theory. In vivo scans were performed to compare fat separation with and with out spectral modeling of fat. RESULTS: Theoretical SNR calculations for methods that include spectral modeling of fat agree closely with experimental SNR measurements. Spectral modeling of fat more accurately separates fat and water signals, with only a slight decrease in the SNR performance of the water-only image, although with a relatively large decrease in the fat SNR performance. CONCLUSION: The optimal echo combination that provides the best SNR performance for water using spectral modeling of fat is very similar to previous optimizations that modeled fat as a single peak. Therefore, the optimal echo spacing commonly used for single fat peak models is adequate for most applications that use spectral modeling of fat.

Phase and amplitude correction for multi-echo water-fat separation with bipolar acquisitions.

PURPOSE: To address phase and amplitude errors for multi-point water-fat separation with "bipolar" acquisitions, which efficiently collect all echoes with alternating read-out gradient polarities in one repetition. MATERIALS AND METHODS: With the bipolar acquisitions, eddy currents and other system nonidealities can induce inconsistent phase errors between echoes, disrupting water-fat separation. Previous studies have addressed phase correction in the read-out direction. However, the bipolar acquisitions may be subject to spatially high order phase errors as well as an amplitude modulation in the read-out direction. A method to correct for the 2D phase and amplitude errors is introduced. Low resolution reference data with reversed gradient polarities are collected. From the pair of low-resolution data collected with opposite gradient polarities, the two-dimensional phase errors are estimated and corrected. The pair of data are then combined for water-fat separation. RESULTS: We demonstrate that the proposed method can effectively remove the high order errors with phantom and in vivo experiments, including obliquely oriented scans. CONCLUSION: For bipolar multi-echo acquisitions, uniform water-fat separation can be achieved by removing high order phase errors with the proposed method.

Independent estimation of T*2 for water and fat for improved accuracy of fat quantification.

Noninvasive biomarkers of intracellular accumulation of fat within the liver (hepatic steatosis) are urgently needed for detection and quantitative grading of nonalcoholic fatty liver disease, the most common cause of chronic liver disease in the United States. Accurate quantification of fat with MRI is challenging due the presence of several confounding factors, including T*(2) decay. The specific purpose of this work is to quantify the impact of T*(2) decay and develop a multiexponential T*(2) correction method for improved accuracy of fat quantification, relaxing assumptions made by previous T*(2) correction methods. A modified Gauss-Newton algorithm is used to estimate the T*(2) for water and fat independently. Improved quantification of fat is demonstrated, with independent estimation of T*(2) for water and fat using phantom experiments. The tradeoffs in algorithm stability and accuracy between multiexponential and single exponential techniques are discussed.