Registration and alignment of three-dimensional images: an interactive visual approach

A three-dimensional registration and alignment algorithm was developed to align single photon emission computed tomography examinations and magnetic resonance images. Operators manipulated images interactively with real-time visual feedback, with use of both internal and surface features to achieve accurate alignment. Operators aligned five brain phantom examinations (accuracy, 1.6 pixels; consistency, 0.7 pixels) and eight patient brain examinations (consistency, 0.5 pixels).

Gadolinium-enhanced MR imaging demonstrates abduction-caused hip ischemia and its reversal in piglets

PURPOSE

To determine if gadolinium-enhanced MR imaging can detect early reversible ischemia of the capital femoral epiphysis and physis induced by hip hyperabduction in piglets.

MATERIALS AND METHODS

Thirteen 1- to 3-week-old piglets were placed in maximal bilateral hip abduction and then studied with dynamic gadolinium-enhanced MR imaging 1-6 hr later to assess ischemia of the 26 femoral heads. The piglets were then allowed to ambulate freely for 1 or 7 days and reimaged in neutral position to assess reperfusion. We evaluated enhancement on MR images and compared them with histologic findings.

RESULTS

Decreased or absent enhancement, interpreted as ischemia, developed after maximal hip abduction in all 26 cartilaginous epiphyses and 85% of the 26 physes. The most frequently seen abnormality was a sharply marginated, nonenhancing area in the anterior part of the femoral head. A smaller area of decreased enhancement developed in the posterior part of the femoral head adjacent to the acetabular rim. The secondary center of ossification was ischemic in 10 (56%) of the 18 hips after 1 hr of abduction and in all 8 hips after 4 or 6 hr (p = .02). The overall severity of ischemia was greater with longer abduction times (p < .001) and greater degrees of abduction (p < .01). Reperfusion was complete in two (17%) of the 12 hips after 1 day of ambulation and in all 10 (100%) after 1 week of ambulation.

CONCLUSION

Enhanced MR imaging detects early ischemia of the epiphyseal and physeal cartilage and the epiphyseal marrow. In piglets, ischemia due to maximal abduction is reversible if corrected within 6 hr.

Density-matrix calculations of the 1.5 T citrate signal acquired with volume-localized STEAM sequences

Citrate detection and quantitation with proton spectroscopic methods are of current interest as potential tools in the diagnosis and staging of prostate cancer. The stimulated echo acquisition mode (STEAM) sequence is a commonly used volume-localization method for detecting citrate signal. Since the 1H citrate resonance at clinically available field strengths arises from a strongly coupled two-spin system, the 90 degrees RF pulses and localizing gradients used in STEAM sequences result in a complicated dependence of signal intensity on timing intervals and gradient amplitudes. The density-matrix formalism has been applied to arrive at a general solution to this problem. Citrate-signal properties at 1.5 T for different gradient localization schemes are examined with the solution. Optimal interpulse delays, deleterious gradient balances, zero-quantum oscillations with mixing time, and a low-frequency, large-amplitude oscillation with echo time are identified for signals acquired with the standard disposition of gradients in STEAM. The generality of the solution also allows for an examination of non-standard gradient disposition schemes for enhancing citrate signal and for quantifying the sensitivity of such approaches to both field inhomogeneities and off-resonance effects.

Line scan imaging of brain metabolites with CPMG sequences at 1.5 tesla

A line scan Carr-Purcell-Meiboom-Gill (CPMG) spectroscopic imaging sequence has been implemented on a standard 1.5 T clinical scanner to map metabolite signals at multiple echo times from voxels along selected tissue columns through the brain. The CPMG multiecho spectroscopic image data sets are used to estimate brain metabolite T2 decay parameters in a group of healthy volunteers and in one tumor patient. Inherent trade-offs between T2 decay, spectral resolution, and echo spacing prove to be important limiting factors. In particular, separate quantitation of choline and creatine resonances at 1.5 T was not achieved in the present implementation. However, the ability to collect data sets suitable for T2 decay analyses of combined choline and creatine resonances and N-acetyl aspartate resonances in under 10 minutes may prove of clinical utility in the study of brain pathology.

Triexponential decomposition of 1H spin-lattice relaxation decay curves of paramagnetically doped red cell suspensions at 7 T

The spin-lattice relaxation behaviour of protons in paramagnetically doped red cell suspensions at two haematocrit levels has been studied using high-field (7 T) inversion recovery data. The resulting relaxation decay curves were found to be best characterized by triexponential functions. The two-site exchange model, generally applied to biexponential relaxation data in calculating red cell water exchange parameters, was applied to the two fastest-relaxing fractions of the triexponential fits. The intracellular to extracellular water exchange rates so obtained were in good agreement with literature values. Additional exchange parameters including intracellular and extracellular water volume fractions and extracellular relaxation rates were also calculated directly from the relaxation data and found to be consistent with sample haematocrits and with independent relaxation rate measurements of the resuspension medium. The small-amplitude, slowly relaxing third component recovered from the triexponential fits of the relaxation data is attributed to intracellular haemoglobin protons.

Relative phosphocreatine and nucleoside triphosphate concentrations in cerebral gray and white matter measured in vivo by 31P nuclear magnetic resonance

Rates of ATP metabolism generally are higher in cerebral gray matter compared to white matter. In order to study the physiology of this regional difference in vivo, the 1-dimensional chemical shift imaging technique (1D-CSI) was used to acquire 31P nuclear magnetic resonance spectra from 2.5 mm slices of 4-week old piglet brains. Spectra from predominantly gray matter slices (estimated 76% gray matter, 7 mm below the scalp) were compared to predominantly white matter slices (56% estimated white matter, 13 mm below the scalp) as assessed by magnetic resonance images. The 1D-CSI technique introduced no systematic changes in the ratio of signals from a single chamber phantom containing a phosphocreatine (PCr) and ATP solution. Gray matter slices showed a PCr/NTP ratio of 0.93 +/- 0.11 (mean +/- S.D.) using a 2 s interpulse interval, a value very close to the ratio in surface coil localized spectra. The predominantly white matter slices showed a PCr/NTP ratio of 1.32 +/- 0.18 (P < 0.02 for gray versus white matter). Using the estimated percentages of gray and white matter in the two slices and calculated concentrations from fully relaxed spectra, the gray matter PCr/NTP ratio is approximately 0.77, while the ratio in white matter is approximately 2.18. The difference in PCr/NTP measured in vivo suggests that either the total NTP concentration is higher or the steady state PCr concentration is lower in gray matter than in white matter in the piglet brain.

Magnetic resonance image-directed stereotactic neurosurgery: use of image fusion with computerized tomography to enhance spatial accuracy

Distortions of the magnetic field, such as those caused by susceptibility artifacts and peripheral magnetic field warping, can limit geometric precision in the use of magnetic resonance (MR) imaging in stereotactic procedures. The authors have routinely found systematic error in MR stereotactic coordinates with a median of 4 mm compared to computerized tomography (CT) coordinates. This error may place critical neural structures in jeopardy in sme procedures. A description is given of an image fusion technique that uses a chamfer matching algorithm; the advantages of MR imaging in anatomical definition are combined with the geometric precision of CT, while eliminating most of the anatomical spatial distortion of stereotactic MR imaging. A stereotactic radiosurgical case is presented in which the use of MR localization alone would have led to both irradiation of vital neural structures outside the desired target volume and underdose of the intended target volume. The image fusion approach allows for the use of MR imaging, combined with stereotactic CT, as a reliable localizing technique for stereotactic neurosurgery and radiosurgery.

In vivo characterization of cytotoxic intracellular edema by multicomponent analysis of transverse magnetization decay curves

RATIONALE AND OBJECTIVES

We investigated the multicompartmental nature of T2 decay in a specific white matter edema model.

METHODS

Triethyltin (TET) intoxication was produced in six male New Zealand White rabbits. Images were obtained over the 23-day study duration using a 64-echo Carr-Purcell-Meiboom-Gill (CPMG) sequence (repetition time = 3000 msec, echo time = 20 msec). T2 decay curves were extracted from 0.7 x 0.7 x 3.0 mm3 voxels in the corpus callosum and contiguous white matter tracts, cortex, thalamic nuclei, hypothalamic nuclei, and the masseter muscles. The curves were fit with biexponential functions.

RESULTS

Increased signal intensity in the corpus callosum was evident 2-3 days after the first TET injection. At this time, a substantial slowly relaxing component appeared in the decay curves of the corpus callosum and, to a lesser extent, in the thalamus and hypothalamus. Changes in the rabbits' body weight, general physical condition, and neurologic state paralleled the growth and regression of the second, slowly relaxing component.

CONCLUSION

The appearance and regression of a slowly decaying second component in the T2 decay curve is consistent with the formation and shrink-age of intracellular vesicles in the intramyelin sheaths of central white matter.

Spectroscopic imaging of the knee with line scan CPMG sequences

OBJECTIVE

A line scan spectroscopic imaging method providing variable T2-weighted spectra from many small voxels along selected tissue columns was applied to study the chemical composition of hematopoietic and fatty marrow in the knees of adults and children.

MATERIALS AND METHODS

Line scan Carr-Purcell-Meiboom-Gill (CPMG) spectroscopic imaging sequences were implemented on a 1.5 T clinical scanner. Variable T2-weighted proton spectra from 128 locations along 20 cm long, 5 mm2 columns oriented superiorly to inferiorly through knees were collected from eight healthy adults and eight children.

RESULTS

In adult yellow marrow, olefinic protons, water, a composite lipid proton peak, and methyl/methylene protons contributed 6.4 +/- 0.4, 4.2 +/- 1.5, 7.2 +/- 0.5, and 82.2 +/- 1.9% (mean +/- SD) to the spectra, respectively. Marrow spectra were largely independent of position along the column. Marrow spectra of normal children showed distinct positional dependences. Epiphyseal marrow spectra of children (8-16 years old) resembled adult spectra but with more water (mean 15 vs. 4%). Metaphyseal marrow had higher, variable water content, reflecting the extent of marrow conversion and generally obscuring the olefinic proton peak.

CONCLUSIONS

Spectroscopic imaging of columns is a time-efficient method for sampling extensive regions of bone marrow with high spatial resolution. It should prove useful for proton spectroscopic studies of hematologic pathologies and conditions requiring the monitoring of lipid composition.

Gadolinium-enhanced MR imaging demonstrates abduction-caused hip ischemia and its reversal in piglets

Purpose. To determine whether gadolinium-enhanced MR imaging can detect early reversible ischemia of the capital femoral epiphysis and physis induced by hip hyperabduction in piglets. Materials and methods. Thirteen 1- to 3-week-old piglets were placed in maximal abduction of both hips and studied with dynamic gadolinium-enhanced MR imaging 1-6 h later to assess ischemia of the 26 femoral heads. They were then allowed to ambulate freely for 1 or 7 days, and reimaged in neutral position to assess reperfusion. Enhancement was evaluated on MR images and compared with histologic findings.Results. Ischemia after hyperabduction developed in all 26 cartilaginous epiphyses and in 85 % of the physes. The most frequent abnormality was a sharply marginated nonenhancing area in the anterior part of the femoral head. A smaller area of ischemia developed in the posterior part of the femoral head, adjacent to the acetabular rim. The secondary center of ossification was ischemic in 56 % of the hips after 1 h of abduction and in all hips after 4 or 6 h (p = 0.02). The overall severity of ischemia was greater with increasing abduction time (p < 0.001) and increasing degree of abduction (p < 0.01). There was partial reperfusion in 83 % of the hips after 1 day of ambulation and complete reperfusion in all 26 hips (100 %) after 1 week.Conclusion. Enhanced MRI detects early ischemia of the epiphyseal and physeal cartilage and the epiphyseal marrow. In piglets, ischemia due to hyperabduction is reversible if corrected within 6 h.

Silicone-fat differentiation in the breast: exploiting the bright-fat phenomenon in fast spin-echo MR imaging

Selective suppression of silicone or fat with chemical shift-selective (CHESS) pulses is difficult because of the small chemical shift difference between the primary lipid signal and the primary silicone signal at 1.5 T. Differentiation of these chemically distinct species is, however, an important clinical task in assessing implant rupture and silicone migration in breast tissue. A method uniquely suited for silicone-fat differentiation with fast spin-echo (FSE) sequences is reported. It is based on the dependence of fat signal on echo spacing in FSE imaging and results show that it may provide a clinically robust method for silicone-fat differentiation in magnetic resonance imaging of the breast.

Comparison between fast spin-echo and conventional spin-echo imaging of normal and abnormal musculoskeletal structures in children and young adults

RATIONALE AND OBJECTIVES

The differences in imaging characteristics between conventional and fast spin-echo studies of the skeletons of children and young adults were evaluated.

METHODS

Concurrent conventional and fast spin-echo studies of 23 patients were compared by measuring signal intensity, contrast, and, subjectively, conspicuity of normal and abnormal musculoskeletal structures.

RESULTS

Fast proton-density-weighted images had lower signal-to-noise ratios of muscle, fat, and physeal, epiphyseal, and articular cartilage. Using more than three echoes for proton-density images resulted in blurring and decreased lesion conspicuity. On fast T2-weighted images, there was greater conspicuity of normal cortex, ligaments, and muscle; but less contrast between fat and water because of a higher signal-to-noise ratio of fat. When both sequences were obtained with similar image quality, fast spin-echo was 40% faster.

CONCLUSION

Fast spin-echo studies allows faster imaging, but can have blurring on proton-density-weighted images and decreased fat-water contrast on T2-weighted images.

Bone marrow characterization in the lumbar spine with inner volume spectroscopic CPMG imaging studies

The authors describe new magnetic resonance (MR) spectroscopic and postprocessing methods for characterizing major proton peaks and their spectral T2 values in many small voxels throughout extensive regions of bone marrow within the adult lumbar spine. The techniques are based on spectroscopic interrogation of 128 voxels along columns oriented through the spine at eight TE values. Mean fat content measurements, based on quantification of the proton peaks of water and saturated fat (-CH2-)n, corrected for T2 decay, ranged from 40% to 60%. The mean T2 value of the lipid peak, 113 msec +/- 21, was significantly longer (P < .001) than that of water (71 msec +/- 14). The techniques combine features of MR spectroscopy and imaging most suited for spatially efficient coverage of bone marrow at spectral resolutions sufficient for intra-voxel fat or water content measurements. The methods introduced provide a practical, quantitative means for characterizing vertebral marrow in diseases affecting marrow cellularity.

Image fusion for stereotactic radiotherapy and radiosurgery treatment planning

PURPOSE

We describe an image fusion application that addresses two basic problems that previously limited the use of magnetic resonance imaging (MRI) for geometric localization in stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT). The first limitation is imposed by the use of a relocatable, MRI-incompatible, stereotactic frame for stereotactic radiotherapy. The second limitation is an inherent lack of geometric fidelity in current MRI scanners that invalidates the use of MRI for stereotactic localization.

METHODS AND MATERIALS

We recently developed and implemented a novel automated method for fusing computerized tomography (CT) and MRI volumetric image studies. The method is based on a chamfer matching algorithm, and provides a quality assurance procedure to verify the accuracy of the fused image set. The image fusion protocol removes the need for stereotactic fixation of the patient for the MRI study.

RESULTS

The image fusion protocol significantly improves on the spatial accuracy of the MRI study. We demonstrate the effect of distortion and the effectiveness of the fusion with a phantom study. We present two case studies, an acoustic neurinoma treated with SRS, and a pilocytic astrocytoma treated with SRT.

CONCLUSION

The image fusion protocol significantly improves our logistical management of treating patients with radiosurgery and makes conformal therapy practical for treating patients with SRT. The image fusion protocol demonstrates both the superior diagnostic quality and the poor geometric fidelity of MRI. MRI is a required imaging modality in stereotactic therapy. Image fusion combines the superior MRI diagnostic quality with the superior CT geometric definition, and makes the use of MRI in stereotactic therapy possible and practical.

Fast spin-echo MR in the detection of vertebral metastases: comparison of three sequences

PURPOSE

To examine the relative capabilities for the detection of vertebral metastases of three available fast spin-echo sequences: T1-weighted fast spin-echo, short tau inversion recovery (STIR) fast spin-echo, and T2-weighted fast spin-echo sequences with chemical shift selective saturation pulse fat suppression.

METHODS

Fourteen patients were evaluated prospectively over a 2-month period with T1-weighted fast spin-echo (four echo train, four acquisitions, 1 min 59 sec-2 min 37 sec). STIR fast spin-echo (16 echo train, four acquisitions, 2 min 30 sec-3 min 19 sec), and T2-weighted fast spin-echo (16 echo train, 4 acquisitions, 2 min 27 sec-3 min 16 sec). For all three pulse sequences, measurements were obtained of the signal intensities of normal marrow, abnormal marrow, fat, and noise posterior to the spine. Contrast-to-noise ratios were calculated for metastases in each case. Lesions were evaluated by three observers and rated for size, location, and conspicuity.

RESULTS

Signal intensities of fat, normal marrow, and noise were highest for T1-weighted fast spin-echo sequences. STIR fast spin-echo and fat-suppressed T2-weighted fast spin-echo had approximately similar fat-suppression capabilities. Though contrast-to-noise ratios were highest overall for STIR fast spin-echo, the finding was not statistically significant and lesion conspicuity was deemed better with fat-suppressed T2-weighted fast spin-echo and T1-weighted fast spin-echo images. Discrete lesions were well identified on all three pulse sequences.

CONCLUSION

Fast spin-echo sequences appear promising for the detection of vertebral metastases. Further work should be directed toward comparison with conventional spin-echo to determine whether fast spin-echo may replace conventional spin-echo sequences for evaluation of vertebral metastases.

Tissue temperature monitoring for thermal interventional therapy: comparison of T1-weighted MR sequences

For thermal interventional therapy, near real-time monitoring of temperature changes in the treated area is desirable. In this study, various fast T1-weighted magnetic resonance (MR) imaging protocols were compared to determine the sensitivity and resolution of signal intensity for temperatures within the range of 36 degrees C-66 degrees C in gel phantoms and in vitro porcine liver specimens. The results showed that a T1-weighted fast spin-echo sequence with a TR of 100 msec had better temperature sensitivity and resolution than other sequences with comparable temporal resolutions. The longer imaging times required for fast spin-echo sequences with a TR of 300 msec did not improve temperature sensitivity. The methods introduced to evaluate temperature sensitivity and resolution should prove useful in selecting appropriate MR protocols for monitoring thermal treatment modalities such as interstitial laser therapy, focused ultrasound therapy, or radio-frequency heating.

Head and neck: initial clinical experience with fast spin-echo MR imaging

Fast spin-echo (FSE) is a new magnetic resonance (MR) imaging pulse sequence that employs echo trains of 180 degrees radio-frequency pulses to generate multiple refocused echoes during a single repetition-time interval. Phase encoding is reordered with the lowest spatial frequency views obtained in the echoes nearest the desired effective echo time. These techniques were used to examine 30 patients with pathologic conditions of the head and neck. The images were compared with closely matched conventional T2-weighted spin-echo (SE) images obtained during the same examination. Three unblinded readers evaluated 15 sets of both images for lesion conspicuity, motion artifact, diagnostic information, number of lesions seen, image quality, and sharpness of lesion borders. In all categories, FSE images were judged better than or equal to SE images, and in most cases FSE images were obtained in one-fourth to one-half the imaging time. In no case were lesions depicted on conventional T2-weighted SE images missed on FSE images; in fact, more lesions were seen on FSE images than on conventional T2-weighted SE images.

Fast spin-echo imaging of intracranial neoplasms

Our goal was to compare dual echo fast SE (FSE) T2-weighted MRI of intracranial neoplasms with conventional SE (CSE) images. In phase 1 of the study, CSE and FSE dual echo MR studies of 33 patients with intracranial neoplasms and 26 normal controls were separately interpreted by three neuroradiologists blinded to clinical history to ascertain differences in lesion conspicuity. The CSE and FSE images were read independently, in random order, with at least a 3 week interval between readings. In phase 2 of the study, CSE and FSE sequences were compared side by side by three neuroradiologists independently to evaluate lesion conspicuity and artifacts and to determine whether FSE would be an acceptable replacement for CSE imaging. Lesion detection was equivalent in 111 of 117 interpretations (94.9%). The CSE and FSE sequences were equivalent in detecting lesion-associated abnormalities (hemorrhage, calcium, mass effect, edema, and hydrocephalus) and in characterizing lesion size, margins, and signal intensity. Nonspecific T2 white matter hyperintensities were detected more often with CSE, while susceptibility artifacts were less conspicuous on FSE. Ventricular catheters, postoperative soft tissue and bony changes, and postradiation therapy changes were detected equally well on both sequences. In phase 2 of the study, lesion conspicuity and presence of artifacts were felt to be equivalent with the two sequences. The FSE sequences can serve as a rapid, feasible alternative to conventional CSE sequences for intracranial tumor detection.

[Fast spin echo MRI techniques. Contrast characteristics and clinical potentials]

Based on partial RF echo planar principles, Fast Spin Echo techniques (FSE) were implemented on high field systems. These methods produce image quality and contrast which resemble to conventional spin echo (SE) techniques. By reducing acquisition times by factors between 1.4 and 16 over SE methods, FSE allows for several imaging options usually prohibitive with conventional spin echo (SE) sequences. These include fast scans (especially breath-hold acquisitions); improved T2 contrast with longer TR intervals; increased spatial resolution with the use of larger image matrices and/or smaller fields of view; and 3D volume imaging with a 3D multislab FSE technique. Contrast features of FSE techniques are directly comparable to those of multiple echo SE sequences using the same echo spacing than FSE methods. However, essential contrast differences existing between the FSE sequences and their routine asymmetric dual SE counterpart can be identified. Decreased magnetic susceptibility effects and increased fat signal present within T2 weighted images compared to conventional dual SE images are due to the use of shorter echo spacings employed in FSE sequences. Off-resonance irradiation inherent to the use of a large number of radio frequency pulses in shown to results in dramatic magnetization contrast transfer effects in FSE images acquired in a multislice mode.

The general solution to the Bloch equation with constant rf and relaxation terms: application to saturation and slice selection

The general solution to the Bloch equation in the rotating frame which includes the effects of relaxation during a constant amplitude, off-resonance rf field has been developed. The solution is used to monitor the transient approach to steady-state saturation levels during off-resonance irradiation applied continuously or in pulses to systems with arbitrary relaxation rates. The time course of the magnetization during amplitude modulated rf pulses is followed with the general solution and the transverse relaxation time dependence of typical slice profiles is examined. The calculations serve to illustrate the generality of the solution. A thorough discussion of various computational concerns is provided.

Rapid fat/water assessment in knee bone marrow with inner-volume RARE spectroscopic imaging

An inner-volume modification of a spectroscopic imaging technique based on RARE (rapid acquisition with relaxation enhancement) sequences is shown to provide, in less than 1 minute, spectra suitable for fat/water peak-area integration from selected imaging columns containing more than 1,000 5 x 5 x 1-mm voxels. A limitation is the unavoidable T2 weighting of the spectral peaks, which influences estimations of true fat/water composition from the spectra. Studies obtained in the knees of healthy volunteers demonstrate the ability of the technique to enable characterization of the two major proton peaks in bone marrow. Data collected at two or more effective TEs are suitable for extrapolation of fat/water estimates to zero TE.