Quality assurance methods and phantoms for magnetic resonance imaging: report of AAPM nuclear magnetic resonance Task Group No. 1

[Signal-to-noise ratio measurement in parallel MRI with subtraction mapping and consecutive methods]

When measuring the signal-to-noise ratio (SNR) of an image the used parallel magnetic resonance imaging, it was confirmed that there was a problem in the application of past SNR measurement. With the method of measuring the noise from the background signal, SNR with parallel imaging was higher than that without parallel imaging. In the subtraction method (NEMA standard), which sets a wide region of interest, the white noise was not evaluated correctly although SNR was close to the theoretical value. We proposed two techniques because SNR in parallel imaging was not uniform according to inhomogeneity of the coil sensitivity distribution and geometry factor. Using the first method (subtraction mapping), two images were scanned with identical parameters. The SNR in each pixel divided the running mean (7 by 7 pixels in neighborhood) by standard deviation/radical2 in the same region of interest. Using the second (consecutive) method, more than fifty consecutive scans of the uniform phantom were obtained with identical scan parameters. Then the SNR was calculated from the ratio of mean signal intensity to the standard deviation in each pixel on a series of images. Moreover, geometry factors were calculated from SNRs with and without parallel imaging. The SNR and geometry factor using parallel imaging in the subtraction mapping method agreed with those of the consecutive method. Both methods make it possible to obtain a more detailed determination of SNR in parallel imaging and to calculate the geometry factor.

Automated quality control of brain MR images

PURPOSE

To present a novel fully automated method for assessing the quality of magnetic resonance imaging (MRI) data acquired in a clinical trials environment.

MATERIALS AND METHODS

This work was performed in the context of clinical trials for multiple sclerosis. Quality control (QC) procedures included were: (i) patient brain identity verification, (ii) alphanumeric parameter matching, (iii) signal-to-noise ratio estimation, (iv) gadolinium-enhancement verification, and (v) detection of ghosting due to head motion. Each QC procedure produces a quantitative measurement which is compared against an acceptance threshold that was determined based on receiver operating characteristic analysis of traditional manual and visual QC performed by trained experts.

RESULTS

The automated QC results have high sensitivity and specificity when compared with the visual QC.

CONCLUSION

Our automated objective QC procedure can replace many manual subjective procedures to provide increased data throughput while reducing reader variability.

The osteoarthritis initiative (OAI) magnetic resonance imaging quality assurance methods and results

OBJECTIVE

To outline the osteoarthritis initiative's (OAI) magnetic resonance (MR) system quality assurance (QA) processes and present the first 3 years' results.

METHOD

OAI MR QA included acquisitions evaluated manually at each of the four sites and other acquisitions assessed by an automated computer program. Key image characteristics such as signal-to-noise, contrast-to-noise, signal uniformity, T2 relaxation times, local and global geometric distortion were quantified monthly using the automated program.

RESULTS

Uniformly high quality, artifact-free subject images were obtained from all four OAI 3 tesla MR facilities. Over a 3-year period, key criteria for quantitative cartilage morphometry were excellent with a 190.0 mm diameter and 148.0 mm length object having reproducible diameter (0.04% RMS CV) and length (0.56% RMS CV). This resulted in spherical volume reproducibility of 0.46% RMS CV. Ghost levels were consistently <0.2%. T2 relaxation time varied longitudinally site-by-site from 2.3 to 18.8% RMS CV. All other measures of MR system stability were met except: 3.0 mm and 5.0 mm slice thicknesses were consistently larger than expected; knee coil signal uniformity and signal level varied significantly over time.

CONCLUSIONS

OAI MR QA results compared favorably to prior publications and identified similar technical issues for geometric measurements. The longitudinal variations measured in the OAI QA process should have minimal impact on the accuracy and reproducibility of cartilage thickness and volume quantification. This stability should enable direct comparison of baseline and follow-up images. Cross-comparison of the results from all four OAI sites reveals that the MR systems are sufficiently uniform to enable results to be combined.

Diffusion tensor imaging and tractography of the median nerve in carpal tunnel syndrome: preliminary results

The purpose was to demonstrate the feasibility of in vivo diffusion tensor imaging (DTI) and tractography of the human median nerve with a 1.5-T MR scanner and to assess potential differences in diffusion between healthy volunteers and patients suffering from carpal tunnel syndrome. The median nerve was examined in 13 patients and 13 healthy volunteers with MR DTI and tractography using a 1.5-T MRI scanner with a dedicated wrist coil. T1-weighted images were performed for anatomical correlation. Mean fractional anisotropy (FA) and mean apparent diffusion coefficient (ADC) values were quantified in the median nerve on tractography images. In all subjects, the nerve orientation and course could be detected with tractography. Mean FA values were significantly lower in patients (p=0.03). However, no statistically significant differences were found for mean ADC values. In vivo assessment of the median nerve in the carpal tunnel using DTI with tractography on a 1.5-T MRI scanner is possible. Microstructural parameters can be easily obtained from tractography images. A significant decrease of mean FA values was found in patients suffering from chronic compression of the median nerve. Further investigations are necessary to determine if mean FA values may be correlated with the severity of nerve entrapment.

PET/MRI hybrid imaging: devices and initial results

The combination of functional and morphological imaging technologies such as positron emission tomography (PET) and X-ray computed tomography (CT) has shown its value in the clinical and preclinical field. However, CT provides only very limited soft-tissue contrast and exposes the examined patient or laboratory animal to a high X-ray radiation dose. In comparison to CT, magnetic resonance tomography (MRI) provides excellent soft-tissue contrast and allows for nuclear magnetic resonance spectroscopy (NMRS) or functional MRI (fMRI). Thus, the combination of PET and MRI has been pursued for several years. First approaches have succeeded using conventional photo multiplier tube (PMT) technology together with light fibers to transfer scintillation light away from the high magnetic field. Latest PET/MRI developments use solid-state light detectors that can be operated even at high magnetic fields. Initial pilot studies with prototype animal PET/MRI systems have shown promising results by combining high resolution morphology with multifunctional information isochronously.

A practical method for 2D multiple-animal MRI

PURPOSE

To investigate practical methods for achieving routine simultaneous 2D MRI of multiple animals in large-bore experimental scanners.

MATERIALS AND METHODS

Three four-element array geometries were compared against a standard single-coil configuration in terms of image quality, ease of use, and data efficiency using a four-channel, 4.7 T small animal imaging system.

RESULTS

A linear arrangement of volume resonators permits unobstructed animal preparation and use of an imaging protocol that is almost identical to the single-coil configuration without requiring any image correction or other additional postprocessing. Resulting in vivo images were visually indistinguishable from those acquired through the single-coil configuration.

CONCLUSION

The efficiency of animal studies employing 2D MRI techniques can be substantially improved by using a linear array of commercially available resonators.

3.0 T cardiovascular magnetic resonance in patients treated with coronary stenting for myocardial infarction: evaluation of short term safety and image quality

Purpose To evaluate safety and image quality of cardiovascular magnetic resonance (CMR) at 3.0 T in patients with coronary stents after myocardial infarction (MI), in comparison to the clinical standard at 1.5 T. Methods Twenty-five patients (21 men; 55 ± 9 years) with first MI treated with primary stenting, underwent 18 scans at 3.0 T and 18 scans at 1.5 T. Twenty-four scans were performed 4 ± 2 days and 12 scans 125 ± 23 days after MI. Cine (steady-state free precession) and late gadolinium-enhanced (LGE, segmented inversion-recovery gradient echo) images were acquired. Patient safety and image artifacts were evaluated, and in 16 patients stent position was assessed during repeat catheterization. Additionally, image quality was scored from 1 (poor quality) to 4 (excellent quality). Results There were no clinical events within 30 days of CMR at 3.0 T or 1.5 T, and no stent migration occurred. At 3.0 T, image quality of cine studies was clinically useful in all, but not sufficient for quantitative analysis in 44% of the scans, due to stent (6/18 scans), flow (7/18 scans) and/or dark band artifacts (8/18 scans). Image quality of LGE images at 3.0 T was not sufficient for quantitative analysis in 53%, and not clinically useful in 12%. At 1.5 T, all cine and LGE images were quantitatively analyzable. Conclusion 3.0 T is safe in the acute and chronic phase after MI treated with primary stenting. Although cine imaging at 3.0 T is suitable for clinical use, quantitative analysis and LGE imaging is less reliable than at 1.5 T. Further optimization of pulse sequences at 3.0 T is essential.

In vivo MR tractography of thigh muscles using diffusion imaging: initial results

The aims of this preliminary study were (1) to demonstrate the feasibility of providing in vivo 3D architecture of human thigh muscles using tractography on a 1.5T magnet, and (2) to assess the value of tractography images to obtain averaged microstructural parameters, i.e., the fractional anisotropy (FA) and the mean apparent diffusion coefficient (ADC), over the whole thigh. Five healthy volunteers were included in this study. Their right thighs were imaged using diffusion tensor imaging and gradient-echo T2* sequences. Muscular tractography was performed on each muscle. MR tractography provided a good approach of the muscle shape and of the orientation of the muscle fibers. There was no aberration in the color-encoding scheme nor in the luminosity assigned to each fiber. In contrast, tendons were not drawn in any of the muscles studied. FA values ranged from 0.27 to 0.38. Mean ADC values ranged from 0.76 to 0.96 x 10(-3) mm2/s. Our study demonstrated the feasibility of providing in vivo 3D architecture of human thigh muscles using tractography on a 1.5T magnet, and of determining muscular microstructural parameters (FA and ADC). Musculoskeletal radiologists should be aware of these new developments that may provide complementary information on muscles to the usual sequences.

Characterization, prediction, and correction of geometric distortion in 3 T MR images

The work presented herein describes our methods and results for predicting, measuring and correcting geometric distortions in a 3 T clinical magnetic resonance (MR) scanner for the purpose of image guidance in radiation treatment planning. Geometric inaccuracies due to both inhomogeneities in the background field and nonlinearities in the applied gradients were easily visualized on the MR images of a regularly structured three-dimensional (3D) grid phantom. From a computed tomography scan, the locations of just under 10 000 control points within the phantom were accurately determined in three dimensions using a MATLAB-based computer program. MR distortion was then determined by measuring the corresponding locations of the control points when the phantom was imaged using the MR scanner. Using a reversed gradient method, distortions due to gradient nonlinearities were separated from distortions due to inhomogeneities in the background B0 field. Because the various sources of machine-related distortions can be individually characterized, distortions present in other imaging sequences (for which 3D distortion cannot accurately be measured using phantom methods) can be predicted negating the need for individual distortion calculation for a variety of other imaging sequences. Distortions were found to be primarily caused by gradient nonlinearities and maximum image distortions were reported to be less than those previously found by other researchers at 1.5 T. Finally, the image slices were corrected for distortion in order to provide geometrically accurate phantom images.

The development and evaluation of new neck coil for GE MR system

Due to the MRI signal is much low, the improvement of image quality becomes the important goals for MRI equipment R&D. The RF coil is one of the most important factors in detecting the MRI signal. A new neck coil is developed with four channels phase array design and evaluated. Compared with original coil, the image signal to noise ratio (SNR) and uniformity of new neck coil are improved evidently.

Denoising of complex MRI data by wavelet-domain filtering: Application to high-b-value diffusion-weighted imaging

The Rician distribution of noise in magnitude magnetic resonance (MR) images is particularly problematic in low signal-to-noise ratio (SNR) regions. The Rician noise distribution causes a nonzero minimum signal in the image, which is often referred to as the rectified noise floor. True low signal is likely to be concealed in the noise, and quantification is severely hampered in low-SNR regions. To address this problem we performed noise reduction (or denoising) by Wiener-like filtering in the wavelet domain. The filtering was applied to complex MRI data before construction of the magnitude image. The noise-reduction algorithm was applied to simulated and experimental diffusion-weighted (DW) images. Denoising considerably reduced the signal standard deviation (SD, by up to 87% in simulated images) and decreased the background noise floor (by approximately a factor of 6 in simulated and experimental images).

Report on a multicenter fMRI quality assurance protocol

Temporal stability during an fMRI acquisition is very important because the blood oxygen level-dependent (BOLD) effects of interest are only a few percent in magnitude. Also, studies involving the collection of groups of subjects over time require stable scanner performance over days, weeks, months, and even years. We describe a protocol designed by one of the authors that has been tested for several years within the context of a large, multicenter collaborative fMRI research project (FIRST-BIRN). A full description of the phantom, the quality assurance (QA) protocol, and the several calculations used to measure performance is provided. The results obtained with this protocol at multiple sites over time are presented. These data can be used as benchmarks for other centers involved in fMRI research. Some issues with the various protocol measures are highlighted and discussed, and possible protocol improvements are also suggested. Overall, we expect that other fMRI centers will find this approach to QA useful and this report may facilitate developing a similar QA protocol locally. Based on the findings reported herein, the authors are convinced that monitoring QA in this way will improve the quality of fMRI data.

Experimental determination of the effect of detector size on profile measurements in narrow photon beams

The aim of this work is to investigate experimentally the detector size effect on narrow beam profile measurements. Polymer gel and magnetic resonance imaging dosimetry was used for this purpose. Profile measurements (Pm(s)) of a 5 mm diameter 6 MV stereotactic beam were performed using polymer gels. Eight measurements of the profile of this narrow beam were performed using correspondingly eight different detector sizes. This was achieved using high spatial resolution (0.25 mm) two-dimensional measurements and eight different signal integration volumes A X A X slice thickness, simulating detectors of different size. "A" ranged from 0.25 to 7.5 mm, representing the detector size. The gel-derived profiles exhibited increased penumbra width with increasing detector size, for sizes >0.5 mm. By extrapolating the gel-derived profiles to zero detector size, the true profile (Pt) of the studied beam was derived. The same polymer gel data were also used to simulate a small-volume ion chamber profile measurement of the same beam, in terms of volume averaging. The comparison between these results and actual corresponding small-volume chamber profile measurements performed in this study, reveal that the penumbra broadening caused by both volume averaging and electron transport alterations (present in actual ion chamber profile measurements) is a lot more intense than that resulted by volume averaging effects alone (present in gel-derived profiles simulating ion chamber profile measurements). Therefore, not only the detector size, but also its composition and tissue equivalency is proved to be an important factor for correct narrow beam profile measurements. Additionally, the convolution kernels related to each detector size and to the air ion chamber were calculated using the corresponding profile measurements (Pm(s)), the gel-derived true profile (Pt), and convolution theory. The response kernels of any desired detector can be derived, allowing the elimination of the errors associated with narrow beam profile measurements.

Practical approaches to the evaluation of signal-to-noise ratio performance with parallel imaging: application with cardiac imaging and a 32-channel cardiac coil

In this work, two practical methods for the measurement of signal-to-noise-ratio (SNR) performance in parallel imaging are described. Phantoms and human studies were performed with a 32-channel cardiac coil in the context of ultrafast cardiac CINE imaging at 1.5 T using steady-state free precession (SSFP) and TSENSE. SNR and g-factor phantom measurements using a "multiple acquisition" method were compared to measurements from a "difference method". Excellent agreement was seen between the two methods, and the g-factor shows qualitative agreement with theoretical predictions from the literature. Examples of high temporal (42.6 ms) and spatial (2.1x2.1x8 mm3) resolution cardiac CINE SSFP images acquired from human volunteers using TSENSE are shown for acceleration factors up to 7. Image quality agrees qualitatively with phantom SNR measurements, suggesting an optimum acceleration of 4. With this acceleration, a cardiac function study consisting of 6 image planes (3 short-axis views, 3 long-axis views) was obtained in an 18-heartbeat breath-hold.

Geometric distortion in clinical MRI systems Part I: evaluation using a 3D phantom

Recently, a 3D phantom that can provide a comprehensive and accurate measurement of the geometric distortion in MRI has been developed. Using this phantom, a full assessment of the geometric distortion in a number of clinical MRI systems (GE and Siemens) has been carried out and detailed results are presented in this paper. As expected, the main source of geometric distortion in modern superconducting MRI systems arises from the gradient field nonlinearity. Significantly large distortions with maximum absolute geometric errors ranged between 10 and 25 mm within a volume of 240 x 240 x 240 mm(3) were observed when imaging with the new generation of gradient systems that employs shorter coils. By comparison, the geometric distortion was much less in the older-generation gradient systems. With the vendor's correction method, the geometric distortion measured was significantly reduced but only within the plane in which these 2D correction methods were applied. Distortion along the axis normal to the plane was, as expected, virtually unchanged. Two-dimensional correction methods are a convenient approach and in principle they are the only methods that can be applied to correct geometric distortion in a single slice or in multiple noncontiguous slices. However, these methods only provide an incomplete solution to the problem and their value can be significantly reduced if the distortion along the normal of the correction plane is not small.

Protocolo de testes de aceitação em equipamentos de imagem por ressonância magnética

OBJETIVO: Este trabalho tem como objetivo criar um protocolo de testes de aceitação para equipamentos de imagem por ressonância magnética e demonstrar como e quais tipos de dispositivos de teste podem ser usados para a coleta de dados. MATERIAIS E MÉTODOS: Para cada um dos 15 testes selecionados foram elaborados a definição, o procedimento, a forma de análise e o critério de aceitação. RESULTADOS: Através dos testes de aceitação descritos é possível verificar características técnicas que constam nas propostas de venda dos fabricantes, assim como estabelecer valores de referências para serem utilizados em posteriores testes de constância. CONCLUSÃO: Futuros programas de garantia da qualidade em imagem por ressonância magnética devem considerar testes semelhantes ou iguais aos descritos neste trabalho.

Method for a detailed measurement of image intensity nonuniformity in magnetic resonance imaging

In magnetic resonance imaging (MRI), the MR signal intensity can vary spatially and this spatial variation is usually referred to as MR intensity nonuniformity. Although the main source of intensity nonuniformity arises from B1 inhomogeneity of the coil acting as a receiver and/or transmitter, geometric distortion also alters the MR signal intensity. It is useful on some occasions to have these two different sources be separately measured and analyzed. In this paper, we present a practical method for a detailed measurement of the MR intensity nonuniformity. This method is based on the same three-dimensional geometric phantom that was recently developed for a complete measurement of the geometric distortion in MR systems. In this paper, the contribution to the intensity nonuniformity from the geometric distortion can be estimated and thus, it provides a mechanism for estimation of the intensity nonuniformity that reflects solely the spatial characteristics arising from B1. Additionally, a comprehensive scheme for characterization of the intensity nonuniformity based on the new measurement method is proposed. To demonstrate the method, the intensity nonuniformity in a 1.5 T Sonata MR system was measured and is used to illustrate the main features of the method.

A proposed scheme for comprehensive characterization of the measured geometric distortion in magnetic resonance imaging using a three-dimensional phantom

Recently, a 3-dimensional phantom that can provide a comprehensive, accurate and complete measurement of the geometric distortion in MRI has been developed. In this paper, a scheme for characterizing the measured geometric distortion using the 3-D phantom is described. In the proposed scheme, a number of quantitative measures are developed and used to characterize the geometric distortion. These measures encompass the overall and spatial aspects of the geometric distortion. Two specific types of volume of interest, rectangular parallelepipeds (including cubes) and spheres are considered in the proposed scheme. As an illustration, characterization of the geometric distortion in a Siemens 1.5T Sonata MRI system using the proposed scheme is presented. As shown, the proposed scheme provides a comprehensive assessment of the geometric distortion. The scheme can be potentially used as a standard procedure for the assessment of geometric distortion in MRI.

[Trial of signal-to-noise ratio adjustment by repetition time in magnetic resonance imaging]

The purpose of this study was to find an equation between signal-to-noise ratio (SNR) and repetition time (TR) in order to adjust SNR by changing TR in magnetic resonance imaging (MRI) examinations. Using a phantom for SNR measurement, according to NEMA MS 1-1988, measurement of SNR was performed by spin-echo pulse sequences for various TR values. An equation of SNR and scanning parameters including TR were obtained from these results. In order to determine the range of TR where the images showed contrast suitable for diagnosis, the contrast-to-noise ratio (CNR) was measured for various TR values. CNR measurement was performed by scanning a brain phantom, and CNR was defined as the contrast of white matter and gray matter divided by noise. Scanning of a resolution phantom was carried out with various scanning parameters, and the usefulness of the equation obtained was determined by whether or not pins in the phantom were visible. The reliability of the equation was confirmed from this verification. Results showed that TR can be used for the adjustment of SNR using the equation obtained in this study.

Multicenter trial for the set-up of a MRI quality assurance programme

Many international protocols related to RMI-QC program are focused on acquisition methods and analysis of several image quality parameters but rarely normality ranges or measurement frequencies are presented. To address this problem we investigated the variability of many magnetic resonance imaging (MRI) systems with the set-up of multicenter trial. The trial was set up to investigate short-and mid-term variability of two fundamental nongeometric image quality parameters: signal-to-noise (SNR) and integral percent uniformity (U%). Ten centers (12 devices) participated to data collection consisting of a three-step-protocol. First, 10 consecutive images of a phantom were collected with a spin echo sequence. As second step the series collection was repeated 24 h later. Finally a single image acquisition was performed twice a week for 5 weeks. The analysis of results allowed us to define a "physiological" variability of +/-3% of the reference level for both parameters and to conclude that a weekly measurement is adequate to detect relevant variations of device performance.

A novel phantom and method for comprehensive 3-dimensional measurement and correction of geometric distortion in magnetic resonance imaging

A phantom that can be used for mapping geometric distortion in magnetic resonance imaging (MRI) is described. This phantom provides an array of densely distributed control points in three-dimensional (3D) space. These points form the basis of a comprehensive measurement method to correct for geometric distortion in MR images arising principally from gradient field non-linearity and magnet field inhomogeneity. The phantom was designed based on the concept that a point in space can be defined using three orthogonal planes. This novel design approach allows for as many control points as desired. Employing this novel design, a highly accurate method has been developed that enables the positions of the control points to be measured to sub-voxel accuracy. The phantom described in this paper was constructed to fit into a body coil of a MRI scanner, (external dimensions of the phantom were: 310 mm x 310 mm x 310 mm), and it contained 10,830 control points. With this phantom, the mean errors in the measured coordinates of the control points were on the order of 0.1 mm or less, which were less than one tenth of the voxel's dimensions of the phantom image. The calculated three-dimensional distortion map, i.e., the differences between the image positions and true positions of the control points, can then be used to compensate for geometric distortion for a full image restoration. It is anticipated that this novel method will have an impact on the applicability of MRI in both clinical and research settings, especially in areas where geometric accuracy is highly required, such as in MR neuro-imaging.

Comparison of In Vitro and In Vivo MRI of the Spine Using Parallel Imaging

OBJECTIVE

The purpose of this study was to compare the image quality of two parallel-imaging methods applied to standard turbo spin-echo T2-weighted imaging of the lumbar spine.

MATERIALS AND METHODS

Phantom imaging and lumbar spine studies of 15 healthy subjects were performed using T2-weighted turbo spin-echo sequences obtained with and without parallel imaging (generalized autocalibrating partially parallel acquisition [GRAPPA] and modified sensitive encoding [mSENSE]) on a 1.5-T magnet. The signal-to-noise ratio (SNR) and uniformity were measured in the phantom, and SNR and signal difference-noise ratio were evaluated in cerebrospinal fluid, vertebral bodies, and subcutaneous fat of the volunteers, using both techniques sequentially. Aliasing artifacts on GRAPPA and mSENSE images were visually evaluated. SNRs were compared using the Student's paired t test, with p values less than 0.05 considered significant.

RESULTS

In the phantom study, when the same number of coil elements were used (n = 3), SNR and uniformity values obtained with standard T2-weighted turbo spin-echo sequences were higher than those obtained with parallel sequences. The GRAPPA SNR obtained with three coil elements was higher than the standard T2-weighted SNR obtained with one coil element. Similar findings were noted regarding uniformity. In the lumbar spine, GRAPPA SNR values for fat, cerebrospinal fluid, and vertebral bodies were significantly higher than mSENSE SNR values, with a p value less than 0.01, but were not significantly different from T2-weighted turbo spin-echo SNR values. GRAPPA signal difference-noise ratio values were significantly higher than mSENSE signal difference-noise ratio values, with a p value less than 0.01, but were not significantly different from T2-weighted turbo spin-echo signal difference-noise ratio values. GRAPPA produced fewer aliasing artifacts than mSENSE.

CONCLUSION

In spine MRI, GRAPPA may be used to reduce scanning time and yields a higher SNR than mSENSE without any increase in aliasing artifacts and with an SNR similar to that obtained with standard T2-weighted turbo spin-echo.

[Accuracy of signal-to-noise ratio measurement method for magnetic resonance images]

The signal-to-noise ratio (SNR) of a magnetic resonance image is a common measure of imager performance. However, evaluations for the calculation of the SNR use various methods. A problem with measuring SNR is caused by the distortion of noise statistics in commonly used magnitude images. In this study, measurement accuracy was compared among four methods of evaluating SNR according to the size and position of regions of interest (ROIs). The results indicated that the method that used the difference between two images showed the best agreement with the theoretical value. In the method that used a single image, the SNR calculated by using a small size of ROI showed better agreement with the theoretical value because of noise bias and image artifacts. However, in the method that used the difference between two images, a large size of ROI was better in reducing statistical errors. In the same way, the methods that used air noise and air signal were better when applied to a large ROI. In addition, the image subtraction process used to calculate pixel-by-pixel differences in images may reach zero on a minus pixel value when using an image processor with the MRI system and apparatuses associated with it. A revised equation is presented for this case. It is important to understand the characteristics of each method and to choose a suitable method carefully according to the purpose of the study.

Characteristics and quality assurance of a dedicated open 0.23 T MRI for radiation therapy simulation

A commercially available open MRI unit is under routine use for radiation therapy simulation. The effects of a gradient distortion correction (GDC) program used to post process the images were assessed by comparison with the known geometry of a phantom. The GDC reduced the magnitude of the distortions at the periphery of the axial images from 12 mm to 2 mm horizontally along the central axis and distortions exceeding 20 mm were reduced to as little as 2 mm at the image periphery. Coronal and sagittal scans produced similar results. Coalescing these data into distortion as a function of radial distance, we found that for radial distances of <10 cm, the distortion after GDC was <2 mm and for radial distances up to 20 cm, the distortion was <5 mm. The dosimetric errors resulting from homogeneous dose calculations with this level of distortion of the external contour is <2%. A set of triangulation lasers has been added to establish a virtual isocenter for convenient setup and marking of patients and phantoms. Repeated measurements of geometric phantoms over several months showed variations in position between the virtual isocenter and the magnetic isocenter were constrained to <2 mm. Additionally, the interscan variations of 12 randomly selected points in space defined by a rectangular grid phantom was found to be within the intraobserver error of approximately 1 mm in the coronal, sagittal, and transverse planes. Thus, the open MRI has sufficient geometric accuracy for most radiation therapy planning and is temporally stable.

Optimization of multiple spin-echo sequences for 3D polymer gel dosimetry

The overall performance of polymer gel dosimeters for three-dimensional radiation dosimetry is determined by the temporal and spatial stability of the gels, dose sensitivity and image quality with respect to both systematic and stochastic deviations. The dose resolution (D(p)delta) is determined by the dose sensitivity and the signal-to-noise ratio (SNR) in the dose images. The dose sensitivity can be altered by changing the chemical composition of the polymer gel. The SNR is determined by the scanner and the imaging sequence. In the dose verification of conformal radiotherapy treatments the chosen number of slices may reach a number of 10-20. For these experiments, to obtain a sufficient SNR within a reasonable measurement time using a certain MR scanner, the imaging sequence should be optimized. A few other studies have emphasized the importance of optimizing the imaging sequence with respect to dose resolution (D(p)delta) or SNR but do not give quantitative values for the optimal sequence parameters for scanning a polymer gel dosimeter in three dimensions. In this paper, it is proved that a multiple spin-echo sequence is preferable to a single spin-echo sequence. It is also shown that when using a multiple spin-echo sequence it is not the inter-echo time that should be optimized but the number of echoes. An algebraical expression is derived for the dose resolution in terms of sequence parameters. A mathematical formalism and look-up tables are provided that can be used to optimize both a single and a slice-selective multiple spin-echo sequence to acquire a set of dose images at various locations. The use of the optimization protocol is illustrated by some examples. The optimization protocol enables the user to derive the optimal sequence parameters to acquire a set of dose maps obtained by quantitative T2 imaging for each polymer gel dosimeter within the shortest time possible.

Measurements of MTF and SNR(f) using a subtraction method in MRI

A method was developed for accurate measurement of the modulation transfer function (MTF) and signal-to-noise ratio in the spatial frequency domain (SNR(f)) of magnetic resonance images (MRI). The MTF was calculated from the complex images of a line object which were obtained by the subtraction of two separately acquired data sets of a specially designed phantom with a sliding sheet. Moreover, the SNR(f) was calculated from the MTF and Wiener spectrum, both of which were determined using the same phantom configuration. The MTFs and SNR(f)s in the conventional spin-echo (SE) and turbo SE, in which the effective echo time was set to the first echo, were evaluated by changing the T2 of the phantom and the echo train length. The MTFs in the positive and negative frequencies indicated the effect of the k-space trajectory for each pulse sequence. SNR(f)s gave spatial frequency information that was not obtained with conventional methods. In this method, the influence of image nonuniformity and unwanted artefacts (edge and ghost) could be eliminated. An analysis of the MTF and the SNR in the spatial frequency domain provides additional information for the assessment of image quality in MRI.

Effectiveness and relevance of MR acceptance testing: results of an 8 year audit

The effectiveness and relevance of independent acceptance testing was assessed by means of an audit of acceptance procedures for 17 MRI systems, with field strengths in the range 0.5-1.5 T, acquired over 8 years. Signal-to-noise ratio and geometric linearity were found to be the image quality parameters most likely to fall below acceptable or expected standards. These received confirmed successful corrective action in 69% of instances. Non-uniformity, ghosting and poor fat suppression were the next most common non-compliant parameters, but yielded less satisfactory outcomes. Spatial resolution was not found to be a sensitive parameter in determining acceptability. 49% of all non-compliant parameters received verifiable corrective attention. A schedule of actual acceptance criteria is presented and shown to be reasonable. Parameter failure rates were shown not to have improved with time. A safety audit of 11 of the installations revealed the most common failings to be inadequate suite layout and poor use of signs. The mean number of safety issues per installation identified as requiring attention was 5, from a questionnaire of 100 points. A number of anecdotal errors and omissions are reported. The data support the importance of an appropriate acceptance procedure for new clinical MRI equipment and for the involvement of a suitably qualified safety adviser on the project team from the outset.

Comparison of MR imaging breast coils

In one volunteer, five breast coils were evaluated for signal-to-noise ratio (SNR), uniformity, comfort, subject orientation, access to the breast, and unilateral imaging options. The four-coil arrays provided superior SNR, imaging flexibility, and access. Uniformity and comfort were issues with all coils. Substantial design differences exist between coils; purchasers should ensure that their specific requirements are met.

Artefacts in multi-echo T2 imaging for high-precision gel dosimetry: III. Effects of temperature drift during scanning

In high-precision 3D gel dosimetry, long MR measurement times together with a high amount of RF energy being absorbed by the phantom are very common, and result in a spatially dependent temperature rise in the gel. As T2 of the dosimeter gel is temperature dependent, dose estimation will be affected. In this study we assess the temperature rise in the dosimeter gel by use of MR temperature mapping and computer modelling. It is shown that in conventional MR sequences. where linear k-space sampling is used, a temperature rise of 3 C results in a dose underestimation of 10% over the whole dose map. To correct for these dose errors, a compensation method involving centric k-space ordering is suggested. Computer simulations have been performed to analyse the robustness of the proposed method. Applying the compensated sequence, a temperature rise of 3 C leads to a narrow dose artefact of the order of 3% for a 'worst case' situation in which a single pixel dose gradient is assumed. Negligible deviations are found in the rest of the dose map.

A high-resolution phantom for MRI

Assessment of spatial resolution is an important step to test the performance of new sequence techniques-especially ultrafast techniques with dedicated k-space trajectories or interpolation algorithms. Measurement of the modulation transfer function (MTF) is a rather difficult procedure, but using suitable resolution phantoms allows a simple visual evaluation of spatial resolution. In contrast to commonly used test objects with a very restricted number of resolution patterns we developed a phantom containing resolution patterns from 0.1 to 1.5 mm in steps of 0.1 mm. One resolution pattern consists of five parallel Plexiglas strips with the distance of the strips being equal to their thickness. Together with a Plexiglas cuboid the resolution patterns are mounted on a Plexiglas plate on the bottom of the cylindrical phantom. An aqueous solution of manganese chloride is used to fill the phantom. High resolution cross sections (pixel size: 50 microm) through the resolution patterns were measured to confirm the correct dimensions of the phantom. To verify the appropriateness of the 0.1 and 0.2 mm stacks micro-CT images with a pixel size of 25 microm were acquired additionally for both patterns. Besides visual inspection evaluation of the profile function of signal intensity across the stacks demonstrates that the resolution patterns are sufficiently correct. T(1)-weighted SE sequences with slightly different pixel sizes as well as T(1)- and T(2*)- weighted gradient echo sequences were applied to demonstrate some possible applications of this phantom. In conclusion, the proposed phantom is well suited to assess the spatial resolution qualitatively (i.e., visually) and quantitatively over a wide range in steps of 0.1 mm.

Multiphase ECG-triggered 3D contrast-enhanced MR angiography: utility for evaluation of hilar and mediastinal invasion of bronchogenic carcinoma

The purpose of this study was to evaluate the usefulness of cardiac synchronized magnetic resonance angiography [electrocardiographically (ECG)-triggered MRA] for improving image quality and detection of hilar and mediastinal invasion of bronchogenic carcinoma. Fifty patients, suspected of having hilar or mediastinal invasion of bronchogenic carcinoma, underwent contrast-enhanced computed tomography and MR imaging including conventional and ECG-triggered MRA. Twenty patients subsequently also underwent surgical resection. Vascular enhancement-to-background ratio (VBR), vascular enhancement-to-tumor ratio (VTR), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image quality scores of thoracic vessels obtained with both MRA techniques were determined and compared. In addition, the diagnostic accuracy of tumor invasion of pulmonary vessels was compared. VBRs and VTRs of both MRA techniques were not significantly different. ECG-triggered MRA significantly improved SNRs and CNRs (P < 0.05). Two readers judged that overall image quality of ECG-triggered MRA was better than that of conventional MRA (kappa > or = 0.41). In conclusion, ECG-triggered MRA improves the image quality and the detection of hilar and mediastinal invasion of bronchogenic carcinoma.

Image analysis methods for assessing levels of image plane nonuniformity and stochastic noise in a magnetic resonance image of a homogeneous phantom

Magnetic response image plane nonuniformity and stochastic noise are properties that greatly influence the outcome of quantitative magnetic resonance imaging (MRI) evaluations such as gel dosimetry measurements using MRI. To study these properties, robust and accurate image analysis methods are required. New nonuniformity level assessment methods were designed, since previous methods were found to be insufficiently robust and accurate. The new and previously reported nonuniformity level assessment methods were analyzed with respect to, for example, insensitivity to stochastic noise; and previously reported stochastic noise level assessment methods with respect to insensitivity to nonuniformity. Using the same image data, different methods were found to assess significantly different levels of nonuniformity. Nonuniformity levels obtained using methods that count pixels in an intensity interval, and obtained using methods that use only intensity values, were found not to be comparable. The latter were found preferable, since they assess the quantity intrinsically sought. A new method which calculates a deviation image, with every pixel representing the deviation from a reference intensity, was least sensitive to stochastic noise. Furthermore, unlike any other analyzed method, it includes all intensity variations across the phantom area and allows for studies of nonuniformity shapes. This new method was designed for accurate studies of nonuniformities in gel dosimetry measurements, but could also be used with benefit in quality assurance and acceptance testing of MRI, scintillation camera, and computer tomography systems. The stochastic noise level was found to be greatly method dependent. Two methods were found to be insensitive to nonuniformity and also simple to use in practice. One method assesses the stochastic noise level as the average of the levels at five different positions within the phantom area, and the other assesses the stochastic noise in a region outside the phantom area.

Artefacts in multi-echo T2 imaging for high-precision gel dosimetry: II. Analysis of B1-field inhomogeneity

In BANG gel dosimetry, the spin-spin relaxation rate, R2 = 1/T2, is related to radiation dose that has been delivered to a gel phantom. R2 is calculated by fitting the pixel intensities of a set of differently T2-weighted base images. The accuracy that is aimed for in this quantitative MR application is about 5% relative to the maximum dose. In a conventional imaging MR scanner, however, several imaging artefacts may perturb the final dose map. These deviations manifest themselves as either a deformation of the dose map or an inaccuracy of the dose pixel value. Inaccuracies in the dose maps are caused by both spatial and temporal deviations in signal intensities during scanning. This study deals with B1-field inhomogeneities as a source of dose inaccuracy. First, the influence of B1-field inhomogeneities on slice profiles is investigated using a thin-slice phantom. Secondly, a FLASH sequence is used to map the B1-field by assessing the effective flip angle in each voxel of a homogeneous phantom. In addition, both experiments and computer simulations revealed the effects of B1 field inhomogeneities on the measured R2. This work offers a method to correct R2 maps for B1 -field inhomogeneities.

Quality assurance for MRI: practical experience

The aim of this study is to propose guidelines for quality assurance (QA) in MRI, based on a comprehensive assessment of QA parameters undertaken on a busy clinical MRI scanner over the course of 1 year. QA phantoms supplied by the scanner manufacturer were used together with the Eurospin MRI phantom set. Signal-to-noise ratio (SNR) and image uniformity were measured daily from spin echo images acquired using a quadrature send-receive head coil and from a gradient echo sequence using the Helmholtz body coil. The voltage of the transmit radiofrequency (RF) amplifier was noted. Monthly measurements of slice thickness, geometric distortion, slice position, image resolution and image ghosting were acquired using the head coil. In addition, SNR was measured monthly on a selection of commonly used coils. Apart from some drift of the RF amplifier voltage, all measurements were within acceptable limits and were stable over the course of 1 year. Satisfactory measurements of SNR were possible using the simple phantom supplied with the scanner. The SNR, geometric distortion and RF amplifier voltage are simple to determine and can be measured in less than 15 min by the scanner operator, using the scanner software. Weekly recording of these parameters is recommended for busy clinical MRI scanners, as this should allow deviations from acceptable limits to be identified early. Such in-house checks can usefully be compared with the less frequent estimations performed by the service engineer. Comprehensive QA routines are discussed for systems used for quantitative measurements.

A three-coil comparison for MR angiography

The purpose of this work was to compare intracranial magnetic resonance angiography (MRA) image quality using three different radiofrequency coils. The three coil types included a reduced volume quadrature birdcage coil with endcap, a commercially available quadrature birdcage head coil, and a four-element phased-array coil. Signal-to-noise ratio (SNR) measurements were obtained from comparison studies performed on a uniform cylindrical phantom. MRA comparisons were performed using data acquired from 15 volunteers and applying a thick-slab three-dimensional time-of-flight sequence. Analysis was performed using the signal difference-to-noise ratio, a quantitative measure of the relative vascular signal. The reduced-volume endcap and phased-array coils, which were designed specifically for imaging the intracranial volume of the head, improved the image SNR and vascular detail considerably over that obtained using the commercially available head coil. The endcap coil configuration provided the best vascular signal overall, while the phased-array coil provided the best results for arteries close to the coil elements.

A comparison of two methods for measuring the signal to noise ratio on MR images

The signal to noise ratio (SNR) is one of the important measures of the performance of a magnetic resonance imaging (MRI) system. The object of this study was to compare a single acquisition method, which estimates the noise from background pixels, with a dual acquisition method which estimates the noise from the subtraction of two sequentially acquired images. The dual acquisition method is more exact, but is slower to perform and requires image manipulation. A comparison between the two methods gave a good correlation, and a regression equation of SNRsingle = 1.1 + 0.94 SNRdual. The single acquisition method is therefore appropriate for use in a quality assurance programme, since it is quicker and simpler to perform and is a good indicator of the more exact measure.

A study of artefacts in simultaneous PET and MR imaging using a prototype MR compatible PET scanner

We have assessed the possibility of artefacts that can arise in attempting to perform simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) using a small prototype MR compatible PET scanner (McPET). In these experiments, we examine MR images for any major artefacts or loss in image quality due to inhomogeneities in the magnetic field, radiofrequency interference or susceptibility effects caused by operation of the PET system inside the MR scanner. In addition, possible artefacts in the PET images caused by the static and time-varying magnetic fields or radiofrequency interference from the MR system were investigated. Biological tissue and a T2-weighted spin echo sequence were used to examine susceptibility artefacts due to components of the McPET scanner (scintillator, optical fibres) situated in the MR field of view. A range of commonly used MR pulse sequences was studied while acquiring PET data to look for possible artefacts in either the PET or MR images. Other than a small loss in signal-to-noise using gradient echo sequences, there was no significant interaction between the two imaging systems. Simultaneous PET and MR imaging of simple phantoms was also carried out in different MR systems with field strengths ranging from 0.2 to 4.7 T. The results of these studies demonstrate that it is possible to acquire PET and MR images simultaneously, without any significant artefacts or loss in image quality, using our prototype MR compatible PET scanner.

Measurement of small inter-scan fluctuations in voxel dimensions in magnetic resonance images using registration

We present a method to estimate fluctuations in voxel dimensions in MR images. In the proposed method images of a standard test object are acquired serially and registered to an initial dataset. We present the results of experiments where changes in voxel dimensions between 0.1% and 2% were prescribed and measured with an accuracy of 0.02%. The method can be integrated as part of a standard MRI Quality Assurance program and may also be useful to correct for inter-scan variability introduced by fluctuations in gradient performance.

Automatic tumor segmentation using knowledge-based techniques

A system that automatically segments and labels glioblastoma-multiforme tumors in magnetic resonance images (MRI's) of the human brain is presented. The MRI's consist of T1-weighted, proton density, and T2-weighted feature images and are processed by a system which integrates knowledge-based (KB) techniques with multispectral analysis. Initial segmentation is performed by an unsupervised clustering algorithm. The segmented image, along with cluster centers for each class are provided to a rule-based expert system which extracts the intracranial region. Multispectral histogram analysis separates suspected tumor from the rest of the intracranial region, with region analysis used in performing the final tumor labeling. This system has been trained on three volume data sets and tested on thirteen unseen volume data sets acquired from a single MRI system. The KB tumor segmentation was compared with supervised, radiologist-labeled "ground truth" tumor volumes and supervised k-nearest neighbors tumor segmentations. The results of this system generally correspond well to ground truth, both on a per slice basis and more importantly in tracking total tumor volume during treatment over time.

Test objects for MRI quality assurance based on polymer gels

Radiation-sensitive polymer gels have been adapted for making test objects that can be used to assess the imaging characteristics of magnetic resonance imaging (MRI) systems. The polymer gels contain acrylic monomers within a gel matrix, and when irradiated with x rays the constituents polymerize to produce highly cross-linked microparticles that dramatically affect water NMR relaxation rates where they form. The size of these effects depends on the radiation dose and composition of the mixture irradiated, while the spatial pattern of relaxation time changes can be precisely controlled by spatial modulation of the x-ray exposure. This permits the manufacture of complex test patterns free of susceptibility or edge effects, and overall image performance can be assessed by constructing contrast-detail diagrams using a singly irradiated gel containing areas of different sizes and contrasts. Polymer gels are stable and a variety of different tests objects can be constructed inexpensively. Such materials and test phantoms may find widespread application in diagnostic MRI quality assurance and testing programs.

Errors in MR stereotaxy due to undetected extraneous metal objects

MR stereotaxic procedures are being increasingly used, particularly in functional neurosurgery where very high levels of localization accuracy are required. Whilst many studies have investigated intrinsic causes of non-linearity, potential errors due to an extrinsic cause are not generally appreciated. It is not uncommon to find objects such as hair clips, paper clips and pins inside high-field magnets. They can remain undetected for long periods because they can reach positions not open to visual inspection and because they often do not produce observable deterioration in routine image quality. In this study we measured the maximum absolute positional shifts caused by such objects and found that these can be significant (> 1 mm, even up to 200 mm from one such object). Additional measurements were performed using an MR compatible Leksell stereotaxic frame to calculate actual stereotaxic coordinate errors. The encompassing nature of the frame is such that some degree of compensation for such nonlinearities is inherent, and so errors for areas of the brain more proximal to the object are found to be reduced but not eliminated. Stereotaxic coordinate errors will not be reduced in nonencompassing designs and in frameless stereotaxy. The prevalence of such objects in clinical systems and the measures required to detect their presence are discussed. The need for quality control testing before each stereotaxic procedure is highlighted.

A three-dimensional volumetric test object for geometry evaluation in magnetic resonance imaging

The design of a test object for the volumetric evaluation of geometric image quality parameters in magnetic resonance imaging (MRI) is presented. Two-dimensional parameters: linearity, distortion, slice position, slice width, slice oblique angle, spatial resolution, line spread function (LSF) are measurable in all slice planes within a volume corresponding to a typical head examination. Additionally, parameters particular to three-dimensional Fourier transform (3-DFT) imaging are measurable: 3D ghosting and 3D LSF. Parameter measurements are correctable with regard to test object positioning through the determination of the six degrees of freedom of the test object within the scanner's field of view.

Information in magnetic resonance images: evaluation of signal, noise and contrast

The assessment of diagnostic image quality for MRI is considered. The assessment of three key image quality determinants is addressed: signal, noise and contrast. There is a distinction between random noise evaluation, for the calculation of the SNR, and structured noise evaluation for the assessment of image artefacts. Specific methods used are correlation techniques and the Wiener spectrum. Contrast is assessed by comparison of experimental data and theoretical predictions. For each assessment, the theory and method of the evaluation strategy are discussed. The discussion is illustrated with analysis results from commercial MR systems. The choice of analysis method and the subsequent derivation of quality indices are shown to be critical in respect of robustness and accuracy.

MRI segmentation: methods and applications

The current literature on MRI segmentation methods is reviewed. Particular emphasis is placed on the relative merits of single image versus multispectral segmentation, and supervised versus unsupervised segmentation methods. Image pre-processing and registration are discussed, as well as methods of validation. The application of MRI segmentation for tumor volume measurements during the course of therapy is presented here as an example, illustrating problems associated with inter- and intra-observer variations inherent to supervised methods.