Phased array detectors and an automated intensity-correction algorithm for high-resolution MR imaging of the human brain

A local multi-transmit coil combined with a high-density receive array for cerebellar fMRI at 7 T

The human cerebellum is involved in a wide array of functions, ranging from motor control to cognitive control, and as such is of great neuroscientific interest. However, its function is underexplored in vivo, due to its small size, its dense structure and its placement at the bottom of the brain, where transmit and receive fields are suboptimal. In this study, we combined two dense coil arrays of 16 small surface receive elements each with a transmit array of three antenna elements to improve BOLD sensitivity in the human cerebellum at 7 T. Our results showed improved B₁⁺ and SNR close to the surface as well as g-factor gains compared with a commercial coil designed for whole-head imaging. This resulted in improved signal stability and large gains in the spatial extent of the activation close to the surface (<3.5 cm), while good performance was retained deeper in the cerebellum. Modulating the phase of the transmit elements of the head coil to constructively interfere in the cerebellum improved the B₁⁺ , resulting in a temporal SNR gain. Overall, our results show that a dedicated transmit array along with the SNR gains of surface coil arrays can improve cerebellar imaging, at the cost of a decreased field of view and increased signal inhomogeneity.

MRI-Based Quantitative Osteoporosis Imaging at the Spine and Femur

Osteoporosis is a systemic skeletal disease with a high prevalence worldwide, characterized by low bone mass and microarchitectural deterioration, predisposing an individual to fragility fractures. Dual-energy X-ray absorptiometry (DXA) has been the clinical reference standard for diagnosing osteoporosis and for assessing fracture risk for decades. However, other imaging modalities are of increasing importance to investigate the etiology, treatment, and fracture risk. The purpose of this work is to review the available literature on quantitative magnetic resonance imaging (MRI) methods and related findings in osteoporosis at the spine and proximal femur as the clinically most important fracture sites. Trabecular bone microstructure analysis at the proximal femur based on high-resolution MRI allows for a better prediction of osteoporotic fracture risk than DXA-based bone mineral density (BMD) alone. In the 1990s, T₂ * mapping was shown to correlate with the density and orientation of the trabecular bone. Recently, quantitative susceptibility mapping (QSM), which overcomes some of the limitations of T₂ * mapping, has been applied for trabecular bone quantifications at the spine, whereas ultrashort echo time (UTE) imaging provides valuable surrogate markers of cortical bone quantity and quality. Magnetic resonance spectroscopy (MRS) and chemical shift encoding-based water-fat MRI (CSE-MRI) enable the quantitative assessment of the nonmineralized bone compartment through extraction of the bone marrow fat fraction (BMFF). Furthermore, CSE-MRI allows for the differentiation of osteoporotic vs. pathologic fractures, which is of high clinical relevance. Lastly, advanced postprocessing and image analysis tools, particularly considering statistical parametric mapping and region-specific BMFF distributions, have high potential to further improve MRI-based fracture risk assessments at the spine and hip. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 2.

Uniform combined reconstruction of multichannel 7T knee MRI receive coil data without the use of a reference scan

BACKGROUND

MR image intensity nonuniformity is often observed at 7T. Reference scans from the body coil used for uniformity correction at lower field strengths are typically not available at 7T.

PURPOSE

To evaluate the efficacy of a novel algorithm, Uniform Combined Reconstruction (UNICORN), to correct receive coil-induced nonuniformity in musculoskeletal 7T MRI without the use of a reference scan.

STUDY TYPE

Retrospective image analysis study.

SUBJECTS

MRI data of 20 subjects was retrospectively processed offline. Field Strength/Sequence: Knees of 20 subjects were imaged at 7T with a single-channel transmit, 28-channel phased-array receive knee coil. A turbo-spin-echo sequence was used to acquire 33 series of images.

ASSESSMENT

Three fellowship-trained musculoskeletal radiologists with cumulative experience of 42 years reviewed the images. The uniformity, contrast, signal-to-noise ratio (SNR), and overall image quality were evaluated for images with no postprocessing, images processed with N4 bias field correction algorithm, and the UNICORN algorithm.

STATISTICAL TESTS

Intraclass correlation coefficient (ICC) was used for measuring the interrater reliability. ICC and 95% confidence intervals (CIs) were calculated using the R statistical package employing a two-way mixed-effects model based on a mean rating (k = 3) for absolute agreement. The Wilcoxon signed-rank test with continuity correction was used for analyzing the overall image quality scores.

RESULTS

UNICORN was preferred among the three methods evaluated for uniformity in 97.9% of the pooled ratings, with excellent interrater agreement (ICC of 0.98, CI 0.97-0.99). UNICORN was also rated better than N4 for contrast and equivalent to N4 in SNR with ICCs of 0.80 (CI 0.72-0.86) and 0.67 (CI 0.54-0.77), respectively. The overall image quality scores for UNICORN were significantly higher than N4 (P < 6 × 10^-13 ), with good to excellent interrater agreement (ICC 0.90, CI 0.86-0.93).

DATA CONCLUSION

Without the use of a reference scan, UNICORN provides better image uniformity, contrast, and overall image quality at 7T compared with the N4 bias field-correction algorithm.

LEVEL OF EVIDENCE

4 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:1534-1544.

Potential acceleration performance of a 256-channel whole-brain receive array at 7 T

Purpose

Assess the potential gain in acceleration performance of a 256‐channel versus 32‐channel receive coil array at 7 T in combination with a 2D CAIPIRINHA sequence for 3D data sets.

Methods

A 256‐channel receive setup was simulated by placing 2 small 16‐channel high‐density receive arrays at 2 × 8 different locations on the head of healthy participants. Multiple consecutive measurements were performed and coil sensitivity maps were combined to form a complete 256‐channel data set. This setup was compared with a standard 32‐channel head coil, in terms of SNR, noise correlation, and acceleration performance (g‐factor).

Results

In the periphery of the brain, the receive SNR was on average a factor 1.5 higher (ranging up to a factor 2.7 higher) than the 32‐channel coil; in the center of the brain the SNR was comparable or lower, depending on the size of the region of interest, with a factor 1.0 on average (ranging from 0.7 up to a factor of 1.6). The average noise correlation between coil elements was 3% for the 256‐channel coil, and 5% for the 32‐channel coil. At acceptable g‐factors (< 2), the achievable acceleration factor using SENSE and 2D CAIPIRINHA was 24 and 28, respectively, versus 9 and 12 for the 32‐channel coil.

Conclusion

The receive performance of the simulated 256 channel array was better than the 32‐channel reference. Combined with 2D CAIPIRINHA, a peak acceleration factor of 28 was assessed, showing great potential for high‐density receive arrays.

A non-iterative multi-scale approach for intensity inhomogeneity correction in MRI

Intensity inhomogeneity is the prime obstacle for MR image processing like automatic segmentation, registration etc. This complication has strong dependence on the associated acquisition hardware and patient anatomy which recommends retrospective correction. In this paper, a new method is developed for correcting the intensity inhomogeneity using a non-iterative multi-scale approach that doesn't necessitate segmentation and any prior knowledge on the scanner or subject. The proposed algorithm extracts bias field at different scales using a Log-Gabor filter bank followed by smoothing operation. Later, they are combined to fit a third degree polynomial to estimate the bias field. Finally, the corrected image is estimated by performing pixel-wise division of original image and bias field. The performance of the same was tested on BrainWeb simulated data, HCP dataset and is found to provide better performance than the state-of-the-art method, N4. A good agreement between the extracted and ground truth bias field is observed through correlation coefficient on different MR modality images that include T1w, T2w and PD. Significant reduction in coefficient variation and coefficient of joint variation ratios in real data indicate an improved inter-class separation and reduced intra-class intensity variations across white and grey matter tissue regions.

Value of Repeat Brain MRI in Children with Focal Epilepsy and Negative Findings on Initial MRI

Objective

To evaluate the value of repeat brain magnetic resonance imaging (MRI) in identifying potential epileptogenic lesions in children with initial MRI-negative focal epilepsy.

Materials and Methods

Our Institutional Review Board approved this retrospective study and waived the requirement for informed consent. During a 15-year period, 257 children (148 boys and 109 girls) with initial MRI-negative focal epilepsy were included. After re-evaluating both initial and repeat MRIs, positive results at repeat MRI were classified into potential epileptogenic lesions (malformation of cortical development and hippocampal sclerosis) and other abnormalities. Contributing factors for improved lesion conspicuity of the initially overlooked potential epileptogenic lesions were analyzed and classified into lesion factors and imaging factors.

Results

Repeat MRI was positive in 21% (55/257) and negative in 79% cases (202/257). Of the positive results, potential epileptogenic lesions comprised 49% (27/55) and other abnormalities comprised 11% of the cases (28/257). Potential epileptogenic lesions included focal cortical dysplasia (n = 11), hippocampal sclerosis (n = 10), polymicrogyria (n = 2), heterotopic gray matter (n = 2), microlissencephaly (n = 1), and cortical tumor (n = 1). Of these, seven patients underwent surgical resection. Contributing factors for new diagnoses were classified as imaging factors alone (n = 6), lesion factors alone (n = 2), both (n = 18), and neither (n = 1).

Conclusion

Repeat MRI revealed positive results in 21% of the children with initial MRI-negative focal epilepsy, with 50% of the positive results considered as potential epileptogenic lesions. Enhanced MRI techniques or considering the chronological changes of lesions on MRI may improve the diagnostic yield for identification of potential epileptogenic lesions on repeat MRI.

A Specialized Multi-Transmit Head Coil for High Resolution fMRI of the Human Visual Cortex at 7T

PURPOSE

To design, construct and validate radiofrequency (RF) transmit and receive phased array coils for high-resolution visual cortex imaging at 7 Tesla.

METHODS

A 4 channel transmit and 16 channel receive array was constructed on a conformal polycarbonate former. Transmit field efficiency and homogeneity were simulated and validated, along with the Specific Absorption Rate, using [Formula: see text] mapping techniques and electromagnetic simulations. Receiver signal-to-noise ratio (SNR), temporal SNR (tSNR) across EPI time series, g-factors for accelerated imaging and noise correlations were evaluated and compared with a commercial 32 channel whole head coil. The performance of the coil was further evaluated with human subjects through functional MRI (fMRI) studies at standard and submillimeter resolutions of upto 0.8mm isotropic.

RESULTS

The transmit and receive sections were characterized using bench tests and showed good interelement decoupling, preamplifier decoupling and sample loading. SNR for the 16 channel coil was ∼ 1.5 times that of the commercial coil in the human occipital lobe, and showed better g-factor values for accelerated imaging. fMRI tests conducted showed better response to Blood Oxygen Level Dependent (BOLD) activation, at resolutions of 1.2mm and 0.8mm isotropic.

CONCLUSION

The 4 channel phased array transmit coil provides homogeneous excitation across the visual cortex, which, in combination with the dual row 16 channel receive array, makes for a valuable research tool for high resolution anatomical and functional imaging of the visual cortex at 7T.

Hybrid-Space SENSE Reconstruction for Simultaneous Multi-Slice MRI

Simultaneous Multi-Slice (SMS) magnetic resonance imaging (MRI) is a rapidly evolving technique for increasing imaging speed. Controlled aliasing techniques utilize periodic undersampling patterns to help mitigate the loss in signal-to-noise ratio (SNR) in SMS MRI. To evaluate the performance of different undersampling patterns, a quantitative description of the image SNR loss is needed. Additionally, eddy current effects in echo planar imaging (EPI) lead to slice-specific Nyquist ghosting artifacts. These artifacts cannot be accurately corrected for each individual slice before or after slice-unaliasing. In this work, we propose a hybrid-space sensitivity encoding (SENSE) reconstruction framework for SMS MRI by adopting a three-dimensional representation of the SMS acquisition. Analytical SNR loss maps are derived for SMS acquisitions with arbitrary phase encoding undersampling patterns. Moreover, we propose a matrix-decoding correction method that corrects the slice-specific Nyquist ghosting artifacts in SMS EPI acquisitions. Brain images demonstrate that the proposed hybrid-space SENSE reconstruction generates images with comparable quality to commonly used split-slice-generalized autocalibrating partially parallel acquisition reconstruction. The analytical SNR loss maps agree with those calculated by a Monte Carlo based method, but require less computation time for high quality maps. The analytical maps enable a fair comparison between the performances of coherent and incoherent SMS undersampling patterns. Phantom and brain SMS EPI images show that the matrix-decoding method performs better than the single-slice and slice-averaged Nyquist ghosting correction methods under the hybrid-space SENSE reconstruction framework.

Optimized multimodal functional magnetic resonance imaging/near-infrared spectroscopy probe for ultrahigh-resolution mapping

Functional near-infrared spectroscopy (fNIRS) is an increasingly important noninvasive method in neuroscience due to its high temporal resolution and ability to independently measure oxy- and deoxy-hemoglobin. However, the relatively low spatial resolution of fNIRS makes it difficult to relate this signal to underlying anatomy. Simultaneous functional magnetic resonance imaging (fMRI) can complement fNIRS with superior spatial resolution and the ability to image the entire brain, providing additional information to improve fNIRS localization. However, current simultaneous fMRI/fNIRS acquisition methods are not optimal, due to the poor physical compatibility of existing MR coils and fNIRS optodes. Here, we present a technique to manufacture a true multimodal fMRI/fNIRS probe in which both modalities can be used with maximal sensitivity. To achieve this, we designed custom MR coils with integral fNIRS optodes using three-dimensional printing. This multimodal probe can be used to optimize spatial ([Formula: see text]) and temporal resolution (2.5 Hz) of fMRI, and it provides maximal MRI sensitivity, while allowing for high flexibility in the location and density of fNIRS optodes within the area of interest. Phantom and human data are shown to confirm the improvement in sensitivity in both modalities. This probe shows promise for addressing fundamental questions of the relation of fNIRS to physiology.

Multi-flux-transformer MRI detection with an atomic magnetometer

Recently, anatomical ultra-low field (ULF) MRI has been demonstrated with an atomic magnetometer (AM). A flux-transformer (FT) has been used for decoupling MRI fields and gradients to avoid their negative effects on AM performance. The field of view (FOV) was limited because of the need to compromise between the size of the FT input coil and MRI sensitivity per voxel. Multi-channel acquisition is a well-known solution to increase FOV without significantly reducing sensitivity. In this paper, we demonstrate twofold FOV increase with the use of three FT input coils. We also show that it is possible to use a single atomic magnetometer and single acquisition channel to acquire three independent MRI signals by applying a frequency-encoding gradient along the direction of the detection array span. The approach can be generalized to more channels and can be critical for imaging applications of non-cryogenic ULF MRI where FOV needs to be large, including head, hand, spine, and whole-body imaging.

Clinical cell therapy imaging using a perfluorocarbon tracer and fluorine-19 MRI

PURPOSE

Cellular therapeutics are emerging as a treatment option for a host of serious human diseases. To accelerate clinical translation, noninvasive imaging of cell grafts in clinical trials can potentially be used to assess the initial delivery and behavior of cells.

METHODS

The use of a perfluorocarbon (PFC) tracer agent for clinical fluorine-19 ((19) F) MRI cell detection is described. This technology was used to detect immunotherapeutic dendritic cells (DCs) delivered to colorectal adenocarcinoma patients. Autologous DC vaccines were labeled with a PFC MRI agent ex vivo. Patients received DCs intradermally, and (19) F spin-density-weighted MRI at 3 Tesla (T) was used to observe cells.

RESULTS

Spin-density-weighted (19) F images at the injection site displayed DCs as background-free "hot-spot" images. (19) F images were acquired in clinically relevant scan times (<10 min). Apparent DC numbers could be quantified in two patients from the (19) F hot-spots and were observed to decrease by ∼50% at injection site by 24 h. From 3T phantom studies, the sensitivity limit for DC detection is estimated to be on the order of ∼10(5) cells/voxel in this study.

CONCLUSION

These results help to establish a clinically applicable means to track a broad range of cell types used in cell therapy.

Neuroimaging of epilepsy: a review of MRI findings in uncommon etiologies and atypical presentations of seizures

ABSTRACT: 

Imaging patients with seizures presents a challenge to both clinician and radiologist, especially when symptoms or EEG features are atypical, not conforming to established epilepsy syndromes or EEG patterns. Appropriate, directed use of MRI enhances the detection of underlying epileptogenic foci and can evaluate both common and unusual etiologies. This review examines imaging evaluation of epilepsies due to uncommon presentations of common conditions, unusual conditions and atypical seizure presentations. Understanding these uncommon presentations of seizures ensures optimal clinical management and can guide appropriate intervention. Advances in newer imaging methods including diffusion tensor imaging, functional connectivity MRI, magnetic source imaging and magnetic resonance spectroscopic imaging can further increase sensitivity to detect subtle structural abnormalities causing epilepsy and can also be used to plan more successful epilepsy surgery.

Massively parallel MRI detector arrays

Originally proposed as a method to increase sensitivity by extending the locally high-sensitivity of small surface coil elements to larger areas via reception, the term parallel imaging now includes the use of array coils to perform image encoding. This methodology has impacted clinical imaging to the point where many examinations are performed with an array comprising multiple smaller surface coil elements as the detector of the MR signal. This article reviews the theoretical and experimental basis for the trend towards higher channel counts relying on insights gained from modeling and experimental studies as well as the theoretical analysis of the so-called "ultimate" SNR and g-factor. We also review the methods for optimally combining array data and changes in RF methodology needed to construct massively parallel MRI detector arrays and show some examples of state-of-the-art for highly accelerated imaging with the resulting highly parallel arrays.

Multi-reception strategy with improved SNR for multichannel MR imaging

A multi-reception strategy with extended GRAPPA is proposed in this work to improve MR imaging performance at ultra-high field MR systems with limited receiver channels. In this method, coil elements are separated to two or more groups under appropriate grouping criteria. Those groups are enabled in sequence for imaging first, and then parallel acquisition is performed to compensate for the redundant scan time caused by the multiple receptions. To efficiently reconstruct the data acquired from elements of each group, a specific extended GRAPPA was developed. This approach was evaluated by using a 16-element head array on a 7 Tesla whole-body MRI scanner with 8 receive channels. The in-vivo experiments demonstrate that with the same scan time, the 16-element array with twice receptions and acceleration rate of 2 can achieve significant SNR gain in the periphery area of the brain and keep nearly the same SNR in the center area over an eight-element array, which indicates the proposed multi-reception strategy and extended GRAPPA are feasible to improve image quality for MRI systems with limited receive channels. This study also suggests that it is advantageous for a MR system with N receiver channels to utilize a coil array with more than N elements if an appropriate acquisition strategy is applied.

Parallel-transmission-enabled magnetization-prepared rapid gradient-echo T1-weighted imaging of the human brain at 7 T

One of the promises of Ultra High Field (UHF) MRI scanners is to bring finer spatial resolution in the human brain images due to an increased signal to noise ratio. However, at such field strengths, the spatial non-uniformity of the Radio Frequency (RF) transmit profiles challenges the applicability of most MRI sequences, where the signal and contrast levels strongly depend on the flip angle (FA) homogeneity. In particular, the MP-RAGE sequence, one of the most commonly employed 3D sequences to obtain T1-weighted anatomical images of the brain, is highly sensitive to these spatial variations. These cause deterioration in image quality and complicate subsequent image post-processing such as automated tissue segmentation at UHF. In this work, we evaluate the potential of parallel-transmission (pTx) to obtain high-quality MP-RAGE images of the human brain at 7 T. To this end, non-selective transmit-SENSE pulses were individually tailored for each of 8 subjects under study, and applied to an 8-channel transmit-array. Such RF pulses were designed both for the low-FA excitation train and the 180° inversion preparation involved in the sequence, both utilizing the recently introduced k(T)-point trajectory. The resulting images were compared with those obtained from the conventional method and from subject-specific RF-shimmed excitations. In addition, four of the volunteers were scanned at 3 T for benchmarking purposes (clinical setup without pTx). Subsequently, automated tissue classification was performed to provide a more quantitative measure of the final image quality. Results indicated that pTx could already significantly improve image quality at 7 T by adopting a suitable RF-Shim. Exploiting the full potential of the pTx-setup, the proposed k(T)-point method provided excellent inversion fidelity, comparable to what is commonly only achievable at 3 T with energy intensive adiabatic pulses. Furthermore, the cumulative energy deposition was simultaneously reduced by over 40% compared to the conventional adiabatic inversions. Regarding the low-FA k(T)-point based excitations, the FA uniformity achieved at 7 T surpassed what is typically obtained at 3 T. Subsequently, automated white and gray matter segmentation not only confirmed the expected improvements in image quality, but also suggests that care should be taken to properly account for the strong local susceptibility effects near cranial cavities. Overall, these findings indicate that the k(T)-point-based pTx solution is an excellent candidate for UHF 3D imaging, where patient safety is a major concern due to the increase of specific absorption rates.

A radiofrequency coil to facilitate B₁⁺ shimming and parallel imaging acceleration in three dimensions at 7 T

A 15-channel transmit-receive (transceive) radiofrequency (RF) coil was developed to image the human brain at 7 T. A hybrid decoupling scheme was implemented that used both capacitive decoupling and the partial geometric overlapping of adjacent coil elements. The decoupling scheme allowed coil elements to be arrayed along all three Cartesian axes; this facilitated shimming of the transmit field, B₁⁺, and parallel imaging acceleration along the longitudinal direction in addition to the standard transverse directions. Each channel was independently controlled during imaging using a 16-channel console and a 16 × 1-kW RF amplifier-matrix. The mean isolation between all combinations of coil elements was 18 ± 7 dB. After B₁⁺ shimming, the standard deviation of the transmit field uniformity was 11% in an axial plane and 32% over the entire brain superior to the mid-cerebellum. Transmit uniformity was sufficient to acquire fast spin echo images of this region of the brain with a single B₁⁺ shim solution. Signal-to-noise ratio (SNR) maps showed higher SNR in the periphery vs center of the brain, and higher SNR in the occipital and temporal lobes vs the frontal lobe. Parallel imaging acceleration in a rostral-caudal oblique plane was demonstrated. The implication of the number of channels in a transmit-receive coil was discussed: it was determined that improvements in SNR and B₁⁺ shimming can be expected when using more than 15 independently controlled transmit-receive channels.

Size-optimized 32-channel brain arrays for 3 T pediatric imaging

Size-optimized 32-channel receive array coils were developed for five age groups, neonates, 6 months old, 1 year old, 4 years old, and 7 years old, and evaluated for pediatric brain imaging. The array consisted of overlapping circular surface coils laid out on a close-fitting coil-former. The two-section coil former design was obtained from surface contours of aligned three-dimensional MRI scans of each age group. Signal-to-noise ratio and noise amplification for parallel imaging were evaluated and compared to two coils routinely used for pediatric brain imaging; a commercially available 32-channel adult head coil and a pediatric-sized birdcage coil. Phantom measurements using the neonate, 6-month-old, 1-year-old, 4-year-old, and 7-year-old coils showed signal-to-noise ratio increases at all locations within the brain over the comparison coils. Within the brain cortex the five dedicated pediatric arrays increased signal-to-noise ratio by up to 3.6-, 3.0-, 2.6-, 2.3-, and 1.7-fold, respectively, compared to the 32-channel adult coil, as well as improved G-factor maps for accelerated imaging. This study suggests that a size-tailored approach can provide significant sensitivity gains for accelerated and unaccelerated pediatric brain imaging.

CENTS: cortical enhanced neonatal tissue segmentation

The acquisition of high-quality magnetic resonance (MR) images of neonatal brains is largely hampered by their characteristically small head size and insufficient tissue contrast. As a result, subsequent image processing and analysis, especially brain tissue segmentation, are often affected. To overcome this problem, a dedicated phased array neonatal head coil is utilized to improve MR image quality by augmenting signal-to-noise ratio and spatial resolution without lengthening data acquisition time. In addition, a specialized hybrid atlas-based tissue segmentation algorithm is developed for the delineation of fine structures in the acquired neonatal brain MR images. The proposed tissue segmentation method first enhances the sheet-like cortical gray matter (GM) structures in the to-be-segmented neonatal image with a Hessian filter for generation of a cortical GM confidence map. A neonatal population atlas is then generated by averaging the presegmented images of a population, weighted by their cortical GM similarity with respect to the to-be-segmented image. Finally, the neonatal population atlas is combined with the GM confidence map, and the resulting enhanced tissue probability maps for each tissue form a hybrid atlas is used for atlas-based segmentation. Various experiments are conducted to compare the segmentations of the proposed method with manual segmentation (on both images acquired with a dedicated phased array coil and a conventional volume coil), as well as with the segmentations of two population-atlas-based methods. Results show the proposed method is capable of segmenting the neonatal brain with the best accuracy, and also preserving the most structural details in the cortical regions.

High-resolution imaging techniques for the assessment of osteoporosis

The importance of assessing the bone's microarchitectural make-up in addition to its mineral density in the context of osteoporosis has been emphasized in several publications. The high spatial resolution required to resolve the bone's microstructure in a clinically feasible scan time is challenging. At present, the best suited modalities meeting these requirements in vivo are high-resolution peripheral quantitative imaging (HR-pQCT) and magnetic resonance imaging (MRI). Whereas HR-pQCT is limited to peripheral skeleton regions like the wrist and ankle, MRI can also image other sites like the proximal femur but usually with lower spatial resolution. In addition, multidetector computed tomography has been used for high-resolution imaging of trabecular bone structure; however, the radiation dose is a limiting factor. This article provides an overview of the different modalities, technical requirements, and recent developments in this emerging field. Details regarding imaging protocols as well as image postprocessing methods for bone structure quantification are discussed.

New directions in clinical imaging of cortical dysplasias

Neuroimaging is essential in the work-up of patients with intractable epilepsy. In pediatric patients with medically refractory epilepsy, cortical dysplasias account for a large percentage of the epileptogenic substrate. Unfortunately, these are also the most subtle lesions to identify. For this reason, there has been ongoing interest in utilizing new advanced magnetic resonance imaging (MRI) techniques to improve the ability to identify, diagnose, characterize, and delineate cortical dysplasias. Technologic gains such as multichannel coils (32 phased array and beyond) and higher field strengths (3T, 7T, and greater) coupled with newer imaging sequences such as arterial spin labeling (ASL), susceptibility weighted imaging (SWI) and diffusion tensor/spectrum imaging (DTI/DSI) are likely to increase yield. Improved MRI techniques coupled with a multimodality approach including magnetoencephalography (MEG), positron emission tomography (PET), and other techniques will increase sensitivity and specificity for identifying cortical dysplasias.

Evaluation of correction methods for coil-induced intensity inhomogeneities and their influence on trabecular bone structure parameters from MR images

Magnetic resonance (MR) imaging-based quantitative trabecular bone structure analysis has gained increasing interest in osteoporotic fracture risk assessment and treatment evaluation related to osteoporosis. In vivo MR images of anatomic regions such as the proximal femur and distal tibia are generally acquired with a surface coil in order to obtain sufficient sensitivity and resolution for quantification of the trabeculae. However, these coils introduce intensity inhomogeneities which affect the trabecular bone structure analysis. This work evaluates the applicability of a fully automatic coil correction by nonparametric nonuniform intensity normalization (N3) in the analysis of trabecular bone parameters. The ability to correct for coil-induced intensity inhomogeneity was evaluated ex vivo on proximal femur specimens scanned with both a surface coil and a volume coil, which allowed for a direct evaluation of the performance of the coil correction methods without any major confounding factors. In addition, trabecular bone parameter values were correlated with values from high-resolution peripheral computed tomography (HR-pQCT) scans, and the reproducibility of trabecular bone parameters was evaluated in an in vivo study of repeat hip MR scans. The trabecular bone parameters determined from MR surface coil scans processed with the N3 coil correction method showed significant correlation (p < 0.05) with corresponding values from homogeneous intensity data in the ex vivo study. This can be compared to the correlation without coil correction (p < 0.5), and coil correction using low-pass filtering (LPF) (p < 0.53). The in vivo interscan variability was reduced from 8.9% to 12.8% using LPF-based to 3.6%-8.4% (CV) using N3 coil correction; hence the results showed that N3 is advantageous to LPF-based coil correction. No significant differences in correlation to HR-pQCT data were found for the coil correction methods. The significant correlations with volume coil data and high reproducibility of the N3 processed data imply that N3 coil correction preserve image information while accurately correcting for coil-induced intensity inhomogeneities, which makes it suitable for quantitative analysis of trabecular bone structure from MR images acquired with surface coils.

Connectivity alterations assessed by combining fMRI and MR-compatible hand robots in chronic stroke

The aim of this study was to investigate functional reorganization of motor systems by probing connectivity between motor related areas in chronic stroke patients using functional magnetic resonance imaging (fMRI) in conjunction with a novel MR-compatible hand-induced, robotic device (MR_CHIROD). We evaluated data sets obtained from healthy volunteers and right-hand-dominant patients with first-ever left-sided stroke > or =6 months prior and mild to moderate hemiparesis affecting the right hand. We acquired T1-weighted echo planar and fluid attenuation inversion recovery MR images and multi-level fMRI data using parallel imaging by means of the GeneRalized Autocalibrating Partially Parallel Acquisitions (GRAPPA) algorithm on a 3 T MR system. Participants underwent fMRI while performing a motor task with the MR_CHIROD in the MR scanner. Changes in effective connectivity among a network of primary motor cortex (M1), supplementary motor area (SMA) and cerebellum (Ce) were assessed using dynamic causal modeling. Relative to healthy controls, stroke patients exhibited decreased intrinsic neural coupling between M1 and Ce, which was consistent with a dysfunctional M1 to Ce connection. Stroke patients also showed increased SMA to M1 and SMA to cerebellum coupling, suggesting that changes in SMA and Ce connectivity may occur to compensate for a dysfunctional M1. The results demonstrate for the first time that connectivity alterations between motor areas may help counterbalance a functionally abnormal M1 in chronic stroke patients. Assessing changes in connectivity by means of fMRI and MR_CHIROD might be used in the future to further elucidate the neural network plasticity that underlies functional recovery in chronic stroke patients.

High-resolution phased-array MRI of the human brain at 7 tesla: initial experience in multiple sclerosis patients

Recent advancement for magnetic resonance imaging (MRI) involves the incorporation of higher-field strengths. Although imagers with higher magnetic field strengths were developed and tested in research labs, the direct application to patient MR studies have been extremely limited. Imaging at 7 Tesla (7T) affords advantages in signal-to-noise ratio and image contrast and resolution; however, these benefits can only be realized if the correct coils exist to capture the images. The objective of this study was to develop optimized high-resolution 7T MRI techniques using high sensitivity, specialized phased-array coils, for improved gray matter (GM) and white matter differentiation, in an effort to improve visualization of multiple sclerosis (MS) lesions in vivo. Twenty-three subjects were enrolled in this preliminary study, 17 with clinically definite MS (11 females, 6 males; mean age 43.4 years; range 22-64 years) and 6 healthy controls (2 females, 4 males; mean age 39.0 years; range 27-67 years). MR imaging of MS patients at 7T was demonstrated to be safe, well tolerated, and provided high-resolution anatomical images allowing visualization of structural abnormalities localized near or within the cortical layers. Clear involvement of the GM was observed with improved morphological detail in comparison to imaging at lower-field strength.

Feasibility and reproducibility of relaxometry, morphometric, and geometrical measurements of the hip joint with magnetic resonance imaging at 3T

PURPOSE

To test the feasibility of in vivo magnetic resonance T(1rho) relaxation time measurements of hip cartilage, and quantify the reproducibility of hip cartilage thickness, volume, T(2), T(1rho), and size of femoral head measurements.

MATERIALS AND METHODS

The hip joint of five human healthy volunteers, one subject with mild hip osteoarthritis (OA) and one subject with advanced hip OA, was imaged with magnetic resonance imaging (MRI) at 3T. Hip cartilage thickness, volume, T(1rho), and T(2) were quantified, as well as the size of the femoral head. All imaging and analysis procedures were performed twice for the healthy volunteers to assess reproducibility.

RESULTS

In vivo MR T(1rho) measurements of hip cartilage at 3T were feasible as demonstrated by high quality images and relaxation time maps. High levels of reproducibility were obtained for measurements of hip cartilage thickness (CV(SD) = 2.19%), volume (CV(SD) = 3.5%), T(2) (CV(SD) = 5.89%), T(1rho) (CV(SD) = 2.03%), and size of femoral head (CV(SD) = 0.49%). Mean T(2) and T(1rho) relaxation time values for human healthy subjects were 28.38 (+/-2.66) msec and 38.72 (+/-3.84) msec, respectively. Mean T(2) and T(1rho) relaxation time values for subjects with OA were 34.78 (+/-8.36) msec and 44.07 (+/-0.99) msec, respectively. T(2) and T(1rho) values increased from the deep to the superficial layers.

CONCLUSION

Qualitative and quantitative results indicate that the MRI techniques presented in this study may be applied clinically to patients with OA of the hip to investigate these parameters at different stages of disease.

Quantitative imaging of musculoskeletal tissue

Quantitative imaging of musculoskeletal tissue, including radiography, computed tomography (CT), and magnetic resonance imaging (MRI), has become the essential methodology in clinical practice for diagnosis and monitoring of various musculoskeletal conditions. Furthermore, quantitative imaging technologies have become indispensable for research and development in diseases of the human skeleton. Standardized methods of image analysis have been developed through the years to quantify measurements on bone and cartilage with high precision and accuracy. Key areas of musculoskeletal disease where quantitative imaging is currently employed are osteoporosis and arthritis.

GRAPPA-based susceptibility-weighted imaging of normal volunteers and patients with brain tumor at 7 T

Susceptibility-weighted imaging (SWI) is a valuable technique for high-resolution imaging of brain vasculature that greatly benefits from the emergence of higher field strength MR scanners. Autocalibrating partially parallel imaging techniques can be employed to reduce lengthy acquisition times as long as the decrease in signal-to-noise ratio does not significantly affect the contrast between vessels and brain parenchyma. This study assessed the feasibility of a Generalized Autocalibrating Partially Parallel Acquisition (GRAPPA)-based SWI technique at 7 T in both healthy volunteers and brain tumor patients. GRAPPA-based SWI allowed a twofold or more reduction in scan time without compromising vessel contrast and small vessel detection. Postprocessing parameters for the SWI needed to be modified for patients where the tumor causes high-frequency phase wrap artifacts but did not adversely affect vessel contrast. GRAPPA-based SWI at 7 T revealed regions of microvascularity, hemorrhage and calcification within heterogeneous brain tumors that may aid in characterizing active or necrotic tumor and monitoring treatment effects.

In vivo determination of bone structure in postmenopausal women: a comparison of HR-pQCT and high-field MR imaging

Bone structural measures obtained by two noninvasive imaging tools-3T MRI and HR-pQCT-were compared. Significant but moderate correlations and 2- to 4-fold discrepancies in parameter values were detected, suggesting that differences in acquisition and analysis must be considered when interpreting data from these imaging modalities.

INTRODUCTION

High-field MRI and high resolution (HR)-pQCT are currently being used in longitudinal bone structure studies. Substantial differences in acquisition and analysis between these modalities may influence the quantitative data produced and could potentially influence clinical decisions based on their results. Our goal was to compare trabecular and cortical bone structural measures obtained in vivo by 3T MRI and HR-pQCT.

MATERIALS AND METHODS

Postmenopausal osteopenic women (n = 52) were recruited for this study. HR-pQCT imaging of the radius and tibia was performed using the XtremeCT scanner, with a voxel size of 82 x 82 x 82 microm(3). MR imaging was performed on a 3T Signa scanner using SSFP imaging sequences, with a pixel size of 156 x 156 microm(2) and slice thickness of 500 microm. Structure parameters were calculated using standard HR-pQCT and MRI analysis techniques. Relationships between measures derived from HR-pQCT, MRI, and DXA were studied.

RESULTS

Significant correlations between HR-pQCT and MRI parameters were found (p < 0.0001) and were strongest for Tb.N (r(2) = 0.52), Ct.Th (r(2) = 0.59), and site-specific Tb.Sp (r(2) = 0.54-0.60). MRI and HR-pQCT provided statistically different values of structure parameters (p < 0.0001), with BV/TV and Tb.Th exhibiting the largest discrepancies (MR/HR-pQCT = 3-4). Although differences in the Tb.N values were statistically significant, the mean differences were on the order of our reproducibility measurements. Systematic differences between MRI and HR-pQCT analysis procedures leading to discrepancies in cortical thickness values were observed, with MRI values consistently higher. Minimal correlations were found between MRI or HR-pQCT parameters and DXA BMD or T-score, except between HR-pQCT measures at the radius and the ultradistal radius T-scores, where moderate correlations were found (r(2) = 0.19-0.58).

CONCLUSIONS

This study provides unique insight into two emerging noninvasive tools for bone structure evaluation. Our findings highlight the significant influence of analysis technique on results of in vivo assessment and underscore the importance of accounting for these differences when interpreting results from these modalities.

Partially-parallel, susceptibility-weighted MR imaging of brain vasculature at 7 Tesla using sensitivity encoding and an autocalibrating parallel technique

Susceptibility-weighted magnetic resonance imaging is a powerful tool for high resolution imaging of the vasculature, aiding in the diagnosis of many pathologic conditions. The technique is especially beneficial at higher field strengths where traditional sequences that measure cerebral blood volume suffer from severe distortions, rendering them inapplicable at 7 T. However, conventional susceptibility-weighted imaging (SWI) sequences involve long scan times, on the order of 10 minutes for a 2 cm slab of coverage. This work implemented two partially parallel imaging reconstruction methods, 1) an autocalibrating parallel technique based on GRAPPA algorithm, and 2) sensitivity encoding (SENSE) for accelerating SWI of the brain at 7 Tesla. By employing twofold under-sampling in the phase-encoding direction for both techniques, a two-fold reduction in scan time was simulated. Analysis of contrast ratios in large and small vessels compared to the surrounding brain parenchyma showed close agreement between the full and GRAPPA reconstructed datasets for both vessel sizes, while a decrease in the small vessel contrast was observed with SENSE.

Assessment of biologic aggressiveness of prostate cancer: correlation of MR signal intensity with Gleason grade after radical prostatectomy

PURPOSE

To retrospectively investigate whether the signal intensity (SI) of prostate cancer on T2-weighted magnetic resonance (MR) images correlates with the Gleason grade at whole-mount step-section pathologic evaluation after radical prostatectomy.

MATERIALS AND METHODS

The institutional review board approved and issued a waiver of informed consent for this HIPAA-compliant study of 74 patients (median age, 57.5 years; range, 32-72 years) who underwent endorectal MR imaging before radical prostatectomy, with subsequent whole-mount step-section pathologic evaluation, between January 2001 and July 2004. Inclusion criteria were that they had: no prior treatment; at least one lesion of uniform Gleason grade 3 or 4 or with Gleason grade 5 components, with a bidimensional diameter product of 20 mm2 or greater; no high SI on T1-weighted MR images indicative of postbiopsy changes; and an interval of more than 4 weeks between biopsy and MR imaging. SI of prostate tumors, nontumor prostatic tissue, and internal obturator muscles was measured on uncorrected and corrected T2-weighted MR images. Correlations between Gleason grades and SI ratios were assessed by using generalized estimating equations. SI ratios in peripheral zone (PZ) and transition zone (TZ) lesions of the same Gleason grade were compared with an unpaired t test.

RESULTS

Seventy-nine Gleason grade 3, eight Gleason grade 4, and four mixed Gleason grades 4 and 5 lesions identified at pathologic evaluation were analyzed. Gleason grade correlated significantly with tumor-muscle SI ratio for PZ tumors on corrected and uncorrected images (P = .006 and <.001, respectively). Higher Gleason grades were associated with lower tumor-muscle SI ratios. Nontumor-muscle SI ratios did not correlate with patients' Gleason grades. Tumor-muscle SI ratios were lower in TZ than in PZ tumors (P < .001).

CONCLUSION

Higher Gleason grades were associated with lower tumor-muscle SI ratios on T2-weighted MR images. SI evaluation on T2-weighted MR images may facilitate noninvasive assessment of prostate cancer aggressiveness.

Development of a robust method for generating 7.0 T multichannel phase images of the brain with application to normal volunteers and patients with neurological diseases

The increased susceptibility effects and high signal-to-noise ratio at 7.0 T enable imaging of the brain using the phase of the magnetic resonance signal. This study describes and evaluates a robust method for calculating phase images from gradient-recalled echo (GRE) scans. The GRE scans were acquired at 7.0 T using an eight-channel receive coil at spatial resolutions up to 0.195 x 0.260 x 2.00 mm. The entire 7.0 T protocol took less than 10 min. Data were acquired from forty-seven subjects including clinical patients with multiple sclerosis (MS) or brain tumors. The phase images were post-processed using a fully automated phase unwrapping algorithm that combined the data from the different channels. The technique was used to create the first phase images of MS patients at any field strength and the first phase images of brain tumor patients above 1.5 T. The clinical images showed novel contrast in MS plaques and depicted microhemorrhages and abnormal vasculature in brain tumors with unsurpassed resolution and contrast.

Technical evaluation of in vivo abdominal fat and IMCL quantification using MRI and MRSI at 3 T

OBJECTIVES

The objectives of this study were to develop protocols that measure abdominal fat and calf muscle lipids with magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS), respectively, at 3 T and to examine the correlation between these parameters and insulin sensitivity.

MATERIALS AND METHODS

Ten nondiabetic subjects [five insulin-sensitive (IS) subjects and five insulin-resistant (IR) subjects] were scanned at 3 T. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were segmented semiautomatically from abdominal imaging. Intramyocellular lipids (IMCL) in calf muscles were quantified with single-voxel MRS in both soleus and tibialis anterior muscles and with magnetic resonance spectroscopic imaging (MRSI).

RESULTS

The average coefficient of variation (CV) of VAT/(VAT+SAT) was 5.2%. The interoperator CV was 1.1% and 5.3% for SAT and VAT estimates, respectively. The CV of IMCL was 13.7% in soleus, 11.9% in tibialis anterior and 2.9% with MRSI. IMCL based on MRSI (3.8+/-1.2%) were significantly inversely correlated with glucose disposal rate, as measured by a hyperinsulinemic-euglycemic clamp. VAT volume correlated significantly with IMCL. IMCL based on MRSI for IR subjects was significantly greater than that for IS subjects (4.5+/-0.9% vs. 2.8+/-0.5%, P=.02).

CONCLUSION

MRI and MRS techniques provide a robust noninvasive measurement of abdominal fat and muscle IMCL, which are correlated with insulin action in humans.

MRI intensity nonuniformity correction using simultaneously spatial and gray-level histogram information

A novel approach for correcting intensity nonuniformity in magnetic resonance imaging (MRI) is presented. This approach is based on the simultaneous use of spatial and gray-level histogram information. Spatial information about intensity nonuniformity is obtained using cubic B-spline smoothing. Gray-level histogram information of the image corrupted by intensity nonuniformity is exploited from a frequential point of view. The proposed correction method is illustrated using both physical phantom and human brain images. The results are consistent with theoretical prediction, and demonstrate a new way of dealing with intensity nonuniformity problems. They are all the more significant as the ground truth on intensity nonuniformity is unknown in clinical images.

Cardiac MRI in mice at 9.4 Tesla with a transmit-receive surface coil and a cardiac-tailored intensity-correction algorithm

PURPOSE

To evaluate the use of a transmit-receive surface (TRS) coil and a cardiac-tailored intensity-correction algorithm for cardiac MRI in mice at 9.4 Tesla (9.4T).

MATERIALS AND METHODS

Fast low-angle shot (FLASH) cines, with and without delays alternating with nutations for tailored excitation (DANTE) tagging, were acquired in 13 mice. An intensity-correction algorithm was developed to compensate for the sensitivity profile of the surface coil, and was tailored to account for the unique distribution of noise and flow artifacts in cardiac MR images.

RESULTS

Image quality was extremely high and allowed fine structures such as trabeculations, valve cusps, and coronary arteries to be clearly visualized. The tag lines created with the surface coil were also sharp and clearly visible. Application of the intensity-correction algorithm improved signal intensity, tissue contrast, and image quality even further. Importantly, the cardiac-tailored properties of the correction algorithm prevented noise and flow artifacts from being significantly amplified.

CONCLUSION

The feasibility and value of cardiac MRI in mice with a TRS coil has been demonstrated. In addition, a cardiac-tailored intensity-correction algorithm has been developed and shown to improve image quality even further. The use of these techniques could produce significant potential benefits over a broad range of scanners, coil configurations, and field strengths.

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

Magnetic resonance imaging (MRI) and quantitative image analysis technology has recently started to generate a great wealth of quantitative information on articular cartilage and bone physiology, pathophysiology and degenerative changes in osteoarthritis. This paper reviews semiquantitative scoring of changes of articular tissues (e.g. WORMS = whole-organ MRI scoring or KOSS = knee osteoarthritis scoring system), quantification of cartilage morphology (e.g. volume and thickness), quantitative measurements of cartilage composition (e.g. T2, T1rho, T1Gd = dGEMRIC index) and quantitative measurement of bone structure (e.g. app. BV/TV, app. TbTh, app. Tb.N, app. Tb.Sp) in osteoarthritis. For each of these fields we describe the hardware and MRI sequences available, the image analysis systems and techniques used to derive semiquantitative and quantitative parameters, the technical accuracy and precision of the measurements reported to date and current results from cross-sectional and longitudinal studies in osteoarthritis. Moreover, the paper summarizes studies that have compared MRI-based measurements with radiography and discusses future perspectives of quantitative MRI in osteoarthritis. In summary, the above methodologies show great promise for elucidating the pathophysiology of various tissues and identifying risk factors of osteoarthritis, for developing structure modifying drugs (DMOADs) and for combating osteoarthritis with new and better therapy.

A Review on MR Image Intensity Inhomogeneity Correction

Intensity inhomogeneity (IIH) is often encountered in MR imaging, and a number of techniques have been devised to correct this artifact. This paper attempts to review some of the recent developments in the mathematical modeling of IIH field. Low-frequency models are widely used, but they tend to corrupt the low-frequency components of the tissue. Hypersurface models and statistical models can be adaptive to the image and generally more stable, but they are also generally more complex and consume more computer memory and CPU time. They are often formulated together with image segmentation within one framework and the overall performance is highly dependent on the segmentation process. Beside these three popular models, this paper also summarizes other techniques based on different principles. In addition, the issue of quantitative evaluation and comparative study are discussed.

Computation of transmitted and received B1 fields in magnetic resonance imaging

Computation of B1 fields is a key issue for determination and correction of intensity nonuniformity in magnetic resonance images. This paper presents a new method for computing transmitted and received B1 fields. Our method combines a modified MRI acquisition protocol and an estimation technique based on the Levenberg-Marquardt algorithm and spatial filtering. It enables accurate estimation of transmitted and received B1 fields for both homogeneous and heterogeneous objects. The method is validated using numerical simulations and experimental data from phantom and human scans. The experimental results are in agreement with theoretical expectations.

MR imaging and epilepsy--3T or not 3T? That is the question

3T-Phased Array MRI Improves the Presurgical Evaluation in Focal Epilepsies: A Prospective Study

Knake S, Triantafyllou C, Wald LL, Wiggins G, Kirk GP, Larsson PG, Stufflebeam SM, Foley MT, Shiraishi H, Dale AM, Halgren E, Grant PE

Neurology 2005;65(7):1026–1031

Background

Although detection of concordant lesions on MRI significantly improves postsurgical outcomes in focal epilepsy (FE), many conventional MR studies remain negative. The authors evaluated the role of phased array surface coil studies performed at 3 Tesla (3T PA-MRI).

Methods

Forty patients with medically intractable focal epilepsies were prospectively imaged with 3T PA-MRI, including high matrix TSE T2, fluid attenuated inversion recovery, and magnetization prepared rapid gradient echo. All patients were considered candidates for epilepsy surgery. 3T PA-MRIs were reviewed by a neuroradiologist experienced in epilepsy imaging with access to clinical information. Findings were compared to reports of prior standard 1.5T MRI epilepsy studies performed at tertiary care centers.

Results

Experienced, unblinded review of 3T PA-MRI studies yielded additional diagnostic information in 48% (19/40) compared to routine clinical reads at 1.5T. In 37.5% (15/40), this additional information motivated a change in clinical management. In the subgroup of patients with prior 1.5T MRIs interpreted as normal, 3T PA-MRI resulted in the detection of a new lesion in 65% (15/23). In the subgroup of 15 patients with known lesions, 3T PA-MRI better defined the lesion in 33% (5/15).

Conclusion

Phased array surface coil studies performed at 3 Tesla read by an experienced unblinded neuroradiologist can improve the presurgical evaluation of patients with focal epilepsy when compared to routine clinical 1.5T studies read at tertiary care centers. MR Imaging of Patients with Localization-Related Seizures: Initial Experience at 3.0T and Relevance to the NICE Guidelines Griffiths PD, Coley SC, Connolly DJ, Hodgson T, Romanowski CA, Widjaja E, Darwent G, Wilkinson ID Clin Radiol 2005;60(10):1090–1099 The purpose of this study is to describe our initial experience of imaging adults with localization-related epilepsy using MR imaging at 3.0T. We discuss the findings in the context of the recently released NICE guidelines that provide detailed advice on imaging people with epilepsy in the UK. One hundred twenty consecutive people over the age of 16 years with localization-related epilepsy were referred for clinical MR examinations from a regional neuroscience center in England. None of the people had had MR examinations prior to the present study. Highresolution MR imaging was performed taking advantage of the high field strength and high performance gradients of the system. Two experienced neuroradiologists reported on the examinations independently and the presence and type of pathology was recorded. There was complete agreement between the two reporters in all 120 cases. The overall frequency of abnormalities shown by MR was 31 of 120 (26%) and the commonest abnormality shown was mesial temporal sclerosis found in 10 of 120 (8%). Tumors were shown in 4 of 120, all of which appeared low grade as judged by imaging criteria. Epilepsy is the commonest neurological condition and demands a significant resource in order to provide good care for sufferers. Recent guidelines published in the UK have suggested that the majority of people with epilepsy should receive brain MR as part of their routine assessment. Our work shows that using the most sophisticated MR imaging in a highly selected population there is a modest pick-up rate of brain abnormalities. If a widespread epilepsy-imaging programme is started the detection rate is likely to be much lower. Although MR is acknowledged to be a reliable way of detecting pathology in people with epilepsy there is a dearth of information studying the health economics of imaging epilepsy in relation to patient management and outcomes.

Trabecular bone structure of the calcaneus: comparison of MR imaging at 3.0 and 1.5 T with micro-CT as the standard of reference

PURPOSE

To investigate in vitro the calcaneal trabecular bone structure in elderly human donors with high spatial resolution magnetic resonance (MR) imaging at 3.0 T and 1.5 T, to quantitatively compare MR measures of bone microarchitecture with those from micro-computed tomography (CT), and to compare the performance of 3.0-T MR imaging with that of 1.5-T MR imaging in differentiating donors with spinal fractures from those without spinal fractures.

MATERIALS AND METHODS

The study was performed in line with institutional and legislative requirements; all donors had dedicated their body for educational and research purposes prior to death. Sagittal MR images of 49 human calcaneus cadaveric specimens were obtained (mean age of donors, 79.5 years +/- 11 [standard deviation]; 26 male donors, 23 female donors). After the spatial coregistering of images acquired at 3.0-T and 1.5-T MR imaging, the signal-to-noise-ratios and structural parameters obtained at each magnetic field strength were compared in corresponding sections. Micro-CT was performed on calcaneus cores obtained from corresponding regions in 40 cadaveric specimens. Vertebral deformities of the thoracic and lumbar spine were radiographically classified by using the spinal fracture index. Diagnostic performance of the structural parameters in differentiating donors with vertebral fractures from those without was assessed by using receiver operator characteristic (ROC) analysis, including area under the ROC curve (A(z)).

RESULTS

Correlations between structural parameters at 3.0-T MR imaging and those at micro-CT were significantly higher (P < .05) than correlations between structural parameters at 1.5-T MR imaging and those at micro-CT (trabecular thickness, r = 0.76 at 3.0 T vs r = 0.57 at 1.5 T). Trabecular dimensions were amplified at 3.0 T because of increasing susceptibility artifacts. Also, higher ROC values were found for structural parameters at 3.0 T than at 1.5 T, but differences were not significant (trabecular thickness, A(z) = 0.75 at 3.0 T vs A(z) = 0.66 at 1.5 T, P > .05).

CONCLUSION

MR imaging at 3.0 T provided a better measure of the trabecular bone structure than did MR imaging at 1.5 T. There was a trend for better differentiation of donors with from those without osteoporotic vertebral fractures at 3.0 T than at 1.5 T.

Intensity non-uniformity correction in MRI: existing methods and their validation

Magnetic resonance imaging is a popular and powerful non-invasive imaging technique. Automated analysis has become mandatory to efficiently cope with the large amount of data generated using this modality. However, several artifacts, such as intensity non-uniformity, can degrade the quality of acquired data. Intensity non-uniformity consists in anatomically irrelevant intensity variation throughout data. It can be induced by the choice of the radio-frequency coil, the acquisition pulse sequence and by the nature and geometry of the sample itself. Numerous methods have been proposed to correct this artifact. In this paper, we propose an overview of existing methods. We first sort them according to their location in the acquisition/processing pipeline. Sorting is then refined based on the assumptions those methods rely on. Next, we present the validation protocols used to evaluate these different correction schemes both from a qualitative and a quantitative point of view. Finally, availability and usability of the presented methods is discussed.

Prefrontal GABA levels in cocaine-dependent subjects increase with pramipexole and venlafaxine treatment

RATIONALE

There is evidence that prefrontal lobe GABA levels are low in cocaine-dependent (CD) individuals, and treatment with GABA agonists decreases cocaine self-administration.

OBJECTIVES

The aim of the study is to measure changes in GABA levels in CD subjects at baseline and after 8 weeks of treatment with pramipexole, venlafaxine, or placebo.

METHODS

CD subjects enrolled in a treatment trial for cocaine dependence were recruited for this proton (1H) magnetic resonance spectroscopy (MRS) study. GABA levels in the prefrontal lobe were measured before and after treatment.

RESULTS

Mean percentage changes in GABA levels were as follows: pramipexole +17.0+/-28.0%, venlafaxine +13.0+/-11.0%, and placebo -2.1+/-19.5%. Pramipexole-treated subjects had significantly increased brain GABA levels compared to placebo (p=0.031). Venlafaxine treatment was nonsignificantly associated with increased GABA levels compared to placebo (p=0.16). The overall statistical model for the effect of drug treatment vs placebo on brain GABA levels, including adjustment for baseline levels, was highly significant (p=0.002). Despite significant changes in GABA levels, there were no significant differences in the number of urine samples positive for cocaine metabolites.

CONCLUSIONS

This study demonstrates that 1H MRS can measure changes in GABA levels following pharmacologic treatment. The increase in GABA levels, although significant, is modest compared to other MRS studies of depression or epilepsy associated with clinical improvements. The failure to see larger increases in GABA levels and an associated reduction in cocaine consumption may reflect the relatively low doses of medication used.

Effects of salmon calcitonin on trabecular microarchitecture as determined by magnetic resonance imaging: results from the QUEST study

The unique noninvasive MRI technique was used to assess trabecular microarchitecture at multiple skeletal sites in 91 postmenopausal osteoporotic women receiving nasal spray salmon calcitonin (CT-NS) or placebo over 2 years. In the distal radius and lower trochanter of the hip, individuals treated with CT-NS exhibited significant preservation of trabecular bone microarchitecture compared with placebo, where significant deterioration was shown. MRI analyses of os calcis or microCT/histomorphometric analyses of bone biopsies did not reveal consistent differences in architecture between CT-NS and placebo.

INTRODUCTION

It is postulated that the reduction in osteoporotic fracture risk in response to certain antiresorptive osteoporosis therapies is caused less by effects on bone quantity than on bone quality (specifically trabecular microarchitecture). To test this hypothesis, the QUEST study was conducted to assess the effects of nasal spray salmon calcitonin (CT-NS) or placebo on parameters of trabecular microarchitecture at multiple skeletal sites using noninvasive MRI technology and iliac crest bone biopsies by microCT/histomorphometry.

MATERIALS AND METHODS

Ninety-one postmenopausal osteoporotic women were followed for 2 years (n = 46 for CT-NS, n = 45 for placebo); all women received 500 mg calcium daily. MRI measurements at distal radius, hip (T2 relaxation time [T2*]), and os calcis (obtained yearly), iliac crest bone biopsies with 2D histomorphometry and 3D microCT (obtained at study onset and conclusion), DXA-BMD at spine/hip/wrist/os calcis (obtained yearly), and markers of bone turnover (obtained at 2-week to 12-month intervals) were analyzed, with an analysis of covariance model used to assess treatment effect for parameters of interest.

RESULTS AND CONCLUSIONS

MRI assessment of trabecular microarchitecture at individual regions of the distal radius revealed significant improvement, or preservation (no significant loss), in the CT-NS-treated group compared with significant deterioration in the placebo control group, as reflected in apparent BV/TV (p < 0.03), apparent trabecular number (p < 0.01), and apparent trabecular spacing (p < 0.01). Also, at the hip, the CT-NS group exhibited preservation of trabecular microarchitecture at the lower trochanter (p < 0.05) as determined by T2* MRI technology. Significant deterioration of trabecular bone architecture was noted in the placebo group at the femoral neck, Ward's triangle, and lower trochanteric sites. Apart from a significant increase in apparent trabecular number in the CT-NS group, significant changes within or between groups were not noted at the os calcis. Combined microCT/histomorphometric analysis of iliac crest bone biopsies did not reveal significant differences between treated and placebo groups. In the CT-NS group, regardless of the change in BMD (gain or loss) at the spine, hip, or distal radius, preservation of parameters of trabecular microarchitecture was noted, whereas in the placebo group, regardless of the change in BMD (gain or loss) at the spine, hip, or distal radius, loss or preservation was noted; however, changes in DXA/BMD (of the spine, hip, wrist, os calcis) between CT-NS and placebo groups were not significant. Serum C-telopeptide (S-CTx), a specific bone resorption marker, was reduced by 22.5% at 24 months (p = 0.056). The results of the QUEST study suggest therapeutic benefit of CT-NS compared with placebo in maintaining trabecular microarchitecture at multiple skeletal sites and support the use of MRI technology for assessment of trabecular microarchitecture in clinical research trials. However, the results also highlight site specific differences in response to antiresorptive therapies and the importance of sufficiently large sampling volumes (areas) to obtain reliable assessment of bone architecture.

Correction of bias field in MR images using singularity function analysis

A new approach for correcting bias field in magnetic resonance (MR) images is proposed using the mathematical model of singularity function analysis (SFA), which represents a discrete signal or its spectrum as a weighted sum of singularity functions. Through this model, an MR image's low spatial frequency components corrupted by a smoothly varying bias field are first removed, and then reconstructed from its higher spatial frequency components not polluted by bias field. The thus reconstructed image is then used to estimate bias field for final image correction. The approach does not rely on the assumption that anatomical information in MR images occurs at higher spatial frequencies than bias field. The performance of this approach is evaluated using both simulated and real clinical MR images.

A study of the relationship between molecular biomarkers of joint degeneration and the magnetic resonance-measured characteristics of cartilage in 16 symptomatic knees

We used quantitative magnetic resonance (MR) imaging to determine if relationships exist between proposed molecular biomarkers for degenerative joint disease (DJD) and structural characteristics of articular cartilage. Subjects were eight male and eight female volunteers diagnosed with osteoarthritis. Magnetic resonance images of the symptomatic knee were taken and blood samples were drawn. Concentrations of serum cartilage oligomeric matrix protein (COMP) and cleaved collagen neoepitope were compared to cartilage volume and cartilage T2, respectively, in four compartments of the tibiofemoral joint. A significant, negative correlation was found between serum COMP and medial tibia volume in the male subject group (rho=-.738, P=.037). A significant, positive correlation (rho=.881, P=.0039) was found between serum COMP and lateral femur volume in the female subject group. In both groups, positive correlations were found between serum C2C and cartilage T2, which were significant in two compartments of the male group (rho=.714, P=.047; rho=.738, P=.037) and similarly strong, but not statistically significant (rho=.750, P=.052), in one compartment of the female group. We identify strong and biologically relevant correlations between two proposed molecular biomarkers for DJD and MR measures of symptomatic knees of a small number of arthritic patients. Our findings support the hypothesis that cartilage molecular biomarkers reflect the molecular processes of cartilage degeneration and loss.

Eight-channel phased array coil and detunable TEM volume coil for 7 T brain imaging

An eight-channel receive-only brain coil and table-top detunable volume transmit coil were developed and tested at 7 T for human imaging. Optimization of this device required attention to sources of interaction between the array elements, between the transmit and receive coils and minimization of common mode currents on the coaxial cables. Circular receive coils (85 mm dia.) were designed on a flexible former to fit tightly around the head and within a 270-mm diameter TEM transmit volume coil. In the near cortex, the array provided a fivefold increase in SNR compared to a TEM transmit-receive coil, a gain larger than that seen in comparable coils at 3 T. The higher SNR gain is likely due to strong dielectric effects, which cause the volume coil to perform poorly in the cortex compared to centrally. The sensitivity and coverage of the array is demonstrated with high-resolution images of the brain cortex.

A pilot, two-year longitudinal study of the interrelationship between trabecular bone and articular cartilage in the osteoarthritic knee

OBJECTIVE

To examine the relationship between structural changes of trabecular bone and cartilage, in patients with varying degrees of osteoarthritis (OA) over 2 years, using magnetic resonance imaging.

METHODS

High-resolution, axial images were acquired for assessing trabecular bone structure, using a 3-D fast gradient-echo sequence. High-resolution, fat-suppressed, sagittal images were acquired for assessing cartilage structure, using a 3-D spoiled gradient-echo sequence. In a subset of the patients, sagittal images were acquired for measuring T(2) relaxation time, using a 2-D dual-echo spin echo sequence.

RESULTS

A large variation in bone and cartilage parameters is evident among individual subjects in each group, however, group-specific means demonstrate decreasing trends (in bone and cartilage parameters) in osteoarthritic subjects (especially in mild OA subjects). The mean T(2) increased significantly (P<0.05) between the baseline and follow-up exams for all cartilage compartments except the lateral tibia. A positive relationship was established between cartilage changes and localized bone changes closest to the joint line, while a negative relationship was established between cartilage changes and global bone changes farthest from the joint line.

CONCLUSION

This study quantifies the changes in bone and cartilage structural parameters over time, and demonstrates a longitudinal relationship between the morphological changes in bone and cartilage structure in patients with varying degrees of OA. Although a large variation of bone and cartilage changes is apparent among subjects, significant trends are evident in a relatively small sample size, with a short follow-up duration.