Measurement and correction of respiration-inducedB0 variations in breast1H MRS at 4 Tesla

A k-space-based method to measure and correct for temporal B0 field variations in MR temperature imaging

PURPOSE

Present a method to use change in phase in repeated Cartesian k-space measurements to monitor the change in magnetic field for dynamic MR temperature imaging.

METHODS

The method is applied to focused ultrasound heating experiments in a gelatin phantom and an ex vivo salt pork sample, without and with simulated respiratory motion.

RESULTS

In each experiment, phase variations due to B0 field drift and respiration were readily apparent in the measured phase difference. With correction, the SD of the temperature over time was reduced from 0.18°C to 0.14°C (no breathing) and from 0.81°C to 0.22°C (with breathing) for the gelatin phantom, and from 0.68°C to 0.13°C (no breathing) and from 1.06°C to 0.17°C (with breathing) for the pork sample. The accuracy in nonheated regions, assessed as the RMS error deviation from 0°C, improved from 1.70°C to 1.11°C (no breathing) and from 4.73°C to 1.47°C (with breathing) for the gelatin phantom, and from 5.95°C to 0.88°C (no breathing) and from 13.40°C to 1.73°C (with breathing) for the pork sample. The correction did not affect the temperature measurement accuracy in the heated regions.

CONCLUSION

This work demonstrates that phase changes resulting from variations in B0 due to drift and respiration, commonly seen in MR thermometry applications, can be measured directly from 3D Cartesian acquisition methods. The correction of temporal field variations using the presented technique improved temperature accuracy, reduced variability in nonheated regions, and did not reduce accuracy in heated regions.

Uncertainty in denoising of MRSI using low-rank methods

PURPOSE

Low-rank denoising of MRSI data results in an apparent increase in spectral SNR. However, it is not clear if this translates to a lower uncertainty in metabolite concentrations after spectroscopic fitting. Estimation of the true uncertainty after denoising is desirable for downstream analysis in spectroscopy. In this work, the uncertainty reduction from low-rank denoising methods based on spatiotemporal separability and linear predictability in MRSI are assessed. A new method for estimating metabolite concentration uncertainty after denoising is proposed. Automatic rank threshold selection methods are also assessed in simulated low SNR regimes.

METHODS

Assessment of denoising methods is conducted using Monte Carlo simulation of proton MRSI data and by reproducibility of repeated in vivo acquisitions in 5 subjects.

RESULTS

In simulated and in vivo data, spatiotemporal based denoising is shown to reduce the concentration uncertainty, but linear prediction denoising increases uncertainty. Uncertainty estimates provided by fitting algorithms after denoising consistently underestimate actual metabolite uncertainty. However, the proposed uncertainty estimation, based on an analytical expression for entry-wise variance after denoising, is more accurate. It is also shown automated rank threshold selection using Marchenko-Pastur distribution can bias the data in low SNR conditions. An alternative soft-thresholding function is proposed.

CONCLUSION

Low-rank denoising methods based on spatiotemporal separability do reduce uncertainty in MRS(I) data. However, thorough assessment is needed as assessment by SNR measured from residual baseline noise is insufficient given the presence of non-uniform variance. It is also important to select the right rank thresholding method in low SNR cases.

Bilateral gradient-echo spectroscopic imaging with correction of frequency variations for measurement of fatty acid composition in mammary adipose tissue

PURPOSE

To develop a simultaneous dual-slab three-dimensional gradient-echo spectroscopic imaging (GSI) technique with frequency drift compensation for rapid (<6 min) bilateral measurement of fatty acid composition (FAC) in mammary adipose tissue.

METHODS

A bilateral GSI sequence was developed using a simultaneous dual-slab excitation followed by 128 monopolar echoes. A short train of navigator echoes without phase or partition encoding was included at the beginning of each pulse repetition time period to correct for frequency variation caused by respiration and heating of the cryostat. Voxel-wise spectral fitting was applied to measure the areas of the lipid spectral peaks to estimate the number of double-bond (ndb), number of methylene-interrupted double-bond (nmidb), and chain length (cl). The proposed method was tested in an oil phantom and 10 postmenopausal women to assess the influence of the frequency variation on FAC estimation.

RESULTS

The frequency drift observed over 5:27 min during the phantom scan was about 10 Hz. Phase correction based on the navigator reduced the median error of ndb, nmidb, and cl from 9.7%, 17.6%, and 3.2% to 2.1%, 9.5%, and 2.8%, respectively. The in vivo data showed a mean ± standard deviation frequency drift of 17.4 ± 2.5 Hz, with ripples at 0.3 ± 0.1 Hz. Our reconstruction algorithm successfully separated signals from the left and right breasts with negligible residual aliasing. Phase correction reduced the interquartile range within each subject's adipose tissue of ndb, nmidb, and cl by 18.4 ± 10.6%, 18.5 ± 13.9%, and 18.4 ± 10.6%, respectively.

CONCLUSION

This study shows the feasibility of obtaining bilateral spectroscopic imaging data in the breast and that incorporation of a frequency navigator improves the estimation of FAC.

Water-suppression cycling 3-T cardiac 1 H-MRS detects altered creatine and choline in patients with aortic or mitral stenosis

Cardiac proton spectroscopy (1 H-MRS) is widely used to quantify lipids. Other metabolites (e.g. creatine and choline) are clinically relevant but more challenging to quantify because of their low concentrations (approximately 10 mmol/L) and because of cardiac motion. To quantify cardiac creatine and choline, we added water-suppression cycling (WSC) to two single-voxel spectroscopy sequences (STEAM and PRESS). WSC introduces controlled residual water signals that alternate between positive and negative phases from transient to transient, enabling robust phase and frequency correction. Moreover, a particular weighted sum of transients eliminates residual water signals without baseline distortion. We compared WSC and the vendor's standard 'WET' water suppression in phantoms. Next, we tested repeatability in 10 volunteers (seven males, three females; age 29.3 ± 4.0 years; body mass index [BMI] 23.7 ± 4.1 kg/m2 ). Fat fraction, creatine concentration and choline concentration when quantified by STEAM-WET were 0.30% ± 0.11%, 29.6 ± 7.0 μmol/g and 7.9 ± 6.7 μmol/g, respectively; and when quantified by PRESS-WSC they were 0.30% ± 0.15%, 31.5 ± 3.1 μmol/g and 8.3 ± 4.4 μmol/g, respectively. Compared with STEAM-WET, PRESS-WSC gave spectra whose fitting quality expressed by Cramér-Rao lower bounds improved by 26% for creatine and 32% for choline. Repeatability of metabolite concentration measurements improved by 72% for creatine and 40% for choline. We also compared STEAM-WET and PRESS-WSC in 13 patients with severe symptomatic aortic or mitral stenosis indicated for valve replacement surgery (10 males, three females; age 75.9 ± 6.3 years; BMI 27.4 ± 4.3 kg/m2 ). Spectra were of analysable quality in eight patients for STEAM-WET, and in nine for PRESS-WSC. We observed comparable lipid concentrations with those in healthy volunteers, significantly reduced creatine concentrations, and a trend towards decreased choline concentrations. We conclude that PRESS-WSC offers improved performance and reproducibility for the quantification of cardiac lipids, creatine and choline concentrations in healthy volunteers at 3 T. It also offers improved performance compared with STEAM-WET for detecting altered creatine and choline concentrations in patients with valve disease.

DeepResp: Deep learning solution for respiration-induced B0 fluctuation artifacts in multi-slice GRE

Respiration-induced B₀ fluctuation corrupts MRI images by inducing phase errors in k-space. A few approaches such as navigator have been proposed to correct for the artifacts at the expense of sequence modification. In this study, a new deep learning method, which is referred to as DeepResp, is proposed for reducing the respiration-artifacts in multi-slice gradient echo (GRE) images. DeepResp is designed to extract the respiration-induced phase errors from a complex image using deep neural networks. Then, the network-generated phase errors are applied to the k-space data, creating an artifact-corrected image. For network training, the computer-simulated images were generated using artifact-free images and respiration data. When evaluated, both simulated images and in-vivo images of two different breathing conditions (deep breathing and natural breathing) show improvements (simulation: normalized root-mean-square error (NRMSE) from 7.8 ± 5.2% to 1.3 ± 0.6%; structural similarity (SSIM) from 0.88 ± 0.08 to 0.99 ± 0.01; ghost-to-signal-ratio (GSR) from 7.9 ± 7.2% to 0.6 ± 0.6%; deep breathing: NRMSE from 13.9 ± 4.6% to 5.8 ± 1.4%; SSIM from 0.86 ± 0.03 to 0.95 ± 0.01; GSR 20.2 ± 10.2% to 5.7 ± 2.3%; natural breathing: NRMSE from 5.2 ± 3.3% to 4.0 ± 2.5%; SSIM from 0.94 ± 0.04 to 0.97 ± 0.02; GSR 5.7 ± 5.0% to 2.8 ± 1.1%). Our approach does not require any modification of the sequence or additional hardware, and may therefore find useful applications. Furthermore, the deep neural networks extract respiration-induced phase errors, which is more interpretable and reliable than results of end-to-end trained networks.

Application of in vivo MR methods in the study of breast cancer metabolism

In the last two decades, various in vivo MR methodologies have been evaluated for their potential in the study of cancer metabolism. During malignant transformation, metabolic alterations occur, leading to morphological and functional changes. Among various MR methods, in vivo MRS has been extensively used in breast cancer to study the metabolism of cells, tissues or whole organs. It provides biochemical information at the metabolite level. Altered choline, phospholipid and energy metabolism has been documented using proton (¹ H), phosphorus (³¹ P) and carbon (¹³ C) isotopes. Increased levels of choline-containing compounds, phosphomonoesters and phosphodiesters in breast cancer, which are indicative of altered choline and phospholipid metabolism, have been reported using in vivo, in vitro and ex vivo NMR studies. These changes are reversed on successful therapy, which depends on the treatment regimen given. Monitoring the various tumor intermediary metabolic pathways using nuclear spin hyperpolarization of ¹³ C-labeled substrates by dynamic nuclear polarization has also been recently reported. Furthermore, the utility of various methods such as diffusion, dynamic contrast and perfusion MRI have also been evaluated to study breast tumor metabolism. Parameters such as tumor volume, apparent diffusion coefficient, volume transfer coefficient and extracellular volume ratio are estimated. These parameters provide information on the changes in tumor microstructure, microenvironment, abnormal vasculature, permeability and grade of the tumor. Such changes seen during cancer progression are due to alterations in the tumor metabolism, leading to changes in cell architecture. Due to architectural changes, the tissue mechanical properties are altered; this can be studied using magnetic resonance elastography, which measures the elastic properties of tissues. Moreover, these structural MRI methods can be used to investigate the effect of therapy-induced changes in tumor characteristics. This review discusses the potential of various in vivo MR methodologies in the study of breast cancer metabolism.

Referenced MR thermometry using three-echo phase-based fat water separation method

A three-point image reconstruction method for internally referenced MR thermometry was developed. The technique exploits the fact that temperature-induced changes in the water resonance frequency are small relative to the chemical shift difference between water and fat signals. This property enabled the use of small angle approximations to derive an analytic phase-based fat-water separation method for MR thermometry. Ethylene glycol and cream cool-down experiments were performed to validate measurement technique. Over a cool-down temperature range of 20 °C, maximum deviation between probe and MR measurement (averaged over 1.3 cm³ region surrounding probe) was 0.6 °C and 1.1 °C for ethylene glycol and cream samples, respectively.

Investigating the accuracy of FatNav-derived estimates of temporal B0 changes and their application to retrospective correction of high-resolution 3D GRE of the human brain at 7T

PURPOSE

To investigate the precision of estimates of temporal variations of magnetic field achievable by double-echo fat image navigators (FatNavs), and their potential application to retrospective correction of 3-dimensional gradient echo-based sequences.

METHODS

Both head motion and temporal changes of B₀ were tracked using double-echo highly accelerated 3-dimensional FatNavs as navigators, allowing estimation of the temporal changes in low spatial-order field coefficients. The accuracy of the method was determined by direct comparison to controlled offsets in the linear imaging gradients. Double-echo FatNavs were also incorporated into a high-resolution, 3-dimensional gradient echo-based sequence to retrospectively correct for both motion and temporal changes in B₀ during natural and deep breathing. The additional scan time was 5 min (a 40% increase). Correction was also investigated using only the first echo of the FatNav to explore the trade-off in accuracy versus scan time.

RESULTS

Excellent accuracy (0.27 Hz, 1.57-2.75 Hz/m) was achieved for tracking field changes, and no significant bias could be observed. Artifacts in the 3-dimensional gradient echo-based images induced by temporal field changes, if present, were effectively reduced using either the field estimates from the double echo or the first echo only from the FatNavs.

CONCLUSION

The FatNavs were shown to be an excellent candidate for accurate, fast, and precise estimation of global field variations for the tested patterns of respiration. Future work will investigate ways to increase the temporal sampling to increase robustness to variations in breathing patterns. Magn Reson Med 80:585-597, 2018. © 2018 International Society for Magnetic Resonance in Medicine.

Magnetic Resonance Spectroscopy and its Clinical Applications: A Review

In vivo NMR spectroscopy is known as magnetic resonance spectroscopy (MRS). MRS has been applied as both a research and a clinical tool in order to detect visible or nonvisible abnormalities. The adaptability of MRS allows a technique that can probe a wide variety of metabolic uses across different tissues. Although MRS is mostly applied for brain tissue, it can be used for detection, localization, staging, tumour aggressiveness evaluation, and tumour response assessment of breast, prostate, hepatic, and other cancers. In this article, the medical applications of MRS in the brain, including tumours, neural and psychiatric disorder studies, breast, prostate, hepatic, gastrointestinal, and genitourinary investigations have been reviewed.

Breast Tissue Metabolism by Magnetic Resonance Spectroscopy

Metabolic alterations are known to occur with oncogenesis and tumor progression. During malignant transformation, the metabolism of cells and tissues is altered. Cancer metabolism can be studied using advanced technologies that detect both metabolites and metabolic activities. Identification, characterization, and quantification of metabolites (metabolomics) are important for metabolic analysis and are usually done by nuclear magnetic resonance (NMR) or by mass spectrometry. In contrast to the magnetic resonance imaging that is used to monitor the tumor morphology during progression of the disease and during therapy, in vivo NMR spectroscopy is used to study and monitor tumor metabolism of cells/tissues by detection of various biochemicals or metabolites involved in various metabolic pathways. Several in vivo, in vitro and ex vivo NMR studies using ¹H and ³¹P magnetic resonance spectroscopy (MRS) nuclei have documented increased levels of total choline containing compounds, phosphomonoesters and phosphodiesters in human breast cancer tissues, which is indicative of altered choline and phospholipid metabolism. These levels get reversed with successful treatment. Another method that increases the sensitivity of substrate detection by using nuclear spin hyperpolarization of ¹³C-lableled substrates by dynamic nuclear polarization has revived a great interest in the study of cancer metabolism. This review discusses breast tissue metabolism studied by various NMR/MRS methods.

MR spectroscopy of breast cancer for assessing early treatment response: Results from the ACRIN 6657 MRS trial

PURPOSE

To estimate the accuracy of predicting response to neoadjuvant chemotherapy (NACT) in patients with locally advanced breast cancer using MR spectroscopy (MRS) measurements made very early in treatment.

MATERIALS AND METHODS

This prospective Health Insurance Portability and Accountability Act (HIPAA)-compliant protocol was approved by the American College of Radiology and local-site institutional review boards. One hundred nineteen women with invasive breast cancer of ≥3 cm undergoing NACT were enrolled between September 2007 and April 2010. MRS measurements of the concentration of choline-containing compounds ([tCho]) were performed before the first chemotherapy regimen (time point 1, TP1) and 20-96 h after the first cycle of treatment (TP2). The change in [tCho] was assessed for its ability to predict pathologic complete response (pCR) and radiologic response using the area under the receiver operating characteristic curve (AUC) and logistic regression models.

RESULTS

Of the 119 subjects enrolled, only 29 cases (24%) with eight pCRs provided usable data for the primary analysis. Technical challenges in acquiring quantitative MRS data in a multi-site trial setting limited the capture of usable data. In this limited data set, the decrease in tCho from TP1 to TP2 had poor ability to predict either pCR (AUC = 0.53, 95% confidence interval [CI]: 0.27-0.79) or radiologic response (AUC = 0.51, 95% CI: 0.27-0.75).

CONCLUSION

The technical difficulty of acquiring quantitative MRS data in a multi-site clinical trial setting led to a low yield of analyzable data, which was insufficient to accurately measure the ability of early MRS measurements to predict response to NACT.

LEVEL OF EVIDENCE

1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:290-302.

Accurate MR thermometry by hyperpolarized 129 Xe

PURPOSE

To investigate the temperature dependence of the resonance frequency of lipid-dissolved xenon (LDX) and to assess the accuracy of LDX-based MR thermometry.

METHODS

The chemical shift temperature dependence of water protons, methylene protons, and LDX was measured from samples containing tissues with varying fat contents using a high-resolution NMR spectrometer. LDX results were then used to acquire relative and absolute temperature maps in vivo and the results were compared with PRF-based MR thermometry.

RESULTS

The temperature dependence of proton resonance frequency (PRF) is strongly affected by the specific distribution of water and fat. A redistribution of water and fat compartments can reduce the apparent temperature dependence of the water chemical shift from -0.01 ppm/°C to -0.006 ppm, whereas the LDX chemical shift shows a consistent temperature dependence of -0.21 ppm/°C. The use of the methylene protons resonance frequency as internal reference improves the accuracy of LDX-based MR thermometry, but degrades that of PRF-based MR thermometry, as microscopic susceptibility gradients affected lipid and water spins differently.

CONCLUSION

The LDX resonance frequency, with its higher temperature dependence, provides more accurate and precise temperature measurements, both in vitro and in vivo. More importantly, the resonance frequency of nearby methylene protons can be used to extract absolute temperature information. Magn Reson Med 78:1070-1079, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Comparative Investigation of Single Voxel Magnetic Resonance Spectroscopy and Dynamic Contrast Enhancement MR Imaging in Differentiation of Benign and Malignant Breast Lesions in a Sample of Iranian Women

PURPOSE

To make a comparison of single voxel magnetic resonance spectroscopy (SV-MRS) and dynamic contrast enhancement (DCE) MRI for differentiation of benign and malignant breast lesions in a sample of Iranian women.

MATERIALS AND METHODS

A total of 30 women with abnormal breast lesions detected in mammography, ultrasound, or clinical breast exam were examined with DCE and SV-MRS. tCho (total choline) resonance in MRS spectra was qualitatively evaluated and detection of a visible tCho peak at 3.2 ppm was defined as a positive finding for malignancy. Different types of DCE curves were persistent (type 1), plateau (type 2), and washout (type 3). At first, lesions were classified according to choline findings and types of DCE curve, finally being compared to pathological results as the standard reference.

RESULTS

this study included 19 patients with malignant lesions and 11 patients with benign ones. While 63.6 % of benign lesions (7 of 11) showed type 1 DCE curves and 36.4% (4 of 11) showed type 2, 57.9% (11of 19) of malignant lesions were type 3 and 42.1% (8 of 19) type 2. Choline peaks were detected in 18 of 19 malignant lesions and in 3 of 11 benign counterparts. 1 malignant and 8 benign cases did not show any visible resonance at 3.2 ppm so SV-MRS featured 94.7% sensitivity, 72.7 % specificity and 86.7% accuracy.

CONCLUSIONS

The present findings indicate that a combined approach using MRS and DCE MRI can improve the specificity of MRI for differentiation of benign and malignant breast lesions.

Respiration artifact correction in three-dimensional proton resonance frequency MR thermometry using phase navigators

PURPOSE

To develop reliable three-dimensional (3D) segmented echo planar imaging (seg-EPI) proton resonance frequency (PRF) temperature monitoring in the presence of respiration-induced B0 variation.

METHODS

A free induction decay (FID) phase navigator was inserted into a 3D seg-EPI sequence before and after EPI readout to monitor B0 field variations. Using the field change estimates, the phase of each k-space line was adjusted to remove the additional phase from the respiratory induced off-resonance. This correction technique was evaluated while heating with MR-guided focused ultrasound (MRgFUS) in phantoms with simulated breathing and during nonheating conditions in healthy in vivo breasts.

RESULTS

With k-space phase correction, the standard deviation of magnitude images and PRF temperature measurements in breast from five volunteers improved by an average factor of 1.5 and 2.1, respectively. Improved accuracy of temperature estimates was observed after correction while heating with MRgFUS in phantoms.

CONCLUSION

Phase correction based on two FID navigators placed before and after the echo train provides promising results for implementing 3D monitoring of thermal therapy treatments in the presence of field variations due to respiration. Magn Reson Med 76:206-213, 2016. © 2015 Wiley Periodicals, Inc.

Dixon imaging-based partial volume correction improves quantification of choline detected by breast 3D-MRSI

OBJECTIVES

Our aim was to develop a partial volume (PV) correction method of choline (Cho) signals detected by breast 3D-magnetic resonance spectroscopic imaging (3D-MRSI), using information from water/fat-Dixon MRI.

METHODS

Following institutional review board approval, five breast cancer patients were measured at 3 T. 3D-MRSI (1 cm(3) resolution, duration ~11 min) and Dixon MRI (1 mm(3), ~2 min) were measured in vivo and in phantoms. Glandular/lesion tissue was segmented from water/fat-Dixon MRI and transformed to match the resolution of 3D-MRSI. The resulting PV values were used to correct Cho signals. Our method was validated on a two-compartment phantom (choline/water and oil). PV values were correlated with the spectroscopic water signal. Cho signal variability, caused by partial-water/fat content, was tested in 3D-MRSI voxels located in/near malignant lesions.

RESULTS

Phantom measurements showed good correlation (r = 0.99) with quantified 3D-MRSI water signals, and better homogeneity after correction. The dependence of the quantified Cho signal on the water/fat voxel composition was significantly (p < 0.05) reduced using Dixon MRI-based PV correction, compared to the original uncorrected data (1.60-fold to 3.12-fold) in patients.

CONCLUSIONS

The proposed method allows quantification of the Cho signal in glandular/lesion tissue independent of water/fat composition in breast 3D-MRSI. This can improve the reproducibility of breast 3D-MRSI, particularly important for therapy monitoring.

Requirements for static and dynamic higher order B0 shimming of the human breast at 7 T

The increased magnetic susceptibility effects at higher magnetic fields increase the demands for shimming of the B0 field for in vivo MRI and MRS. Both static and dynamic techniques have been developed to compensate for susceptibility-induced field inhomogeneities. In this study, we investigate the impact of and need for both static and dynamic higher order B0 shimming of magnetic field homogeneities in clinical breast MRI at 7 T. Both global and local field variations at lipid-tissue interfaces were observed in the magnetic field using TE-optimized B0 mapping at 7 T. With static B0 shimming, a field homogeneity of 39 ± 11 Hz (n = 48) was reached in a single breast using second-order shimming. Further compensation of the residual local field inhomogeneities caused by lipid-tissue interfaces does not seem to be feasible with shallow spherical harmonic fields. For bilateral shimming, the shimming quality was significantly less at 62 ± 15 Hz (n = 22) over both breasts, even after (simulated) fourth-order shimming. In addition, a substantial time-dependent field instability of 30 Hz peak to peak, with significant higher order field contributions, was observed during regular breathing. In conclusion, TE-optimized B0 field mapping reveals substantial field variations in the lipid-rich environment of the human breast, in both space and time. The static field variations could be partially minimized by third-order B0 shimming, providing sufficient lipid suppression. However, in order to fully benefit from the increased spectral dispersion at high fields, the significant magnetic field variations during breathing need to be considered.

Neonatal cardiac MRI using prolonged balanced SSFP imaging at 3T with active frequency stabilization

Cardiac MRI in neonates holds promise as a tool that can provide detailed functional information in this vulnerable group. However, their small size, rapid heart rate, and inability to breath-hold, pose particular challenges that require prolonged high-contrast and high-SNR methods. Balanced-steady state free precession (SSFP) offers high SNR efficiency and excellent contrast, but is vulnerable to off-resonance effects that cause banding artifacts. This is particularly problematic in the blood-pool, where off-resonance flow artifacts severely degrade image quality.

METHODS

In this article, we explore active frequency stabilization, combined with image-based shimming, to achieve prolonged SSFP imaging free of banding artifacts. The method was tested using 2D multislice SSFP cine acquisitions on 18 preterm infants, and the functional measures derived were validated against phase-contrast flow assessment.

RESULTS

Significant drifts in the resonant frequency (165 ± 23Hz) were observed during 10-min SSFP examinations. However, full short-axis stacks free of banding artifacts were achieved in 16 subjects with stabilization; the cardiac output obtained revealed a mean difference of 9.0 ± 8.5% compared to phase-contrast flow measurements.

CONCLUSION

Active frequency stabilization has enabled the use of prolonged SSFP acquisitions for neonatal cardiac imaging at 3T. The findings presented could have broader implications for other applications using prolong SSFP acquisitions.

Feedback field control improves linewidths in in vivo magnetic resonance spectroscopy

PURPOSE

Magnetic resonance spectroscopy (MRS) experiments rely on a homogeneous and stable magnetic field within the sample. Field homogeneity is typically optimized by static B0 shimming while reproducible effects from dynamic field variation are commonly diminished by means of gradient system calibration as well as calibration based on non-water suppressed reference data. However, residual encoding deficiencies from incomplete calibration and nonreproducible field perturbations deteriorate the quality of the obtained data. To overcome this problem, we propose to adapt higher-order feedback field control based on NMR field probes for its application in MRS.

METHODS

To allow for field measurements simultaneously with the spectroscopy readout, radiofrequency-shielded field probes were employed. The setup was evaluated in vitro and tested in vivo for single-voxel MRS at 7T to correct for field perturbations that occur due to subject breathing and limb motion.

RESULTS

The in vitro experiments showed an effective field control during the MRS sequence. The resulting spectroscopy data were free of spurious signal and the achieved field stabilization improved the spectral resolution in vitro and in vivo.

CONCLUSION

High-field MRS is limited by nonreproducible field perturbations for which spatiotemporal field feedback provides a solution without compromising sequence timing and efficiency.

Dynamic slice-dependent shim and center frequency update in 3 T breast diffusion weighted imaging

PURPOSE

To demonstrate dynamic slice-dependent shim update as a simple method to reduce susceptibility-induced B0 inhomogeneity and associated pixel shift artifacts in diffusion-weighted echo planar imaging (DW-EPI) in 3 T breast imaging.

METHODS

Dynamic slice-dependent update of linear shim and center frequency was implemented in a dual-echo B0 mapping sequence and a DW-EPI sequence. Multi-slice axial B0 maps and diffusion-weighted images were obtained from four volunteers with both conventional and dynamic shim methods. The two shim methods were compared in terms of B0 homogeneity and EPI pixel shift artifacts.

RESULTS

In all volunteers the B0 maps showed significantly improved homogeneity; the left-right asymmetry was reduced by 79% and within-slice B0 standard deviation was reduced by 20% on the average. The improvements were better than what was previously reported for conventional (static) third-order shim in bilateral breast. Anatomy-referenced apparent diffusion coefficient (ADC) maps showed reduced overall image registration error obtainable with dynamic shim.

CONCLUSIONS

Dynamic shim is an effective method to improve B0 shimming and DW-EPI image quality in 3 T bilateral breast imaging. Magn Reson Med 71:1813-1818, 2014. © 2013 Wiley Periodicals, Inc.

Magnetic resonance spectroscopy of the breast: current status

In vivo magnetic resonance spectroscopy (MRS) of the breast can be used to measure the level of choline-containing compounds, which is a biomarker of malignancy. In the diagnostic setting, MRS can provide high specificity for distinguishing benign from malignant lesions. MRS also can be used as an early response indicator in patients undergoing neoadjuvant chemotherapy. This article describes the acquisition and analysis methods used for measuring total choline levels in the breast using MRS, reviews the findings from clinical studies of diagnosis and treatment response, and discusses problems, limitations, and future developments for this promising clinical technology.

Enhanced fat suppression technique for breast imaging

PURPOSE

To evaluate a new fat suppression technique using multiple fat suppression pulses intended for breast dynamic contrast-enhanced (DCE) imaging using segmented three-dimensional fast field echo (FFE).

MATERIALS AND METHODS

The effect of multiple spectrally-selective fat suppression radiofrequency pulses was modeled using numerical Bloch-equation solutions for the following fat suppression techniques: spectral-selective inversion recovery (SPIR: one pulse), double fat suppression (DFS: two pulses, combining one SPIR pulse and one CHESS pulse), and triple fat suppression (TFS: three pulses, combining one SPIR pulse and two CHESS pulses). The simulation data were evaluated in terms of fat suppression performance, scan time, and specific absorption rate (SAR) relative to the SPIR technique. The DFS technique was selected as the optimal technique based on the efficacy of fat suppression versus the costs of scan time and SAR. The DFS technique was compared with SPIR in six volunteer studies using segmented T1 -weighted three-dimensional FFE.

RESULTS

The DFS technique produced sufficient fat suppression using only two segments (two fat suppression shots). Breast DCE precontrast images using DFS presented uniform fat suppression compared with SPIR in both axial and sagittal scans in all six volunteers.

CONCLUSION

DFS is a promising fat suppression technique for breast imaging even in regions with B1 (+) inhomogeneity.

Patient-to-patient variation of susceptibility-induced B₀ field in bilateral breast MRI

PURPOSE

To evaluate intersubject variability of susceptibility-induced static field inhomogeneity in breast and to assess effectiveness of whole-body high-order shimming applied to bilateral breast.

MATERIALS AND METHODS

A fast, computationally efficient method to calculate susceptibility-induced static field from anatomical images was developed. The method was validated against the conventional multiecho B(0) mapping method and was used to generate data for linear and higher-order shim simulation on 13 volunteers.

RESULTS

Most volunteers showed a significant anterior-posterior B(0) gradient. The majority of the subjects also exhibited a statistically significant left-right gradient. The second- and third-order shimming provided only minor (<5% each) improvement in B(0) homogeneity.

CONCLUSION

The shape of the air-tissue boundary determines most of the observed B(0) distribution in bilateral breast. Despite significant variability among subjects, a common feature traceable to generic anatomy exists in the linear gradient. Nonlinear variation of susceptibility-induced B(0) field occurs over a relatively short length scale and is likely best shimmed by slice-dependent or localized shimming.

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

PURPOSE

To rapidly calculate and validate subject-specific field maps based on the three-dimensional shape of the bilateral breast volume.

MATERIALS AND METHODS

Ten healthy female volunteers were scanned at 3 Tesla using a multi-echo sequence that provides water, fat, in-phase, out-of-phase, and field map images. A shape-specific binary mask was automatically generated to calculate a computed field map using a dipole field model. The measured and computed field maps were compared by visualizing the spatial distribution of the difference field map, the mean absolute error, and the 80% distribution widths of frequency histograms.

RESULTS

The 10 computed field maps had a mean absolute error of 38 Hz (0.29 ppm) compared with the measured field maps. The average 80% distribution widths for the histograms of all of the computed, measured, and difference field maps are 205 Hz, 233 Hz, and 120 Hz, respectively.

CONCLUSION

The computed field maps had substantial overall agreement with the measured field maps, indicating that breast MRI field maps can be computed based on the air-tissue interfaces. These estimates may provide a predictive model for field variations and thus have the potential to improve applications in breast MRI.

Fat-referenced MR thermometry in the breast and prostate using IDEAL

PURPOSE

To demonstrate a three-echo fat-referenced MR thermometry technique that estimates and corrects for time-varying phase disturbances in heterogeneous tissues.

MATERIALS AND METHODS

Fat protons do not exhibit a temperature-dependent frequency shift. Fat-referenced thermometry methods exploit this insensitivity and use the signal from fat to measure and correct for magnetic field disturbances. In this study, we present a fat-referenced method that uses interpolation of the fat signal to correct for phase disturbances in fat free regions. Phantom and ex vivo tissue cool-down experiments were performed to evaluate the accuracy of this method in the absence of motion. Non-heated in vivo imaging of the breast and prostate was performed to demonstrate measurement robustness in the presence of systemic and motion-induced field disturbances. Measurement accuracy of the method was compared to conventional proton resonance frequency shift MR thermometry.

RESULTS

In the ex vivo porcine tissue experiment, maximum measurement error of the fat-referenced method was reduced 42% from 3.3 to 1.9°C when compared to conventional MR thermometry. In the breasts, measurement errors were reduced by up to 70% from 6.4 to 1.9°C.

CONCLUSION

Ex vivo and in vivo results show that the proposed method reduces measurement errors in the heterogeneous tissue experiments when compared to conventional MR thermometry.

Direct B0 field monitoring and real-time B0 field updating in the human breast at 7 Tesla

Large dynamic fluctuations of the static magnetic field (B(0)) are observed in the human body during MR scanning, compromising image quality and detection sensitivity in several MR imaging and spectroscopy sequences. Partially, these dynamic B(0) fluctuations are due to physiological motion such as breathing, but other sources of temporal B(0) field fluctuations are also present in the MR system (e.g., eddy currents). Especially at ultrahigh field (≥7 T), the increased susceptibility effects lead to large B(0) field variations over time. Direct measurement and correction of these temporal field variations of up to 70 Hz will lead to a significant reduction of artifacts and improved measurement stability/reproducibility. For direct measurement of the temporally changing B(0) field, a simple field probe was developed, that was placed in proximity to the tissue of interest. In this work, it is shown how such a field probe system can be used to monitor temporal B(0) field variations in the human body during MRI and magnetic resonance spectroscopy. Furthermore, it is shown how the acquired temporal B(0) field information can drive a dynamic shim module to directly correct the B(0) magnetic field in real time.

High-resolution NMR spectroscopy in unstable and inhomogeneous fields via stroboscopic acquisition

In this paper, we demonstrated that despite the insensitivity of intermolecular zero-quantum coherences (iZQCs) to B(0) variations, the influence of unstable fields on the observable single-quantum coherence signals causes strong t(1) noises in the high-resolution iZQC projection spectra. Stroboscopic acquisition was then proposed for noise suppression. The feasibility of the modified sequences with the proposed acquisition scheme was verified by computer simulations and experiments in different unstable fields generated by the Z0 and Z1 coil current oscillations, which mimic the unstable fields of NMR using externally powered magnets and MRS in the presence of physiological motions, respectively.

Correction of breathing-induced errors in magnetic resonance thermometry of hyperthermia using multiecho field fitting techniques

PURPOSE

Breathing motion can create large errors when performing magnetic resonance (MR) thermometry of the breast. Breath holds can be used to minimize these errors, but not eliminate them. Between breath holds, the referenceless method can be used to further reduce errors by relying on regions of nonheated fatty tissue surrounding the heated region. When the surrounding tissue is heated (i.e., for a hyperthermia treatment), errors can result due to phase changes of the small amounts of water in the tissue. Therefore, an extension of the referenceless method is proposed which fits for the field in fatty tissue independent of temperature change and extrapolates it to the water-rich regions.

METHODS

Nonheating experiments were performed with male volunteers performing breath holds on top of a phantom mimicking a breast with a tumor. Heating experiments were also conducted with the same phantom while mechanically simulated breath holds were performed. A nonheating experiment was also performed with a healthy female breast. For each experiment, a nonlinear fitting algorithm was used to fit for temperature change and B0 field inside of the fatty tissue. The field changes were then extrapolated into water-rich (tumor) portions of the image using a least-squares fit to a fifth-order equation, to correct for field changes due to breath hold changes. Similar results were calculated using the image phase, to mimic the use of the referenceless method.

RESULTS

Phantom results showed large reduction of mean error and standard deviation. In the non-heating experiments, the traditional referenceless method and our extended method both corrected by similar amounts. However, in the heating experiments, the average deviation of the temperature calculated with the extended method from a fiber optic probe temperature was approximately 50% less than the deviation with the referenceless method. The in vivo breast results demonstrated reduced standard deviation and mean.

CONCLUSIONS

In this paper, we have developed an extension of the referenceless method to correct for breathing errors using multiecho fitting methods to fit for the B0 field in the fatty tissue and using measured field changes as references to extrapolate field corrections into a water-only (tumor) region. This technique has been validated in a number of situations, and in all cases, the correction method has been shown to greatly reduce temperature error in water-rich regions. The method has also been shown to be an improvement over similar methods that use image phase changes instead of field changes, particularly when temperature changes are induced.

Improved hyperthermia treatment control using SAR/temperature simulation and PRFS magnetic resonance thermal imaging

PURPOSE

This article explores the feasibility of using coupled electromagnetic and thermodynamic simulations to improve planning and control of hyperthermia treatments for cancer. The study investigates the usefulness of preplanning to improve heat localisation in tumour targets in treatments monitored with PRFS-based magnetic resonance thermal imaging (MRTI).

METHODS

Heating capabilities of a cylindrical radiofrequency (RF) mini-annular phased array (MAPA) applicator were investigated with electromagnetic and thermal simulations of SAR in homogeneous phantom models and two human leg sarcomas. High frequency structure simulator (HFSS) (Ansoft) was used for electromagnetic simulations and SAR patterns were coupled into EPhysics (Ansoft) for thermal modelling with temperature-dependent variable perfusion. Simulations were accelerated by integrating tumour-specific anatomy into a pre-gridded whole body tissue model. To validate this treatment planning approach, simulations were compared with MR thermal images in both homogenous phantoms and heterogeneous tumours.

RESULTS

SAR simulations demonstrated excellent agreement with temperature rise distributions obtained with MR thermal imaging in homogeneous phantoms and clinical treatments of large soft-tissue sarcomas. The results demonstrate feasibility of preplanning appropriate relative phases of antennas for localising heat in tumour.

CONCLUSIONS

Advances in the accuracy of computer simulation and non-invasive thermometry via MR thermal imaging have provided powerful new tools for optimisation of clinical hyperthermia treatments. Simulations agree well with MR thermal images in both homogeneous tissue models and patients with lower leg tumours. This work demonstrates that better quality hyperthermia treatments should be possible when simplified hybrid model simulations are performed routinely as part of the clinical pretreatment plan.

Single-voxel MRS with prospective motion correction and retrospective frequency correction

Subject motion during MRS investigations is a factor limiting the quality and the diagnostic value of the spectra. The possibility of using external motion tracking data to correct for artefacts in MR imaging has been demonstrated previously. In this paper the utility of prospective motion correction for single-voxel proton MRS is investigated. The object motion data are used in real time to update the position of the spectroscopy voxel during the acquisition prior to every sequence repetition cycle. It is not, however, sufficient to update the voxel position alone due to shim changes accompanying subject motion. Adverse effects of frequency shifts induced by subject motion are effectively suppressed by the interleaved reference scan method.

Assessment of therapeutic response of locally advanced breast cancer (LABC) patients undergoing neoadjuvant chemotherapy (NACT) monitored using sequential magnetic resonance spectroscopic imaging (MRSI)

The potential of total choline (tCho) signal-to-noise ratio (SNR) (ChoSNR) and tumor volume in the assessment of tumor response in locally advanced breast cancer (LABC) patients (n = 30) undergoing neoadjuvant chemotherapy (NACT) was investigated using magnetic resonance spectroscopic imaging (MRSI) and conventional MRI at 1.5 T. Experiments were carried out sequentially at four time-points: prior to therapy and after I, II and III NACT and ChoSNR, and the tumor volume was measured. The MR response was compared with the clinical response. Sequential data of 25 patients were retrospectively analyzed by classifying them as clinical responders and non-responders. In 14 responders, the pre-therapy ChoSNR was 7.8 +/- 5.1. In 10/14 responders, no choline was observed after III NACT while in the remaining four patients the ChoSNR was reduced to 3.6 +/- 1.1 (p < 0.05). Non-responders showed no statistically significant change in ChoSNR. After III NACT, the tumor volume reduced by 84.0 +/- 14.8% in responders. Using receiver operating curve (ROC) analysis, cut-off values of 53% for ChoSNR and 47.5% for volume were obtained to differentiate responders from non-responders. The sensitivity to detect responders from non-responders using ChoSNR was 85.7% with 91% specificity while 100% sensitivity was observed for volume but with reduced specificity of 73%. Our results indicate that ChoSNR may serve as a useful parameter to predict tumor response to NACT with higher specificity compared to volume, suggesting its potential in effective treatment management.

An internal reference model-based PRF temperature mapping method with Cramer-Rao lower bound noise performance analysis

The conventional phase difference method for MR thermometry suffers from disturbances caused by the presence of lipid protons, motion-induced error, and field drift. A signal model is presented with multi-echo gradient echo (GRE) sequence using a fat signal as an internal reference to overcome these problems. The internal reference signal model is fit to the water and fat signals by the extended Prony algorithm and the Levenberg-Marquardt algorithm to estimate the chemical shifts between water and fat which contain temperature information. A noise analysis of the signal model was conducted using the Cramer-Rao lower bound to evaluate the noise performance of various algorithms, the effects of imaging parameters, and the influence of the water:fat signal ratio in a sample on the temperature estimate. Comparison of the calculated temperature map and thermocouple temperature measurements shows that the maximum temperature estimation error is 0.614 degrees C, with a standard deviation of 0.06 degrees C, confirming the feasibility of this model-based temperature mapping method. The influence of sample water:fat signal ratio on the accuracy of the temperature estimate is evaluated in a water-fat mixed phantom experiment with an optimal ratio of approximately 0.66:1.

In vivo proton MR spectroscopy of the breast using the total choline peak integral as a marker of malignancy

OBJECTIVE

The purpose of our study was to use the total choline-containing compound (tCho) peak integral as a marker of malignancy in breast MR spectroscopy (MRS).

SUBJECTS AND METHODS

Forty-eight single-voxel water- and fat-suppressed 1.5-T MRS measurements were performed in 42 patients, obtaining both absolute tCho peak integral and tCho peak integral normalized for the volume of interest (VOI). Our reference standard was histology for lesions with BI-RADS category 4 and 5 and histology or at least a 2-year follow-up for findings with BI-RADS 2 and 3 and normal glands. Receiver operating characteristic (ROC) analysis, Mann-Whitney U test, and Spearman's rank correlation were used.

RESULTS

Three of 48 measurements (6%) failed. Of the remaining 45 spectra, 18 nonmalignant tissues showed no tCho peak, eight nonmalignant tissues showed a tCho peak integral from 0.99 to 9.03 arbitrary units (AU), and 19 malignant lesions showed a tCho peak integral from 1.26 to 19.80 AU. The diameter of nonmalignant tissues was 16.9 +/- 7.4 mm; that of malignant lesions was 15.3 +/- 6.9 mm (p = 0.308). At ROC analysis, the optimal threshold was 1.90 AU for absolute tCho peak, with 0.895 (17/19) sensitivity, 0.923 (24/26) specificity, and an AUC (area under the curve) of 0.917 (95% CI, 0.822-1.000); the optimal threshold was 0.85 AU/mL for the normalized tCho peak integral with 0.842 (16/19) sensitivity, 0.885 (23/26) specificity, and an AUC of 0.941 (0.879-1.000) (p = 0.470). A negative correlation (p = 0.011) was found between the VOI and the normalized tCho peak integral of malignant tissues.

CONCLUSION

Breast MRS using tCho peak integral reaches a high level of diagnostic performance.

Gradient moment compensated magnetic resonance spectroscopic imaging

Spectroscopic imaging applications outside of the brain can suffer from artifacts due to inherent long scan times and susceptibility to motion. A fast spectroscopic imaging sequence has been devised with reduced sensitivity to motion. The sequence uses oscillating readout gradients and acquires k-space data in a spiral out-in fashion, which allows fast k-space coverage. We show that a spiral out-in readout acquisition is characterized by small gradient moments, reducing sensitivity to motion-induced artifacts. Data are acquired comparing the sequence to normal phase encoded spectroscopic imaging and conventional spiral spectroscopic imaging protocols. In addition, in vivo data are acquired from the liver, demonstrating potential usage as a multivoxel fat/water spectroscopic imaging tool. Results indicate that in the presence of motion, ghosting effects are reduced while metabolite signal increases of approximately 10% can be achieved.

Biochemical characterization of breast tumors by in vivo and in vitro magnetic resonance spectroscopy (MRS)

Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) have evolved as sensitive tools for anatomic and metabolic evaluation of breast cancer. In vivo MRS studies have documented the presence of choline containing compounds (tCho) as a reliable biochemical marker of malignancy and also useful for monitoring the tumor response to therapy. Recent studies on the absolute quantification of tCho are expected to provide cut-off values for discrimination of various breast pathologies. Addition of MRS investigation was also reported to increase the specificity of MRI. Further, ex vivo and in vitro MRS studies of intact tissues and tissue extracts provided several metabolites that were not be detected in vivo and provided insight into underlying biochemistry of the disease processes. In this review, we present briefly the role of various 1H MRS methods used in breast cancer research and their potential in relation to diagnosis, monitoring of therapeutic response and metabolism.

Metabolite quantification and high-field MRS in breast cancer

In vivo 1H MRS is rapidly developing as a clinical tool for diagnosing and characterizing breast cancers. Many in vivo and in vitro experiments have demonstrated that alterations in concentrations of choline-containing metabolites are associated with malignant transformation. In recent years, considerable efforts have been made to evaluate the role of 1H MRS measurements of total choline-containing compounds in the management of patients with breast cancer. Current technological developments, including the use of high-field MR scanners and quantitative spectroscopic analysis methods, promise to increase the sensitivity and accuracy of breast MRS. This article reviews the literature describing in vivo MRS in breast cancer, with an emphasis on the development of high-field MR scanning and quantitative methods. Potential applications of these technologies for diagnosing suspicious lesions and monitoring response to chemotherapy are discussed.

Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) in Breast Cancer

Breast cancer is a major health problem in women and early detection is of prime importance. Breast magnetic resonance imaging (MRI) provides both physical and physiologic tissue features that are useful in discriminating malignant from benign lesions. Contrast enhanced MRI is valuable for diagnosis of small tumors in dense breast and the structural and kinetic parameters improved the specificity of diagnosing benign from malignant lesions. It is a complimentary modality for preoperative staging, to follow response to therapy, to detect recurrences and for screening high risk women. Diffusion, perfusion and MR elastography have been applied to breast lesion characterization and show promise.

In-vivo MR spectroscopy (MRS) is a valuable method to obtain the biochemical status of normal and diseased tissues. Malignant tissues contain high concentration of choline containing compounds that can be used as a biochemical marker. MRS helps to increase the specificity of MRI in lesions larger than 1cm and to monitor the tumor response. Various MR techniques show promise primarily as adjunct to the existing standard detection techniques, and its acceptability as a screening method will increase if specificity can be improved. This review presents the progress made in different MRI and MRS techniques in beast cancer management.

Detection of choline signal in human breast lesions with chemical-shift imaging

PURPOSE

To investigate the application of MR spectroscopy using chemical-shift imaging (CSI) for characterizing human breast lesions at 1.5T, and to evaluate the diagnostic performance using ROC (receiver operating characteristics) analysis.

MATERIALS AND METHODS

Thirty-six patients (35-73 years old, mean 52), with 27 malignant and 9 benign lesions, underwent anatomical imaging, dynamic contrast-enhanced MR imaging, and CSI. The ROC analysis was performed and the cutoff point yielding the highest accuracy was found to be a choline (Cho) signal-to-noise ratio (SNR) >3.2.

RESULTS

The mean Cho SNR was 2.8 +/- 0.8 (range, 1.8-4.3) for the benign group and 5.9 +/- 3.4 (2.1-17.5) for the malignant group (P = 0.01). Based on the criterion of Cho SNR >3.2 as malignant, CSI correctly diagnosed 22 of 27 malignant lesions and 7 of 9 benign lesions, resulting in a sensitivity of 81%, specificity of 78%, and overall accuracy of 81%. If the criterion was set higher at Cho SNR >4.0 the specificity improved to 89% but sensitivity was lowered to 67%.

CONCLUSION

The ROC analysis presented in this work could be used to set an objective diagnostic criterion depending on preferred emphasis on sensitivity or specificity.

Temperature mapping considerations in the breast with line scan echo planar spectroscopic imaging

A line-scan echo planar spectroscopic imaging (LSEPSI) sequence was used to serially acquire spectra from 4,096 voxels every 6.4 s throughout the breasts of nine female subjects in vivo. Data from the serial acquisitions were analyzed to determine the potential of the technique to characterize temperature changes using either the water frequency alone or the water-methylene frequency difference. Fluctuations of the apparent temperature change under these conditions of no heating were smallest using the water-methylene frequency difference, most probably due to a substantial reduction of motion effects both within and without the imaged plane. The approach offers considerable advantages over other methods for temperature change monitoring in the breast with magnetic resonance but suffers from some limitations, including the unavailability of lipid and water resonances in some voxels as well as a surprisingly large distribution of water-methylene frequency differences, which may preclude absolute temperature measurement.

On restoring motion-induced signal loss in single-voxel magnetic resonance spectra

Destructive interference from phase fluctuations caused by motion during (1)H magnetic resonance spectroscopy (MRS) stimulated-echo acquisition mode (STEAM) and point-resolved spectroscopy (PRESS) acquisitions can significantly diminish the traditional radicalN-gain in signal-to-noise ratio (SNR) afforded by averaging N signals, especially in the torso. The SNR loss is highly variable among individuals, even when identical acquisition protocols are used. This paper presents a theory for the SNR loss, assuming that the phase fluctuates randomly. It is shown that SNR in conventional averaging is reduced by the factor sinc(sigma(phi) radical3/pi), where sigma(phi) is the standard deviation (SD) of the phase. "Constructive averaging," whereby each individual acquisition is phase-corrected using the phase of a high-SNR peak before averaging, reverses the SNR loss from motion-induced dephasing, resulting in a {1/sinc(sigma(phi) radical3/pi)}-fold SNR improvement. It is also shown that basing phase corrections on an average of radicalN adjacent points both improves correction accuracy and effectively eliminates false signal artifacts when corrections are based on low-SNR peaks. The theory is validated over a sevenfold range of variation in signal loss due to motion observed in (1)H STEAM and PRESS data acquired from 17 human subjects (heart: N = 16; leg: N = 1). Constructive averaging should be incorporated as a routine tool for in vivo (1)H MRS.

Correction of proton resonance frequency shift temperature maps for magnetic field disturbances caused by breathing

Respiratory induced resonance offset (RIRO) is a periodic disturbance of a magnetic field due to breathing. Such disturbance handicaps the accuracy of the proton resonance frequency shift (PRFS) method of MRI temperature mapping in anatomies situated nearby the lungs and chest wall. In this work, we propose a method capable of minimizing errors caused by RIRO in PRFS temperature maps. In this method, a set of baseline images characterizing RIRO at a variety of respiratory cycle instants is acquired before the thermal treatment starts. During the treatment, the temperature evolution is found from two successive images. Then, the calculated temperature changes are corrected for the additional contribution caused by RIRO using the pre-treatment baseline images acquired at the identical instances of the respiratory cycle. Our method is shown to improve the accuracy and stability of PRFS temperature maps in the presence of RIRO and inter-scan motion in phantom and volunteers' breathing experiments. Our method is also shown to be applicable to anatomies moving during breathing if a proper registration procedure is applied.

Monitoring the therapeutic response of locally advanced breast cancer patients: Sequential in vivo proton MR spectroscopy study

PURPOSE

To evaluate the use of the water-to-fat (W-F) value obtained from in vivo proton ((1)H) MR spectroscopy (MRS) as a response indicator of cytologically confirmed patients with locally advanced breast cancer (LABC), and to monitor the therapeutic response of such patients to neoadjuvant chemotherapy (NACT).

MATERIALS AND METHODS

Serial (1)H MR spectra were recorded both before and after the completion of chemotherapy in 33 LABC patients (with infiltrating ductal carcinoma (IDC)) at 1.5T. In addition, spectra from normal breast tissues of 28 healthy volunteers were recorded.

RESULTS

Malignant breast tissues showed elevated W-F values compared to normal breast tissues of controls. Statistically significant higher pretherapy W-F value (P < 0.01) was observed in patients compared to controls. In patients who received NACT resulting in the reduction of the primary tumor size, the W-F value showed a decrease that was statistically significant (P < 0.01). Analysis of the MR data further indicates that the W-F value had no correlation with the menstrual status of the patients. A comparison of pretherapy W-F value with pretherapy tumor volume showed a fair correlation (P = 0.05), while the posttherapy W-F value showed no such correlation with the posttherapy tumor volume.

CONCLUSION

This study demonstrates that simple, conventional in vivo (1)H MRS is a useful technique for monitoring the therapeutic response of breast cancer patients. The observed trend in the reduction of W-F value provides a noninvasive response indicator to monitor the clinical outcome of locally advanced breast cancer patients to NACT.