Compensation of slice profile mismatch in combined spin- and gradient-echo echo-planar imaging pulse sequences

Navigator-based motion compensation for liver BOLD measurement with five-echo SAGE EPI and breath-hold task

PURPOSE

The purpose of this work is to apply multi-echo spin- and gradient-echo (SAGE) echo-planar imaging (EPI) combined with a navigator-based (NAV) prospective motion compensation method for a quantitative liver blood oxygen level dependent (BOLD) measurement with a breath-hold (BH) task.

METHODS

A five-echo SAGE sequence was developed to quantitatively measure T2 and T2* to depict function with sufficient signal-to-noise ratio, spatial resolution and sensitivity to BOLD changes induced by the BH task. To account for respiratory motion, a navigator was employed in the form of a single gradient-echo projection readout, located at the diaphragm along the inferior-superior direction. Prior to each transverse imaging slice of the spin-echo EPI-based readouts, navigator acquisition and fat suppression were incorporated. Motion data was obtained from the navigator and transmitted back to the sequence, allowing real-time adjustments to slice positioning. Six healthy volunteers and three patients with liver carcinoma were included in this study. Quantitative T2 and T2* were calculated at each time point of the BH task. Parameters of t value from first-level analysis using a general linear model and hepatovascular reactivity (HVR) of Echo1, T2 and T2* were calculated.

RESULTS

The motion caused by respiratory activity was successfully compensated using the navigator signal. The average changes of T2 and T2* during breath-hold were about 1% and 0.7%, respectively. With the help of NAV prospective motion compensation whole liver t values could be obtained without motion artifacts. The quantified liver T2 (34.7 ± 0.7 ms) and T2* (29 ± 1.2 ms) values agreed with values from literature. In healthy volunteers, the distribution of statistical t value and HVR was homogeneous throughout the whole liver. In patients with liver carcinoma, the distribution of t value and HVR was inhomogeneous due to metastases or therapy.

CONCLUSIONS

This study demonstrates the feasibility of using a NAV prospective motion compensation technique in conjunction with five-echo SAGE EPI for the quantitative measurement of liver BOLD with a BH task.

Rapid simultaneous estimation of relaxation rates using multi-echo, multi-contrast MRI

PURPOSE

Multi-echo, multi-contrast methods are increasingly used in dynamic imaging studies to simultaneously quantify R2∗ and R2. To overcome the computational challenges associated with nonlinear least squares (NLSQ) fitting, we propose a generalized linear least squares (LLSQ) solution to rapidly fit R2∗ and R2.

METHODS

Spin- and gradient-echo (SAGE) data were simulated across T2∗ and T2 values at high (200) and low (20) SNR. Full (four-parameter) and reduced (three-parameter) parameter fits were implemented and compared with both LLSQ and NLSQ fitting. Fit data were compared to ground truth using concordance correlation coefficient (CCC) and coefficient of variation (CV). In vivo SAGE perfusion data were acquired in 20 subjects with relapsing-remitting multiple sclerosis. LLSQ R2∗ and R2, as well as cerebral blood volume (CBV), were compared with the standard NLSQ approach.

RESULTS

Across all fitting methods, T2∗ was well-fit at high (CCC = 1, CV = 0) and low (CCC ≥ 0.87, CV ≤ 0.08) SNR. Except for short T2∗ values (5-15 ms), T2 was well-fit at high (CCC = 1, CV = 0) and low (CCC ≥ 0.99, CV ≤ 0.03) SNR. In vivo, LLSQ R2∗ and R2 estimates were similar to NLSQ, and there were no differences in R2∗ across fitting methods at high SNR. However, there were some differences at low SNR and for R2 at high and low SNR. In vivo NLSQ and LLSQ three parameter fits performed similarly, as did NLSQ and LLSQ four-parameter fits. LLSQ CBV nearly matched the standard NLSQ method for R2∗- (0.97 ratio) and R2-CBV (0.98 ratio). Voxel-wise whole-brain fitting was faster for LLSQ (3-4 min) than NLSQ (16-18 h).

CONCLUSIONS

LLSQ reliably fit for R2∗ and R2 in simulated and in vivo data. Use of LLSQ methods reduced the computational demand, enabling rapid estimation of R2∗ and R2.

Reslice3Dto2D: Introduction of a software tool to reformat 3D volumes into reference 2D slices in cardiovascular magnetic resonance imaging

OBJECTIVE

Cardiovascular magnetic resonance enables the quantification of functional and morphological parameters with an impact on therapeutical decision making. While quantitative assessment is established in 2D, novel 3D techniques lack a standardized approach. Multi-planar-reformatting functionality in available software relies on visual matching location and often lacks necessary functionalities for further post-processing. Therefore, the easy-to-use Reslice3Dto2D software tool was developed as part of another research project to fill this gap and is now introduced with this work.

RESULTS

The Reslice3Dto2D reformats 3D data at the exact location of a reference slice with a two-step-based interpolation in order to reflect in-plane discretization and through-plane slice thickness including a slice profile selection. The tool was successfully validated on an artificial dataset and tested on 119 subjects with different underlying pathologies. The exported reformatted data could be imported into three different post-processing software tools. The quantified image sharpness by the Frequency Domain Image Blur Measure was significantly decreased by around 40% on rectangular slice profiles with 7 mm slice thickness compared to 0 mm due to partial volume effects. Consequently, Reslice3Dto2D enables the quantification of 3D data with conventional post-processing tools as well as the comparison of 3D acquisitions with their established 2D version.

Optimization and validation of multi-echo, multi-contrast SAGE acquisition in fMRI

The purpose of this study was to optimize and validate a multi-contrast, multi-echo fMRI method using a combined spin- and gradient-echo (SAGE) acquisition. It was hypothesized that SAGE-based blood oxygen level-dependent (BOLD) functional MRI (fMRI) will improve sensitivity and spatial specificity while reducing signal dropout. SAGE-fMRI data were acquired with five echoes (2 gradient-echoes, 2 asymmetric spin-echoes, and 1 spin-echo) across 12 protocols with varying acceleration factors, and temporal SNR (tSNR) was assessed. The optimized protocol was then implemented in working memory and vision tasks in 15 healthy subjects. Task-based analysis was performed using individual echoes, quantitative dynamic relaxation times T2 * and T2, and echo time-dependent weighted combinations of dynamic signals. These methods were compared to determine the optimal analysis method for SAGE-fMRI. Implementation of a multiband factor of 2 and sensitivity encoding (SENSE) factor of 2.5 yielded adequate spatiotemporal resolution while minimizing artifacts and loss in tSNR. Higher BOLD contrast-to-noise ratio (CNR) and tSNR were observed for SAGE-fMRI relative to single-echo fMRI, especially in regions with large susceptibility effects and for T2-dominant analyses. Using a working memory task, the extent of activation was highest with T2 *-weighting, while smaller clusters were observed with quantitative T2 * and T2. SAGE-fMRI couples the high BOLD sensitivity from multi-gradient-echo acquisitions with improved spatial localization from spin-echo acquisitions, providing two contrasts for analysis. SAGE-fMRI provides substantial advantages, including improving CNR and tSNR for more accurate analysis.

Simultaneous quantification of perfusion, permeability, and leakage effects in brain gliomas using dynamic spin-and-gradient-echo echoplanar imaging MRI

OBJECTIVE

To determine the feasibility and biologic correlations of dynamic susceptibility contrast (DSC), dynamic contrast enhanced (DCE), and quantitative maps derived from contrast leakage effects obtained simultaneously in gliomas using dynamic spin-and-gradient-echo echoplanar imaging (dynamic SAGE-EPI) during a single contrast injection.

MATERIALS AND METHODS

Thirty-eight patients with enhancing brain gliomas were prospectively imaged with dynamic SAGE-EPI, which was processed to compute traditional DSC metrics (normalized relative cerebral blood flow [nrCBV], percentage of signal recovery [PSR]), DCE metrics (volume transfer constant [Ktrans], extravascular compartment [ve]), and leakage effect metrics: ΔR2,ss* (reflecting T2*-leakage effects), ΔR1,ss (reflecting T1-leakage effects), and the transverse relaxivity at tracer equilibrium (TRATE, reflecting the balance between ΔR2,ss* and ΔR1,ss). These metrics were compared between patient subgroups (treatment-naïve [TN] vs recurrent [R]) and biological features (IDH status, Ki67 expression).

RESULTS

In IDH wild-type gliomas (IDHwt-i.e., glioblastomas), previous exposure to treatment determined lower TRATE (p = 0.002), as well as higher PSR (p = 0.006), Ktrans (p = 0.17), ΔR1,ss (p = 0.035), ve (p = 0.006), and ADC (p = 0.016). In IDH-mutant gliomas (IDHm), previous treatment determined higher Ktrans and ΔR1,ss (p = 0.026). In TN-gliomas, dynamic SAGE-EPI metrics tended to be influenced by IDH status (p ranging 0.09-0.14). TRATE values above 142 mM-1s-1 were exclusively seen in TN-IDHwt, and, in TN-gliomas, this cutoff had 89% sensitivity and 80% specificity as a predictor of Ki67 > 10%.

CONCLUSIONS

Dynamic SAGE-EPI enables simultaneous quantification of brain tumor perfusion and permeability, as well as mapping of novel metrics related to cytoarchitecture (TRATE) and blood-brain barrier disruption (ΔR1,ss), with a single contrast injection.

CLINICAL RELEVANCE STATEMENT

Simultaneous DSC and DCE analysis with dynamic SAGE-EPI reduces scanning time and contrast dose, respectively alleviating concerns about imaging protocol length and gadolinium adverse effects and accumulation, while providing novel leakage effect metrics reflecting blood-brain barrier disruption and tumor tissue cytoarchitecture.

KEY POINTS

• Traditionally, perfusion and permeability imaging for brain tumors requires two separate contrast injections and acquisitions. • Dynamic spin-and-gradient-echo echoplanar imaging enables simultaneous perfusion and permeability imaging. • Dynamic spin-and-gradient-echo echoplanar imaging provides new image contrasts reflecting blood-brain barrier disruption and cytoarchitecture characteristics.

Technical note: Accuracy and precision of T2 and T2* with a gradient-echo spin-echo (GESE) sequence for cardiac imaging

BACKGROUND

The use of a gradient echo spin echo (GESE) method to obtain rapid T2 and T2* estimation in the heart has been proposed. The effect of acquisition parameter settings on T2 and T2* bias and precision have not been investigated in depth.

PURPOSE

To understand factors impacting the quantification of T2 and T2* values with a gradient echo spin echo (GESE) method using echo planar imaging (EPI) readouts in a reduced field of view acquisition.

METHODS

The GESE method is implemented with a reduced field-of-view using an outer volume suppression (OVS) technique to minimize the time for multi-echo EPI readouts. The number of EPI readouts (images) for the GESE is optimized using Cramer-Rao Lower Bound (CRLB) and Monte Carlo simulations with a nonlinear least-square (NLLS) estimator. The SNR requirements were studied using the latter simulation method for a selected range of T2 and T2* values and T2/T2* ratios. Two healthy control subjects were imaged with the proposed GESE sequence and evaluated with the NLLS estimation method. In addition, the proposed OVS method was compared with a saturation bands OVS method in one subject. Clinical T2 and T2* mappings were used as the reference.

RESULTS

The optimal number of EPI readouts is five and the performance is slightly better when the refocusing pulse is placed between the 2nd and 3rd readouts. The SNR requirement for achieving a target bias < 1 ms and standard deviation (SD) < 5 ms is more demanding when T2/T2* ratio increases. The minimum SNR requirement in the GESE acquisition should vary from 6 to 20 depending on specific myocardial T2 and T2* values at 3T. The T2 and T2* estimates using the proposed OVS method and the saturation bands OVS method are both similar to the reference.

CONCLUSION

The GESE sequence with five EPI readouts is a feasible and efficient technique that can estimate T2 and T2* values in the septal myocardium within a heartbeat when the SNR requirement can be satisfied.

Accelerated Simultaneous T2 and T2* Mapping of Multiple Sclerosis Lesions Using Compressed Sensing Reconstruction of Radial RARE-EPI MRI

(1) Background: Radial RARE-EPI MRI facilitates simultaneous T₂ and T₂* mapping (2in1-RARE-EPI). With modest undersampling (R = 2), the speed gain of 2in1-RARE-EPI relative to Multi-Spin-Echo and Multi-Gradient-Recalled-Echo references is limited. Further reduction in scan time is crucial for clinical studies investigating T₂ and T₂* as imaging biomarkers. We demonstrate the feasibility of further acceleration, utilizing compressed sensing (CS) reconstruction of highly undersampled 2in1-RARE-EPI. (2) Methods: Two-fold radially-undersampled 2in1-RARE-EPI data from phantoms, healthy volunteers (n = 3), and multiple sclerosis patients (n = 4) were used as references, and undersampled (R_extra = 1-12, effective undersampling R_eff = 2-24). For each echo time, images were reconstructed using CS-reconstruction. For T₂ (RARE module) and T₂* mapping (EPI module), a linear least-square fit was applied to the images. T₂ and T₂* from CS-reconstruction of undersampled data were benchmarked against values from CS-reconstruction of the reference data. (3) Results: We demonstrate accelerated simultaneous T₂ and T₂* mapping using undersampled 2in1-RARE-EPI with CS-reconstruction is feasible. For R_extra = 6 (TA = 01:39 min), the overall MAPE was ≤8% (T₂*) and ≤4% (T₂); for R_extra = 12 (TA = 01:06 min), the overall MAPE was <13% (T₂*) and <5% (T₂). (4) Conclusion: Substantial reductions in scan time are achievable for simultaneous T₂ and T₂* mapping of the brain using highly undersampled 2in1-RARE-EPI with CS-reconstruction.

Development of a novel 10-echo multi-contrast sequence based on EPIK to deliver simultaneous quantification of T2 and T2 * with application to oxygen extraction fraction

PURPOSE

The simultaneous quantification of T₂ and T₂ * maps based on fast sequences for combined GE and SE acquisition has rekindled research and clinical interest by offering a wide range of attractive applications, e.g., dynamic tracking of oxygen extraction fraction (OEF). However, previously published methods based on EPI-readouts have been hindered by resolution and the number of acquired echoes.

METHODS

This work presents a novel 10-echo GE-SE EPIK (EPI with keyhole) sequence for the rapid quantification of T₂ '. T₂ /T₂ * maps from the GE-SE EPIK sequence were validated using three phantoms and 15 volunteers at 3T. The incorporation of a sliding window approach, combined with the full sampling of the k-space center inherent to EPIK, enables a high effective temporal resolution. That is, for an eight-slice breath-hold experiment, a temporal sampling rate of eight reconstructed slices per 1.1 s.

RESULTS

In comparison with repeated single-echo SE, multi-echo GE, and spectroscopy methods, the GE-SE EPIK sequence shows good agreement in quantifying T₂ /T₂ * values, while the gray matter/white matter separation yielded the expected contrast differentiation. The OEF was calculated with a view to an initial application with clinical relevance, producing results comparable to those in the literature and with good sensitivity in breath-hold experiments.

CONCLUSIONS

GE-SE EPIK provides increased resolution and more echoes, including two SEs, than comparable sequences. Moreover, GE-SE EPIK achieves this within an acquisition time of 57 s for 20 slices (matrix size = 128×128; FOV = 24 cm) and with a reasonably short TE for the final echo (114 ms). The sequence can dynamically track OEF changes in a breath-hold experiment.

Blip up-down acquisition for spin- and gradient-echo imaging (BUDA-SAGE) with self-supervised denoising enables efficient T2 , T2 *, para- and dia-magnetic susceptibility mapping

PURPOSE

To rapidly obtain high resolution T₂ , T₂ *, and quantitative susceptibility mapping (QSM) source separation maps with whole-brain coverage and high geometric fidelity.

METHODS

We propose Blip Up-Down Acquisition for Spin And Gradient Echo imaging (BUDA-SAGE), an efficient EPI sequence for quantitative mapping. The acquisition includes multiple T₂ *-, T₂ '-, and T₂ -weighted contrasts. We alternate the phase-encoding polarities across the interleaved shots in this multi-shot navigator-free acquisition. A field map estimated from interim reconstructions was incorporated into the joint multi-shot EPI reconstruction with a structured low rank constraint to eliminate distortion. A self-supervised neural network (NN), MR-Self2Self (MR-S2S), was used to perform denoising to boost SNR. Using Slider encoding allowed us to reach 1 mm isotropic resolution by performing super-resolution reconstruction on volumes acquired with 2 mm slice thickness. Quantitative T₂ (=1/R₂ ) and T₂ * (=1/R₂ *) maps were obtained using Bloch dictionary matching on the reconstructed echoes. QSM was estimated using nonlinear dipole inversion on the gradient echoes. Starting from the estimated R₂ /R₂ * maps, R₂ ' information was derived and used in source separation QSM reconstruction, which provided additional para- and dia-magnetic susceptibility maps.

RESULTS

In vivo results demonstrate the ability of BUDA-SAGE to provide whole-brain, distortion-free, high-resolution, multi-contrast images and quantitative T₂ /T₂ * maps, as well as yielding para- and dia-magnetic susceptibility maps. Estimated quantitative maps showed comparable values to conventional mapping methods in phantom and in vivo measurements.

CONCLUSION

BUDA-SAGE acquisition with self-supervised denoising and Slider encoding enables rapid, distortion-free, whole-brain T₂ /T₂ * mapping at 1 mm isotropic resolution under 90 s.

A multi-inversion multi-echo spin and gradient echo echo planar imaging sequence with low image distortion for rapid quantitative parameter mapping and synthetic image contrasts

PURPOSE

Brain imaging exams typically take 10-20 min and involve multiple sequential acquisitions. A low-distortion whole-brain echo planar imaging (EPI)-based approach was developed to efficiently encode multiple contrasts in one acquisition, allowing for calculation of quantitative parameter maps and synthetic contrast-weighted images.

METHODS

Inversion prepared spin- and gradient-echo EPI was developed with slice-order shuffling across measurements for efficient acquisition with T1 , T2 , and T 2 ∗ weighting. A dictionary-matching approach was used to fit the images to quantitative parameter maps, which in turn were used to create synthetic weighted images with typical clinical contrasts. Dynamic slice-optimized multi-coil shimming with a B0 shim array was used to reduce B0 inhomogeneity and, therefore, image distortion by >50%. Multi-shot EPI was also implemented to minimize distortion and blurring while enabling high in-plane resolution. A low-rank reconstruction approach was used to mitigate errors from shot-to-shot phase variation.

RESULTS

The slice-optimized shimming approach was combined with in-plane parallel-imaging acceleration of 4× to enable single-shot EPI with more than eight-fold distortion reduction. The proposed sequence efficiently obtained 40 contrasts across the whole-brain in just over 1 min at 1.2 × 1.2 × 3 mm resolution. The multi-shot variant of the sequence achieved higher in-plane resolution of 1 × 1 × 4 mm with good image quality in 4 min. Derived quantitative maps showed comparable values to conventional mapping methods.

CONCLUSION

The approach allows fast whole-brain imaging with quantitative parameter maps and synthetic weighted contrasts. The slice-optimized multi-coil shimming and multi-shot reconstruction approaches result in minimal EPI distortion, giving the sequence the potential to be used in rapid screening applications.

Investigating the relationship between multi-scale perfusion and white matter microstructural integrity in patients with relapsing-remitting MS

Background

Multiple sclerosis is characterized by the formation of central nervous system demyelinating lesions with microvasculature inflammation.

Objective

Evaluate how lesion cerebral perfusion relates to white matter microstructural integrity in patients with RRMS using perfusion MRI and myelin-related T₁-weighted to T₂-weighted (T₁w/T₂w) ratios.

Methods

Forty-eight patients with RRMS were imaged with dynamic susceptibility contrast imaging using SAGE (spin- and gradient-echo) to calculate global and capillary-sized perfusion parameters, including cerebral blood flow (CBF), volume (CBV), and mean transit time (MTT). T₁w/T₂w ratios were used to indirectly assess white matter microstructural integrity.

Results

For global perfusion metrics, CBF was reduced 28.4% in lesion regions of interest (ROIs) compared to normal appearing white matter (NAWM), CBV was reduced 25.9% in lesion ROIs compared to NAWM, and MTT increased 12.9%. For capillary perfusion metrics (via spin-echo (SE)), CBF-SE was reduced 35.7% in lesion ROIs compared to NAWM, CBV-SE was reduced 35.2% in lesion ROIs compared to NAWM, and MTT-SE increased 9.1%. Capillary-level CBF was correlated (ρ = 0.34, p = 0.024) with white matter microstructural integrity in lesion ROIs.

Conclusion

This study demonstrates that lesion perfusion is reduced at both the global and capillary level and capillary-associated hypoperfusion is associated with reduced white matter microstructural integrity in RRMS.

Non-Invasive Evaluation of Cerebral Microvasculature Using Pre-Clinical MRI: Principles, Advantages and Limitations

Alterations to the cerebral microcirculation have been recognized to play a crucial role in the development of neurodegenerative disorders. However, the exact role of the microvascular alterations in the pathophysiological mechanisms often remains poorly understood. The early detection of changes in microcirculation and cerebral blood flow (CBF) can be used to get a better understanding of underlying disease mechanisms. This could be an important step towards the development of new treatment approaches. Animal models allow for the study of the disease mechanism at several stages of development, before the onset of clinical symptoms, and the verification with invasive imaging techniques. Specifically, pre-clinical magnetic resonance imaging (MRI) is an important tool for the development and validation of MRI sequences under clinically relevant conditions. This article reviews MRI strategies providing indirect non-invasive measurements of microvascular changes in the rodent brain that can be used for early detection and characterization of neurodegenerative disorders. The perfusion MRI techniques: Dynamic Contrast Enhanced (DCE), Dynamic Susceptibility Contrast Enhanced (DSC) and Arterial Spin Labeling (ASL), will be discussed, followed by less established imaging strategies used to analyze the cerebral microcirculation: Intravoxel Incoherent Motion (IVIM), Vascular Space Occupancy (VASO), Steady-State Susceptibility Contrast (SSC), Vessel size imaging, SAGE-based DSC, Phase Contrast Flow (PC) Quantitative Susceptibility Mapping (QSM) and quantitative Blood-Oxygenation-Level-Dependent (qBOLD). We will emphasize the advantages and limitations of each strategy, in particular on applications for high-field MRI in the rodent's brain.

Echo planar time-resolved imaging with subspace reconstruction and optimized spatiotemporal encoding

PURPOSE

To develop new encoding and reconstruction techniques for fast multi-contrast/quantitative imaging.

METHODS

The recently proposed Echo Planar Time-resolved Imaging (EPTI) technique can achieve fast distortion- and blurring-free multi-contrast/quantitative imaging. In this work, a subspace reconstruction framework is developed to improve the reconstruction accuracy of EPTI at high encoding accelerations. The number of unknowns in the reconstruction is significantly reduced by modeling the temporal signal evolutions using low-rank subspace. As part of the proposed reconstruction approach, a B₀ -update algorithm and a shot-to-shot B₀ variation correction method are developed to enable the reconstruction of high-resolution tissue phase images and to mitigate artifacts from shot-to-shot phase variations. Moreover, the EPTI concept is extended to 3D k-space for 3D GE-EPTI, where a new "temporal-variant" of CAIPI encoding is proposed to further improve performance.

RESULTS

The effectiveness of the proposed subspace reconstruction was demonstrated first in 2D GESE EPTI, where the reconstruction achieved higher accuracy when compared to conventional B₀ -informed GRAPPA. For 3D GE-EPTI, a retrospective undersampling experiment demonstrates that the new temporal-variant CAIPI encoding can achieve up to 72× acceleration with close to 2× reduction in reconstruction error when compared to conventional spatiotemporal-CAIPI encoding. In a prospective undersampling experiment, high-quality whole-brain T 2 ∗ and tissue phase maps at 1 mm isotropic resolution were acquired in 52 seconds at 3T using 3D GE-EPTI with temporal-variant CAIPI encoding.

CONCLUSION

The proposed subspace reconstruction and optimized temporal-variant CAIPI encoding can further improve the performance of EPTI for fast quantitative mapping.

Propeller echo-planar time-resolved imaging with dynamic encoding (PEPTIDE)

PURPOSE

To develop a motion-robust extension to the recently developed echo-planar time-resolved imaging (EPTI) approach, referred to as PROPELLER EPTI with dynamic encoding (PEPTIDE), by incorporating rotations into the rapid, multishot acquisition to enable shot-to-shot motion correction.

METHODS

Echo-planar time-resolved imaging is a multishot EPI-based approach that allows extremely rapid acquisition of distortion-free and blurring-free multicontrast imaging and quantitative mapping. By combining k-space encoding rotations into the EPTI sampling strategy to repeatedly sample the low-resolution k-space center, PEPTIDE enables significant tolerance to shot-to-shot motion and B₀ phase variations. Retrospective PEPTIDE data sets are created through a combination of in vivo EPTI data sets with rotationally acquired protocols, to enable direct comparison of the 2 methods and their robustness to identical motion. The PEPTIDE data sets are also prospectively acquired and again compared with EPTI, in the presence of true subject motion.

RESULTS

The PEPTIDE approach is shown to be motion-robust to even severe subject motion (demonstrated > 30° in-plane rotation, alongside translational and through-plane motion), while maintaining the rapid encoding benefits of the EPTI technique. The technique enables accurate quantitative maps to be calculated from even severe motion data sets. While the performance of the motion correction depends on the type and severity of motion encountered, in all cases PEPTIDE significantly increases image quality in the presence of motion comparative to conventional EPTI.

CONCLUSION

The newly developed PEPTIDE technique combines a high degree of motion tolerance into the EPTI framework, enabling highly rapid acquisition of distortion-free and blurring-free images at multiple TEs in the presence of motion.

In vivo measurements of irreversible and reversible transverse relaxation rates in human basal ganglia at 7 T: making inferences about the microscopic and mesoscopic structure of iron and calcification deposits

The goal of this study was to measure irreversible and reversible transverse relaxation rates in the globus pallidus and putamen at 7 T, and to use these rates to make inferences about the sub-voxel structure of iron and calcification deposits. Gradient Echo Sampling of a Spin Echo (GESSE) data were acquired at 7 T on eighteen volunteers spanning a large range of ages (23-85 years), with calcifications in the globus pallidus incidentally observed in one volunteer. Maps of transverse relaxation rates were derived from the GESSE data, and the mean value of these rates in globus pallidus and putamen was estimated for each volunteer. Both irreversible and reversible transverse relaxation rates increased with the expected age-dependent iron content in these structures, except for the individual with calcifications for whom extremely large reversible relaxation rates but normal irreversible relaxation rates were found in the globus pallidus. Given the sensitivity of irreversible and reversible transverse relaxation rates to microscopic and mesoscopic field variations, respectively, our findings suggest that joint consideration of these rates may yield information not only about the amount of iron and calcification deposited in the brain, but also about the sub-voxel structure of these deposits, perhaps revealing certain aspects of their geometry and cellular distribution.

Accelerated whole-brain perfusion imaging using a simultaneous multislice spin-echo and gradient-echo sequence with joint virtual coil reconstruction

PURPOSE

Dynamic susceptibility contrast imaging requires high temporal sampling, which poses limits on achievable spatial coverage and resolution. Additionally, more encoding-intensive multi-echo acquisitions for quantitative imaging are desired to mitigate contrast leakage effects, which further limits spatial encoding. We present an accelerated sequence that provides whole-brain coverage at an improved spatio-temporal resolution, to allow for dynamic quantitative R2 and R2 * mapping during contrast-enhanced imaging.

METHODS

A multi-echo spin and gradient-echo sequence was implemented with simultaneous multislice acquisition. Complementary k-space sampling between repetitions and joint virtual coil reconstruction were used along with a dynamic phase-matching technique to achieve high-quality reconstruction at 9-fold acceleration, which enabled 2 × 2 × 5 mm whole-brain imaging at TR of 1.5 to 1.7 seconds. The multi-echo images from this sequence were fit to achieve quantitative R2 and R2 * maps for each repetition, and subsequently used to find perfusion measures including cerebral blood flow and cerebral blood volume.

RESULTS

Images reconstructed using joint virtual coil show improved image quality and g-factor compared with conventional reconstruction methods, resulting in improved quantitative maps with a 9-fold acceleration factor and whole-brain coverage during the dynamic perfusion acquisition.

CONCLUSION

The method presented shows the advantage of using a joint virtual coil-GRAPPA reconstruction to allow for high acceleration factors while maintaining reliable image quality for quantitative perfusion mapping, with the potential to improve tumor diagnostics and monitoring.

Echo planar time-resolved imaging (EPTI)

PURPOSE

To develop an efficient distortion- and blurring-free multi-shot EPI technique for time-resolved multiple-contrast and/or quantitative imaging.

METHODS

EPI is a commonly used sequence but suffers from geometric distortions and blurring. Here, we introduce a new multi-shot EPI technique termed echo planar time-resolved imaging (EPTI), which has the ability to rapidly acquire distortion- and blurring-free multi-contrast data set. The EPTI approach performs encoding in ky -t space and uses a new highly accelerated spatio-temporal CAIPI sampling trajectory to take advantage of signal correlation along these dimensions. Through this acquisition and a B0 -informed parallel imaging reconstruction, hundreds of "time-resolved" distortion- and blurring-free images at different TEs across the EPI readout window can be created at sub-millisecond temporal increments using a small number of EPTI shots. Moreover, a method for self-estimation and correction of shot-to-shot B0 variations was developed. Simultaneous multi-slice acquisition was also incorporated to further improve the acquisition efficiency.

RESULTS

We evaluated EPTI under varying simulated acceleration factors, B0 -inhomogeneity, and shot-to-shot B0 variations to demonstrate its ability to provide distortion- and blurring-free images at multiple TEs. Two variants of EPTI were demonstrated in vivo at 3T: (1) a combined gradient- and spin-echo EPTI for quantitative mapping of T2 , T2* , proton density, and susceptibility at 1.1 × 1.1 × 3 mm3 whole-brain in 28 s (0.8 s/slice), and (2) a gradient-echo EPTI, for multi-echo and quantitative T2* fMRI at 2 × 2 × 3 mm3 whole-brain at a 3.3 s temporal resolution.

CONCLUSION

EPTI is a new approach for multi-contrast and/or quantitative imaging that can provide fast acquisition of distortion- and blurring-free images at multiple TEs.

Simultaneous R2, R2' and R2* measurement of skeletal muscle in a rabbit model of unilateral artery embolization

PURPOSE

To demonstrate the feasibility of using a susceptibility-based MRI technique with multi-echo gradient and spin echo (MEGSE) sequence to achieve simultaneous R2, R2' and R2* measurement and assess skeletal muscle oxygenation alternations in a rabbit model of unilateral artery embolization.

MATERIALS AND METHODS

Approved by the local institutional review board for experimental animal studies, nine New Zealand White rabbits were included in this study. The MEGSE sequence consists of embedding a set of gradient echoes around the echo of a single spin-echo sequence using several gradient echoes to collect the magnetization intensity during the formation and attenuation of spin-echo simultaneously after 180° radio frequency pulse. Within-session and between-day tests were conducted to evaluate the reproducibility of this skeletal muscle oxygenation alternations measurement. Furthermore, all the MEGSE scans of skeletal muscle were conducted using a 3-T clinical MRI scanner during resting state (before unilateral artery embolization operation, pre), 1 h after unilateral artery embolization operation (post1) and 2 h after unilateral artery embolization operation (post2) model to verify the feasibility and sensitivity of this method.

RESULTS

The within-session coefficient of variations (CVs) of R2, R2' and R2* measurements were 1.57%, 3.33% and 2.57%, while the between-day CVs of were 1.42%, 5.85% and 2.85%. In all rabbits, the mean R2 decreased significantly from 36.46 ± 1.03 s^-1 (pre) to 30.58 ± 2.11 s^-1 (post1,**P < 0.01, relative to pre) and 28.62 ± 1.53 s^-1 (post2, **P < 0.01, relative to post1), and the mean R2' went up markedly from 9.88 ± 2.14 s^-1 (pre) to 16.10 ± 2.74 s^-1 (post1, **P < 0.01) and 17.33 ± 2.25 s^-1 (post2, **P < 0.05). The mean R2* increased from 43.27 ± 3.75 s^-1 (pre) to 47.90 ± 5.08 s^-1 (post1, *P < 0.05) and to 48.04 ± 4.42 s^-1 (post2, NS, P > 0.05).

CONCLUSION

This study demonstrates the feasibility of simultaneous R2, R2' and R2* measurement method for the evaluation of skeletal muscle ischemia. Besides, this study indicates the sensitivity of the R2 and R2' compared with R2* and especially the necessity of R2 and R2' measurement for the further evaluation of skeletal muscle ischemia which always causes both edema and hypoxia in a rabbit model of unilateral artery embolization.

Validation of vessel size imaging (VSI) in high-grade human gliomas using magnetic resonance imaging, image-guided biopsies, and quantitative immunohistochemistry

To evaluate the association between a vessel size index (VSIMRI) derived from dynamic susceptibility contrast (DSC) perfusion imaging using a custom spin-and-gradient echo echoplanar imaging (SAGE-EPI) sequence and quantitative estimates of vessel morphometry based on immunohistochemistry from image-guided biopsy samples. The current study evaluated both relative cerebral blood volume (rCBV) and VSIMRI in eleven patients with high-grade glioma (7 WHO grade III and 4 WHO grade IV). Following 26 MRI-guided glioma biopsies in these 11 patients, we evaluated tissue morphometry, including vessel density and average radius, using an automated procedure based on the endothelial cell marker CD31 to highlight tumor vasculature. Measures of rCBV and VSIMRI were then compared to histological measures. We demonstrate good agreement between VSI measured by MRI and histology; VSIMRI = 13.67 μm and VSIHistology = 12.60 μm, with slight overestimation of VSIMRI in grade III patients compared to histology. rCBV showed a moderate but significant correlation with vessel density (r = 0.42, p = 0.03), and a correlation was also observed between VSIMRI and VSIHistology (r = 0.49, p = 0.01). The current study supports the hypothesis that vessel size measures using MRI accurately reflect vessel caliber within high-grade gliomas, while traditional measures of rCBV are correlated with vessel density and not vessel caliber.

Perfusion weighted imaging using combined gradient/spin echo EPIK: Brain tumour applications in hybrid MR-PET

Advanced perfusion-weighted imaging (PWI) methods that combine gradient echo (GE) and spin echo (SE) data are important tools for the study of brain tumours. In PWI, single-shot, EPI-based methods have been widely used due to their relatively high imaging speed. However, when used with increasing spatial resolution, single-shot EPI methods often show limitations in whole-brain coverage for multi-contrast applications. To overcome this limitation, this work employs a new version of EPI with keyhole (EPIK) to provide five echoes: two with GEs, two with mixed GESE and one with SE; the sequence is termed "GESE-EPIK." The performance of GESE-EPIK is evaluated against its nearest relative, EPI, in terms of the temporal signal-to-noise ratio (tSNR). Here, data from brain tumour patients were acquired using a hybrid 3T MR-BrainPET scanner. GESE-EPIK resulted in reduced susceptibility artefacts, shorter TEs for the five echoes and increased brain coverage when compared to EPI. Moreover, compared to EPI, EPIK achieved a comparable tSNR for the first and second echoes and significantly higher tSNR for other echoes. A new method to obtain multi-echo GE and SE data with shorter TEs and increased brain coverage is demonstrated. As proposed here, the workflow can be shortened and the integration of multimodal clinical MR-PET studies can be facilitated.

Simultaneous pH-sensitive and oxygen-sensitive MRI of human gliomas at 3 T using multi-echo amine proton chemical exchange saturation transfer spin-and-gradient echo echo-planar imaging (CEST-SAGE-EPI)

PURPOSE

To introduce a new pH-sensitive and oxygen-sensitive MRI technique using amine proton CEST echo spin-and-gradient echo (SAGE) EPI (CEST-SAGE-EPI).

METHODS

pH-weighting was obtained using CEST estimations of magnetization transfer ratio asymmetry (MTRasym ) at 3 ppm, and oxygen-weighting was obtained using R2' measurements. Glutamine concentration, pH, and relaxation rates were varied in phantoms to validate simulations and estimate relaxation rates. The values of MTRasym and R2' in normal-appearing white matter, T2 hyperintensity, contrast enhancement, and macroscopic necrosis were measured in 47 gliomas.

RESULTS

Simulation and phantom results confirmed an increase in MTRasym with decreasing pH. The CEST-SAGE-EPI estimates of R2 , R2*, and R2' varied linearly with gadolinium diethylenetriamine penta-acetic acid concentration (R2  = 6.2 mM-1 ·sec-1 and R2* = 6.9 mM-1 ·sec-1 ). The CEST-SAGE-EPI and Carr-Purcell-Meiboom-Gill estimates of R2 (R2  = 0.9943) and multi-echo gradient-echo estimates of R2* (R2  = 0.9727) were highly correlated. T2 lesions had lower R2' and higher MTRasym compared with normal-appearing white matter, suggesting lower hypoxia and high acidity, whereas contrast-enhancement tumor regions had elevated R2' and MTRasym , indicating high hypoxia and acidity.

CONCLUSION

The CEST-SAGE-EPI technique provides simultaneous pH-sensitive and oxygen-sensitive image contrasts for evaluation of the brain tumor microenvironment. Advantages include fast whole-brain acquisition, in-line B0 correction, and simultaneous estimation of CEST effects, R2 , R2*, and R2' at 3 T.

Evaluation of renal oxygenation change under the influence of carbogen breathing using a dynamic R2 , R2 ' and R2 * quantification approach

The purpose of this study is to demonstrate the feasibility of dynamic renal R₂ /R₂ '/R₂ * measurements based on a method, denoted psMASE-ME, in which a periodic 180° pulse-shifting multi-echo asymmetric spin echo (psMASE) sequence, combined with a moving estimation (ME) strategy, is adopted. Following approval by the institutional animal care and use committee, a block design of respiratory challenge with interleaved air and carbogen (97% O₂ , 3% CO₂ ) breathing was employed in nine rabbits. Parametrical R₂ /R₂ '/R₂ * maps were computed and average R₂ /R₂ '/R₂ * values were measured in regions of interest in the renal medulla and cortex. Bland-Altman plots showed good agreement between the proposed method and reference standards of multi-echo spin echo and multi-echo gradient echo sequences. Renal R₂ , R₂ ' and R₂ * decreased significantly from 16.2 ± 4.4 s^-1 , 9.8 ± 5.2 s^-1 and 25.9 ± 5.0 s^-1 to 14.9 ± 4.4 s^-1 (p < 0.05), 8.5 ± 4.1 s^-1 (p < 0.05) and 23.4 ± 4.8 s^-1 (p < 0.05) in the cortex when switching the gas mixture from room air to carbogen. In the renal medulla, R₂ , R₂ ' and R₂ * also decreased significantly from 12.9 ± 4.7 s^-1 , 15.1 ± 5.8 s^-1 and 27.9 ± 5.3 s^-1 to 11.8 ± 4.5 s^-1 (p < 0.05), 14.2 ± 4.2 s^-1 (p < 0.05) and 25.8 ± 5.1 s^-1 (p < 0.05). No statistically significant differences in relative R₂ , R₂ ' and R₂ * changes were observed between the cortex and medulla (p = 0.72 for R₂ , p = 0.39 for R₂ ' and p = 0.61 for R₂ *). The psMASE-ME method for dynamic renal R₂ /R₂ '/R₂ * measurements, together with the respiratory challenge, has potential use in the evaluation of renal oxygenation in many renal diseases.

Assessment of a simplified spin and gradient echo (sSAGE) approach for human brain tumor perfusion imaging

The goal of this study was to validate a simplified spin- and gradient-echo (sSAGE) approach to obtain T₁-corrected dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) data in a clinical brain tumor population. A five-echo SAGE sequence was used to acquire DSC-MRI data (n=8 patients, 3 primary glioma, and 5 brain metastases). The ΔR₂^⁎ and ΔR₂ time series obtained from a nonlinear fit of all echoes (SAGE) were compared to ΔR₂^⁎ and ΔR₂ time series obtained analytically (sSAGE) using three echoes (two GEs and one SE). Through the use of multiple echoes, both methods removed T₁ leakage effects from the ΔR₂^⁎ and ΔR₂ time series, and the sSAGE ΔR₂^⁎ and ΔR₂ time series were highly correlated with those from SAGE, with average correlations of 0.9. The resulting hemodynamic parameters included GE and SE cerebral blood volume (CBV), cerebral blood flow (CBF), mean vessel diameter (mVD), volume transfer constant (K^trans), and volume fraction of the extravascular extracellular space (v_e). For each metric, there was good correlation (>0.86) between sSAGE and SAGE, with no significant differences. The sSAGE method provides T₁-corrected GE and SE DSC-MRI parameters in an efficient and clinically feasible manner.

Matching of postcontraction perfusion to oxygen consumption across submaximal contraction intensities in exercising humans

Studying the magnitude and kinetics of blood flow, oxygen extraction, and oxygen consumption at exercise onset and during the recovery from exercise can lead to insights into both the normal control of metabolism and blood flow and the disturbances to these processes in metabolic and cardiovascular diseases. The purpose of this study was to examine the on- and off-kinetics for oxygen delivery, extraction, and consumption as functions of submaximal contraction intensity. Eight healthy subjects performed four 1-min isometric dorsiflexion contractions, with two at 20% MVC and two at 40% MVC. During one contraction at each intensity, relative perfusion changes were measured by using arterial spin labeling, and the deoxyhemoglobin percentage (%HHb) was estimated using the spin- and gradient-echo sequence and a previously published empirical calibration. For the whole group, the mean perfusion did not increase during contraction. The %HHb increased from ∼28 to 38% during contractions of each intensity, with kinetics well described by an exponential function and mean response times (MRTs) of 22.7 and 21.6 s for 20 and 40% MVC, respectively. Following contraction, perfusion increased ∼2.5-fold. The %HHb, oxygen consumption, and perfusion returned to precontraction levels with MRTs of 27.5, 46.4, and 50.0 s, respectively (20% MVC), and 29.2, 75.3, and 86.0 s, respectively (40% MVC). These data demonstrate in human subjects the varied recovery rates of perfusion and oxygen consumption, along with the similar rates of %HHb recovery, across these exercise intensities.

A simplified spin and gradient echo approach for brain tumor perfusion imaging

PURPOSE

In this study, we propose a simplified acquisition and analysis approach for spin and gradient echo (SAGE)-based dynamic susceptibility-contrast MRI (DSC-MRI) data that is free of contrast agent T1 leakage effects.

METHODS

A five-echo SAGE sequence was used to acquire DSC-MRI data in rat C6 tumors (n = 7). Nonlinear fitting of all echoes was performed to obtain T1-insensitive ΔR2* and ΔR2 time series. The simplified approach, which includes two gradient echoes and one spin echo, was also used to analytically compute T1-insensitive ΔR2* using the two gradient echoes and ΔR2 using all three echoes. The blood flow, blood volume, and vessel size values derived from each method were compared.

RESULTS

In all cases, the five-echo and simplified SAGE ΔR2* and ΔR2 were in excellent agreement and demonstrated significant T1 leakage correction compared with the uncorrected single-echo data. The derived hemodynamic parameters for blood volume, blood flow, and vessel size were not significantly different between the two methods.

CONCLUSIONS

The proposed simplified SAGE technique enables the acquisition of gradient and spin echo DSC-MRI data corrected for T1 leakage effects yields parameters that are in agreement with the five-echo SAGE approach and does not require nonlinear fitting to extract ΔR2* and ΔR2 time series.

Vessel caliber--a potential MRI biomarker of tumour response in clinical trials

Our understanding of the importance of blood vessels and angiogenesis in cancer has increased considerably over the past decades, and the assessment of tumour vessel calibre and structure has become increasingly important for in vivo monitoring of therapeutic response. The preferred method for in vivo imaging of most solid cancers is MRI, and the concept of vessel-calibre MRI has evolved since its initial inception in the early 1990s. Almost a quarter of a century later, unlike traditional contrast-enhanced MRI techniques, vessel-calibre MRI remains widely inaccessible to the general clinical community. The narrow availability of the technique is, in part, attributable to limited awareness and a lack of imaging standardization. Thus, the role of vessel-calibre MRI in early phase clinical trials remains to be determined. By contrast, regulatory approvals of antiangiogenic agents that are not directly cytotoxic have created an urgent need for clinical trials incorporating advanced imaging analyses, going beyond traditional assessments of tumour volume. To this end, we review the field of vessel-calibre MRI and summarize the emerging evidence supporting the use of this technique to monitor response to anticancer therapy. We also discuss the potential use of this biomarker assessment in clinical imaging trials and highlight relevant avenues for future research.

Evaluation of a multiple spin- and gradient-echo (SAGE) EPI acquisition with SENSE acceleration: applications for perfusion imaging in and outside the brain

Perfusion-based changes in MR signal intensity can occur in response to the introduction of exogenous contrast agents and endogenous tissue properties (e.g. blood oxygenation). MR measurements aimed at capturing these changes often implement single-shot echo planar imaging (ssEPI). In recent years ssEPI readouts have been combined with parallel imaging (PI) to allow fast dynamic multi-slice imaging as well as the incorporation of multiple echoes. A multiple spin- and gradient-echo (SAGE) EPI acquisition has recently been developed to allow measurement of transverse relaxation rate (R2 and R2(*)) changes in dynamic susceptibility contrast (DSC)-MRI experiments in the brain. With SAGE EPI, the use of PI can influence image quality, temporal resolution, and achievable echo times. The effect of PI on dynamic SAGE measurements, however, has not been evaluated. In this work, a SAGE EPI acquisition utilizing SENSE PI and partial Fourier (PF) acceleration was developed and evaluated. Voxel-wise measures of R2 and R2(*) in healthy brain were compared using SAGE EPI and conventional non-EPI multiple echo acquisitions with varying SENSE and PF acceleration. A conservative SENSE factor of 2 with PF factor of 0.73 was found to provide accurate measures of R2 and R2(*) in white (WM) (rR2=[0.55-0.79], rR2*=[0.47-0.71]) and gray (GM) matter (rR2=[0.26-0.59], rR2*=[0.39-0.74]) across subjects. The combined use of SENSE and PF allowed the first dynamic SAGE EPI measurements in muscle, with a SENSE factor of 3 and PF factor of 0.6 providing reliable relaxation rate estimates when compared to multi-echo methods. Application of the optimized SAGE protocol in DSC-MRI of high-grade glioma patients provided T1 leakage-corrected estimates of CBV and CBF as well as mean vessel diameter (mVD) and simultaneous measures of DCE-MRI parameters K(trans) and ve. Likewise, application of SAGE in a muscle reperfusion model allowed dynamic measures of R2', a parameter that has been shown to correlate with muscle oxy-hemoglobin saturation.

Assessment of a combined spin- and gradient-echo (SAGE) DSC-MRI method for preclinical neuroimaging

The goal of this study was to optimize and validate a combined spin- and gradient-echo (SAGE) sequence for dynamic susceptibility-contrast magnetic resonance imaging to obtain hemodynamic parameters in a preclinical setting. The SAGE EPI sequence was applied in phantoms and in vivo rat brain (normal, tumor, and stroke tissue). Partial and full Fourier encoding schemes were implemented and characterized. Maps of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), vessel size index (VSI), volume transfer constant (K(trans)), and volume fraction of the extravascular extracellular space (ve) were obtained. Partial Fourier encoding provided shortened echo times with acceptable signal-to-noise ratio and temporal stability, thus enabling reliable characterization of T2, T2(*) and T1 in both phantoms and rat brain. The hemodynamic parameters CBV, CBF, and MTT for gradient-echo and spin-echo contrast were determined in tumor and stroke; VSI, K(trans), and ve were also computed in tumor tissue. The SAGE EPI sequence allows the acquisition of multiple gradient- and spin-echoes, from which measures of perfusion, permeability, and vessel size can be obtained in a preclinical setting. Partial Fourier encoding can be used to minimize SAGE echo times and reliably quantify dynamic T2 and T2(*) changes. This acquisition provides a more comprehensive assessment of hemodynamic status in brain tissue with vascular and perfusion abnormalities.

Slab profile encoding (PEN) for minimizing slab boundary artifact in three-dimensional diffusion-weighted multislab acquisition

PURPOSE

To propose a method for mitigating slab boundary artifacts in three-dimensional (3D) multislab diffusion imaging with no or minimal increases in scan time.

METHODS

The multislab acquisition was treated as parallel imaging acquisition where the slab profiles acted as the traditional receiver sensitivity profiles. All the slabs were then reconstructed simultaneously along the slab direction using Cartesian-based sensitivity encoding (SENSE) reconstruction. The slab profile estimation was performed using either a Bloch simulation or a calibration scan.

RESULTS

Both phantom and in vivo results showed negligible slab boundary artifacts after reconstruction using the proposed method. The performance of the proposed method is comparable to the state-of-the-art slab combination method without the scan time penalty that depends on the number of acquired volumes. The obtained g-factor map of the SENSE reconstruction problem showed a maximum g-factor of 1.7 in the region of interest.

CONCLUSION

We proposed a novel method for mitigating slab boundary artifacts in 3D diffusion imaging by treating the multislab acquisition as a parallel imaging acquisition and reconstructing all slabs simultaneously using Cartesian SENSE. Unlike existing methods, the scan time increase, if any, does not scale with the number of image volumes acquired.

Simultaneous perfusion and permeability measurements using combined spin- and gradient-echo MRI

The purpose of this study was to estimate magnetic resonance imaging-based brain perfusion parameters from combined multiecho spin-echo and gradient-echo acquisitions, to correct them for T₁₋, T₂₋, and T₂₋*-related contrast agent (CA) extravasation effects, and to simultaneously determine vascular permeability. Perfusion data were acquired using a combined multiecho spin- and gradient-echo (SAGE) echo-planar imaging sequence, which was corrected for CA extravasation effects using pharmacokinetic modeling. The presented method was validated in simulations and brain tumor patients, and compared with uncorrected single-echo and multiecho data. In the presence of CA extravasation, uncorrected single-echo data resulted in underestimated CA concentrations, leading to underestimated single-echo cerebral blood volume (CBV) and mean transit time (MTT). In contrast, uncorrected multiecho data resulted in overestimations of CA concentrations, CBV, and MTT. The correction of CA extravasation effects resulted in CBV and MTT estimates that were more consistent with the underlying tissue characteristics. Spin-echo perfusion data showed reduced large-vessel blooming effects, facilitating better distinction between increased CBV due to active tumor progression and elevated CBV due to the presence of cortical vessels in tumor proximity. Furthermore, extracted permeability parameters were in good agreement with elevated T1-weighted postcontrast signal values.

Combined spin- and gradient-echo perfusion-weighted imaging

In this study, a spin- and gradient-echo echo-planar imaging (SAGE EPI) MRI pulse sequence is presented that allows simultaneous measurements of gradient-echo and spin-echo dynamic susceptibility-contrast perfusion-weighted imaging data. Following signal excitation, five readout trains were acquired using spin- and gradient-echo echo-planar imaging, all of them with echo times of less than 100 ms. Contrast agent concentrations in brain tissue were determined based on absolute R2* and R(2) estimates rather than relative changes in the signals of individual echo trains, producing T(1)-independent dynamic susceptibility-contrast perfusion-weighted imaging data. Moreover, this acquisition technique enabled vessel size imaging through the simultaneous quantification of R2* and R(2), without an increase in acquisition time. In this work, the concepts of SAGE EPI pulse sequence and results in stroke and tumor imaging are presented. Overall, SAGE EPI combined the advantages of higher sensitivity to contrast agent passage of gradient-echo perfusion-weighted imaging with better microvascular selectivity of spin-echo perfusion-weighted imaging.