A new framework for interleaved scanning in cardiovascular MR: Application to image-based respiratory motion correction in coronary MR angiography

GABA, glutamatergic dynamics and BOLD contrast assessed concurrently using functional MRS during a cognitive task

A recurring issue in functional neuroimaging is how to link task-driven haemodynamic blood oxygen level dependent functional MRI (BOLD-fMRI) responses to underlying neurochemistry at the synaptic level. Glutamate and γ-aminobutyric acid (GABA), the major excitatory and inhibitory neurotransmitters respectively, are typically measured with MRS sequences separately from fMRI, in the absence of a task. The present study aims to resolve this disconnect, developing acquisition and processing techniques to simultaneously assess GABA, glutamate and glutamine (Glx) and BOLD in relation to a cognitive task, at 3 T. Healthy subjects (N = 81) performed a cognitive task (Eriksen flanker), which was presented visually in a task-OFF, task-ON block design, with individual event onset timing jittered with respect to the MRS readout. fMRS data were acquired from the medial anterior cingulate cortex during task performance, using an adapted MEGA-PRESS implementation incorporating unsuppressed water-reference signals at a regular interval. These allowed for continuous assessment of BOLD activation, through T2 *-related changes in water linewidth. BOLD-fMRI data were additionally acquired. A novel linear model was used to extract modelled metabolite spectra associated with discrete functional stimuli, building on well established processing and quantification tools. Behavioural outcomes from the flanker task, and activation patterns from the BOLD-fMRI sequence, were as expected from the literature. BOLD response assessed through fMRS showed a significant correlation with fMRI, specific to the fMRS-targeted region of interest; fMRS-assessed BOLD additionally correlated with lengthening of response time in the incongruent flanker condition. While no significant task-related changes were observed for GABA+, a significant increase in measured Glx levels (~8.8%) was found between task-OFF and task-ON periods. These findings verify the efficacy of our protocol and analysis pipelines for the simultaneous assessment of metabolite dynamics and BOLD. As well as establishing a robust basis for further work using these techniques, we also identify a number of clear directions for further refinement in future studies.

Interleaved and simultaneous multi-nuclear magnetic resonance in vivo. Review of principles, applications and potential

Magnetic resonance signals from different nuclei can be excited or received at the same time,rendering simultaneous or rapidly interleaved multi-nuclear acquisitions feasible. The advan-tages are a reduction of total scan time compared to sequential multi-nuclear acquisitions or that additional information from heteronuclear data is obtained at thesame time and anatomical position. Information content can be qualitatively increased by delivering a more comprehensive MR-based picture of a transient state (such as an exercise bout). Also, combiningnon-proton MR acquisitions with ¹ Hinformation (e.g., dynamic shim updates and motion correction) can be used to improve data quality during long scans and benefits image coregistration. This work reviews the literature on interleaved and simultaneous multi-nuclear MRI and MRS in vivo. Prominent use cases for this methodology in clinical and research applications are brain and muscle, but studies have also been carried out in other targets, including the lung, knee, breast and heart. Simultaneous multi-nuclear measurements in the liver and kidney have also been performed, but exclusively in rodents. In this review, a consistent nomenclature is proposed, to help clarify the terminology used for this principle throughout the literature on in-vivo MR. An overview covers the basic principles, the technical requirements on the MR scanner and the implementations realised either by MR system vendors or research groups, from the early days until today. Considerations regarding the multi-tuned RF coils required and heteronuclear polarisation interactions are briefly discussed, and fields for future in-vivo applications for interleaved multi-nuclear MR pulse sequences are identified.

Accuracy investigations for volumetric head-motion navigators with and without EPI at 7 T

Purpose

Accuracy investigation of volumetric navigators for motion correction, with emphasis on geometric EPI distortions at ultrahigh field.

Methods

High‐resolution Dixon images were collected in different head positions and reconstructed to water, fat, T₂*, and B₀ maps. Resolution reduction was performed, and the T₂* and B₀ maps were used to apply effects of TE and EPI distortions to simulate various volumetric water and fat navigators. Registrations of the simulated navigators were compared with registrations of the original high‐resolution images.

Results

Increased accuracy was observed with increased spatial resolution for non‐EPI navigators. When using EPI, the distortions had a negative effect on registration accuracy, which was most noticeable for high‐resolution navigators. Parallel imaging helped to alleviate those caveats to a certain extent, and 5‐fold acceleration gave close to similar accuracy to non‐EPI in most cases. Shortening the TE by partial Fourier sampling was shown to be mostly beneficial, except for water navigators with long readout durations. The EPI blip direction had an influence on navigator accuracy, and positive blip gradient polarities (yielding mostly image stretching frontally) typically gave the best accuracy for water navigators, whereas no clear recommendation could be made for fat navigators. Generally, fat EPI navigators had lower accuracy than water EPI navigators with otherwise similar parameters.

Conclusions

Echo planar imaging has been widely used for MRI navigators, but the induced distortions reduce navigator accuracy at ultrahigh field. This study can help protocol optimization and guide the complex tradeoff between resolution and EPI acceleration in navigator parameter setup.

Tracking of rigid head motion during MRI using an EEG system

Purpose

To demonstrate a novel method for tracking of head movements during MRI using electroencephalography (EEG) hardware for recording signals induced by native imaging gradients.

Theory and Methods

Gradient switching during simultaneous EEG–fMRI induces distortions in EEG signals, which depend on subject head position and orientation. When EEG electrodes are interconnected with high‐impedance carbon wire loops, the induced voltages are linear combinations of the temporal gradient waveform derivatives. We introduce head tracking based on these signals (CapTrack) involving 3 steps: (1) phantom scanning is used to characterize the target sequence and a fast calibration sequence; (2) a linear relation between changes of induced signals and head pose is established using the calibration sequence; and (3) induced signals recorded during target sequence scanning are used for tracking and retrospective correction of head movement without prolonging the scan time of the target sequence. Performance of CapTrack is compared directly to interleaved navigators.

Results

Head‐pose tracking at 27.5 Hz during echo planar imaging (EPI) was demonstrated with close resemblance to rigid body alignment (mean absolute difference: [0.14 0.38 0.15]‐mm translation, [0.30 0.27 0.22]‐degree rotation). Retrospective correction of 3D gradient‐echo imaging shows an increase of average edge strength of 12%/−0.39% for instructed/uninstructed motion with CapTrack pose estimates, with a tracking interval of 1561 ms and high similarity to interleaved navigator estimates (mean absolute difference: [0.13 0.33 0.12] mm, [0.28 0.15 0.22] degrees).

Conclusion

Motion can be estimated from recordings of gradient switching with little or no sequence modification, optionally in real time at low computational burden and synchronized to image acquisition, using EEG equipment already found at many research institutions.

MP3RAGE: Simultaneous mapping of T1 and B 1 + in human brain at 7T

PURPOSE

To map T₁ and the local flip angle ( B 1 + ) in human brain using a single MP3RAGE sequence with 3 rapid acquisitions of gradient echoes (RAGEs).

THEORY AND METHODS

A third RAGE with a relatively high flip angle was appended to an MP2RAGE sequence. Through curve fitting and a rational approximation for small flip angles and short TR, closed form solutions for T₁ and B 1 + were derived. The influence of different k-space encoding schemes on precision and whether edge enhancement artifacts could be reduced with a saturation pulse applied prior to the third RAGE were explored. Validation of T₁ estimates was performed using single-slice inversion recovery (IR) and a subsequent region-of-interest-based comparison, whereas validation of B 1 + was performed using a whole brain pixelwise comparison to a DREAM flip angle mapping protocol. Lastly, MP3RAGE was compared to T₁ -mapping by MP2RAGE with separate B 1 + correction.

RESULTS

Whole brain maps of T₁ and B 1 + at 1 mm isotropic resolution were obtained with MP3RAGE in 06:37 min. A linear-reverse centric-reverse centric phase-encoding order of the 3 RAGEs improved precision, and artifacts were successfully reduced with the saturation pulse. Estimations of T₁ and B 1 + deviated +2.5 ± 3.1% and -1.7 ± 8.6% from their respective references.

CONCLUSION

T₁ and B 1 + can be mapped simultaneously using MP3RAGE. The approach can be thought of as combining MP2RAGE with a dual flip angle T₁ -mapping protocol. Both maps can be solved for analytically and will be inherently co-registered at the high resolution associated with MPRAGE.

Interleaved water and fat MR thermometry for monitoring high intensity focused ultrasound ablation of bone lesions

PURPOSE

To demonstrate that interleaved MR thermometry can monitor temperature in water and fat with adequate temporal resolution. This is relevant for high intensity focused uUltrasounds (HIFU) treatment of bone lesions, which are often found near aqueous tissues, as muscle, or embedded in adipose tissues, as subcutaneous fat and bone marrow.

METHODS

Proton resonance frequency shift (PRFS)-based thermometry scans and T1 -based 2D variable flip angle (2D-VFA) thermometry scans were acquired alternatingly over time. Temperature in water was monitored using PRFS thermometry, and in fat by 2D-VFA thermometry with slice profile effect correction. The feasibility of interleaved water/fat temperature monitoring was studied ex vivo in porcine bone during MR-HIFU sonication. Precision and stability of measurements in vivo were evaluated in a healthy volunteer under non-heating conditions.

RESULTS

The method allowed observing temperature change over time in muscle and fat, including bone marrow, during MR-HIFU sonication, with a temporal resolution of 6.1 s. In vivo, the apparent temperature change was stable on the time scale of the experiment: In 7 min the systematic drift was <0.042°C/min in muscle (PRFS after drift correction) and <0.096°C/min in bone marrow (2D-VFA). The SD of the temperature change averaged over time was 0.98°C (PRFS) and 2.7°C (2D-VFA).

CONCLUSIONS

Interleaved MR thermometry allows temperature measurements in water and fat with a temporal resolution high enough for monitoring HIFU ablation. Specifically, combined fat and water thermometry provides uninterrupted information on temperature changes in tissue close to the bone cortex.

Field drift correction of proton resonance frequency shift temperature mapping with multichannel fast alternating nonselective free induction decay readouts

PURPOSE

To demonstrate that proton resonance frequency shift MR thermometry (PRFS-MRT) acquisition with nonselective free induction decay (FID), combined with coil sensitivity profiles, allows spatially resolved B0 drift-corrected thermometry.

METHODS

Phantom experiments were performed at 1.5T and 3T. Acquisition of PRFS-MRT and FID were performed during MR-guided high-intensity focused ultrasound heating. The phase of the FIDs was used to estimate the change in angular frequency δωdrift per coil element. Two correction methods were investigated: (1) using the average δωdrift over all coil elements (0th-order) and (2) using coil sensitivity profiles for spatially resolved correction. Optical probes were used for independent temperature verification. In-vivo feasibility of the methods was evaluated in the leg of 1 healthy volunteer at 1.5T.

RESULTS

In 30 minutes, B0 drift led to an apparent temperature change of up to -18°C and -98°C at 1.5T and 3T, respectively. In the sonicated area, both corrections had a median error of 0.19°C at 1.5T and -0.54°C at 3T. At 1.5T, the measured median error with respect to the optical probe was -1.28°C with the 0th-order correction and improved to 0.43°C with the spatially resolved correction. In vivo, without correction the spatiotemporal median of the apparent temperature was at -4.3°C and interquartile range (IQR) of 9.31°C. The 0th-order correction had a median of 0.75°C and IQR of 0.96°C. The spatially resolved method had the lowest median at 0.33°C and IQR of 0.80°C.

CONCLUSION

FID phase information from individual receive coil elements allows spatially resolved B0 drift correction in PRFS-based MRT.

MR spectroscopy using static higher order shimming with dynamic linear terms (HOS-DLT) for improved water suppression, interleaved MRS-fMRI, and navigator-based motion correction at 7T

PURPOSE

To interleave global and local higher order shimming for single voxel MRS. Single voxel MR spectroscopy requires optimization of the B₀ field homogeneity in the region of the voxel to obtain a narrow linewidth and provide high data quality. However, the optimization of local higher order fields on a localized MRS voxel typically leads to large field offsets outside that volume. This compromises interleaved MR sequence elements that benefit from global field homogeneity such as water suppression, interleaved MRS-fMRI, and MR motion correction.

METHODS

A shimming algorithm was developed to optimize the MRS voxel homogeneity and the whole brain homogeneity for interleaved sequence elements, using static higher order shims and dynamic linear terms (HOS-DLT). Shimming performance was evaluated using 6 brain regions and 10 subjects. Furthermore, the benefits of HOS-DLT was demonstrated for water suppression, MRS-fMRI, and motion corrected MRS using fat-navigators.

RESULTS

The HOS-DLT algorithm was shown to improve the whole brain homogeneity compared to an MRS voxel-based shim, without compromising the MRS voxel homogeneity. Improved water suppression over the brain, reduced image distortions in MRS-fMRI, and improved quality of motion navigators were demonstrated using the HOS-DLT method.

CONCLUSION

HOS-DLT shimming allowed for both local and global field homogeneity, providing excellent MR spectroscopy data quality, as well as good field homogeneity for interleaved sequence elements, even without the need for dynamic higher order shimming capabilities.

Dynamic magnetic resonance measurements of calf muscle oxygenation and energy metabolism in peripheral artery disease

Background

Clinical assessments of peripheral artery disease (PAD) severity are insensitive to pathophysiological changes in muscle tissue oxygenation and energy metabolism distal to the affected artery.

Purpose

To quantify the blood oxygenation level‐dependent (BOLD) response and phosphocreatine (PCr) recovery kinetics on a clinical MR system during a single exercise‐recovery session in PAD patients.

Study Type

Case–control study.

Subjects

Fifteen Fontaine stage II patients, and 18 healthy control subjects

Field Strength/Sequence

Interleaved dynamic multiecho gradient‐echo ¹H T₂* mapping and adiabatic pulse‐acquire ³¹P‐MR spectroscopy at 3T.

Assessment

Blood pressure in the arms and ankles were measured to determine the ankle‐brachial index (ABI). Subjects performed a plantar flexion exercise‐recovery protocol. The gastrocnemius and soleus muscle BOLD responses were characterized using the T₂* maps. High‐energy phosphate metabolite concentrations were quantified by fitting the series of ³¹P‐MR spectra. The PCr recovery time constant (τ_PCr) was derived as a measure of in vivo mitochondrial oxidative capacity.

Statistical Tests

Comparisons between groups were performed using two‐sided Mann–Whitney U‐tests. Relations between variables were assessed by Pearson's r correlation coefficients.

Results

The amplitude of the functional hyperemic BOLD response in the gastrocnemius muscle was higher in PAD patients compared with healthy subjects (–3.8 ± 1.4% vs. –1.4 ± 0.3%; P < 0.001), and correlated with the ABI (r = 0.79; P < 0.001). PCr recovery was slower in PAD patients (τ_PCr = 52.0 ± 13.5 vs. 30.3 ± 9.7 sec; P < 0.0001), and correlated with the ABI (r = –0.64; P < 0.001). Moreover, τ_PCr correlated with the hyperemic BOLD response in the gastrocnemius muscle (r = –0.66; P < 0.01).

Data Conclusion

MR readouts of calf muscle tissue oxygenation and high‐energy phosphate metabolism were acquired essentially simultaneously during a single exercise‐recovery session. A pronounced hypoxia‐triggered vasodilation in PAD is associated with a reduced mitochondrial oxidative capacity.

Level of Evidence: 2

Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:98–107.

Improvement in diagnostic quality of structural and angiographic MRI of the brain using motion correction with interleaved, volumetric navigators

INTRODUCTION

Subject movements lead to severe artifacts in magnetic resonance (MR) brain imaging. In this study we evaluate the diagnostic image quality in T1-weighted, T2-weighted, and time-of-flight angiographic MR sequences when using a flexible, navigator-based prospective motion correction system (iMOCO).

METHODS

Five healthy volunteers were scanned during different movement scenarios with and without (+/-) iMOCO activated. An experienced neuroradiologist graded images for image quality criteria (grey-white-matter discrimination, basal ganglia, and small structure and vessel delineation), and general image quality on a four-grade scale.

RESULTS

In scans with deliberate motion, there was a significant improvement in the image quality with iMOCO compared to the scans without iMOCO in both general image impression (T1 p<0.01, T2 p<0.01, TOF p = 0.03) and in anatomical grading (T1 p<0.01, T2 p<0.01, TOF p = 0.01). Subjective image quality was considered non-diagnostic in 91% of the scans with motion -iMOCO, but only in 4% of the scans with motion +iMOCO. iMOCO performed best in the T1-weighted sequence and least well in the angiography sequence. iMOCO was not shown to have any negative effect on diagnostic image quality, as no significant difference in diagnostic quality was seen between scans -iMOCO and +iMOCO with no deliberate movement.

CONCLUSION

The evaluation showed that iMOCO enables substantial improvements in image quality in scans affected by subject movement, recovering important diagnostic information in an otherwise unusable scan.

The applied research of simultaneous image acquisition of T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) in the assessment of patients with prostate cancer

We aimed to evaluate the feasibility of simultaneous image acquisition of multiple instantaneous switchable scan (MISS) for prostate magnetic resonance imaging (MRI) on 3T. Fifty-three patients were scanned with MRI due to suspected prostate cancer. Twenty-eight of them got histological results. First, two readers assessed the structure delineation and image quality based on images of conventional T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) (CTD). Second, two readers identified the index lesion together, and then, reader one evaluated the contrast of index lesion on T2WI and signal ratio on apparent diffusion coefficient map. Third, they assigned Prostate Imaging Reporting and Data System (PI-RADS) score in consensus for the index lesion. After 4 weeks, the images of MISS were reviewed by the same readers following the same process. Finally, two readers gave preference for image interpretation, respectively. Kappa coefficient, Wilcoxon signed-rank test, paired-sample t-test, Bland–Altman analysis, and receiver operating characteristic (ROC) analysis were used for statistical analysis. The acquisition time of CTD was 6 min and 10 s, while the acquisition time of MISS was 4 min and 30 s. Interobserver agreements for image evaluation were κ = 0.65 and κ = 0.80 for CTD and MISS, respectively. MISS-T2WI showed better delineation for seminal vesicles than CTD-T2WI (reader 1: P < 0.001, reader 2: P = 0.001). The index lesion demonstrated higher contrast in MISS-T2WI (P < 0.001). The PI-RADS scores based on CTD and MISS exhibited high ability in predicting clinically significant cancer (area under curve [AUC] = 0.828 vs 0.854). Readers preferred to use MISS in 41.5%–47.2% of cases. MISS showed comparable performance to conventional technique with less acquisition time.

Interleaved susceptibility-weighted and FLAIR MRI for imaging lesion-penetrating veins in multiple sclerosis

Purpose

To simultaneously image brain lesions and veins in multiple sclerosis.

Methods

An interleaved sequence was developed to simultaneously acquire 3D T2*-weighted (or susceptibility-weighted, SW) and fluid-attenuated inversion recovery (FLAIR) images on a 3.0T MRI system. The pulse sequence parameters were calculated to minimize signal perturbation from steady state while maintaining acceptable image contrast and scan time. Fifteen multiple sclerosis patients were enrolled in this prospective study and underwent a standard MS imaging protocol. In addition, SW and FLAIR images were acquired separately and also in an interleaved manner. The SW and FLAIR images were combined into one image to visualize lesions and penetrating veins. The contrast ratios between white matter lesions and penetrating veins were compared between the interleaved sequence and the individual non-interleaved acquisitions.

Results

Interleaved scanning of the FLAIR and the SW pulse sequences was achieved, producing aligned images, and with similar image contrast as in the non-interleaved images. A total of 1076 lesions were identified in all patients on the combined SW-FLAIR image, of which 968 lesions (90%) had visible penetrating veins. Lesion-to-vein contrast ratio was 32.7 ± 17.9 (mean ± standard deviation) for the interleaved sequence compared to 28.1 ± 13.7 using the separate acquisitions (P<0.001).

Conclusion

The feasibility of interleaved acquisition of susceptibility-weighted and FLAIR images was demonstrated. This sequence provides self-registered images and facilitates the visualization of veins in brain lesions.

Interleaved Mapping of Temperature and Longitudinal Relaxation Rate to Monitor Drug Delivery During Magnetic Resonance-Guided High-Intensity Focused Ultrasound-Induced Hyperthermia

OBJECTIVES

Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a method to heat lesions noninvasively to a stable, elevated temperature and a well-suited method to induce local hyperthermia (41°C-43°C) in deep-seated tissues. Magnetic Resonance (MR) imaging provides therapy planning on anatomical images and offers temperature feedback based on near-real-time MR thermometry. Although constant acquisition of MR thermometry data is crucial to ensure prolonged hyperthermia, it limits the freedom to perform measurements of other MR parameters, which are of interest during hyperthermia treatments. In image-guided drug delivery applications, co-encapsulation of paramagnetic MR contrast agents with a drug inside temperature-sensitive liposomes (TSLs) allows to visualize hyperthermia-triggered drug delivery through changes of the longitudinal relaxation rate R1. While the drug accumulates in the heated tumor tissue, R1 changes can be used for an estimate of the tumor drug concentration. The main objective of this study was to demonstrate that interleaved MR sequences are able to monitor temperature with an adequate temporal resolution and could give a reasonable estimate of the achieved tumor drug concentration through R1 changes. To this aim, in vitro validation tests and an in vivo proof-of-concept study were performed.

MATERIALS AND METHODS

All experiments were performed on a clinical 3-T MR-HIFU system adapted with a preclinical setup. The validity of the R1 values and the temperature maps stability were evaluated in phantom experiments and in ex vivo porcine muscle tissue. In vivo experiments were performed on rats bearing a 9L glioma tumor on their hind limb. All animals (n = 4 HIFU-treated, n = 4 no HIFU) were injected intravenously with TSLs co-encapsulating doxorubicin and gadoteridol as contrast agent. The TSL injection was followed by either 2 times 15 minutes of MR-HIFU-induced hyperthermia or a sham treatment. R1 maps were acquired before, during, and after sonication, using a single slice Inversion Recovery Look-Locker (IR-LL) sequence (field of view [FOV], 50 × 69 mm; in-plane resolution, 0.52 × 0.71 mm; slice thickness, 3 mm; 23 phases of 130 milliseconds; 1 full R1 map every 2 minutes). The R1 maps acquired during treatment were interleaved with 2 perpendicular proton resonance frequency shift (PRFS) MR thermometry slices (dynamic repetition time, 8.6 seconds; FOV, 250 × 250 mm; 1.4 × 1.4 mm in-plane resolution; 4 mm slice thickness). Tumor doxorubicin concentrations were determined fluorometrically.

RESULTS

In vitro results showed a slight but consistent overestimation of the measured R1 values compared with calibrated R1 values, regardless whether the R1 was acquired with noninterleaved IR-LL or interleaved. The average treatment cell temperature had a slightly higher temporal standard deviation for the interleaved PRFS sequence compared with the noninterleaved PRFS sequence (0.186°C vs 0.101°C, respectively). The prolonged time in between temperature maps due to the interleaved IR-LL sequence did not degrade the temperature stability during MR-HIFU treatment (Taverage = 40.9°C ± 0.3°C). Upon heat treatment, some tumors showed an R1 increase in a large part of the tumor while other tumors hardly showed any ΔR1. The tumor doxorubicin concentration showed a linear correlation with the average ΔR1 during both sonications (n = 8, Radj = 0.933), which was higher than for the ΔR1 measured after tumor cooldown (averaged for both sonications, n = 8, Radj = 0.877).

CONCLUSIONS

The new approach of interleaving different MR sequences was applied to simultaneously acquire R1 maps and PRFS thermometry scans during a feedback-controlled MR-HIFU-induced hyperthermia treatment. Interleaved acquisition did not compromise speed or accuracy of each scan. The ΔR1 acquired during treatment was used to visualize and quantify hyperthermia-triggered release of gadoteridol from TSLs and better reflected the intratumoral doxorubicin concentrations than the ΔR1 measured after cooldown of the tumor, exemplifying the benefit of interleaving R1 maps with temperature maps during drug delivery. Our study serves as an example for interleaved MR acquisition schemes, which introduce a higher flexibility in speed, sequence optimization, and timing.

Improved respiratory self-navigation for 3D radial acquisitions through the use of a pencil-beam 2D-T2 -prep for free-breathing, whole-heart coronary MRA

PURPOSE

In respiratory self-navigation (SN), signal from static structures, such as the chest wall, may complicate motion detection or introduce post-correction artefacts. Suppressing signal from superfluous tissues may therefore improve image quality. We thus test the hypothesis that SN whole-heart coronary magnetic resonance angiography (MRA) will benefit from an outer-volume suppressing 2D-T2 -Prep and present both phantom and in vivo results.

METHODS

A 2D-T2 -Prep and a conventional T2 -Prep were used prior to a free-breathing 3D-radial SN sequence. Both techniques were compared by imaging a home-built moving cardiac phantom and by performing coronary MRA in nine healthy volunteers. Reconstructions were performed using both a reference-based and a reference-independent approach to motion tracking, along with several coil combinations. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were compared, along with vessel sharpness (VS).

RESULTS

In phantoms, using the 2D-T2 -Prep increased SNR by 16% to 53% and mean VS by 8%; improved motion tracking precision was also achieved. In volunteers, SNR increased by an average of 29% to 33% in the blood pool and by 15% to 25% in the myocardium, depending on the choice of reconstruction coils and algorithm, and VS increased by 34%.

CONCLUSION

A 2D-T2 -Prep significantly improves image quality in both phantoms and volunteers when performing SN coronary MRA. Magn Reson Med 79:1293-1303, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Technical note: Accelerated nonrigid motion-compensated isotropic 3D coronary MR angiography

PURPOSE

To develop an accelerated and nonrigid motion-compensated technique for efficient isotropic 3D whole-heart coronary magnetic resonance angiography (CMRA) with Cartesian acquisition.

METHODS

Highly efficient whole-heart 3D CMRA was achieved by combining image reconstruction from undersampled data using compressed sensing (CS) with a nonrigid motion compensation framework. Undersampled acquisition was performed using a variable-density Cartesian trajectory with radial order (VD-CAPR). Motion correction was performed in two steps: beat-to-beat 2D translational correction with motion estimated from interleaved image navigators, and bin-to-bin 3D nonrigid correction with motion estimated from respiratory-resolved images reconstructed from undersampled 3D CMRA data using CS. Nonrigid motion fields were incorporated into an undersampled motion-compensated reconstruction, which combines CS with the general matrix description formalism. The proposed approach was tested on 10 healthy subjects and compared against a conventional twofold accelerated 5-mm navigator-gated and tracked acquisition.

RESULTS

The proposed method achieves isotropic 1.2-mm Cartesian whole-heart CMRA in 5 min ± 1 min (~8× acceleration). The proposed approach provides good-quality images of the left and right coronary arteries, comparable to those of a twofold accelerated navigator-gated and tracked acquisition, but scan time was up to about four times faster. For both coronaries, no significant differences (P > 0.05) in vessel sharpness and length were found between the proposed method and reference scan.

CONCLUSION

The feasibility of a highly efficient motion-compensated reconstruction framework for accelerated 3D CMRA has been demonstrated in healthy subjects. Further investigation is required to assess the clinical value of the method.

Simultaneous acquisition sequence for improved hepatic pharmacokinetics quantification accuracy (SAHA) for dynamic contrast-enhanced MRI of liver

PURPOSE

To propose a simultaneous acquisition sequence for improved hepatic pharmacokinetics quantification accuracy (SAHA) method for liver dynamic contrast-enhanced MRI.

METHODS

The proposed SAHA simultaneously acquired high temporal-resolution 2D images for vascular input function extraction using Cartesian sampling and 3D large-coverage high spatial-resolution liver dynamic contrast-enhanced images using golden angle stack-of-stars acquisition in an interleaved way. Simulations were conducted to investigate the accuracy of SAHA in pharmacokinetic analysis. A healthy volunteer and three patients with cirrhosis or hepatocellular carcinoma were included in the study to investigate the feasibility of SAHA in vivo.

RESULTS

Simulation studies showed that SAHA can provide closer results to the true values and lower root mean square error of estimated pharmacokinetic parameters in all of the tested scenarios. The in vivo scans of subjects provided fair image quality of both 2D images for arterial input function and portal venous input function and 3D whole liver images. The in vivo fitting results showed that the perfusion parameters of healthy liver were significantly different from those of cirrhotic liver and HCC.

CONCLUSIONS

The proposed SAHA can provide improved accuracy in pharmacokinetic modeling and is feasible in human liver dynamic contrast-enhanced MRI, suggesting that SAHA is a potential tool for liver dynamic contrast-enhanced MRI. Magn Reson Med 79:2629-2641, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Simultaneous acquisition of perfusion image and dynamic MR angiography using time-encoded pseudo-continuous ASL

PURPOSE

Both dynamic magnetic resonance angiography (4D-MRA) and perfusion imaging can be acquired by using arterial spin labeling (ASL). While 4D-MRA highlights large vessel pathology, such as stenosis or collateral blood flow patterns, perfusion imaging provides information on the microvascular status. Therefore, a complete picture of the cerebral hemodynamic condition could be obtained by combining the two techniques. Here, we propose a novel technique for simultaneous acquisition of 4D-MRA and perfusion imaging using time-encoded pseudo-continuous arterial spin labeling.

METHODS

The time-encoded pseudo-continuous arterial spin labeling module consisted of a first subbolus that was optimized for perfusion imaging by using a labeling duration of 1800 ms, whereas the other six subboli of 130 ms were used for encoding the passage of the labeled spins through the arterial system for 4D-MRA acquisition. After the entire labeling module, a multishot 3D turbo-field echo-planar-imaging readout was executed for the 4D-MRA acquisition, immediately followed by a single-shot, multislice echo-planar-imaging readout for perfusion imaging. The optimal excitation flip angle for the 3D turbo-field echo-planar-imaging readout was investigated by evaluating the image quality of the 4D-MRA and perfusion images as well as the accuracy of the estimated cerebral blood flow values.

RESULTS

When using 36 excitation radiofrequency pulses with flip angles of 5 or 7.5°, the saturation effects of the 3D turbo-field echo-planar-imaging readout on the perfusion images were relatively moderate and after correction, there were no statistically significant differences between the obtained cerebral blood flow values and those from traditional time-encoded pseudo-continuous arterial spin labeling.

CONCLUSIONS

This study demonstrated that simultaneous acquisition of 4D-MRA and perfusion images can be achieved by using time-encoded pseudo-continuous arterial spin labeling. Magn Reson Med 79:2676-2684, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Large coverage black-bright blood interleaved imaging sequence (LaBBI) for 3D dynamic contrast-enhanced MRI of vessel wall

PURPOSE

To propose a large coverage black-bright blood interleaved imaging sequence (LaBBI) for 3D dynamic contrast-enhanced MRI (DCE-MRI) of the vessel wall.

METHODS

LaBBI consists of a 3D black-blood stack-of-stars golden angle radial acquisition with high spatial resolution for vessel wall imaging and a 2D bright-blood Cartesian acquisition with high temporal resolution for arterial input function estimation. The two acquisitions were performed in an interleaved fashion within a single scan. Simulations, phantom experiments, and in vivo tests in three patients were performed to investigate the feasibility and performance of the proposed LaBBI.

RESULTS

In simulation tests, the estimated K^trans and v_p by LaBBI were more accurate than conventional bright-blood DCE-MRI with lower root mean square error in all the tested conditions. In phantom test, no signal interference was found on the 2D scan in LaBBI. Pharmacokinetic analysis of the patients' data acquired by LaBBI showed that K^trans was higher in fibrous tissue (0.0717 ± 0.0279 min^-1 ), while lower in necrotic core (0.0206 ± 0.0040 min^-1 ) and intraplaque hemorrhage (0.0078 ± 0.0007 min^-1 ), compared with normal vessel wall (0.0273 ± 0.0052 min^-1 ).

CONCLUSION

The proposed LaBBI sequence, with high spatial and temporal resolution, and large coverage blood suppression, was promising to probe the perfusion properties of vessel wall lesions. Magn Reson Med 79:1334-1344, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Analysis of spatiotemporal fidelity in quantitative 3D first-pass perfusion cardiovascular magnetic resonance

BACKGROUND

Whole-heart first-pass perfusion cardiovascular magnetic resonance (CMR) relies on highly accelerated image acquisition. The influence of undersampling on myocardial blood flow (MBF) quantification has not been systematically investigated yet. In the present work, the effect of spatiotemporal scan acceleration on image reconstruction accuracy and MBF error was studied using a numerical phantom and validated in-vivo.

METHODS

Up to 10-fold scan acceleration using k-t PCA and k-t SPARSE-SENSE was simulated using the MRXCAT CMR numerical phantom framework. Image reconstruction results were compared to ground truth data in the k-f domain by means of modulation transfer function (MTF) analysis. In the x-t domain, errors pertaining to specific features of signal intensity-time curves and MBF values derived using Fermi model deconvolution were analysed. In-vivo first-pass CMR data were acquired in ten healthy volunteers using a dual-sequence approach assessing the arterial input function (AIF) and myocardial enhancement. 10x accelerated 3D k-t PCA and k-t SPARSE-SENSE were compared and related to non-accelerated 2D reference images.

RESULTS

MTF analysis revealed good recovery of data upon k-t PCA reconstruction at 10x undersampling with some attenuation of higher temporal frequencies. For 10x k-t SPARSE-SENSE the MTF was found to decrease to zero at high spatial frequencies for all temporal frequencies indicating a loss in spatial resolution. Signal intensity-time curve errors were most prominent in AIFs from 10x k-t PCA, thereby emphasizing the need for separate AIF acquisition using a dual-sequence approach. These findings were confirmed by MBF estimation based on AIFs from fully sampled and undersampled simulations. Average in-vivo MBF estimates were in good agreement between both accelerated and the fully sampled methods. Intra-volunteer MBF variation for fully sampled 2D scans was lower compared to 10x k-t PCA and k-t SPARSE-SENSE data.

CONCLUSION

Quantification of highly undersampled 3D first-pass perfusion CMR yields accurate MBF estimates provided the AIF is obtained using fully sampled or moderately undersampled scans as part of a dual-sequence approach. However, relative to fully sampled 2D perfusion imaging, intra-volunteer variation is increased using 3D approaches prompting for further developments.

Highly efficient nonrigid motion-corrected 3D whole-heart coronary vessel wall imaging

Purpose

To develop a respiratory motion correction framework to accelerate free‐breathing three‐dimensional (3D) whole‐heart coronary lumen and coronary vessel wall MRI.

Methods

We developed a 3D flow‐independent approach for vessel wall imaging based on the subtraction of data with and without T2‐preparation prepulses acquired interleaved with image navigators. The proposed method corrects both datasets to the same respiratory position using beat‐to‐beat translation and bin‐to‐bin nonrigid corrections, producing coregistered, motion‐corrected coronary lumen and coronary vessel wall images. The proposed method was studied in 10 healthy subjects and was compared with beat‐to‐beat translational correction (TC) and no motion correction for the left and right coronary arteries. Additionally, the coronary lumen images were compared with a 6‐mm diaphragmatic navigator gated and tracked scan.

Results

No significant differences (P > 0.01) were found between the proposed method and the gated and tracked scan for coronary lumen, despite an average improvement in scan efficiency to 96% from 59%. Significant differences (P < 0.01) were found in right coronary artery vessel wall thickness, right coronary artery vessel wall sharpness, and vessel wall visual score between the proposed method and TC.

Conclusion

The feasibility of a highly efficient motion correction framework for simultaneous whole‐heart coronary lumen and vessel wall has been demonstrated. Magn Reson Med 77:1894–1908, 2017. © 2016 International Society for Magnetic Resonance in Medicine

Quantitative three-dimensional myocardial perfusion cardiovascular magnetic resonance with accurate two-dimensional arterial input function assessment

BACKGROUND

Quantification of myocardial perfusion from first-pass cardiovascular magnetic resonance (CMR) images at high contrast agent (CA) dose requires separate acquisition of blood pool and myocardial tissue enhancement. In this study, a dual-sequence approach interleaving 2D imaging of the arterial input function with high-resolution 3D imaging for myocardial perfusion assessment is presented and validated for low and high CA dose.

METHODS

A dual-sequence approach interleaving 2D imaging of the aortic root and 3D imaging of the whole left ventricle using highly accelerated k-t PCA was implemented. Rest perfusion imaging was performed in ten healthy volunteers after administration of a Gadolinium-based CA at low (0.025 mmol/kg b.w.) and high dose (0.1 mmol/kg b.w.). Arterial input functions extracted from the 2D and 3D images were analysed for both doses. Myocardial contrast-to-noise ratios (CNR) were compared across volunteers and doses. Variations of myocardial perfusion estimates between volunteers and across myocardial territories were studied.

RESULTS

High CA dose imaging resulted in strong non-linearity of the arterial input function in the 3D images at peak CA concentration, which was avoided when the input function was derived from the 2D images. Myocardial CNR was significantly increased at high dose compared to low dose, with a 2.6-fold mean CNR gain. Most robust myocardial blood flow estimation was achieved using the arterial input function extracted from the 2D image at high CA dose. In this case, myocardial blood flow estimates varied by 24% between volunteers and by 20% between myocardial territories when analysed on a per-volunteer basis.

CONCLUSION

Interleaving 2D imaging for arterial input function assessment enables robust quantitative 3D myocardial perfusion imaging at high CA dose.

Time-efficient interleaved human (23)Na and (1)H data acquisition at 7 T

The aim of this study was to implement and evaluate a flexible and time-efficient interleaved imaging approach for the acquisition of proton and sodium images of the human knee at 7 T within a clinically relevant timescale. A flexible software framework was established which allowed the interleaving of multiple, different, fully specific absorption ratio (SAR)-validated scans. The system was able to switch between these different scans at flexible time points. The practical example presented consists of interleaved proton (Dixon imaging and T2* mapping) and sodium (mapping the sodium content and fluid-suppressed component separately) sequences with the key idea to perform proton MRI whilst the sodium nuclei relax towards thermal equilibrium, and vice versa. Comparisons were made between these four scans being acquired sequentially in the normal mode of scanner operation and those acquired in an interleaved fashion. Images acquired in the interleaved mode were very similar to those acquired in sequential scans with no image artifacts produced by the slight intra-sequence variation in steady-state magnetization. A reduction in scanning time of almost a factor of two was established using the interleaved scans, allowing such a protocol to be completed within 30 min. Phantom experiments and in vivo scans performed in healthy volunteers and in one patient proved the basic feasibility of this approach. This approach for the interleaving of multiple proton and sodium scans, each with different contrasts, is an efficient method for the design of new practical clinical protocols for sodium MRI.

Three-dimensional heart locator and compressed sensing for whole-heart MR angiography

PURPOSE

We sought to develop a whole-heart magnetic resonance angiography technique with three-dimensional (3D) respiratory motion compensation and reduced scan time.

METHODS

A novel respiratory motion compensation method was implemented that acquires a 1D navigator (NAV) and a low-resolution 3D-image of the heart (3D-LOC) just before the angiography data. The central 10% of SSFP k-space was fully acquired using NAV-gating, and then 10% of peripheral k-space was randomly undersampled to complete the scan. Spatial registration of the 3D-LOC information was used to correct the central and peripheral k-space lines for the bulk respiratory motion in three dimensions, and then the remaining k-space data was estimated using compressed sensing (CS). Ten volunteers each underwent two angiography acquisitions with 1 mm(3) resolution: (i) conventional NAV with CS, and (ii) the new 3D-LOC with CS.

RESULTS

Compared with conventional NAV, the new 3D-LOC with CS technique had a shorter scan time (4.8 ± 1.1 versus 6.3 ± 1.7 min; P < 0.001), better objective vessel sharpness for all three coronary arteries (P < 0.05), and no difference in subjective vessel sharpness for all three coronary arteries.

CONCLUSION

Compared with conventional NAV with CS, acceleration and respiratory motion correction using 3D-LOC with CS reduces scan time and improves objective vessel sharpness.