Motion-resolved four-dimensional abdominal diffusion-weighted imaging using PROPELLER EPI (4D-DW-PROPELLER-EPI)

PURPOSE

To develop a distortion-free motion-resolved four-dimensional diffusion-weighted PROPELLER EPI (4D-DW-PROPELLER-EPI) technique for benefiting clinical abdominal radiotherapy (RT).

METHODS

An improved abdominal 4D-DWI technique based on 2D diffusion-weighted PROPELLER-EPI (2D-DW-PROPELLER-EPI), termed 4D-DW-PROPELLER-EPI, was proposed to improve the frame rate of repeated data acquisition and produce distortion-free 4D-DWI images. Since the radial or PROPELLER sampling with golden-angle rotation can achieve an efficient k-space coverage with a flexible time-resolved acquisition, the golden-angle multi-blade acquisition was used in the proposed 4D-DW-PROPELLER-EPI to improve the performance of data sorting. A new k-space and blade (K-B) amplitude binning method was developed for the proposed 4D-DW-PROPELLER-EPI to optimize the number of blades and the k-space uniformity before performing conventional PROPELLER-EPI reconstruction, by using two metrics to evaluate the adequacy of the acquired data. The proposed 4D-DW-PROPELLER-EPI was preliminarily evaluated in both simulation experiments and in vivo experiments with varying frame rates and different numbers of repeated acquisition.

RESULTS

The feasibility of achieving distortion-free 4D-DWI images by using the proposed 4D-DW-PROPELLER-EPI technique was demonstrated in both digital phantom and healthy subjects. Evaluation of the 4D completeness metrics shows that the K-B amplitude binning method could simultaneously improve the acquisition efficiency and data reconstruction performance for 4D-DW-PROPELLER-EPI.

CONCLUSION

4D-DW-PROPELLER-EPI with K-B amplitude binning is an advanced technique that can provide distortion-free 4D-DWI images for resolving respiratory motion, and may benefit the application of image-guided abdominal RT.

Multi-band multi-shot diffusion MRI reconstruction with joint usage of structured low-rank constraints and explicit phase mapping

PURPOSE

To develop a joint reconstruction method for multi-band multi-shot diffusion MRI.

THEORY AND METHODS

Multi-band multi-shot EPI acquisition is an effective approach for high-resolution diffusion MRI, but requires specific algorithms to correct the inter-shot phase variations. The phase correction can be done by first estimating the explicit phase map and then feeding it into the k-space signal formulation model. Alternatively, the phase information can be used indirectly as structured low-rank constraints in k-space. The 2 methods differ in reconstruction accuracy and efficiency. We aim to combine the 2 different approaches for improved image quality and reconstruction efficiency simultaneously, termed "joint usage of structured low-rank constraints and explicit phase mapping" (JULEP). The proposed JULEP reconstruction is tested on both single-band and multi-band, multi-shot diffusion data, with different resolutions and b values. The results of JULEP are compared with conventional methods with explicit phase mapping (i.e., multiplexed sensitivity-encoding [MUSE]) and structured low-rank constraints (i.e., MUSSELS), and another joint reconstruction method (i.e., network estimated artifacts for tempered reconstruction [NEATR]).

RESULTS

JULEP improves the quality of the navigator and subsequently facilitates the reconstruction of final diffusion images. Compared with all 3 other methods (MUSE, MUSSELS, and NEATR), JULEP mitigates residual structural bias and improves temporal SNRs in the final diffusion image, particularly at high multi-band factors. Compared with MUSSELS, JULEP also improves computational efficiency.

CONCLUSION

The proposed JULEP method significantly improves the image quality and reconstruction efficiency of multi-band multi-shot diffusion MRI, which can promote a broader application of high-resolution diffusion MRI.

Comparison of single-shot EPI and multi-shot EPI in prostate DWI at 3.0 T

In prostate MRI, single-shot EPI (ssEPI) DWI still suffers from distortion and blurring. Multi-shot EPI (msEPI) overcomes the drawbacks of ssEPI DWI. The aim of this article was to compare the image quality and diagnostic performance for clinically significant prostate cancer (csPC) between ssEPI DWI and msEPI DWI. This retrospective study included 134 patients with suspected PC who underwent 3.0 T MRI and subsequent MRI-guided biopsy. Three radiologists independently assessed anatomical distortion, prostate edge clarity, and lesion conspicuity score for pathologically confirmed csPC. Lesion apparent diffusion coefficient (ADC) and benign ADC were also calculated. In 17 PC patients who underwent prostatectomy, three radiologists independently assessed eight prostate regions by DWI score in PI-RADS v 2.1. Anatomical distortion and prostate edge clarity were significantly higher in msEPI DWI than in ssEPI DWI in the three readers. Lesion conspicuity score was significantly higher in msEPI DWI than in ssEPI DWI in reader 1 and reader 3. Regarding discrimination ability between PC with GS ≤ 3 + 4 and PC with GS ≥ 4 + 3 using lesion ADC, AUC was comparable between ssEPI DWI and msEPI DWI. For diagnostic performance of csPC using DWI score, AUC was comparable between msEPI DWI and ssEPI DWI in all readers. Compared with ssEPI DWI, msEPI DWI had improved image quality and similar or higher diagnostic performance.

Diffusion-weighted imaging in prostate cancer

Diffusion-weighted imaging (DWI), a key component in multiparametric MRI (mpMRI), is useful for tumor detection and localization in clinically significant prostate cancer (csPCa). The Prostate Imaging Reporting and Data System versions 2 and 2.1 (PI-RADS v2 and PI-RADS v2.1) emphasize the role of DWI in determining PIRADS Assessment Category in each of the transition and peripheral zones. In addition, several recent studies have demonstrated comparable performance of abbreviated biparametric MRI (bpMRI), which incorporates only T2-weighted imaging and DWI, compared with mpMRI with dynamic contrast-enhanced MRI. Therefore, further optimization of DWI is essential to achieve clinical application of bpMRI for efficient detection of csPC in patients with elevated PSA levels. Although DWI acquisition is routinely performed using single-shot echo-planar imaging, this method suffers from such as susceptibility artifact and anatomic distortion, which remain to be solved. In this review article, we will outline existing problems in standard DWI using the single-shot echo-planar imaging sequence; discuss solutions that employ newly developed imaging techniques, state-of-the-art technologies, and sequences in DWI; and evaluate the current status of quantitative DWI for assessment of tumor aggressiveness in PC.

High-fidelity diffusion tensor imaging of the cervical spinal cord using point-spread-function encoded EPI

Diffusion tensor imaging (DTI) of the spinal cord is technically challenging due to the size of its structure and susceptibility-induced field inhomogeneity, which impedes clinical applications. This study aimed to achieve high-fidelity spinal cord DTI with reasonable SNR and practical acquisition efficiency. Particularly, a distortion-free multi-shot EPI technique, namely point-spread-function encoded EPI (PSF-EPI), was adopted for diffusion imaging of the cervical spinal cord (CSC). The shot number can be reduced to six for sagittal scans through titled-CAIPI acceleration and partial Fourier undersampling, consequently rendering this technique beneficial in clinics. Fifteen healthy volunteers and seven patients with metallic implants underwent sagittal scans using tilted-CAIPI PSF-EPI at 3T. Unsuppressed fat signals were further removed by retrospective water/fat separation using the intrinsic chemical-shift encoded signals. Compared with multi-shot interleaved EPI method, highly accelerated PSF-EPI method provided evidently improved distortion reduction and higher consistency with anatomical references even with metallic implants. Additionally, axial DTI scans using PSF-EPI were also evaluated quantitatively, and the measured DTI metrics are similar to those obtained from the zonal oblique multi-slice EPI (ZOOM-EPI) method and reported values. The high anatomical consistency, practical scan time and quantitative reliability indicate PSF-EPI's clinical potential for CSC diffusion imaging.

High-resolution whole-brain diffusion MRI at 3T using simultaneous multi-slab (SMSlab) acquisition

High-resolution diffusion MRI (dMRI) is a crucial tool in neuroscience studies to detect fine fiber structure, depict complex fiber architecture and analyze cortical anisotropy. However, high-resolution dMRI is limited by its intrinsically low SNR due to diffusion attenuation. A series of techniques have been proposed to improve the SNR performance, but most of them are at the cost of long scan time, which in turn sacrifice the SNR efficiency, especially for large FOV imaging, such as whole-brain imaging. Recently, a combination of 3D multi-slab acquisition and simultaneous multi-slice (SMS) excitation, namely simultaneous multi-slab (SMSlab), has been demonstrated to have potential for high-resolution diffusion imaging with high SNR and SNR efficiency. In our previous work, we have proposed a 3D Fourier encoding and reconstruction framework for SMSlab acquisition. In this study, we extend this 3D k-space framework to diffusion imaging, by developing a novel navigator acquisition strategy and exploring a k-space-based phase correction method. In vivo brain data are acquired using the proposed SMSlab method and compared with a series of different acquisitions, including the traditional 3D multi-slab, 2D SMS and 2D single-shot EPI (ss-EPI) acquisitions. The results demonstrate that SMSlab has a better SNR performance compared with 3D multi-slab and 2D SMS. The detection capacity of fine fiber structures is improved using SMSlab, compared with the low-resolution diffusion imaging using conventional 2D ss-EPI.

Diffusion tensor magnetic resonance imaging of the postoperative spine with metallic implants

There has been a growing need to understand the mechanism of development of acute spinal cord injury (SCI) and to optimize treatment. The paramagnetic nature of metallic implants has hampered the application of diffusion tensor imaging (DTI) in postsurgical SCI monitoring. We describe here a successful implementation of spinal DTI in postsurgical SCI patients. Data were acquired using a single-shot turbo-spin-echo sequence, where an extra gradient is applied before the refocusing pulse train to eliminate contributions from the non-Carr-Purcell-Meiboom-Gill components following a diffusion preparation block where a single-spin echo scheme is deployed. The DTI images were acquired in axial orientation with a 2 x 2 x 4 mm³ resolution and a total of 18 slices. Diffusion gradients were applied in six directions with b values of 0 and 600 seconds/mm² . The whole scan took ~10 minutes. The sequence was compared with SENSE-DW-EPI and ZOOM-DW-EPI on a phantom, eight patients with either anterior or posterior titanium alloy implants, and a pork loin with a similar implant. The protocol resulted in dramatically reduced geometric distortions compared with routine imaging sequences, however, the SNR efficiency was compromised. The spinal cord signal displacement was 0.68±1.00 mm (mean±SD, n = 8) for the proposed protocol, and 5.14±3.07 and 2.82±1.60 mm for the SENSE-DW-EPI and ZOOM-DW-EPI sequences, respectively. Fiber tracking was achieved in the presence of implants, which in one case was accompanied by central spinal cord caviation. Mathematical analysis concluded that the proposed protocol would be generally applicable in the spinal cord when the titanium alloy implant is ~15 mm away (<0.5 kHz B₀ field drift). The protocol described is capable of DTI in postsurgery SCI patients with metallic implants at sufficient resolution and SNR.

Phase-constrained reconstruction of high-resolution multi-shot diffusion weighted image

Diffusion weighted imaging (DWI) is a unique examining method in tumor diagnosis, acute stroke evaluation. Single-shot echo planar imaging is currently conventional method for DWI. However, single-shot DWI suffers from image distortion, blurring and low spatial resolution. Although multi-shot DWI improves image resolution, it brings phase variations among different shots at the same time. In this paper, we introduce a smooth phase constraint of each shot image into multi-shot navigator-free DWI reconstruction by imposing the low-rankness of Hankel matrix constructed from the k-space data. Furthermore, we exploit the partial sum minimization of singular values to constrain the low-rankness of Hankel matrix. Results on brain imaging data show that the proposed method outperforms the state-of-the-art methods in terms of artifacts removal and our method potentially has the ability to reconstruct high number of shot of DWI.

Qualitative and quantitative comparison of image quality between single-shot echo-planar and interleaved multi-shot echo-planar diffusion-weighted imaging in female pelvis

OBJECTIVES

To qualitatively and quantitatively compare the image quality between single-shot echo-planar (SS-EPI) and multi-shot echo-planar (IMS-EPI) diffusion-weighted imaging (DWI) in female pelvis METHODS: This was a prospective study involving 80 females who underwent 3.0T pelvic magnetic resonance imaging (MRI). SS-EPI and IMS-EPI DWI were acquired with 3 b values (0, 400, 800 s/mm²). Two independent reviewers assessed the overall image quality, artifacts, sharpness, and lesion conspicuity based on a 5-point Likert scale. Regions of interest (ROI) were placed on the endometrium and the gluteus muscles to quantify the signal intensities and apparent diffusion coefficient (ADC). Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and geometric distortion were quantified on both sequences. Inter-rater agreement was assessed using κ statistics and Kendall test. Qualitative scores were compared using Wilcoxon signed-rank test and quantitative parameters were compared with paired t test and Bland-Altman analysis.

RESULTS

IMS-EPI demonstrated better image quality than SS-EPI for all aspects evaluated (SS-EPI vs. IMS-EPI: overall quality 3.04 vs. 4.17, artifacts 3.09 vs. 3.99, sharpness 2.40 vs. 4.32, lesion conspicuity 3.20 vs. 4.25; p < 0.001). Good agreement and correlation were observed between two reviewers (SS-EPI κ 0.699, r 0.742; IMS-EPI κ 0.702, r 0.789). IMS-EPI showed lower geometric distortion, SNR, and CNR than SS-EPI (p < 0.050). There was no significant difference in the mean ADC between the two sequences.

CONCLUSION

IMS-EPI showed better image quality with lower geometric distortion without affecting the quantification of ADC, though the SNR and CNR decreased due to post-processing limitations.

KEY POINTS

• IMS-EPI showed better image quality than SS-EPI. • IMS-EPI showed lower geometric distortion without affecting ADC compared with SS-EPI. • The SNR and CNR of IMS-EPI decreased due to post-processing limitations.

A 3D k-space Fourier encoding and reconstruction framework for simultaneous multi-slab acquisition

PURPOSE

To propose a novel 3D k-space Fourier encoding and reconstruction framework for simultaneous multi-slab (SMSlab) acquisition and demonstrate its efficacy in high-resolution imaging.

METHODS

First, it is illustrated in theory how the inter-slab gap interferes with the formation of the SMSlab 3D k-space. Then, joint RF and gradient encoding are applied to remove the inter-slab gap interference and form a SMSlab 3D k-space. In vivo experiments are performed to validate the proposed theory. Acceleration in the proposed SMSlab 3D k-space is also evaluated.

RESULTS

High-resolution (1.0 mm isotropic) images can be reconstructed using the proposed SMSlab 3D framework. Controlled aliasing in parallel imaging sampling and 2D GRAPPA reconstruction can also be applied in the SMSlab 3D k-space. Compared with conventional multi-slab acquisition, SMSlab exhibits better SNR maintainability (such as lower g-factors), especially at high acceleration factors.

CONCLUSION

It is demonstrated that the joint application of RF and gradient encoding enables SMSlab within a 3D Fourier encoding framework. Images with high isotropic resolution can be reconstructed, and further acceleration is also applicable. The proposed SMSlab 3D k-space can be valuable for both high-resolution and high-efficiency diffusion and functional MRI.

SMS MUSSELS: A navigator-free reconstruction for simultaneous multi-slice-accelerated multi-shot diffusion weighted imaging

PURPOSE

To introduce a novel reconstruction method for simultaneous multi-slice (SMS)-accelerated multi-shot diffusion weighted imaging (ms-DWI).

METHODS

SMS acceleration using blipped-CAIPI schemes have been proposed to speed up the acquisition of ms-DWIs. The reconstruction of the data requires (a) phase compensation to combine data from different shots and (b) slice unfolding to separate the data of different slices. The traditional approaches first estimate the phase maps corresponding to each shot and slice which are then employed to iteratively recover the slice unfolded DWIs without phase artifacts. In contrast, the proposed reconstruction directly recovers the slice-unfolded k-space data of the multiple shots for each slice in a single-step recovery scheme. The proposed method is enabled by the low-rank property inherent in the k-space samples of ms-DW acquisition. This enabled to formulate a joint recovery scheme that simultaneously (a) unfolds the k-space data of each slice using a SENSE-based scheme and (b) recover the missing k-space samples in each slice of the multi-shot acquisition employing a structured low-rank matrix completion. Additional smoothness regularization is also utilized for higher acceleration factors. The proposed joint recovery is tested on simulated and in vivo data and compared to similar un-navigated methods.

RESULTS

Our experiments show effective slice unfolding and successful recovery of DWIs with minimal phase artifacts using the proposed method. The performance is comparable to existing methods at low acceleration factors and better than existing methods for higher acceleration factors.

CONCLUSIONS

For the slice accelerations considered in this study, the proposed method can successfully recover DWIs from SMS-accelerated ms-DWI acquisitions.