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Muslu Y, Tamada D, Roberts NT, Cashen TA, Mandava S, Kecskemeti SR, Hernando D, Reeder SB. Free-breathing, fat-corrected T 1 mapping of the liver with stack-of-stars MRI, and joint estimation of T 1, PDFF, R 2 * , and B 1 + . Magn Reson Med 2024; 92:1913-1932. [PMID: 38923009 DOI: 10.1002/mrm.30182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/03/2024] [Accepted: 05/16/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE Quantitative T1 mapping has the potential to replace biopsy for noninvasive diagnosis and quantitative staging of chronic liver disease. Conventional T1 mapping methods are confounded by fat andB 1 + $$ {B}_1^{+} $$ inhomogeneities, resulting in unreliable T1 estimations. Furthermore, these methods trade off spatial resolution and volumetric coverage for shorter acquisitions with only a few images obtained within a breath-hold. This work proposes a novel, volumetric (3D), free-breathing T1 mapping method to account for multiple confounding factors in a single acquisition. THEORY AND METHODS Free-breathing, confounder-corrected T1 mapping was achieved through the combination of non-Cartesian imaging, magnetization preparation, chemical shift encoding, and a variable flip angle acquisition. A subspace-constrained, locally low-rank image reconstruction algorithm was employed for image reconstruction. The accuracy of the proposed method was evaluated through numerical simulations and phantom experiments with a T1/proton density fat fraction phantom at 3.0 T. Further, the feasibility of the proposed method was investigated through contrast-enhanced imaging in healthy volunteers, also at 3.0 T. RESULTS The method showed excellent agreement with reference measurements in phantoms across a wide range of T1 values (200 to 1000 ms, slope = 0.998 (95% confidence interval (CI) [0.963 to 1.035]), intercept = 27.1 ms (95% CI [0.4 54.6]), r2 = 0.996), and a high level of repeatability. In vivo imaging studies demonstrated moderate agreement (slope = 1.099 (95% CI [1.067 to 1.132]), intercept = -96.3 ms (95% CI [-82.1 to -110.5]), r2 = 0.981) compared to saturation recovery-based T1 maps. CONCLUSION The proposed method produces whole-liver, confounder-corrected T1 maps through simultaneous estimation of T1, proton density fat fraction, andB 1 + $$ {B}_1^{+} $$ in a single, free-breathing acquisition and has excellent agreement with reference measurements in phantoms.
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Affiliation(s)
- Yavuz Muslu
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Daiki Tamada
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | | | | | | | - Diego Hernando
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Scott B Reeder
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Hager A, Boule N, Pritchard L, Hodgetts S, Noga M, Guo Y, Mazurak V, Grenier J, Thompson R, Gilmour SM, Mager DR. Sarcopenia in Children Post Liver Transplant: Development of a Home-Based Video Program to Support Muscle Strength and Function-A Pre-Post Controlled Pilot Study. Clin Transplant 2024; 38:e15455. [PMID: 39254094 DOI: 10.1111/ctr.15455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 08/09/2024] [Accepted: 08/24/2024] [Indexed: 09/11/2024]
Abstract
INTRODUCTION Sarcopenia is common in children after liver transplantation (LTx). Resistance training (RT) may be effective in combating sarcopenia. OBJECTIVES The purpose of the study was to test the feasibility and impact of a 12-week RT program on skeletal muscle mass (SMM), muscle strength, physical performance (PP), and child-parent perspectives about RT. METHODS Children (6-18 years) post-LTx and healthy controls (HC) underwent progressive RT using resistance bands. SMM and adipose tissue (MRI: abdomen and thigh), muscle strength (handgrip, push-ups, sit-to-stand), and PP (6-minute walk test [6MWT], timed-up-and-down-stair test [TUDS]) were measured before and after 12-weeks of RT. RESULTS Ten children post-LTx (11.9 ± 3.5 years) and 13 HC (11.7 ± 3.9 years) participated. LTx children significantly increased abdominal SM-index (+4.6% LTx vs. a -2.7% HC; p = 0.01) and decreased visceral adipose tissue-index (-18% LTx vs. -0.8% HC; p = 0.04) compared to HC. No thigh SMI changes were noted. Significant increases in 6MWT distance (LTx; p = 0.04), number of push-ups (p = 0.04), and greater reduction times for TUDS (-10.6% vs. +1.7%; p = 0.05) occurred after 12 weeks. Higher thigh muscle-fat content was associated with worse physical performance. These results were impacted by adherence (≥75% vs. <75%) and family engagement. CONCLUSIONS RT in children post-LTx is feasible and effective. RT in children post-LTx may alleviate adverse outcomes associated with sarcopenia.
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Affiliation(s)
- Amber Hager
- Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Edmonton, Canada
| | - Normand Boule
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Lesley Pritchard
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Sandra Hodgetts
- Department of Occupational Therapy, University of Alberta, Edmonton, Canada
| | - Michelle Noga
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Yuxin Guo
- Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Edmonton, Canada
| | - Vera Mazurak
- Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Edmonton, Canada
| | - Justin Grenier
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada
| | - Richard Thompson
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada
| | - Susan M Gilmour
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Division of Pediatric Gastroenterology & Nutrition/Transplant Services, The Stollery Children's Hospital, Alberta Health Services, Edmonton, Canada
| | - Diana R Mager
- Department of Agricultural, Food & Nutritional Sciences, University of Alberta, Edmonton, Canada
- Department of Pediatrics, University of Alberta, Edmonton, Canada
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Stelter J, Weiss K, Steinhelfer L, Spieker V, Huaroc Moquillaza E, Zhang W, Makowski MR, Schnabel JA, Kainz B, Braren RF, Karampinos DC. Simultaneous whole-liver water T 1 $$ {\mathrm{T}}_1 $$ and T 2 $$ {\mathrm{T}}_2 $$ mapping with isotropic resolution during free-breathing. NMR IN BIOMEDICINE 2024:e5216. [PMID: 39099162 DOI: 10.1002/nbm.5216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 06/03/2024] [Accepted: 06/18/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE To develop and validate a data acquisition scheme combined with a motion-resolved reconstruction and dictionary-matching-based parameter estimation to enable free-breathing isotropic resolution self-navigated whole-liver simultaneous water-specificT 1 $$ {\mathrm{T}}_1 $$ (wT 1 $$ {\mathrm{wT}}_1 $$ ) andT 2 $$ {\mathrm{T}}_2 $$ (wT 2 $$ {\mathrm{wT}}_2 $$ ) mapping for the characterization of diffuse and oncological liver diseases. METHODS The proposed data acquisition consists of a magnetization preparation pulse and a two-echo gradient echo readout with a radial stack-of-stars trajectory, repeated with different preparations to achieve differentT 1 $$ {\mathrm{T}}_1 $$ andT 2 $$ {\mathrm{T}}_2 $$ contrasts in a fixed acquisition time of 6 min. Regularized reconstruction was performed using self-navigation to account for motion during the free-breathing acquisition, followed by water-fat separation. Bloch simulations of the sequence were applied to optimize the sequence timing forB 1 $$ {B}_1 $$ insensitivity at 3 T, to correct for relaxation-induced blurring, and to mapT 1 $$ {\mathrm{T}}_1 $$ andT 2 $$ {\mathrm{T}}_2 $$ using a dictionary. The proposed method was validated on a water-fat phantom with varying relaxation properties and in 10 volunteers against imaging and spectroscopy reference values. The performance and robustness of the proposed method were evaluated in five patients with abdominal pathologies. RESULTS Simulations demonstrate goodB 1 $$ {B}_1 $$ insensitivity of the proposed method in measuringT 1 $$ {\mathrm{T}}_1 $$ andT 2 $$ {\mathrm{T}}_2 $$ values. The proposed method produces co-registeredwT 1 $$ {\mathrm{wT}}_1 $$ andwT 2 $$ {\mathrm{wT}}_2 $$ maps with a good agreement with reference methods (phantom:wT 1 = 1 . 02 wT 1,ref - 8 . 93 ms , R 2 = 0 . 991 $$ {\mathrm{wT}}_1=1.02\kern0.1em {\mathrm{wT}}_{1,\mathrm{ref}}-8.93\kern0.1em \mathrm{ms},{R}^2=0.991 $$ ;wT 2 = 1 . 03 wT 2,ref + 0 . 73 ms , R 2 = 0 . 995 $$ {\mathrm{wT}}_2=1.03\kern0.1em {\mathrm{wT}}_{2,\mathrm{ref}}+0.73\kern0.1em \mathrm{ms},{R}^2=0.995 $$ ). The proposedwT 1 $$ {\mathrm{wT}}_1 $$ andwT 2 $$ {\mathrm{wT}}_2 $$ mapping exhibits good repeatability and can be robustly performed in patients with pathologies. CONCLUSIONS The proposed method allows whole-liverwT 1 $$ {\mathrm{wT}}_1 $$ andwT 2 $$ {\mathrm{wT}}_2 $$ quantification with high accuracy at isotropic resolution in a fixed acquisition time during free-breathing.
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Affiliation(s)
- Jonathan Stelter
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | | | - Lisa Steinhelfer
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Veronika Spieker
- Institute of Machine Learning for Biomedical Imaging, Helmholtz Munich, Neuherberg, Germany
- School of Computation, Information and Technology, Technical University of Munich, Munich, Germany
| | - Elizabeth Huaroc Moquillaza
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Weitong Zhang
- Department of Computing, Imperial College London, London, United Kingdom
| | - Marcus R Makowski
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Julia A Schnabel
- Institute of Machine Learning for Biomedical Imaging, Helmholtz Munich, Neuherberg, Germany
- School of Computation, Information and Technology, Technical University of Munich, Munich, Germany
- School of Biomedical Imaging and Imaging Sciences, King's College London, London, United Kingdom
| | - Bernhard Kainz
- Department of Computing, Imperial College London, London, United Kingdom
- Department Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Rickmer F Braren
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Institute of Diagnostic and Interventional Radiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, Garching, Germany
- Munich Data Science Institute, Technical University of Munich, Garching, Germany
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Paterson DI, White JA, Beaulieu C, Sherrington R, Prado CM, Tandon P, Halloran K, Smith S, McCombe JA, Ritchie B, Pituskin E, Haykowsky MJ, Coulden R, Emery D, Tsui AK, Wu KY, Oudit GY, Ezekowitz JA, Thompson RB. Rationale and design of the multi organ inflammation with serial testing study: a comprehensive assessment of functional and structural abnormalities in patients with recovered COVID-19. Front Med (Lausanne) 2024; 11:1392169. [PMID: 39114821 PMCID: PMC11303169 DOI: 10.3389/fmed.2024.1392169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/03/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Short-term clinical outcomes from SARS-CoV-2 infection are generally favorable. However, 15-20% of patients report persistent symptoms of at least 12 weeks duration, often referred to as long COVID. Population studies have also demonstrated an increased risk of incident diabetes and cardiovascular disease at 12 months following infection. While imaging studies have identified multi-organ injury patterns in patients with recovered COVID-19, their respective contributions to the disability and morbidity of long COVID is unclear. Methods A multicenter, observational study of 215 vaccine-naïve patients with clinically recovered COVID-19, studied at 3-6 months following infection, and 133 healthy volunteers without prior SARS-CoV-2 infection. Patients with recovered COVID-19 were screened for long COVID related symptoms and their impact on daily living. Multi-organ, multi-parametric magnetic resonance imaging (MRI) and circulating biomarkers were acquired to document sub-clinical organ pathology. All participants underwent pulmonary function, aerobic endurance (6 min walk test), cognition testing and olfaction assessment. Clinical outcomes were collected up to 1 year from infection. The primary objective of this study is to identify associations between organ injury and disability in patients with long-COVID symptoms in comparison to controls. As a secondary objective, imaging and circulating biomarkers with the potential to exacerbate cardiovascular health were characterized. Discussion Long-term sequelae of COVID-19 are common and can result in significant disability and cardiometabolic disease. The overall goal of this project is to identify novel targets for the treatment of long COVID including mitigating the risk of incident cardiovascular disease. Study registration clinicaltrials.gov (MOIST late cross-sectional study; NCT04525404).
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Affiliation(s)
- D. Ian Paterson
- University of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada
| | - James A. White
- Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada
| | - Christian Beaulieu
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Rachel Sherrington
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Carla M. Prado
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, Canada
| | - Puneeta Tandon
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Kieran Halloran
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Smith
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - Bruce Ritchie
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Edith Pituskin
- College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Mark J. Haykowsky
- College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Richard Coulden
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Derek Emery
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Albert K. Tsui
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - Kai Y. Wu
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Mazankowski Alberta Heart Institute, Edmonton, AB, Canada
| | - Gavin Y. Oudit
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Mazankowski Alberta Heart Institute, Edmonton, AB, Canada
| | - Justin A. Ezekowitz
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
- Mazankowski Alberta Heart Institute, Edmonton, AB, Canada
| | - Richard B. Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
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Yang R, Peng H, Pan J, Wan Q, Zou C, Hu F. Native and Gd-EOB-DTPA-Enhanced T1 mapping for Assessment of Liver Fibrosis in NAFLD: Comparative Analysis of Modified Look-Locker Inversion Recovery and Water-specific T1 mapping. Acad Radiol 2024:S1076-6332(24)00443-4. [PMID: 39043516 DOI: 10.1016/j.acra.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/03/2024] [Accepted: 07/04/2024] [Indexed: 07/25/2024]
Abstract
RATIONALE AND OBJECTIVES To investigate the diagnostic performance of water-specific T1 mapping for staging liver fibrosis in a non-alcoholic fatty liver disease (NAFLD) rabbit model, in comparison to Modified Look-Locker Inversion recovery (MOLLI) T1 mapping. MATERIALS AND METHODS 60 rabbits were randomly divided into the control group (12 rabbits) and NAFLD model groups (eight rabbits per subgroup) corresponding to different durations of high-fat high cholesterol diet feeding. All rabbits underwent MRI examination including MOLLI T1 mapping and 3D multi-echo variable flip angle (VFAME- GRE) sequences were acquired before and 20 min after the administration of Gd- EOB-DTPA. Histological assessments were performed to evaluate steatosis, inflammation, ballooning, and fibrosis. Statistical analysis included the intraclass correlation coefficient, analysis of variance, spearman correlation, multiple linear regression, and receiver operating characteristic curve. RESULTS A moderate correlation was observed between conventional native T1 and MRI-PDFF (r = -0.513, P < 0.001), as well as between conventional native T1 and liver steatosis grades (r = -0.319, P = 0.016). However, no significant correlation was found between the native wT1 and PDFF (r = 0.137, P = 0.314), or between the native wT1 and steatosis grades (r = 0.106, P = 0.435). In the multiple regression analysis, liver fibrosis, and hepatocellular ballooning were identified as independent factors influencing native wT1 in this study (R2 =0.545, P < 0.05), while steatosis was independently associated with conventional native T1 (R2 =0.321, P < 0.05). The AUC values for native T1, native wT1, HBP T1, and HBP wT1 were 0.549(0.410-0.682), 0.811(0.684-0.903), 0.775(0.644-0.876), and 0.752(0.619-0.858) for F1 or higher, 0.581(0.441-0.711), 0.828(0.704-0.916), 0.832(0.708-0.919), and 0.854(0.734-0.934) for F2 or higher, respectively. CONCLUSION The native wT1 may provide a more reliable assessment of early liver fibrosis in the context of NAFLD compared to conventional native T1.
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Affiliation(s)
- Ru Yang
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, No.278, Baoguang Road, Xindu District, Chengdu, Sichuan, China (R.Y., J.P., F.H.)
| | - Hao Peng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, China (H.P., Q.W., C.Z.)
| | - Jing Pan
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, No.278, Baoguang Road, Xindu District, Chengdu, Sichuan, China (R.Y., J.P., F.H.)
| | - Qian Wan
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, China (H.P., Q.W., C.Z.)
| | - Chao Zou
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, China (H.P., Q.W., C.Z.)
| | - Fubi Hu
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, No.278, Baoguang Road, Xindu District, Chengdu, Sichuan, China (R.Y., J.P., F.H.).
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Li J. Editorial for "Reference Values for Water-Specific T1 of the Liver at 3T: T2*-Compensation and the Confounding Effects of Fat". J Magn Reson Imaging 2024. [PMID: 38450894 DOI: 10.1002/jmri.29320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China
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Thompson RB, Sherrington R, Beaulieu C, Kirkham A, Paterson DI, Seres P, Grenier J. Reference Values for Water-Specific T1 of the Liver at 3 T: T2*-Compensation and the Confounding Effects of Fat. J Magn Reson Imaging 2024. [PMID: 38305588 DOI: 10.1002/jmri.29262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND T1 mapping of the liver is confounded by the presence of fat. Multiparametric T1 mapping combines fat-water separation with T1-weighting to enable imaging of water-specific T1 (T1Water ), proton density fat fraction (PDFF), and T2* values. However, normative T1Water values in the liver and its dependence on age/sex is unknown. PURPOSE Determine normative values for T1Water in the liver with comparison to MOLLI and evaluate a T2*-compensation approach to reduce T1 variability. STUDY TYPE Prospective observational; phantoms. POPULATIONS One hundred twenty-four controls (56 male, 18-75 years), 50 patients at-risk for liver disease (18 male, 30-76 years). FIELD STRENGTH/SEQUENCE 2.89 T; Saturation-recovery chemical-shift encoded T1 Mapping (SR-CSE); MOLLI. ASSESSMENT SR-CSE provided T1Water measurements, PDFF and T2* values in the liver across three slices in 6 seconds. These were compared with MOLLI T1 values. A new T2*-compensation approach to reduce T1 variability was evaluated test/re-test reproducibility. STATISTICAL TESTS Linear regression, ANCOVA, t-test, Bland and Altman, intraclass correlation coefficient (ICC). P < 0.05 was considered statistically significant. RESULTS Liver T1 values were significantly higher in healthy females (F) than males (M) for both SR-CSE (F-973 ± 78 msec, M-930 ± 72 msec) and MOLLI (F-802 ± 55 msec, M-759 ± 69 msec). T1 values were negatively correlated with age, with similar sex- and age-dependencies observed in T2*. The T2*-compensation model reduced the variability of T1 values by half and removed sex- and age-differences (SR-CSE: F-946 ± 36 msec, M-941 ± 43 msec; MOLLI: F-775 ± 35 msec, M-770 ± 35 msec). At-risk participants had elevated PDFF and T1 values, which became more distinct from the healthy cohort after T2*-compensation. MOLLI systematically underestimated liver T1 values by ~170 msec with an additional positive T1-bias from fat content (~11 msec/1% in PDFF). Reproducibility ICC values were ≥0.96 for all parameters. DATA CONCLUSION Liver T1Water values were lower in males and decreased with age, as observed for SR-CSE and MOLLI acquisitions. MOLLI underestimated liver T1 with an additional large positive fat-modulated T1 bias. T2*-compensation removed sex- and age-dependence in liver T1, reduced the range of healthy values and increased T1 group differences between healthy and at-risk groups. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Richard B Thompson
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Rachel Sherrington
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Christian Beaulieu
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Amy Kirkham
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - David I Paterson
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Peter Seres
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Justin Grenier
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
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8
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Hernando D, van der Heijden RA, Reeder SB. A better understanding of liver T1. Eur Radiol 2023; 33:6841-6843. [PMID: 37552263 DOI: 10.1007/s00330-023-10067-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 08/09/2023]
Affiliation(s)
- Diego Hernando
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA.
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA.
| | - Rianne A van der Heijden
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI, USA
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Higashi M, Tanabe M, Yamane M, Keerthivasan MB, Imai H, Yonezawa T, Nakamura M, Ito K. Impact of fat on the apparent T1 value of the liver: assessment by water-only derived T1 mapping. Eur Radiol 2023; 33:6844-6851. [PMID: 37552261 DOI: 10.1007/s00330-023-10052-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/24/2023] [Accepted: 06/16/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES To determine the impact of fat on the apparent T1 value of the liver using water-only derived T1 mapping. METHODS 3-T MRI included 2D Look-Locker T1 mapping and proton density fat fraction (PDFF) mapping. T1 values of the liver were compared among T1 maps obtained by in-phase (IP), opposed-phase (OP), and Dixon water sequences using paired t-test. The correlation between T1 values of the liver on each T1 map and PDFF was assessed using Spearman correlation coefficient. The absolute differences between T1 value of the liver on Dixon water images and that on IP or OP images were also correlated with PDFF. RESULTS One hundred sixty-two patients (median age, 70 [range, 24-91] years, 90 men) were retrospectively evaluated. The T1 values of the liver on each T1 map were significantly different (p < 0.001). The T1 value of the liver on IP images was significantly negatively correlated with PDFF (r = - 0.438), while the T1 value of the liver on OP images was slightly positively correlated with PDFF (r = 0.164). The T1 value of the liver on Dixon water images was slightly negatively correlated with PDFF (r = - 0.171). The absolute differences between T1 value of the liver on Dixon water images and that on IP or OP images were significantly correlated with PDFF (r = 0.606, 0.722; p < 0.001). CONCLUSION Fat correction for the apparent T1 value by water-only derived T1 maps will be helpful for accurately evaluating the T1 value of the liver. CLINICAL RELEVANCE STATEMENT Fat-corrected T1 mapping of the liver with the water component only obtained from the 2D Dixon Look-Locker sequence could be useful for accurately evaluating the T1 value of the liver without the impact of fat in daily clinical practice. KEY POINTS • The T1 values of the liver on the conventional T1 maps are significantly affected by the presence of fat. • The apparent T1 value of the liver on water-only derived T1 maps would be slightly impacted by the presence of fat. • Fat correction for the apparent T1 values is necessary for the accurate assessment of the T1 values of the liver.
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Affiliation(s)
- Mayumi Higashi
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
| | - Masahiro Tanabe
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
| | - Masatoshi Yamane
- Department of Radiological Technology, Yamaguchi University Hospital, Yamaguchi, Japan
| | | | - Hiroshi Imai
- MR Research and Collaboration, Siemens Healthcare K.K., Tokyo, Japan
| | - Teppei Yonezawa
- Department of Radiological Technology, Yamaguchi University Hospital, Yamaguchi, Japan
| | - Michihiro Nakamura
- Department of Organ Anatomy & NANOMEDICINE, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Katsuyoshi Ito
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan
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10
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Christensen RAG, Haykowsky MJ, Nadler M, Prado CM, Small SD, Rickard JN, Pituskin E, Paterson DI, Mackey JR, Thompson RB, Kirkham AA. Rationale and design of IMPACT-women: a randomised controlled trial of the effect of time-restricted eating, healthy eating and reduced sedentary behaviour on metabolic health during chemotherapy for early-stage breast cancer. Br J Nutr 2023; 130:852-859. [PMID: 36453589 PMCID: PMC10404477 DOI: 10.1017/s0007114522003816] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
Abstract
Metabolic dysfunction and excess accumulation of adipose tissue are detrimental side effects from breast cancer treatment. Diet and physical activity are important treatments for metabolic abnormalities, yet patient compliance can be challenging during chemotherapy treatment. Time-restricted eating (TRE) is a feasible dietary pattern where eating is restricted to 8 h/d with water-only fasting for the remaining 16 h. The purpose of this study is to evaluate the effect of a multimodal intervention consisting of TRE, healthy eating, and reduced sedentary time during chemotherapy treatment for early-stage (I-III) breast cancer on accumulation of visceral fat (primary outcome), other fat deposition locations, metabolic syndrome and cardiovascular disease risk (secondary outcomes) compared with usual care. The study will be a two-site, two-arm, parallel-group superiority randomised control trial enrolling 130 women scheduled for chemotherapy for early-stage breast cancer. The intervention will be delivered by telephone, including 30-60-minute calls with a registered dietitian who will provide instructions on TRE, education and counselling on healthy eating, and goal setting for reducing sedentary time. The comparison group will receive usual cancer and supportive care including a single group-based nutrition class and healthy eating and physical activity guidelines. MRI, blood draws and assessment of blood pressure will be performed at baseline, after chemotherapy (primary end point), and 2-year follow-up. If our intervention is successful in attenuating the effect of chemotherapy on visceral fat accumulation and cardiometabolic dysfunction, it has the potential to reduce risk of cardiometabolic disease and related mortality among breast cancer survivors.
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Affiliation(s)
| | | | - Michelle Nadler
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Carla M. Prado
- Department of Agriculture, Food and Nutrition Science, University of Alberta, Edmonton, AB, Canada
| | - Stephanie D. Small
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON, Canada
| | - Julia N. Rickard
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON, Canada
| | - Edith Pituskin
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - D. Ian Paterson
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - John R. Mackey
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Richard B. Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Amy Ashley Kirkham
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehabilitation Institute, Toronto, ON, Canada
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11
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Greidanus PG, Pagano JJ, Escudero CA, Thompson R, Tham EB. Regional Elevation of Liver T1 in Fontan Patients. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2023; 2:134-142. [PMID: 37969352 PMCID: PMC10642140 DOI: 10.1016/j.cjcpc.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/08/2023] [Indexed: 11/17/2023]
Abstract
Background Fontan-associated liver disease (FALD) is characterized by hepatic congestion and progressive hepatic fibrosis in patients with the Fontan operation. This condition is generally clinically silent until late, necessitating techniques for early detection. Liver T1 mapping has been used to screen for FALD, but without consideration of regional variations in T1 values. Methods Liver T1 measured with a liver-specific T1 mapping sequence (PROFIT1) in Fontan patients was compared with cohorts of patients with biventricular congenital heart disease (BiV-CHD) and controls with normal cardiac function and anatomy. Results Liver T1 was significantly elevated in the Fontan cohort (n = 20) compared with patients with BiV-CHD (n = 12) and controls (n = 9) (781, 678, and 675 milliseconds, respectively; P < 0.001), with a consistent pattern of significantly elevated T1 values in the peripheral compared with central liver regions (ΔT1 = 54, 2, and 11 milliseconds; P < 0.001). PROFIT1 also yielded simultaneous T2∗ maps and fat fraction values that were similar in all groups. Fontan liver T1 values were also significantly elevated as compared with BiV-CHD and controls as measured with the cardiac (modified Look-Locker inversion) acquisitions (728, 583, and 583 milliseconds, respectively; P < 0.001) and values correlated with PROFIT1 liver T1 (R = 0.87, P < 0.001). Conclusions Fontan patients have globally increased liver T1 values and consistent spatial variations, with higher values in the peripheral liver regions as compared with spatially uniform values in BiV-CHD and controls. The spatial patterns may provide insight into the progression of FALD. Liver T1 mapping studies should include uniform spatial coverage to avoid bias based on slice locations in this population.
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Affiliation(s)
- Paul G. Greidanus
- Division of Pediatric Cardiology, Stollery Children’s Hospital & Mazankowski Alberta Heart Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Joseph J. Pagano
- Division of Pediatric Cardiology, Stollery Children’s Hospital & Mazankowski Alberta Heart Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carolina A. Escudero
- Division of Pediatric Cardiology, Stollery Children’s Hospital & Mazankowski Alberta Heart Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Edythe B. Tham
- Division of Pediatric Cardiology, Stollery Children’s Hospital & Mazankowski Alberta Heart Institute, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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12
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Crosier R, Kafil TS, Paterson DI. Imaging for Cardiovascular Complications of COVID-19: Cardiac Manifestations in Context. Can J Cardiol 2023; 39:779-792. [PMID: 36731604 PMCID: PMC9886397 DOI: 10.1016/j.cjca.2023.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/29/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023] Open
Abstract
After the first confirmed case in 2019, COVID-19 rapidly spread worldwide and overwhelmed the medical community. In the intervening time, we have learned about COVID-19's clinical manifestations and have developed effective therapies and preventative vaccines. Severe COVID-19 infection is associated with many cardiovascular disorders in the acute phase, and patients recovered from illness can also manifest long-term sequelae, including long COVID syndrome. Furthermore, severe acute respiratory syndrome-related coronavirus-2 messenger RNA (mRNA) vaccination can trigger rare cases of myopericarditis. We have gained significant knowledge of the acute and long-term cardiovascular complications of COVID-19- and mRNA vaccine-associated myocarditis through clinical and investigative studies using cardiac imaging. In this review, we describe how cardiovascular imaging can be used to understand the cardiovascular complications and cardiac injury associated with acute COVID-19 infection, review the imaging findings in patients recovered from illness, and discuss the role and limitations of cardiac imaging in COVID-19 mRNA vaccine-associated myocarditis.
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Affiliation(s)
- Rebecca Crosier
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Tahir S Kafil
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - D Ian Paterson
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
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13
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Kirkham AA, Ford KL, Ramos Da Silva B, Topolnyski J, Prado CM, Joy AA, Paterson DI, Boulé N, Pituskin E, Haykowsky MJ, Thompson RB. Implementation of weekday time-restricted eating to improve metabolic health in breast cancer survivors with overweight/obesity. Obesity (Silver Spring) 2023; 31 Suppl 1:150-160. [PMID: 36695128 DOI: 10.1002/oby.23654] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE This study aimed to evaluate the implementation of telephone-based delivery of weekday-only time-restricted eating (TRE), its preliminary efficacy for metabolic outcomes, and concurrent lifestyle changes. METHODS Twenty-two breast cancer survivors aged 60+ years with overweight/obesity completed an 8-week feasibility study of 12 to 8 p.m. weekday-only ad libitum TRE. The intervention was delivered by one registered dietitian call, twice-daily automated text messages asking about eating start and stop times, and three support phone calls. Magnetic resonance imaging, venipuncture, and 3 days of diet records and accelerometry were performed at baseline and after intervention. RESULTS Participants had a mean age of 66 (SD 5) years with BMI of 31.8 (4.8) kg/m2 . Intervention implementation was successful, including excellent adherence (98%), participant acceptability, and a low symptom profile and cost ($63/participant). There were no significant changes in individual components of metabolic syndrome, lipid profile, or hemoglobin A1c , despite clinically relevant changes occurring within individual participants. Magnetic resonance imaging-derived hepatic steatosis and thigh myosteatosis did not change. Dietary intake changes included reduced energy (-22%) and protein (-0.2 g/kg). Physical activity and sleep did not change. CONCLUSIONS Eight weeks of telephone-delivered weekday TRE is a feasible, acceptable, low-symptom, and low-cost intervention. Future studies may consider a longer intervention length for more consistent metabolic improvements and counseling to enhance protein intake.
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Affiliation(s)
- Amy A Kirkham
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Katherine L Ford
- Department of Agriculture, Food & Nutrition Science, University of Alberta, Edmonton, Alberta, Canada
| | - Bruna Ramos Da Silva
- Department of Agriculture, Food & Nutrition Science, University of Alberta, Edmonton, Alberta, Canada
| | - Jordan Topolnyski
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Carla M Prado
- Department of Agriculture, Food & Nutrition Science, University of Alberta, Edmonton, Alberta, Canada
| | - Anil A Joy
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - D Ian Paterson
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Normand Boulé
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Edith Pituskin
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Mark J Haykowsky
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Richard B Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
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14
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Fotaki A, Velasco C, Prieto C, Botnar RM. Quantitative MRI in cardiometabolic disease: From conventional cardiac and liver tissue mapping techniques to multi-parametric approaches. Front Cardiovasc Med 2023; 9:991383. [PMID: 36756640 PMCID: PMC9899858 DOI: 10.3389/fcvm.2022.991383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023] Open
Abstract
Cardiometabolic disease refers to the spectrum of chronic conditions that include diabetes, hypertension, atheromatosis, non-alcoholic fatty liver disease, and their long-term impact on cardiovascular health. Histological studies have confirmed several modifications at the tissue level in cardiometabolic disease. Recently, quantitative MR methods have enabled non-invasive myocardial and liver tissue characterization. MR relaxation mapping techniques such as T1, T1ρ, T2 and T2* provide a pixel-by-pixel representation of the corresponding tissue specific relaxation times, which have been shown to correlate with fibrosis, altered tissue perfusion, oedema and iron levels. Proton density fat fraction mapping approaches allow measurement of lipid tissue in the organ of interest. Several studies have demonstrated their utility as early diagnostic biomarkers and their potential to bear prognostic implications. Conventionally, the quantification of these parameters by MRI relies on the acquisition of sequential scans, encoding and mapping only one parameter per scan. However, this methodology is time inefficient and suffers from the confounding effects of the relaxation parameters in each single map, limiting wider clinical and research applications. To address these limitations, several novel approaches have been proposed that encode multiple tissue parameters simultaneously, providing co-registered multiparametric information of the tissues of interest. This review aims to describe the multi-faceted myocardial and hepatic tissue alterations in cardiometabolic disease and to motivate the application of relaxometry and proton-density cardiac and liver tissue mapping techniques. Current approaches in myocardial and liver tissue characterization as well as latest technical developments in multiparametric quantitative MRI are included. Limitations and challenges of these novel approaches, and recommendations to facilitate clinical validation are also discussed.
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Affiliation(s)
- Anastasia Fotaki
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom,*Correspondence: Anastasia Fotaki,
| | - Carlos Velasco
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Claudia Prieto
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom,School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile,Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile,Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
| | - René M. Botnar
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom,School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile,Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile,Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile
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15
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Roberts NT, Tamada D, Muslu Y, Hernando D, Reeder SB. Confounder-corrected T 1 mapping in the liver through simultaneous estimation of T 1 , PDFF, R 2 * , and B 1 + in a single breath-hold acquisition. Magn Reson Med 2023; 89:2186-2203. [PMID: 36656152 PMCID: PMC10139739 DOI: 10.1002/mrm.29590] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/23/2022] [Accepted: 01/01/2023] [Indexed: 01/20/2023]
Abstract
PURPOSE Quantitative volumetric T1 mapping in the liver has the potential to aid in the detection, diagnosis, and quantification of liver fibrosis, inflammation, and spatially resolved liver function. However, accurate measurement of hepatic T1 is confounded by the presence of fat and inhomogeneous B 1 + $$ {B}_1^{+} $$ excitation. Furthermore, scan time constraints related to respiratory motion require tradeoffs of reduced volumetric coverage and/or increased acquisition time. This work presents a novel 3D acquisition and estimation method for confounder-corrected T1 measurement over the entire liver within a single breath-hold through simultaneous estimation of T1 , fat and B 1 + $$ {B}_1^{+} $$ . THEORY AND METHODS The proposed method combines chemical shift encoded MRI and variable flip angle MRI with a B 1 + $$ {B}_1^{+} $$ mapping technique to enable confounder-corrected T1 mapping. The method was evaluated theoretically and demonstrated in both phantom and in vivo acquisitions at 1.5 and 3.0T. At 1.5T, the method was evaluated both pre- and post- contrast enhancement in healthy volunteers. RESULTS The proposed method demonstrated excellent linear agreement with reference inversion-recovery spin-echo based T1 in phantom acquisitions at both 1.5 and 3.0T, with minimal bias (5.2 and 45 ms, respectively) over T1 ranging from 200-1200 ms. In vivo results were in general agreement with reference saturation-recovery based 2D T1 maps (SMART1 Map, GE Healthcare). CONCLUSION The proposed 3D T1 mapping method accounts for fat and B 1 + $$ {B}_1^{+} $$ confounders through simultaneous estimation of T1 , B 1 + $$ {B}_1^{+} $$ , PDFF and R 2 * $$ {R}_2^{\ast } $$ . It demonstrates strong linear agreement with reference T1 measurements, with low bias and high precision, and can achieve full liver coverage in a single breath-hold.
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Affiliation(s)
- Nathan T Roberts
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Electrical and Computer Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Daiki Tamada
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Yavuz Muslu
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Diego Hernando
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Electrical and Computer Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Medicine, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Emergency Medicine, University of Wisconsin - Madison, Madison, Wisconsin, USA
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16
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Li Z, Mathew M, Syed AB, Feng L, Brunsing R, Pauly JM, Vasanawala SS. Rapid fat-water separated T 1 mapping using a single-shot radial inversion-recovery spoiled gradient recalled pulse sequence. NMR IN BIOMEDICINE 2022; 35:e4803. [PMID: 35891586 DOI: 10.1002/nbm.4803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 05/04/2023]
Abstract
T1 mapping is increasingly used in clinical practice and research studies. With limited scan time, existing techniques often have limited spatial resolution, contrast resolution and slice coverage. High fat concentrations yield complex errors in Look-Locker T1 methods. In this study, a dual-echo 2D radial inversion-recovery T1 (DEradIR-T1) technique was developed for fast fat-water separated T1 mapping. The DEradIR-T1 technique was tested in phantoms, 5 volunteers and 28 patients using a 3 T clinical MRI scanner. In our study, simulations were performed to analyze the composite (fat + water) and water-only T1 under different echo times (TE). In standardized phantoms, an inversion-recovery spin echo (IR-SE) sequence with and without fat saturation pulses served as a T1 reference. Parameter mapping with DEradIR-T1 was also assessed in vivo, and values were compared with modified Look-Locker inversion recovery (MOLLI). Bland-Altman analysis and two-tailed paired t-tests were used to compare the parameter maps from DEradIR-T1 with the references. Simulations of the composite and water-only T1 under different TE values and levels of fat matched the in vivo studies. T1 maps from DEradIR-T1 on a NIST phantom (Pcomp = 0.97) and a Calimetrix fat-water phantom (Pwater = 0.56) matched with the references. In vivo T1 was compared with that of MOLLI: R comp 2 = 0.77 ; R water 2 = 0.72 . In this work, intravoxel fat is found to have a variable, echo-time-dependent effect on measured T1 values, and this effect may be mitigated using the proposed DRradIR-T1.
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Affiliation(s)
- Zhitao Li
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Manoj Mathew
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Ali B Syed
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Li Feng
- Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ryan Brunsing
- Department of Radiology, Stanford University, Stanford, California, USA
| | - John M Pauly
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
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17
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Wan Q, Peng H, Lyu J, Liu F, Cheng C, Qiao Y, Deng J, Zheng H, Wang Y, Zou C, Liu X. Water Specific MRI T1 Mapping for Evaluating Liver Inflammation Activity Grades in Rats With Methionine-Choline-Deficient Diet-Induced Nonalcoholic Fatty Liver Disease. J Magn Reson Imaging 2022; 56:1429-1436. [PMID: 35212074 DOI: 10.1002/jmri.28131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Early detection and grading of liver inflammation are important for the management of nonalcoholic fatty liver disease (NAFLD) patients. There is still lack of a noninvasive way for the inflammation characterization in NAFLD. PURPOSE To assess liver inflammation grades by water specific T1 (wT1) in a rat model. STUDY TYPE Prospective. ANIMAL MODEL A total of 65 male rats with methionine-choline-deficient diet-induced NAFLD and 15 male normal rats as control. FIELD STRENGTH/SEQUENCE A 3 T; multiecho variable flip angle gradient echo sequence. ASSESSMENT The wT1 and proton density fat fraction were quantified. Inflammation and fibrosis were assessed histologically with H&E and Sirius red stained slices according to the nonalcoholic steatohepatitis scoring system. Inflammation grade was scored with G0/G1/G2/G3 as none/mild/moderate/severe inflammation in NALFD rats. G0 + G1 and G2 + G3 were combined as none-to-mild grade (GL) and moderate-to-severe grade (GH) inflammation groups. STATISTICAL TESTS Analysis of variance (ANOVA), Mann-Whitney U test, Spearman's correlation, and receiver operating characteristic (ROC) analysis were performed. The areas under ROC (AUROC) was used for the diagnostic performance of wT1 in discriminating GH and GL. A P value < 0.01 was considered statistically significant. RESULTS Seventy-six rats were included in the analysis. The numbers in G0-G3 groups were 5, 16, 13, and 27. wT1 of G0-G3 was 568.55 ± 63.93 msec, 582.53 ± 62.98 msec, 521.21 ± 67.31 msec, and 508.79 ± 60.53 msec. A moderate but significant negative correlation between wT1 and histopathological inflammation grades was observed (rs = -0.42). The wT1 of GH (512.80 ± 62.22 msec) was significantly lower than GL (579.20 ± 61.89 msec). The AUROC of wT1 was 0.79, and the optimal cut-off of wT1 was 562.64 msec (sensitivity: 90%, specificity: 76%), for the discrimination of GL and GH. DATA CONCLUSIONS wT1 could differentiate none-to-mild inflammation from moderate-to-severe inflammation in the early stage of the NAFLD rat model. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Qian Wan
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Hao Peng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.,School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Jianxun Lyu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Feng Liu
- Department of Radiology, Peking University People's Hospital, Beijing, 100044, China.,Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, Peking University People's Hospital, Beijing, 100044, China
| | - Chuanli Cheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yangzi Qiao
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Jie Deng
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas, 75390, USA
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yi Wang
- Department of Radiology, Peking University People's Hospital, Beijing, 100044, China
| | - Chao Zou
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
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18
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Dasgupta K, Boulé N, Henson J, Chevalier S, Redman E, Chan D, McCarthy M, Champagne J, Arsenyadis F, Rees J, Da Costa D, Gregg E, Yeung R, Hadjiconstantinou M, Dattani A, Friedrich MG, Khunti K, Rahme E, Fortier I, Prado CM, Sherman M, Thompson RB, Davies MJ, McCann GP, Yates T. Remission of type 2 diabetes and improved diastolic function by combining structured exercise with meal replacement and food reintroduction among young adults: the RESET for REMISSION randomised controlled trial protocol. BMJ Open 2022; 12:e063888. [PMID: 36130753 PMCID: PMC9494595 DOI: 10.1136/bmjopen-2022-063888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) onset before 40 years of age has a magnified lifetime risk of cardiovascular disease. Diastolic dysfunction is its earliest cardiac manifestation. Low energy diets incorporating meal replacement products can induce diabetes remission, but do not lead to improved diastolic function, unlike supervised exercise interventions. We are examining the impact of a combined low energy diet and supervised exercise intervention on T2DM remission, with peak early diastolic strain rate, a sensitive MRI-based measure, as a key secondary outcome. METHODS AND ANALYSIS This prospective, randomised, two-arm, open-label, blinded-endpoint efficacy trial is being conducted in Montreal, Edmonton and Leicester. We are enrolling 100 persons 18-45 years of age within 6 years' T2DM diagnosis, not on insulin therapy, and with obesity. During the intensive phase (12 weeks), active intervention participants adopt an 800-900 kcal/day low energy diet combining meal replacement products with some food, and receive supervised exercise training (aerobic and resistance), three times weekly. The maintenance phase (12 weeks) focuses on sustaining any weight loss and exercise practices achieved during the intensive phase; products and exercise supervision are tapered but reinstituted, as applicable, with weight regain and/or exercise reduction. The control arm receives standard care. The primary outcome is T2DM remission, (haemoglobin A1c of less than 6.5% at 24 weeks, without use of glucose-lowering medications during maintenance). Analysis of remission will be by intention to treat with stratified Fisher's exact test statistics. ETHICS AND DISSEMINATION The trial is approved in Leicester (East Midlands - Nottingham Research Ethics Committee (21/EM/0026)), Montreal (McGill University Health Centre Research Ethics Board (RESET for remission/2021-7148)) and Edmonton (University of Alberta Health Research Ethics Board (Pro00101088). Findings will be shared widely (publications, presentations, press releases, social media platforms) and will inform an effectiveness trial. TRIAL REGISTRATION NUMBER ISRCTN15487120.
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Affiliation(s)
- Kaberi Dasgupta
- Department of Medicine, McGill University and Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Normand Boulé
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Joseph Henson
- Diabetes Research Centre, University of Leicester and NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Emma Redman
- Leicester Diabetes Centre, University Hospitals of Leicester NHS Trust and NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Deborah Chan
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Matthew McCarthy
- Diabetes Research Centre, University of Leicester and NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Julia Champagne
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Frank Arsenyadis
- Diabetes Research Centre, University of Leicester and NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Jordan Rees
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Deborah Da Costa
- Department of Medicine, McGill University and Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Edward Gregg
- School of Public Health, Imperial College London, London, UK
| | - Roseanne Yeung
- Division of Endocrinology & Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Hadjiconstantinou
- Diabetes Research Centre, University of Leicester and NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Abhishek Dattani
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Matthias G Friedrich
- Courtois Cardiovascular Signature Centre, McGill University Health Centre and Departments of Medicine and Diagnostic Radiology, McGill University, Montreal, Quebec, Canada
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester and NIHR Applied Research Collaboration - East Midlands (ARC-EM), University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Elham Rahme
- Department of Medicine, McGill University and Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Isabel Fortier
- Department of Medicine, McGill University and Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Mark Sherman
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Richard B Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester and NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester and NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
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19
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Al Onazi MM, Campbell KL, Thompson RB, Ghosh S, Mackey JR, Muir A, McNeely ML. Decongestive progressive resistance exercise with an adjustable compression wrap for breast cancer-related lymphoedema (DREAM): protocol for a randomised controlled trial. BMJ Open 2022; 12:e053165. [PMID: 35379618 PMCID: PMC8981291 DOI: 10.1136/bmjopen-2021-053165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Breast cancer-related lymphoedema (BCRL) is a chronic swelling in the arm on the side of the breast cancer surgery, affecting one in five women. Recent studies in BCRL have demonstrated that resistance exercise can improve symptoms and quality of life without worsening lymphoedema. No studies have explored whether combining the principles of progressive resistance exercise training with therapeutic strategies of compression therapy and the decongestive lymphatic exercise sequence are beneficial in reducing arm lymphoedema volume. The aim of this three-arm, provincial randomised controlled trial is to determine the efficacy of a 12-week decongestive progressive resistance exercise (DRE) programme in combination with the one of two types of compression garments compared with standard care. METHODS AND ANALYSIS Sixty women with BCRL will be recruited and randomly assigned to one of the following three groups: (1) Standard care, (2) DRE with use of a daytime compression garment during exercise and (3) DRE with use of an adjustable compression wrap during exercise. The primary outcome is the percentage reduction in arm lymphoedema volume. Secondary outcomes include bioimpedance analysis, muscular strength, shoulder range of motion, physical activity level and health-related quality of life. Exploratory outcomes include evaluating changes in arm tissue composition using MRI and examining outcomes between the two DRE experimental groups. The primary analysis will compare changes between the groups from baseline to week 12 reflecting the end of the randomised control trial period. ETHICS AND DISSEMINATION The trial has received ethics approval from the Health Research Ethics Board of Alberta: Cancer Committee. The study results will be disseminated through scientific peer-reviewed publications, and presented at national and international conferences, and other media portals. The programme protocol will be shared with healthcare professionals and patient groups through clinical workshops and webinars. TRIAL REGISTRATION NUMBER NCT05022823. PROTOCOL VERSION 12 November 2021. ISSUE DATE 26 April 2021.
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Affiliation(s)
- Mona M Al Onazi
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Kristin L Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Richard B Thompson
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Sunita Ghosh
- Department of Mathematics and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - John R Mackey
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Anne Muir
- Cancer Rehabilitation Clinic, University of Alberta, Edmonton, Alberta, Canada
| | - Margaret L McNeely
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
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20
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Fortier V, Levesque IR. Longitudinal relaxation in fat-water mixtures and its dependence on fat content at 3 T. NMR IN BIOMEDICINE 2022; 35:e4629. [PMID: 34636097 DOI: 10.1002/nbm.4629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 08/27/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Longitudinal (T1 ) relaxation of triglyceride molecules and water is of interest for fat-water separation and fat quantification. A better understanding of T1 relaxation could benefit modeling for applications in fat quantification and relaxation mapping. This work investigated T1 relaxation of spectral resonances of triglyceride molecules and water in liquid fat-water mixtures and its dependence on the fat fraction. Dairy cream and a safflower oil emulsion were used. These were diluted with distilled water to produce a variety of fat mass fractions (4.4% to 35% in dairy cream and 6.3% to 52.3% in safflower oil emulsion). T1 was measured at room temperature at 3 T using an inversion recovery STimulated Echo Acquisition Mode (STEAM) MR spectroscopy method with a series of inversion times. T1 variations as a function of fat fraction were investigated for various resonances. A two-component model was developed to describe the relaxation in a fat-water mixture as a function of the fat fraction. The T1 of water and of all fat resonances studied in this work decreased as the fat fraction increased. The relative variation in T1 was different for each fat resonance. The T1 of the methylene resonance showed the least variation as a function of the fat fraction. The proposed two-component model closely fits the observed T1 variations. In conclusion, this work clarifies how the T1 of major and minor fat resonances and of the water resonance varies as a function of the fat fraction in fat-water mixtures. Knowledge of these variations could serve modeling, analysis of MRI measurements in fat-water mixtures, and phantom preparation.
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Affiliation(s)
- Véronique Fortier
- Medical Physics Unit, McGill University, Montréal, QC, Canada
- Biomedical Engineering, McGill University, Montréal, QC, Canada
| | - Ives R Levesque
- Medical Physics Unit, McGill University, Montréal, QC, Canada
- Biomedical Engineering, McGill University, Montréal, QC, Canada
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Gerald Bronfman Department of Oncology, McGill University, Montréal, Canada
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21
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Wang N, Cao T, Han F, Xie Y, Zhong X, Ma S, Kwan A, Fan Z, Han H, Bi X, Noureddin M, Deshpande V, Christodoulou AG, Li D. Free-breathing multitasking multi-echo MRI for whole-liver water-specific T 1 , proton density fat fraction, and R2∗ quantification. Magn Reson Med 2022; 87:120-137. [PMID: 34418152 PMCID: PMC8616772 DOI: 10.1002/mrm.28970] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To develop a 3D multitasking multi-echo (MT-ME) technique for the comprehensive characterization of liver tissues with 5-min free-breathing acquisition; whole-liver coverage; a spatial resolution of 1.5 × 1.5 × 6 mm3 ; and simultaneous quantification of T1 , water-specific T1 (T1w ), proton density fat fraction (PDFF), and R2∗ . METHODS Six-echo bipolar spoiled gradient echo readouts following inversion recovery preparation was performed to generate T1 , water/fat, and R2∗ contrast. MR multitasking was used to reconstruct the MT-ME images with 3 spatial dimensions: 1 T1 recovery dimension, 1 multi-echo dimension, and 1 respiratory dimension. A basis function-based approach was developed for T1w quantification, followed by the estimation of R2∗ and T1 -corrected PDFF. The intrasession repeatability and agreement against references of MT-ME measurements were tested on a phantom and 15 clinically healthy subjects. In addition, 4 patients with confirmed liver diseases were recruited, and the agreement between MT-ME measurements and references was assessed. RESULTS MT-ME produced high-quality, coregistered T1 , T1w , PDFF, and R2∗ maps with good intrasession repeatability and substantial agreement with references on phantom and human studies. The intra-class coefficients of T1 , T1w , PDFF, and R2∗ from the repeat MT-ME measurements on clinically healthy subjects were 0.989, 0.990, 0.999, and 0.988, respectively. The intra-class coefficients of T1 , PDFF, and R2∗ between the MT-ME and reference measurements were 0.924, 0.987, and 0.975 in healthy subjects and 0.980, 0.999, and 0.998 in patients. The T1w was independent to PDFF (R = -0.029, P = .904). CONCLUSION The proposed MT-ME technique quantifies T1 , T1w , PDFF, and R2∗ simultaneously and is clinically promising for the comprehensive characterization of liver tissue properties.
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Affiliation(s)
- Nan Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Tianle Cao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA,Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Fei Han
- MR Research and Development, Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Xiaodong Zhong
- MR Research and Development, Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA
| | - Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alan Kwan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA,Departments of Imaging and Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA,Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hui Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Xiaoming Bi
- MR Research and Development, Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA
| | - Mazen Noureddin
- Karsh Division of Gastroenterology & Hepatology, Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Vibhas Deshpande
- MR Research and Development, Siemens Medical Solutions USA, Inc., Austin, TX, USA
| | - Anthony G. Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA,Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA,Department of Bioengineering, University of California, Los Angeles, CA, USA,Corresponding Author Contact Information: Debiao Li, Ph.D., Director, Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, 8700 Beverly Blvd, PACT 400, Los Angeles, California, USA 90048, Phone: 310-423-7743,
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22
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Peng H, Cheng C, Wan Q, Jia S, Wang S, Lv J, Liang D, Liu W, Liu X, Zheng H, Zou C. Fast multi-parametric imaging in abdomen by B 1 + corrected dual-flip angle sequence with interleaved echo acquisition. Magn Reson Med 2021; 87:2194-2208. [PMID: 34888911 DOI: 10.1002/mrm.29127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/07/2022]
Abstract
PURPOSE To achieve simultaneous T1, w /proton density fat fraction (PDFF)/ R 2 ∗ mapping in abdomen within a single breadth-hold, and validate the accuracy using state-of-art measurement. THEORY AND METHODS An optimized multiple echo gradient echo (GRE) sequence with dual flip-angle acquisition was used to realize simultaneous water T1 (T1, w )/PDFF/ R 2 ∗ quantification. A new method, referred to as "solving the fat-water ambiguity based on their T1 difference" (SORT), was proposed to address the fat-water separation problem. This method was based on the finding that compared to the true solution, the wrong (or aliased) solution to fat-water separation problem showed extra dependency on the applied flip angle due to the T1 difference between fat and water. The B 1 + measurement sequence was applied to correct the B 1 + inhomogeneity for T1, w relaxometry. The 2D parallel imaging was incorporated to enable the acquisition within a single breath-hold in abdomen. RESULTS The multi-parametric quantification results of the proposed method were consistent with the results of reference methods in phantom experiments (PDFF quantification: R2 = 0.993, mean error 0.73%; T1, w quantification: R2 = 0.999, mean error 4.3%; R 2 ∗ quantification: R2 = 0.949, mean error 4.07 s-1 ). For volunteer studies, robust fat-water separation was achieved without evident fat-water swaps. Based on the accurate fat-water separation, simultaneous T1, w /PDFF/ R 2 ∗ quantification was realized for whole liver within a single breath-hold. CONCLUSION The proposed method accurately quantified T1, w /PDFF/ R 2 ∗ for the whole liver within a single breath-hold. This technique serves as a quantitative tool for disease management in patients with hepatic steatosis.
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Affiliation(s)
- Hao Peng
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Chuanli Cheng
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Qian Wan
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Sen Jia
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Shuai Wang
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jianxun Lv
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Dong Liang
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Wenzhong Liu
- School of Artificial Intelligence and Automation, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Image Processing and Intelligent Control, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Liu
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Hairong Zheng
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
| | - Chao Zou
- Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province, Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advance Technology, Chinese Academy of Sciences, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
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23
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Kirkham AA, King K, Joy AA, Pelletier AB, Mackey JR, Young K, Zhu X, Meza-Junco J, Basi SK, Hiller JP, Brkin T, Michalowski B, Pituskin E, Paterson DI, Courneya KS, Thompson RB, Prado CM. Rationale and design of the Diet Restriction and Exercise-induced Adaptations in Metastatic breast cancer (DREAM) study: a 2-arm, parallel-group, phase II, randomized control trial of a short-term, calorie-restricted, and ketogenic diet plus exercise during intravenous chemotherapy versus usual care. BMC Cancer 2021; 21:1093. [PMID: 34629067 PMCID: PMC8504029 DOI: 10.1186/s12885-021-08808-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An underlying cause of solid tumor resistance to chemotherapy treatment is diminished tumor blood supply, which leads to a hypoxic microenvironment, dependence on anaerobic energy metabolism, and impaired delivery of intravenous treatments. Preclinical data suggest that dietary strategies of caloric restriction and low-carbohydrate intake can inhibit glycolysis, while acute exercise can transiently enhance blood flow to the tumor and reduce hypoxia. The Diet Restriction and Exercise-induced Adaptations in Metastatic Breast Cancer (DREAM) study will compare the effects of a short-term, 50% calorie-restricted and ketogenic diet combined with aerobic exercise performed during intravenous chemotherapy treatment to usual care on changes in tumor burden, treatment side effects, and quality of life. METHODS Fifty patients with measurable metastases and primary breast cancer starting a new line of intravenous chemotherapy will be randomly assigned to usual care or the combined diet and exercise intervention. Participants assigned to the intervention group will be provided with food consisting of 50% of measured calorie needs with 80% of calories from fat and ≤ 10% from carbohydrates for 48-72 h prior to each chemotherapy treatment and will perform 30-60 min of moderate-intensity cycle ergometer exercise during each chemotherapy infusion, for up to six treatment cycles. The diet and exercise durations will be adapted for each chemotherapy protocol. Tumor burden will be assessed by change in target lesion size using axial computed tomography (primary outcome) and magnetic resonance imaging (MRI)-derived apparent diffusion coefficient (secondary outcome) after up to six treatments. Tertiary outcomes will include quantitative MRI markers of treatment toxicity to the heart, thigh skeletal muscle, and liver, and patient-reported symptoms and quality of life. Exploratory outcome measures include progression-free and overall survival. DISCUSSION The DREAM study will test a novel, short-term diet and exercise intervention that is targeted to mechanisms of tumor resistance to chemotherapy. A reduction in lesion size is likely to translate to improved cancer outcomes including disease progression and overall survival. Furthermore, a lifestyle intervention may empower patients with metastatic breast cancer by actively engaging them to play a key role in their treatment. TRIAL REGISTRATION ClinicalTrials.gov, NCT03795493 , registered 7 January, 2019.
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Affiliation(s)
- Amy A Kirkham
- Faculty of Kinesiology & Physical Education, University of Toronto, 422, 100 Devonshire Pl, Toronto, ON, M5S 2C9, Canada.
| | - Karen King
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Anil A Joy
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | | | - John R Mackey
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Kelvin Young
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Xiaofu Zhu
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Judith Meza-Junco
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Sanraj K Basi
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Julie Price Hiller
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Tina Brkin
- Cross Cancer Institute, Edmonton, AB, Canada
| | | | - Edith Pituskin
- Cross Cancer Institute, Edmonton, AB, Canada
- University of Alberta, Edmonton, AB, Canada
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24
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Feng L, Liu F, Soultanidis G, Liu C, Benkert T, Block KT, Fayad ZA, Yang Y. Magnetization-prepared GRASP MRI for rapid 3D T1 mapping and fat/water-separated T1 mapping. Magn Reson Med 2021; 86:97-114. [PMID: 33580909 PMCID: PMC8197608 DOI: 10.1002/mrm.28679] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE This study aimed to (i) develop Magnetization-Prepared Golden-angle RAdial Sparse Parallel (MP-GRASP) MRI using a stack-of-stars trajectory for rapid free-breathing T1 mapping and (ii) extend MP-GRASP to multi-echo acquisition (MP-Dixon-GRASP) for fat/water-separated (water-specific) T1 mapping. METHODS An adiabatic non-selective 180° inversion-recovery pulse was added to a gradient-echo-based golden-angle stack-of-stars sequence for magnetization-prepared 3D single-echo or 3D multi-echo acquisition. In combination with subspace-based GRASP-Pro reconstruction, the sequence allows for standard T1 mapping (MP-GRASP) or fat/water-separated T1 mapping (MP-Dixon-GRASP), respectively. The accuracy of T1 mapping using MP-GRASP was evaluated in a phantom and volunteers (brain and liver) against clinically accepted reference methods. The repeatability of T1 estimation was also assessed in the phantom and volunteers. The performance of MP-Dixon-GRASP for water-specific T1 mapping was evaluated in a fat/water phantom and volunteers (brain and liver). RESULTS ROI-based mean T1 values are correlated between the references and MP-GRASP in the phantom (R2 = 1.0), brain (R2 = 0.96), and liver (R2 = 0.73). MP-GRASP achieved good repeatability of T1 estimation in the phantom (R2 = 1.0), brain (R2 = 0.99), and liver (R2 = 0.82). Water-specific T1 is different from in-phase and out-of-phase composite T1 (composite T1 when fat and water signal are mixed in phase or out of phase) both in the phantom and volunteers. CONCLUSION This work demonstrated the initial performance of MP-GRASP and MP-Dixon-GRASP MRI for rapid 3D T1 mapping and 3D fat/water-separated T1 mapping in the brain (without motion) and in the liver (during free breathing). With fat/water-separated T1 estimation, MP-Dixon-GRASP could be potentially useful for imaging patients with fatty-liver diseases.
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Affiliation(s)
- Li Feng
- Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Fang Liu
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Georgios Soultanidis
- Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Chenyu Liu
- Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Thomas Benkert
- MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany
| | - Kai Tobias Block
- MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany
- Center for Advanced Imaging Innovation and Research (CAIR), New York University School of Medicine, New York, NY, USA
| | - Zahi A. Fayad
- Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yang Yang
- Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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