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Tajima T, Akai H, Sugawara H, Furuta T, Yasaka K, Kunimatsu A, Yoshioka N, Akahane M, Abe O, Ohtomo K, Kiryu S. Feasibility of accelerated whole-body diffusion-weighted imaging using a deep learning-based noise-reduction technique in patients with prostate cancer. Magn Reson Imaging 2022; 92:169-179. [PMID: 35772583 DOI: 10.1016/j.mri.2022.06.014] [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: 02/21/2022] [Revised: 06/04/2022] [Accepted: 06/23/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the possibility of reducing the image acquisition time for diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) by denoising with deep learning-based reconstruction (dDLR). METHODS Seventeen patients with prostate cancer who underwent DWIBS by 1.5 T magnetic resonance imaging with a number of excitations of 2 (NEX2) and 8 (NEX8) were prospectively enrolled. The NEX2 image data were processed by dDLR (dDLR-NEX2), and the NEX2, dDLR-NEX2, and NEX8 image data were analyzed. In qualitative analysis, two radiologists rated the perceived coarseness, conspicuity of metastatic lesions (lymph nodes and bone), and overall image quality. The contrast-to-noise ratios (CNRs), contrast ratios, and mean apparent diffusion coefficients (ADCs) of metastatic lesions were calculated in a quantitative analysis. RESULTS The image acquisition time of NEX2 was 2.8 times shorter than that of NEX8 (3 min 30 s vs 9 min 48 s). The perceived coarseness and overall image quality scores reported by both readers were significantly higher for dDLR-NEX2 than for NEX2 (P = 0.005-0.040). There was no significant difference between dDLR-NEX2 and NEX8 in the qualitative analysis. The CNR of bone metastasis was significantly greater for dDLR-NEX2 than for NEX2 and NEX8 (P = 0.012 for both comparisons). The contrast ratios and mean ADCs were not significantly different among the three image types. CONCLUSIONS dDLR improved the image quality of DWIBS with NEX2. In the context of lymph node and bone metastasis evaluation with DWIBS in patients with prostate cancer, dDLR-NEX2 has potential to be an alternative to NEX8 and reduce the image acquisition time.
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Affiliation(s)
- Taku Tajima
- Department of Radiology, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan; Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda Narita, Chiba 286-0124, Japan
| | - Hiroyuki Akai
- Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda Narita, Chiba 286-0124, Japan; Department of Radiology, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| | - Haruto Sugawara
- Department of Radiology, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| | - Toshihiro Furuta
- Department of Radiology, The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan
| | - Koichiro Yasaka
- Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda Narita, Chiba 286-0124, Japan; Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Akira Kunimatsu
- Department of Radiology, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan
| | - Naoki Yoshioka
- Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda Narita, Chiba 286-0124, Japan
| | - Masaaki Akahane
- Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda Narita, Chiba 286-0124, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kuni Ohtomo
- International University of Health and Welfare, 2600-1 kitakanamaru, Otawara, Tochigi 324-8501, Japan
| | - Shigeru Kiryu
- Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda Narita, Chiba 286-0124, Japan.
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Al-Sarhani H, Gottumukkala RV, Grasparil ADS, Tung EL, Gee MS, Greer MLC. Screening of cancer predisposition syndromes. Pediatr Radiol 2022; 52:401-417. [PMID: 33791839 DOI: 10.1007/s00247-021-05023-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/14/2021] [Accepted: 02/17/2021] [Indexed: 12/19/2022]
Abstract
Pediatric patients with cancer predisposition syndromes are at increased risk of developing malignancies compared with their age-matched peers, necessitating regular surveillance. Screening protocols differ among syndromes and are composed of a number of elements, imaging being one. Surveillance can be initiated in infants, children and adolescents with a tumor known or suspected of being related to a cancer predisposition syndrome or where genetic testing identifies a germline pathogenic gene variant in an asymptomatic child. Pre-symptomatic detection of malignant neoplasms offers potential to improve treatment options and survival outcomes, but the benefits and risks of screening need to be weighed, particularly with variable penetrance in many cancer predisposition syndromes. In this review we discuss the benefits and risks of surveillance imaging and the importance of integrating imaging and non-imaging screening elements. We explore the principles of surveillance imaging with particular reference to whole-body MRI, considering the strategies to minimize false-negative and manage false-positive whole-body MRI results, the value of standardized nomenclature when reporting risk stratification to better guide patient management, and the need for timely communication of results to allay anxiety. Cancer predisposition syndrome screening is a multimodality, multidisciplinary and longitudinal process, so developing formalized frameworks for surveillance imaging programs should enhance diagnostic performance while improving the patient experience.
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Affiliation(s)
- Haifa Al-Sarhani
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Ravi V Gottumukkala
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Angelo Don S Grasparil
- Department of Radiological Sciences, Cardinal Santos Medical Center, San Juan City, Philippines
| | - Eric L Tung
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mary-Louise C Greer
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada. .,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
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Schick F, Pieper CC, Kupczyk P, Almansour H, Keller G, Springer F, Mürtz P, Endler C, Sprinkart AM, Kaufmann S, Herrmann J, Attenberger UI. 1.5 vs 3 Tesla Magnetic Resonance Imaging: A Review of Favorite Clinical Applications for Both Field Strengths-Part 1. Invest Radiol 2021; 56:680-691. [PMID: 34324464 DOI: 10.1097/rli.0000000000000812] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACT Whole-body magnetic resonance imaging (MRI) systems with a field strength of 3 T have been offered by all leading manufacturers for approximately 2 decades and are increasingly used in clinical diagnostics despite higher costs. Technologically, MRI systems operating at 3 T have reached a high standard in recent years, as well as the 1.5-T devices that have been in use for a longer time. For modern MRI systems with 3 T, more complexity is required, especially for the magnet and the radiofrequency (RF) system (with multichannel transmission). Many clinical applications benefit greatly from the higher field strength due to the higher signal yield (eg, imaging of the brain or extremities), but there are also applications where the disadvantages of 3 T might outweigh the advantages (eg, lung imaging or examinations in the presence of implants). This review describes some technical features of modern 1.5-T and 3-T whole-body MRI systems, and reports on the experience of using both types of devices in different clinical settings, with all sections written by specialist radiologists in the respective fields.This first part of the review includes an overview of the general physicotechnical aspects of both field strengths and elaborates the special conditions of diffusion imaging. Many relevant aspects in the application areas of musculoskeletal imaging, abdominal imaging, and prostate diagnostics are discussed.
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Affiliation(s)
- Fritz Schick
- From the Section of Experimental Radiology, Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen
| | | | - Patrick Kupczyk
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Haidara Almansour
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Gabriel Keller
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Fabian Springer
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Petra Mürtz
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Christoph Endler
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Alois M Sprinkart
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Sascha Kaufmann
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Judith Herrmann
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Ulrike I Attenberger
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
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Modified Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging of the Prostate: Comparison With Reduced Field-of-View Imaging and Single Shot Echo-Planar Imaging. J Comput Assist Tomogr 2021; 45:367-373. [PMID: 34297508 DOI: 10.1097/rct.0000000000001156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to compare the image quality and apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) with modified reduced field of view (FOV) based on 2-dimensional (2D)-selective radiofrequency excitations by tilting the excitation plane in prostate with reduced FOV using parallel-transmit-accelerated 2D-selective radiofrequency excitation and single-shot echo planar imaging (ssEPI). METHODS Fifty patients who underwent multiparametric magnetic resonance imaging including 3 DWIs were included. Two observers independently performed qualitative image analyses using 5-point scale. Apparent diffusion coefficient measurements were performed for quantitative analysis. RESULTS Modified reduced FOV provided the highest qualitative scores for all categories compared with reduced FOV and ssEPI (P < 0.000). Both reduced FOV DWIs showed higher ADC values compared with ssEPI (P < 0.001); however, the ADC ratios between the lesion and peripheral zone were not significantly different (all P > 0.05). CONCLUSIONS The modified reduced FOV DWI showed better overall image quality, differentiability of anatomic regions, and lesion conspicuity with fewer artifacts compared with DWI with reduced FOV and ssEPI.
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Multimodal magnetic resonance imaging of peripheral nerves: Establishment and validation of brachial and lumbosacral plexi measurements in 163 healthy subjects. Eur J Radiol 2019; 117:41-48. [PMID: 31307651 DOI: 10.1016/j.ejrad.2019.05.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/19/2019] [Accepted: 05/23/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE This study aims to provide normal reference values for quantitative parameters for brachial and lumbosacral plexi on multimodal MRI. In addition, the parameter variations between the left and right sides, the individual nerve groups, genders and age groups were also evaluated. MATERIALS AND METHODS Multimodal MRI was evaluated in 163 healthy subjects, who were randomly divided into three groups: brachial plexus, lumbosacral plexus and diffusion tensor imaging groups. Nerve diameters, contrast ratios, T2 nerve-muscle signal ratios (nT2), fractional anisotropy (FA) values and apparent diffusion coefficients (ADC) were measured in both plexi. Parametric tests and Pearson correlation for normally distributed data, and non-parametric tests and Spearman correlation for non-normally distributed data were used. RESULTS There were no significant differences in parameters between the left and right sides. The diameters of the C7, L4-S1, sciatic, and femoral nerve roots were larger in men than in women (P < 0.05). The nT2 in the brachial and lumbosacral plexi and the contrast ratio in the lumbosacral plexus were significantly higher in the elderly. The diameter of the S1 nerve root was smaller in the elderly. There were no significant differences between the individual nerve groups in contrast ratios and in brachial plexus nT2. A gradual increase in the nT2 from the top to the bottom was observed in the L4-S1 nerve roots (P < 0.05). CONCLUSION This study provides multi-parameter normative data for the brachial and lumbosacral plexi while considering differences between the two sides, the individual nerves, genders, and the ages.
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Mürtz P, Pieper CC, Reick M, Sprinkart AM, Schild HH, Willinek WA, Kukuk GM. Is liver lesion characterisation by simplified IVIM DWI also feasible at 3.0 T? Eur Radiol 2019; 29:5889-5900. [DOI: 10.1007/s00330-019-06192-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/25/2019] [Accepted: 03/20/2019] [Indexed: 12/21/2022]
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Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging of the Prostate at 3 Tesla. J Comput Assist Tomogr 2017; 41:949-956. [DOI: 10.1097/rct.0000000000000634] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Padormo F, Beqiri A, Hajnal JV, Malik SJ. Parallel transmission for ultrahigh-field imaging. NMR IN BIOMEDICINE 2016; 29:1145-61. [PMID: 25989904 PMCID: PMC4995736 DOI: 10.1002/nbm.3313] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 03/27/2015] [Accepted: 03/29/2015] [Indexed: 05/24/2023]
Abstract
The development of MRI systems operating at or above 7 T has provided researchers with a new window into the human body, yielding improved imaging speed, resolution and signal-to-noise ratio. In order to fully realise the potential of ultrahigh-field MRI, a range of technical hurdles must be overcome. The non-uniformity of the transmit field is one of such issues, as it leads to non-uniform images with spatially varying contrast. Parallel transmission (i.e. the use of multiple independent transmission channels) provides previously unavailable degrees of freedom that allow full spatial and temporal control of the radiofrequency (RF) fields. This review discusses the many ways in which these degrees of freedom can be used, ranging from making more uniform transmit fields to the design of subject-tailored RF pulses for both uniform excitation and spatial selection, and also the control of the specific absorption rate. © 2015 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.
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Affiliation(s)
- Francesco Padormo
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Arian Beqiri
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Joseph V Hajnal
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Shaihan J Malik
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
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Assessment of Liver Perfusion by IntraVoxel Incoherent Motion (IVIM) Magnetic Resonance-Diffusion-Weighted Imaging: Correlation With Phase-Contrast Portal Venous Flow Measurements. J Comput Assist Tomogr 2015; 39:365-72. [PMID: 25700227 DOI: 10.1097/rct.0000000000000220] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To prospectively verify, in vivo, Le Bihan's model of signal decay in magnetic resonance/diffusion-weighted imaging (intravoxel incoherent motion) in healthy liver parenchyma. METHODS Informed consent and institutional board approval were obtained. To measure both underfasting and postprandial conditions, apparent, slow, and fast diffusion (D*) coefficients and perfusion fraction of liver parenchyma, 40 healthy volunteers (19 women and 21 men) underwent a 3.0-T magnetic resonance imaging examination, including portal venous flow measurements by a 2-dimensional phase-contrast sequence, and multi-b diffusion-weighted imaging acquired before and 30 minutes after a 600-Kcal meal. Parameters were measured by fitting procedure with regions of interest drawn on the right liver lobe. Paired-sample t test was performed to search for any statistically significant difference between preprandial and postprandial values of each parameter and of portal flow. Pearson correlation coefficients were calculated to evaluate the relationship between portal flow increase and diffusion-weighted imaging parameter changes in postprandial conditions. Interobserver agreement for measurement of the intravoxel incoherent motion parameters was determined, both for preprandial and postprandial values. RESULTS Mean increase in postprandial portal flow was 98% (P < 0.0009). The t test did not show any statistically significant difference between the preprandial and postprandial values for apparent, slow diffusion coefficients and perfusion fraction (P ≥ 0.05), whereas a statistically significant postprandial increase (P < 0.01) of D* was detected. Correlation with portal venous flow increase at Pearson test was statistically significant for D* (P = 0.04) and nonsignificant for the other parameters. All the parameters showed wide variability, with a higher percent coefficient of variation for D*. Interobserver agreement was always greater than 0.70. CONCLUSIONS This study verifies Le Bihan's theory, confirming that in the liver, D* is influenced by perfusional changes related to portal venous flow.
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Brink WM, Gulani V, Webb AG. Clinical applications of dual-channel transmit MRI: A review. J Magn Reson Imaging 2015; 42:855-69. [PMID: 25854179 DOI: 10.1002/jmri.24791] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 09/04/2014] [Accepted: 09/04/2014] [Indexed: 11/09/2022] Open
Abstract
This article reviews the principle of dual-channel transmit MRI and highlights current clinical applications which are performed primarily at 3 Tesla. The main benefits of dual-channel transmit compared with single-transmit systems are the increased image contrast homogeneity and the decreased scanning time due to the more accurate local specific absorption ratio estimation, meaning that less conservative safety limits are needed. The dual-transmit approach has been particularly beneficial in body imaging applications, and is also promising in terms of cardiac, spine, and fetal imaging. Future advances in transmit SENSE, the combination of dual-channel transmit with high permittivity pads, as well as the potential increase in the number of transmit channels are also discussed.
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Affiliation(s)
- Wyger M Brink
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vikas Gulani
- Department of Radiology, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, Ohio, USA
| | - Andrew G Webb
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Fat suppression techniques (STIR vs. SPAIR) on diffusion-weighted imaging of breast lesions at 3.0 T: preliminary experience. Radiol Med 2015; 120:705-13. [PMID: 25665796 DOI: 10.1007/s11547-015-0508-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 05/19/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim of this work was to perform a qualitative and quantitative comparison of the performance of two fat suppression techniques on breast diffusion-weighted imaging (DWI). MATERIALS AND METHODS Fifty-one women underwent clinical breast magnetic resonance imaging, including DWI with short TI inversion recovery (STIR) and spectral attenuated inversion recovery (SPAIR). Four were excluded from the analysis due to image artefacts. Rating of fat suppression uniformity and lesion visibility were performed. Agreement between the two sequences was evaluated. Additionally, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) values for normal gland, benign and malignant lesions were compared. Receiver operating characteristic analysis was also performed. RESULTS From the 52 lesions found, 47 were detected by both sequences. DWI-STIR evidenced more homogeneous fat suppression (p = 0.03). Although these lesions were seen with both techniques, DWI-SPAIR evidenced higher score for lesion visibility in nine of them. SNR and CNR were comparable, except for SNR in benign lesions (p < 0.01), which was higher for DWI-SPAIR. Mean ADC values for lesions were similar. ADC for normal fibroglandular tissue was higher when using DWI-STIR (p = 0.006). Sensitivity, specificity, accuracy and area under the curve values were alike: 84.0 % for both; 77.3, 71.4 %; 80.9, 78.3 %; 82.5, 81.3 % for DWI-SPAIR and DWI-STIR, respectively. CONCLUSION DWI-STIR showed superior fat suppression homogeneity. No differences were found for SNR and CNR, except for SNR in benign lesions. ADCs for lesions were comparable. Findings in this study are consistent with previous studies at 1.5 T, meaning that both fat suppression techniques are appropriate for breast DWI at 3.0 T.
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Mürtz P, Kaschner M, Lakghomi A, Gieseke J, Willinek WA, Schild HH, Thomas D. Diffusion-weighted MR neurography of the brachial and lumbosacral plexus: 3.0 T versus 1.5 T imaging. Eur J Radiol 2015; 84:696-702. [PMID: 25623827 DOI: 10.1016/j.ejrad.2015.01.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 11/17/2014] [Accepted: 01/01/2015] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare intraindividually the nerve conspicuity of the brachial and lumbosacral plexus on diffusion-weighted (DW) MR neurography (MRN) at two different field strengths. MATERIALS AND METHODS 16 healthy volunteers were investigated at 3.0 T and 1.5 T applying optimized variants of a DW spin-echo echo-planar imaging sequence with short TI inversion recovery fat suppression. Full-volume (FV) and curved sub-volume (CSV) maximum intensity projection (MIP) images were reconstructed and nerve conspicuity was visually assessed. Moreover, visible length and sharpness of the nerves were quantitatively analyzed. RESULTS On FV MIP images, nerve conspicuity at 3.0 T compared to 1.5 T was worse for brachial plexus (P=0.00228), but better for lumbosacral plexus (P=0.00666). On CSV MIP images, nerve conspicuity did not differ significantly for brachial plexus, but was better at 3.0 T for lumbosacral plexus (P=0.00091). The visible length of the analyzed nerves did not differ significantly with the exception of some lumbosacral nerves, which were significantly longer at 3.0 T. The sharpness of all investigated nerves was significantly higher at 3.0 T by about 40-60% for cervical and 97-169% for lumbosacral nerves. CONCLUSION DW MRN imaging at 3.0 T compared to 1.5 T is superior for lumbosacral plexus, but not for brachial plexus.
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Affiliation(s)
- P Mürtz
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
| | - M Kaschner
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
| | - A Lakghomi
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
| | - J Gieseke
- Philips Healthcare, Lübeckertordamm 5, 20099 Hamburg, Germany; Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
| | - W A Willinek
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
| | - H H Schild
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
| | - D Thomas
- Department of Radiology, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany.
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Thierfelder KM, Sommer WH, Dietrich O, Meinel FG, Theisen D, Paprottka PM, Strobl FF, Pfeuffer J, Reiser MF, Nikolaou K. Parallel-transmit-accelerated spatially-selective excitation mri for reduced-fov diffusion-weighted-imaging of the pancreas. Eur J Radiol 2014; 83:1709-14. [DOI: 10.1016/j.ejrad.2014.06.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 06/04/2014] [Accepted: 06/08/2014] [Indexed: 02/06/2023]
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Seeger A, Klose U, Bischof F, Strobel J, Ernemann U, Hauser TK. Zoomed EPI DWI of Acute Spinal Ischemia Using a Parallel Transmission System. Clin Neuroradiol 2014; 26:177-82. [PMID: 25168248 DOI: 10.1007/s00062-014-0342-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 08/14/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE A new method for diffusion-weighted imaging (DWI) using independent parallel transmission technique resulting in zoomed DWI was applied in four patients suffering from acute spinal cord ischemia. METHODS Four patients with clinical symptoms of acute spinal cord ischemia were examined on a 3 T MR-system equipped with a two-channel transmit array. Scans included T2-weighted turbo spin echo, conventional DWI, and zoomed DWI. Image evaluation was performed with regard to overall image quality, anatomic delineation of the spinal cord, and the level of confidence to establish the diagnosis of spinal cord ischemia. RESULTS Through spatially selective excitation, zoomed DWI allows for acquisition of high-resolution images with reduced scan time due to a reduced field of view in phase-encoding direction, resulting in zoomed images. In all cases the ischemia was demonstrated in conventional DWI as well as zoomed DWI. CONCLUSIONS Compared to conventional DWI, zoomed DWI enables a faster image acquisition and allowed a more detailed analysis of the spinal lesion which may be critical to attribute the lesion to a particular vessel territory.
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Affiliation(s)
- A Seeger
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - U Klose
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - F Bischof
- Department of Neurology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - J Strobel
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - U Ernemann
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - T-K Hauser
- Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls-University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
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Diffusion-weighted MRI of the Prostate: Advantages of Zoomed EPI with Parallel-transmit-accelerated 2D-selective Excitation Imaging. Eur Radiol 2014; 24:3233-41. [DOI: 10.1007/s00330-014-3347-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 06/30/2014] [Accepted: 07/15/2014] [Indexed: 10/24/2022]
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Rosenkrantz AB, Chandarana H, Pfeuffer J, Triolo MJ, Shaikh MB, Mossa DJ, Geppert C. Zoomed echo-planar imaging using parallel transmission: impact on image quality of diffusion-weighted imaging of the prostate at 3T. ACTA ACUST UNITED AC 2014; 40:120-6. [DOI: 10.1007/s00261-014-0181-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Padhani AR, Makris A, Gall P, Collins DJ, Tunariu N, de Bono JS. Therapy monitoring of skeletal metastases with whole-body diffusion MRI. J Magn Reson Imaging 2014; 39:1049-78. [PMID: 24510426 DOI: 10.1002/jmri.24548] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 07/25/2013] [Indexed: 12/18/2022] Open
Abstract
Current methods of assessing tumor response at skeletal sites with metastatic disease use a combination of imaging tests, serum and urine biochemical markers, and symptoms assessment. These methods do not always enable the positive assessment of therapeutic benefit to be made but instead provide an evaluation of progression, which then guides therapy decisions in the clinic. Functional imaging techniques such as whole-body diffusion magnetic resonance imaging (MRI) when combined with anatomic imaging and other emerging "wet" biomarkers can improve the classification of therapy response in patients with metastatic bone disease. A range of imaging findings can be seen in the clinic depending on the type of therapy and duration of treatment. Successful response to systemic therapy is usually depicted by reductions in signal intensity accompanied by apparent diffusion coefficient (ADC) increases. Rarer patterns of successful treatment include no changes in signal intensity accompanying increases in ADC values (T2 shine-through pattern) or reductions in signal intensity without ADC value changes. Progressive disease results in increases in extent/intensity of disease on high b-value images with variable ADC changes. Diffusion MRI therapy response criteria need to be developed and tested in prospective studies in order to address current, unmet clinical and pharmaceutical needs for reliable measures of tumor response in metastatic bone disease.
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Affiliation(s)
- Anwar R Padhani
- Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, Middlesex, UK
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Kinner S, Blex S, Maderwald S, Forsting M, Gerken G, Lauenstein TC. Addition of diffusion-weighted imaging can improve diagnostic confidence in bowel MRI. Clin Radiol 2013; 69:372-7. [PMID: 24360512 DOI: 10.1016/j.crad.2013.09.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 09/04/2013] [Accepted: 09/30/2013] [Indexed: 01/08/2023]
Abstract
AIM To evaluate whether the addition of diffusion-weighted imaging (DWI) in bowel abdominal magnetic resonance imaging (MRI) can improve diagnostic confidence. MATERIALS AND METHODS One hundred and eleven consecutive patients with suspected or known inflammatory bowel disease (n = 59), tumour disease (n = 31), unspecific abdominal pain (n = 16), and suspected graft-versus-host disease (n = 5) underwent bowel MRI using a 1.5 T MRI machine. In addition to T2-weighted (T2W) and contrast-enhanced T1-weighted (CE-T1W) data, axial and coronal DWI sequences were collected (b = 50, 500, 1000). Diagnostic confidence for lesion detection with and without DWI was evaluated using a four-point Likert scale [1 = certainly no lesion(s), 2 = probably no lesion(s), 3 = probably lesion(s), 4 = certainly lesion(s)]. RESULTS In 11 of 111 patients (10%), the diagnostic confidence was improved by DWI. In seven patients, readers changed their diagnosis from "probable" to "certain presence of lesions". In another four patients, lesions were diagnosed based on DWI, which were not delineated on CE-T1W and T2W imaging. CONCLUSION DWI of the bowel can provide additional information to the reader and, therefore, improve diagnostic confidence. Hence, additional DWI should be integrated into a standard bowel MRI protocol.
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Affiliation(s)
- S Kinner
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
| | - S Blex
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - S Maderwald
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| | - M Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - G Gerken
- Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany
| | - T C Lauenstein
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
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Koh DM, Tunariu N, Blackledge M, Collins DJ. Competing Technology for PET/Computed Tomography: Diffusion-weighted Magnetic Resonance Imaging. PET Clin 2013; 8:259-77. [PMID: 27158069 DOI: 10.1016/j.cpet.2013.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Whole-body diffusion-weighted (DW) imaging is a recent development. The image contrast is based on differences in mobility of water between tissues and reflects tissue cellularity and integrity of cell membranes. The tissue water diffusivity is quantified by the apparent diffusion coefficient. By performing imaging at multiple imaging stations, whole-body DW imaging has been applied to improve tumor staging, disease characterization, as well as for the assessment of treatment response. Information from DW imaging studies could be combined with those using PET imaging tracers to further refine and improve the assessment of patients with cancer.
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Affiliation(s)
- Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK.
| | - Nina Tunariu
- Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK
| | - Matthew Blackledge
- CRUK EPSRC Imaging Centre, Institute of Cancer Research, Sutton, SM2 5NG, UK
| | - David J Collins
- CRUK EPSRC Imaging Centre, Institute of Cancer Research, Sutton, SM2 5NG, UK
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De Paepe K, Bevernage C, De Keyzer F, Wolter P, Gheysens O, Janssens A, Oyen R, Verhoef G, Vandecaveye V. Whole-body diffusion-weighted magnetic resonance imaging at 3 Tesla for early assessment of treatment response in non-Hodgkin lymphoma: a pilot study. Cancer Imaging 2013; 13:53-62. [PMID: 23466737 PMCID: PMC3589948 DOI: 10.1102/1470-7330.2013.0006] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Objective: To evaluate 3 Tesla (T) whole-body diffusion-weighted magnetic resonance imaging (WB DWI) for early treatment assessment in aggressive non-Hodgkin lymphoma (NHL). Methods: Fourteen patients with NHL treated with standard chemotherapy underwent 3-T WB DWI before and 2 and 4 weeks during treatment, using b-values of 0–1000 s/mm2 from which the apparent diffusion coefficient (ADC) was calculated. Patient follow-up (average 20.3 months, range 15–23 months) was the reference standard. Volume and ADC changes between baseline and 2 weeks (Vratio2w, ADCratio2w) and 4 weeks (Vratio4w, ADCratio4w) of responding and non-responding lesions (lymph node and organ lesions) were compared using Mann–Whitney U tests. The per patient values of VratioN and ADCratioN to predict progression-free survival were determined with a log-rank test. Results: Eight patients showed complete remission and 6 showed tumour progression. The ADCratio2w and ADCratio4w differed significantly in lesions showing tumour progression versus complete remission (ADCratio2w = 4 ± 21% versus 119 ± 68%; ADCratio4w = 18 ± 61% versus 155 ± 78%; both P < 0.0001); the Vratio2w and Vratio4w did not (P > 0.05). Per body region, the ADCratio2w showed a negative predictive value of 100% and positive predictive value of 86%. Per patient, the ADCratio2w and ADCratio4w correlated significantly with progression-free survival (P < 0.05). Conclusion: 3-T WB DWI with ADC quantification may enable early treatment assessment of aggressive NHL.
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Affiliation(s)
- Katja De Paepe
- Department of Radiology, University Hospitals Leuven, Belgium
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Akay S, Kocaoglu M, Emer O, Battal B, Arslan N. Diagnostic accuracy of whole-body diffusion-weighted magnetic resonance imaging with 3.0 T in detection of primary and metastatic neoplasms. J Med Imaging Radiat Oncol 2013; 57:274-82. [PMID: 23721135 DOI: 10.1111/1754-9485.12026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 09/09/2012] [Indexed: 12/27/2022]
Abstract
INTRODUCTION To discuss the accuracy of the whole-body diffusion-weighted imaging with background body signal suppression (WB-DWIBS) technique performed in the 3.0-T system. METHODS We studied 17 patients who underwent positron emission tomography (PET)/CT and WB-DWIBS examinations for staging their diseases. The DWIBS pulse and echo-planar imaging-short T1 inversion recovery single-shot pulse sequences were performed for WB-DWIBS. A PET/CT scan was performed with 18-fluorodeoxyglucose. The lesions were localised and counted in both of the examinations, and WB-DWIBS was evaluated for the neoplastic tissue detection rate, while PET/CT was accepted as the reference standard modality. RESULTS The WB-DWIBS scan had a room occupation time of 32-35 min. All of the metastasis positive patients (n = 12) detected with PET/CT were also detected with WB-DWIBS (100%). In our patient group, there were a total of 109 bone metastases on PET/CT scans, and 93 of them (85.3%) were demonstrated with WB-DWIBS. We detected 128 metastatic lymph nodes on PET/CT, and 123 of them (96.3%) were demonstrated with WB-DWIBS. There were a total of 17 liver metastases on PET/CT, and 15 of them (88.2%) were detected with WB-DWIBS. There was no statistically significant difference between the two imaging modalities in detecting bone, lymph node and liver metastases (P > 0.05). CONCLUSIONS WB-DWIBS is a non-invasive technique that may successfully detect the spreading of the tumoural tissue in cancer patients when compared with PET/CT.
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Affiliation(s)
- Sinan Akay
- Department of Radiology, Gulhane Military Medical School, Ankara, Turkey.
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