Diffusion characteristics of large molecules assessed by proton MRS on a whole-body MR system

Diffusion-weighted MR spectroscopy: Consensus, recommendations, and resources from acquisition to modeling

Brain cell structure and function reflect neurodevelopment, plasticity, and aging; and changes can help flag pathological processes such as neurodegeneration and neuroinflammation. Accurate and quantitative methods to noninvasively disentangle cellular structural features are needed and are a substantial focus of brain research. Diffusion-weighted MRS (dMRS) gives access to diffusion properties of endogenous intracellular brain metabolites that are preferentially located inside specific brain cell populations. Despite its great potential, dMRS remains a challenging technique on all levels: from the data acquisition to the analysis, quantification, modeling, and interpretation of results. These challenges were the motivation behind the organization of the Lorentz Center workshop on "Best Practices & Tools for Diffusion MR Spectroscopy" held in Leiden, the Netherlands, in September 2021. During the workshop, the dMRS community established a set of recommendations to execute robust dMRS studies. This paper provides a description of the steps needed for acquiring, processing, fitting, and modeling dMRS data, and provides links to useful resources.

Transcriptome and fatty-acid signatures of adipocyte hypertrophy and its non-invasive MR-based characterization in human adipose tissue

Background

The adipocyte-hypertrophy associated remodeling of fat cell function is considered causal for the development of metabolic disorders. A better understanding of transcriptome and fatty acid (FA) related alterations with adipocyte hypertrophy combined with less-invasive strategies for the detection of the latter can help to increase the prognostic and diagnostic value of adipocyte size and FA composition as markers for metabolic disease.

Methods

To clarify adipocyte-hypertrophy associated transcriptomic alterations, fat cell size was related to RNA-Seq data from white adipose tissue and size-separated adipocytes. The relationship between adipocyte size and adipose tissue FA composition as measured by GC-MS was investigated. MR spectroscopy (MRS) methods for clinical scanning were developed to characterize adipocyte size and FA composition in a fast and non-invasive manner.

Findings

With enlarged adipocyte size, substantial transcriptomic alterations of genes involved in mitochondrial function and FA metabolism were observed. Investigations of these two mechanisms revealed a reciprocal relationship between adipocyte size and estimated thermogenic adipocyte content as well as depot-specific correlations of adipocyte size and FA composition. MRS on a clinical scanner was suitable for the in-parallel assessment of adipose morphology and FA composition.

Interpretation

The current study provides a comprehensive overview of the adipocyte-hypertrophy associated transcriptomic and FA landscape in both subcutaneous and visceral adipose tissue. MRS represents a promising technique to translate the observed mechanistic, structural and functional changes in WAT with adipocyte hypertrophy into a clinical context for an improved phenotyping of WAT in the context of metabolic diseases.

Funding

Competence network for obesity (FKZ 42201GI1128), ERC (No 677661, ProFatMRI; No 875488, FatVirtualBiopsy), Else Kröner-Fresenius-Foundation.

Lipid droplet-size mapping in human adipose tissue using a clinical 3T system

PURPOSE

To develop a methodology for probing lipid droplet sizes with a clinical system based on a diffusion-weighted stimulated echo-prepared turbo spin-echo sequence and to validate the methodology in water-fat emulsions and show its applicability in ex vivo adipose-tissue samples.

METHODS

A diffusion-weighted stimulated echo-prepared preparation was combined with a single-shot turbo spin-echo readout for measurements at different b-values and diffusion times. The droplet size was estimated with an analytical expression, and three fitting approaches were compared: magnitude-based spatial averaging with voxel-wise residual minimization, complex-based spatial averaging with voxel-wise residual minimization, and complex-based spatial averaging with neighborhood-regularized residual minimization. Simulations were performed to characterize the fitting residual landscape and the approaches' noise performance. The applicability was assessed in oil-in-water emulsions in comparison with laser deflection and in ten human white adipose tissue samples in comparison with histology.

RESULTS

The fitting residual landscape showed a minimum valley with increasing extent as the droplet size increased. In phantoms, a very good agreement of the mean droplet size was observed between the diffusion-weighted MRI-based and the laser deflection measurements, showing the best performance with complex-based spatial averaging with neighborhood-regularized residual minimization processing (R² /P: 0.971/0.014). In the human adipose-tissue samples, complex-based spatial averaging with neighborhood-regularized residual minimization processing showed a significant correlation (R² /P: 0.531/0.017) compared with histology.

CONCLUSION

The proposed acquisition and parameter-estimation methodology was able to probe restricted diffusion effects in lipid droplets. The methodology was validated using phantoms, and its feasibility in measuring an apparent lipid droplet size was demonstrated ex vivo in white adipose tissue.

Detecting Mild Lower-limb Skeletal Muscle Fatigue with Stimulated-echo q-space Imaging

The feasibility of detecting mild exercise-related muscle fatigue via stimulated echo (STE) and q-space imaging (qsi) was evaluated. The right calves of seven healthy volunteers were subjected to mild exercise loading, and qsi was generated using spin echo (Δ: 45.6 ms) and three different STE (Δ: 114, 214, and 414 ms) acquisitions. We concluded that qsi with an increased STE diffusion time can detect mild fatigue in the gastrocnemius muscle.

Confounding factors in breast magnetic resonance fingerprinting: B 1 + , slice profile, and diffusion effects

PURPOSE

Magnetic resonance fingerprinting (MRF) offers rapid quantitative imaging but may be subject to confounding effects (CE) if these are not included in the model-based reconstruction. This study characterizes the influence of in-plane B 1 + , slice profile and diffusion effects on T₁ and T₂ estimation in the female breast at 1.5T.

METHODS

Simulations were used to predict the influence of each CE on the accuracy of MRF and to investigate the influence of electronic noise and spiral aliasing artefacts. The experimentally observed bias in regions of fibroglandular tissue (FGT) and fatty tissue (FT) was analyzed for undersampled spiral breast MRF data of 6 healthy volunteers by performing MRF reconstruction with and without a CE.

RESULTS

Theoretic analysis predicts T₁ under-/T₂ overestimation if the nominal flip angles are underestimated and inversely, T₁ under-/T₂ overestimation if omitting slice profile correction, and T₁ under-/T₂ underestimation if omitting diffusion in the signal model. Averaged over repeated signal simulations, including spiral aliasing artefacts affected precision more than accuracy. Strong in-plane B 1 + effects occurred in vivo, causing T₂ left-right inhomogeneity between both breasts. Their correction decreased the T₂ difference from 29 to 5 ms in FGT and from 29 to 9 ms in FT. Slice profile correction affected FGT T₂ most strongly, resulting in -22% smaller values. For the employed spoiler gradient strengths, diffusion did not affect the parameter maps, corresponding well with theoretic predictions.

CONCLUSION

Understanding CEs and their relative significance for an MRF sequence is important when defining an MRF signal model for accurate parameter mapping.

Measuring large lipid droplet sizes by probing restricted lipid diffusion effects with diffusion-weighted MRS at 3T

Purpose

The in vivo probing of restricted diffusion effects in large lipid droplets on a clinical MR scanner remains a major challenge due to the need for high b‐values and long diffusion times. This work proposes a methodology to probe mean lipid droplet sizes using diffusion‐weighted MRS (DW‐MRS) at 3T.

Methods

An analytical expression for restricted diffusion was used. Simulations were performed to evaluate the noise performance and the influence of particle size distribution. To validate the method, oil‐in‐water emulsions were prepared and examined using DW‐MRS, laser deflection and light microscopy. The tibia bone marrow was scanned in volunteers to test the method repeatability and characterize microstructural differences at different locations.

Results

The simulations showed accurate and precise droplet size estimation when a sufficient SNR is reached with minor dependence on the size distribution. In phantoms, a good correlation between the measured droplet sizes by DW‐MRS and by laser deflection (R² = 0.98; P = 0.01) and microscopy (R² = 0.99; P < 0.01) measurements was obtained. A mean coefficient of variation of 11.5 % was found for the lipid droplet diameter in vivo. The average diameter was smaller at a proximal (50.1 ± 7.3 µm) compared with a distal tibia location (61.1 ± 6.8 µm) (P < 0.01).

Conclusion

The presented methods were able to probe restricted diffusion effects in lipid droplets using DW‐MRS and to estimate lipid droplet size. The methodology was validated using phantoms and the in vivo feasibility in bone marrow was shown based on a good repeatability and findings in agreement with literature.

Semiquantitative Evaluation of Muscle Repair by Diffusion Tensor Imaging in Mice

Muscle injury is one of the most common traumas in orthopedic and sports medicine. However, there are only a few treatment options with marginal clinical benefits for this condition. Muscle repair after injury involves multiple and complex processes, such as the inflammation phase, regeneration phase, and remodeling phase. To develop a treatment modality and to examine the efficacy of novel interventions and agents for patients with muscle injuries, it is essential to establish a reliable and sensitive method to monitor the changes in muscle structure and status during muscle repair. Diffusion-weighted magnetic resonance imaging has been widely used to assess the diffusivity of water molecules in tissue. When it is used in combination with diffusion tensor imaging (DTI), the microstructure of muscle tissue can be indirectly depicted. In the present study, we evaluated the time-course changes in the diffusivity and anisotropy in muscles by DTI and histology after injury in mice. We found that the diffusivity and anisotropy exhibit distinct kinetics during muscle repair and that these kinetics were significantly altered in mutant mice with a defect in muscle regeneration. Our data show that muscle repair processes can be readily evaluated and monitored by DTI technique and suggest that DTI can be clinically applied for assessing muscle injury and repair in humans. © 2018 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

In vivo diffusion MRS investigation of non-water molecules in biological tissues

Diffusion MRS of non-water molecules offers great potential in directly revealing various tissue microstructures and physiology at both cellular and subcellular levels. In brain, ¹ H diffusion MRS has been demonstrated as a new tool for probing normal tissue microstructures and their pathological changes. In skeletal muscle, ¹ H diffusion MRS could characterize slow and restricted intramyocellular lipid diffusion, providing a sensitive marker for metabolic alterations, while ³¹ P diffusion MRS can measure ATP and PCr diffusion, which may reflect the capacity of cellular energy transport, complementing the information from frequently used ³¹ P MRS in muscle. In intervertebral disk, ¹ H diffusion MRS can directly monitor extracellular matrix integrity by quantifying the mobility of macromolecules such as proteoglycans and collagens. In tumor tissue, ¹³ C diffusion MRS could probe intracellular glycolytic metabolism, while ¹ H diffusion MRS may separate the spectrally overlapped lactate and lipid resonances. In this review, recent diffusion MRS studies of these biologically relevant non-water molecules under normal and diseased conditions will be presented. Technical considerations for diffusion MRS experiments will be discussed. With advances in MRI hardware and diffusion methodology, diffusion MRS of non-water molecules is expected to provide increasingly valuable and biologically specific information on tissue microstructures and physiology, complementing the traditional diffusion MRI of small and ubiquitous water molecules. Copyright © 2016 John Wiley & Sons, Ltd.

Water and lipid diffusion MRI using chemical shift displacement-based separation of lipid tissue (SPLIT)

PURPOSE

To obtain water and lipid diffusion-weighted images (DWIs) simultaneously, we devised a novel method utilizing chemical shift displacement-based separation of lipid tissue (SPLIT) imaging.

MATERIALS AND METHODS

Single-shot diffusion echo-planar imaging without fat suppression was used and the imaging parameters were optimized to separate water and lipid DWIs by chemical shift displacement of the lipid signals along the phase-encoding direction. Using the optimized conditions, transverse DWIs at the maximum diameter of the right calf were scanned with multiple b-values in five healthy subjects. Then, apparent diffusion coefficients (ADCs) were calculated in the tibialis anterior muscle (TA), tibialis bone marrow (TB), and subcutaneous fat (SF), as well as restricted and perfusion-related diffusion coefficients (D and D*, respectively) and the fraction of the perfusion-related diffusion component (F) for TA.

RESULTS

Water and lipid DWIs were separated adequately. The mean ADCs of the TA, TB, and SF were 1.56±0.03mm²/s, 0.01±0.01mm²/s, and 0.06±0.02mm²/s, respectively. The mean D*, D, and F of the TA were 13.7±4.3mm²/s, 1.48±0.05mm²/s, and 4.3±1.6%, respectively.

CONCLUSION

SPLIT imaging makes it possible to simply and simultaneously obtain water and lipid DWIs without special pulse sequence and increases the amount of diffusion information of water and lipid tissue.

Second-order motion compensated PRESS for cardiac spectroscopy

PURPOSE

Second-order motion compensation for point-resolved spectroscopy (PRESS) is proposed to allow for robust single-voxel cardiac spectroscopy throughout the entire cardiac cycle and at various heart rates.

METHODS

Bipolar FID spoiling gradient pairs compensating for first and second-order motion were designed and implemented into a cardiac-triggered PRESS sequence on a clinical MR system. A numerical three-dimensional model of cardiac motion was used to optimize and validate the gradient waveforms. In vivo measurements in healthy volunteers were obtained to assess the signal-to-noise ratio (SNR) and triglyceride-to-water ratio (TG/W). SNR gains and variability of TG/W of the proposed approach were evaluated against a conventional PRESS sequence with optimized gradients.

RESULTS

The proposed sequence increases the mean SNR by 32% (W) and 23% (TG) on average with significantly lower variability for different trigger delays. The variability of TG/W quantification over the cardiac cycle is significantly decreased with second-order motion compensated PRESS when compared with conventional PRESS with reduced-spoiler gradients (coefficient of variation: 0.1 ± 0.02 versus 0.37 ± 0.26).

CONCLUSION

Second-order motion compensated PRESS effectively reduces cardiac motion-induced signal degradation during FID spoiling, providing higher SNR and less variability for TG/W quantification. The sequence is considered promising to assess the TG/W modulation during various interventions including pharmacologically induced stress. Magn Reson Med 77:57-64, 2017. © 2016 Wiley Periodicals, Inc.

Intravoxel Incoherent Motion Diffusion-weighted Imaging of Multiple Myeloma Lesions: Correlation with Whole-Body Dynamic Contrast Agent-enhanced MR Imaging

PURPOSE

To correlate intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters with the enhancement patterns of bone marrow and focal lesion obtained on whole-body (WB) dynamic contrast agent-enhanced (DCE) magnetic resonance (MR) images in patients with stage-III multiple myeloma (MM) before and after systemic therapy.

MATERIALS AND METHODS

Twenty-seven patients with MM were retrospectively included in this institutional review board-approved study. Requirement for written informed consent was waived. All patients underwent WB DCE MR imaging before treatment and 18 patients underwent repeat MR imaging 3 months after treatment. A transverse IVIM DWI sequence with 10 b values (0, 10, 20, 30, 50, 80, 100, 200, 400, and 800 sec/mm(2)) was acquired within bone marrow and focal lesions. The IVIM parameters (perfusion fraction [f], molecular diffusion coefficient [D], and perfusion-related D [D*]) and apparent diffusion coefficient (ADC) were extracted for both focal lesions and bone marrow and correlated with focal lesions and maximal bone marrow enhancement (BMEmax) (Spearman correlation coefficient) at baseline and at follow-up (Wilcoxon signed-rank test).

RESULTS

D and ADC values positively correlated with BMEmax (r = 0.7, P < .001; and r = 0.455, P = .0435, respectively). Patients with increased BMEmax showed significantly increased ADC and D within bone marrow versus patients who did not have increased BMEmax (ADC, 0.67 × 10(-3) mm(2)/sec vs 0.54 × 10(-3) mm(2)/sec, P = .03; D, 0.58 × 10(-3) mm(2)/sec vs 0.42 × 10(-3) mm(2)/sec, P < .001). Within focal lesions, f was the maximum in lesions that showed enhancement followed by washout. After treatment in good responders, the significant decrease in maximal enhancement value of focal lesions (baseline vs after treatment, 213.9% ± 78.7 [standard deviation] vs 131% ± 53.6, respectively; P < .001) was accompanied by a significant decrease in f (baseline vs after treatment, 11% ± 3.8 vs 5.8% ± 4.7, respectively; P < .001).

CONCLUSION

Diffuse bone marrow involvement is associated with increased D. Hypervascular focal lesions with high maximal enhancement value of focal lesions also show high f value. Likewise, the decreased maximal enhancement value of focal lesions after treatment is accompanied by decreased f.

Proton diffusion tensor spectroscopy of metabolites in human muscle in vivo

PURPOSE

To study the apparent diffusivity and its directionality for metabolites of skeletal muscle in humans in vivo by (1) H magnetic resonance spectroscopy.

METHODS

The diffusion tensors were determined on a 3 Tesla MR system using optimized acquisition and processing methods including an adapted STEAM sequence with orientation-dependent diffusion weighting, pulse-triggering with individually adapted delays, eddy-current correction schemes, median filtering, and simultaneous prior-knowledge fitting of all related spectra.

RESULTS

The average apparent diffusivities, as well as the fractional anisotropies of taurine (ADCav=0.74 × 10(-3) s/mm(2) , FA=0.46), creatine (ADCav =0.41 × 10(-3) s/mm(2) , FA=0.33), trimethylammonium compounds (ADCav =0.48 × 10(-3) s/mm(2) , FA=0.34), carnosine (ADCav =0.46 × 10(-3) s/mm(2) , FA=0.47), and water (ADCav=1.5 × 10(-3) s/mm(2) , FA=0.36) were estimated. The diffusivities of most metabolites and water were significantly different from each other. Diffusion was found to be anisotropic and the diffusion tensors showed tensor correlation coefficients close to 1 and were hence found to be essentially coaligned. The magnitudes of apparent metabolite diffusivities were largely ordered according to molecular weight, with taurine as the smallest molecule diffusing fastest, both along and across the fiber direction.

CONCLUSION

Diffusivities, directional dependence of diffusion and fractional anisotropies of (1) H MRS-visible muscle metabolites were presented. It was shown that metabolites share diffusion directionality with water and have similar fractional anisotropies, hinting at similar diffusion barriers.

Diffusion magnetic resonance monitors intramyocellular lipid droplet size in vivo

PURPOSE

Intramyocellular lipid (IMCL) droplets are dynamic organelles whose morphology reflects their vital roles in lipid synthesis, usage, and storage in muscle energy metabolism. To develop noninvasive means to measure droplet microstructure in vivo, we investigated the molecular diffusion behavior of IMCL with diffusion magnetic resonance spectroscopy.

METHODS

Using extremely large diffusion weighting, we measured the IMCL apparent diffusion coefficients (ADCs) in hindlimb muscle of rodents from normal feeding, 60-h fasting, streptozotocin-induced diabetic, and high-fat-diet-induced obese groups.

RESULTS

IMCL ADCs decreased markedly with diffusion time, confirming the restricted diffusion of lipid molecules within IMCL droplets. IMCL droplet size, determined by transmission electron microscopy, was closely correlated with ADC. IMCL ADC was sensitive to metabolic alterations, decreasing in the 60-h fasting and diabetic groups while increasing in the obese group. These findings indicated that the IMCL droplet size decreased following 60-h fasting and in STZ-induced diabetes but increased in high-fat-diet-induced obesity.

CONCLUSION

MR diffusion characterization of IMCL droplet size provides a unique means to examine the intracellular lipid dynamics and metabolic abnormalities in vivo.

Online tool for calculating null points in various inversion recovery sequences

Accurate equations for calculating the inversion time of the null point (TInull) in inversion recovery (IR) sequences are required for adequate suppression of fat or cerebrospinal fluid (CSF) but are not widely known. The purpose of this study is to elucidate the process of deriving accurate TInull equations using schematic diagrams that allow the equations to be easily understood, and to devise a convenient online tool for instant calculation of TInull. We investigated various IR sequences in which a 180° inversion pulse is followed by spin echo (SE) type sequences, termed IR-SE-type sequences, including FLAIR (fluid attenuated inversion recovery), STIR (short inversion time inversion recovery), and SPAIR (spectral adiabatic inversion recovery, spectral attenuated inversion recovery). We classified these sequences into three types according to the behavior of the longitudinal magnetization before the next IR pulse: having a train of multiple spin echoes, a single spin echo, or a train of multiple inversions by SPAIR pulses (with no spin echo). For each sequence type, we produced a precise diagram of the behavior of the longitudinal magnetization and clarified the process of deriving the equation for TInull. Three accurate TInull equations were derived. We created an online tool that calculates TInull using these three equations. The validity of the resulting TInull was evaluated on pelvic SPAIR diffusion-weighted (DW) images at 3T in 21 volunteers, using various inversion times (TI) around the calculated TInull. The tool displays the calculated TInull value instantly, after inputting imaging parameters and the T1 values of fat or CSF. The TInull values calculated using the tool achieved sufficient suppression in all subjects. When the actual TI value differed by more than 5% from the calculated TInull value, the fat suppression effect was significantly less on pelvic SPAIR DW images (P<0.01). In conclusion, this online tool is easily available and enables adequate suppression of fat or CSF according to the imaging parameters.

Quantitative analysis of the diffusion-weighted steady-state free precession signal in vertebral bone marrow lesions

OBJECTIVES

: Diffusion-weighted steady-state free precession (DW-SSFP) sequences have shown great potential for the differential diagnosis of benign osteoporotic and malignant neoplastic vertebral compression fractures, which appear hypo- to isointense or hyperintense in DW-SSFP magnetic resonance imaging, respectively. In contrast to other diffusion weighting sequences, the DW-SSFP signal depends not only on the apparent diffusion coefficient (ADC), but also on the tissue relaxation times and sequence parameters. The purpose of the present study was to provide a detailed analysis of the DW-SSFP signal in benign and malignant vertebral lesions (VLs) and in vertebral bone marrow (VBM) to understand the observed signal alterations and their dependence on tissue and sequence parameters.

MATERIALS AND METHODS

: Magnetic resonance imaging was performed in 40 patients with benign (n = 20) or malignant (n = 20) VLs to determine the fat fraction and tissue parameters (ADC, T1, T2, T2*) for both the water and fat signal. With these values, the DW-SSFP signal was simulated and compared with the measured signals for different diffusion gradients by determining the signal intensity ratio between the SSFP signals of the lesions and of normal-appearing VBM for both malignant and benign VLs.

RESULTS

: The simulated DW-SSFP contrast agreed well with the measured contrast and provided a very good differentiation between benign osteoporotic and malignant VLs. ADCs were significantly different in both lesion types (malignant 1.36 vs. osteoporotic 1.77 × 10 mm/s); however, the observed contrast differences were caused predominantly by an opposed-phase readout in combination with significantly different T2* values (malignant 22 vs. osteoporotic 14 ms) and fat fractions (malignant 3.9% vs. osteoporotic 12%) in the lesions as well as significantly different fat fractions in normal-appearing VBM (malignant 42% vs. osteoporotic 52%) of both patient groups.

CONCLUSIONS

: Although the ADCs of the evaluated malignant and benign VLs showed highly significant differences, the influence of diffusion on the DW-SSFP signal contrast is relatively low compared with other tissue parameters due to the very complex signal mechanism of the SSFP sequence. Thus, the observed DW-SSFP signal contrast of different VLs (hypo-/isointense vs. hyperintense signal) is rather fat- and T2*-weighted than diffusion-weighted. The intermediate diffusion weighting of the applied SSFP sequence, however, helps to shift the different contrasts into a signal range that is easily visually accessible.

MRI of trabecular bone using a decay due to diffusion in the internal field contrast imaging sequence

PURPOSE

To characterize the DDIF (Decay due to Diffusion in the Internal Field) method using intact animal trabecular bone specimens of varying trabecular structure and porosity, under ex vivo conditions closely resembling in vivo physiological conditions. The DDIF method provides a diffusion contrast which is related to the surface-to-volume ratio of the porous structure of bones. DDIF has previously been used successfully to study marrow-free trabecular bone, but the DDIF contrast hitherto had not been tested in intact specimens containing marrow and surrounded by soft tissue.

MATERIALS AND METHODS

DDIF imaging was implemented on a 4.7 Tesla (T) small-bore, horizontal, animal scanner. Ex vivo results on fresh bone specimens containing marrow were obtained at body temperature. Control measurements were carried out in surrounding tissue and saline.

RESULTS

Significant DDIF effect was observed for trabecular bone samples, while it was considerably smaller for soft tissue outside the bone and for lipids. Additionally, significant differences were observed between specimens of different trabecular structure.

CONCLUSION

The DDIF contrast is feasible despite the reduction of the diffusion constant and of T(1) in such conditions, increasing our confidence that DDIF imaging in vivo may be clinically viable for bone characterization.

Restricted or severely hindered diffusion of intramyocellular lipids in human skeletal muscle shown by in vivo proton MR spectroscopy

Although magnetic resonance spectroscopy can be used as a unique tool to study molecular diffusion, it is rarely used to measure the diffusion properties of intramyocellular and extramyocellular lipids. Lipids have very low apparent diffusion coefficients (ADCs), which make these measurements difficult and necessitate strong diffusion gradients and long diffusion times. Consequence is that these measurements have inherently low signal-to-noise ratio and are prone to artifacts. The addition of physiological triggering and individual storage and processing of the spectra is seen to be a possible approach to maximize signal intensity and achieve high reproducibility of the experiments. Thus, the optimized measurement protocol was used to investigate the diffusion properties of lipids in human skeletal muscle in vivo. At a diffusion time of about 110 ms, intramyocellular lipids show a significantly lower ADC (2.0 × 10(-6) mm(2)/s, 95% confidence interval 1.10 × 10(-6) to 2.94 × 10(-6) mm(2)/s) than extramyocellular lipids (1.58 × 10(-5) mm(2)/s, 95% confidence interval 1.41 × 10(-5) to 1.75 × 10(-5) mm(2)/s). Because the chemical properties of both lipid pools can be assumed to be similar, the difference can only be attributed to restricted or severely hindered diffusion in the intramyocellular droplets.

Robust fat suppression at 3T in high-resolution diffusion-weighted single-shot echo-planar imaging of human brain

Single-shot echo-planar imaging is the most common acquisition technique for whole-brain diffusion tensor imaging (DTI) studies in vivo. Higher field MRI systems are readily available and advantageous for acquiring DTI due to increased signal. One of the practical issues for DTI with single-shot echo-planar imaging at high-field is incomplete fat suppression resulting in a chemically shifted fat artifact within the brain image. Unsuppressed fat is especially detrimental in DTI because the diffusion coefficient of fat is two orders of magnitude lower than that of parenchyma, producing brighter appearing fat artifacts with greater diffusion weighting. In this work, several fat suppression techniques were tested alone and in combination with the goal of finding a method that provides robust fat suppression and can be used in high-resolution single-shot echo-planar imaging DTI studies. Combination of chemical shift saturation with slice-select gradient reversal within a dual-spin-echo diffusion preparation period was found to provide robust fat suppression at 3 T.

Quantitative diffusion imaging of adipose tissue in the human lower leg at 1.5 T

Diffusion-weighted spin-echo echo-planar imaging was developed and applied for assessment of diffusion coefficients of adipose tissue in human lower leg on a 1.5-T whole-body MR scanner. Because of the higher molecular weight of triglycerides, apparent diffusion coefficients (ADCs) of adipose tissue are approximately two orders of magnitude smaller compared with water, leading to the necessity of using high b-values up to 50,000 sec/mm(2) and an echo time of 240 msec for sufficient diffusion-related signal attenuation. ADC maps of adipose tissue in the human lower leg were derived for diffusion encoding along orthogonal spatial directions in six healthy volunteers. Mean diffusion coefficients in the tibial bone marrow amounted to (1.81 ± 0.10) × 10(-5) mm(2) /sec (left-right), (1.96 ± 0.10) × 10(-5) mm(2) /sec (anterior-posterior), and (1.96 ± 0.20) × 10(-5) mm(2) /sec (head-feet), respectively. Pixel-wise calculated ADC values of subcutaneous adipose tissue showed a distinctly higher variation with the smallest ADC values similar to those measured for tibial bone marrow. Some subcutaneous adipose tissue regions showed increased signal attenuation at higher b-values resulting in ADC coefficients up to 4.2 × 10(-5) mm(2) /sec. It must be noted that diffusion measurements with extremely high b-values in vivo are extremely sensitive to incoherent motion effects in tissue. Nonetheless, it could be shown that in vivo diffusion imaging of adipose tissue in human lower leg is possible at 1.5 T in acceptable measurement time of a few minutes. Potential future applications of fat diffusion imaging are seen in temperature measurements in adipose tissue, detection of free fatty acids in white or brown adipose tissue in case of high lipolysis, differentiation of macro- and microvesicular steatosis, or assessment of the mobility of intramyocellular lipids.

Diffusion-weighted imaging of normal fibroglandular breast tissue: influence of microperfusion and fat suppression technique on the apparent diffusion coefficient

The influence of microperfusion and fat suppression technique on the apparent diffusion coefficient (ADC) values obtained with diffusion weighted imaging (DWI) of normal fibroglandular breast tissue was investigated. Seven volunteers (14 breasts) were scanned using diffusion weighting factors (b values) up to 1600 s/mm(2) and the four different fat suppression techniques: STIR, fat saturation, SPAIR, and Water Excitation. The relationship between the logarithmic DW attenuation curves and b was linear for b values up to 600 s/mm(2) (R(2) > 0.999). Small differences were noted between the ADC values obtained with the various fat suppression methods, especially at the higher b values. Water Excitation had the highest mean SNR, exceeding STIR (p = 0.03) though not significantly different from fat saturation and SPAIR. In conclusion, the ADC of fibroglandular breast tissue is not influenced by microperfusion and Water Excitation is recommended because it yielded the best SNR values. These factors may be crucial in the differentiation between benign and malignant lesions.

On high b diffusion imaging in the human brain: ruminations and experimental insights

Interest in the manner in which brain tissue signal decays with b factor in diffusion imaging schemes has grown in recent years following the observation that the decay curves depart from purely monoexponential decay behavior. Regardless of the model or fitting function proposed for characterizing sufficiently sampled decay curves (vide infra), the departure from monoexponentiality spells increased tissue characterization potential. The degree to which this potential can be harnessed to improve specificity, sensitivity and spatial localization of diseases in brain, and other tissues, largely remains to be explored. Furthermore, the degree to which currently popular diffusion tensor imaging methods, including visually impressive white matter fiber "tractography" results, have almost completely ignored the nonmonoexponential nature of the basic signal decay with b factor is worthy of communal introspection. Here we limit our attention to a review of the basic experimental features associated with brain water signal diffusion decay curves as measured over extended b-factor ranges, the simple few parameter fitting functions that have been proposed to characterize these decays and the more involved models, e.g.,"ruminations," which have been proposed to account for the nonmonoexponentiality to date.

In vivo lipid diffusion coefficient measurements in rat bone marrow

The diffusion coefficient of lipids, D(l), within bone marrow, fat deposits and metabolically active intracellular lipids in vivo will depend on several factors including the precise chemical composition of the lipid distribution (chain lengths, degree of unsaturation, etc.) as well as the temperature. As such, D(l) may ultimately prove of value in assessing abnormal fatty acid distributions linked to diseases such as cystic fibrosis, diabetes and coronary heart disease. A sensitive temperature dependence of D(l) may also prove of value for MR-guided thermal therapies for bone tumors or disease within other fatty tissues like the breast. Measuring diffusion coefficients of high molecular weight lipids in vivo is, however, technically difficult for a number of reasons. For instance, due to the much lower diffusion coefficients compared to water, much higher b factors than those used for central nervous system applications are needed. In addition, the pulse sequence design must incorporate, as much as possible, immunity to motion, susceptibility and chemical shift effects present whenever body imaging is performed. In this work, high b-factor line scan diffusion imaging sequences were designed, implemented and tested for D(l) measurement using a 4.7-T horizontal bore animal scanner. The gradient set available allowed for b factors as high as 0.03 micros/nm(2) (30,000 s/mm(2)) at echo times as short as 42 ms. The methods were used to measure lipid diffusion coefficients within the marrow of rat paws in vivo, yielding lipid diffusion coefficients approximately two orders of magnitude smaller than typical tissue water diffusion coefficients. Phantom experiments that demonstrate the sensitivity of lipid diffusion coefficients to chain length and temperature were also performed.

Diffusion-weighted and diffusion tensor imaging for pediatric musculoskeletal disorders

Diffusion-weighted imaging (DWI) is a powerful tool that has recently been applied to evaluate several pediatric musculoskeletal disorders. DWI probes abnormalities of tissue structure by detecting microscopic changes in water mobility that develop when disease alters the organization of normal tissue. DWI provides tissue characterization at a cellular level beyond what is available with other imaging techniques, and can sometimes identify pathology before gross anatomic alterations manifest. These features of early detection and tissue characterization make DWI particularly appealing for probing diseases that affect the musculoskeletal system. This article focuses on the current and future applications of DWI in the musculoskeletal system, with particular attention paid to pediatric disorders. Although most of the applications are experimental, we have emphasized the current state of knowledge and the main research questions that need to be investigated.

Musculoskeletal spectroscopy

Magnetic resonance spectroscopy (MRS) of skeletal muscle has been successfully applied by physiologists over several decades, particularly for studies of high-energy phosphates (by (31)P-MRS) and glycogen (by (13)C-MRS). Unfortunately, the observation of these heteronuclei requires equipment that is typically not available on clinical MR scanners, such as broadband capability and a second channel for decoupling and nuclear Overhauser enhancement (NOE). On the other hand, (1)H-MR spectra of skeletal muscle can be acquired on many routine MR systems and also provide a wealth of physiological information. In particular, studies of intramyocellular lipids (IMCL) attract physiologists and endocrinologists because IMCL levels are related to insulin resistance and thus can lead to a better understanding of major health problems in industrial countries. The combination of (1)H-, (13)C-, and (31)P-MRS gives access to the major long- and short-term energy sources of skeletal muscle. This review summarizes the technical aspects and unique MR-methodological features of the different nuclei. It reviews clinical studies that employed MRS of one or more nuclei, or combinations of MRS with other MR modalities. It also illustrates that MR spectra contain additional physiological information that is not yet used in routine clinical applications.

Biexponential parameterization of diffusion and T2 relaxation decay curves in a rat muscle edema model: decay curve components and water compartments

Quantitative T2 relaxation and diffusion imaging studies of a rat muscle edema model were performed in order to determine the effects of intra- and extracellular water compartmentation on the respective decay curves. The right hind paw of rats was injected with a carrageenan solution to generate edematous muscle. A Carr-Purcell-Meiboom-Gill (CPMG) imaging sequence was used to acquire T2 relaxation decay curves from both paws. A line scan diffusion imaging (LSDI) sequence was then used to acquire diffusion decay curves from the same paws over a wide b-factor range. Measurements were made from both edematous muscle (EM) and control muscle (CM). The EM and CM T2 relaxation decay curves were best fit with biexponential functions. The fraction of the fast T2 component dropped dramatically from approximately 0.95 in CM to 0.45 in EM, consistent with a water compartmentation model in which the fast and slow T2 components reflect intra- and extracellular water, respectively. Both CM and EM diffusion decay curves required biexponential fitting functions, and the diffusion coefficients of the fast and slow components were substantially larger in EM than CM. The fraction of the fast diffusion component, however, was not radically altered between CM and EM conditions (0.84 versus 0.89 for CM versus EM). Assuming a model in which intra- and extracellular water compartments are responsible for the fast and slow T2-decay components and for the slow and fast diffusion decay components, respectively, leads to fractional sizes of the diffusion components that are not supported by experiment. We conclude that intra- and extracellular water compartmentation is a reasonable interpretation for the two T2-decay components in both CM and EM but that other factors, such as restricted diffusion and/or alternate forms of water compartmentation like surface versus volume water, most probably have profound influences on the precise shapes of the diffusion decay curves, a complete understanding of which will require significant theoretical work.

Dairy cream as a phantom material for biexponential diffusion decay

Commercially available aliquots of dairy cream are shown to have diffusion decay curves characterized by biexponential functions when studied over a wide range of b-factors. The fast and slow diffusion components responsible for the biexponential decay are attributed to water and lipid protons, respectively. The fast diffusion coefficient and relative fast and slow diffusion component fractions obtained from biexponential fits of cream phantoms over a wide range of b-factors up to 3,000 s/mm2 are similar to those obtained previously for brain. The slow diffusion coefficient from lipid protons is smaller than that found in the brain. Overall, however, the results suggest that dairy cream can serve as a widely available phantom material for testing software and hardware components designed to perform quantitative, biexponential diffusion decay studies.