Quantitative T(1)(ρ) imaging using phase cycling for B0 and B1 field inhomogeneity compensation

Cartilage compositional MRI-a narrative review of technical development and clinical applications over the past three decades

Articular cartilage damage and degeneration are among hallmark manifestations of joint injuries and arthritis, classically osteoarthritis. Cartilage compositional MRI (Cart-C MRI), a quantitative technique, which aims to detect early-stage cartilage matrix changes that precede macroscopic alterations, began development in the 1990s. However, despite the significant advancements over the past three decades, Cart-C MRI remains predominantly a research tool, hindered by various technical and clinical hurdles. This paper will review the technical evolution of Cart-C MRI, delve into its clinical applications, and conclude by identifying the existing gaps and challenges that need to be addressed to enable even broader clinical application of Cart-C MRI.

Novel spin-lock time sampling strategies for improved reproducibility in quantitative T1ρ mapping

This study aimed to optimize the sampling of spin-lock times (TSLs) in quantitative T1ρ mapping for improved reproducibility. Two new TSL sampling schemes were proposed: (i) reproducibility-guided random sampling (RRS) and (ii) reproducibility-guided optimal sampling (ROS). They were compared to the existing linear sampling (LS) and precision-guided sampling (PS) schemes for T1ρ reproducibility through numerical simulations, phantom experiments, and volunteer studies. Each study evaluated the four sampling schemes with three commonly used T1ρ preparations based on composite and balanced spin-locking. Additionally, the phantom and volunteer studies investigated the impact of B0 and B1 field inhomogeneities on T1ρ reproducibility, respectively. The reproducibility was assessed using the coefficient of variation (CoV) by repeating the T1ρ measurements eight times for phantom experiments and five times for volunteer studies. Numerical simulations resulted in lower mean CoVs for the proposed RRS (1.74%) and ROS (0.68%) compared to LS (2.93%) and PS (3.68%). In the phantom study, the mean CoVs were also lower for RRS (2.7%) and ROS (2.6%) compared to LS (4.1%) and PS (3.1%). Furthermore, the mean CoVs of the proposed RRS and ROS were statistically lower (P < 0.001) compared to existing LS and PS schemes at a B1 offset of 20%. In the volunteer study, consistently lower mean CoVs were observed in bilateral thigh muscles for RRS (9.3%) and ROS (9.2%) compared to LS (10.9%) and PS (10.2%), and the difference was more prominent at B0 offsets higher than 50 Hz. The proposed sampling schemes improve the reproducibility of quantitative T1ρ mapping by optimizing the selection of TSLs. This improvement is especially beneficial for longitudinal studies that track and monitor disease progression and treatment response.

Alternating Look-Locker for quantitative T1 , T1ρ and B1 3D MRI mapping

PURPOSE

To develop a new MRI method, entitled alternating Look-Locker (aLL), for quantitativeT 1 $$ {T}_1 $$ ,T 1 ρ $$ {T}_{1\uprho} $$ , andB 1 $$ {B}_1 $$ 3D mapping.

METHODS

A Look-Locker scheme that alternates magnetization from +Z and -Z axes of the laboratory frame is utilized in combination with a 3D Multi-Band Sweep Imaging with Fourier Transformation (MB-SWIFT) readout. The analytical solution describing the spin evolution during aLL, as well as the correction required for segmented acquisition were derived. The simultaneousB 1 $$ {B}_1 $$ andT 1 $$ {T}_1 $$ mapping are demonstrated on an agar/saline phantom and on an in-vivo rat head.T 1 ρ $$ {T}_{1\uprho} $$ relaxation was achieved by cyclically applying magnetization preparation (MP) modules consisting of two adiabatic pulses.T 1 ρ $$ {T}_{1\uprho} $$ values in the rat brain in-vivo and in a gadobenate dimeglumine (Gd-DTPA) phantom were compared to those obtained with a previously introduced steady-state (SS) method.

RESULTS

The accuracy and precision of the analytical solution was tested by Bloch simulations. With the application of MP modules, the aLL method provides simultaneousT 1 $$ {T}_1 $$ andT 1 ρ $$ {T}_{1\uprho} $$ maps. Conversely, without it, the method can be used for simultaneousT 1 $$ {T}_1 $$ andB 1 $$ {B}_1 $$ mapping.T 1 ρ $$ {T}_{1\uprho} $$ values were similar with both aLL and SS techniques. However, the aLL method resulted in more robust quantitative mapping compared to the SS method. Unlike the SS method, the aLL method does not require additional scans for generatingT 1 $$ {T}_1 $$ maps.

CONCLUSION

The proposed method offers a new flexible tool for quantitative mapping ofT 1 $$ {T}_1 $$ ,T 1 ρ $$ {T}_{1\uprho} $$ , andB 1 $$ {B}_1 $$ . The aLL method can also be used with readout schemes different from MB-SWIFT.

Synthetic Knee MRI T1p Maps as an Avenue for Clinical Translation of Quantitative Osteoarthritis Biomarkers

A 2D U-Net was trained to generate synthetic T1p maps from T2 maps for knee MRI to explore the feasibility of domain adaptation for enriching existing datasets and enabling rapid, reliable image reconstruction. The network was developed using 509 healthy contralateral and injured ipsilateral knee images from patients with ACL injuries and reconstruction surgeries acquired across three institutions. Network generalizability was evaluated on 343 knees acquired in a clinical setting and 46 knees from simultaneous bilateral acquisition in a research setting. The deep neural network synthesized high-fidelity reconstructions of T1p maps, preserving textures and local T1p elevation patterns in cartilage with a normalized mean square error of 2.4% and Pearson's correlation coefficient of 0.93. Analysis of reconstructed T1p maps within cartilage compartments revealed minimal bias (-0.10 ms), tight limits of agreement, and quantification error (5.7%) below the threshold for clinically significant change (6.42%) associated with osteoarthritis. In an out-of-distribution external test set, synthetic maps preserved T1p textures, but exhibited increased bias and wider limits of agreement. This study demonstrates the capability of image synthesis to reduce acquisition time, derive meaningful information from existing datasets, and suggest a pathway for standardizing T1p as a quantitative biomarker for osteoarthritis.

Region of interest-specific loss functions improve T2 quantification with ultrafast T2 mapping MRI sequences in knee, hip and lumbar spine

MRI T2 mapping sequences quantitatively assess tissue health and depict early degenerative changes in musculoskeletal (MSK) tissues like cartilage and intervertebral discs (IVDs) but require long acquisition times. In MSK imaging, small features in cartilage and IVDs are crucial for diagnoses and must be preserved when reconstructing accelerated data. To these ends, we propose region of interest-specific postprocessing of accelerated acquisitions: a recurrent UNet deep learning architecture that provides T2 maps in knee cartilage, hip cartilage, and lumbar spine IVDs from accelerated T2-prepared snapshot gradient-echo acquisitions, optimizing for cartilage and IVD performance with a multi-component loss function that most heavily penalizes errors in those regions. Quantification errors in knee and hip cartilage were under 10% and 9% from acceleration factors R = 2 through 10, respectively, with bias for both under 3 ms for most of R = 2 through 12. In IVDs, mean quantification errors were under 12% from R = 2 through 6. A Gray Level Co-Occurrence Matrix-based scheme showed knee and hip pipelines outperformed state-of-the-art models, retaining smooth textures for most R and sharper ones through moderate R. Our methodology yields robust T2 maps while offering new approaches for optimizing and evaluating reconstruction algorithms to facilitate better preservation of small, clinically relevant features.

Uncertainty-aware self-supervised neural network for liverT1ρmapping with relaxation constraint

Objective.T1ρmapping is a promising quantitative MRI technique for the non-invasive assessment of tissue properties. Learning-based approaches can mapT1ρfrom a reduced number ofT1ρweighted images but requires significant amounts of high-quality training data. Moreover, existing methods do not provide the confidence level of theT1ρestimation. We aim to develop a learning-based liverT1ρmapping approach that can mapT1ρwith a reduced number of images and provide uncertainty estimation.Approach. We proposed a self-supervised neural network that learns aT1ρmapping using the relaxation constraint in the learning process. Epistemic uncertainty and aleatoric uncertainty are modelled for theT1ρquantification network to provide a Bayesian confidence estimation of theT1ρmapping. The uncertainty estimation can also regularize the model to prevent it from learning imperfect data. Main results. We conducted experiments onT1ρdata collected from 52 patients with non-alcoholic fatty liver disease. The results showed that when only collecting twoT1ρ-weighted images, our method outperformed the existing methods forT1ρquantification of the liver. Our uncertainty estimation can further regularize the model to improve the performance of the model and it is consistent with the confidence level of liverT1ρvalues.Significance. Our method demonstrates the potential for accelerating theT1ρmapping of the liver by using a reduced number of images. It simultaneously provides uncertainty ofT1ρquantification which is desirable in clinical applications.

A self-compensated spin-locking scheme for quantitative R1ρ dispersion MR imaging in ordered tissues

PURPOSE

To propose a self-compensated spin-locking (SL) method for quantitative R_1ρ dispersion imaging in ordered tissues.

METHODS

Two pairs of antiphase rotary-echo SL pulses were proposed in a new scheme with each pairs sandwiching one refocusing RF pulse. This proposed SL method was evaluated by Bloch simulations and experimental studies relative to three prior schemes. Quantitative R_1ρR dispersion imaging studies with constant SL duration (TSL = 40 ms) were carried out on an agarose (1-4% w/v) phantom and one in vivo human knee at 3 T, using six SL RF strengths ranging from 50 to 1000 Hz. The performances of these SL schemes were characterized with an average coefficient of variation (CV) of the signal intensities in agarose gels and the sum of squared errors (SSE) for quantifying in vivo R_1ρ dispersion of the femoral and tibial cartilage.

RESULTS

The simulations demonstrate that the proposed SL scheme was less prone to B₀ and B₁ field inhomogeneities. This theoretical prediction was supported by fewer image banding artifacts and less signal fluctuation signified by a reduced CV (%) on the phantom without R_1ρ dispersion (i.e., 4.04 ± 1.36 vs. 18.87 ± 4.46 or 6.66 ± 2.92 or 5.71 ± 2.05 for others), and further by mostly decreased SSE (*10^-3) for characterizing R_1ρ dispersion of the femoral (i.e., 0.3 vs. 1.2 or 0.4 or 0.1) and tibial (i.e., 0.4 vs. 7.2 or 3.2 or 2.8) cartilage.

CONCLUSION

The proposed SL scheme is less sensitive to B₀ and B₁ field artifacts for a wide range of SL RF strengths and thus more suitable for quantitative R_1ρ dispersion imaging in ordered tissues.

Simultaneous T1 , T2 , and T1ρ cardiac magnetic resonance fingerprinting for contrast agent-free myocardial tissue characterization

PURPOSE

To develop a simultaneous T₁ , T₂ , and T_1ρ cardiac magnetic resonance fingerprinting (MRF) approach to enable comprehensive contrast agent-free myocardial tissue characterization in a single breath-hold scan.

METHODS

A 2D gradient-echo electrocardiogram-triggered cardiac MRF sequence with low flip angles, varying magnetization preparation, and spiral trajectory was acquired at 1.5 T to encode T₁ , T₂ , and T_1⍴ simultaneously. The MRF images were reconstructed using low-rank inversion, regularized with a multicontrast patch-based higher-order reconstruction. Parametric maps were generated and matched in the singular value domain to extended phase graph-based dictionaries. The proposed approach was tested in phantoms and 10 healthy subjects and compared against conventional methods in terms of coefficients of determination and best fits for the phantom study, and in terms of Bland-Altman agreement, average values and coefficient of variation of T₁ , T₂ , and T_1⍴ for the healthy subjects study.

RESULTS

The T₁ , T₂ , and T_1⍴ MRF values showed excellent correlation with conventional spin-echo and clinical mapping methods in phantom studies (r² > 0.97). Measured MRF values in myocardial tissue (mean ± SD) were 1133 ± 33 ms, 38.8 ± 3.5 ms, and 52.0 ± 4.0 ms for T₁ , T₂ and T1_⍴ , respectively, against 1053 ± 47 ms, 50.4 ± 3.9 ms, and 55.9 ± 3.3 ms for T₁ modified Look-Locker inversion imaging, T₂ gradient and spin echo, and T_1⍴ turbo field echo, respectively.

CONCLUSION

A cardiac MRF approach for simultaneous quantification of myocardial T₁ , T₂ , and T_1ρ in a single breath-hold MR scan of about 16 seconds has been proposed. The approach has been investigated in phantoms and healthy subjects showing good agreement with reference spin echo measurements and conventional clinical maps.

Simultaneous comprehensive liver T1 , T2 , T 2 ∗ , T1ρ , and fat fraction characterization with MR fingerprinting

PURPOSE

To develop a novel simultaneous co-registered T₁ , T₂ , T 2 ∗ , T_1ρ , and fat fraction abdominal MR fingerprinting (MRF) approach for fully comprehensive liver-tissue characterization in a single breath-hold scan.

METHODS

A gradient-echo liver MRF sequence with low fixed flip angle, multi-echo radial readout, and varying magnetization preparation pulses for multiparametric encoding is performed at 1.5 T. The T 2 ∗ and fat fraction are estimated from a graph/cut water/fat separation method using a six-peak fat model. Water/fat singular images obtained are then matched to an MRF dictionary, estimating water-specific T₁ , T₂ , and T_1ρ . The proposed approach was tested in phantoms and 10 healthy subjects and compared against conventional sequences.

RESULTS

For the phantom studies, linear fits show excellent coefficients of determination (r² > 0.9) for every parametric map. For in vivo studies, the average values measured within regions of interest drawn on liver, spleen, muscle, and fat are statistically different from the reference scans (p < 0.05) for T₁ , T₂ , and T_1⍴ but not for T 2 ∗ and fat fraction, whereas correlation between MRF and reference scans is excellent for each parameter (r² > 0.92 for every parameter).

CONCLUSION

The proposed multi-echo inversion-recovery, T₂ , and T_1⍴ prepared liver MRF sequence presented in this work allows for quantitative T₁ , T₂ , T 2 ∗ , T_1⍴ , and fat fraction liver-tissue characterization in a single breath-hold scan of 18 seconds. The approach showed good agreement and correlation with respect to reference clinical maps.

Magnetization-prepared spoiled gradient-echo snapshot imaging for efficient measurement of R2 -R1ρ in knee cartilage

PURPOSE

To validate the potential of quantifying R₂ -R_1ρ using one pair of signals with T_1ρ preparation and T₂ preparation incorporated to magnetization-prepared angle-modulated partitioned k-space spoiled gradient-echo snapshots (MAPSS) acquisition and to find an optimal preparation time (T_prep ) for in vivo knee MRI.

METHODS

Bloch equation simulations were first performed to assess the accuracy of quantifying R₂ -R_1ρ using T_1ρ - and T₂ -prepared signals with an equivalent T_prep . For validation of this technique in comparison to the conventional approach that calculates R₂ -R_1ρ after estimating both T₂ and T_1ρ , phantom experiments and in vivo validation with five healthy subjects and five osteoarthritis patients were performed at a clinical 3T scanner.

RESULTS

Bloch equation simulations demonstrated that the accuracy of this efficient R₂ -R_1ρ quantification method and the optimal T_prep can be affected by image signal-to-noise ratio (SNR) and tissue relaxation times, but quantification can be closest to the reference with an around 25 ms T_prep for knee cartilage. Phantom experiments demonstrated that the proposed method can depict R₂ -R_1ρ changes with agarose gel concentration. With in vivo data, significant correlation was observed between cartilage R₂ -R_1ρ measured from the conventional and the proposed methods, and a T_prep of 25.6 ms provided the most agreement by Bland-Altman analysis. R₂ -R_1ρ was significantly lower in patients than in healthy subjects for most cartilage compartments.

CONCLUSION

As a potential biomarker to indicate cartilage degeneration, R₂ -R_1ρ can be efficiently measured using one pair of T_1ρ -prepared and T₂ -prepared signals with an optimal T_prep considering cartilage relaxation times and image SNR.

Three-Dimensional GRE T1ρ mapping of the brain using tailored variable flip-angle scheduling

PURPOSE

To introduce a new approach called tailored variable flip-angle (VFA) scheduling for SNR-efficient 3D T_1ρ mapping of the brain using a magnetization-prepared gradient-echo sequence.

METHODS

Simulations were used to assess the relative SNR efficiency, quantitative accuracy, and spatial blurring of tailored VFA scheduling for T_1ρ mapping of brain tissue compared with magnetization-prepared angle-modulated partitioned k-space spoiled gradient-echo snapshots (MAPSS), a state-of-the-art technique for accurate 3D gradient-echo T_1ρ mapping. Simulations were also used to calculate optimal imaging parameters for tailored VFA scheduling versus MAPSS, without and with nulling of CSF. Four participants were imaged at 3T MRI to demonstrate the feasibility of tailored VFA scheduling for T_1ρ mapping of the brain. Using MAPSS as a reference standard, in vivo data were used to validate the relative SNR efficiency and quantitative accuracy of the new approach.

RESULTS

Tailored VFA scheduling can provide a 2-fold to 4-fold gain in the SNR of the resulting T_1ρ map as compared with MAPSS when using identical sequence parameters while limiting T_1ρ quantification errors to 2% or less. In vivo whole-brain 3D T_1ρ maps acquired with tailored VFA scheduling had superior SNR efficiency than is achievable with MAPSS, and the SNR efficiency improved with a greater number of views per segment.

CONCLUSIONS

Tailored VFA scheduling is an SNR-efficient GRE technique for 3D T_1ρ mapping of the brain that provides increased flexibility in choice of imaging parameters compared with MAPSS, which may benefit a variety of applications.

Proton Exchange Magnetic Resonance Imaging: Current and Future Applications in Psychiatric Research

Proton exchange provides a powerful contrast mechanism for magnetic resonance imaging (MRI). MRI techniques sensitive to proton exchange provide new opportunities to map, with high spatial and temporal resolution, compounds important for brain metabolism and function. Two such techniques, chemical exchange saturation transfer (CEST) and T1 relaxation in the rotating frame (T1ρ), are emerging as promising tools in the study of neurological and psychiatric illnesses to study brain metabolism. This review describes proton exchange for non-experts, highlights the current status of proton-exchange MRI, and presents advantages and drawbacks of these techniques compared to more traditional methods of imaging brain metabolism, including positron emission tomography (PET) and MR spectroscopy (MRS). Finally, this review highlights new frontiers for the use of CEST and T1ρ in brain research.

Chemical-shift encoding-based water-fat separation with multifrequency fat spectrum modeling in spin-lock MRI

PURPOSE

Chemical exchange saturation transfer is used commonly to generate MRI contrast based on the chemical exchange effect. The spin-lock techniques can also be used to probe the chemical exchange and other molecular motion processes in tissues. The presence of fat can cause errors in spin-lock MRI. Signals from fat are typically suppressed based on spectral selectivity or T₁ nulling approaches in spin-lock imaging. However, these methods cannot be used to suppress fat signals from multiple fat peaks. To address this problem, we report chemical-shift encoding-based water-fat separation approaches with multifrequency fat spectrum modeling.

METHODS

Both the conventional spin-lock and the adiabatic continuous-wave constant-amplitude spin lock (ACCSL) with multi-echo acquisitions are investigated for chemical-shift encoding-based water-fat separation in spin-lock imaging. A comparison is made of reconstructions based on 3 models: a single-peak fat spectrum model, a standard precalibrated proton density 6-peak fat spectrum model, and the self-calibrated relaxation-dependent 3-peak fat spectrum model. Comparisons were performed using Bloch simulations, phantom, and in vivo experiments at 3 T.

RESULTS

Conventional spin-lock acquisitions cannot be used for reliable water-fat separation with a multipeak fat spectrum model. Water-fat separation based on ACCSL acquisitions achieves superior performance compared with the use of conventional spin-lock acquisitions. The best result is achieved from ACCSL acquisition with self-calibrated relaxation-dependent multipeak fat spectrum modeling.

CONCLUSION

The ACCSL acquisition can be used for chemical-shift encoding-based water-fat separation with multipeak fat spectrum modeling. This approach has the potential to improve quantitative analysis using spin-lock MRI for assessing the biochemical properties of tissues.

On-resonance and off-resonance continuous wave constant amplitude spin-lock and T1ρ quantification in the presence of B1 and B0 inhomogeneities

Spin-lock MRI is a valuable diagnostic imaging technology, as it can be used to probe the macromolecule environment of tissues. Quantitative T_1ρ imaging is one application of spin-lock MRI that is reported to be promising for a number of clinical applications. Spin-lock is often performed with a continuous RF wave at a constant RF amplitude either on resonance or off resonance. However, both on- and off-resonance spin-lock approaches are susceptible to B₁ and B₀ inhomogeneities, which results in image artifacts and quantification errors. In this work, we report a continuous wave constant amplitude spin-lock approach that can achieve negligible image artifacts in the presence of B₁ and B₀ inhomogeneities for both on- and off-resonance spin-lock. Under the adiabatic condition, by setting the maximum B₁ amplitude of the adiabatic pulses equal to the B₁ amplitude of spin-lock RF pulse, the spins are ensured to align along the effective field throughout the spin-lock process. We show that this results in simultaneous compensation of B₁ and B₀ inhomogeneities for both on- and off-resonance spin-lock. The relaxation effect during the entire adiabatic half passage (AHP) and reverse AHP, and the stationary solution of the Bloch-McConnell equation present at off-resonance frequency offset, are considered in the revised relaxation model. We demonstrate that these factors create a direct current component to the conventional relaxation model. In contrast to the previously reported dual-acquisition method, the revised relaxation model just requires one acquisition to perform quantification. The simulation, phantom, and in vivo experiments demonstrate that the proposed approach achieves superior image quality compared with the existing methods, and the revised relaxation model can perform T_1ρ quantification with one acquisition instead of two.

Biexponential T1ρ relaxation mapping of human knee cartilage in vivo at 3 T

The purpose of this study was to demonstrate the feasibility of biexponential T_1ρ relaxation mapping of human knee cartilage in vivo. A three-dimensional, customized, turbo-flash sequence was used to acquire T_1ρ -weighted images from healthy volunteers employing a standard 3-T MRI clinical scanner. A series of T_1ρ -weighted images was fitted using monoexponential and biexponential models with two- and four-parametric non-linear approaches, respectively. Non-parametric Kruskal-Wallis and Mann-Whitney U-statistical tests were used to evaluate the regional relaxation and gender differences, respectively, with a level of significance of P = 0.05. Biexponential relaxations were detected in the cartilage of all volunteers. The short and long relaxation components of T_1ρ were estimated to be 6.9 and 51.0 ms, respectively. Similarly, the fractions of short and long T_1ρ were 37.6% and 62.4%, respectively. The monoexponential relaxation of T_1ρ was 32.6 ms. The experiments showed good repeatability with a coefficient of variation (CV) of less than 20%. A biexponential relaxation model showed a better fit than a monoexponential model to the T_1ρ relaxation decay in knee cartilage. Biexponential T_1ρ components could potentially be used to increase the specificity to detect early osteoarthritis by the measurement of different water compartments and their fractions.

Artifacts correction for T1rho imaging with constant amplitude spin-lock

T1rho imaging with constant amplitude spin-lock is prone to artifacts in the presence of B1 RF and B0 field inhomogeneity. Despite significant technological progress, improvements on the robustness of constant amplitude spin-lock are necessary in order to use it for routine clinical practice. This work proposes methods to simultaneously correct for B1 RF and B0 field inhomogeneity in constant amplitude spin-lock. By setting the maximum B1 amplitude of the excitation adiabatic pulses equal to the expected constant amplitude spin-lock frequency, the spins become aligned along the effective field throughout the spin-lock process. This results in T1rho-weighted images free of artifacts, despite the spatial variation of the effective field caused by B1 RF and B0 field inhomogeneity. When the pulse is long, the relaxation effect during the adiabatic half passage may result in a non-negligible error in the mono-exponential relaxation model. A two-acquisition approach is presented to solve this issue. Simulation, phantom, and in-vivo scans demonstrate the proposed methods achieve superior image quality compared to existing methods, and that the two-acquisition method is effective in resolving the relaxation effect during the adiabatic half passage.

Functional magnetic resonance imaging techniques and their development for radiation therapy planning and monitoring in the head and neck cancers

Radiation therapy (RT), in particular intensity-modulated radiation therapy (IMRT), is becoming a more important nonsurgical treatment strategy in head and neck cancer (HNC). The further development of IMRT imposes more critical requirements on clinical imaging, and these requirements cannot be fully fulfilled by the existing radiotherapeutic imaging workhorse of X-ray based imaging methods. Magnetic resonance imaging (MRI) has increasingly gained more interests from radiation oncology community and holds great potential for RT applications, mainly due to its non-ionizing radiation nature and superior soft tissue image contrast. Beyond anatomical imaging, MRI provides a variety of functional imaging techniques to investigate the functionality and metabolism of living tissue. The major purpose of this paper is to give a concise and timely review of some advanced functional MRI techniques that may potentially benefit conformal, tailored and adaptive RT in the HNC. The basic principle of each functional MRI technique is briefly introduced and their use in RT of HNC is described. Limitation and future development of these functional MRI techniques for HNC radiotherapeutic applications are discussed. More rigorous studies are warranted to translate the hypotheses into credible evidences in order to establish the role of functional MRI in the clinical practice of head and neck radiation oncology.

Paired self-compensated spin-lock preparation for improved T1ρ quantification

PURPOSE

Spin-lock (SL) imaging allows quantification of the spin-lattice relaxation time in the rotating frame (T1ρ). B0 and B1 inhomogeneities impact T1ρ quantification because the preparatory block in SL imaging is sensitive to the field heterogeneities. Here, a modified preparatory block (PSC-SL) is proposed that attempts to alleviate SL sensitivity to field inhomogeneities in scenarios where existing approaches fail, i.e. high SL frequencies.

METHODS

Computer simulations, phantom and in vivo experiments were used to determine the effect of field inhomogeneities on T1ρ quantification. Existing SL preparations were compared with PSC-SL in different conditions to assess the advantages and disadvantages of each method.

RESULTS

Phantom experiments and computer modeling demonstrate that PSC-SL provides superior T1ρ quantification at high SL frequencies in situations where the existing SL preparation methods fail. This result has been confirmed in pre-clinical neuro and body imaging at 7T.

CONCLUSION

PSC-SL complements existing methods by increasing the accuracy of T1ρ quantification at high spin-lock frequencies when large field inhomogeneities are present. A-priory information about the experimental conditions such, as field distribution and spinlock frequency are useful for selecting an appropriate spin-lock preparation for specific applications.

Measurement of Myocardial T1ρ with a Motion Corrected, Parametric Mapping Sequence in Humans

PURPOSE

To develop a robust T1ρ magnetic resonance imaging (MRI) sequence for assessment of myocardial disease in humans.

MATERIALS AND METHODS

We developed a breath-held T1ρ mapping method using a single-shot, T1ρ-prepared balanced steady-state free-precession (bSSFP) sequence. The magnetization trajectory was simulated to identify sources of T1ρ error. To limit motion artifacts, an optical flow-based image registration method was used to align T1ρ images. The reproducibility and accuracy of these methods was assessed in phantoms and 10 healthy subjects. Results are shown in 1 patient with pre-ventricular contractions (PVCs), 1 patient with chronic myocardial infarction (MI) and 2 patients with hypertrophic cardiomyopathy (HCM).

RESULTS

In phantoms, the mean bias was 1.0 ± 2.7 msec (100 msec phantom) and 0.9 ± 0.9 msec (60 msec phantom) at 60 bpm and 2.2 ± 3.2 msec (100 msec) and 1.4 ± 0.9 msec (60 msec) at 80 bpm. The coefficient of variation (COV) was 2.2 (100 msec) and 1.3 (60 msec) at 60 bpm and 2.6 (100 msec) and 1.4 (60 msec) at 80 bpm. Motion correction improved the alignment of T1ρ images in subjects, as determined by the increase in Dice Score Coefficient (DSC) from 0.76 to 0.88. T1ρ reproducibility was high (COV < 0.05, intra-class correlation coefficient (ICC) = 0.85-0.97). Mean myocardial T1ρ value in healthy subjects was 63.5 ± 4.6 msec. There was good correspondence between late-gadolinium enhanced (LGE) MRI and increased T1ρ relaxation times in patients.

CONCLUSION

Single-shot, motion corrected, spin echo, spin lock MRI permits 2D T1ρ mapping in a breath-hold with good accuracy and precision.

Quantitative assessment of morphology, T1ρ, and T2 of shoulder cartilage using MRI

OBJECTIVES

The aim of this study was to assess the feasibility of quantifying shoulder cartilage morphology and relaxometry in a clinically feasible scan time comparing different pulse sequences and assessing their reproducibility at 3 Tesla.

METHODS

Three pulse sequences were compared for morphological assessments of shoulder cartilage thickness and volume (SPGR, MERGE, FIESTA), while a combined T1ρ-T2 sequence was optimized for relaxometry measurements. The shoulders of six healthy subjects were scanned twice with repositioning, and the cartilage was segmented and quantified. The degree of agreement between the three morphological sequences was assessed using Bland-Altman plots, while the morphological and relaxometry reproducibility were assessed with root-mean-square coefficients of variation (RMS-CVs) RESULTS: Bland-Altman plots indicated good levels of agreement between the morphological assessments of the three sequences. The reproducibility of morphological assessments yielded RMS-CVs between 4.0 and 17.7 %. All sequences correlated highly (R > 0.9) for morphologic assessments with no statistically significant differences. For relaxometry assessments of humeral cartilage, RMS-CVs of 6.4 and 10.6 % were found for T1ρ and T2, respectively.

CONCLUSIONS

The assessment of both cartilage morphology and relaxometry is feasible in the shoulder with SPGR, humeral head, and T1ρ being the more reproducible morphological sequence, anatomic region, and quantitative sequence, respectively.

KEY POINTS

• The thin cartilage morphology can be assessed in the shoulder in vivo. • Non-invasive biochemical assessment of shoulder cartilage is feasible in vivo using MRI.

T1ρ magnetic resonance: basic physics principles and applications in knee and intervertebral disc imaging

T1ρ relaxation time provides a new contrast mechanism that differs from T1- and T2-weighted contrast, and is useful to study low-frequency motional processes and chemical exchange in biological tissues. T1ρ imaging can be performed in the forms of T1ρ-weighted image, T1ρ mapping and T1ρ dispersion. T1ρ imaging, particularly at low spin-lock frequency, is sensitive to B0 and B1 inhomogeneity. Various composite spin-lock pulses have been proposed to alleviate the influence of field inhomogeneity so as to reduce the banding-like spin-lock artifacts. T1ρ imaging could be specific absorption rate (SAR) intensive and time consuming. Efforts to address these issues and speed-up data acquisition are being explored to facilitate wider clinical applications. This paper reviews the T1ρ imaging's basic physic principles, as well as its application for cartilage imaging and intervertebral disc imaging. Compared to more established T2 relaxation time, it has been shown that T1ρ provides more sensitive detection of proteoglycan (PG) loss at early stages of cartilage degeneration. T1ρ has also been shown to provide more sensitive evaluation of annulus fibrosis (AF) degeneration of the discs.

Errors in quantitative T1rho imaging and the correction methods

The spin-lattice relaxation time constant in rotating frame (T1rho) is useful for assessment of the properties of macromolecular environment inside tissue. Quantification of T1rho is found promising in various clinical applications. However, T1rho imaging is prone to image artifacts and quantification errors, which remains one of the greatest challenges to adopt this technique in routine clinical practice. The conventional continuous wave spin-lock is susceptible to B1 radiofrequency (RF) and B0 field inhomogeneity, which appears as banding artifacts in acquired images. A number of methods have been reported to modify T1rho prep RF pulse cluster to mitigate this effect. Adiabatic RF pulse can also be used for spin-lock with insensitivity to both B1 RF and B0 field inhomogeneity. Another source of quantification error in T1rho imaging is signal evolution during imaging data acquisition. Care is needed to affirm such error does not take place when specific pulse sequence is used for imaging data acquisition. Another source of T1rho quantification error is insufficient signal-to-noise ratio (SNR), which is common among various quantitative imaging approaches. Measurement of T1rho within an ROI can mitigate this issue, but at the cost of reduced resolution. Noise-corrected methods are reported to address this issue in pixel-wise quantification. For certain tissue type, T1rho quantification can be confounded by magic angle effect and the presence of multiple tissue components. Review of these confounding factors from inherent tissue properties is not included in this article.

Improved differentiation between knees with cartilage lesions and controls using 7T relaxation time mapping

Background/Objective

T1_ρ and T2 relaxation mapping in knee cartilage have been used extensively at 3 Tesla (T) as markers for proteoglycan and collagen, respectively. The objective of this study was to evaluate the feasibility of T1_ρ and T2 imaging of knee cartilage at 7T in comparison to 3T and to evaluate the ability of T1_ρ and T2 to determine differences between normal and osteoarthritis (OA) patients.

Materials and methods

Twenty patients, seven healthy patients (Kellgren–Lawrence = 0), and 13 patients with signs of radiographic OA (Kellgren–Lawrence > 0) were scanned at 3T and 7T. The knee cartilage was segmented into six compartments and the T1_ρ and T2 values were fit using a two-parameter model. Additionally, patients were stratified by the presence of cartilage lesions using the modified Whole Organ Magnetic Resonance Imaging Score classification of the knee. One-way analysis of variance was used to compare the healthy and OA groups at 3T and 7T. The specific absorption ratio was kept under Food and Drug Administration limits during all scans.

Results

T1_ρ and T2 values at 3T and 7T were significantly higher in the lateral femoral condyle and patella in patients with OA. However, more regions were significant or approached significance at 7T compared with 3T, with the differences between healthy and OA patients also larger at 7T. The signal to noise ratio across all cartilage and meniscus compartments was 60% higher on average at 7T compared to 3T.

Conclusion

T1_ρ imaging at 7T has been established as a viable imaging method for the differentiation of degenerated cartilage despite previous concerns over specific absorption rate and imaging time. The potential increased sensitivity of T1_ρ and T2 imaging at 7T may be useful for future studies in the development of OA.

Brain abnormalities in bipolar disorder detected by quantitative T1ρ mapping

Abnormal metabolism has been reported in bipolar disorder, however, these studies have been limited to specific regions of the brain. To investigate whole-brain changes potentially associated with these processes, we applied a magnetic resonance imaging technique novel to psychiatric research, quantitative mapping of T1 relaxation in the rotating frame (T1ρ). This method is sensitive to proton chemical exchange, which is affected by pH, metabolite concentrations and cellular density with high spatial resolution relative to alternative techniques such as magnetic resonance spectroscopy and positron emission tomography. Study participants included 15 patients with bipolar I disorder in the euthymic state and 25 normal controls balanced for age and gender. T1ρ maps were generated and compared between the bipolar and control groups using voxel-wise and regional analyses. T1ρ values were found to be elevated in the cerebral white matter and cerebellum in the bipolar group. However, volumes of these areas were normal as measured by high-resolution T1- and T2-weighted magnetic resonance imaging. Interestingly, the cerebellar T1ρ abnormalities were normalized in participants receiving lithium treatment. These findings are consistent with metabolic or microstructural abnormalities in bipolar disorder and draw attention to roles of the cerebral white matter and cerebellum. This study highlights the potential utility of high-resolution T1ρ mapping in psychiatric research.

Detection of low back pain using pH level-dependent imaging of the intervertebral disc using the ratio of R1ρ dispersion and -OH chemical exchange saturation transfer (RROC)

PURPOSE

Low pH is associated with intervertebral disc (IVD)-generated low back pain (LBP). The purpose of this work was to develop an in vivo pH level-dependent magnetic resonance imaging (MRI) method for detecting discogenic LBP, without using exogenous contrast agents.

METHODS

The ratio of R1ρ dispersion and chemical exchange saturation transfer (CEST) (RROC) was used for pH-level dependent imaging of the IVD while eliminating the effect of labile proton concentration. The technique was validated by numerical simulations and studies on phantoms and ex vivo porcine spines. Four male (ages 42.8 ± 18.3) and two female patients (ages 55.5 ± 2.1) with LBP and scheduled for discography were examined with the method on a 3.0 Tesla MR scanner. RROC measurements were compared with discography outcomes using paired t-test.

RESULTS

Simulation and phantom results indicated RROC is a concentration independent and pH level-dependent technique. Porcine spine study results found higher RROC value was related to lower pH level. Painful discs based on discography had significant higher RROC values than those with negative diagnosis (P < 0.05).

CONCLUSION

RROC imaging is a promising pH level dependent MRI technique that has the potential to be a noninvasive imaging tool to detect painful IVDs in vivo.

Further exploration of MRI techniques for liver T1rho quantification

With biliary duct ligation and CCl4 induced rat liver fibrosis models, recent studies showed that MR T1rho imaging is able to detect liver fibrosis, and the degree of fibrosis is correlated with the degree of elevation of the T1rho measurements, suggesting liver T1rho quantification may play an important role for liver fibrosis early detection and grading. It has also been reported it is feasible to obtain consistent liver T1rho measurement for human subjects at 3 Tesla (3 T), and preliminary clinical data suggest liver T1rho is increased in patients with cirrhosis. In these previous studies, T1rho imaging was used with the rotary-echo spin-lock pulse for T1rho preparation, and number of signal averaging (NSA) was 2. Due to the presence of inhomogeneous B0 field, artifacts may occur in the acquired T1rho-weighted images. The method described by Dixon et al. (Magn Reson Med 1996;36:90-4), which is a hard RF pulse with 135° flip angle and same RF phase as the spin-locking RF pulse is inserted right before and after the spin-locking RF pulse, has been proposed to reduce sensitivity to B0 field inhomogeneity in T1rho imaging. In this study, we compared the images scanned by rotary-echo spin-lock pulse method (sequence 1) and the pulse modified according to Dixon method (sequence 2). When the artifacts occurred in T1rho images, we repeated the same scan until satisfactory. We accepted images if artifact in liver was less than 10% of liver area by visual estimation. When NSA =2, the breath-holding duration for data acquisition of one slice scanning was 8 sec due to a delay time of 6,000 ms for magnetization restoration. If NSA =1, the duration was shortened to be 2 sec. In previous studies, manual region of interest (ROI) analysis of T1rho map was used. In this current study, histogram analysis was also applied to evaluate liver T1rho value on T1rho maps. MRI data acquisition was performed on a 3 T clinical scanner. There were 29 subjects with 61 examinations obtained. Liver T1rho values obtained by sequence 1 (NSA =2) and sequence 2 (NSA =2) showed similar values, i.e., 43.1±2.1 ms (range: 38.6-48.0 ms, n=40 scans) vs. 43.5±2.5 ms (range: 39.0-47.7 ms, 
n=12 scans, P=0.74) respectively. For the six volunteers scanned with both sequences in one session, the intraclass correlation coefficient (ICC) was 0.939. Overall, the success rate of obtaining satisfactory images per acquisition was slightly over 50% for both sequence 1 and sequence 2. Satisfactory images can usually be obtained by asking the volunteer subjects to better hold their breath. However, sequence 2 did not increase the scan success rate. For the nine subjects scanned by sequence 2 with both NSA =2 and NSA =1 during one session, the ICC was 0.274, demonstrated poor agreement. T1rho measurement by ROI method and histogram had an ICC of 0.901 (P>0.05), demonstrated very good agreement. We conclude that by including 135° flip angle before and after the spin-locking RF pulse, the rate of artifacts occurring did not decrease. On the other hand, sequence 1 and sequence 2 measured similar T1rho value in healthy liver. While reducing the breath-holding duration significantly, NSA =1 did not offer satisfactory signal-to-noise ratio. Histogram measurement can be adopted for future studies.

Quantitative MRI of articular cartilage and its clinical applications

Cartilage is one of the most essential tissues for healthy joint function and is compromised in degenerative and traumatic joint diseases. There have been tremendous advances during the past decade using quantitative MRI techniques as a noninvasive tool for evaluating cartilage, with a focus on assessing cartilage degeneration during osteoarthritis (OA). In this review, after a brief overview of cartilage composition and degeneration, we discuss techniques that grade and quantify morphologic changes as well as the techniques that quantify changes in the extracellular matrix. The basic principles, in vivo applications, advantages, and challenges for each technique are discussed. Recent studies using the OA Initiative (OAI) data are also summarized. Quantitative MRI provides noninvasive measures of cartilage degeneration at the earliest stages of joint degeneration, which is essential for efforts toward prevention and early intervention in OA.

Study of magnetization evolution by using composite spin-lock pulses for T₁ρ imaging

B(0) and B(1) field inhomogeneities may generate banding-like artifacts in T(1ρ)-weighted images and hence result in errors of T(1ρ) quantification. Several types of composite spin-lock pulses have been proposed to alleviate such artifacts. In this study, magnetization evolution with T(1ρ) and T(2ρ) relaxation by using these composite spin-lock pulses are theoretically derived. The effectiveness and limitation of each spin-lock pulse are explicitly illustrated in mathematical forms and phantom T(1ρ)-weighted images acquired by using each spin-lock pulse are presented. This study also provides a theoretical framework for T(1ρ) quantification from T(1ρ)-weighted images even with B(0) and B(1) inhomogeneity artifacts.

Simultaneous acquisition of T1ρ and T2 quantification in knee cartilage: repeatability and diurnal variation

PURPOSE

To develop a robust sequence that combines T1ρ and T2 quantifications and to examine the in vivo repeatability and diurnal variation of T1ρ and T2 quantifications in knee cartilage.

MATERIALS AND METHODS

Six healthy volunteers were scanned in the morning and afternoon on 2 days using a combined T1ρ and T2 quantification sequence developed in this study. Repeatability of T1ρ and T2 quantification was estimated using root-mean-square coefficients-of-variation (RMS-CV). T1ρ and T2 values from morning scans were compared to those from afternoon scans using paired t-tests.

RESULTS

The overall RMS-CV of in vivo T1ρ and T2 quantification was 5.3% and 5.2%, respectively. The RMS-CV of am scans was 4.2% and 5.0% while the RMS-CV of pm scans was 6.0% and 6.3% for T1ρ and T2 , respectively. No significant difference was found between T1ρ or T2 values in the morning and in the afternoon.

CONCLUSION

A sequence that combines T1ρ and T2 quantification with scan time less than 10 minutes and is robust to B0 and B1 inhomogeneity was developed with excellent repeatability. For a cohort with low-level daily activity, although no significant diurnal variation of cartilage MR relaxation times was observed, the afternoon scans had inferior repeatability compared to morning scans.

MR chemical exchange imaging with spin-lock technique (CESL): a theoretical analysis of the Z-spectrum using a two-pool R(1ρ) relaxation model beyond the fast-exchange limit

The chemical exchange (CE) process has been exploited as a novel and powerful contrast mechanism for MRI, which is primarily performed in the form of chemical exchange saturation transfer (CEST) imaging. A spin-lock (SL) technique can also be used for CE studies, although traditionally performed and interpreted quite differently from CEST. Chemical exchange imaging with spin-lock technique (CESL), theoretically based on the Bloch-McConnell equations common to CEST, has the potential to be used as an alternative to CEST and to better characterize CE processes from slow and intermediate to fast proton exchange rates through the tuning of spin-lock pulse parameters. In this study, the Z-spectrum and asymmetric magnetization transfer ratio (MTR(asym)) obtained by CESL are theoretically analyzed and numerically simulated using a general two-pool R(1ρ) relaxation model beyond the fast-exchange limit. The influences of spin-lock parameters, static magnetic field strength B(0) and physiological properties on the Z-spectrum and MTR(asym) are quantitatively revealed. Optimization of spin-lock frequency and spin-lock duration for the maximum CESL contrast enhancement is also investigated. Numerical simulation results in this study are compatible with the findings in the existing literature on CE imaging studies.

Quantification of T(1ρ) relaxation by using rotary echo spin-lock pulses in the presence of B(0) inhomogeneity

T(1ρ) relaxation is traditionally described as a mono-exponential signal decay with spin-lock time. However, T(1ρ) quantification by fitting to the mono-exponential model can be substantially compromised in the presence of field inhomogeneities, especially for low spin-lock frequencies. The normal approach to address this issue involves the development of dedicated composite spin-lock pulses for artifact reduction while still using the mono-exponential model for T(1ρ) fitting. In this work, we propose an alternative approach for improved T(1ρ) quantification with the widely-used rotary echo spin-lock pulses in the presence of B(0) inhomogeneities by fitting to a modified theoretical model which is derived to reveal the dependence of T(1ρ)-prepared magnetization on T(1ρ), T(2ρ), spin-lock time, spin-lock frequency and off-resonance, without involving complicated spin-lock pulse design. It has potentials for T(1ρ) quantification improvement at low spin-lock frequencies. Improved T(1ρ) mapping was demonstrated on phantom and in vivo rat spin-lock imaging at 3 T compared to the mapping using the mono-exponential model.