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Tabari A, Lang M, Awan K, Liu W, Clifford B, Lo WC, Splitthoff DN, Cauley S, Rapalino O, Schaefer P, Huang SY, Conklin J. Optimized flow compensation for contrast-enhanced T1-weighted Wave-CAIPI 3D MPRAGE imaging of the brain. Eur Radiol Exp 2023; 7:34. [PMID: 37394534 DOI: 10.1186/s41747-023-00351-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/25/2023] [Indexed: 07/04/2023] Open
Abstract
Flow-related artifacts have been observed in highly accelerated T1-weighted contrast-enhanced wave-controlled aliasing in parallel imaging (CAIPI) magnetization-prepared rapid gradient-echo (MPRAGE) imaging and can lead to diagnostic uncertainty. We developed an optimized flow-mitigated Wave-CAIPI MPRAGE acquisition protocol to reduce these artifacts through testing in a custom-built flow phantom. In the phantom experiment, maximal flow artifact reduction was achieved with the combination of flow compensation gradients and radial reordered k-space acquisition and was included in the optimized sequence. Clinical evaluation of the optimized MPRAGE sequence was performed in 64 adult patients, who all underwent contrast-enhanced Wave-CAIPI MPRAGE imaging without flow-compensation and with optimized flow-compensation parameters. All images were evaluated for the presence of flow-related artifacts, signal-to-noise ratio (SNR), gray-white matter contrast, enhancing lesion contrast, and image sharpness on a 3-point Likert scale. In the 64 cases, the optimized flow mitigation protocol reduced flow-related artifacts in 89% and 94% of the cases for raters 1 and 2, respectively. SNR, gray-white matter contrast, enhancing lesion contrast, and image sharpness were rated as equivalent for standard and flow-mitigated Wave-CAIPI MPRAGE in all subjects. The optimized flow mitigation protocol successfully reduced the presence of flow-related artifacts in the majority of cases.Relevance statementAs accelerated MRI using novel encoding schemes become increasingly adopted in clinical practice, our work highlights the need to recognize and develop strategies to minimize the presence of unexpected artifacts and reduction in image quality as potential compromises to achieving short scan times.Key points• Flow-mitigation technique led to an 89-94% decrease in flow-related artifacts.• Image quality, signal-to-noise ratio, enhancing lesion conspicuity, and image sharpness were preserved with the flow mitigation technique.• Flow mitigation reduced diagnostic uncertainty in cases where flow-related artifacts mimicked enhancing lesions.
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Affiliation(s)
- Azadeh Tabari
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit Street, Charlestown, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Min Lang
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit Street, Charlestown, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
| | - Komal Awan
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit Street, Charlestown, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
| | - Wei Liu
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | | | | | | | - Stephen Cauley
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit Street, Charlestown, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
| | - Otto Rapalino
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit Street, Charlestown, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
| | - Pamela Schaefer
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit Street, Charlestown, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
| | - Susie Y Huang
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit Street, Charlestown, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
- Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - John Conklin
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 55 Fruit Street, Charlestown, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
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Lee EJ, Kim MG, Chung MS, Kim SO, Byun JS, Yim Y. Diagnosis of intracranial lesions using accelerated 3D T1 MPRAGE with wave-CAIPI technique: comparison with conventional 3D T1 MPRAGE. Sci Rep 2022; 12:21930. [PMID: 36536040 PMCID: PMC9763340 DOI: 10.1038/s41598-022-25725-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
We aimed to evaluate the agreement in the diagnosis of intracranial lesions between conventional pre-contrast 3D T1 magnetization-prepared rapid gradient echo (MPRAGE) and wave-CAIPI (wave-controlled aliasing in parallel imaging) MPRAGE. Institutional review board approval was obtained and informed consent was waived for this retrospective study. We included 149 consecutive patients who had undergone brain MR with both conventional MPRAGE (scan time: 5 min 42 s) and wave-CAIPI MPRAGE (scan time: 2 min 44 s) from February to June 2018. All images were independently reviewed by two radiologists for the diagnosis of intracranial lesion and scored image quality using visual analysis. One technician measured signal-to-noise ratio. The agreement for diagnosis of intracranial lesion was calculated, and the intra- and interobserver agreements were analyzed by using kappa value. For the diagnosis of intracranial lesion, the conventional and wave-CAIPI MPRAGE demonstrated 99.7% of agreement (297 of 298) in the pooled analysis with very good agreement (k = 0.994). Intra- and inter-observer agreement showed very good (k > 0.9 in all) and good (k > 0.75) agreement, respectively. In the quantitative analysis, the signal-to-noise ratio had no difference (P > 0.05 for all). The overall image quality was poorer in images of wave-CAIPI MPRAGE (P < 0.001), but motion artifact had no difference between two sequences (P = 0.06). Compared to conventional MPRAGE, pre-contrast 3D T1 wave-CAIPI MPRAGE achieved higher agreement for the diagnosis of intracranial lesions and reduced the scan time by approximately 50%.
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Affiliation(s)
- Eun Jung Lee
- Department of Radiology, Human Medical Imaging & Intervention Center, Seoul, Korea ,grid.254224.70000 0001 0789 9563Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-Ro, Dongjak-Gu, Seoul, Republic of Korea
| | - Min Gu Kim
- grid.254224.70000 0001 0789 9563Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-Ro, Dongjak-Gu, Seoul, Republic of Korea
| | - Mi Sun Chung
- Department of Radiology, Human Medical Imaging & Intervention Center, Seoul, Korea ,grid.254224.70000 0001 0789 9563Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-Ro, Dongjak-Gu, Seoul, Republic of Korea
| | - Seon-Ok Kim
- grid.267370.70000 0004 0533 4667Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, Republic of Korea
| | - Jun Soo Byun
- Department of Radiology, Human Medical Imaging & Intervention Center, Seoul, Korea ,grid.254224.70000 0001 0789 9563Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-Ro, Dongjak-Gu, Seoul, Republic of Korea
| | - Younghee Yim
- grid.254224.70000 0001 0789 9563Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-Ro, Dongjak-Gu, Seoul, Republic of Korea
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Yun SY, Heo YJ. Accelerated Nonenhanced 3D T1-MPRAGE Using Wave-Controlled Aliasing in Parallel Imaging for Infant Brain Imaging. AJNR Am J Neuroradiol 2022; 43:1797-1801. [PMID: 36265893 DOI: 10.3174/ajnr.a7680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/19/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE MPRAGE is the most commonly used sequence for high-resolution 3D T1-weighted imaging in pediatric patients. However, its longer scan time is a major drawback because pediatric patients are prone to motion and frequently require sedation. This study compared nonenhanced accelerated MPRAGE using wave-controlled aliasing in parallel imaging (wave-T1-MPRAGE) with standard MPRAGE in infants. MATERIALS AND METHODS We retrospectively evaluated 68 infants (mean age, 1.78 [SD. 1.70] months) who underwent nonenhanced standard and wave-T1-MPRAGE. Two neuroradiologists independently assessed each image for image quality, artifacts, myelination degree, and anatomic delineation using the 4-point Likert scale. For diagnostic performance, both observers determined whether nonenhancing lesions were present in the brain parenchyma in 2 types of nonenhanced MPRAGE sequences. RESULTS Wave-T1-MPRAGE showed a significantly lower mean score and lower interobserver agreement for overall image quality and anatomic delineation than standard MPRAGE (P< .001 for each). However, there were no significant differences between the 2 types of MPRAGE sequences for motion artifacts (P = .90 for observer 1, P = .14 for observer 2) and degree of myelination (P = .16 for observer 1, P = .32 for observer 2). Among the nonenhancing pathologic lesions observed on standard MPRAGE by both observers, only 2 were missed on wave-T1-MPRAGE, and they were very tiny, faint, nonhemorrhagic WM injuries. CONCLUSIONS Although wave-T1-MPRAGE showed lower overall image quality than standard MPRAGE, the diagnostic performance for nonenhancing parenchymal lesions was comparable. Wave-T1-MPRAGE could be an alternative for diagnosing intracranial lesions in infants, with marked scan time reduction.
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Affiliation(s)
- S Y Yun
- From the Department of Radiology, Inje University Busan Paik Hospital, Busan, South Korea
| | - Y J Heo
- From the Department of Radiology, Inje University Busan Paik Hospital, Busan, South Korea
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Baek HJ, Heo YJ, Kim D, Yun SY, Baek JW, Jeong HW, Choo HJ, Lee JY, Oh SI. Usefulness of Wave-CAIPI for Postcontrast 3D T1-SPACE in the Evaluation of Brain Metastases. AJNR Am J Neuroradiol 2022; 43:857-863. [PMID: 35618423 DOI: 10.3174/ajnr.a7520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/24/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE High-resolution postcontrast 3D T1WI is a widely used sequence for evaluating brain metastasis, despite the long scan time. This study aimed to compare highly accelerated postcontrast 3D T1-weighted sampling perfection with application-optimized contrasts by using different flip angle evolution by using wave-controlled aliasing in parallel imaging (wave-T1-SPACE) with the commonly used standard high-resolution postcontrast 3D T1-SPACE for the evaluation of brain metastases. MATERIALS AND METHODS Among the 387 patients who underwent postcontrast wave-T1-SPACE and standard SPACE, 56 patients with suspected brain metastases were retrospectively included. Two neuroradiologists assessed the number of enhancing lesions according to lesion size, contrast-to-noise ratiolesion/parenchyma, contrast-to-noise ratiowhite matter/gray matter, contrast ratiolesion/parenchyma, and overall image quality for the 2 different sequences. RESULTS Although there was no significant difference in the evaluation of larger enhancing lesions (>5 mm) between the 2 different sequences (P = .66 for observer 1, P = .26 for observer 2), wave-T1-SPACE showed a significantly lower number of smaller enhancing lesions (<5 mm) than standard SPACE (1.61 [SD, 0.29] versus 2.84 [SD, 0.47] for observer 1; 1.41 [SD, 0.19] versus 2.68 [SD, 0.43] for observer 2). Furthermore, mean contrast-to-noise ratiolesion/parenchyma and overall image quality of wave-T1-SPACE were significantly lower than those in standard SPACE. CONCLUSIONS Postcontrast wave-T1-SPACE showed comparable diagnostic performance for larger enhancing lesions (>5 mm) and marked scan time reduction compared with standard SPACE. However, postcontrast wave-T1-SPACE showed underestimation of smaller enhancing lesions (<5 mm) and lower image quality than standard SPACE. Therefore, postcontrast wave-T1-SPACE should be interpreted carefully in the evaluation of brain metastasis.
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Affiliation(s)
- H J Baek
- From the Department of Radiology (H.J.B.), Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Y J Heo
- Department of Radiology (Y.J.H., D.K., S.Y.Y., J.W.B., H.W.J., H.J.C.), Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - D Kim
- Department of Radiology (Y.J.H., D.K., S.Y.Y., J.W.B., H.W.J., H.J.C.), Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - S Y Yun
- Department of Radiology (Y.J.H., D.K., S.Y.Y., J.W.B., H.W.J., H.J.C.), Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - J W Baek
- Department of Radiology (Y.J.H., D.K., S.Y.Y., J.W.B., H.W.J., H.J.C.), Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - H W Jeong
- Department of Radiology (Y.J.H., D.K., S.Y.Y., J.W.B., H.W.J., H.J.C.), Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - H J Choo
- Department of Radiology (Y.J.H., D.K., S.Y.Y., J.W.B., H.W.J., H.J.C.), Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - J Y Lee
- Department of Internal Medicine (J.Y.L), Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - S-I Oh
- Department of Neurology (S.-I.O.), Inje University Busan Paik Hospital, Busan, Republic of Korea
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