Low-Cost High-Performance MRI

Diffusion tensor brain imaging at 0.55T: A feasibility study

PURPOSE

To investigate the feasibility of diffusion tensor brain imaging at 0.55T with comparisons against 3T.

METHODS

Diffusion tensor imaging data with 2 mm isotropic resolution was acquired on a cohort of five healthy subjects using both 0.55T and 3T scanners. The signal-to-noise ratio (SNR) of the 0.55T data was improved using a previous SNR-enhancing joint reconstruction method that jointly reconstructs the entire set of diffusion weighted images from k-space using shared-edge constraints. Quantitative diffusion tensor parameters were estimated and compared across field strengths. We also performed a test-retest assessment of repeatability at each field strength.

RESULTS

After applying SNR-enhancing joint reconstruction, the diffusion tensor parameters obtained from 0.55T data were strongly correlated (R 2 ≥ 0 . 70 $$ {R}^2\ge 0.70 $$ ) with those obtained from 3T data. Test-retest analysis showed that SNR-enhancing reconstruction improved the repeatability of the 0.55T diffusion tensor parameters.

CONCLUSION

High-resolution in vivo diffusion MRI of the human brain is feasible at 0.55T when appropriate noise-mitigation strategies are applied.

Diffusion-Weighted Imaging Fluid-Attenuated Inversion Recovery Mismatch on Portable, Low-Field Magnetic Resonance Imaging Among Acute Stroke Patients

OBJECTIVE

For stroke patients with unknown time of onset, mismatch between diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) can guide thrombolytic intervention. However, access to MRI for hyperacute stroke is limited. Here, we sought to evaluate whether a portable, low-field (LF)-MRI scanner can identify DWI-FLAIR mismatch in acute ischemic stroke.

METHODS

Eligible patients with a diagnosis of acute ischemic stroke underwent LF-MRI acquisition on a 0.064-T scanner within 24 h of last known well. Qualitative and quantitative metrics were evaluated. Two trained assessors determined the visibility of stroke lesions on LF-FLAIR. An image coregistration pipeline was developed, and the LF-FLAIR signal intensity ratio (SIR) was derived.

RESULTS

The study included 71 patients aged 71 ± 14 years and a National Institutes of Health Stroke Scale of 6 (interquartile range 3-14). The interobserver agreement for identifying visible FLAIR hyperintensities was high (κ = 0.85, 95% CI 0.70-0.99). Visual DWI-FLAIR mismatch had a 60% sensitivity and 82% specificity for stroke patients <4.5 h, with a negative predictive value of 93%. LF-FLAIR SIR had a mean value of 1.18 ± 0.18 <4.5 h, 1.24 ± 0.39 4.5-6 h, and 1.40 ± 0.23 >6 h of stroke onset. The optimal cut-point for LF-FLAIR SIR was 1.15, with 85% sensitivity and 70% specificity. A cut-point of 6.6 h was established for a FLAIR SIR <1.15, with an 89% sensitivity and 62% specificity.

INTERPRETATION

A 0.064-T portable LF-MRI can identify DWI-FLAIR mismatch among patients with acute ischemic stroke. Future research is needed to prospectively validate thresholds and evaluate a role of LF-MRI in guiding thrombolysis among stroke patients with uncertain time of onset. ANN NEUROL 2024;96:321-331.

Ultra-low-field magnetization transfer imaging at 0.055T with low specific absorption rate

PURPOSE

To demonstrate magnetization transfer (MT) effects with low specific absorption rate (SAR) on ultra-low-field (ULF) MRI.

METHODS

MT imaging was implemented by using sinc-modulated RF pulse train (SPT) modules to provide bilateral off-resonance irradiation. They were incorporated into 3D gradient echo (GRE) and fast spin echo (FSE) protocols on a shielding-free 0.055T head scanner. MT effects were first verified using phantoms. Brain MT imaging was conducted in both healthy subjects and patients.

RESULTS

MT effects were clearly observed in phantoms using six SPT modules with total flip angle 3600° at central primary saturation bands of approximate offset ±786 Hz, even in the presence of large relative B0 inhomogeneity. For brain, strong MT effects were observed in gray matter, white matter, and muscle in 3D GRE and FSE imaging using six and sixteen SPT modules with total flip angle 3600° and 9600°, respectively. Fat, cerebrospinal fluid, and blood exhibited relatively weak MT effects. MT preparation enhanced tissue contrasts in T2-weighted and FLAIR-like images, and improved brain lesion delineation. The estimated MT SAR was 0.0024 and 0.0008 W/kg for two protocols, respectively, which is far below the US Food and Drug Administration (FDA) limit of 3.0 W/kg.

CONCLUSION

Robust MT effects can be readily obtained at ULF with extremely low SAR, despite poor relative B0 homogeneity in ppm. This unique advantage enables flexible MT pulse design and implementation on low-cost ULF MRI platforms to achieve strong MT effects in brain and beyond, potentially augmenting their clinical utility in the future.

Ultra-low-field magnetic resonance angiography at 0.05 T: A preliminary study

We aim to explore the feasibility of head and neck time-of-flight (TOF) magnetic resonance angiography (MRA) at ultra-low-field (ULF). TOF MRA was conducted on a highly simplified 0.05 T MRI scanner with no radiofrequency (RF) and magnetic shielding. A flow-compensated three-dimensional (3D) gradient echo (GRE) sequence with a tilt-optimized nonsaturated excitation RF pulse, and a flow-compensated multislice two-dimensional (2D) GRE sequence, were implemented for cerebral artery and vein imaging, respectively. For carotid artery and jugular vein imaging, flow-compensated 2D GRE sequences were utilized with venous and arterial blood presaturation, respectively. MRA was performed on young healthy subjects. Vessel-to-background contrast was experimentally observed with strong blood inflow effect and background tissue suppression. The large primary cerebral arteries and veins, carotid arteries, jugular veins, and artery bifurcations could be identified in both raw GRE images and maximum intensity projections. The primary brain and neck arteries were found to be reproducible among multiple examination sessions. These preliminary experimental results demonstrated the possibility of artery TOF MRA on low-cost 0.05 T scanners for the first time, despite the extremely low MR signal. We expect to improve the quality of ULF TOF MRA in the near future through sequence development and optimization, ongoing advances in ULF hardware and image formation, and the use of vascular T1 contrast agents.

Homogeneous B0 coil design method for open-access ultra-low field magnetic resonance imaging: A simulation study

A multimodal brain function measurement system integrating functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG) is expected to be a tool that will provide new insights into neuroscience. To integrate fMRI and MEG, an ultra-low-field MRI (ULF-MRI) scanner that can generate a static magnetic field (B0) with an electromagnetic coil and turn off the B0 during MEG measurements is desirable. While electromagnetic B0 coil has the above advantages, it also has a trade-off between size and the broadness of the magnetic field homogeneity. In this study, we proposed a method for designing a B0 multi-stage circular coil arrangement that determines the number of coils required to maximize magnetic field homogeneity and minimize the total wiring length of the coils. The optimized multi-stage coil arrangement had an external shape of 600 mm in diameter and a maximum height of 600 mm, with an aperture of 600 mm in diameter and 300 mm in height. The magnetic field homogeneity was <100 ppm over a 210 mm diameter spherical volume (DSV). Compared to a previous two coil pairs arrangement with the same magnetic field homogeneity, the diameter was 1/1.9 times smaller, indicating that the newly designed B0 coil arrangement realized a smaller size and wider magnetic field homogeneity.

Any-nucleus distributed active programmable transmit coil

PURPOSE

There are 118 known elements. Nearly all of them have NMR active isotopes and at least 39 different nuclei have biological relevance. Despite this, most of today's MRI is based on only one nucleus-1H. To facilitate imaging all potential nuclei, we present a single transmit coil able to excite arbitrary nuclei in human-scale MRI.

THEORY AND METHODS

We present a completely new type of RF coil, the Any-nucleus Distributed Active Programmable Transmit Coil (ADAPT Coil), with fast switches integrated into the structure of the coil to allow it to operate at any relevant frequency. This coil eliminates the need for the expensive traditional RF amplifier by directly converting direct current (DC) power into RF magnetic fields with frequencies chosen by digital control signals sent to the switches. Semiconductor switch imperfections are overcome by segmenting the coil.

RESULTS

Circuit simulations demonstrated the effectiveness of the ADAPT Coil approach, and a 9 cm diameter surface ADAPT Coil was implemented. Using the ADAPT Coil, 1H, 23Na, 2H, and 13C phantom images were acquired, and 1H and 23Na ex vivo images were acquired. To excite different nuclei, only digital control signals were changed, which can be programmed in real time.

CONCLUSION

The ADAPT Coil presents a low-cost, scalable, and efficient method for exciting arbitrary nuclei in human-scale MRI. This coil concept provides further opportunities for scaling, programmability, lowering coil costs, lowering dead-time, streamlining multinuclear MRI workflows, and enabling the study of dozens of biologically relevant nuclei.

Bringing MRI to low- and middle-income countries: Directions, challenges and potential solutions

The global disparity of magnetic resonance imaging (MRI) is a major challenge, with many low- and middle-income countries (LMICs) experiencing limited access to MRI. The reasons for limited access are technological, economic and social. With the advancement of MRI technology, we explore why these challenges still prevail, highlighting the importance of MRI as the epidemiology of disease changes in LMICs. In this paper, we establish a framework to develop MRI with these challenges in mind and discuss the different aspects of MRI development, including maximising image quality using cost-effective components, integrating local technology and infrastructure and implementing sustainable practices. We also highlight the current solutions-including teleradiology, artificial intelligence and doctor and patient education strategies-and how these might be further improved to achieve greater access to MRI.

Low-Field, Low-Cost, Point-of-Care Magnetic Resonance Imaging

Low-field magnetic resonance imaging (MRI) has recently experienced a renaissance that is largely attributable to the numerous technological advancements made in MRI, including optimized pulse sequences, parallel receive and compressed sensing, improved calibrations and reconstruction algorithms, and the adoption of machine learning for image postprocessing. This new attention on low-field MRI originates from a lack of accessibility to traditional MRI and the need for affordable imaging. Low-field MRI provides a viable option due to its lack of reliance on radio-frequency shielding rooms, expensive liquid helium, and cryogen quench pipes. Moreover, its relatively small size and weight allow for easy and affordable installation in most settings. Rather than replacing conventional MRI, low-field MRI will provide new opportunities for imaging both in developing and developed countries. This article discusses the history of low-field MRI, low-field MRI hardware and software, current devices on the market, advantages and disadvantages, and low-field MRI's global potential.

Electromagnetic interference elimination via active sensing and deep learning prediction for radiofrequency shielding-free MRI

At present, MRI scans are typically performed inside fully enclosed radiofrequency (RF) shielding rooms, posing stringent installation requirements and causing patient discomfort. We aim to eliminate electromagnetic interference (EMI) for MRI with no or incomplete RF shielding. In this study, a method of active sensing and deep learning EMI prediction is presented to model, predict, and remove EMI signal components from acquired MRI signals. Specifically, during each MRI scan, separate EMI-sensing coils placed in various locations are utilized to simultaneously sample external and internal EMI signals within two windows (for both conventional MRI signal acquisition and EMI characterization acquisition). A convolution neural network model is trained using the EMI characterization data to relate EMI signals detected by EMI-sensing coils to EMI signals in the MRI receive coil. This model is then used to retrospectively predict and remove EMI signal components detected by the MRI receive coil during the MRI signal acquisition window. This strategy was implemented on a low-cost ultralow-field 0.055 T permanent magnet MRI scanner without RF shielding. It produced final image signal-to-noise ratios that were comparable with those obtained using a fully enclosed RF shielding cage, and outperformed existing analytical EMI elimination methods (i.e., spectral domain transfer function and external dynamic interference estimation and removal [EDITER] methods). A preliminary experiment also demonstrated its applicability on a 1.5 T superconducting magnet MRI scanner with incomplete RF shielding. Altogether, the results demonstrated that the proposed method was highly effective in predicting and removing various EMI signals from both external environments and internal scanner electronics at both 0.055 T (2.3 MHz) and 1.5 T (63.9 MHz). The proposed strategy enables shielding-free MRI. The concept is relatively simple and is potentially applicable to other RF signal detection scenarios in the presence of external and/or internal EMI.

UNITY: A low-field magnetic resonance neuroimaging initiative to characterize neurodevelopment in low and middle-income settings

Measures of physical growth, such as weight and height have long been the predominant outcomes for monitoring child health and evaluating interventional outcomes in public health studies, including those that may impact neurodevelopment. While physical growth generally reflects overall health and nutritional status, it lacks sensitivity and specificity to brain growth and developing cognitive skills and abilities. Psychometric tools, e.g., the Bayley Scales of Infant and Toddler Development, may afford more direct assessment of cognitive development but they require language translation, cultural adaptation, and population norming. Further, they are not always reliable predictors of future outcomes when assessed within the first 12-18 months of a child's life. Neuroimaging may provide more objective, sensitive, and predictive measures of neurodevelopment but tools such as magnetic resonance (MR) imaging are not readily available in many low and middle-income countries (LMICs). MRI systems that operate at lower magnetic fields (< 100mT) may offer increased accessibility, but their use for global health studies remains nascent. The UNITY project is envisaged as a global partnership to advance neuroimaging in global health studies. Here we describe the UNITY project, its goals, methods, operating procedures, and expected outcomes in characterizing neurodevelopment in sub-Saharan Africa and South Asia.

Assessment of Calcaneal Spongy Bone Magnetic Resonance Characteristics in Women: A Comparison between Measures Obtained at 0.3 T, 1.5 T, and 3.0 T

BACKGROUND

There is a growing interest in bone tissue MRI and an even greater interest in using low-cost MR scanners. However, the characteristics of bone MRI remain to be fully defined, especially at low field strength. This study aimed to characterize the signal-to-noise ratio (SNR), T2, and T2* in spongy bone at 0.3 T, 1.5 T, and 3.0 T. Furthermore, relaxation times were characterized as a function of bone-marrow lipid/water ratio content and trabecular bone density.

METHODS

Thirty-two women in total underwent an MR-imaging investigation of the calcaneus at 0.3 T, 1.5 T, and 3.0 T. MR-spectroscopy was performed at 3.0 T to assess the fat/water ratio. SNR, T2, and T2* were quantified in distinct calcaneal regions (ST, TC, and CC). ANOVA and Pearson correlation statistics were used.

RESULTS

SNR increase depends on the magnetic field strength, acquisition sequence, and calcaneal location. T2* was different at 3.0 T and 1.5 T in ST, TC, and CC. Relaxation times decrease as much as the magnetic field strength increases. The significant linear correlation between relaxation times and fat/water found in healthy young is lost in osteoporotic subjects.

CONCLUSION

The results have implications for the possible use of relaxation vs. lipid/water marrow content for bone quality assessment and the development of quantitative MRI diagnostics at low field strength.

Water-Fat Separation for the Knee on a 50 mT Portable MRI Scanner

OBJECTIVE

The Dixon method is frequently employed in clinical and scientific research for fat suppression, because it has lower sensitivity to static magnetic field inhomogeneity compared to chemical shift selective saturation or its variants and maintains image signal-to-noise ratio (SNR). Recently, research on very-low-field (VLF < 100 mT) magnetic resonance imaging (MRI) has regained popularity. However, there is limited literature on water-fat separation in VLF MRI. Here, we present a modified two-point Dixon method specifically designed for VLF MRI.

METHODS

Most experiments were performed on a homemade 50 mT portable MRI scanner. The receiving coil adopted a homemade quadrature receiving coil. The data were acquired using spin-echo and gradient-echo sequences. We considered the T2* effect, and added priori information to existing two-point Dixon method. Then, the method used regional iterative phasor extraction (RIPE) to extract the error phasor. Finally, least squares solutions for water and fat were obtained and fat signal fraction was calculated.

RESULTS

For phantom evaluation, water-only and fat-only images were obtained and the local fat signal fractions were calculated, with two samples being 0.94 and 0.93, respectively. For knee imaging, cartilage, muscle and fat could be clearly distinguished. The water-only images were able to highlight areas such as cartilage that could not be easily distinguished without separation.

CONCLUSION

This work has demonstrated the feasibility of using a 50 mT MRI scanner for water-fat separation.

SIGNIFICANCE

To the best of our knowledge, this is the first reported result of water-fat separation at a 50 mT portable MRI scanner.

Surveying the landscape of diagnostic imaging in dentistry's future: Four emerging technologies with promise

BACKGROUND

Advances in digital radiography for both intraoral and panoramic imaging and cone-beam computed tomography have led the way to an increase in diagnostic capabilities for the dental care profession. In this article, the authors provide information on 4 emerging technologies with promise.

TYPES OF STUDIES REVIEWED

The authors feature the following: artificial intelligence in the form of deep learning using convolutional neural networks, dental magnetic resonance imaging, stationary intraoral tomosynthesis, and second-generation cone-beam computed tomography sources based on carbon nanotube technology and multispectral imaging. The authors review and summarize articles featuring these technologies.

RESULTS

The history and background of these emerging technologies are previewed along with their development and potential impact on the practice of dental diagnostic imaging. The authors conclude that these emerging technologies have the potential to have a substantial influence on the practice of dentistry as these systems mature. The degree of influence most likely will vary, with artificial intelligence being the most influential of the 4.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The readers are informed about these emerging technologies and the potential effects on their practice going forward, giving them information on which to base decisions on adopting 1 or more of these technologies. The 4 technologies reviewed in this article have the potential to improve imaging diagnostics in dentistry thereby leading to better patient care and heightened professional satisfaction.

Breast imaging with an ultra-low field MRI scanner: a pilot study

Breast cancer screening is necessary to reduce mortality due to undetected breast cancer. Current methods have limitations, and as a result many women forego regular screening. Magnetic resonance imaging (MRI) can overcome most of these limitations, but access to conventional MRI is not widely available for routine annual screening. Here, we used an MRI scanner operating at ultra-low field (ULF) to image the left breasts of 11 women (mean age, 35 years ±13 years) in the prone position. Three breast radiologists reviewed the imaging and were able to discern the breast outline and distinguish fibroglandular tissue (FGT) from intramammary adipose tissue. Additionally, the expert readers agreed on their assessment of the breast tissue pattern including fatty, scattered FGT, heterogeneous FGT, and extreme FGT. This preliminary work demonstrates that ULF breast MRI is feasible and may be a potential option for comfortable, widely deployable, and low-cost breast cancer diagnosis and screening.

Comparison of image quality and diagnostic efficacy of routine clinical lumbar spine imaging at 0.55T and 1.5/3T

PURPOSE

To compare image quality, assess inter-reader variability, and evaluate the diagnostic efficacy of routine clinical lumbar spine sequences at 0.55T compared with those collected at 1.5/3T to assess common spine pathology.

METHODS

665 image series across 70 studies, collected at 0.55T and 1.5/3T, were assessed by two neuroradiology fellows for overall imaging quality (OIQ), artifacts, and accurate visualization of anatomical features (intervertebral discs, neural foramina, spinal cord, bone marrow, and conus / cauda equina nerve roots) using a 4-point Likert scale (1 = non-diagnostic to 4 = excellent). For the 0.55T scans, the most appropriate diagnosis(es) from a picklist of common spine pathologies was selected. The mean ± SD of all scores for all features for each sequence and reader at 0.55T and 1.5/3T were calculated. Paired t-tests (p ≤ 0.05) were used to compare ratings between field strengths. The inter-reader agreement was calculated using linear-weighted Cohen's Kappa coefficient (p ≤ 0.05). Unpaired VCG analysis for OIQ was additionally employed to represent differences between 0.55T and 1.5/3T (95 % CI).

RESULTS

All sequences at 0.55T were rated as acceptable (≥2) for diagnostic use by both readers despite significantly lower scores for some compared to those at 1.5/3T. While there was low inter-reader agreement on individual scores, the agreement on the diagnosis was high, demonstrating the potential of this system for detecting routine spine pathology.

CONCLUSIONS

Clinical lumbar spine imaging at 0.55T produces diagnostic-quality images demonstrating the feasibility of its use in diagnosing spinal pathology, including osteomyelitis/discitis, post-surgical changes with complications, and metastatic disease.

Development of a Helmet-Shape Dual-Channel RF coil for brain imaging at 54 mT using inverse boundary element method

Very-low field (VLF) magnetic resonance imaging (MRI) offers advantages in term of size, weight, cost, and the absence of robust shielding requirements. However, it encounters challenges in maintaining a high signal-to-noise ratio (SNR) due to low magnetic fields (below 100 mT). Developing a close-fitting radio frequency (RF) receive coil is crucial to improve the SNR. In this study, we devised and optimized a helmet-shaped dual-channel RF receive coil tailored for brain imaging at a magnetic field strength of 54 mT (2.32 MHz). The methodology integrates the inverse boundary element method (IBEM) to formulate initial coil structures and wiring patterns, followed by optimization through introducing regularization terms. This approach frames the design process as an inverse problem, ensuring a close fit to the head contour. Combining theoretical optimization with physical measurements of the coil's AC resistance, we identified the optimal loop count for both axial and radial coils as nine and eight loops, respectively. The effectiveness of the designed dual-channel coil was verified through the imaging of a CuSO4 phantom and a healthy volunteer's brain. Notably, the in-vivo images exhibited an approximate 16-25 % increase in SNR with poorer B1 homogeneity compared to those obtained using single-channel coils. The high-quality images achieved by T1, T2-weighted, and fluid-attenuated inversion-recovery (FLAIR) protocols enhance the diagnostic potential of VLF MRI, particularly in cases of cerebral stroke and trauma patients. This study underscores the adaptability of the design methodology for the customization of RF coil structures in alignment with individual imaging requirements.

13C MRI of hyperpolarized pyruvate at 120 µT

Nuclear spin hyperpolarization increases the sensitivity of magnetic resonance dramatically, enabling many new applications, including real-time metabolic imaging. Parahydrogen-based signal amplification by reversible exchange (SABRE) was employed to hyperpolarize [1-13C]pyruvate and demonstrate 13C imaging in situ at 120 µT, about twice Earth's magnetic field, with two different signal amplification by reversible exchange variants: SABRE in shield enables alignment transfer to heteronuclei (SABRE-SHEATH), where hyperpolarization is transferred from parahydrogen to [1-13C]pyruvate at a magnetic field below 1 µT, and low-irradiation generates high tesla (LIGHT-SABRE), where hyperpolarization was prepared at 120 µT, avoiding magnetic field cycling. The 3-dimensional images of a phantom were obtained using a superconducting quantum interference device (SQUID) based magnetic field detector with submillimeter resolution. These 13C images demonstrate the feasibility of low-field 13C metabolic magnetic resonance imaging (MRI) of 50 mM [1-13C]pyruvate hyperpolarized by parahydrogen in reversible exchange imaged at about twice Earth's magnetic field. Using thermal 13C polarization available at 120 µT, the same experiment would have taken about 300 billion years.

Self-gated cine phase-contrast balanced SSFP flow quantification at 0.55 T

PURPOSE

To implement cine phase-contrast balanced SSFP (PC-bSSFP) for low-field 0.55T cardiac MRI by exploiting the intrinsic flow sensitivity of the bSSFP slice-select gradient and the in-plane phase-cancelation properties of radial trajectories, enabling self-gated and referenceless PC-bSSFP flow quantification at 0.55 T.

METHODS

A free-running, tiny golden-angle radial PC-bSSFP approach was implemented on 0.55T and 1.5T systems. Cardiac and respiratory self-gating was incorporated to enable electrocardiogram-free scanning during breath-hold and free-breathing. By exploiting the intrinsic in-plane phase-cancelation properties of radial acquisitions and background phase fitting, referenceless single-point PC-bSSFP was realized. In vivo data were acquired in the ascending aorta of healthy subjects at 0.55 T and 1.5 T during breath-hold and free-breathing. Flow data, SNR, and velocity-to-noise ratio were compared relative to data obtained with phase-contrast spoiled gradient-echo variants.

RESULTS

Velocities acquired with PC-bSSFP compared well with data from phase-contrast spoiled gradient-echo (RMSEv  = 5.8 cm/s). PC-bSSFP at 0.55 T resulted in high-quality cine magnitude images and phase maps with sufficient SNR and velocity-to-noise ratio. Breath-hold and free-breathing PC-bSSFP performed very similarly, with comparable flow quantification (RMSEv  = 5.7 cm/s). Referenceless single-point PC-bSSFP results agreed well with two-point PC-bSSFP (-1.8 ± 5.2 cm/s) while reducing scan times 2-fold.

CONCLUSION

PC-bSSFP is feasible on low-field 0.55T systems, producing high-quality cine images while permitting simultaneous aortic flow measurements during breath-hold and free-breathing and without the need for electrocardiogram gating.

MRI scarcity in low- and middle-income countries

Since the introduction of MRI as a sustainable diagnostic modality, global accessibility to its services has revealed a wide discrepancy between populations-leaving most of the population in LMICs without access to this important imaging modality. Several factors lead to the scarcity of MRI in LMICs; for example, inadequate infrastructure and the absence of a dedicated workforce are key factors in the scarcity observed. RAD-AID has contributed to the advancement of radiology globally by collaborating with our partners to make radiology more accessible for medically underserved communities. However, progress is slow and further investment is needed to ensure improved global access to MRI.

Facile hyperpolarization chemistry for molecular imaging and metabolic tracking of [1-13C]pyruvate in vivo

Hyperpolarization chemistry based on reversible exchange of parahydrogen, also known as Signal Amplification By Reversible Exchange (SABRE), is a particularly simple approach to attain high levels of nuclear spin hyperpolarization, which can enhance NMR and MRI signals by many orders of magnitude. SABRE has received significant attention in the scientific community since its inception because of its relative experimental simplicity and its broad applicability to a wide range of molecules, however in vivo detection of molecular probes hyperpolarized by SABRE has remained elusive. Here we describe a first demonstration of SABRE-hyperpolarized contrast detected in vivo, specifically using hyperpolarized [1-13C]pyruvate. Biocompatible formulations of hyperpolarized [1-13C]pyruvate in, both, methanol-water mixtures, and ethanol-water mixtures followed by dilution with saline and catalyst filtration were prepared and injected into healthy Sprague Dawley and Wistar rats. Effective hyperpolarization-catalyst removal was performed with silica filters without major losses in hyperpolarization. Metabolic conversion of pyruvate to lactate, alanine, and bicarbonate was detected in vivo. Pyruvate-hydrate was also observed as minor byproduct. Measurements were performed on the liver and kidney at 4.7 T via time-resolved spectroscopy and chemical-shift-resolved MRI. In addition, whole-body metabolic measurements were obtained using a cryogen-free 1.5 T MRI system, illustrating the utility of combining lower-cost MRI systems with simple, low-cost hyperpolarization chemistry to develop safe, and scalable molecular imaging.

Development of neonatal-specific sequences for portable ultralow field magnetic resonance brain imaging: a prospective, single-centre, cohort study

Background

Magnetic Resonance (MR) imaging is key for investigation of suspected newborn brain abnormalities. Access is limited in low-resource settings and challenging in infants needing intensive care. Portable ultralow field (ULF) MRI is showing promise in bedside adult brain imaging. Use in infants and children has been limited as brain-tissue composition differences necessitate sequence modification. The aim of this study was to develop neonatal-specific ULF structural sequences and test these across a range of gestational maturities and pathologies to inform future validation studies.

Methods

Prospective cohort study within a UK neonatal specialist referral centre. Infants undergoing 3T MRI were recruited for paired ULF (64mT) portable MRI by convenience sampling from the neonatal unit and post-natal ward. Key inclusion criteria: 1) Infants with risk or suspicion of brain abnormality, or 2) preterm and term infants without suspicion of major genetic, chromosomal or neurological abnormality. Exclusions: presence of contra-indication for MR scanning. ULF sequence parameters were optimised for neonatal brain-tissues by iterative and explorative design. Neuroanatomic and pathologic features were compared by unblinded review, informing optimisation of subsequent sequence generations in a step-wise manner. Main outcome: visual identification of healthy and abnormal brain tissues/structures. ULF MR spectroscopy, diffusion, susceptibility weighted imaging, arteriography, and venography require pre-clinical technical development and have not been tested.

Findings

Between September 23, 2021 and October 25, 2022, 102 paired scans were acquired in 87 infants; 1.17 paired scans per infant. Median age 9 days, median postmenstrual age 40+2 weeks (range: 31+3-53+4). Infants had a range of intensive care requirements. No adverse events observed. Optimised ULF sequences can visualise key neuroanatomy and brain abnormalities. In finalised neonatal sequences: T2w imaging distinguished grey and white matter (7/7 infants), ventricles (7/7), pituitary tissue (5/7), corpus callosum (7/7) and optic nerves (7/7). Signal congruence was seen within the posterior limb of the internal capsule in 10/11 infants on finalised T1w scans. In addition, brain abnormalities visualised on ULF optimised sequences have similar MR signal patterns to 3T imaging, including injury secondary to infarction (6/6 infants on T2w scans), hypoxia-ischaemia (abnormal signal in basal ganglia, thalami and white matter 2/2 infants on T2w scans, cortical highlighting 1/1 infant on T1w scan), and congenital malformations: polymicrogyria 3/3, absent corpus callosum 2/2, and vermian hypoplasia 3/3 infants on T2w scans. Sequences are susceptible to motion corruption, noise, and ULF artefact. Non-identified pathologies were small or subtle.

Interpretation

On unblinded review, optimised portable MR can provide sufficient contrast, signal, and resolution for neuroanatomical identification and detection of a range of clinically important abnormalities. Blinded validation studies are now warranted.

Funding

The Bill and Melinda Gates Foundation, the MRC, the Wellcome/EPSRC Centre for Medical Engineering, the MRC Centre for Neurodevelopmental Disorders, and the National Institute for Health Research (NIHR) Biomedical Research Centres based at Guy's and St Thomas' and South London & Maudsley NHS Foundation Trusts and King's College London.

Detection of Intracerebral Hemorrhage Using Low-Field, Portable Magnetic Resonance Imaging in Patients With Stroke

BACKGROUND

Neuroimaging is essential for detecting spontaneous, nontraumatic intracerebral hemorrhage (ICH). Recent data suggest ICH can be characterized using low-field magnetic resonance imaging (MRI). Our primary objective was to investigate the sensitivity and specificity of ICH on a 0.064T portable MRI (pMRI) scanner using a methodology that provided clinical information to inform rater interpretations. As a secondary aim, we investigated whether the incorporation of a deep learning (DL) reconstruction algorithm affected ICH detection.

METHODS

The pMRI device was deployed at Yale New Haven Hospital to examine patients presenting with stroke symptoms from October 26, 2020 to February 21, 2022. Three raters independently evaluated pMRI examinations. Raters were provided the images alongside the patient's clinical information to simulate real-world context of use. Ground truth was the closest conventional computed tomography or 1.5/3T MRI. Sensitivity and specificity results were grouped by DL and non-DL software to investigate the effects of software advances.

RESULTS

A total of 189 exams (38 ICH, 89 acute ischemic stroke, 8 subarachnoid hemorrhage, 3 primary intraventricular hemorrhage, 51 no intracranial abnormality) were evaluated. Exams were correctly classified as positive or negative for ICH in 185 of 189 cases (97.9% overall accuracy). ICH was correctly detected in 35 of 38 cases (92.1% sensitivity). Ischemic stroke and no intracranial abnormality cases were correctly identified as blood-negative in 139 of 140 cases (99.3% specificity). Non-DL scans had a sensitivity and specificity for ICH of 77.8% and 97.1%, respectively. DL scans had a sensitivity and specificity for ICH of 96.6% and 99.3%, respectively.

CONCLUSIONS

These results demonstrate improvements in ICH detection accuracy on pMRI that may be attributed to the integration of clinical information in rater review and the incorporation of a DL-based algorithm. The use of pMRI holds promise in providing diagnostic neuroimaging for patients with ICH.

[Research on a portable shielding-free ultra-low field magnetic resonance imaging system]

The portable light-weight magnetic resonance imaging system can be deployed in special occasions such as Intensive Care Unit (ICU) and ambulances, making it possible to implement bedside monitoring imaging systems, mobile stroke units and magnetic resonance platforms in remote areas. Compared with medium and high field imaging systems, ultra-low-field magnetic resonance imaging equipment utilizes light-weight permanent magnets, which are compact and easy to move. However, the image quality is highly susceptible to external electromagnetic interference without a shielded room and there are still many key technical problems in hardware design to be solved. In this paper, the system hardware design and environmental electromagnetic interference elimination algorithm were studied. Consequently, some research results were obtained and a prototype of portable shielding-free 50 mT magnetic resonance imaging system was built. The light-weight magnet and its uniformity, coil system and noise elimination algorithm and human brain imaging were verified. Finally, high-quality images of the healthy human brain were obtained. The results of this study would provide reference for the development and application of ultra-low-field magnetic resonance imaging technology.

A safety study on ultra‑high or moderate static magnetic fields combined with platycodin D against lung cancer

Due to the serious side effects of chemotherapy drugs against lung cancer, and the antitumor properties and high safety of magnetic fields, the present study combined moderate or ultra-high intensity statics magnetic fields (SMFs) with platycodin D (PD) to explore the antitumor efficiency and biosafety. The antitumor effects of PD with or without moderate and ultra-high SMFs on A549 cells bearing mice were compared. Mouse body weight, food/water intake, hematology routine, blood biochemistry, tumor weight and tissues hematoxylin and eosin (H&E) staining were examined. Behavior was measured using the elevated plus maze, open field and vital signs tests. The combined targets of PD and SMFs were detected using RNA-sequencing (RNA-seq). The results showed that the antitumor effect of 22 Tesla (T) SMF group was 3.6-fold higher compared with that of the 2 mg/kg PD group (tumor growth inhibition=10.08%), while the antitumor effect of 150 mT SMF was only 1.56-fold higher compared with that of PD. Although PD reduced the food intake, there was no significant difference in body weight, water intake or food consumption among PD and SMF groups. Behavioral results indicated that PD ameliorated dysphoria in mice, but SMFs reduced this effect. However, no significant abnormalities were found in routine blood, blood biochemistry test, H&E staining or organ index, except renal index which was reduced by PD with or without SMFs. RNA-sequencing (RNA-seq) demonstrated that SMFs and PD synergistically targeted the expression of genes associated with tumor growth, inflammation and neurological disease. The present study showed the antitumor efficacy and biosafety of moderate or ultra-high SMF combined with PD, which exhibited only few side effects in the treatment of lung cancer, thus supporting further research for the clinical application of magnetic fields.

Low-field MRI: A report on the 2022 ISMRM workshop

In March 2022, the first ISMRM Workshop on Low-Field MRI was held virtually. The goals of this workshop were to discuss recent low field MRI technology including hardware and software developments, novel methodology, new contrast mechanisms, as well as the clinical translation and dissemination of these systems. The virtual Workshop was attended by 368 registrants from 24 countries, and included 34 invited talks, 100 abstract presentations, 2 panel discussions, and 2 live scanner demonstrations. Here, we report on the scientific content of the Workshop and identify the key themes that emerged. The subject matter of the Workshop reflected the ongoing developments of low-field MRI as an accessible imaging modality that may expand the usage of MRI through cost reduction, portability, and ease of installation. Many talks in this Workshop addressed the use of computational power, efficient acquisitions, and contemporary hardware to overcome the SNR limitations associated with low field strength. Participants discussed the selection of appropriate clinical applications that leverage the unique capabilities of low-field MRI within traditional radiology practices, other point-of-care settings, and the broader community. The notion of "image quality" versus "information content" was also discussed, as images from low-field portable systems that are purpose-built for clinical decision-making may not replicate the current standard of clinical imaging. Speakers also described technical challenges and infrastructure challenges related to portability and widespread dissemination, and speculated about future directions for the field to improve the technology and establish clinical value.

Current role of portable MRI in diagnosis of acute neurological conditions

Neuroimaging is an inevitable component of the assessment of neurological emergencies. Magnetic resonance imaging (MRI) is the preferred imaging modality for detecting neurological pathologies and provides higher sensitivity than other modalities. However, difficulties such as intra-hospital transport, long exam times, and availability in strict access-controlled suites limit its utility in emergency departments and intensive care units (ICUs). The evolution of novel imaging technologies over the past decades has led to the development of portable MRI (pMRI) machines that can be deployed at point-of-care. This article reviews pMRI technologies and their clinical implications in acute neurological conditions. Benefits of pMRI include timely and accurate detection of major acute neurological pathologies such as stroke and intracranial hemorrhage. Additionally, pMRI can be potentially used to monitor the progression of neurological complications by facilitating serial measurements at the bedside.

Brain imaging with portable low-field MRI

The advent of portable, low-field MRI (LF-MRI) heralds new opportunities in neuroimaging. Low power requirements and transportability have enabled scanning outside the controlled environment of a conventional MRI suite, enhancing access to neuroimaging for indications that are not well suited to existing technologies. Maximizing the information extracted from the reduced signal-to-noise ratio of LF-MRI is crucial to developing clinically useful diagnostic images. Progress in electromagnetic noise cancellation and machine learning reconstruction algorithms from sparse k-space data as well as new approaches to image enhancement have now enabled these advancements. Coupling technological innovation with bedside imaging creates new prospects in visualizing the healthy brain and detecting acute and chronic pathological changes. Ongoing development of hardware, improvements in pulse sequences and image reconstruction, and validation of clinical utility will continue to accelerate this field. As further innovation occurs, portable LF-MRI will facilitate the democratization of MRI and create new applications not previously feasible with conventional systems.

Design and realization of a multi-coil array for B0 field control in a compact 1.5T head-only MRI scanner

PURPOSE

To design and implement a multi-coil (MC) array for B0 field generation for image encoding and simultaneous advanced shimming in a novel 1.5T head-only MRI scanner.

METHODS

A 31-channel MC array was designed following the unique constraints of this scanner design: The vertically oriented magnet is very short, stopping shortly above the shoulders of a sitting subject, and includes a window for the subject to see through. Key characteristics of the MC hardware, the B0 field generation capabilities, and thermal behavior, were optimized in simulations prior to its construction. The unit was characterized via bench testing. B0 field generation capabilities were validated on a human 4T MR scanner by analysis of experimental B0 fields and by comparing images for several MRI sequences acquired with the MC array to those acquired with the system's linear gradients.

RESULTS

The MC system was designed to produce a multitude of linear and nonlinear magnetic fields including linear gradients of up to 10 kHz/cm (23.5 mT/m) with MC currents of 5 A per channel. With water cooling it can be driven with a duty cycle of up to 74% and ramp times of 500 μs. MR imaging experiments encoded with the developed multi-coil hardware were largely artifact-free; residual imperfections were predictable, and correctable.

CONCLUSION

The presented compact multi-coil array is capable of generating image encoding fields with amplitudes and quality comparable to clinical systems at very high duty cycles, while additionally enabling high-order B0 shimming capabilities and the potential for nonlinear encoding fields.

SNAP-Tag-Targeted MRI-Fluorescent Multimodal Probes

Magnetic resonance imaging (MRI) is a powerful imaging modality, widely employed in research and clinical settings. However, MRI images suffer from low signals and a lack of target specificity. We aimed to develop a multimodal imaging probe to detect targeted cells by MRI and fluorescence microscopy. We synthesized a trifunctional imaging probe consisting of a SNAP-tag substrate for irreversible and specific labelling of cells, cyanine dyes for bright fluorescence, and a chelated GdIII molecule for enhancing MRI contrast. Our probes exhibit specific and efficient labelling of genetically defined cells (expressing SNAP-tag at their membrane), bright fluorescence and MRI signal. Our synthetic approach provides a versatile platform for the production of multimodal imaging probes, particularly for light microscopy and MRI.

Iron oxide nanoparticles as positive T1 contrast agents for low-field magnetic resonance imaging at 64 mT

We have investigated the efficacy of superparamagnetic iron oxide nanoparticles (SPIONs) as positive T₁ contrast agents for low-field magnetic resonance imaging (MRI) at 64 millitesla (mT). Iron oxide-based agents, such as the FDA-approved ferumoxytol, were measured using a variety of techniques to evaluate T₁ contrast at 64 mT. Additionally, we characterized monodispersed carboxylic acid-coated SPIONs with a range of diameters (4.9-15.7 nm) in order to understand size-dependent properties of T₁ contrast at low-field. MRI contrast properties were measured using 64 mT MRI, magnetometry, and nuclear magnetic resonance dispersion (NMRD). We also measured MRI contrast at 3 T to provide comparison to a standard clinical field strength. SPIONs have the capacity to perform well as T₁ contrast agents at 64 mT, with measured longitudinal relaxivity (r₁) values of up to 67 L mmol^-1 s^-1, more than an order of magnitude higher than corresponding r₁ values at 3 T. The particles exhibit size-dependent longitudinal relaxivities and outperform a commercial Gd-based agent (gadobenate dimeglumine) by more than eight-fold at physiological temperatures. Additionally, we characterize the ratio of transverse to longitudinal relaxivity, r₂/r₁ and find that it is ~ 1 for the SPION based agents at 64 mT, indicating a favorable balance of relaxivities for T₁-weighted contrast imaging. We also correlate the magnetic and structural properties of the particles with models of nanoparticle relaxivity to understand generation of T₁ contrast. These experiments show that SPIONs, at low fields being targeted for point-of-care low-field MRI systems, have a unique combination of magnetic and structural properties that produce large T₁ relaxivities.

An evolution of low-field strength MRI

The paper describes the evolution of low-field MRI from the very early pioneering days in the late 70 s until today. It is not meant to give a comprehensive historical account of the development of MRI, but rather to highlight the different research environments then and now. In the early 90 s, when low-field systems below 1.5 T essentially vanished, there were just no reasonable means available to make up for the factor of roughly three in signal-to-noise-ratio (SNR) between 0.5 and 1.5 T. This has drastically changed. Improvements in hardware-closed Helium-free magnets, RF receiver systems and especially much faster gradients, much more flexible sampling schemes including parallel imaging and compressed sensing and especially the use of AI at all stages of the imaging process have made low-field MRI a clinically viable supplement to conventional MRI. Ultralow-field MRI with magnets around 0.05 T are also back and constitute a bold and courageous endeavor to bring MRI to communities, which have neither the means nor the infrastructure to sustain a current standard of care MRI.

Enhanced 129 Xe T1 relaxation in whole blood and in the presence of SPIONs at low magnetic field strengths

PURPOSE

To compare the effect of superparamagnetic iron oxide nanoparticles (SPIONs) on the T1 of 129 Xe and 1 H and to measure the relaxation of 129 Xe in blood at low and high magnetic field strengths.

METHODS

129 Xe and 1 H T1 relaxometry was performed at low- and high-field strengths in samples containing different SPION concentrations, while imaging was used to compare the contrast obtainable in these two field regimes. In vivo experiments at variable field strengths were performed to determine the depolarization of 129 Xe in blood and the feasibility of in vivo dissolved-phase spectroscopy and imaging at low field.

RESULTS

The SPION relaxivity was substantially greater at low field for 1 H, increasing from 0.92 ± 0.06 mM s-1 at 11.7T to 31.5 ± 1.8 mM s-1 at 0.6 mT, and for 129 Xe, which increased from 0.13 ± 0.03 mM s-1 at 11.7T to 7.32 ± 0.71 mM s-1 at 2.1 mT. The additional MR signal loss increased from 0.7% at 9.4T to 20.6 ± 4.2% at 0.6 mT for 1 H and from -0.7 ± 3.4% at 9.4T to 12.7 ± 3.5% at 2.1 mT for 129 Xe. Blood was found to depolarize 129 Xe below 3T in a manner inversely proportional to the field strength. In vitro studies at 2.1 mT suggest 129 Xe relaxation times below 5 s in blood dilutions as low as 0.4% volume.

CONCLUSION

SPIONs longitudinal relaxivity increases at low field both for 1 H and 129 Xe. The depolarization of xenon in blood, which is found to increase below 3T, effectively prevents in vivo dissolved-phase spectroscopy and imaging at low-field strengths.

Concomitant field compensation of spiral turbo spin-echo at 0.55 T

OBJECTIVE

Diagnostic-quality neuroimaging methods are vital for widespread clinical adoption of low field MRI. Spiral imaging is an efficient acquisition method that can mitigate the reduced signal-to-noise ratio at lower field strengths. As concomitant field artifacts are worse at lower field, we propose a generalizable quadratic gradient-field nulling as an echo-to-echo compensation and apply it to spiral TSE at 0.55 T.

MATERIALS AND METHODS

A spiral in-out TSE acquisition was developed with a compensation for concomitant field variation between spiral interleaves, by adding bipolar gradients around each readout to minimize phase differences at each refocusing pulse. Simulations were performed to characterize concomitant field compensation approaches. We demonstrate our proposed compensation method in phantoms and (n = 8) healthy volunteers at 0.55 T.

RESULTS

Spiral read-outs with integrated spoiling demonstrated strong concomitant field artifacts but were mitigated using the echo-to-echo compensation. Simulations predicted a decrease of concomitant field phase RMSE between echoes of 42% using the proposed compensation. Spiral TSE improved SNR by 17.2 ± 2.3% compared to reference Cartesian acquisition.

DISCUSSION

We demonstrated a generalizable approach to mitigate concomitant field artifacts for spiral TSE acquisitions via the addition of quadratic-nulling gradients, which can potentially improve neuroimaging at low-field through increased acquisition efficiency.

Magnetic resonance imaging using a nonuniform Bo (NuBo) field-cycling magnet

Magnetic resonance imaging (MRI) is a powerful noninvasive diagnostic tool with superior soft tissue contrast. However, access to MRI is limited since current systems depend on homogeneous, high field strength main magnets (B0-fields), with strong switchable gradients which are expensive to install and maintain. In this work we propose a new approach to MRI where imaging is performed in an inhomogeneous field using radiofrequency spatial encoding, thereby eliminating the need for uniform B0-fields and conventional cylindrical gradient coils. The proposed technology uses an innovative data acquisition and reconstruction approach by integrating developments in field cycling, parallel imaging and non-Fourier based algebraic reconstruction. The scanner uses field cycling to image in an inhomogeneous B0-field; in this way magnetization is maximized during the high field polarization phase, and B0 inhomogeneity effects are minimized by using a low field during image acquisition. In addition to presenting the concept, this work provides experimental verification of a long-lived spin echo signal, spatially varying resolution, as well as both simulated and experimental 2D images. Our initial design creates an open MR system that can be installed in a patient examination table for body imaging (e.g., breast or liver) or built into a wall for weighted-spine imaging. The proposed system introduces a new class of inexpensive, open, silent MRIs that could be housed in doctor's offices much like ultrasound is today, making MRI more widely accessible.

Future of Neurology & Technology: Neuroimaging Made Accessible Using Low-Field, Portable MRI

In the 20th century, the advent of neuroimaging dramatically altered the field of neurologic care. However, despite iterative advances since the invention of CT and MRI, little progress has been made to bring MR neuroimaging to the point of care. Recently, the emergence of a low-field (<1 T) portable MRI (pMRI) is setting the stage to revolutionize the landscape of accessible neuroimaging. Users can transport the pMRI into a variety of locations, using a standard 110-220 V wall outlet. In this article, we discuss current applications for pMRI, including in the acute and critical care settings, the barriers to broad implementation, and future opportunities.

In vivo quantitative MRI: T1 and T2 measurements of the human brain at 0.064 T

OBJECTIVE

To measure healthy brain [Formula: see text] and [Formula: see text] relaxation times at 0.064 T.

MATERIALS AND METHODS

[Formula: see text] and [Formula: see text] relaxation times were measured in vivo for 10 healthy volunteers using a 0.064 T magnetic resonance imaging (MRI) system and for 10 test samples on both the MRI and a separate 0.064 T nuclear magnetic resonance (NMR) system. In vivo [Formula: see text] and [Formula: see text] values are reported for white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF) for automatic segmentation regions and manual regions of interest (ROIs).

RESULTS

[Formula: see text] sample measurements on the MRI system were within 10% of the NMR measurement for 9 samples, and one sample was within 11%. Eight [Formula: see text] sample MRI measurements were within 25% of the NMR measurement, and the two longest [Formula: see text] samples had more than 25% variation. Automatic segmentations generally resulted in larger [Formula: see text] and [Formula: see text] estimates than manual ROIs.

DISCUSSION

[Formula: see text] and [Formula: see text] times for brain tissue were measured at 0.064 T. Test samples demonstrated accuracy in WM and GM ranges of values but underestimated long [Formula: see text] in the CSF range. This work contributes to measuring quantitative MRI properties of the human body at a range of field strengths.

Relaxation measurements of an MRI system phantom at low magnetic field strengths

OBJECTIVE

Temperature controlled T₁ and T₂ relaxation times are measured on NiCl₂ and MnCl₂ solutions from the ISMRM/NIST system phantom at low magnetic field strengths of 6.5 mT, 64 mT and 550 mT.

MATERIALS AND METHODS

The T₁ and T₂ were measured of five samples with increasing concentrations of NiCl₂ and five samples with increasing concentrations of MnCl₂. All samples were scanned at 6.5 mT, 64 mT and 550 mT, at sample temperatures ranging from 10 °C to 37 °C.

RESULTS

The NiCl₂ solutions showed little change in T₁ and T₂ with magnetic field strength, and both relaxation times decreased with increasing temperature. The MnCl₂ solutions showed an increase in T₁ and a decrease in T₂ with increasing magnetic field strength, and both T₁ and T₂ increased with increasing temperature.

DISCUSSION

The low field relaxation rates of the NiCl₂ and MnCl₂ arrays in the ISMRM/NIST system phantom are investigated and compared to results from clinical field strengths of 1.5 T and 3.0 T. The measurements can be used as a benchmark for MRI system functionality and stability, especially when MRI systems are taken out of the radiology suite or laboratory and into less traditional environments.

Tackling SNR at low-field: a review of hardware approaches for point-of-care systems

OBJECTIVE

To review the major hardware components of low-field point-of-care MRI systems which affect the overall sensitivity.

METHODS

Designs for the following components are reviewed and analyzed: magnet, RF coils, transmit/receive switches, preamplifiers, data acquisition system, and methods for grounding and mitigating electromagnetic interference.

RESULTS

High homogeneity magnets can be produced in a variety of different designs including C- and H-shaped as well as Halbach arrays. Using Litz wire for RF coil designs enables unloaded Q values of ~ 400 to be reached, with body loss representing about 35% of the total system resistance. There are a number of different schemes to tackle issues arising from the low coil bandwidth with respect to the imaging bandwidth. Finally, the effects of good RF shielding, proper electrical grounding, and effective electromagnetic interference reduction can lead to substantial increases in image signal-to-noise ratio.

DISCUSSION

There are many different magnet and RF coil designs in the literature, and to enable meaningful comparisons and optimizations to be performed it would be very helpful to determine a standardized set of sensitivity measures, irrespective of design.

Modern Manufacturing Enables Magnetic Field Cycling Experiments and Parahydrogen-Induced Hyperpolarization with a Benchtop NMR

Benchtop NMR (btNMR) spectrometers are revolutionizing the way we use NMR and lowering the cost drastically. Magnetic field cycling (MFC) experiments with precise timing and control over the magnetic field, however, were hitherto not available on btNMRs, although some systems exist for high-field, high-resolution NMR spectrometers. Still, the need and potential for btNMR MFC is great─e.g., to perform and analyze parahydrogen-induced hyperpolarization, another method that has affected analytical chemistry and NMR beyond expectations. Here, we describe a setup that enables MFC on btNMRs for chemical analysis and hyperpolarization. Taking full advantage of the power of modern manufacturing, including computer-aided design, three-dimensional printing, and microcontrollers, the setup is easy to reproduce, highly reliable, and easy to adjust and operate. Within 380 ms, the NMR tube was shuttled reliably from the electromagnet to the NMR isocenter (using a stepper motor and gear rod). We demonstrated the power of this setup by hyperpolarizing nicotinamide using signal amplification by reversible exchange (SABRE), a versatile method to hyperpolarize a broad variety of molecules including metabolites and drugs. Here, the standard deviation of SABRE hyperpolarization was between 0.2 and 3.3%. The setup also allowed us to investigate the field dependency of the polarization and the effect of different sample preparation protocols. We found that redissolution of the activated and dried Ir catalyst always reduced the polarization. We anticipate that this design will greatly accelerate the ascension of MFC experiments for chemical analysis with btNMR─adding yet another application to this rapidly developing field.

Using a Dedicated Extremity MRI Scanner for Depicting Anatomic Structures of Common Wrist Pathologies: A Pilot Comparison with a 3-Tesla MRI Scanner

Background  This pilot study explored the value of a dedicated extremity magnetic resonance imaging (MRI) scanner by focusing on the qualitative depiction of important wrist structures in common wrist pathologies, the overall image quality, artifacts, and participant experience in undergoing the examinations. Methods  Images of the right wrist of 10 healthy adult volunteers were acquired with a 0.31-Tesla (T) dedicated extremity MRI and a 3-T MRI system, using a dedicated wrist coil. Images were separately evaluated by three radiologists. Paired images were randomized and graded for the visibility of anatomical details, including the triangular fibrocartilage complex (TFCC; central disc, meniscus homolog, and ulnar attachment), carpal ligaments (scapholunate [SL] and lunotriquetral [LT] ligaments), intercarpal cartilage, and median and ulnar nerves. Mean values and standard deviations of evaluation results were calculated for each sequence. Participants' experience in undergoing the examination in both MRI scanners was explored using a questionnaire. Results  The mean values of anatomic structures and overall image quality were significantly in favor of the 3-T MRI scanner, compared with the dedicated extremity MRI scanner. With respect to patient satisfaction in undergoing the examination, the overall trend suggested that patients were more in favor of the dedicated extremity MRI scanner. Conclusion  For defining the real clinical value of the dedicated MRI scanner in the treatment of hand and wrist pathology, studies focused on pathologies are needed, which is certainly warranted, considering the important benefits of these devices including lower costs and higher accessibility for both patients and health care providers.

Specific absorption rate (SAR) simulations for low-field (< 0.1 T) MRI systems

OBJECTIVE

To simulate the magnetic and electric fields produced by RF coil geometries commonly used at low field. Based on these simulations, the specific absorption rate (SAR) efficiency can be derived to ensure safe operation even when using short RF pulses and high duty cycles.

METHODS

Electromagnetic simulations were performed at four different field strengths between 0.05 and 0.1 T, corresponding to the lower and upper limits of current point-of-care (POC) neuroimaging systems. Transmit magnetic and electric fields, as well as transmit efficiency and SAR efficiency were simulated. The effects of a close-fitting shield on the EM fields were also assessed. SAR calculations were performed as a function of RF pulse length in turbo-spin echo (TSE) sequences.

RESULTS

Simulations of RF coil characteristics and B₁⁺ transmit efficiencies agreed well with corresponding experimentally determined parameters. Overall, the SAR efficiency was, as expected, higher at the lower frequencies studied, and many orders of magnitude greater than at conventional clinical field strengths. The tight-fitting transmit coil results in the highest SAR in the nose and skull, which are not thermally sensitive tissues. The calculated SAR efficiencies showed that only when 180° refocusing pulses of duration ~ 10 ms are used for TSE sequences does SAR need to be carefully considered.

CONCLUSION

This work presents a comprehensive overview of the transmit and SAR efficiencies for RF coils used for POC MRI neuroimaging. While SAR is not a problem for conventional sequences, the values derived here should be useful for RF intensive sequences such as T_1ρ, and also demonstrate that if very short RF pulses are required then SAR calculations should be performed.

Superconducting magnet designs and MRI accessibility: A review

Presently, magnetic resonance imaging (MRI) magnets must deliver excellent magnetic field (B₀ ) uniformity to achieve optimum image quality. Long magnets can satisfy the homogeneity requirements but require considerable superconducting material. These designs result in large, heavy, and costly systems that aggravate as field strength increases. Furthermore, the tight temperature tolerance of niobium titanium magnets adds instability to the system and requires operation at liquid helium temperature. These issues are crucial factors in the disparity of MR density and field strength use across the globe. Low-income settings show reduced access to MRI, especially to high field strengths. This article summarizes the proposed modifications to MRI superconducting magnet design and their impact on accessibility, including compact, reduced liquid helium, and specialty systems. Reducing the amount of superconductor inevitably entails shrinking the magnet size, resulting in higher field inhomogeneity. This work also reviews the state-of-the-art imaging and reconstruction methods to overcome this issue. Finally, we summarize the current and future challenges and opportunities in the design of accessible MRI.

Hyperpolarized 129Xe MRI at low field: Current status and future directions

Magnetic Resonance Imaging (MRI) is dictated by the magnetization of the sample, and is thus a low-sensitivity imaging method. Inhalation of hyperpolarized (HP) noble gases, such as helium-3 and xenon-129, is a non-invasive, radiation-risk free imaging technique permitting high resolution imaging of the lungs and pulmonary functions, such as the lung microstructure, diffusion, perfusion, gas exchange, and dynamic ventilation. Instead of increasing the magnetic field strength, the higher spin polarization achievable from this method results in significantly higher net MR signal independent of tissue/water concentration. Moreover, the significantly longer apparent transverse relaxation time T₂* of these HP gases at low magnetic field strengths results in fewer necessary radiofrequency (RF) pulses, permitting larger flip angles; this allows for high-sensitivity imaging of in vivo animal and human lungs at conventionally low (<0.5 T) field strengths and suggests that the low field regime is optimal for pulmonary MRI using hyperpolarized gases. In this review, theory on the common spin-exchange optical-pumping method of hyperpolarization and the field dependence of the MR signal of HP gases are presented, in the context of human lung imaging. The current state-of-the-art is explored, with emphasis on both MRI hardware (low field scanners, RF coils, and polarizers) and image acquisition techniques (pulse sequences) advancements. Common challenges surrounding imaging of HP gases and possible solutions are discussed, and the future of low field hyperpolarized gas MRI is posed as being a clinically-accessible and versatile imaging method, circumventing the siting restrictions of conventional high field scanners and bringing point-of-care pulmonary imaging to global facilities.

Building a comprehensive cardiovascular magnetic resonance exam on a commercial 0.55 T system: A pictorial essay on potential applications

Background

Contemporary advances in low-field magnetic resonance imaging systems can potentially widen access to cardiovascular magnetic resonance (CMR) imaging. We present our initial experience in building a comprehensive CMR protocol on a commercial 0.55 T system with a gradient performance of 26 mT/m amplitude and 45 T/m/s slew rate. To achieve sufficient image quality, we adapted standard imaging techniques when possible, and implemented compressed-sensing (CS) based techniques when needed in an effort to compensate for the inherently low signal-to-noise ratio at lower field strength.

Methods

A prototype CMR exam was built on an 80 cm, ultra-wide bore commercial 0.55 T MR system. Implementation of all components aimed to overcome the inherently lower signal of low-field and the relatively longer echo and repetition times owing to the slower gradients. CS-based breath-held and real-time cine imaging was built utilizing high acceleration rates to meet nominal spatial and temporal resolution recommendations. Similarly, CS 2D phase-contrast cine was implemented for flow. Dark-blood turbo spin echo sequences with deep learning based denoising were implemented for morphology assessment. Magnetization-prepared single-shot myocardial mapping techniques incorporated additional source images. CS-based dynamic contrast-enhanced imaging was implemented for myocardial perfusion and 3D MR angiography. Non-contrast 3D MR angiography was built with electrocardiogram-triggered, navigator-gated magnetization-prepared methods. Late gadolinium enhanced (LGE) tissue characterization methods included breath-held segmented and free-breathing single-shot imaging with motion correction and averaging using an increased number of source images. Proof-of-concept was demonstrated through porcine infarct model, healthy volunteer, and patient scans.

Results

Reasonable image quality was demonstrated for cardiovascular structure, function, flow, and LGE assessment. Low-field afforded utilization of higher flip angles for cine and MR angiography. CS-based techniques were able to overcome gradient speed limitations and meet spatial and temporal resolution recommendations with imaging times comparable to higher performance scanners. Tissue mapping and perfusion imaging require further development.

Conclusion

We implemented cardiac applications demonstrating the potential for comprehensive CMR on a novel commercial 0.55 T system. Further development and validation studies are needed before this technology can be applied clinically.

Fast, interleaved, Look-Locker-based T1 mapping with a variable averaging approach: Towards temperature mapping at low magnetic field

Proton resonance frequency shift (PRFS) is currently the gold standard method for magnetic resonance thermometry. However, the linearity between the temperature-dependent phase accumulation and the static magnetic field B₀ confines its use to rather high-field scanners. Applications such as thermal therapies could naturally benefit from lower field MRI settings through leveraging increased accessibility, a lower physical and economical footprint, and further consideration of the technical challenges associated with the integration of heating systems into conventional clinical scanners. T 1 -based thermometry has been proposed as an alternative to the gold standard; however, because of longer acquisition times, it has found clinical use solely with adipose tissue where PRFS fails. At low field, the enhanced T 1 dispersion, combined with reduced relaxation times, make T 1 mapping an appealing candidate. Here, an interleaved Look-Locker-based T 1 mapping sequence was proposed for temperature quantification at 0.1 T. A variable averaging scheme was introduced, to maximize the signal-to-noise ratio throughout T 1 recovery. In calibrated samples, an average T 1 accuracy of 85% ± 4% was achieved in 10 min, compared with the 77% ± 7% obtained using a standard averaging scheme. Temperature maps between 29.0 and 41.7°C were eventually reconstructed, with a precision of 3.0 ± 1.1°C and an accuracy of 1.5 ± 1.0°C. Accounting for longer thermal treatments and less strict temperature constraints, applications such as MR-guided mild hyperthermia treatments at low field could be envisioned.

Benchmarking the performance of a low-cost magnetic resonance control system at multiple sites in the open MaRCoS community

PURPOSE

To describe the current properties and capabilities of an open-source hardware and software package that is being developed by many sites internationally with the aim of providing an inexpensive yet flexible platform for low-cost MRI.

METHODS

This article describes three different setups from 50 to 360 mT in different settings, all of which used the MaRCoS console for acquiring data, and different types of software interface (custom-built GUI or Pulseq overlay) to acquire it.

RESULTS

Images are presented both from phantoms and in vivo from healthy volunteers to demonstrate the image quality that can be obtained from the MaRCoS hardware/software interfaced to different low-field magnets.

CONCLUSIONS

The results presented here show that a number of different sequences commonly used in the clinic can be programmed into an open-source system relatively quickly and easily, and can produce good quality images even at this early stage of development. Both the hardware and software will continue to develop, and it is an aim of this article to encourage other groups to join this international consortium.

Advancements in Gradient System Performance for Clinical and Research MRI

In magnetic resonance imaging (MRI), spatial field gradients are applied along each axis to encode the location of the nuclear spin in the frequency domain. During recent years, the development of new gradient technologies has been focused on the generation of stronger and faster gradient fields for imaging with higher spatial and temporal resolution. This benefits imaging methods, such as brain diffusion and functional MRI, and enables human imaging at ultra-high field MRI. In addition to improving gradient performance, new technologies have been presented to minimize peripheral nerve stimulation and gradient-related acoustic noise, both generated by the rapid switching of strong gradient fields. This review will provide a general background on the gradient system and update on the state-of-the-art gradient technology. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 1.

Low-field MRI: Clinical promise and challenges

Modern MRI scanners have trended toward higher field strengths to maximize signal and resolution while minimizing scan time. However, high-field devices remain expensive to install and operate, making them scarce outside of high-income countries and major population centers. Low-field strength scanners have drawn renewed academic, industry, and philanthropic interest due to advantages that could dramatically increase imaging access, including lower cost and portability. Nevertheless, low-field MRI still faces inherent limitations in image quality that come with decreased signal. In this article, we review advantages and disadvantages of low-field MRI scanners, describe hardware and software innovations that accentuate advantages and mitigate disadvantages, and consider clinical applications for a new generation of low-field devices. In our review, we explore how these devices are being or could be used for high acuity brain imaging, outpatient neuroimaging, MRI-guided procedures, pediatric imaging, and musculoskeletal imaging. Challenges for their successful clinical translation include selecting and validating appropriate use cases, integrating with standards of care in high resource settings, expanding options with actionable information in low resource settings, and facilitating health care providers and clinical practice in new ways. By embracing both the promise and challenges of low-field MRI, clinicians and researchers have an opportunity to transform medical care for patients around the world. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 6.

Nanoparticles for MRI-guided radiation therapy: a review

The development of nanoparticle agents for MRI-guided radiotherapy is growing at an increasing pace, with clinical trials now underway and many pre-clinical evaluation studies ongoing. Gadolinium and iron-oxide-based nanoparticles remain the most clinically advanced nanoparticles to date, although several promising candidates are currently under varying stages of development. Goals of current and future generation nanoparticle-based contrast agents for MRI-guided radiotherapy include achieving positive signal contrast on T1-weighted MRI scans, local radiation enhancement at clinically relevant concentrations and, where applicable, avoidance of uptake by the reticuloendothelial system. Exploiting the enhanced permeability and retention effect or the use of active targeting ligands on nanoparticle surfaces is utilised to promote tumour uptake. This review outlines the current status of promising nanoparticle agents for MRI-guided radiation therapy, including several platforms currently undergoing clinical evaluation or at various stages of the pre-clinical development process. Challenges facing nanoparticle agents and possible avenues for current and future development are discussed.