MR Contrast Agent at High-Field MRI (3 Tesla)

3 T: the good, the bad and the ugly

It is around 20 years since the first commercial 3 T MRI systems became available. The theoretical promise of twice the signal-to-noise ratio of a 1.5 T system together with a greater sensitivity to magnetic susceptibility-related contrast mechanisms, such as the blood oxygen level dependent effect that is the basis for functional MRI, drove the initial market in neuroradiology. However, the limitations of the increased field strength soon became apparent, including the increased radiofrequency power deposition, tissue-dependent changes in relaxation times, increased artifacts, and greater safety concerns. Many of these issues are dependent upon MR physics and workarounds have had to be developed to try and mitigate their effects. This article reviews the underlying principles of the good, the bad and the ugly aspects of 3 T, discusses some of the methods used to improve image quality and explains the remaining challenges and concerns.

T1-weighted MR imaging of glioma at 3T: a comparative study of 3D MPRAGE vs. conventional 2D spin-echo imaging

PURPOSE

This study aims to investigate difference between magnetization-prepared rapid gradient-echo imaging (MPRAGE) and spin-echo (SE) imaging for evaluating glioma on pre-contrast-enhanced (CE) and post-CE T1-weighted images at 3 T.

MATERIALS AND METHODS

We retrospectively assessed pre-CE and post-CE T1-weighted images for tumor contrast in 64 consecutive glioma patients.

RESULTS

In the nonenhancing tumors, the contrast was significantly clearer in MPRAGE than SE. In the enhancing tumors, post-CE contrast ratio was significantly higher in SE than MPRAGE, but when subtraction images are evaluated, the difference got smaller.

CONCLUSION

MPRAGE can be a good substitute of SE for T1-weighted imaging of glioma.

Definition of K(trans) and FA thresholds for better assessment of experimental glioma using high-field MRI: a feasibility study

PURPOSE

To define K(trans) and fractional anisotropy (FA) thresholds in correlation to histology for improved magnetic resonance imaging (MRI) tumor assessment in an animal model of brain glioma.

METHODS

Twelve rats underwent 4.7 T MRI at day 10 after tumor implantation. Anatomical scans (T2, T1 at 8 min after double dose contrast application) as well as dynamic contrast-enhanced (DCE) imaging with calculation of K(trans) and diffusion tensor imaging (DTI) with calculation of FA were performed. T2- and T1-derived tumor volumes were calculated and thresholds for K(trans) and FA were defined for best MRI tumor assessment correlated to histology.

RESULTS

Tumor volumes were 159 ± 14 mm(3) (histology), 126 ± 26 mm(3) (T1 with contrast, r=0.76), and 153 ± 12 mm(3) (T2, r=0.84), respectively. K(trans)- and FA-derived tumor volumes were 160 ± 16 mm(3) (for K(trans ≥ 0.04 min(-1), r=0.94), and 159 ± 14 mm(3) (for FA £0.14, r=0.96), respectively.

CONCLUSIONS

DCE-MRI and DTI with calculation of K(trans) and FA maps allow very precise brain glioma assessment comparable to histology if established thresholds for the given tumor model are used.

Diagnostic usefulness of 3 tesla MRI of the brain for cushing disease in a child

It is sometimes difficult to confirm the location of a microadenoma in Cushing disease. Recently, we experienced an 11-yr-old female case of Cushing disease with hyperprolactinemia. She was referred to our hospital because of decrease of height velocity with body weight gain. On admission, she had typical symptoms of Cushing syndrome. Although no pituitary microadenomas were detected on 1.5 Tesla MRI of the brain, endocrinological examinations including IPS and CS sampling were consistent with Cushing disease with hyperprolactinemia. Oral administration of methyrapone instead of neurosurgery was started after discharge, but subsequent 3 Tesla MRI of the brain clearly demonstrated a 3-mm less-enhanced lesion in the left side of the pituitary gland. Finally, transsphenoidal surgery was performed, and a 3.5-mm left-sided microadenoma was resected. Compared with 1.5 Tesla MRI, 3 Tesla MRI offers the advantage of a higher signal to noise ratio (SNR), which provides higher resolution and proper image quality. Therefore, 3 Tesla MRI is a very useful tool to localize microadenomas in Cushing disease in children as well as in adults. It will be the first choice of radiological examinations in suspected cases of Cushing disease.

Initial experience of 3 Tesla versus conventional field strength magnetic resonance imaging of small functioning pituitary tumours

BACKGROUND

Higher field strength magnetic resonance imaging (MRI) is becoming increasingly available and offers improved image quality; however, the clinical usefulness of this technique for the demonstration of surgically treatable functional pituitary adenomas has not been clearly established.

OBJECTIVE

To determine whether 3 Tesla (3T) MRI improves the detection of ACTH- and GH-secreting microadenomas over conventional imaging at field strengths of up to 1·5 Tesla (1·5T).

DESIGN

Data sets from postgadolinium T1-weighted MRI at 1·5T and 3T were blinded, randomly ordered and assessed for the presence of pituitary tumour by two radiologists. Where possible, lesion signal difference to noise ratio (SDNR) was calculated for quantitative comparison. Imaging diagnoses were correlated with subsequent surgical and histological findings.

PATIENTS

Twenty-four patients (10 men, 14 women) with biochemical evidence of Cushing's disease (19) or acromegaly (5) were identified over a 5-year period.

RESULTS

1·5T MRI gave a clear diagnosis of 12 pituitary tumours, all confirmed at 3T. Four additional definite lesions and one suspicious case were correctly identified at 3T. Histological correlation in 21 cases showed sensitivity improving from 54% with 1·5T to 85% with 3T. Radiologists' subjective image preference favoured 3T in 92%. Quantitative difference between tumour and parenchymal signal was significantly greater at 3T (mean SDNR -7·9 [3T] and -2·8 [1·5T], paired t-test P < 0·05).

CONCLUSIONS

3T MRI appears to offer increased conspicuity and detection of GH- and ACTH-secreting pituitary microadenomas. It is potentially clinically useful when 1·5T imaging is negative or equivocal.

Preliminary Experience with 3-Tesla MRI and Cushing's Disease

Because radiographic visualization of a pituitary microadenoma is frequently difficult, we hypothesized that microadenomas associated with Cushing's disease may be better resolved and localized via acquisition with 3-Tesla (3T) compared with standard 1.5-Tesla (1.5T) magnetic resonance imaging (MRI). Five patients (four females, one male; age range, 14 to 50 years old) with endocrine and clinical confirmation of Cushing's disease underwent 1.5T and 3T MRI and corticotropin-releasing hormone stimulation/inferior petrosal sinus sampling (IPSS) as part of their preoperative evaluation. All patients underwent a transnasal trans-sphenoidal pituitary adenomectomy. In two cases, tumor could not be localized on either 1.5T or 3T MRI on the initial radiologist's review. In two other cases, the 1.5T images delineated the tumor location, but it was more clearly defined on 3T MRI. In a fifth case, the 1.5T MRI showed a probable right-sided adenoma. However, on both 3T MRI and at surgical exploration the tumor was localized on the left side. Therefore, in three of five cases, 3T MRI either more clearly defined tumors seen on 1.5T MRI or predicted the location of tumor contrary to the 1.5T images. IPSS identified the correct side of the tumor in two patients, an incorrect location in two patients, and was indeterminate in one patient. In certain cases 3T MRI is a new tool that may ameliorate imaging difficulties associated with adrenocorticotrophic hormone-secreting pituitary adenomas. Its role in the diagnostic evaluation of Cushing's disease will be better defined with further experience.

Dynamic contrast enhancement of experimental glioma an intra-individual comparative study to assess the optimal time delay

RATIONALE AND OBJECTIVES

The aim of this study was to compare tumor signal and contrast media uptake characteristics on contrast-enhanced T1-weighted sequences at 3 Tesla over 30 minutes after double-dose administration of different contrast agents in an animal model of brain glioma.

MATERIALS AND METHODS

Nine rats underwent magnetic resonance imaging (MRI) after stereotactic F98 glioma cell implantation before and repetitively for 30 minutes after injection of gadobutrol, gadopentetate, and gadobenate, respectively. Signal-to-noise ratio (SNR) and tumor contrast-to-noise ratio (CNR) were evaluated and MRI-derived tumor volumes were compared to histology.

RESULTS

Postcontrast tumor SNR and CNR peaked at 4 minutes after contrast application. While contrast-enhancement within the tumor was fading, tumor volume increased by continuous contrast-uptake of peripheral parts between 4 minutes (137 + or - 29 mm(3), 126 + or - 16 mm(3), 141 + or - 24 mm(3)) and 20 minutes (182 + or - 35 mm(3), 164 + or - 32 mm(3), 191 + or - 25 mm(3)), respectively. At 8 and 12 minutes, 84% and 91% of the tumor volume were definable, respectively.

CONCLUSION

Optimal correlation between MRI-derived tumor volume and histology is achieved by imaging up to 20 minutes after contrast application. At 4 minutes (this delay is mostly used in clinical routine), only 75% of the enhancing tumor volume is assessable. A delay of 8 minutes already reveals 84% of the tumor and seems to be a practical clinical compromise.

[Imaging techniques for giant cell arteritis. Ultrasound and MRI]

This article summarizes the examination technique, typical findings, interpretation and limitations of ultrasound diagnosis in patients with giant cell arteritis. Colour-coded sonography of the temporal artery has gained increasing attention. If experienced ultrasound examiners are available, diagnosis of giant cell arteritis in patients with a typical clinical constellation can be made based solely on sonographic findings, in particular by a hypoechogenic halo. The hitherto probably under-diagnosed large vessel variant of giant cell arteritis shows characteristic findings with a simple and quick ultrasound examination of the proximal arm arteries. High resolution MRI has been shown to be a promising technique for non-invasive imaging of giant cell arteritis. Mural inflammatory changes of the superficial temporal arteries can be depicted and the cranial involvement pattern can be readily assessed and in combination with MR angiography extracranial involvement can be determined within the same investigation. Aortitis is a feared complication of giant cell arteritis but can be detected and inflammatory stenoses of the aortic branch vessels can also be revealed. In the hands of an experienced operator ultrasonography can be regarded as the non-invasive imaging modality of first choice whereas MRI is more expensive and may not be as widely available. However, its imaging acquisition is standardized and is more observer-independent. Reading of the images is a routine task for a vascular radiologist and larger areas of the vasculature can be simultaneously assessed.

Difference in enhancement between spin echo and 3-dimensional fast spoiled gradient recalled acquisition in steady state magnetic resonance imaging of brain metastasis at 3-T magnetic resonance imaging

OBJECTIVE

To compare the enhancement of brain metastasis between 3-dimensional fast spoiled gradient recalled acquisition in the steady state (3DFSPGR) and spin echo (SE) T1-weighted imaging at 3-T magnetic resonance imaging.

METHODS

The subjects comprised 18 patients with 81 suspected brain metastases. Axial SE and 3DFSPGR images were obtained before and after gadoteridol injection. The signal intensity of each tumor was measured for each sequence; the enhancement and contrast rates were also calculated.

RESULTS

For equivalent slice thicknesses, the enhancement and contrast rates of the 3DFSPGR images were lower than those of the SE images (<0.05), whereas for the thin slices, the rates were higher for the 3DFSPGR images (P < 0.01).

CONCLUSIONS

On 3-T magnetic resonance imaging, the enhancement of 3DFSPGR images was less than that of the SE images under the same conditions, but not to a fatal degree, and thin slice 3DFSPGR imaging is therefore considered to be useful for detecting small lesions, when given a high dose of contrast agent and a suitable scanning delay time.

Perspectives on body MR imaging at ultrahigh field

As investigators consider approaching the challenge of MR imaging at field strengths above 3T, do they follow the same paradigm, and continue to work around the same problems they have encountered thus far at 3T, or do they explore other ways of answering the clinical questions more effectively and more comprehensively? The most immediate problems of imaging at ultrahigh field strength are not unfamiliar, as many of them are still pressing issues at 3T: radiofrequency coils, B1 homogeneity, specific absorption rate, safety, B0 field homogeneity, alterations in tissue contrast, and chemical shift. In this article, these issues are briefly reviewed in terms of how they may affect image quality at field strengths beyond 3T. The authors propose various approaches to overcoming the challenges, and discuss potential applications of ultrahigh field MR imaging as it applies to specific abdominal, pelvic, peripheral vascular, and breast imaging protocols.

A review of MR physics: 3T versus 1.5T

This article illustrates changes in the underlying physics concepts related to increasing the main magnetic field from 1.5T to 3T. The effects of these changes on tissue constants and practical hardware limitations is discussed as they affect scan time, quality, and contrast. Changes in susceptibility artifacts, chemical shift artifacts, and dielectric effects as a result of the increased field strength are also illustrated. Based on these fundamental considerations, an overall understanding of the benefits and constraints of signal-to-noise ratio and contrast-to-noise ratio changes between 1.5T and 3T MR systems is developed.

Bilateral ce-MR angiography of the hands at 3.0 T and 1.5 T: intraindividual comparison of quantitative and qualitative image parameters in healthy volunteers

The purpose of this study was to determine the benefit of bilateral contrast-enhanced MR angiography (ce-MRA) of the hands at 3.0 Tesla (T) compared with an established 1.5-T technique in healthy volunteers. Intraindividual bilateral ce-MRA of the hands was performed at 1.5 T and 3.0 T in 14 healthy volunteers using a timed ultra-fast GRE sequence featuring parallel acquisition. The evaluation comprised measurement of the vessel signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), rating of the image quality and the assessment of artefacts and venous contamination. At 3.0 T, SNR improved up to 95% and CNR up to 129%. The image quality of the larger inflow arteries, the palm arches and common digital arteries was good or sufficient at either magnetic field strengths. However, 3.0-T MRA was clearly superior in the depiction of the digital arteries. Ce-MRA of the hand clearly profits from the use of 3.0 T. Compared with 1.5 T, a substantial increase of CNR is found resulting in a significantly better delineation of the small digital arteries. Saturation affects more the SNR of the perivascular tissue than the contrast-enhanced blood, and thus leads to a marked increase of CNR at 3.0.

Brain Tumor Enhancement in MR Imaging at 3 Tesla

PURPOSE

The purpose of this study was to compare brain and tumor signal characteristics of T1-weighted turbo spin-echo (TSE) and gradient recalled echo (GRE) sequence techniques at 3 T compared to TSE at 1.5 T, focusing on the detection of contrast enhancement, in a standardized animal model of a brain glioma.

MATERIALS AND METHODS

Twelve rats with implanted brain gliomas were evaluated at 1.5 and 3 T using matched hardware configurations. At 1.5 T, scanning was performed using a TSE sequence optimized for field strength (480/15 milliseconds; 125 Hz/Px) with postcontrast scans acquired at multiple time points after gadoteridol injection (0.1 mmol/kg). At 3 T, scanning was performed using the 1.5 T equivalent TSE as well as with TSE and GRE techniques optimized for 3 T. Signal-to-noise ratio (SNR) of brain and tumor and tumor contrast-to-noise ratio (CNR) were evaluated for all techniques at both field strengths.

RESULTS

Postcontrast tumor SNR (63.7 +/- 10.8 vs. 29.5 +/- 4.3; P < 0.0001) and brain SNR (35.8 +/- 1.5 vs. 19.1 +/- 0.7; P < 0.0001) showed significant increase at 3 T using matched TSE. Comparing TSE optimized to each field strength (for optimized gray-white contrast), tumor and brain SNR still showed a significant increase at 3 T of 73% and 56%, respectively (both P < 0.0001). Comparing TSE at 1.5 T and GRE at 3 T, tumor SNR increased by 105%, whereas brain SNR increased by 141% (both P < 0.0001). Tumor CNR with matched TSE increased by 168% (P < 0.0001), with optimized TSE by 111% (P < 0.0001), and with GRE at 3 T versus TSE at 1.5 T by 36% (P < 0.001). With additional adjustments for echo time the gain in tumor CNR for 2D GRE may again reach 60%.

CONCLUSIONS

With TSE at 3 T, the SNR gain comes close to the theoretically expected doubling with an even higher tumor CNR increase. In a clinical like setting at 3 T, where a T1w GRE sequence is used, tumor CNR gain is limited. Contrast dose should therefore not be decreased at 3 T.

Myocardial Perfusion Imaging With Gadobutrol: A Comparison Between 3 and 1.5 Tesla With an Identical Sequence Design

OBJECTIVES

To implement myocardial first-pass perfusion imaging at 3 Tesla and to evaluate the potential benefit with regard to signal parameters in comparison to 1.5 Tesla using identical sequence settings and an intraindividual comparison.

MATERIALS AND METHODS

In 16 volunteers, myocardial first-pass perfusion imaging was performed at 1.5 Tesla (Magnetom Avanto) and 3 Tesla (Magnetom TIM Trio) after injection of 0.05 mmol/kg body weight Gadobutrol using an accelerated saturation recovery TurboFLASH technique (GRAPPA; R=2) at 1.5 and 3 Tesla. Detailed sequence parameters (TR 2.3 milliseconds, TE 0.93 milliseconds, flip angle 15 degrees , bandwidth 780 Hz/px) as well as spatial resolution were kept identical for both field strengths. Artifacts were assessed quantitatively and qualitatively, signal-to-noise ratio (SNR) and contrast enhancement ratio (CER) were calculated from raw data signal intensity-time curves. A linear fit on the upslope was performed for semiquantitative perfusion analysis.

RESULTS

SNR was significantly higher at 3 Tesla than at 1.5 Tesla (35.7+/-11.9 vs. 18.0+/-5.5, P<0.001). CER was significantly greater at 3 Tesla than at 1.5 Tesla (2.2+/-0.9 vs. 1.4+/-0.5, P<0.001). Maximum upslope was significantly higher at 3 Tesla than at 1.5 Tesla (3.3+/-2.4 vs. 2.0+/-1.0, P<0.001). A qualitative examination of all images for artifacts by 2 board-certified radiologists yielded no significant differences between the field strengths.

CONCLUSIONS

Three Tesla significantly improves CER and SNR compared with 1.5 Tesla with identical sequence parameters. In addition, the most important semiquantitative perfusion parameter maximum upslope is significantly increased. This may allow for an improvement of spatial resolution and potentially for a better delineation of perfusion defects. However, further studies are necessary to potentially demonstrate a benefit of 3 Tesla perfusion imaging in a clinical setting.

Gain in signal-to-noise for first-pass contrast-enhanced abdominal MR angiography at 3 Tesla over standard 1.5 Tesla: prediction with a computer model

RATIONALE AND OBJECTIVES

To estimate the gain in signal-to-noise ratio (SNR) in first-pass contrast-enhanced (CE) abdominal magnetic resonance angiography (MRA) at 3.0 T compared with 1.5 T.

MATERIALS AND METHODS

Three protocols were simulated using six contrast agents: gadopentetate dimeglumine (Magnevist, Berlex, Wayne, NJ), gadoteridol (Prohance, Bracco, Princeton, NJ), gadobenate dimeglumine (Multihance, Bracco, Princeton, NJ), gadodiamide (Omniscan, Amersham Health, Princeton, NJ), gadoversetamide (Optimark, Mallinckrodt, St. Louis, MO), and gadofosveset trisodium (MS-325, EPIX Medical, Cambridge, MA). Contrast concentrations were calculated for five abdominal vessels. Based on these data, the gain in SNR during CE abdominal MRA at 3.0 T over 1.5 T was estimated.

RESULTS

In these simulations, peak concentrations in all five target vessels were about 5 mM, 10 mM, and 0.7 mM for protocol 1, protocol 2, and protocol 3, respectively. A gain in SNR at 3 T over 1.5 T during CE abdominal MRA of at least 94% in all five target vessels could be achieved by applying protocol 1 or protocol 2, whereas protocol 3 provided a gain in SNR of 70%.

CONCLUSIONS

Although five of the contrast agents studied fulfill the expectation of providing approximately twice the SNR at 3.0 T versus 1.5 T during CE abdominal MRA, MS-325 offers a gain in SNR of 70% only.

Relaxivity of Gd-based contrast agents on X nuclei with long intrinsic relaxation times in aqueous solutions

The relaxivity of commercially available gadolinium (Gd)-based contrast agents was studied for X-nuclei resonances with long intrinsic relaxation times ranging from 6 s to several hundred seconds. Omniscan in pure 13C formic acid had a relaxivity of 2.9 mM(-1) s(-1), whereas its relaxivity on glutamate C1 and C5 in aqueous solution was approximately 0.5 mM(-1) s(-1). Both relaxivities allow the preparation of solutions with a predetermined short T1 and suggest that in vitro substantial sensitivity gains in their measurement can be achieved. 6Li has a long intrinsic relaxation time, on the order of several minutes, which was strongly affected by the contrast agents. Relaxivity ranged from approximately 0.1 mM(-1) s(-1) for Omniscan to 0.3 for Magnevist, whereas the relaxivity of Gd-DOTP was at 11 mM(-1) s(-1), which is two orders of magnitude higher. Overall, these experiments suggest that the presence of 0.1- to 10-microM contrast agents should be detectable, provided sufficient sensitivity is available, such as that afforded by hyperpolarization, recently introduced to in vivo imaging.

Detection of brain metastasis at 3T: comparison among SE, IR-FSE and 3D-GRE sequences

The objective of this study is to compare the detectability of brain metastases at 3T among three contrast-enhanced sequences, spin-echo (SE) sequence, inversion recovery fast SE (IR-FSE) sequence (both with section thickness of 6 mm), and three-dimensional fast spoiled gradient-echo (3D fast SPGR) sequence with 1.4 mm isotropic voxel. First, phantom studies were performed to quantify the contrast-enhancement ratio (CER) with three sequences. In 21 consecutive patients with brain metastases, axial images of three sequences at 3T were obtained after administration of gadoteridol. Two neuroradiologists assessed the detectability of brain metastases for the three sequences. In the phantom study, no evident difference in the CER was demonstrated among three sequences. Significantly more brain metastases were detected with 3D fast SPGR than with SE and IR-FSE (a total of 97 lesions with 3D fast SPGR vs. 64 with SE and 63 with IR-FSE). In particular, 3D fast SPGR was superior to the other two sequences in detection of the small lesions (<3 mm). At 3T, the contrast-enhanced 3D fast SPGR with 1.4 mm isotropic voxel is clinically more valuable for detecting small brain metastases than the SE and IR-FSE with section thickness of 6 mm.

MR lymphangiography using dendrimer-based contrast agents: A comparison at 1.5T and 3.0T

Most macromolecular contrast agents (CAs) show lower r1 and higher r2 relaxivities at 3.0T than at 1.5T. MR lymphangiography in mice using a macromolecular G6 dendrimer-based CA was serially performed and compared at both 1.5T and 3.0T. The r1 and r2 relaxivities of the G6 CA were 25 and 78/s/mM at 1.5T and 17 and 82/s/mM at 3.0T, respectively. The lymph node (LN)-to-fat ratios (LN signal intensity (SI)/fat SI) of T1-weighted 3D-fast spoiled gradient-echo (3D-FSPGR) were 3.2+/-0.4 (mean+/-standard deviation (SD)) at 1.5T and 2.7+/-0.3 at 3.0T (P=0.021), and the LN-to-fat ratios of T2/T1-weighted 3D-fast imaging employing steady-state acquisition with phase cycling (3D-FIESTA-C) were 1.8+/-0.2 at 1.5T and 1.2+/-0.4 at 3.0T (P=0.003). Although 3D-FSPGR successfully delineated the LNs at both 1.5T and 3.0T, 3D-FIESTA-C at 3.0T failed to visualize the LNs.

Imaging the female pelvis at 3.0 T

Three-Tesla whole body imaging is rapidly becoming part of routine clinical practice. Although it is generally thought that pelvic imaging at 3.0 T will be beneficial because of increased signal to noise and greater spectral separation, adjustments in protocol and sequence parameters are necessary to optimize image quality. The question remains as to whether 3.0-T imaging will offer further benefits beyond 1.5 T in terms of lesion characterization and functional imaging. This article aims to address safety concerns and to illustrate the potential benefits and technical challenges of imaging the female pelvis at 3.0 T. Imaging protocols and sequence parameters for routine gynecologic indications are suggested, and potential clinical applications at 3.0 T are discussed such as magnetic resonance spectroscopy, perfusion, diffusion weighted imaging, and the use of alternate contrast agents.

Brain magnetic resonance imaging at 3 Tesla using BLADE compared with standard rectilinear data sampling

OBJECTIVES

We sought to evaluate Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction (PROPELLER; BLADE) data acquisition in comparison with standard k-space sampling techniques for axial and sagittal brain imaging at 3 T regarding imaging artifacts.

MATERIAL AND METHODS

Forty patients who gave consent were included in a prospective comparison of standard and PROPELLER (BLADE) k-space sampling techniques. All examinations were performed at 3 T with comparison of standard T2-weighted fluid-attenuated inversion recovery (FLAIR) to PROPELLER T2-weighted FLAIR in the axial image orientation and standard T1-weighted gradient echo to PROPELLER T1-weighted FLAIR in the sagittal image orientation. Imaging protocols were matched for spatial resolution, with data evaluation performed by 2 experienced neuroradiologists. Image data were compared regarding various image artifacts and overall image quality. Reader agreement was assessed by Cohen's kappa statistics.

RESULTS

PROPELLER T2-weighted axial data acquisition showed significantly less pulsation and Gibb's artifacts than the standard T2-weighted scan. Even without motion correction, the frequency of ghosting (motion) artifacts was substantially lower in the PROPELLER T2-weighted data and readers concordantly (kappa = 1) rated PROPELLER as better than or equal to the standard T2-weighted scan in the majority of cases (95%; P < 0.0001). In the comparison of sagittal T1-weighted data sets, readers showed only fair agreement (kappa = 0.24) and noted consistent wrap artifacts in PROPELLER T1-weighted FLAIR.

CONCLUSION

PROPELLER (BLADE) brain magnetic resonance imaging is also applicable at 3 T. In addition to minimizing motion artifacts, the PROPELLER acquisition scheme reduces other magnetic resonance artifacts that would otherwise degrade scan quality.

High resolution 3T MRI for the assessment of cervical and superficial cranial arteries in giant cell arteritis

A new high-resolution MR protocol for the combined assessment of neurovascular arterial anatomy and subsequent evaluation of inflammatory disease in cranial vessels walls has been investigated. First-pass contrast-enhanced MR angiography (CE-MRA) in combination with parallel imaging at high field permits the depiction of the neurovascular geometry with large coverage, including the aortic arch, supraaortic vessels, and almost the entire head, with high, submillimeter detail. Utilizing the remaining contrast agent, postcontrast T(1)-weighted turbo spin-echo (TSE) imaging was used to generate late enhancement images of the vessel walls to assess the morphology and potential inflammatory changes in cranial arteries with high in-plane (195 x 260 microm(2)) spatial resolution. As a result, a combined analysis of neurovascular arterial anatomy as well as cranial vessel wall inflammations could be achieved in less than 45 minutes in all studies. The feasibility and clinical value for the diagnosis of rheumatologic diseases and simultaneous arteriosclerotic involvement was demonstrated in seven patients with suspected giant cell arteritis (GCA). Excellent CE-MRA image quality could be achieved and even vascular geometry of small superficial cranial arteries could be successfully visualized using single dose (0.1 mmol/kg) contrast agent administration and a dedicated phased-array head and neck coil at 3T.

Delivery of chemotherapy and antibodies across the blood-brain barrier and the role of chemoprotection, in primary and metastatic brain tumors: report of the Eleventh Annual Blood-Brain Barrier Consortium meeting

Although knowledge of molecular biology and cellular physiology has advanced at a rapid pace, much remains to be learned about delivering chemotherapy and antibodies across the blood-brain barrier (BBB) for the diagnosis and treatment of central nervous system (CNS) disease. A meeting, partially funded by an NIH R13 grant, was convened to discuss the state of the science, current knowledge gaps, and future directions in the delivery of drugs and proteins to the CNS, for the treatment of primary and metastatic brain tumors. Meeting topics included CNS metastases and the BBB, and chemoprotection and chemoenhancement in CNS disorders. The discussions regarding CNS metastases generated possibilities of chemoprotection as a means not only to decrease treatment-related toxicity but also to increase chemotherapy dose intensity. The increasing incidence of sanctuary brain metastasis from breast cancer, in part due to the difficulty of monoclonal antibodies (mAbs) such as herceptin to cross the BBB, was one of the most salient "take home" messages of the meeting.

3-T MRI reveals cranial and thoracic inflammatory changes in giant cell arteritis

Giant cell arteritis (GCA) is a diagnostic challenge. The correct diagnosis is needed for immediate initiation of corticosteroid treatment since blindness is a dreaded complication. Typically, the superficial cranial arteries are affected by this granulomatous vasculitis of large- and medium-sized arteries. However, GCA is not limited to the cranial arteries. Involvement of various arteries such as the cervical and thoracic arteries can also occur. Here, we report a case of histologically proven GCA with cranial and extracranial involvement. We illustrate the usefulness of a comprehensive vascular high-resolution magnetic resonance imaging examination that combines assessment of mural inflammatory changes of the small temporal and occipital arteries with the evaluation of extracranial vasculature to assist in the difficult non-invasive diagnosis and to determine the extent of this inflammatory disease.

Investigations into the physicochemical properties of dextran small particulate gadolinium oxide nanoparticles

RATIONALE AND OBJECTIVES

Relatively few studies involving the physicochemical properties of crystalline, nanometer-sized particulate gadolinium complexes have been reported. This is in part because of the challenges associated with making nanoparticulate gadolinium suspensions that are stable in aqueous solution. Small particulate gadolinium oxide (SPGO) and SPGO embedded in albumin microspheres (gadolinium oxide albumin microspheres, GOAM), have been used experimentally as prototype contrast agents for multimodality imaging.

MATERIALS AND METHODS

In the present study, an initial attempt was made to better solubilize SPGO, prevent particle aggregation, and investigate the physicochemical properties of dextran SPGO relevant to its use as a high-field magnetic resonance contrast agent in aqueous solution.

RESULTS

Dextran SPGO demonstrates regular crystalline lattices and has a gadolinium oxide electron diffraction pattern consistent with that of published X-ray powder diffraction (XPD) patterns. The subtraction XPD pattern of dextran SPGO shows diffraction angles and intensities similar, but not identical, to that of published Gd2O3 diffraction patterns. High r2/r1 ratios and magnetic susceptibility studies indicate dextran SPGO can be classified as a superparamagnetic compound. Enhanced relaxivity is observed at high magnetic field strength; largely because of solubilization of SPGO via the surface adherent carbohydrate. Perhaps also contributing to the observed relaxivity enhancement is the ideal lattice structure of the central gadolinium oxide crystal and the effects of sonochemical preparation on nanoparticle physicochemical properties.

CONCLUSIONS

It is anticipated that these studies will help provide a basis for the development of novel nanoparticulate contrast agent platforms capable of improving T1 and T2/T2* contrast for high-field magnetic resonance imaging and molecular imaging.

The Efficacy of Gadobenate Dimeglumine (Gd-BOPTA) at 3 Tesla in Brain Magnetic Resonance Imaging

OBJECTIVES

The objectives of this study were to analyze the differences in contrast enhancement using gadobenate dimeglumine (Gd-BOPTA or MultiHance) at 3 T versus 1.5 T and to compare Gd-BOPTA with a standard gadolinium chelate, gadopentetate dimeglumine (Gd-DTPA or Magnevist), at 3 T in a rat glioma model.

MATERIALS AND METHODS

Twelve rats with surgically implanted gliomas were randomized to either comparing Gd-BOPTA at 1.5 T versus 3 T (n=7) or comparing Gd-BOPTA and Gd-DTPA at 3 T (n=5). Matched T1-weighted spin-echo techniques were used for both comparisons and the order of examinations was randomized. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and lesion enhancement (LE) were evaluated using a region-of-interest analysis. A veterinary histopathologist evaluated all brain specimens.

RESULTS

In the evaluation of Gd-BOPTA at 3 T and 1.5 T, there were significant increases in SNR, LE, and CNR at 3 T. Average increases in brain and tumor SNR were 93% (P<0.0001) and 92% (P<0.0001), respectively. CNR increased by 121% (P<0.0001). Comparison of Gd-BOPTA and Gd-DTPA at 3 T demonstrated significantly higher CNR and LE with Gd-BOPTA. CNR increased by 35% (P=0.002). LE increased by 44% (P=0.03).

CONCLUSIONS

Gd-BOPTA provides significantly higher CNR at 3 T compared with 1.5 T and also demonstrates significantly higher CNR when compared with a standard Gd-chelate at 3 T. As a result of transient protein binding, Gd-BOPTA may be superior to standard gadolinium chelates in neurologic imaging at 3 T.

T1-Weighted Imaging of the Brain at 3 Tesla Using a 2-Dimensional Spoiled Gradient Echo Technique

RATIONALE AND OBJECTIVES

The objective of this study was to evaluate a 2-dimensional spoiled gradient echo (GRE) imaging approach using a very short in-phase TE for routine T1-weighted imaging of the brain at 3 T.

MATERIALS AND METHODS

Patient examinations were compared from a 3 T magnetic resonance (MR) unit located immediately adjacent to a similarly equipped 1.5 T unit. Pre- and postcontrast T1-weighted images were evaluated and compared at 1.5 versus 3 T with a 2-dimensional (2-D) spin echo sequence used at 1.5 T and a 2-D GRE sequence at 3 T. The 2 MR systems used are from the same vendor, use similar 8-channel coils, and use identical gradients. The T1-weighted GRE sequence, used at 3 T, relies on a short TE (2.4 ms) to limit flow-related and susceptibility artifacts. Region-of-interest analysis was performed on 16 different sagittal patient examinations at both field strengths (32 total) and similarly on 10 different pre- and postcontrast axial examinations (40 total). Four blinded neuroradiologists also evaluated these studies.

RESULTS

Using an off-midline sagittal slice depicting the caudate nucleus (signal-to-noise ratio [SNR] 163 +/- 28 vs. 70 +/- 7, 3 T vs. 1.5 T) and corona radiata (SNR 214 +/- 35 vs. 82 +/- 10), 3 T markedly outperformed 1.5 T in both SNR and contrast-to-noise ratio (CNR) (51 +/- 14 vs. 12 +/- 5). On axial imaging, despite a reduction in slice thickness (5 to 3 mm) and scan time (5 to 1 minute), there was no significant difference pre- or postcontrast in SNR and CNR comparing 3 and 1.5 T. On blinded film review, 3 T performed slightly better on sagittal scans than 1.5 T in regard to motion artifacts (reduced), gray-white matter differentiation, and overall image quality. On axial scans, 3 T performed markedly better in all 3 categories both pre- and postcontrast. In regard to overall image quality, 3 T was preferred 9:2 precontrast and 4:1 postcontrast.

CONCLUSIONS

High-quality, thin-section (3-mm) T1-weighted imaging can be readily performed at 3 T using a short TE 2-D GRE technique. This approach offers superior SNR and CNR with reduced motion artifacts and scan time as compared with imaging at 1.5 T and is advocated for routine brain imaging at 3 T. It is robust (used in over 1500 patients to date) and does not experience significant specific absorption ratio limitations, poor tissue contrast, or accentuated motion artifacts like encountered with spin echo T1-weighted imaging at 3 T.

Magnetic Resonance Imaging of the Pancreas at 3.0 Tesla

OBJECTIVES

We sought to perform a preliminary comparison of signal-to-noise ratio (SNR) and image quality for magnetic resonance imaging (MRI) of the pancreas at 1.5 and 3 T.

MATERIALS AND METHODS

Two imaging cohorts were studied using a T2-weighted, single-shot fast spin-echo pulse sequence and a T1-weighted, fat-suppressed 3D gradient-echo pulse sequence. In the first cohort, 4 subjects were imaged using identical imaging parameters before and after contrast administration at 1.5 and 3.0 T. The SNR was quantified for the pancreas as well as for the liver, spleen, and muscle. In a second cohort of 12 subjects in whom the receiver bandwidth was adjusted for field strength, SNR measurements and qualitative rankings of image quality were performed.

RESULTS

In the study cohort using identical imaging parameters at both magnetic field strengths, the mean (SD) ratios of SNR at 3.0 to 1.5 T of the single-shot fast spin-echo images for the pancreas, liver, spleen, and muscle were 1.63 (0.39), 1.82 (0.39), 1.45 (0.18), 2.01 (0.16), respectively. For the precontrast fat-suppressed 3D gradient-echo sequence, the corresponding ratios were 1.28 (0.29), 1.26 (0.30), 1.16 (0.27), and 1.76 (0.45), respectively; for the arterial phase, the corresponding ratios were 2.02 (0.28), 1.60 (0.42), 1.47 (0.26), and 1.94 (0.32), respectively; and for the delayed postcontrast phase, the corresponding ratios were 1.63 (0.51), 2.01 (0.25), 1.66 (0.06), and 2.31 (0.47), respectively. The SNR benefit of 3.0 T was significantly greater on contrast-enhanced as compared with noncontrast T1-weighted 3D gradient-echo images. In the second study cohort, SNR was superior at 3.0 T, although the use of a reduced readout bandwidth at 1.5 T substantially diminished the advantage of the higher field system. With qualitative comparison of images obtained at the 2 magnetic field strengths, the fat-suppressed 3D gradient-echo images obtained at 3.0 T were preferred, whereas the single shot fast spin-echo images obtained at 1.5 T were preferred because of better signal homogeneity.

CONCLUSIONS

Our results in a small cohort of volunteers and patients demonstrate a marked improvement in SNR at 3.0 T compared with 1.5 T (by a factor of 2 in some cases) when identical imaging parameters were used. The SNR advantage at 3.0 T is diminished but persists when the receiver bandwidth is adjusted for magnetic field strength. The results suggest that 3.0 T may offer promise for improved body MRI, although further technical development to optimize SNR and improve signal homogeneity will be needed before its full potential can be achieved.

Rapid vessel prototyping: vascular modeling using 3t magnetic resonance angiography and rapid prototyping technology

OBJECT

Conversion of thoracic aortic vasculature as measured by Magnetic Resonance Imaging into a real physical replica.

MATERIALS AND METHODS

Several procedural steps including data acquisition with contrast enhanced MR Angiography at 3T, data visualization and 3D computer model generation, as well as rapid prototyping were used to construct an in-vitro model of the vessel geometry.

RESULTS

A rapid vessel prototyping process was implemented and used to convert complex vascular geometry of the entire thoracic aorta and major branching arteries into a real physical replica with large anatomical coverage and high spatial resolution.

CONCLUSION

Rapid vessel prototyping permits the creation of a concrete solid replica of a patient's vascular anatomy.

Brain Tumor Enhancement in Magnetic Resonance Imaging

OBJECTIVE

The objective of this study was to compare the difference in lesion enhancement between 1.5 and 3 T using an extracellular gadolinium chelate in a rat brain glioma model.

METHODS

Five rats (CDF Fischer 344) with implanted C6/LacZ brain gliomas were evaluated using matched T1-weighted spin echo techniques and hardware configurations at 1.5 and 3 T. Serial imaging over 10 minutes after gadoteridol (ProHance) administration was performed. Contrast enhancement (CE), signal-to-noise ratios (SNR) for brain and tumor, as well as contrast-to-noise ratios (CNR) were evaluated using region-of-interest (ROI) analysis at both field strengths. All gliomas were also evaluated by histopathology.

RESULTS

CE at 3 T increased by 106% to 137% (all P<0.05) with maximum CE occurring at 5 minutes for both 1.5 and 3 T (9.8+/-2.2 vs 21.1+/-3.5; P=0.0004). At 3 T, SNR increased for normal brain by 66% to 76% (P<0.01) and SNR for tumor increased by 70% to 89% (P<0.01). CNR increased by 101% to 137% (P<0.05) depending on the time postcontrast. The highest CNR for both 1.5 T and 3 T occurred 5 minutes after contrast (1.5 T: 9.4+/-1.1 vs 3 T: 20.3+/-2.4; P<0.0004).

CONCLUSION

Using a standardized animal model and matched scan techniques, this study shows a significant benefit of 3 T compared with 1.5 T in contrast-enhanced brain tumor magnetic resonance imaging.

Routine clinical brain MRI sequences for use at 3.0 Tesla

PURPOSE

To establish image parameters for some routine clinical brain MRI pulse sequences at 3.0 T with the goal of maintaining, as much as possible, the well-characterized 1.5-T image contrast characteristics for daily clinical diagnosis, while benefiting from the increased signal to noise at higher field.

MATERIALS AND METHODS

A total of 10 healthy subjects were scanned on 1.5-T and 3.0-T systems for T(1) and T(2) relaxation time measurements of major gray and white matter structures. The relaxation times were subsequently used to determine 3.0-T acquisition parameters for spin-echo (SE), T(1)-weighted, fast spin echo (FSE) or turbo spin echo (TSE), T(2)-weighted, and fluid-attenuated inversion recovery (FLAIR) pulse sequences that give image characteristics comparable to 1.5 T, to facilitate routine clinical diagnostics. Application of the routine clinical sequences was performed in 10 subjects, five normal subjects and five patients with various pathologies.

RESULTS

T(1) and T(2) relaxation times were, respectively, 14% to 30% longer and 12% to 19% shorter at 3.0 T when compared to the values at 1.5 T, depending on the region evaluated. When using appropriate parameters, routine clinical images acquired at 3.0 T showed similar image characteristics to those obtained at 1.5 T, but with higher signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), which can be used to reduce the number of averages and scan times. Recommended imaging parameters for these sequences are provided.

CONCLUSION

When parameters are adjusted for changes in relaxation rates, routine clinical scans at 3.0 T can provide similar image appearance as 1.5 T, but with superior image quality and/or increased speed.

Orbital and ocular imaging using 3- and 1.5-T MR imaging systems

The goal of this article is to familiarize general radiologists and clinicians (particularly ophthalmologists, neuro-ophthalmologists, neurologists, and neurosurgeons) with the recent introduction of clinical MR imaging scanners operating at a magnetic field strength of 3-T and to compare them with the more common standard scanners operating at 1.5-T. In this study, MR imaging at 3-T was found to offer superior depiction of orbital and intracranial anatomy and pathologic findings. Spin echo, high spatial resolution, T2-weighted, thin-section MR imaging sequences are especially useful and sensitive at 3-T for the evaluation of orbital, ocular, and intracranial anatomy and pathologic findings. The authors din that time-of-flight (TOF) MR angiography at 3-T surpasses the best MR angiography at 1.5-T and that two-dimensional TOF venography and three-dimensional contrast MR venography at 3-T offer superior visualization of intracranial and facial veins as compared with MR venography at 1.5-T. We believe that with further quality image production and efficient coil design, 3-T MR imaging should hold the promise of playing an important role in the diagnostic imaging evaluation of ocular, orbital, and optic pathway pathologic findings.

Integrated head-thoracic vascular MRI at 3 T: Assessment of cranial, cervical and thoracic involvement of giant cell arteritis

Recently, high-resolution contrast-enhanced MRI has proven to be feasible for noninvasive diagnosis of giant cell arteritis in the cranium. In such examinations, thickening of the vessel wall and/or increased contrast enhancement demonstrate mural inflammation. Typically, the superficial cranial arteries with predominance of the superficial temporal artery are affected by the disease. However, giant cell arteritis can also involve other parts of the vascular system and an examination with extended coverage, including head, neck, and thorax would be advantageous. In this study, a novel approach for integrated head-thoracic vascular MRI at 3 T is presented. Combining first-pass imaging of a single-dose contrast agent with post-contrast imaging permits the assessment of both thoracic aortic geometry and wall, in addition to high-resolution head imaging needed for the analysis of the small superficial cranial arteries. Results from a patient feasibility study are presented and confirm that the protocol can successfully be completed in less than 40 min.

The value of high-field MRI (3T) in the assessment of sellar lesions

The aim of this study was the evaluation of the normal sellar anatomy in vitro and in vivo with high-field MRI and its application in the diagnosis of sellar pathologies in comparison to standard MRI. All high-field MR images were obtained using a 3T Bruker Medspec 30/80 Scanner with a head birdcage transmit/receive coil and an actively shielded gradient system with a maximum gradient strength of 45 mT/m. Firstly an in vitro study of the sella turcica was performed to depict normal pituitary and sellar anatomy at high field. After a pilot-study this sequence-protocol was established: A RARE sequence (TR/TE = 7790/19 ms; matrix size, 512 x 512; RARE factor = 8, FOV, 200 mm) was used for T2-weighted coronal, axial and sagittal images. A 3D gradient echo sequence with magnetization-preparation (MP-RAGE, TR/TE/TI = 33.5/7.6/800 ms, matrix size, 512 x 512; FOV, 200 mm, effective slice thickness, 1.88 mm; 3 averages) was used for acquisition of T1-weighted pre- and post-contrast images. Between January 2002 and March 200458 patients were enrolled in this study. Seven patients were examined for suspected microadenoma and in 51 patients 3T MRI was used to obtain additional information about the sellar lesion already known to be present from standard MRI. In 21 cases the accuracy of the imaging findings was assessed afterwards by comparison with intraoperative findings. The infiltration of the medial cavernous sinus wall was suspected on standard MRI on 15 sides (47%), on high-field MRI on 9 sides (28%) and could be verified by intraoperative findings on 6 sides (19%). Accordingly, sensitivity to infiltration was 83% for 3T and 67% for standard MRI. Specificity was 84% for 3T and 58% for standard MRI. Moreover, high-field MRI revealed microadenomas in 7 patients with a median diameter of 4mm (range 2-9 mm). The segments of the cranial nerves were seen as mean 4 hypointense spots (range 2-5 spots) on high-field MRI in contrast to 3 spots (range 0-4 spots) on standard MRI. This difference was considerably significant (P < 0.001, Wilcoxon rank sum test). The histopathological results revealed pituitary adenoma in 16 patients and non-adenomatous sellar pathologies such as Rathke's cleft cyst, sarcoidosis, meningeoma and metastasis in 5 patients. High-field MRI is superior to standard MRI for the prediction of invasion of adjacent structures in patients with pituitary adenomas and improves surgical planning of sellar lesion.

Enhancement Effects and Relaxivities of Gadolinium-DTPA at 1.5 versus 3 Tesla: A Phantom Study

PURPOSE

To investigate the difference in enhancement effects and relaxivities of the gadolinium chelate at 1.5 and 3 Tesla (T) and to elucidate the contribution of the high magnetic field to contrast enhancement in spin-echo (SE) and gradient-echo (GRE) images.

METHODS

Phantoms containing water with or without gadopentetate dimeglumine (Gd-DTPA) at different concentrations were scanned using 1.5T and 3T MRI scanners of the same manufacturer and under the same temperature conditions and scanning parameters. Relaxivities of gadolinium, R1 and R2, were estimated from serial T1 and T2 values of the phantoms using linear regression. Contrast enhancement ratios in SE and GRE T1-weighted images were compared at 1.5 and 3T.

RESULTS

The R1 and R2 of Gd-DTPA at 1.5 and 3T were 4.79 and 5.14, and 4.50 and 5.09, respectively. Although the relaxivities at 3T were slightly lower than those at 1.5T, the contrast enhancement ratio improved in both SE and GRE images as a result of T1 prolongation of the water at 3T.

CONCLUSION

The decrease in relaxivities of the Gd-DTPA at 3T appears to be so small that T1 prolongation of the water improves contrast enhancement, suggesting a potential clinical advantage in administration of Gd-DTPA at high field strength.

MR imaging of the neonatal brain at 3 Tesla

3 Telsa MR scanners are now becoming more widely available and 3 Telsa is likely to become the filed strength of choice for clinical imaging of the brain. The neonatal brain can be safely and successfully imaged at 3 Telsa. The improved signal to noise afforded by a higher field strength may be used to improve image quality or shorten acquisition times. This may be exploited for conventional T1 and T2 weighted imaging and also for advanced techniques such as diffusion tensor imaging, angiography and functional magnetic resonance studies.