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Jacobson AM, Zhao X, Sommer S, Sadik F, Warden SJ, Newman C, Siegmund T, Allen MR, Surowiec RK. A comprehensive set of ultrashort echo time magnetic resonance imaging biomarkers to assess cortical bone health: A feasibility study at clinical field strength. Bone 2024; 181:117031. [PMID: 38311304 PMCID: PMC10923147 DOI: 10.1016/j.bone.2024.117031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Conventional bone imaging methods primarily use X-ray techniques to assess bone mineral density (BMD), focusing exclusively on the mineral phase. This approach lacks information about the organic phase and bone water content, resulting in an incomplete evaluation of bone health. Recent research highlights the potential of ultrashort echo time magnetic resonance imaging (UTE MRI) to measure cortical porosity and estimate BMD based on signal intensity. UTE MRI also provides insights into bone water distribution and matrix organization, enabling a comprehensive bone assessment with a single imaging technique. Our study aimed to establish quantifiable UTE MRI-based biomarkers at clinical field strength to estimate BMD and microarchitecture while quantifying bound water content and matrix organization. METHODS Femoral bones from 11 cadaveric specimens (n = 4 males 67-92 yrs of age, n = 7 females 70-95 yrs of age) underwent dual-echo UTE MRI (3.0 T, 0.45 mm resolution) with different echo times and high resolution peripheral quantitative computed tomography (HR-pQCT) imaging (60.7 μm voxel size). Following registration, a 4.5 mm HR-pQCT region of interest was divided into four quadrants and used across the multi-modal images. Statistical analysis involved Pearson correlation between UTE MRI porosity index and a signal-intensity technique used to estimate BMD with corresponding HR-pQCT measures. UTE MRI was used to calculate T1 relaxation time and a novel bound water index (BWI), compared across subregions using repeated measures ANOVA. RESULTS The UTE MRI-derived porosity index and signal-intensity-based estimated BMD correlated with the HR-pQCT variables (porosity: r = 0.73, p = 0.006; BMD: r = 0.79, p = 0.002). However, these correlations varied in strength when we examined each of the four quadrants (subregions, r = 0.11-0.71). T1 relaxometry and the BWI exhibited variations across the four subregions, though these differences were not statistically significant. Notably, we observed a strong negative correlation between T1 relaxation time and the BWI (r = -0.87, p = 0.0006). CONCLUSION UTE MRI shows promise for being an innocuous method for estimating cortical porosity and BMD parameters while also giving insight into bone hydration and matrix organization. This method offers the potential to equip clinicians with a more comprehensive array of imaging biomarkers to assess bone health without the need for invasive or ionizing procedures.
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Affiliation(s)
- Andrea M Jacobson
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Dept. of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
| | - Xuandong Zhao
- Dept. of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Stefan Sommer
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus, Zurich, Switzerland; Advanced Clinical Imaging Technology (ACIT), Siemens Healthineers International AG, Zurich, Switzerland.
| | - Farhan Sadik
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.
| | - Stuart J Warden
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University Indianapolis, Indianapolis, IN, USA.
| | - Christopher Newman
- Dept. of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Thomas Siegmund
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA.
| | - Matthew R Allen
- Dept. of Anatomy, Physiology, and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Rachel K Surowiec
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Dept. of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
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Jerban S, Jang H, Chang EY, Bukata S, Du J, Chung CB. Bone Biomarkers Based on Magnetic Resonance Imaging. Semin Musculoskelet Radiol 2024; 28:62-77. [PMID: 38330971 DOI: 10.1055/s-0043-1776431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Magnetic resonance imaging (MRI) is increasingly used to evaluate the microstructural and compositional properties of bone. MRI-based biomarkers can characterize all major compartments of bone: organic, water, fat, and mineral components. However, with a short apparent spin-spin relaxation time (T2*), bone is invisible to conventional MRI sequences that use long echo times. To address this shortcoming, ultrashort echo time MRI sequences have been developed to provide direct imaging of bone and establish a set of MRI-based biomarkers sensitive to the structural and compositional changes of bone. This review article describes the MRI-based bone biomarkers representing total water, pore water, bound water, fat fraction, macromolecular fraction in the organic matrix, and surrogates for mineral density. MRI-based morphological bone imaging techniques are also briefly described.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, La Jolla, California
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, La Jolla, California
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, La Jolla, California
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Susan Bukata
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, California
| | - Jiang Du
- Department of Radiology, University of California, San Diego, La Jolla, California
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, La Jolla, California
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
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Surowiec RK, Does MD, Nyman JS. In Vivo Assessment of Bone Quality Without X-rays. Curr Osteoporos Rep 2024; 22:56-68. [PMID: 38227178 PMCID: PMC11050740 DOI: 10.1007/s11914-023-00856-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/17/2024]
Abstract
PURPOSE OF REVIEW This review summarizes recent advances in the assessment of bone quality using non-X-ray techniques. RECENT FINDINGS Quantitative ultrasound (QUS) provides multiple measurements of bone characteristics based on the propagation of sound through bone, the attenuation of that sound, and different processing techniques. QUS parameters and model predictions based on backscattered signals can discriminate non-fracture from fracture cases with accuracy comparable to standard bone mineral density (BMD). With advances in magnetic resonance imaging (MRI), bound water and pore water, or a porosity index, can be quantified in several long bones in vivo. Since such imaging-derived measurements correlate with the fracture resistance of bone, they potentially provide new BMD-independent predictors of fracture risk. While numerous measurements of mineral, organic matrix, and bound water by Raman spectroscopy correlate with the strength and toughness of cortical bone, the clinical assessment of person's bone quality using spatially offset Raman spectroscopy (SORS) requires advanced spectral processing techniques that minimize contaminating signals from fat, skin, and blood. Limiting exposure of patients to ionizing radiation, QUS, MRI, and SORS has the potential to improve the assessment of fracture risk and track changes of new therapies that target bone matrix and micro-structure.
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Affiliation(s)
- Rachel K Surowiec
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Dr., West Lafayette, IN, 47907, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd., Indianapolis, IN, 46202, USA
| | - Mark D Does
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN, 37232, USA
- Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN, 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1161 21st Ave. S., Nashville, TN, 37232, USA
- Department of Electrical Engineering and Computer Science, Vanderbilt University, 400 24th Ave. S., Nashville, TN, 37212, USA
| | - Jeffry S Nyman
- Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN, 37232, USA.
- Department of Orthopaedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. S., Suite 4200, Nashville, TN, 37232, USA.
- Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, 1211 Medical Center Dr., Nashville, TN, 37212, USA.
- Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, 37212, USA.
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Zampini MA, Sijbers J, Verhoye M, Garipov R. A preparation pulse for fast steady state approach in Actual Flip angle Imaging. Med Phys 2024; 51:306-318. [PMID: 37480220 DOI: 10.1002/mp.16624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/26/2023] [Accepted: 06/20/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Actual Flip angle Imaging (AFI) is a sequence used for B1 mapping, also embedded in the Variable flip angle with AFI for simultaneous estimation of T1 , B1 and equilibrium magnetization. PURPOSE To investigate the design of a preparation module for AFI to allow a fast approach to steady state (SS) without requiring the use of dummy acquisitions. METHODS The features of a preparation module with a B1 insensitive adiabatic pulse, spoiler gradients, and a recovery timeT r e c $T_{rec}$ were studied with simulations and validated via experiments and acquired with different k-space traveling strategies. The robustness of the flip angle of the preparation pulse on the acquired signal is studied. RESULTS When a 90° adiabatic pulse is used, the forthcomingT r e c $T_{rec}$ can be expressed as a function of repetition times and AFI flip angle only asTR 1 ( n + cos α ) / ( 1 - cos 2 α ) $\mathrm{TR_1}(n+\cos \alpha )/(1-\cos ^2\alpha )$ , where n represents the ratio between the two repetition times of AFI. The robustness of the method is demonstrated by showing that using the values further away from 90° still allows for a faster approach to SS than the use of dummy pulses. CONCLUSIONS The preparation module is particularly advantageous for low flip angles, as well as for AFI sequences that sample the center of the k-space early in the sequence, such as centric ordering acquisitions, and for ultrafast EPI-based AFI methods, thus allowing to reduce scanner overhead time.
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Affiliation(s)
- Marco Andrea Zampini
- MR Solutions Ltd., Ashbourne House, Guildford, Surrey, UK
- Bio-Imaging Lab, Department of Biomedical Sciences, University of Antwerp, Belgium
| | - Jan Sijbers
- imec-Vision Lab, Department of Physics, University of Antwerp, Belgium
- μNEURO Research Centre of Excellence, University of Antwerp, Belgium
| | - Marleen Verhoye
- Bio-Imaging Lab, Department of Biomedical Sciences, University of Antwerp, Belgium
- μNEURO Research Centre of Excellence, University of Antwerp, Belgium
| | - Ruslan Garipov
- MR Solutions Ltd., Ashbourne House, Guildford, Surrey, UK
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Cui L, McWalter EJ, Moran G, Venugopal N. Design and development of a novel flexible ultra-short echo time (FUSE) sequence. Magn Reson Med 2023; 90:1905-1918. [PMID: 37392415 DOI: 10.1002/mrm.29784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/28/2023] [Accepted: 06/13/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE To present the validation of a new Flexible Ultra-Short Echo time (FUSE) pulse sequence using a short-T2 phantom. METHODS FUSE was developed to include a range of RF excitation pulses, trajectories, dimensionalities, and long-T2 suppression techniques, enabling real-time interchangeability of acquisition parameters. Additionally, we developed an improved 3D deblurring algorithm to correct for off-resonance artifacts. Several experiments were conducted to validate the efficacy of FUSE, by comparing different approaches for off-resonance artifact correction, variations in RF pulse and trajectory combinations, and long-T2 suppression techniques. All scans were performed on a 3 T system using an in-house short-T2 phantom. The evaluation of results included qualitative comparisons and quantitative assessments of the SNR and contrast-to-noise ratio. RESULTS Using the capabilities of FUSE, we demonstrated that we could combine a shorter readout duration with our improved deblurring algorithm to effectively reduce off-resonance artifacts. Among the different RF and trajectory combinations, the spiral trajectory with the regular half-inc pulse achieves the highest SNRs. The dual-echo subtraction technique delivers better short-T2 contrast and superior suppression of water and agar signals, whereas the off-resonance saturation method successfully suppresses water and lipid signals simultaneously. CONCLUSION In this work, we have validated the use of our new FUSE sequence using a short T2 phantom, demonstrating that multiple UTE acquisitions can be achieved within a single sequence. This new sequence may be useful for acquiring improved UTE images and the development of UTE imaging protocols.
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Affiliation(s)
- Lumeng Cui
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Emily J McWalter
- Department of Mechanical Engineering and Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Gerald Moran
- Siemens Healthcare Limited, Oakville, Ontario, Canada
| | - Niranjan Venugopal
- Department of Radiology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Physics and Astronomy, University of Manitoba, Winnipeg, Manitoba, Canada
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Jones BC, Wehrli FW, Kamona N, Deshpande RS, Vu BTD, Song HK, Lee H, Grewal RK, Chan TJ, Witschey WR, MacLean MT, Josselyn NJ, Iyer SK, Al Mukaddam M, Snyder PJ, Rajapakse CS. Automated, calibration-free quantification of cortical bone porosity and geometry in postmenopausal osteoporosis from ultrashort echo time MRI and deep learning. Bone 2023; 171:116743. [PMID: 36958542 PMCID: PMC10121925 DOI: 10.1016/j.bone.2023.116743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/01/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Assessment of cortical bone porosity and geometry by imaging in vivo can provide useful information about bone quality that is independent of bone mineral density (BMD). Ultrashort echo time (UTE) MRI techniques of measuring cortical bone porosity and geometry have been extensively validated in preclinical studies and have recently been shown to detect impaired bone quality in vivo in patients with osteoporosis. However, these techniques rely on laborious image segmentation, which is clinically impractical. Additionally, UTE MRI porosity techniques typically require long scan times or external calibration samples and elaborate physics processing, which limit their translatability. To this end, the UTE MRI-derived Suppression Ratio has been proposed as a simple-to-calculate, reference-free biomarker of porosity which can be acquired in clinically feasible acquisition times. PURPOSE To explore whether a deep learning method can automate cortical bone segmentation and the corresponding analysis of cortical bone imaging biomarkers, and to investigate the Suppression Ratio as a fast, simple, and reference-free biomarker of cortical bone porosity. METHODS In this retrospective study, a deep learning 2D U-Net was trained to segment the tibial cortex from 48 individual image sets comprised of 46 slices each, corresponding to 2208 training slices. Network performance was validated through an external test dataset comprised of 28 scans from 3 groups: (1) 10 healthy, young participants, (2) 9 postmenopausal, non-osteoporotic women, and (3) 9 postmenopausal, osteoporotic women. The accuracy of automated porosity and geometry quantifications were assessed with the coefficient of determination and the intraclass correlation coefficient (ICC). Furthermore, automated MRI biomarkers were compared between groups and to dual energy X-ray absorptiometry (DXA)- and peripheral quantitative CT (pQCT)-derived BMD. Additionally, the Suppression Ratio was compared to UTE porosity techniques based on calibration samples. RESULTS The deep learning model provided accurate labeling (Dice score 0.93, intersection-over-union 0.88) and similar results to manual segmentation in quantifying cortical porosity (R2 ≥ 0.97, ICC ≥ 0.98) and geometry (R2 ≥ 0.82, ICC ≥ 0.75) parameters in vivo. Furthermore, the Suppression Ratio was validated compared to established porosity protocols (R2 ≥ 0.78). Automated parameters detected age- and osteoporosis-related impairments in cortical bone porosity (P ≤ .002) and geometry (P values ranging from <0.001 to 0.08). Finally, automated porosity markers showed strong, inverse Pearson's correlations with BMD measured by pQCT (|R| ≥ 0.88) and DXA (|R| ≥ 0.76) in postmenopausal women, confirming that lower mineral density corresponds to greater porosity. CONCLUSION This study demonstrated feasibility of a simple, automated, and ionizing-radiation-free protocol for quantifying cortical bone porosity and geometry in vivo from UTE MRI and deep learning.
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Affiliation(s)
- Brandon C Jones
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Felix W Wehrli
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Nada Kamona
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Rajiv S Deshpande
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Brian-Tinh Duc Vu
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Hee Kwon Song
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Hyunyeol Lee
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; School of Electronics Engineering, Kyungpook National University, 80 Daehakro, Bukgu, Daegu 41566, Republic of Korea.
| | - Rasleen Kaur Grewal
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Trevor Jackson Chan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Walter R Witschey
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Matthew T MacLean
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Nicholas J Josselyn
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Data Science, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609, United States of America.
| | - Srikant Kamesh Iyer
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America
| | - Mona Al Mukaddam
- Department of Medicine, Division of Endocrinology, Perelman School of Medicine, University of Pennsylvania, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States of America.
| | - Peter J Snyder
- Department of Medicine, Division of Endocrinology, Perelman School of Medicine, University of Pennsylvania, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States of America.
| | - Chamith S Rajapakse
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
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Ketsiri T, Uppuganti S, Harkins KD, Gochberg DF, Nyman JS, Does MD. T 1 relaxation of bound and pore water in cortical bone. NMR IN BIOMEDICINE 2023; 36:e4878. [PMID: 36418236 DOI: 10.1002/nbm.4878] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/01/2022] [Accepted: 11/22/2022] [Indexed: 06/16/2023]
Abstract
MRI measures of bound and/or pore water concentration in cortical bone offer potential diagnostics of bone fracture risk. The transverse relaxation characteristics of both bound and pore water are relatively well understood and have been used to design clinical MRI pulse sequences to image each water pool quantitatively. However, these methods are also sensitive to longitudinal relaxation characteristics, which have been less well studied. Here, spectroscopic relaxometry measurements of 31 human cortical bone specimens provided a more detailed picture of T 1 of both bound and pore water. The results included mean, standard deviation, and range of T 1 spectra from both bound and pore water, as well as novel presentations of the 2D T 1 - T 2 distribution of pore water. Importantly, for each sample the pore water T 1 spectrum was found to span more than one order of magnitude and varied substantially across the 31 sample studies. Because many existing methods assume pore water T 1 to be mono-exponential and constant across individuals, the results were used to compute the potential effect neglecting this intra- and intersample T 1 variation on accurate MRI measurement of both bound and pore water concentrations. The greatest effect was found for adiabatic inversion recovery (AIR) based measurements of bound water concentration, which showed an average of 8.8% and as much as 37% error when using a common mono-exponential assumption of pore water T 1 . Despite these errors, the simulated AIR measurements were still moderately well correlated with the bound water concentrations derived from the spectroscopic data.
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Affiliation(s)
- Thammathida Ketsiri
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sasidhar Uppuganti
- Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Veterans Affairs, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kevin D Harkins
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Daniel F Gochberg
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Physics and Astronomy, Vanderbilt University, Nashville, Tennessee, USA
| | - Jeffry S Nyman
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Veterans Affairs, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
- Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mark D Does
- Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Electrical Engineering, Vanderbilt University, Nashville, Tennessee, USA
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Lombardi AF, Ma YJ, Jang H, Jerban S, Du J, Chang EY, Chung CB. Synthetic CT in Musculoskeletal Disorders: A Systematic Review. Invest Radiol 2023; 58:43-59. [PMID: 36070535 PMCID: PMC9742139 DOI: 10.1097/rli.0000000000000916] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Repeated computed tomography (CT) examinations increase patients' ionizing radiation exposure and health costs, making an alternative method desirable. Cortical and trabecular bone, however, have short T2 relaxation times, causing low signal intensity on conventional magnetic resonance (MR) sequences. Different techniques are available to create a "CT-like" contrast of bone, such as ultrashort echo time, zero echo time, gradient-echo, and susceptibility-weighted image MR sequences, and artificial intelligence. This systematic review summarizes the essential technical background and developments of ultrashort echo time, zero echo time, gradient-echo, susceptibility-weighted image MR imaging sequences and artificial intelligence; presents studies on research and clinical applications of "CT-like" MR imaging; and describes their main advantages and limitations. We also discuss future opportunities in research, which patients would benefit the most, the most appropriate situations for using the technique, and the potential to replace CT in the clinical workflow.
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Affiliation(s)
- Alecio F Lombardi
- From the Department of Radiology, University of California San Diego, La Jolla, and the Research Service, Veterans Affairs San Diego Healthcare System, California
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Liu J, Chen JD, Li P, Liao JW, Feng JX, Chen ZY, Cai ZY, Li W, Chen XJ, Su ZH, Lu H, Li SL, Ma YJ. Comprehensive assessment of osteoporosis in lumbar spine using compositional MR imaging of trabecular bone. Eur Radiol 2022; 33:3995-4006. [PMID: 36571604 DOI: 10.1007/s00330-022-09368-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To comprehensively assess osteoporosis in the lumbar spine, a compositional MR imaging technique is proposed to quantify proton fractions for all the water components as well as fat in lumbar vertebrae measured by a combination of a 3D short repetition time adiabatic inversion recovery prepared ultrashort echo time (STAIR-UTE) MRI and IDEAL-IQ. METHODS A total of 182 participants underwent MRI, quantitative CT, and DXA. Lumbar collagen-bound water proton fraction (CBWPF), free water proton fraction (FWPF), total water proton fraction (TWPF), bone mineral density (BMD), and T-score were calculated in three vertebrae (L2-L4) for each subject. The correlations of the CBWPF, FWPF, and TWPF with BMD and T-score were investigated respectively. A comprehensive diagnostic model combining all the water components and clinical characteristics was established. The performances of all the water components and the comprehensive diagnostic model to discriminate between normal, osteopenia, and osteoporosis cohorts were also evaluated using receiver operator characteristic (ROC). RESULTS The CBWPF showed strong correlations with BMD (r = 0.85, p < 0.001) and T-score (r = 0.72, p < 0.001), while the FWPF and TWPF showed moderate correlations with BMD (r = 0.65 and 0.68, p < 0.001) and T-score (r = 0.47 and 0.49, p < 0.001). The high area under the curve values obtained from ROC analysis demonstrated that CBWPF, FWPF, and TWPF have the potential to differentiate the normal, osteopenia, and osteoporosis cohorts. At the same time, the comprehensive diagnostic model shows the best performance. CONCLUSIONS The compositional MRI technique, which quantifies CBWPF, FWPF, and TWPF in trabecular bone, is promising in the assessment of bone quality. KEY POINTS • Compositional MR imaging technique is able to quantify proton fractions for all the water components (i.e., collagen-bound water proton fraction (CBWPF), free water proton fraction (FWPF), and total water proton fraction (TWPF)) in the human lumbar spine. • The biomarkers derived from the compositional MR imaging technique showed moderate to high correlations with bone mineral density (BMD) and T-score and showed good performance in distinguishing people with different bone mass. • The comprehensive diagnostic model incorporating CBWPF, FWPF, TWPF, and clinical characteristics showed the highest clinical diagnostic capability for the assessment of osteoporosis.
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Affiliation(s)
- Jin Liu
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Jian-Di Chen
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Ping Li
- Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Jian-Wei Liao
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Jia-Xin Feng
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Zi-Yang Chen
- Department of Spinal Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, China
| | - Zhi-Yuan Cai
- Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Wei Li
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Xiao-Jun Chen
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Zhi-Hai Su
- Department of Spinal Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, China
| | - Hai Lu
- Department of Spinal Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, China
| | - Shao-Lin Li
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China. .,Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China.
| | - Ya-Jun Ma
- Department of Radiology, University of California San Diego, 9452 Medical Center Drive, La Jolla, CA, 92037, USA
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10
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Bharadwaj UU, Coy A, Motamedi D, Sun D, Joseph GB, Krug R, Link TM. CT-like MRI: a qualitative assessment of ZTE sequences for knee osseous abnormalities. Skeletal Radiol 2022; 51:1585-1594. [PMID: 35088162 PMCID: PMC9198000 DOI: 10.1007/s00256-021-03987-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 12/15/2021] [Accepted: 12/29/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To qualitatively evaluate the utility of zero echo-time (ZTE) MRI sequences in identifying osseous findings and to compare ZTE with optimized spoiled gradient echo (SPGR) sequences in detecting knee osseous abnormalities. MATERIALS AND METHODS ZTE and standard knee MRI sequences were acquired at 3T in 100 consecutive patients. Three radiologists rated confidence in evaluating osseous abnormalities and image quality on a 5-grade Likert scale in ZTE compared to standard sequences. In a subset of knees (n = 57) SPGR sequences were also obtained, and diagnostic confidence in identifying osseous structures was assessed, comparing ZTE and SPGR sequences. Statistical significance of using ZTE over SPGR was characterized with a paired t-test. RESULTS Image quality of the ZTE sequences was rated high by all reviewers with 278 out of 299 (100 studies, 3 radiologists) scores ≥ 4 on the Likert scale. Diagnostic confidence in using ZTE sequences was rated "very high confidence" in 97%, 85%, 71%, and 73% of the cases for osteophytosis, subchondral cysts, fractures, and soft tissue calcifications/ossifications, respectively. In 74% of cases with osseous findings, reviewer scores indicated confidence levels (score ≥ 3) that ZTE sequences improved diagnostic certainty over standard sequences. The diagnostic confidence in using ZTE over SPGR sequences for osseous structures as well as abnormalities was favorable and statistically significant (p < 0.01). CONCLUSION Incorporating ZTE sequences in the standard knee MRI protocol was technically feasible and improved diagnostic confidence for osseous findings in relation to standard MR sequences. In comparison to SPGR sequences, ZTE improved assessment of osseous abnormalities.
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Affiliation(s)
- Upasana Upadhyay Bharadwaj
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA.
| | - Adam Coy
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
- Musculoskeletal Radiology, Vision Radiology, Dallas, TX, USA
| | - Daria Motamedi
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
| | - Dong Sun
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gabby B Joseph
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
| | - Roland Krug
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
| | - Thomas M Link
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
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11
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Terracciano R, Carcamo-Bahena Y, Royal ALR, Demarchi D, Labis JS, Harris JD, Weiner BK, Gupta N, Filgueira CS. Quantitative high-resolution 7T MRI to assess longitudinal changes in articular cartilage after anterior cruciate ligament injury in a rabbit model of post-traumatic osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100259. [DOI: 10.1016/j.ocarto.2022.100259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/28/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
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12
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Sandberg JK, Young VA, Yuan J, Hargreaves BA, Wishah F, Vasanawala SS. Zero echo time pediatric musculoskeletal magnetic resonance imaging: initial experience. Pediatr Radiol 2021; 51:2549-2560. [PMID: 34156504 DOI: 10.1007/s00247-021-05125-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/24/2021] [Accepted: 06/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Projection radiography (XR) is often supplemented by both CT (to evaluate osseous structures with ionizing radiation) and MRI (for marrow and soft-tissue assessment). Zero echo time (ZTE) MR imaging produces a "CT-like" osseous contrast that might obviate CT. OBJECTIVE This study investigated our institution's initial experience in implementing an isotropic ZTE MR imaging sequence for pediatric musculoskeletal examinations. MATERIALS AND METHODS Pediatric patients referred for extremity MRI at 3 tesla (T) underwent ZTE MR imaging to yield images with contrast similar to that of CT. A radiograph-like image was also created with ray-sum image processing. We assessed ZTE-CT/XR anatomical image quality (Sanat) from 0 (nondiagnostic) to 5 (outstanding). Further, we made image comparisons on a 5-point scale (Scomp) (range of -2 = conventional CT/XR greater anatomical delineation to +2 = ZTE-CT/XR greater anatomical delineation; 0=same) for three cohorts: (1) ZTE-XR to conventional radiography, (2) ZTE-CT to conventional CT and (3) pathological lesion assessment on ZTE-XR to conventional radiography. We measured cortical thickness of ZTE-XR and ZTE-CT and compared these with conventional imaging. We calculated confidence interval of proportions, Wilcoxon rank sum test and intraclass correlation coefficients for inter-reader agreement. RESULTS Cohorts 1, 2 and 3 consisted of 40, 20 and 35 cases, respectively (age range 0.6-23.0 years). ZTE-CT versus CT and ZTE-XR versus radiography of cortical thicknesses were not significantly different (P=0.55 and P=0.31, respectively). Cortical delineation was rated diagnostic or better (score of 3, 4 or 5) in all cases (confidence interval of proportions = 100%) for ZTE-CT/XR. Similarly, intramedullary cavity delineation was rated diagnostic or better in all cases for ZTE-CT, and ZTE-XR was at least diagnostic in 58-63% of cases. For cohort 2, cortex and intramedullary cavity Scomp for ZTE-CT was comparable to those of conventional CT, with confidence interval of proportion (sum of score of -1 to +2) of 93-100% and 95%, respectively. Pathology visualized on ZTE-CT/XR was comparable; Scomp confidence interval of proportions was 95%/97-100%, with improved delineation of non-displaced fractures on ZTE-XR. Readers had moderate to near-perfect intraclass correlation coefficient (range=0.60-0.93). CONCLUSION Implementation of a diagnostic-quality ZTE MRI sequence in the pediatric population is feasible and can be performed as a complementary pulse sequence to enhance musculoskeletal MRI studies. Compared to conventional CT, ZTE has comparable cortical delineation, intramedullary cavity and pathology visualization. While not intended as a replacement for conventional radiography, ZTE-XR provides similar visualization of pathology.
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Affiliation(s)
- Jesse K Sandberg
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA.
| | - Victoria A Young
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
| | - Jianmin Yuan
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
| | - Brian A Hargreaves
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
| | - Fidaa Wishah
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
| | - Shreyas S Vasanawala
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
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13
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Foessl I, Bassett JHD, Bjørnerem Å, Busse B, Calado Â, Chavassieux P, Christou M, Douni E, Fiedler IAK, Fonseca JE, Hassler E, Högler W, Kague E, Karasik D, Khashayar P, Langdahl BL, Leitch VD, Lopes P, Markozannes G, McGuigan FEA, Medina-Gomez C, Ntzani E, Oei L, Ohlsson C, Szulc P, Tobias JH, Trajanoska K, Tuzun Ş, Valjevac A, van Rietbergen B, Williams GR, Zekic T, Rivadeneira F, Obermayer-Pietsch B. Bone Phenotyping Approaches in Human, Mice and Zebrafish - Expert Overview of the EU Cost Action GEMSTONE ("GEnomics of MusculoSkeletal traits TranslatiOnal NEtwork"). Front Endocrinol (Lausanne) 2021; 12:720728. [PMID: 34925226 PMCID: PMC8672201 DOI: 10.3389/fendo.2021.720728] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/21/2021] [Indexed: 12/16/2022] Open
Abstract
A synoptic overview of scientific methods applied in bone and associated research fields across species has yet to be published. Experts from the EU Cost Action GEMSTONE ("GEnomics of MusculoSkeletal Traits translational Network") Working Group 2 present an overview of the routine techniques as well as clinical and research approaches employed to characterize bone phenotypes in humans and selected animal models (mice and zebrafish) of health and disease. The goal is consolidation of knowledge and a map for future research. This expert paper provides a comprehensive overview of state-of-the-art technologies to investigate bone properties in humans and animals - including their strengths and weaknesses. New research methodologies are outlined and future strategies are discussed to combine phenotypic with rapidly developing -omics data in order to advance musculoskeletal research and move towards "personalised medicine".
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Affiliation(s)
- Ines Foessl
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrine Lab Platform, Medical University of Graz, Graz, Austria
| | - J. H. Duncan Bassett
- Molecular Endocrinology Laboratory, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Åshild Bjørnerem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Norwegian Research Centre for Women’s Health, Oslo University Hospital, Oslo, Norway
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Ângelo Calado
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
| | | | - Maria Christou
- Department of Hygiene and Epidemiology, Medical School, University of Ioannina, Ioannina, Greece
| | - Eleni Douni
- Institute for Bioinnovation, Biomedical Sciences Research Center “Alexander Fleming”, Vari, Greece
- Department of Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Imke A. K. Fiedler
- Department of Osteology and Biomechanics, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - João Eurico Fonseca
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon Academic Medical Centre, Lisbon, Portugal
| | - Eva Hassler
- Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University Graz, Graz, Austria
| | - Wolfgang Högler
- Department of Paediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Erika Kague
- The School of Physiology, Pharmacology and Neuroscience, Biomedical Sciences, University of Bristol, Bristol, United Kingdom
| | - David Karasik
- Azrieli Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
| | - Patricia Khashayar
- Center for Microsystems Technology, Imec and Ghent University, Ghent, Belgium
| | - Bente L. Langdahl
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Victoria D. Leitch
- Innovative Manufacturing Cooperative Research Centre, Royal Melbourne Institute of Technology, School of Engineering, Carlton, VIC, Australia
| | - Philippe Lopes
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Georgios Markozannes
- Department of Hygiene and Epidemiology, Medical School, University of Ioannina, Ioannina, Greece
| | | | | | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, Medical School, University of Ioannina, Ioannina, Greece
- Department of Health Services, Policy and Practice, Center for Research Synthesis in Health, School of Public Health, Brown University, Providence, RI, United States
| | - Ling Oei
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Drug Treatment, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Pawel Szulc
- INSERM UMR 1033, University of Lyon, Lyon, France
| | - Jonathan H. Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit, Bristol Medical School, Bristol, University of Bristol, Bristol, United Kingdom
| | - Katerina Trajanoska
- Department of Internal Medicine, Erasmus MC Rotterdam, Rotterdam, Netherlands
| | - Şansın Tuzun
- Physical Medicine & Rehabilitation Department, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Amina Valjevac
- Department of Human Physiology, School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Bert van Rietbergen
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Graham R. Williams
- Molecular Endocrinology Laboratory, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom
| | - Tatjana Zekic
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia
| | | | - Barbara Obermayer-Pietsch
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrine Lab Platform, Medical University of Graz, Graz, Austria
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14
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Talebi M, Abbasi-Rad S, Malekzadeh M, Shahgholi M, Ardakani AA, Foudeh K, Rad HS. Cortical Bone Mechanical Assessment via Free Water Relaxometry at 3 T. J Magn Reson Imaging 2021; 54:1744-1751. [PMID: 34142413 DOI: 10.1002/jmri.27765] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/19/2021] [Accepted: 05/21/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Investigation of cortical bone using magnetic resonance imaging is a developing field, which uses short/ultrashort echo time (TE) pulse sequences to quantify bone water content and to obtain indirect information about bone microstructure. PURPOSE To improve the accuracy of the previously proposed technique of free water T1 quantification and to seek the relationship between cortical bone free water T1 and its mechanical competence. STUDY TYPE Prospective. SUBJECTS Twenty samples of bovine tibia bone. FIELD STRENGTH/SEQUENCES 3.0 T; ultra-fast two-dimensional gradient echo, Radio frequency-spoiled three-dimensional gradient echo. ASSESSMENT Cortical bone free water T1 was quantified via three different methods: inversion recovery (IR), variable flip angle (VFA), and variable repetition time (VTR). Signal-to-noise ratio was measured by dividing the signal of each segmented sample to background noise. Segmentation was done manually. The effect of noise on T1 quantification was evaluated. Then, the samples were subjected to mechanical compression test to measure the toughness, yield stress, ultimate stress, and Young modulus. STATISTICAL TESTS All the statistical analysis (Shapiro-Wilk, way analysis of variance, paired t test, Pearson correlation, and Bland-Altman plot) were done using SPSS. RESULTS Significant difference was found between T1 quantification groups (P < 0.05). Average T1 of each quantification method differed significantly after adding noise (P < 0.05). VFA-T1 values significantly correlated with toughness (r = -0.68, P < 0.05), ultimate stress (r = -0.71, P < 0.05), and yield stress (r = -0.62, P < 0.05). No significant correlation was found between VTR-T1 values and toughness (P = 0.07), ultimate stress (P = 0.47), yield stress (P = 0.30), and Young modulus (P = 0.39). DATA CONCLUSION Pore water T1 value is associated with bone mechanical competence, and VFA method employing short-TE pulse sequence seems a superior technique to VTR method for this quantification. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: 1.
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Affiliation(s)
- Mahsa Talebi
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran.,The Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrokh Abbasi-Rad
- The Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Malakeh Malekzadeh
- The Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran.,Medical Physics Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Shahgholi
- The Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran.,Department of Mechanical Engineering, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Ali A Ardakani
- Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kimia Foudeh
- Department of Mechanical Engineering, Najafabad Branch, Islamic Azad University, Najafabad, Iran
| | - Hamidreza S Rad
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran.,The Quantitative MR Imaging and Spectroscopy Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran.,Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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15
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Ma YJ, Jerban S, Jang H, Chang D, Chang EY, Du J. Quantitative Ultrashort Echo Time (UTE) Magnetic Resonance Imaging of Bone: An Update. Front Endocrinol (Lausanne) 2020; 11:567417. [PMID: 33071975 PMCID: PMC7531487 DOI: 10.3389/fendo.2020.567417] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022] Open
Abstract
Bone possesses a highly complex hierarchical structure comprised of mineral (~45% by volume), organic matrix (~35%) and water (~20%). Water exists in bone in two forms: as bound water (BW), which is bound to bone mineral and organic matrix, or as pore water (PW), which resides in Haversian canals as well as in lacunae and canaliculi. Magnetic resonance (MR) imaging has been increasingly used for assessment of cortical and trabecular bone. However, bone appears as a signal void on conventional MR sequences because of its short T2*. Ultrashort echo time (UTE) sequences with echo times (TEs) 100-1,000 times shorter than those of conventional sequences allow direct imaging of BW and PW in bone. A series of quantitative UTE MRI techniques has been developed for bone evaluation. UTE and adiabatic inversion recovery prepared UTE (IR-UTE) sequences have been developed to quantify BW and PW. UTE magnetization transfer (UTE-MT) sequences have been developed to quantify collagen backbone protons, and UTE quantitative susceptibility mapping (UTE-QSM) sequences have been developed to assess bone mineral.
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Affiliation(s)
- Ya-Jun Ma
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Douglas Chang
- Department of Orthopedic Surgery, University of California, San Diego, San Diego, CA, United States
| | - Eric Y. Chang
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Jiang Du
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
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16
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Jerban S, Ma Y, Wei Z, Jang H, Chang EY, Du J. Quantitative Magnetic Resonance Imaging of Cortical and Trabecular Bone. Semin Musculoskelet Radiol 2020; 24:386-401. [PMID: 32992367 DOI: 10.1055/s-0040-1710355] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Bone is a composite material consisting of mineral, organic matrix, and water. Water in bone can be categorized as bound water (BW), which is bound to bone mineral and organic matrix, or as pore water (PW), which resides in Haversian canals as well as in lacunae and canaliculi. Bone is generally classified into two types: cortical bone and trabecular bone. Cortical bone is much denser than trabecular bone that is surrounded by marrow and fat. Magnetic resonance (MR) imaging has been increasingly used for noninvasive assessment of both cortical bone and trabecular bone. Bone typically appears as a signal void with conventional MR sequences because of its short T2*. Ultrashort echo time (UTE) sequences with echo times 100 to 1,000 times shorter than those of conventional sequences allow direct imaging of BW and PW in bone. This article summarizes several quantitative MR techniques recently developed for bone evaluation. Specifically, we discuss the use of UTE and adiabatic inversion recovery prepared UTE sequences to quantify BW and PW, UTE magnetization transfer sequences to quantify collagen backbone protons, UTE quantitative susceptibility mapping sequences to assess bone mineral, and conventional sequences for high-resolution imaging of PW as well as the evaluation of trabecular bone architecture.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, California
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, California
| | - Zhao Wei
- Department of Radiology, University of California, San Diego, California
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, California.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Jiang Du
- Department of Radiology, University of California, San Diego, California
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17
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Ahmadian S, Jabbari I, Bagherimofidi SM, Saligheh Rad H. Characterization of hardware-related spatial distortions for IR-PETRA pulse sequence using a brain specific phantom. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:213-228. [PMID: 32632747 DOI: 10.1007/s10334-020-00863-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Inversion recovery-pointwise encoding time reduction with radial acquisition (IR-PETRA) is an effective magnetic resonance (MR) pulse sequence in generating pseudo-CTs. The hardware-related spatial-distortion (HRSD) in MR images potentially deteriorates the accuracy of pseudo-CTs. Thus, we aimed at characterizing HRSD for IR-PETRA. MATERIALS AND METHODS gross-HRSDoverall (Euclidean-sum of gross-HRSDi (i = x, y, z)) for IR-PETRA was assessed using a brain-specific phantom for two MR scanners (1.5 T-Aera and 3.0 T-Prisma). Moreover, hardware imperfections were analyzed by determining gradient-nonlinearity spatial-distortion (GNSD) and B0-inhomogeneity spatial-distortion (B0ISD) for magnetization-prepared rapid acquisition gradient-echo (MP-RAGE) which has well-known distortion characteristics. RESULTS In 3.0 T, maximum of gross-GNSDoverall (Euclidean-sum of gross-GNSDi) and gross-B0ISD for MP-RAGE was 2.77 mm and 0.57 mm, respectively. For this scanner, the mean and maximum of gross-HRSDoverall for IR-PETRA were 0.63 ± 0.38 mm and 1.91 mm, respectively. In 1.5 T, maximum of gross-GNSDoverall and gross-B0ISD for MP-RAGE was 3.41 mm and 0.78 mm, respectively. The mean and maximum of gross-HRSDoverall for IR-PETRA were 1.02 ± 0.50 mm and 3.12 mm, respectively. DISCUSSION The spatial accuracy of MR images, besides being impacted by hardware performance, scanner capabilities, and imaging parameters, is mainly affected by its imaging strategy and data acquisition scheme. In 3.0 T, even without applying vendor correction algorithms, spatial accuracy of IR-PETRA image is sufficient for generating pseudo-CTs. In 1.5 T, distortion-correction is required to provide this accuracy.
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Affiliation(s)
- Sima Ahmadian
- Faculty of Advanced Sciences and Technologies, University of Isfahan, Isfahan, Iran
| | - Iraj Jabbari
- Faculty of Advanced Sciences and Technologies, University of Isfahan, Isfahan, Iran.
| | - Seyed Mehdi Bagherimofidi
- Department of Biomedical Engineering, Aliabad Katoul Branch, Islamic Azad University, Aliabad-e-Katoul, Iran
| | - Hamidreza Saligheh Rad
- Quantitative MR Imaging and Spectroscopy Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran
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18
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Mastrogiacomo S, Dou W, Jansen JA, Walboomers XF. Magnetic Resonance Imaging of Hard Tissues and Hard Tissue Engineered Bio-substitutes. Mol Imaging Biol 2020; 21:1003-1019. [PMID: 30989438 DOI: 10.1007/s11307-019-01345-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Magnetic resonance imaging (MRI) is a non-invasive diagnostic imaging tool based on the detection of protons into the tissues. This imaging technique is remarkable because of high spatial resolution, strong soft tissue contrast and specificity, and good depth penetration. However, MR imaging of hard tissues, such as bone and teeth, remains challenging due to low proton content in such tissues as well as to very short transverse relaxation times (T2). To overcome these issues, new MRI techniques, such as sweep imaging with Fourier transformation (SWIFT), ultrashort echo time (UTE) imaging, and zero echo time (ZTE) imaging, have been developed for hard tissues imaging with promising results reported. Within this article, MRI techniques developed for the detection of hard tissues, such as bone and dental tissues, have been reviewed. The main goal was thus to give a comprehensive overview on the corresponding (pre-) clinical applications and on the potential future directions with such techniques applied. In addition, a section dedicated to MR imaging of novel biomaterials developed for hard tissue applications was given as well.
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Affiliation(s)
- Simone Mastrogiacomo
- Department of Biomaterials, Radboud University Medical Center, Philips van Leijdenlaan 25, 6525 EX, Nijmegen, The Netherlands.
- Laboratory of Functional and Molecular Imaging, NINDS, National Institutes of Health, Building 10, 5S261, Bethesda, MD, 20892, USA.
| | - Weiqiang Dou
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
- GE Healthcare, MR Research, Beijing, People's Republic of China
| | - John A Jansen
- Department of Biomaterials, Radboud University Medical Center, Philips van Leijdenlaan 25, 6525 EX, Nijmegen, The Netherlands
| | - X Frank Walboomers
- Department of Biomaterials, Radboud University Medical Center, Philips van Leijdenlaan 25, 6525 EX, Nijmegen, The Netherlands
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Quantifying cortical bone free water using short echo time (STE-MRI) at 1.5 T. Magn Reson Imaging 2020; 71:17-24. [PMID: 32387394 DOI: 10.1016/j.mri.2020.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/12/2020] [Accepted: 04/19/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of our study was to use Dual-TR STE-MR protocol as a clinical tool for cortical bone free water quantification at 1.5 T and validate it by comparing the obtained results (MR-derived results) with dehydration results. METHODS Human studies were compliant with HIPPA and were approved by the institutional review board. Short Echo Time (STE) MR imaging with different Repetition Times (TRs) was used for quantification of cortical bone free water T1 (T1free) and concentration (ρfree). The proposed strategy was compared with the dehydration technique in seven bovine cortical bone samples. The agreement between the two methods was quantified by using Bland and Altman analysis. Then we applied the technique on a cross-sectional population of thirty healthy volunteers (18F/12M) and examined the association of the biomarkers with age. RESULTS The mean values of ρfree for bovine cortical bone specimens were quantified as 4.37% and 5.34% by using STE-MR and dehydration techniques, respectively. The Bland and Altman analysis showed good agreement between the two methods along with the suggestion of 0.99% bias between them. Strong correlations were also reported between ρfree (r2 = 0.62) and T1free and age (r2 = 0.8). The reproducibility of the method, evaluated in eight subjects, yielded an intra-class correlation of 0.95. CONCLUSION STE-MR imaging with dual-TR strategy is a clinical solution for quantifying cortical bone ρfree and T1free.
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Guo T, Ma Y, Jerban S, Jang H, Zhao W, Chang EY, Chen M, Bydder GM, Du J. T 1 measurement of bound water in cortical bone using 3D adiabatic inversion recovery ultrashort echo time (3D IR-UTE) Cones imaging. Magn Reson Med 2019; 84:634-645. [PMID: 31863519 DOI: 10.1002/mrm.28140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/04/2019] [Accepted: 11/30/2019] [Indexed: 11/11/2022]
Abstract
PURPOSE We describe the measurement of bound water T1 ( T 1 BW ) of cortical bone in vitro and in vivo with a 3D adiabatic inversion recovery ultrashort echo time (IR-UTE) Cones sequence using a clinical 3T scanner. METHODS A series IR-UTE data from 6 repetition times (TRs) with 5 inversion times (TIs) at each TR were acquired from 12 human tibial bone specimens, and data from 4 TRs with 5 TIs at each TR were acquired from the tibial midshafts of 8 healthy volunteers. The pore water nulling point was calculated from exponential fitting of the inversion recovery curve at each TR. Bone specimens and volunteers were then scanned again with the calculated nulling point at each TR. T 1 BW was derived through exponential fitting of data from IR-UTE images acquired at different TRs using the calculated pore water nulling point for each TR. RESULTS In vitro pore water nulling TIs were 141.3 ± 11.6, 123.4 ± 8.9, 101.3 ± 6.2, 88.9 ± 5.3, 74.8 ± 4.2, and 59.2 ± 3.9 ms for the 6 TRs of 500, 400, 300, 250, 200, and 150 ms, respectively. In vivo pore water nulling TIs were 132.8 ± 12.8, 110.3 ± 10.0, 80.0 ± 7.2, and 63.9 ± 5.4 ms for the 4 TRs of 400, 300, 200, and 150 ms, respectively. Excellent exponential fitting was achieved for IR-UTE imaging of bound water with pore water nulled at each TR. The mean T 1 BW was 106.9 ± 6.3 ms in vitro and 112.3 ± 16.4 ms in vivo. CONCLUSION Using the 3D IR-UTE Cones with a variable TR/TI approach, T 1 BW of cortical bone was calculated after complete nulling of pore water signals.
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Affiliation(s)
- Tan Guo
- Department of Radiology, Beijing Hospital, Beijing, China.,Department of Radiology, University of California, San Diego, California
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, California
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, California
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California
| | - Wei Zhao
- Department of Radiology, University of California, San Diego, California
| | - Eric Y Chang
- Research Service, VA San Diego Healthcare System, San Diego, California
| | - Min Chen
- Department of Radiology, Beijing Hospital, Beijing, China
| | - Graeme M Bydder
- Department of Radiology, University of California, San Diego, California
| | - Jiang Du
- Department of Radiology, University of California, San Diego, California
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Jerban S, Ma Y, Dorthe EW, Kakos L, Le N, Alenezi S, Sah RL, Chang EY, D'Lima D, Du J. Assessing cortical bone mechanical properties using collagen proton fraction from ultrashort echo time magnetization transfer (UTE-MT) MRI modeling. Bone Rep 2019; 11:100220. [PMID: 31440531 PMCID: PMC6700521 DOI: 10.1016/j.bonr.2019.100220] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/02/2019] [Indexed: 12/19/2022] Open
Abstract
Cortical bone shows as a signal void when using conventional clinical magnetic resonance imaging (MRI). Ultrashort echo time MRI (UTE-MRI) can acquire high signal from cortical bone, thus enabling quantitative assessments. Magnetization transfer (MT) imaging combined with UTE-MRI can indirectly assess protons in the organic matrix of bone. This study aimed to examine UTE-MT MRI techniques to estimate the mechanical properties of cortical bone. A total of 156 rectangular human cortical bone strips were harvested from the tibial and femoral midshafts of 43 donors (62 ± 22 years old, 62 specimens from females, 94 specimens from males). Bone specimens were scanned using UTE-MT sequences on a clinical 3 T MRI scanner and on a micro-computed tomography (μCT) scanner. A series of MT pulse saturation powers (400°, 600°, 800°) and frequency offsets (2, 5, 10, 20, 50 kHz) was used to measure the macromolecular fraction (MMF) utilizing a two-pool MT model. Failure mechanical properties of the bone specimens were measured using 4-point bending tests. MMF from MRI results showed significant strong correlations with cortical bone porosity (R = -0.72, P < 0.01) and bone mineral density (BMD) (R = +0.71, P < 0.01). MMF demonstrated significant moderate correlations with Young modulus, yield stress, and ultimate stress (R = 0.60-0.61, P < 0.01). These results suggest that the two-pool UTE-MT model focusing on the organic matrix of bone can potentially serve as a novel tool to detect the variations of bone mechanical properties and intracortical porosity.
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Key Words
- 3D, three-dimensional
- 3D-UTE, three-dimensional ultrashort echo time imaging
- BMD, bone mineral density
- Bone microstructure
- CT, computed tomography
- Cortical bone
- DEXA, dual-energy X-ray absorptiometry
- FA, flip angle
- FOV, field of view
- MMF, macromolecular proton fraction
- MR, magnetic resonance
- MRI
- MRI, magnetic resonance imaging
- MT, magnetization transfer
- Magnetization transfer
- Mechanical properties
- PBS, phosphate-buffered saline
- RF, radio frequency
- ROI, region of interest
- T2MM, macromolecular T2
- TE, echo time
- TR, repetition time
- Ultrashort echo time
- μCT, micro-computed tomography
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Erik W. Dorthe
- Shiley Center for Orthopedic Research and Education at Scripps Clinic, La Jolla, CA 92037, USA
| | - Lena Kakos
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Nicole Le
- Radiology Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Salem Alenezi
- Research and Laboratories Sector, Saudi Food and Drug Authority, Riyadh 3292, Saudi Arabia
| | - Robert L. Sah
- Department of Bioengineering, University of California, San Diego, CA 92093, USA
- Department of Orthopaedic Surgery, University of California, San Diego, CA 92093, USA
| | - Eric Y. Chang
- Department of Radiology, University of California, San Diego, CA 92093, USA
- Radiology Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Darryl D'Lima
- Shiley Center for Orthopedic Research and Education at Scripps Clinic, La Jolla, CA 92037, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA 92093, USA
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Jerban S, Lu X, Jang H, Ma Y, Namiranian B, Le N, Li Y, Chang EY, Du J. Significant correlations between human cortical bone mineral density and quantitative susceptibility mapping (QSM) obtained with 3D Cones ultrashort echo time magnetic resonance imaging (UTE-MRI). Magn Reson Imaging 2019; 62:104-110. [PMID: 31247253 PMCID: PMC6689249 DOI: 10.1016/j.mri.2019.06.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/06/2019] [Accepted: 06/23/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Quantitative susceptibility mapping (QSM) MRI is a tool that can characterize changes in susceptibility, an intrinsic property which is associated with compositional changes in the tissue. Current QSM estimation of cortical bone is challenging because conventional clinical MRI cannot acquire signal in cortical bone. This study aimed to implement Cones 3D ultrashort echo time MRI (UTE-MRI) for ex vivo QSM measurements in human tibial cortical bone, investigating the correlations of QSM with volumetric intracortical bone mineral density (BMD). MATERIALS AND METHODS Nine tibial midshaft cortical bone specimens (25 mm long specimens cut at the mid-point of tibial shaft, 67 ± 20 years old, 5 women and 4 men) were scanned on a clinical 3 T MRI scanner for QSM measurement. The specimens were also scanned on a high-resolution micro-computed tomography (μCT) scanner for volumetric BMD estimation. QSM and μCT results were compared at approximately nine regions of interest (ROIs) per specimen. RESULTS Average 3D UTE-MRI QSM showed significantly strong correlation with volumetric BMD (R = -0.82, P < 0.01) and bone porosity (R = 0.72, P < 0.01). Combining all data points together (77 ROIs), QSM showed significant moderate to strong correlation with volumetric BMD after correction for interdependencies in specimens (R = -0.70, P < 0.01). The corrections were required because the data points were not independent in each specimen. Similarly, the correlation between QSM and porosity was significant (R = 0.68, P < 0.01). CONCLUSIONS These results suggest that the Cones 3D UTE-MRI QSM technique can potentially serve as a novel and accurate tool to assess intracortical bone mineral density whilst avoiding ionizing radiation.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, CA, USA.
| | - Xing Lu
- Department of Radiology, University of California, San Diego, CA, USA; 12Sigma Technologies, San Diego, CA, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, CA, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, CA, USA
| | - Behnam Namiranian
- Department of Radiology, University of California, San Diego, CA, USA
| | - Nicole Le
- Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Ying Li
- First affiliated hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA; Department of Radiology, University of California, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, USA.
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Jerban S, Ma Y, Li L, Jang H, Wan L, Guo T, Searleman A, Chang EY, Du J. Volumetric mapping of bound and pore water as well as collagen protons in cortical bone using 3D ultrashort echo time cones MR imaging techniques. Bone 2019; 127:120-128. [PMID: 31176044 PMCID: PMC6708764 DOI: 10.1016/j.bone.2019.05.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/28/2019] [Accepted: 05/31/2019] [Indexed: 12/13/2022]
Abstract
Cortical bone assessment using magnetic resonance imaging (MRI) has recently received great attention in an effort to avoid the potential harm associated with ionizing radiation-based techniques. Ultrashort echo time MRI (UTE-MRI) techniques can acquire signal from major hydrogen proton pools in cortical bone, including bound and pore water, as well as from the collagen matrix. This study aimed to develop and evaluate the feasibility of a technique for mapping bound water, pore water, and collagen proton densities in human cortical bone ex vivo and in vivo using three-dimensional UTE Cones (3D-UTE-Cones) MRI. Eight human tibial cortical bone specimens (63 ± 19 years old) were scanned using 3D-UTE-Cones sequences on a clinical 3 T MRI scanner and a micro-computed tomography (μCT) scanner. Total, bound, and pore water proton densities (TWPD, BWPD, and PWPD, respectively) were measured using UTE and inversion recovery UTE (IR-UTE) imaging techniques. Macromolecular proton density (MMPD), a collagen representation, was measured using TWPD and macromolecular fraction (MMF) obtained from two-pool UTE magnetization transfer (UTE-MT) modeling. The correlations between proton densities and μCT-based measures were investigated. The 3D-UTE-Cones techniques were further applied on ten young healthy (34 ± 3 years old) and five old (78 ± 6 years old) female volunteers to evaluate the techniques' feasibility for translational clinical applications. In the ex vivo study, PWPD showed the highest correlations with bone porosity and bone mineral density (BMD) (R = 0.79 and - 0.70, p < 0.01). MMPD demonstrated moderate to strong correlations with bone porosity and BMD (R = -0.67 and 0.65, p < 0.01). MMPD showed strong correlation with age in specimens from female donors (R = -0.91, p = 0.03, n = 5). The presented comprehensive 3D-UTE-Cones imaging protocol allows quantitative mapping of protons in major pools of cortical bone ex vivo and in vivo. PWPD and MMPD can serve as potential novel biomarkers to assess bone matrix and microstructure, as well as bone age- or injury-related variations.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, CA, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, CA, USA
| | - Liang Li
- Department of Radiology, University of California, San Diego, CA, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, CA, USA
| | - Lidi Wan
- Department of Radiology, University of California, San Diego, CA, USA
| | - Tan Guo
- Department of Radiology, University of California, San Diego, CA, USA
| | - Adam Searleman
- Department of Radiology, University of California, San Diego, CA, USA
| | - Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA; Department of Radiology, University of California, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, USA.
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Li Q, Cao X, Ye H, Liao C, He H, Zhong J. Ultrashort echo time magnetic resonance fingerprinting (UTE-MRF) for simultaneous quantification of long and ultrashort T 2 tissues. Magn Reson Med 2019; 82:1359-1372. [PMID: 31131911 DOI: 10.1002/mrm.27812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/27/2019] [Accepted: 04/22/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To demonstrate an ultrashort echo time magnetic resonance fingerprinting (UTE-MRF) method that allows quantifying relaxation times for muscle and bone in the musculoskeletal system and generating bone enhanced images that mimic CT scans. METHODS A fast imaging steady-state free precession MRF sequence with half pulse excitation and half projection readout was designed to sample fast T2 decay signals. Varying echo time (TE) of a sinusoidal pattern was applied to enhance sensitivity for tissues with short and ultrashort T2 values. The performance of UTE-MRF was evaluated via simulations, phantom, and in vivo experiments. RESULTS A minimal TE of 0.05 ms was achieved. Simulations indicated the sinusoidal TE sampling increased T2 quantification accuracy in the cortical bone and tendon but had little impact on long T2 muscle quantifications. For the rubber phantom, the averaged relaxometries from UTE-MRF (T1 = 162 ms and T2 = 1.07 ms) compared well with the gold standard (T1 = 190 ms and T 2 ∗ = 1.03 ms). For the long T2 agarose phantom, the linear regression slope between UTE-MRF and gold standard was 1.07 (R2 = 0.991) for T1 and 1.04 (R2 = 0.994) for T2 . In vivo experiments showed the detection of the cortical bone (averaged T2 = 1.0 ms) and Achilles tendon (averaged T2 = 15 ms). Scalp structures from the bone enhanced image show high similarity with CT. CONCLUSION The UTE-MRF with sinusoidal TEs can simultaneously quantify T1 , T2 , proton density, and B0 in long, short, even ultrashort T2 musculoskeletal structures. Bone enhanced images can be achieved in the brain with UTE-MRF.
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Affiliation(s)
- Qing Li
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaozhi Cao
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Huihui Ye
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, Zhejiang, China
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Congyu Liao
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hongjian He
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jianhui Zhong
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Imaging Sciences, University of Rochester, Rochester, New York
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Jang H, Carl M, Ma Y, Jerban S, Guo T, Zhao W, Chang EY, Du J. Fat suppression for ultrashort echo time imaging using a single-point Dixon method. NMR IN BIOMEDICINE 2019; 32:e4069. [PMID: 30768813 PMCID: PMC6476675 DOI: 10.1002/nbm.4069] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/19/2018] [Accepted: 01/03/2019] [Indexed: 05/16/2023]
Abstract
PURPOSE In ultrashort echo time (UTE) imaging, fat suppression can improve short T2 * contrast but can also reduce short T2 * signals. The conventional two-point Dixon (2p-Dixon) method does not perform well due to short T2 * decay. In this study, we propose a new method to suppress fat for high contrast UTE imaging of short T2 tissues, utilizing a single-point Dixon (1p-Dixon) method. METHODS The proposed method utilizes dual-echo UTE imaging, where UTE is followed by the second TE, chosen flexibly. Fat is estimated by applying a 1p-Dixon method to the non-UTE image after correction of phase errors, which is used to suppress fat in the UTE image. In vivo ankle and knee imaging were performed at 3 T to evaluate the proposed method. RESULT It was observed that fat and water signals in tendons were misestimated by the 2p-Dixon method due to signal decay, while the 1p-Dixon method showed reliable fat and water separation not affected by the short T2 * signal decay. Compared with the conventional chemical shift based fat saturation technique, the 1p-Dixon based approach showed much stronger signal intensities in the Achilles, quadriceps, and patellar tendons, with significantly improved contrast to noise ratios (CNRs) of 11.8 ± 2.2, 16.0 ± 1.6, and 26.8 ± 1.3 with the 1p-Dixon method and 0.6 ± 0.2, 4.6 ± 1.0, and 17.5 ± 1.4 with regular fat saturation, respectively. CONCLUSION The proposed 1p-Dixon based fat suppression allows more flexible selection of imaging parameters and more accurate fat and water separation over the conventional 2p-Dixon in UTE imaging. Moreover, the proposed method provides much improved CNR for short T2 tissues over the conventional fat saturation method.
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Affiliation(s)
- Hyungseok Jang
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
| | | | - Yajun Ma
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
| | - Saeed Jerban
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
| | - Tan Guo
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
| | - Wei Zhao
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
| | - Eric Y. Chang
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
- Radiology Service, VA San Diego Healthcare System, San Diego, CA 92037, USA
| | - Jiang Du
- Department of Radiology, University of California San Diego, San Diego, CA 92103, USA
- Corresponding Author: Jiang Du, Ph.D., , University of California, San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103-8226, Phone (619) 471-0519 Fax (619) 471-0503
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Koromani F, Trajanoska K, Rivadeneira F, Oei L. Recent Advances in the Genetics of Fractures in Osteoporosis. Front Endocrinol (Lausanne) 2019; 10:337. [PMID: 31231309 PMCID: PMC6559287 DOI: 10.3389/fendo.2019.00337] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 05/10/2019] [Indexed: 12/15/2022] Open
Abstract
Genetic susceptibility, together with old age, female sex, and low bone mineral density (BMD) are amongst the strongest determinants of fracture risk. Tmost recent large-scale genome-wide association study (GWAS) meta-analysis has yielded fifteen loci. This review focuses on the advances in the research of genetic determinants of fracture risk. We first discuss the genetic architecture of fracture risk, touching upon different methods and overall findings. We then discuss in a second paragraph the most recent advances in the field and focus on the genetics of fracture risk and also of other endophenotypes closely related to fracture risk such as bone mineral density (BMD). Application of state-of-the-art methodology such as Mendelian randzation in fracture GWAS are reviewed. The final part of this review touches upon potential future directions in genetic research of osteoporotic fractures.
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Affiliation(s)
- Fjorda Koromani
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Katerina Trajanoska
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Ling Oei
- Department of Internal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- *Correspondence: Ling Oei
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Ma YJ, Lu X, Carl M, Zhu Y, Szeverenyi NM, Bydder GM, Chang EY, Du J. Accurate T 1 mapping of short T 2 tissues using a three-dimensional ultrashort echo time cones actual flip angle imaging-variable repetition time (3D UTE-Cones AFI-VTR) method. Magn Reson Med 2018; 80:598-608. [PMID: 29314235 PMCID: PMC5912804 DOI: 10.1002/mrm.27066] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/14/2017] [Accepted: 12/11/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE To develop an accurate T1 measurement method for short T2 tissues using a combination of a 3-dimensional ultrashort echo time cones actual flip angle imaging technique and a variable repetition time technique (3D UTE-Cones AFI-VTR) on a clinical 3T scanner. METHODS First, the longitudinal magnetization mapping function of the excitation pulse was obtained with the 3D UTE-Cones AFI method, which provided information about excitation efficiency and B1 inhomogeneity. Then, the derived mapping function was substituted into the VTR fitting to generate accurate T1 maps. Numerical simulation and phantom studies were carried out to compare the AFI-VTR method with a B1 -uncorrected VTR method, a B1 -uncorrected variable flip angle (VFA) method, and a B1 -corrected VFA method. Finally, the 3D UTE-Cones AFI-VTR method was applied to bovine bone samples (N = 6) and healthy volunteers (N = 3) to quantify the T1 of cortical bone. RESULTS Numerical simulation and phantom studies showed that the 3D UTE-Cones AFI-VTR technique provides more accurate measurement of the T1 of short T2 tissues than the B1 -uncorrected VTR and VFA methods or the B1 -corrected VFA method. The proposed 3D UTE-Cones AFI-VTR method showed a mean T1 of 240 ± 25 ms for bovine cortical bone and 218 ± 10 ms for the tibial midshaft of human volunteers, respectively, at 3 T. CONCLUSION The 3D UTE-Cones AFI-VTR method can provide accurate T1 measurements of short T2 tissues such as cortical bone. Magn Reson Med 80:598-608, 2018. © 2018 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Ya-Jun Ma
- Department of Radiology, University of California, San Diego, CA
| | - Xing Lu
- Department of Radiology, University of California, San Diego, CA
| | | | - Yanchun Zhu
- Department of Radiology, University of California, San Diego, CA
| | | | - Graeme M Bydder
- Department of Radiology, University of California, San Diego, CA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, CA
- Radiology Service, VA San Diego Healthcare System, San Diego, CA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA
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