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Gietzen C, Kaya K, Janssen JP, Gertz RJ, Terzis R, Huflage H, Grunz JP, Gietzen T, Pennig H, Celik E, Borggrefe J, Persigehl T, Kabbasch C, Weiss K, Goertz L, Pennig L. Highly compressed SENSE accelerated relaxation-enhanced angiography without contrast and triggering (REACT) for fast non-contrast enhanced magnetic resonance angiography of the neck: Clinical evaluation in patients with acute ischemic stroke at 3 tesla. Magn Reson Imaging 2024; 112:27-37. [PMID: 38599503 DOI: 10.1016/j.mri.2024.04.009] [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: 02/14/2024] [Revised: 04/06/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND PURPOSE Long acquisition times limit the feasibility of established non-contrast-enhanced MRA (non-CE-MRA) techniques. The purpose of this study was to evaluate a highly accelerated flow-independent sequence (Relaxation-Enhanced Angiography without Contrast and Triggering [REACT]) for imaging of the extracranial arteries in acute ischemic stroke (AIS). MATERIALS AND METHODS Compressed SENSE (CS) accelerated (factor 7) 3D isotropic REACT (fixed scan time: 01:22 min, reconstructed voxel size 0.625 × 0.625 × 0.75 mm3) and CE-MRA (CS factor 6, scan time: 1:08 min, reconstructed voxel size 0.5 mm3) were acquired in 76 AIS patients (69.4 ± 14.3 years, 33 females) at 3 Tesla. Two radiologists assessed scans for the presence of internal carotid artery (ICA) stenosis and stated their diagnostic confidence using a 5-point scale (5 = excellent). Vessel quality of cervical arteries as well as the impact of artifacts and image noise were scored on 5-point scales (5 = excellent/none). Apparent signal- and contrast-to-noise ratios (aSNR/aCNR) were measured for the common carotid artery (CCA) and ICA (C1-segment). RESULTS REACT provided a sensitivity of 88.5% and specificity of 100% for clinically relevant (≥50%) ICA stenosis with substantial concordance to CE-MRA regarding stenosis grading (Cohen's kappa 0.778) and similar diagnostic confidence (REACT: mean 4.5 ± 0.4 vs. CE-MRA: 4.5 ± 0.6; P = 0.674). Presence of artifacts (3.6 ± 0.5 vs. 3.5 ± 0.7; P = 0.985) and vessel quality (all segments: 3.6 ± 0.7 vs. 3.8 ± 0.7; P = 0.004) were comparable between both techniques with REACT showing higher scores at the CCA (4.3 ± 0.6 vs. 3.8 ± 0.9; P < 0.001) and CE-MRA at V2- (3.3 ± 0.5 vs. 3.9 ± 0.8; P < 0.001) and V3-segments (3.3 ± 0.5 vs. 4.0 ± 0.8; P < 0.001). For all vessels, REACT showed a lower impact of image noise (3.8 ± 0.6 vs. 3.6 ± 0.7; P = 0.024) while yielding higher aSNR (52.5 ± 15.1 vs. 37.9 ± 12.5; P < 0.001) and aCNR (49.4 ± 15.0 vs. 34.7 ± 12.3; P < 0.001) for all vessels combined. CONCLUSIONS In patients with acute ischemic stroke, highly accelerated REACT provides an accurate detection of ICA stenosis with vessel quality and scan time comparable to CE-MRA.
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Affiliation(s)
- Carsten Gietzen
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Kenan Kaya
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan Paul Janssen
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roman Johannes Gertz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Robert Terzis
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Henner Huflage
- Institute for Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Jan-Peter Grunz
- Institute for Diagnostic and Interventional Radiology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Thorsten Gietzen
- Department III of Internal Medicine, Heart Center, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Henry Pennig
- Department for Orthopaedic and Trauma Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne
| | - Erkan Celik
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Thorsten Persigehl
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christoph Kabbasch
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Lukas Goertz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lenhard Pennig
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Janssen JP, Rose S, Kaya K, Terzis R, Hahnfeldt R, Gertz RJ, Goertz L, Iuga AI, Grunz JP, Kabbasch C, Rauen P, Persigehl T, Weiss K, Borggrefe J, Pennig L, Gietzen C. Non-contrast-enhanced MR-angiography of Extracranial Arteries in Acute Ischemic Stroke at 1.5 Tesla Using Relaxation-Enhanced Angiography Without Contrast and Triggering (REACT). Clin Neuroradiol 2024:10.1007/s00062-024-01458-4. [PMID: 39316116 DOI: 10.1007/s00062-024-01458-4] [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: 06/20/2024] [Accepted: 08/16/2024] [Indexed: 09/25/2024]
Abstract
PURPOSE To evaluate a novel flow-independent sequence (Relaxation-Enhanced Angiography without Contrast and Triggering (REACT)) for imaging of the extracranial arteries in acute ischemic stroke (AIS) at 1.5 T. METHODS This retrospective single-center study included 47 AIS patients who received REACT (scan time: 3:01 min) and contrast-enhanced MRA (CE-MRA) of the extracranial arteries at 1.5 T in clinical routine. Two radiologists assessed scans for proximal internal carotid artery (ICA) stenosis, stated their diagnostic confidence and rated the image quality of cervical arteries, impact of artifacts and image noise. Apparent signal- and contrast-to-noise ratios (aSNR/aCNR) were measured for the common carotid artery and ICA. RESULTS REACT achieved a sensitivity of 95.0% and a specificity of 97.3% for ICA stenoses in high agreement with CE-MRA (κ = 0.83) with equal diagnostic confidence (p = 0.22). Image quality was rated higher for CE-MRA at the aortic arch (p = 0.002) and vertebral arteries (p < 0.001), whereas REACT provided superior results for the extracranial ICA (p = 0.008). Both sequences were only slightly affected by artifacts (p = 0.60), while image noise was more pronounced in CE-MRA (p < 0.001) in line with higher aSNR (p < 0.001) and aCNR (p < 0.001) values in REACT for all vessels. CONCLUSION Given its good diagnostic performance while yielding comparable image quality and scan time to CE-MRA, REACT may be suitable for the imaging of the extracranial arteries in acute ischemic stroke at 1.5 T.
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Affiliation(s)
- Jan P Janssen
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Sarah Rose
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Kenan Kaya
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Robert Terzis
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Robert Hahnfeldt
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Roman J Gertz
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Lukas Goertz
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Andra-Iza Iuga
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Jan-Peter Grunz
- University Hospital Wuerzburg, Institute for Diagnostic and Interventional Radiology, Wuerzburg, Germany
- University of Wisconsin-Madison, Madison, WI, USA
| | - Christoph Kabbasch
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Philip Rauen
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Thorsten Persigehl
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | | | - Jan Borggrefe
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Lenhard Pennig
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
| | - Carsten Gietzen
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Institute for Diagnostic and Interventional Radiology, Kerpener Straße 62, 50937, Cologne, Germany
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Kuo DY, Wu YW, Hsieh CH, Liao LJ, Shueng PW. Application of Carotid Duplex Ultrasonography in the Surveillance of Carotid Artery Stenosis after Neck Irradiation. Rev Cardiovasc Med 2022; 23:240. [PMID: 39076899 PMCID: PMC11266801 DOI: 10.31083/j.rcm2307240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/23/2022] [Accepted: 04/22/2022] [Indexed: 07/31/2024] Open
Abstract
Head and neck cancer (HNC) shares some risk factors with cardiovascular disease. Neck radiotherapy (RT) causes carotid artery injury and stenosis. In HNC patients treated with RT, the prevalence rate of severe ( > 70%) carotid artery stenosis is > 10%, and the cumulative incidence continuously increases over time. There is at least a two-fold risk of cerebrovascular events in these patients compared with the normal population. Carotid artery stenosis is mainly assessed and diagnosed via duplex ultrasonography. Angioplasty and stenting may be recommended to patients who developed severe post-irradiation carotid artery stenosis. This review assessed Taiwanese data that provided some recommendations for HNC patients treated with RT. With consideration of the high prevalence rate of carotid artery stenosis after neck irradiation, duplex ultrasonography should be included in the follow-up workup.
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Affiliation(s)
- Deng-Yu Kuo
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 220 New Taipei, Taiwan
| | - Yen-Wen Wu
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, 220 New Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, 112 Taipei, Taiwan
| | - Chen-Hsi Hsieh
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 220 New Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, 112 Taipei, Taiwan
- Institute of Traditional Medicine, National Yang Ming Chiao Tung University, 112 Taipei, Taiwan
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, 220 New Taipei, Taiwan
- Biomedical Engineering Office, Far Eastern Memorial Hospital, 220 New Taipei, Taiwan
- Department of Electrical Engineering, Yuan Ze University, 320 Taoyuan, Taiwan
| | - Pei-Wei Shueng
- Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, 220 New Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, 112 Taipei, Taiwan
- Medical Device Innovation and Translation Center, National Yang Ming Chiao Tung University, 112 Taipei, Taiwan
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Hoyer UCI, Lennartz S, Abdullayev N, Fichter F, Jünger ST, Goertz L, Laukamp KR, Gertz RJ, Grunz JP, Hohmann C, Maintz D, Persigehl T, Kabbasch C, Borggrefe J, Weiss K, Pennig L. Imaging of the extracranial internal carotid artery in acute ischemic stroke: assessment of stenosis, plaques, and image quality using relaxation-enhanced angiography without contrast and triggering (REACT). Quant Imaging Med Surg 2022; 12:3640-3654. [PMID: 35782261 PMCID: PMC9246733 DOI: 10.21037/qims-21-1122] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/22/2022] [Indexed: 07/24/2023]
Abstract
BACKGROUND In stroke magnetic resonance imaging (MRI), contrast-enhanced magnetic resonance angiography (CE-MRA) is the clinical standard to depict extracranial arteries but native MRA techniques are of increased interest to facilitate clinical practice. The purpose of this study was to assess the detection of extracranial internal carotid artery (ICA) stenosis and plaques as well as the image quality of cervical carotid arteries between a novel flow-independent relaxation-enhanced angiography without contrast and triggering (REACT) sequence and CE-MRA in acute ischemic stroke (AIS). METHODS In this retrospective, single-center study, 105 consecutive patients (65.27±18.74 years, 63 males) were included, who received a standard stroke protocol at 3T in clinical routine including Compressed SENSE (CS) accelerated (factor 4) 3D isotropic REACT (fixed scan time: 02:46 min) and CS accelerated (factor 6) 3D isotropic CE-MRA. Three radiologists independently assessed scans for the presence of extracranial ICA stenosis and plaques (including hyper-/hypointense signal) with concomitant diagnostic confidence using 3-point scales (3= excellent). Vessel quality, artifacts, and image noise of extracranial carotid arteries were subjectively scored on 5-point scales (5= excellent/none). Wilcoxon tests were used for statistical comparison. RESULTS Considering CE-MRA as the standard of reference, REACT provided a sensitivity of 89.8% and specificity of 95.2% for any and of 93.5% and 95.8% for clinically relevant (≥50%) extracranial ICA stenosis and yielded a to CE-MRA comparable diagnostic confidence [mean ± standard deviation (SD), median (interquartile range): 2.8±0.5, 3 (3-3) vs. 2.7±0.5, 3 (2-3), P=0.03]. Using REACT, readers detected more plaques overall (n=57.3 vs. 47.7, P<0.001) and plaques of hyperintense signal (n=12.3 vs. 5.7, P=0.02) with higher diagnostic confidence [2.8±0.5, 3 (3-3) vs. 2.6±0.7, 3 (2-3), P<0.001] than CE-MRA. After analyzing a total of 1,260 segments, the vessel quality of all segments combined [4.61±0.66 vs. 4.58±0.68, 5 (4-5) vs. 5 (4-5), P=0.0299] and artifacts [4.51±0.70 vs. 4.44±0.73, 5 (4-5) vs. 5 (4-5), P>0.05] were comparable between the sequences with REACT showing a lower image noise [4.43±0.67 vs. 4.25±0.71, 5 (4-5) vs. 4 (4-5), P<0.001]. CONCLUSIONS Without the use of gadolinium-based contrast agents or triggering, REACT provides a high sensitivity and specificity for extracranial ICA stenosis and a potential improved depiction of adjacent plaques while yielding to CE-MRA comparable vessel quality in a large patient cohort with AIS.
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Affiliation(s)
- Ulrike Cornelia Isabel Hoyer
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Simon Lennartz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nuran Abdullayev
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Florian Fichter
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephanie T. Jünger
- Department of General Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lukas Goertz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of General Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kai Roman Laukamp
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Roman Johannes Gertz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Christopher Hohmann
- Department III of Internal Medicine, Heart Center, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christoph Kabbasch
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan Borggrefe
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany
| | | | - Lenhard Pennig
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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5
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Pennig L, Kabbasch C, Hoyer UCI, Lennartz S, Zopfs D, Goertz L, Laukamp KR, Wagner A, Grunz JP, Doerner J, Persigehl T, Weiss K, Borggrefe J. Relaxation-Enhanced Angiography Without Contrast and Triggering (REACT) for Fast Imaging of Extracranial Arteries in Acute Ischemic Stroke at 3 T. Clin Neuroradiol 2020; 31:815-826. [PMID: 33026511 PMCID: PMC8463375 DOI: 10.1007/s00062-020-00963-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/02/2020] [Indexed: 12/18/2022]
Abstract
Purpose To evaluate a novel flow-independent 3D isotropic REACT sequence compared with CE-MRA for the imaging of extracranial arteries in acute ischemic stroke (AIS). Methods This was a retrospective study of 35 patients who underwent a stroke protocol at 3 T including REACT (fixed scan time: 2:46 min) and CE-MRA of the extracranial arteries. Three radiologists evaluated scans regarding vessel delineation, signal, and contrast and assessed overall image noise and artifacts using 5-point scales (5: excellent delineation/no artifacts). Apparent signal- and contrast-to-noise ratios (aSNR/aCNR) were measured for the common carotid artery (CCA), internal carotid artery (ICA, C1 segment), and vertebral artery (V2 segment). Two radiologists graded the degree of proximal ICA stenosis. Results Compared to REACT, CE-MRA showed better delineation for the CCA and ICA (C1 and C2 segments) (median 5, range 2–5 vs. 4, range 3–5; P < 0.05). For the ICA (C1 and C2 segments), REACT provided a higher signal (5, range 3–5; P < 0.05/4.5, range 3–5; P > 0.05 vs. 4, range 2–5) and contrast (5, range 3–5 vs. 4, range 2–5; P > 0.05) than CE-MRA. The remaining segments of the blood-supplying vessels showed equal medians. There was no significant difference regarding artifacts, whereas REACT provided significantly lower image noise (4, range 3–5 vs. 4 range 2–5; P < 0.05) with a higher aSNR (P < 0.05) and aCNR (P < 0.05) for all vessels combined. For clinically relevant (≥50%) ICA stenosis, REACT achieved a detection sensitivity of 93.75% and a specificity of 100%. Conclusion Given its fast acquisition, comparable image quality to CE-MRA and high sensitivity and specificity for the detection of ICA stenosis, REACT was proven to be a clinically applicable method to assess extracranial arteries in AIS. Electronic supplementary material The online version of this article (10.1007/s00062-020-00963-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lenhard Pennig
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Christoph Kabbasch
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Cornelia Isabel Hoyer
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Simon Lennartz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Harvard Medical School, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Else Kröner Forschungskolleg Clonal Evolution in Cancer, University Hospital Cologne, Cologne, Germany
| | - David Zopfs
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lukas Goertz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Center for Neurosurgery, Department of General Neurosurgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kai Roman Laukamp
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anton Wagner
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Jan-Peter Grunz
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - Jonas Doerner
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Jan Borggrefe
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany
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6
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Koktzoglou I, Huang R, Ong AL, Aouad PJ, Walker MT, Edelman RR. High spatial resolution whole-neck MR angiography using thin-slab stack-of-stars quiescent interval slice-selective acquisition. Magn Reson Med 2020; 84:3316-3324. [PMID: 32521094 DOI: 10.1002/mrm.28339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To report a 3D multi-echo thin-slab stack-of-stars (tsSOS) quiescent-interval slice-selective (QISS) strategy for high-resolution magnetic resonance angiography (MRA) of the entire neck in under seven minutes. METHODS The neck arteries of eight subjects were imaged at 3 Tesla. Multi-echo 3D tsSOS QISS using a FLASH readout was compared with 3D tsSOS FLASH, 2D QISS, 2D TOF, and 3D TOF. A root-mean-square (RMS) combination of echo time images was tested. Evaluation metrics included arterial signal-to-noise ratio (SNR), arterial-to-muscle contrast-to-noise ratio (CNR), and image quality. RESULTS 3D multi-echo tsSOS QISS using a RMS combination of echo time images increased SNR and CNR by 60% and 63% with respect to the reconstruction obtained with the shortest echo time. 3D tsSOS QISS showed superior CNR with respect to 3D tsSOS FLASH imaging, and more than 3-fold higher SNR and CNR with respect to 2D radial QISS when normalized for voxel size. 3D tsSOS QISS provided good to excellent image quality that exceeded the image quality of 2D QISS, 2D TOF, and 3D TOF (P < .05). CONCLUSION Whole-neck high-resolution nonenhanced MRA is feasible using 3D tsSOS QISS, and produced image quality that exceeded those of competing nonenhanced MRA protocols at 3 Tesla.
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Affiliation(s)
- Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Rong Huang
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Archie L Ong
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.,Department of Neurology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Pascale J Aouad
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew T Walker
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Robert R Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA.,Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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7
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Koktzoglou I, Huang R, Ong AL, Aouad PJ, Aherne EA, Edelman RR. Feasibility of a sub-3-minute imaging strategy for ungated quiescent interval slice-selective MRA of the extracranial carotid arteries using radial k-space sampling and deep learning-based image processing. Magn Reson Med 2020; 84:825-837. [PMID: 31975432 DOI: 10.1002/mrm.28179] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 12/09/2019] [Accepted: 12/30/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE To develop and test the feasibility of a sub-3-minute imaging strategy for non-contrast evaluation of the extracranial carotid arteries using ungated quiescent interval slice-selective (QISS) MRA, combining single-shot radial sampling with deep neural network-based image processing to optimize image quality. METHODS The extracranial carotid arteries of 12 human subjects were imaged at 3 T using ungated QISS MRA. In 7 healthy volunteers, the effects of radial and Cartesian k-space sampling, single-shot and multishot image acquisition (1.1-3.3 seconds/slice, 141-423 seconds/volume), and deep learning-based image processing were evaluated using segmental image quality scoring, arterial temporal SNR, arterial-to-background contrast and apparent contrast-to-noise ratio, and structural similarity index. Comparison of deep learning-based image processing was made with block matching and 3D filtering denoising. RESULTS Compared with Cartesian sampling, radial k-space sampling increased arterial temporal SNR 107% (P < .001) and improved image quality during 1-shot imaging (P < .05). The carotid arteries were depicted with similar image quality on the rapid 1-shot and much lengthier 3-shot radial QISS protocols (P = not significant), which was corroborated in patient studies. Deep learning-based image processing outperformed block matching and 3D filtering denoising in terms of structural similarity index (P < .001). Compared with original QISS source images, deep learning image processing provided 24% and 195% increases in arterial-to-background contrast (P < .001) and apparent contrast-to-noise ratio (P < .001), and provided source images that were preferred by radiologists (P < .001). CONCLUSION Rapid, sub-3-minute evaluation of the extracranial carotid arteries is feasible with ungated single-shot radial QISS, and benefits from the use of deep learning-based image processing to enhance source image quality.
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Affiliation(s)
- Ioannis Koktzoglou
- Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois.,Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Rong Huang
- Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois
| | - Archie L Ong
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois.,Department of Neurology, NorthShore University HealthSystem, Evanston, Illinois
| | - Pascale J Aouad
- Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois.,Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Emily A Aherne
- Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois.,Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Robert R Edelman
- Department of Radiology, NorthShore University HealthSystem, Evanston, Illinois.,Northwestern University Feinberg School of Medicine, Chicago, Illinois
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