W(h)ither human cardiac and body magnetic resonance at ultrahigh fields? technical advances, practical considerations, applications, and clinical opportunities

The objective of this study was to document and review advances and groundbreaking progress in cardiac and body MR at ultrahigh fields (UHF, B0 ≥ 7.0 T) with the goal to attract talent, clinical adopters, collaborations and resources to the biomedical and diagnostic imaging communities. This review surveys traits, advantages and challenges of cardiac and body MR at 7.0 T. The considerations run the gamut from technical advances to clinical opportunities. Key concepts, emerging technologies, practical considerations, frontier applications and future directions of UHF body and cardiac MR are provided. Examples of UHF cardiac and body imaging strategies are demonstrated. Their added value over the kindred counterparts at lower fields is explored along with an outline of research promises. The achievements of cardiac and body UHF-MR are powerful motivators and enablers, since extra speed, signal and imaging capabilities may be invested to overcome the fundamental constraints that continue to hamper traditional cardiac and body MR applications. If practical obstacles, concomitant physics effects and technical impediments can be overcome in equal measure, sophisticated cardiac and body UHF-MR will help to open the door to new MRI and MRS approaches for basic research and clinical science, with the lessons learned at 7.0 T being transferred into broad clinical use including diagnostics and therapy guiding at lower fields. Copyright © 2015 John Wiley & Sons, Ltd.

Myocardial effective transverse relaxation time T2* Correlates with left ventricular wall thickness: A 7.0 T MRI study

PURPOSE

Myocardial effective relaxation time T2* is commonly regarded as a surrogate for myocardial tissue oxygenation. However, it is legitimate to assume that there are multiple factors that influence T2*. To this end, this study investigates the relationship between T2* and cardiac macromorphology given by left ventricular (LV) wall thickness and left ventricular radius, and provides interpretation of the results in the physiological context.

METHODS

High spatio-temporally resolved myocardial CINE T2* mapping was performed in 10 healthy volunteers using a 7.0 Tesla (T) full-body MRI system. Ventricular septal wall thickness, left ventricular inner radius, and T2* were analyzed. Macroscopic magnetic field changes were elucidated using cardiac phase-resolved magnetic field maps.

RESULTS

Ventricular septal T2* changes periodically over the cardiac cycle, increasing in systole and decreasing in diastole. Ventricular septal wall thickness and T2* showed a significant positive correlation, whereas the inner LV radius and T2* were negatively correlated. The effect of macroscopic magnetic field gradients on T2* can be considered minor in the ventricular septum.

CONCLUSION

Our findings suggest that myocardial T2* is related to tissue blood volume fraction. Temporally resolved T2* mapping could be beneficial for myocardial tissue characterization and for understanding cardiac (patho)physiology in vivo. Magn Reson Med 77:2381-2389, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

16-channel bow tie antenna transceiver array for cardiac MR at 7.0 tesla

PURPOSE

To design, evaluate, and apply a bow tie antenna transceiver radiofrequency (RF) coil array tailored for cardiac MRI at 7.0 Tesla (T).

METHODS

The radiofrequency (RF) coil array comprises 16 building blocks each containing a bow tie shaped λ/2-dipole antenna. Numerical simulations were used for transmission field homogenization and RF safety validation. RF characteristics were examined in a phantom study. The array's suitability for high spatial resolution two-dimensional (2D) CINE imaging and for real time imaging of the heart was examined in a volunteer study.

RESULTS

The arrays transmission fields and RF characteristics are suitable for cardiac MRI at 7.0T. The coil performance afforded a spatial resolution as good as (0.8 × 0.8 × 2.5) mm(3) for segmented 2D CINE MRI at 7.0T which is by a factor of 12 superior versus standardized protocols used in clinical practice at 1.5T. The proposed transceiver array supports 1D acceleration factors of up to R = 6 without impairing image quality significantly.

CONCLUSION

The 16-channel bow tie antenna transceiver array supports accelerated and high spatial resolution cardiac MRI. The array is compatible with multichannel transmission and provides a technological basis for future clinical assessment of parallel transmission techniques at 7.0 Tesla. Magn Reson Med 75:2553-2565, 2016. © 2015 Wiley Periodicals, Inc.

Accelerated fast spin-echo magnetic resonance imaging of the heart using a self-calibrated split-echo approach

Purpose

Design, validation and application of an accelerated fast spin-echo (FSE) variant that uses a split-echo approach for self-calibrated parallel imaging.

Methods

For self-calibrated, split-echo FSE (SCSE-FSE), extra displacement gradients were incorporated into FSE to decompose odd and even echo groups which were independently phase encoded to derive coil sensitivity maps, and to generate undersampled data (reduction factor up to R = 3). Reference and undersampled data were acquired simultaneously. SENSE reconstruction was employed.

Results

The feasibility of SCSE-FSE was demonstrated in phantom studies. Point spread function performance of SCSE-FSE was found to be competitive with traditional FSE variants. The immunity of SCSE-FSE for motion induced mis-registration between reference and undersampled data was shown using a dynamic left ventricular model and cardiac imaging. The applicability of black blood prepared SCSE-FSE for cardiac imaging was demonstrated in healthy volunteers including accelerated multi-slice per breath-hold imaging and accelerated high spatial resolution imaging.

Conclusion

SCSE-FSE obviates the need of external reference scans for SENSE reconstructed parallel imaging with FSE. SCSE-FSE reduces the risk for mis-registration between reference scans and accelerated acquisitions. SCSE-FSE is feasible for imaging of the heart and of large cardiac vessels but also meets the needs of brain, abdominal and liver imaging.

Modular 32-channel transceiver coil array for cardiac MRI at 7.0T

PURPOSE

To design and evaluate a modular transceiver coil array with 32 independent channels for cardiac MRI at 7.0T.

METHODS

The modular coil array comprises eight independent building blocks, each containing four transceiver loop elements. Numerical simulations were used for B1 (+) field homogenization and radiofrequency (RF) safety validation. RF characteristics were examined in a phantom study. The array's suitability for accelerated high spatial resolution two-dimensional (2D) FLASH CINE imaging of the heart was examined in a volunteer study.

RESULTS

Transmission field adjustments and RF characteristics were found to be suitable for the volunteer study. The signal-to-noise intrinsic to 7.0T together with the coil performance afforded a spatial resolution of 1.1 × 1.1 × 2.5 mm(3) for 2D CINE FLASH MRI, which is by a factor of 6 superior to standardized CINE protocols used in clinical practice at 1.5T. The 32-channel transceiver array supports one-dimensional acceleration factors of up to R = 4 without impairing image quality significantly.

CONCLUSION

The modular 32-channel transceiver cardiac array supports accelerated and high spatial resolution cardiac MRI. The array is compatible with multichannel transmission and provides a technological basis for future clinical assessment of parallel transmission techniques at 7.0T.

Progress and promises of human cardiac magnetic resonance at ultrahigh fields: a physics perspective

A growing number of reports eloquently speak about explorations into cardiac magnetic resonance (CMR) at ultrahigh magnetic fields (B0≥7.0 T). Realizing the progress, promises and challenges of ultrahigh field (UHF) CMR this perspective outlines current trends in enabling MR technology tailored for cardiac MR in the short wavelength regime. For this purpose many channel radiofrequency (RF) technology concepts are outlined. Basic principles of mapping and shimming of transmission fields including RF power deposition considerations are presented. Explorations motivated by the safe operation of UHF-CMR even in the presence of conductive implants are described together with the physics, numerical simulations and experiments, all of which detailing antenna effects and RF heating induced by intracoronary stents at 7.0 T. Early applications of CMR at 7.0 T and their clinical implications for explorations into cardiovascular diseases are explored including assessment of cardiac function, myocardial tissue characterization, MR angiography of large and small vessels as well as heteronuclear MR of the heart and the skin. A concluding section ventures a glance beyond the horizon and explores future directions. The goal here is not to be comprehensive but to inspire the biomedical and diagnostic imaging communities to throw further weight behind the solution of the many remaining unsolved problems and technical obstacles of UHF-CMR with the goal to transfer MR physics driven methodological advancements into extra clinical value.

Assessment of the right ventricle with cardiovascular magnetic resonance at 7 Tesla

BACKGROUND

Functional and morphologic assessment of the right ventricle (RV) is of clinical importance. Cardiovascular magnetic resonance (CMR) at 1.5T has become gold standard for RV chamber quantification and assessment of even small wall motion abnormalities, but tissue analysis is still hampered by limited spatial resolution. CMR at 7T promises increased resolution, but is technically challenging. We examined the feasibility of cine imaging at 7T to assess the RV.

METHODS

Nine healthy volunteers underwent CMR at 7T using a 16-element TX/RX coil and acoustic cardiac gating. 1.5T served as gold standard. At 1.5T, steady-state free-precession (SSFP) cine imaging with voxel size (1.2 x 1.2 x 6) mm3 was used; at 7T, fast gradient echo (FGRE) with voxel size (1.2 x 1.2 x 6) mm3 and (1.3 x 1.3 x 4) mm3 were applied. RV dimensions (RVEDV, RVESV), RV mass (RVM) and RV function (RVEF) were quantified in transverse slices. Overall image quality, image contrast and image homogeneity were assessed in transverse and sagittal views.

RESULTS

All scans provided diagnostic image quality. Overall image quality and image contrast of transverse RV views were rated equally for SSFP at 1.5T and FGRE at 7T with voxel size (1.3 x 1.3 x 4)mm3. FGRE at 7T provided significantly lower image homogeneity compared to SSFP at 1.5T. RVEDV, RVESV, RVEF and RVM did not differ significantly and agreed close between SSFP at 1.5T and FGRE at 7T (p=0.5850; p=0.5462; p=0.2789; p=0.0743). FGRE at 7T with voxel size (1.3 x 1.3 x 4) mm3 tended to overestimate RV volumes compared to SSFP at 1.5T (mean difference of RVEDV 8.2 ± 9.3 ml) and to FGRE at 7T with voxel size (1.2 x 1.2 x 6) mm3 (mean difference of RVEDV 9.3 ± 8.6 ml).

CONCLUSIONS

FGRE cine imaging of the RV at 7T was feasible and provided good image quality. RV dimensions and function were comparable to SSFP at 1.5T as gold standard.

High spatial resolution and temporally resolved T2* mapping of normal human myocardium at 7.0 Tesla: an ultrahigh field magnetic resonance feasibility study

Myocardial tissue characterization using T(2)(*) relaxation mapping techniques is an emerging application of (pre)clinical cardiovascular magnetic resonance imaging. The increase in microscopic susceptibility at higher magnetic field strengths renders myocardial T(2)(*) mapping at ultrahigh magnetic fields conceptually appealing. This work demonstrates the feasibility of myocardial T(2)(*) imaging at 7.0 T and examines the applicability of temporally-resolved and high spatial resolution myocardial T(2)(*) mapping. In phantom experiments single cardiac phase and dynamic (CINE) gradient echo imaging techniques provided similar T(2)(*) maps. In vivo studies showed that the peak-to-peak B(0) difference following volume selective shimming was reduced to approximately 80 Hz for the four chamber view and mid-ventricular short axis view of the heart and to 65 Hz for the left ventricle. No severe susceptibility artifacts were detected in the septum and in the lateral wall for T(2)(*) weighting ranging from TE = 2.04 ms to TE = 10.2 ms. For TE >7 ms, a susceptibility weighting induced signal void was observed within the anterior and inferior myocardial segments. The longest T(2)(*) values were found for anterior (T(2)(*) = 14.0 ms), anteroseptal (T(2)(*) = 17.2 ms) and inferoseptal (T(2)(*) = 16.5 ms) myocardial segments. Shorter T(2)(*) values were observed for inferior (T(2)(*) = 10.6 ms) and inferolateral (T(2)(*) = 11.4 ms) segments. A significant difference (p = 0.002) in T(2)(*) values was observed between end-diastole and end-systole with T(2)(*) changes of up to approximately 27% over the cardiac cycle which were pronounced in the septum. To conclude, these results underscore the challenges of myocardial T(2)(*) mapping at 7.0 T but demonstrate that these issues can be offset by using tailored shimming techniques and dedicated acquisition schemes.

Two-dimensional sixteen channel transmit/receive coil array for cardiac MRI at 7.0 T: design, evaluation, and application

PURPOSE

To design, evaluate, and apply a 2D 16-channel transmit/receive (TX/RX) coil array tailored for cardiac magnetic resonance imaging (MRI) at 7.0 T.

MATERIALS AND METHODS

The cardiac coil array consists of two sections each using eight elements arranged in a 2 × 4 array. Radiofrequency (RF) safety was validated by specific absorption rate (SAR) simulations. Cardiac imaging was performed using 2D CINE FLASH imaging, T 2 mapping, and fat-water separation imaging. The characteristics of the coil array were analyzed including parallel imaging performance, left ventricular chamber quantification, and overall image quality.

RESULTS

RF characteristics were found to be appropriate for all subjects included in the study. The SAR values derived from the simulations fall well within the limits of legal guidelines. The baseline signal-to-noise ratio (SNR) advantage at 7.0 T was put to use to acquire 2D CINE images of the heart with a very high spatial resolution of (1 × 1 × 4) mm(3) . The proposed coil array supports 1D acceleration factors of up to R = 4 without significantly impairing image quality.

CONCLUSION

The 16-channel TX/RX coil has the capability to acquire high contrast and high spatial resolution images of the heart at 7.0 T.

Acoustic cardiac triggering: a practical solution for synchronization and gating of cardiovascular magnetic resonance at 7 Tesla

BACKGROUND

To demonstrate the applicability of acoustic cardiac triggering (ACT) for imaging of the heart at ultrahigh magnetic fields (7.0 T) by comparing phonocardiogram, conventional vector electrocardiogram (ECG) and traditional pulse oximetry (POX) triggered 2D CINE acquisitions together with (i) a qualitative image quality analysis, (ii) an assessment of the left ventricular function parameter and (iii) an examination of trigger reliability and trigger detection variance derived from the signal waveforms.

RESULTS

ECG was susceptible to severe distortions at 7.0 T. POX and ACT provided waveforms free of interferences from electromagnetic fields or from magneto-hydrodynamic effects. Frequent R-wave mis-registration occurred in ECG-triggered acquisitions with a failure rate of up to 30% resulting in cardiac motion induced artifacts. ACT and POX triggering produced images free of cardiac motion artefacts. ECG showed a severe jitter in the R-wave detection. POX also showed a trigger jitter of approximately Δt = 72 ms which is equivalent to two cardiac phases. ACT showed a jitter of approximately Δt = 5 ms only. ECG waveforms revealed a standard deviation for the cardiac trigger offset larger than that observed for ACT or POX waveforms.Image quality assessment showed that ACT substantially improved image quality as compared to ECG (image quality score at end-diastole: ECG = 1.7 ± 0.5, ACT = 2.4 ± 0.5, p = 0.04) while the comparison between ECG vs. POX gated acquisitions showed no significant differences in image quality (image quality score: ECG = 1.7 ± 0.5, POX = 2.0 ± 0.5, p = 0.34).

CONCLUSIONS

The applicability of acoustic triggering for cardiac CINE imaging at 7.0 T was demonstrated. ACT's trigger reliability and fidelity are superior to that of ECG and POX. ACT promises to be beneficial for cardiovascular magnetic resonance at ultra-high field strengths including 7.0 T.