Resolution enhancement, noise suppression, and joint T2* decay estimation in dual-echo sodium-23 MR imaging using anatomically guided reconstruction.

PURPOSE: Sodium MRI is challenging because of the low tissue concentration of the 23 Na nucleus and its extremely fast biexponential transverse relaxation rate. In this article, we present an iterative reconstruction framework using dual-echo 23 Na data and exploiting anatomical prior information (AGR) from high-resolution, low-noise, 1 H MR images. This framework enables the estimation and modeling of the spatially varying signal decay due to transverse relaxation during readout (AGRdm), which leads to images of better resolution and reduced noise resulting in improved quantification of the reconstructed 23 Na images. METHODS: The proposed framework was evaluated using reconstructions of 30 noise realizations of realistic simulations of dual echo twisted projection imaging (TPI) 23 Na data. Moreover, three dual echo 23 Na TPI brain datasets of healthy controls acquired on a 3T Siemens Prisma system were reconstructed using conventional reconstruction, AGR and AGRdm. RESULTS: Our simulations show that compared to conventional reconstructions, AGR and AGRdm show improved bias-noise characteristics in several regions of the brain. Moreover, AGR and AGRdm images show more anatomical detail and less noise in the reconstructions of the experimental data sets. Compared to AGR and the conventional reconstruction, AGRdm shows higher contrast in the sodium concentration ratio between gray and white matter and between gray matter and the brain stem. CONCLUSION: AGR and AGRdm generate 23 Na images with high resolution, high levels of anatomical detail, and low levels of noise, potentially enabling high-quality 23 Na MR imaging at 3T.

The choice of dissection or preservation of the inferior pulmonary ligament after an upper lobectomy: a systematic review and meta-analysis.

BACKGROUND: The necessity of the inferior pulmonary ligament (IPL) dissection after an upper lobectomy remains controversial. This meta-analysis aimed to evaluate whether this accessional procedure could reduce the postoperative complications and improve outcomes. METHODS: PubMed, Embase, Ovid, Cochrane Library, CBM, and CNKI databases were searched for the relevant studies which compared the dissection with preservation of IPL during the upper lobectomy. The Review Manager 5.3 software was used for this meta-analysis. RESULTS: Three RCTs and five CCTs were included in this meta-analysis. These studies contained a total of 610 patients, in which 315 patients received a pulmonary ligament dissection (group D) after the upper lobectomy, while the other 295 patients preserved the pulmonary ligament (group P). No significant difference was demonstrated between the group D and group P in terms of drainage time after surgery (MD 0.14, 95%CI - 0.05 to 0.33, P = 0.15), rate of postoperative dead space (OR 1.33, 95%CI 0.72 to 2.46, P = 0.36), rate of postoperative complications (OR 1.20, 95%CI 0.66 to 2.19, P = 0.56). However, the pooled comparison revealed a greater change of the right main bronchial angle (MD 5.00, 95%CI 1.68 to 8.33, P = 0.003) in group D compared with group P, indicated that the dissection of IPL may lead to a greater distortion of bronchus. CONCLUSIONS: This meta-analysis confirmed that the dissection of IPL do not effectively reduce the postoperative complications and improve the prognosis. Therefore, it is not necessary to dissect the IPL after an upper lobectomy.

A circular echo planar sequence for fast volumetric fMRI.

PURPOSE: To demonstrate a circular EPI (CEPI) sequence as well as a generalized EPI reconstruction for fast fMRI with parallel imaging acceleration. METHODS: The CEPI acquisition was constructed using variable readout lengths and maximum ramp sampling as well as blipped-CAIPI z-gradient encoding for simultaneous multislice (SMS) and 3D volumetric imaging. A signal equation model with constant and linear phase terms was used to iteratively reconstruct images with low ghosting. Simulation, phantom, and human imaging experiments including audio/visual fMRI were performed at 3T using a 52-channel coil. RESULTS: Application of CEPI gradients with duration of 27 ms covering a 22-cm FOV at a 64 × 64 pixel resolution in SMS and 3D acquisitions resulted in images with comparable quality to those of standard Cartesian EPI. With parallel imaging techniques robust detection of BOLD fMRI activation with temporal sampling down to 275 ms was possible. The high temporal resolution enabled higher activation statistics at a penalty in increased noise and residual aliasing. The un-accelerated 3D acquisition showed large temporal instability compared with a standard 2D acquisition. CONCLUSION: Nonuniform sampling and generalized image reconstructions can be applied to EPI acquisitions including those with blipped-CAIPI z gradients. The same gradients can be used for either SMS or 3D acquisitions providing identical coverage.

An eight-channel sodium/proton coil for brain MRI at 3 T.

The purpose of this work is to illustrate a new coil decoupling strategy and its application to a transmit/receive sodium/proton phased array for magnetic resonance imaging (MRI) of the human brain. We implemented an array of eight triangular coils that encircled the head. The ensemble of coils was arranged to form a modified degenerate mode birdcage whose eight shared rungs were offset from the z-axis at interleaved angles of ±30°. This key geometric modification resulted in triangular elements whose vertices were shared between next-nearest neighbors, which provided a convenient location for counter-wound decoupling inductors, whilst nearest-neighbor decoupling was addressed with shared capacitors along the rungs. This decoupling strategy alleviated the strong interaction that is characteristic of array coils at low frequency (32.6 MHz in this case) and allowed the coil to operate efficiently in transceive mode. The sodium array provided a 1.6-fold signal-to-noise ratio advantage over a dual-nuclei birdcage coil in the center of the head and up to 2.3-fold gain in the periphery. The array enabled sodium MRI of the brain with 5-mm isotropic resolution in approximately 13 min, thus helping to overcome low sodium MR sensitivity and improving quantification in neurological studies. An eight-channel proton array was integrated into the sodium array to enable anatomical imaging.

Short-T2 imaging for quantifying concentration of sodium (23 Na) of bi-exponential T2 relaxation.

PURPOSE: This work intends to demonstrate a new method for quantifying concentration of sodium (23 Na) of bi-exponential T2 relaxation in patients on MRI scanners at 3.0 Tesla. THEORY AND METHODS: Two single-quantum (SQ) sodium images acquired at very-short and short echo times (TE = 0.5 and 5.0 ms) are subtracted to produce an image of the short-T2 component of the bi-exponential (or bound) sodium. An integrated calibration on the SQ and short-T2 images quantifies both total and bound sodium concentrations. Numerical models were used to evaluate signal response of the proposed method to the short-T2 components. MRI scans on agar phantoms and brain tumor patients were performed to assess accuracy and performance of the proposed method, in comparison with a conventional method of triple-quantum filtering. RESULTS: A good linear relation (R2 = 0.98) was attained between the short-T2 image intensity and concentration of bound sodium. A reduced total scan time of 22 min was achieved under the SAR restriction for human studies in quantifying both total and bound sodium concentrations. CONCLUSION: The proposed method is feasible for quantifying bound sodium concentration in routine clinical settings at 3.0 Tesla. Magn Reson Med 74:162-174, 2015. © 2014 Wiley Periodicals, Inc.

Repeatability of ultrashort echo time-based two-component T2* measurements on cartilages in human knee at 3 T.

Repeatability of in vivo measurement of multicomponent T2* relaxation in articular cartialges in human knee is important to clinical use. This study evaluated the repeatability of two-component T2* relaxation on seven healthy human subjects. The left knee was scanned once a day in three consecutive days, on a clinical 3T MRI scanner with eight-channel knee coil and ultrashort echo time pulse sequence at 11 echo times=0.6-40 ms. The intrasubject and intersubject repeatability was evaluated via coefficient of variation (CV=standard deviation/mean) in four typical cartilage regions: patellar, anterior articular, femoral, and tibial regions. It was found that the intrasubject repeatability was good, with CV<10% for the short- and long-T2* relaxation time in the layered regions in the four cartilages (with one exception) and CV<13% for the component intensity fraction (with two exceptions). The intersubject repeatability was also good, with CV∼8% (range 1-15%) for the short- and long-T2* relaxation time and CV∼10% (range 2-20%) for the component intensity fraction. The long-T2* component showed significantly better repeatability (CV∼8%) than the short-T2* component (CV∼12%) (P<0.005). These CV values suggest that in vivo measurement of two-component T2* relaxation in the knee cartilages is repeatable on clinical scanner at 3 T, with a signal-to-noise ratio of 90.

High-resolution sodium imaging of human brain at 7 T.

The feasibility of high-resolution sodium magnetic resonance imaging on human brain at 7 T was demonstrated in this study. A three-dimensional anisotropic resolution data acquisition was used to address the challenge of low signal-to-noise ratio associated with high resolution. Ultrashort echo-time sequence was used for the anisotropic data acquisition. Phantoms and healthy human brains were studied on a whole-body 7-T magnetic resonance imaging scanner. Sodium images were obtained at two high nominal in-plane resolutions (1.72 and 0.86 mm) at a slice thickness of 4 mm. Signal-to-noise ratio in the brain image (cerebrospinal fluid) was measured as 14.4 and 6.8 at the two high resolutions, respectively. The actual in-plane resolution was measured as 2.9 and 1.6 mm, 69-86% larger than their nominal values. The quantification of sodium concentration on the phantom and brain images enabled better accuracy at the high nominal resolutions than at the low nominal resolution of 3.44 mm (measured resolution 5.5 mm) due to the improvement of in-plane resolution.

Sodium imaging of human brain at 7 T with 15-channel array coil.

Signal-to-noise ratio (SNR) is a major challenge to sodium magnetic resonance imaging. Phased array coils have been shown significantly improving SNR in proton imaging over volume coils. This study investigates SNR advantage of a 15-channel array head coil (birdcage volume coil for transmit/receive and 15-channel array insert for receive-only) in sodium imaging at 7 T. Phantoms and healthy human brains were scanned on a whole-body 7 T magnetic resonance imaging scanner using a customer-developed pulse sequence with the twisted projection imaging trajectory. Noise-only images were acquired with blanked radiofrequency excitations for noise measurement on a pixel basis. SNR was calculated on the root of sum-of-squares images. When compared with the volume coil, the 15-channel array produced SNR more than doubled at the periphery and slightly increased at the center of the phantoms and human brains. Decorrelation of noise across channels of the array coil extended the SNR-doubled region into deep area of the brain. The spatial modulation of element sensitivities on the sum-of-squares combined image was removed by performing self-calibrated sensitivity encoding parallel image reconstruction and uniform image intensity across entire field of view was attained. The 15-channel array coil is an efficient tool to substantially improve SNR in sodium imaging on human brain.

High-resolution ultrashort echo time (UTE) imaging on human knee with AWSOS sequence at 3.0 T.

PURPOSE: To demonstrate the technical feasibility of high-resolution (0.28-0.14 mm) ultrashort echo time (UTE) imaging on human knee at 3T with the acquisition-weighted stack of spirals (AWSOS) sequence. MATERIALS AND METHODS: Nine human subjects were scanned on a 3T MRI scanner with an 8-channel knee coil using the AWSOS sequence and isocenter positioning plus manual shimming. RESULTS: High-resolution UTE images were obtained on the subject knees at TE = 0.6 msec with total acquisition time of 5.12 minutes for 60 slices at an in-plane resolution of 0.28 mm and 10.24 minutes for 40 slices at an in-plane resolution of 0.14 mm. Isocenter positioning, manual shimming, and the 8-channel array coil helped minimize image distortion and achieve high signal-to-noise ratio (SNR). CONCLUSION: It is technically feasible on a clinical 3T MRI scanner to perform UTE imaging on human knee at very high spatial resolutions (0.28-0.14 mm) within reasonable scan time (5-10 min) using the AWSOS sequence.

Quantitative Sodium (23Na) MRI in Pediatric Gliomas: Initial Experience.

Background: 23Na MRI correlates with tumor proliferation, and studies in pediatric patients are lacking. The purpose of the study: (1) to compare total sodium concentration (TSC) between pediatric glioma and non-neoplastic brain tissue using 23Na MRI; (2) compare tissue conspicuity of bound sodium concentration (BSC) using 23Na MRI dual echo relative to TSC imaging. Methods: TSC was measured in: (1) non-neoplastic brain tissues and (2) three types of manually segmented gliomas (diffuse intrinsic brainstem glioma (DIPG), recurrent supratentorial low-grade glioma (LGG), and high-grade glioma (HGG)). In a subset of patients, serial changes in both TSC and BSC (dual echo 23Na MRI) were assessed. Results: Twenty-six pediatric patients with gliomas (median age of 12.0 years, range 4.9−23.3 years) were scanned with 23Na MRI. DIPG treated with RT demonstrated higher TSC values than the uninvolved infratentorial tissues (p < 0.001). Recurrent supratentorial LGG and HGG exhibited higher TSC values than the uninvolved white matter (WM) and gray matter (GM) (p < 0.002 for LGG, and p < 0.02 for HGG). The dual echo 23Na MRI suppressed the sodium signal within both CSF and necrotic foci. Conclusion: Quantitative 23Na MRI of pediatric gliomas demonstrates a range of values that are higher than non-neoplastic tissues. Dual echo 23Na MRI of BCS improves tissue conspicuity relative to TSC imaging.

Improved large tip angle parallel transmission pulse design through a perturbation analysis of the Bloch equation.

Parallel transmission has emerged as an efficient means for implementing multidimensional spatially selective radiofrequency excitation pulses. To date, most theoretical and experimental work on parallel transmission radiofrequency (RF) pulse design is based on the small-tip-angle approximation to the Bloch equation. The small-tip-angle, while mathematically compact, is not an exact solution and leads to significant errors when large-tip-angle pulses are designed. Methods have been proposed to overcome the limitations of the small-tip-angle using regularized least-square optimization or optimal control algorithms. These methods, however, are based on further approximations to the Bloch equation or require the use of general purpose algorithms that do not capitalize fully on the dynamics of the physical model at hand. In this article, a novel algorithm for large-tip-angle parallel transmission pulse design is proposed. The algorithm relies on a perturbation analysis of the Bloch equation and it depicts the relationship between the excited magnetization, its deviation from the target pattern and the desired pulses. Simulations and experiments are used to validate the proposed method on a 7 T 8-channel transmit array. The results demonstrate that the perturbation analysis algorithm provides a fast and accurate approach for multidimensional large-tip-angle pulse design, especially when large acceleration factors and/or echo-planar trajectories are used.

Visualizing pre-osteoarthritis: Integrating MRI UTE-T2* with mechanics and biology to combat osteoarthritis-The 2019 Elizabeth Winston Lanier Kappa Delta Award.

Osteoarthritis (OA) is a leading cause of pain and disability for which disease-modifying treatments remain lacking. This is because the symptoms and radiographic changes of OA occur after the onset of likely irreversible changes. Defining and treating earlier disease states are therefore needed to delay or to halt OA progression. Taking this concept a step further, studying OA pathogenesis before disease onset by characterizing potentially reversible markers of increased OA risk to identify a state of "pre-osteoarthritis (pre-OA)" shifts the paradigm towards OA prevention. The purpose of this review is to summarize the 42 studies comprising the 2019 Kappa Delta Elizabeth Lanier Award where conceptualization of a systems-based definition for "pre-osteoarthritis (pre-OA)" was followed by demonstration of potentially reversible markers of heightened OA risk in patients after anterior cruciate ligament (ACL) injury and reconstruction. In the process, these efforts contributed a new magnetic resonance imaging method of ultrashort echo time (UTE) enhanced T2* mapping to visualize joint tissue damage before the development of irreversible changes. The studies presented here support a transformative approach to OA that accounts for interactions between mechanical, biological, and structural markers of OA risk to develop and evaluate new treatment strategies that can delay or prevent the onset of clinical disease. This body of work was inspired by and performed for patients. Shifting the paradigm from attempting to modify symptomatic radiographic OA towards monitoring and reversing markers of "pre-OA" opens the door for transforming the clinical approach to OA from palliation to prevention.

Multicomponent T2* mapping of knee cartilage: technical feasibility ex vivo.

Disorganization of collagen fibers is a sign of early-stage cartilage degeneration in osteoarthritic knees. Water molecules trapped within well-organized collagen fibrils would be sensitive to collagen alterations. Multicomponent effective transverse relaxation (T2*) mapping with ultrashort echo time acquisitions is here proposed to probe short T(2) relaxations in those trapped water molecules. Six human tibial plateau explants were scanned on a 3T MRI scanner using a home-developed ultrashort echo time sequence with echo times optimized via Monte Carlo simulations. Time constants and component intensities of T2* decays were calculated at individual pixels, using the nonnegative least squares algorithm. Four T2*-decay types were found: 99% of cartilage pixels having mono-, bi-, or nonexponential decay, and 1% showing triexponential decay. Short T2* was mainly in 1-6 ms, while long T2* was ∼ 22 ms. A map of decay types presented spatial distribution of these T2* decays. These results showed the technical feasibility of multicomponent T2* mapping on human knee cartilage explants.

High-resolution spiral imaging on a whole-body 7T scanner with minimized image blurring.

High-resolution (approximately 0.22 mm) images are preferably acquired on whole-body 7T scanners to visualize minianatomic structures in human brain. They usually need long acquisition time ( approximately 12 min) in three-dimensional scans, even with both parallel imaging and partial Fourier samplings. The combined use of both fast imaging techniques, however, leads to occasionally visible undersampling artifacts. Spiral imaging has an advantage in acquisition efficiency over rectangular sampling, but its implementations are limited due to image blurring caused by a strong off-resonance effect at 7T. This study proposes a solution for minimizing image blurring while keeping spiral efficient. Image blurring at 7T was, first, quantitatively investigated using computer simulations and point-spread functions. A combined use of multishot spirals and ultrashort echo time acquisitions was then employed to minimize off-resonance-induced image blurring. Experiments on phantoms and healthy subjects were performed on a whole-body 7T scanner to show the performance of the proposed method. The three-dimensional brain images of human subjects were obtained at echo time = 1.18 ms, resolution = 0.22 mm (field of view = 220 mm, matrix size = 1024), and in-plane spiral shots = 128, using a home-developed ultrashort echo time sequence (acquisition-weighted stack of spirals). The total acquisition time for 60 partitions at pulse repetition time = 100 ms was 12.8 min without use of parallel imaging and partial Fourier sampling. The blurring in these spiral images was minimized to a level comparable to that in gradient-echo images with rectangular acquisitions, while the spiral acquisition efficiency was maintained at eight. These images showed that spiral imaging at 7T was feasible.

Optimal coil array design: the two-coil case.

The optimization problem for coil arrays is largely unsolved, even for the case of a two-coil system. This paper reports a systematic computer simulation to investigate the maximal achievable signal-to-noise ratio (SNR) with a two-coil receiver system where, using cancellation circuitry, mutual inductance is made zero. Both symmetrical and asymmetrical solutions with respect to two-coil geometry are considered. SNR is measured at a single point at a certain depth and also along a longitudinal or transverse line at the same depth. The conducting medium containing these regions of interest is assumed to be an infinite half space, an infinite cylinder or a finite sphere. The previous coil array design using a "magical" overlap only approximates the optimal solution for the infinite half space. For the infinite cylinder and the finite sphere, optimal solutions can be quite different from the "magical" overlap.

[18F]ML-10 PET: Initial Experience in Glioblastoma Multiforme Therapy Response Assessment.

The ability to assess tumor apoptotic response to therapy could provide a direct and prompt measure of therapeutic efficacy. 18F-labeled 2-(5-fluoro-pentyl)-2-methyl-malonic acid ([18F]ML-10) is proposed as a positron emission tomography (PET) apoptosis imaging radiotracer. This manuscript presents initial experience using [18F]ML-10 PET to predict therapeutic response in 4 patients with human glioblastoma multiforme. Each patient underwent [18F]ML-10 PET and contrast-enhanced magnetic resonance imaging (MRI) before (baseline) and at ∼2-3 weeks after therapy (early-therapy assessment). All PET and MRI data were acquired using a Siemens BioGraph mMR integrated PET/MRI scanner. PET acquisitions commenced 120 minutes after injection with 10 mCi of [18F]ML-10. Changes in [18F]ML-10 standard uptake values were assessed in conjunction with MRI changes. Time-to-progression was used as the outcome measure. One patient, ML-10 #4, underwent additional sodium-23 (23Na) MRI at baseline and early-therapy assessment. Siemens 3 T Magnetom Tim Trio scanner with a dual-tuned (1H-23Na) head coil was used for 23Na-MRI, acquiring two three-dimensional single-quantum sodium images at two echo times (TE). Volume-fraction-weighted bound sodium concentration was quantified through pixel-by-pixel subtraction of the two single-quantum sodium images. In the cases presented, [18F]ML-10 uptake changes were not clearly related to time-to-progression. We suggest that this may be because the tumors are undergoing varying rates of cell death and growth. Acquisition of complementary measures of tumor cell proliferation or viability may aid in the interpretation of PET apoptosis imaging.

[Advance of fast magnetic resonance spectroscopic imaging].

The required time of conventional magnetic resonance spectroscopic imaging technique is too long to be applied to clinic. It is necessary to develop the fast methods for magnetic resonance spectroscopic imaging. Nowadays there are 7 kinds of methods presented, which come from MRI techniques. In this contribution the conventional spectroscopic imaging and 7 sorts of fast spectroscopic imaging are elaborated. It is envisaged that more rapid imaging techniques will be designed, if these arbitrary trajectory reconstruction methods in MRI are applied to spectroscopic imaging.

[Software for MR image reconstruction from data acquired on an irregular k-space trajectory].

A PC-based software was developed and programmed with VC++6 for reconstructing MR images from the data acquired on an irregular k-space trajectory. It can read clinical MRI raw data and image data, create numerical phantoms, design k-space trajectories, generate k-space data from numerical phantom, calculate weighting functions, reconstruct images, and carry out error analysis for the reconstructed images. It is helpful to the investigations of new k-space trajectories and new reconstruction algorithms.

Quantitative Magnetic Resonance Imaging UTE-T2* Mapping of Cartilage and Meniscus Healing After Anatomic Anterior Cruciate Ligament Reconstruction.

BACKGROUND: An anterior cruciate ligament (ACL) injury greatly increases the risk for premature knee osteoarthritis (OA). Improved diagnosis and staging of early disease are needed to develop strategies to delay or prevent disabling OA. PURPOSE: Novel magnetic resonance imaging (MRI) ultrashort echo time (UTE)-T2(*) mapping was evaluated against clinical metrics of cartilage health in cross-sectional and longitudinal studies of human participants before and after ACL reconstruction (ACLR) to show reversible deep subsurface cartilage and meniscus matrix changes. STUDY DESIGN: Cohort study (diagnosis/prognosis); Level of evidence, 2. METHODS: Forty-two participants (31 undergoing anatomic ACLR; 11 uninjured) underwent 3-T MRI inclusive of a sequence capturing short and ultrashort T2 signals. An arthroscopic examination of the medial meniscus was performed, and modified Outerbridge grades were assigned to the central and posterior medial femoral condyle (cMFC and pMFC, respectively) of ACL-reconstructed patients. Two years after ACLR, 16 patients underwent the same 3-T MRI. UTE-T2(*) maps were generated for the posterior medial meniscus (pMM), cMFC, pMFC, and medial tibial plateau (MTP). Cross-sectional evaluations of UTE-T2(*) and arthroscopic data along with longitudinal analyses of UTE-T2(*) changes were performed. RESULTS: Arthroscopic grades showed that 74% (23/31) of ACL-reconstructed patients had intact cMFC cartilage (Outerbridge grade 0 and 1) and that 90% (28/31) were Outerbridge grade 0 to 2. UTE-T2(*) values in deep cMFC and pMFC cartilage varied significantly with injury status and arthroscopic grade (Outerbridge grade 0-2: n = 39; P = .03 and .04, respectively). Pairwise comparisons showed UTE-T2(*) differences between uninjured controls (n = 11) and patients with arthroscopic Outerbridge grade 0 for the cMFC (n = 12; P = .01) and arthroscopic Outerbridge grade 1 for the pMFC (n = 11; P = .01) only and not individually between arthroscopic Outerbridge grade 0, 1, and 2 of ACL-reconstructed patients (P > .05). Before ACLR, UTE-T2(*) values of deep cMFC and pMFC cartilage of ACL-reconstructed patients were a respective 43% and 46% higher than those of uninjured controls (14.1 ± 5.5 vs 9.9 ± 2.3 milliseconds [cMFC] and 17.4 ± 7.0 vs 11.9 ± 2.4 milliseconds [pMFC], respectively; P = .02 for both). In longitudinal analyses, preoperative elevations in UTE-T2(*) values in deep pMFC cartilage and the pMM in those with clinically intact menisci decreased to levels similar to those in uninjured controls (P = .02 and .005, respectively), suggestive of healing. No decrease in UTE-T2(*) values for the MFC and new elevation in UTE-T2(*) values for the submeniscus MTP were observed in those with meniscus tears. CONCLUSION: This study shows that novel UTE-T2(*) mapping demonstrates changes in cartilage deep tissue health according to joint injury status as well as a potential for articular cartilage and menisci to heal deep tissue injuries. Further clinical studies of UTE-T2(*) mapping are needed to determine if it can be used to identify joints at risk for rapid degeneration and to monitor effects of new treatments to delay or prevent the development of OA.

Challenges and Approaches to Quantitative Therapy Response Assessment in Glioblastoma Multiforme Using the Novel Apoptosis Positron Emission Tomography Tracer F-18 ML-10.

Evaluation of cancer-therapy efficacy at early time points is necessary for realizing the goal of delivering maximally effective treatment. Molecular imaging with carefully selected tracers and methodologies can provide the means for realizing this ability. Many therapies are aimed at inducing apoptosis in malignant tissue; thus, the ability to quantify apoptosis in vivo may be a fruitful approach. Apoptosis rate changes occur on a fast time scale, potentially allowing correspondingly rapid decisions regarding therapy value. However, quantification of tissue status based on apoptosis imaging is complicated by this time scale and by the spatial heterogeneity of the process. Using the positron emission tomography (PET) tracer 2-(5-fluoro-pentyl)-2-methyl-malonic acid (F-18 ML-10), we present methods of voxelwise analysis yielding quantitative measures of apoptosis changes, parametric apoptosis change images, and graphical representation of apoptotic features. A method of deformable registration to account for anatomic changes between scan time points is also demonstrated. Overall apoptotic rates deduced from imaging depend on tumor density and the specific rate of apoptosis, a situation resulting in an ambiguity in the source of observed image-based changes. The ambiguity may be resolved through multimodality imaging. An example of intracellular sodium magnetic resonance imaging coupled with F-18 ML-10 PET is provided.