Automatic segmentation of deep grey nuclei using a high-resolution 7T magnetic resonance imaging atlas-Quantification of T1 values in healthy volunteers.

We present a new consensus atlas of deep grey nuclei obtained by shape-based averaging of manual segmentation of two experienced neuroradiologists and optimized from 7T MP2RAGE images acquired at (.6 mm)3 in 60 healthy subjects. A group-wise normalization method was used to build a high-contrast and high-resolution T1 -weighted brain template (.5 mm)3 using data from 30 out of the 60 controls. Delineation of 24 deep grey nuclei per hemisphere, including the claustrum and 12 thalamic nuclei, was then performed by two expert neuroradiologists and reviewed by a third neuroradiologist according to tissue contrast and external references based on the Morel atlas. Corresponding deep grey matter structures were also extracted from the Morel and CIT168 atlases. The data-derived, Morel and CIT168 atlases were all applied at the individual level using non-linear registration to fit the subject reference and to extract absolute mean quantitative T1 values derived from the 3D-MP2RAGE volumes, after correction for residual B1+ biases. Three metrics (the Dice and the volumetric similarity coefficients and a novel Hausdorff distance) were used to estimate the inter-rater agreement of manual MRI segmentation and inter-atlas variability, and these metrics were measured to quantify biases due to image registration, and their impact on the measurements of the quantitative T1 values was highlighted. This represents a fully automated segmentation process permitting the extraction of unbiased normative T1 values in a population of young healthy controls as a reference for characterizing subtle structural alterations of deep grey nuclei relevant to a range of neurological diseases.

Magnetic resonance elastography with guided pressure waves.

Magnetic resonance elastography aims to non-invasively and remotely characterize the mechanical properties of living tissues. To quantitatively and regionally map the shear viscoelastic moduli in vivo, the technique must achieve proper mechanical excitation throughout the targeted tissues. Although it is straightforward, ante manibus, in close organs such as the liver or the breast, which practitioners clinically palpate already, it is somewhat fortunately highly challenging to trick the natural protective barriers of remote organs such as the brain. So far, mechanical waves have been induced in the latter by shaking the surrounding cranial bones. Here, the skull was circumvented by guiding pressure waves inside the subject's buccal cavity so mechanical waves could propagate from within through the brainstem up to the brain. Repeatable, reproducible and robust displacement fields were recorded in phantoms and in vivo by magnetic resonance elastography with guided pressure waves such that quantitative mechanical outcomes were extracted in the human brain.

Simultaneous proton density, T1 , T2 , and flip-angle mapping of the brain at 7 T using multiparametric 3D SSFP imaging and parallel-transmission universal pulses.

PURPOSE: Performing simultaneous quantitative MRI at ultrahigh field is challenging, as B0 and B1+ heterogeneities as well as specific absorption rate increase. Too large deviations of flip angle from the target can induce biases and impair SNR in the quantification process. In this work, we use calibration-free parallel transmission, a dedicated pulse-sequence parameter optimization and signal fitting to recover 3D proton density, flip angle, T1 , and T2 maps over the whole brain, in a clinically suitable time. METHODS: Eleven optimized contrasts were acquired with an unbalanced SSFP sequence by varying flip-angle amplitude and RF phase-cycling increment, at a 1.0 × 1.0 × 3.0 mm3 resolution. Acquisition time was 16 minutes 36 seconds for the whole brain. Parallel transmission and universal pulses were used to mitigate B1+ heterogeneity, to improve the results' reliability over 6 healthy volunteers (3 females/3 males, age 22.6 ± 2.7 years old). Quantification of the physical parameters was performed by fitting the acquired contrasts to the simulated ones using the Bloch-Torrey equations with a realistic diffusion coefficient. RESULTS: Whole-brain 3D maps of effective flip angle, proton density, and relaxation times were estimated. Parallel transmission improved the robustness of the results at 7 T. Results were in accordance with literature and with measurements from standard methods. CONCLUSION: These preliminary results show robust proton density, flip angle, T1 , and T2 map retrieval. Other parameters, such as ADC, could be assessed. With further optimization in the acquisition, scan time could be reduced and spatial resolution increased to bring this multiparametric quantification method to clinical research routine at 7 T.

Sources of systematic error in proton density fat fraction (PDFF) quantification in the liver evaluated from magnitude images with different numbers of echoes.

The purpose of this work was to investigate sources of bias in magnetic resonance imaging (MRI) liver fat quantification that lead to a dependence of the proton density fat fraction (PDFF) on the number of echoes. This was a retrospective analysis of liver MRI data from 463 subjects. The magnitude signal variation with TE from spoiled gradient echo images was curve fitted to estimate the PDFF using a model that included monoexponential R2 * decay and a multi-peak fat spectrum. Additional corrections for non-exponential decay (Gaussian), bi-exponential decay, degree of fat saturation, water frequency shift and noise bias were introduced. The fitting error was minimized with respect to 463 × 3 = 1389 subject-specific parameters and seven additional parameters associated with these corrections. The effect on PDFF was analyzed, notably the dependence on the number of echoes. The effects on R2 * were also analyzed. The results showed that the inclusion of bias corrections resulted in an increase in the quality of fit (r2 ) in 427 of 463 subjects (i.e. 92.2%) and a reduction in the total fitting error (residual norm) of 43.6%. This was largely a result of the Gaussian decay (57.8% of the reduction), fat spectrum (31.0%) and biexponential decay (8.8%) terms. The inclusion of corrections was also accompanied by a decrease in the dependence of PDFF on the number of echoes. Similar analysis of R2 * showed a decrease in the dependence on the number of echoes. Comparison of PDFF with spectroscopy indicated excellent agreement before and after correction, but the latter exhibited lower bias on a Bland-Altman plot (1.35% versus 0.41%). In conclusion, correction for known and expected biases in PDFF quantification in liver reduces the fitting error, decreases the dependence on the number of echoes and increases the accuracy.

Quantitative Gd-DOTA-based aerosol deposition mapping in the lungs of asthmatic rats using 3D UTE-MRI.

Asthma is a chronic respiratory disease, commonly treated with inhaled therapy. Better understanding of the mechanisms of aerosol deposition is required to improve inhaled drug delivery. Three-dimensional ultrashort echo time (UTE) MRI acquisitions at 1.5 T were combined with spontaneous nose-only inhalation of aerosolized gadolinium (Gd) to map the aerosol deposition and to characterize signal enhancement in asthmatic rat lungs. The rats were sensitized to ovalbumin (OVA) to develop asthmatic models and challenged before imaging by nebulization of OVA to trigger asthmatic symptoms. The negative controls were not sensitized or challenged by nebulization of saline. The animal lungs were imaged before and after administration of Gd-based aerosol in freely breathing rats, by using a T1 -weighted 3D UTE sequence. A contrast-enhanced quantitative analysis was performed to assess regional concentration. OVA-sensitized rats had lower signal enhancement and lower deposited aerosol concentration. Their enhancement dynamics showed large inter-subject variability. The signal intensity was homogeneously enhanced for controls while OVA-sensitized rats showed heterogeneous enhancement. Contrast-enhanced 3D UTE was applied with aerosolized Gd to efficiently measure spatially resolved deposition in asthmatic lungs. The small administered dose (around 1 µmol/kg body weight) and the use of standard clinical MRI suggest a potential application for the exploration of asthma.

An illustrated comparison of processing methods for phase MRI and QSM: removal of background field contributions from sources outside the region of interest.

The elimination of so-called background fields is an essential step in phase MRI and quantitative susceptibility mapping (QSM). Background fields, which are caused by sources outside the region of interest (ROI), are often one to two orders of magnitude stronger than tissue-related field variations from within the ROI, hampering quantitative interpretation of field maps. This paper reviews the current literature on background elimination algorithms for QSM and provides insights into similarities and differences between the many algorithms proposed. We discuss the basic theoretical foundations and derive fundamental limitations of background field elimination. Copyright © 2016 John Wiley & Sons, Ltd.

Aerosol deposition in the lungs of spontaneously breathing rats using Gd-DOTA-based contrast agents and ultra-short echo time MRI at 1.5 Tesla.

PURPOSE: Aerosol toxicology and drug delivery through the lungs, which depend on various parameters, require methods to quantify particle deposition. Intrapulmonary-administered MRI contrast agent combined with lung-specific imaging sequences has been proposed as a high performance technique for aerosol research. Here, aerosol deposition is assessed using ultra-short echo (UTE) sequences. METHODS: Before and after administration of Gd-DOTA-based aerosol delivered nose-only in free-breathing healthy rats, a T1 -weighted 3D UTE sequence was applied in a clinical 1.5 Tesla scanner. Administration lasted 14 min, and the experiment was performed on six rats. A contrast-enhanced quantitative analysis was done. RESULTS: Fifty percent signal enhancement was obtained in the lung parenchyma. Lung clearance of the contrast agent was evaluated to be 14% per h (corresponding to a characteristic clearance time of 3.6 h) and aerosol deposition was shown to be homogeneous throughout the lung in healthy rats. The total deposited dose was estimated to be 1.05 µmol/kg body weight, and the concentration precision was 0.02 mM. CONCLUSION: The UTE protocol with nebulized Gd-DOTA is replicable to significantly enhance the lung parenchyma and to map aerosol deposition. This functional strategy, applied in a clinical system with a clinical nebulization setup and a low inhaled dose, suggests a feasible translation to human.

2D harmonic filtering of MR phase images in multicenter clinical setting: toward a magnetic signature of cerebral microbleeds.

Cerebral microbleeds (CMBs) have emerged as a new imaging marker of small vessel disease. Composed of hemosiderin, CMBs are paramagnetic and can be detected with MRI sequences sensitive to magnetic susceptibility (typically, gradient recalled echo T2* weighted images). Nevertheless, their identification remains challenging on T2* magnitude images because of confounding structures and lesions. In this context, T2* phase image may play a key role in better characterizing CMBs because of its direct relationship with local magnetic field variations due to magnetic susceptibility difference. To address this issue, susceptibility-based imaging techniques were proposed, such as Susceptibility Weighted Imaging (SWI) and Quantitative Susceptibility Mapping (QSM). But these techniques have not yet been validated for 2D clinical data in multicenter settings. Here, we introduce 2DHF, a fast 2D phase processing technique embedding both unwrapping and harmonic filtering designed for data acquired in 2D, even with slice-to-slice inconsistencies. This method results in internal field maps which reveal local field details due to magnetic inhomogeneity within the region of interest only. This technique is based on the physical properties of the induced magnetic field and should yield consistent results. A synthetic phantom was created for numerical simulations. It simulates paramagnetic and diamagnetic lesions within a 'brain-like' tissue, within a background. The method was evaluated on both this synthetic phantom and multicenter 2D datasets acquired in standardized clinical setting, and compared with two state-of-the-art methods. It proved to yield consistent results on synthetic images and to be applicable and robust on patient data. As a proof-of-concept, we finally illustrate that it is possible to find a magnetic signature of CMBs and CMCs on internal field maps generated with 2DHF on 2D clinical datasets that give consistent results with CT-scans in a subsample of 10 subjects acquired with both modalities.

Phase-contrast velocity mapping for highly diffusive fluids: optimal bipolar gradient pulse parameters for hyperpolarized helium-3.

PURPOSE: In MR-velocity phase-contrast measurements, increasing the encoding bipolar gradient, i.e., decreasing the field of speed, usually improves measurement precision. However, in gases, fast diffusion during the bipolar gradient pulses may dramatically decrease the signal-to-noise ratio, thus degrading measurement precision. These two effects are contradictory. This work aims at determining the optimal sequence parameters to improve the velocity measurement precision. THEORY AND METHODS: This work presents the theoretical optimization of bipolar gradient parameters (duration and amplitude) to improve velocity measurement precision. An analytical approximation is given as well as a numerical optimization. It is shown that the solution depends on the diffusion coefficient and T2 *. Experimental validation using hyperpolarized (3) He diluted in various buffer gases ((4) He, N2 , and SF6 ) is presented at 1.5 Tesla (T) in a straight pipe. RESULTS: Excellent agreement was found with the theoretical results for prediction of optimal field of speed and good agreement was found for the precision in measured velocity, but for SF6 buffered gas. CONCLUSION: The theoretical predictions were validated, providing a way to optimize velocity mapping in gases.

Energetic dysfunction and iron overload in early Parkinson's disease: Two distinct mechanisms?

INTRODUCTION: Identifying biomarkers reflecting cellular dysfunctions in early Parkinson's disease patients (ePD) is needed to develop targeted therapeutic strategies. We aimed to determine if cellular energetic dysfunction related to increased brain sodium concentration would be co-located to microstructural alterations and iron deposition in ePD. METHODS: We prospectively included 12 ePD (mean disease duration 20.0 ± 10.2 months) and 13 healthy controls (HC), scanned with a 7 T 1H and 23Na MRI. Complementary voxel-based and region-based assessments were performed, the latter utilizing a high-resolution multimodal template we created (combining quantitative T1 maps (qT1), transverse relaxation rate (R2*), quantitative magnetic susceptibility mapping (QSM) images) from 200 subjects. This template allowed a precise multiparametric assessment of sodium concentration, QSM, R2*, qT1, mean diffusivity, and fractional anisotropy values. A two-sided p-value<0.05 was considered statistically significant after the Bonferroni correction. RESULTS: Relative to HC, ePD showed significantly higher sodium concentration in left Substantia nigra (SN) pars reticulata (46.13 mM ± 3.52 vs 38.60 mM ± 6.10, p = 0.038), a subpart of the SN pars compacta (SNc) and ventral tegmental area, Putamen, Globus Pallidum external, accumbens nucleus and claustrum. Significantly increased QSM and R2* values, and decreased T1 values, were limited to the Nigrosomes 1 (Nig) and right SNc (all p < 0.05). QSM values in the Nig were significantly correlated to UPDRS-III scores (r = 0.91,p < 0.001). CONCLUSION: In ePD, brain sodium accumulation was broad and dissociated from iron accumulation. As with iron accumulation, a sodium-related pathophysiological approach could lead to identifying potential new therapeutic agents and deserves further investigation.

Morphology enabled dipole inversion for quantitative susceptibility mapping using structural consistency between the magnitude image and the susceptibility map.

The magnetic susceptibility of tissue can be determined in gradient echo MRI by deconvolving the local magnetic field with the magnetic field generated by a unit dipole. This Quantitative Susceptibility Mapping (QSM) problem is unfortunately ill-posed. By transforming the problem to the Fourier domain, the susceptibility appears to be undersampled only at points where the dipole kernel is zero, suggesting that a modest amount of additional information may be sufficient for uniquely resolving susceptibility. A Morphology Enabled Dipole Inversion (MEDI) approach is developed that exploits the structural consistency between the susceptibility map and the magnitude image reconstructed from the same gradient echo MRI. Specifically, voxels that are part of edges in the susceptibility map but not in the edges of the magnitude image are considered to be sparse. In this approach an L1 norm minimization is used to express this sparsity property. Numerical simulations and phantom experiments are performed to demonstrate the superiority of this L1 minimization approach over the previous L2 minimization method. Preliminary brain imaging results in healthy subjects and in patients with intracerebral hemorrhages illustrate that QSM is feasible in practice.

Morphology enabled dipole inversion (MEDI) from a single-angle acquisition: comparison with COSMOS in human brain imaging.

Magnetic susceptibility varies among brain structures and provides insights into the chemical and molecular composition of brain tissues. However, the determination of an arbitrary susceptibility distribution from the measured MR signal phase is a challenging, ill-conditioned inverse problem. Although a previous method named calculation of susceptibility through multiple orientation sampling (COSMOS) has solved this inverse problem both theoretically and experimentally using multiple angle acquisitions, it is often impractical to carry out on human subjects. Recently, the feasibility of calculating the brain susceptibility distribution from a single-angle acquisition was demonstrated using morphology enabled dipole inversion (MEDI). In this study, we further improved the original MEDI method by sparsifying the edges in the quantitative susceptibility map that do not have a corresponding edge in the magnitude image. Quantitative susceptibility maps generated by the improved MEDI were compared qualitatively and quantitatively with those generated by calculation of susceptibility through multiple orientation sampling. The results show a high degree of agreement between MEDI and calculation of susceptibility through multiple orientation sampling, and the practicality of MEDI allows many potential clinical applications.

A novel background field removal method for MRI using projection onto dipole fields (PDF).

For optimal image quality in susceptibility-weighted imaging and accurate quantification of susceptibility, it is necessary to isolate the local field generated by local magnetic sources (such as iron) from the background field that arises from imperfect shimming and variations in magnetic susceptibility of surrounding tissues (including air). Previous background removal techniques have limited effectiveness depending on the accuracy of model assumptions or information input. In this article, we report an observation that the magnetic field for a dipole outside a given region of interest (ROI) is approximately orthogonal to the magnetic field of a dipole inside the ROI. Accordingly, we propose a nonparametric background field removal technique based on projection onto dipole fields (PDF). In this PDF technique, the background field inside an ROI is decomposed into a field originating from dipoles outside the ROI using the projection theorem in Hilbert space. This novel PDF background removal technique was validated on a numerical simulation and a phantom experiment and was applied in human brain imaging, demonstrating substantial improvement in background field removal compared with the commonly used high-pass filtering method.

Quantitative susceptibility map reconstruction from MR phase data using bayesian regularization: validation and application to brain imaging.

The diagnosis of many neurologic diseases benefits from the ability to quantitatively assess iron in the brain. Paramagnetic iron modifies the magnetic susceptibility causing magnetic field inhomogeneity in MRI. The local field can be mapped using the MR signal phase, which is discarded in a typical image reconstruction. The calculation of the susceptibility from the measured magnetic field is an ill-posed inverse problem. In this work, a bayesian regularization approach that adds spatial priors from the MR magnitude image is formulated for susceptibility imaging. Priors include background regions of known zero susceptibility and edge information from the magnitude image. Simulation and phantom validation experiments demonstrated accurate susceptibility maps free of artifacts. The ability to characterize iron content in brain hemorrhage was demonstrated on patients with cavernous hemangioma. Additionally, multiple structures within the brain can be clearly visualized and characterized. The technique introduces a new quantitative contrast in MRI that is directly linked to iron in the brain.

Design of a fast field-cycling magnetic resonance imaging system, characterization and methods for relaxation dispersion measurements around 1.5 T.

The dependence of the nuclear magnetic resonance relaxation rate on the magnetic field has been widely studied, in particular, in biomedical areas with the objectives to better understand the underlying microscopic mechanisms in tissues and provide biomarkers of diseases. By combining fast-field cycling (FFC) and magnetic resonance imaging (MRI), it is possible to provide localized relaxation dispersion measurements in heterogeneous systems with recent demonstrations in solutions, biological samples, human beings, and small animals. We report here the developments and performances of a device designed for small animal FFC-MRI comprising a resistive insert technology operating inside a 1.5 T MRI system. Specific measurement methods were developed to characterize the system efficiency, response time, homogeneity, stability, and compensation. By adding a non-linear element in the system and using a dual amplifier strategy, it is shown that large field offsets can be produced during relaxation periods while maintaining precise field control during detection periods. The measurement of longitudinal nuclear magnetic relaxation dispersion (NMRD) profiles in the range of 1.08 T-1.92 T is reported, essentially displaying a linear variation in this range for common MRI contrast agents. The slopes of both the longitudinal and transverse relaxation dispersion profiles at 1.5 T are measured and validated, extending the capabilities of previous approaches. The performances of a longitudinal relaxation dispersion mapping method are finally reported, opening the way to quantitative preclinical dispersion imaging studies at a high FFC-MRI field.

A new paradigm for lung-conservative total liquid ventilation.

BACKGROUND: Total liquid ventilation (TLV) of the lungs could provide radically new benefits in critically ill patients requiring lung lavage or ultra-fast cooling after cardiac arrest. It consists in an initial filling of the lungs with perfluorocarbons and subsequent tidal ventilation using a dedicated liquid ventilator. Here, we propose a new paradigm for a lung-conservative TLV using pulmonary volumes of perfluorocarbons below functional residual capacity (FRC). METHODS AND FINDINGS: Using a dedicated technology, we showed that perfluorocarbon end-expiratory volumes could be maintained below expected FRC and lead to better respiratory recovery, preserved lung structure and accelerated evaporation of liquid residues as compared to complete lung filling in piglets. Such TLV below FRC prevented volutrauma through preservation of alveolar recruitment reserve. When used with temperature-controlled perfluorocarbons, this lung-conservative approach provided neuroprotective ultra-fast cooling in a model of hypoxic-ischemic encephalopathy. The scale-up and automating of the technology confirmed that incomplete initial lung filling during TLV was beneficial in human adult-sized pigs, despite larger size and maturity of the lungs. Our results were confirmed in aged non-human primates, confirming the safety of this lung-conservative approach. INTERPRETATION: This study demonstrated that TLV with an accurate control of perfluorocarbon volume below FRC could provide the full potential of TLV in an innovative and safe manner. This constitutes a new paradigm through the tidal liquid ventilation of incompletely filled lungs, which strongly differs from the previously known TLV approach, opening promising perspectives for a safer clinical translation. FUND: ANR (COOLIVENT), FRM (DBS20140930781), SATT IdfInnov (project 273).

Calculation of susceptibility through multiple orientation sampling (COSMOS): a method for conditioning the inverse problem from measured magnetic field map to susceptibility source image in MRI.

Magnetic susceptibility differs among tissues based on their contents of iron, calcium, contrast agent, and other molecular compositions. Susceptibility modifies the magnetic field detected in the MR signal phase. The determination of an arbitrary susceptibility distribution from the induced field shifts is a challenging, ill-posed inverse problem. A method called "calculation of susceptibility through multiple orientation sampling" (COSMOS) is proposed to stabilize this inverse problem. The field created by the susceptibility distribution is sampled at multiple orientations with respect to the polarization field, B(0), and the susceptibility map is reconstructed by weighted linear least squares to account for field noise and the signal void region. Numerical simulations and phantom and in vitro imaging validations demonstrated that COSMOS is a stable and precise approach to quantify a susceptibility distribution using MRI.

Clinical Integration of Quantitative Susceptibility Mapping Magnetic Resonance Imaging into Neurosurgical Practice.

OBJECTIVE: To introduce quantitative susceptibility mapping (QSM), a novel magnetic resonance imaging sequence, to the field of neurosurgery. METHODS: QSM is introduced both in its historical context and by providing a brief overview of the physics behind the technique tailored to a neurosurgical audience. Its application to clinical neurosurgery is then highlighted using case examples. RESULTS: QSM offers a quantitative assessment of susceptibility (previously considered as an artifact) via a single, straightforward gradient echo acquisition. QSM differs from standard susceptibility weighted imaging in its ability to both quantify and precisely localize susceptibility effects. Clinical applications of QSM are wide reaching and include precise localization of the deep nuclei for deep brain stimulation electrode placement, differentiation between blood products and calcification within brain lesions, and enhanced sensitivity of cerebral micrometastasis identification. CONCLUSIONS: We present this diverse range of QSM's clinical applications to neurosurgical care via case examples. QSM can be obtained in all patients able to undergo magnetic resonance imaging and is easily integratable into busy neuroradiology programs because of its short acquisition time and straightforward, automated offline postprocessing workflow. Clinical integration of QSM may help clinicians better identify and characterize neurosurgical lesions, thereby improving patient care.

Clinical Integration of Automated Processing for Brain Quantitative Susceptibility Mapping: Multi-Site Reproducibility and Single-Site Robustness.

BACKGROUND AND PURPOSE: Quantitative susceptibility mapping (QSM) of the brain has become highly reproducible and has applications in an expanding array of diseases. To translate QSM from bench to bedside, it is important to automate its reconstruction immediately after data acquisition. In this work, a server system that automatically reconstructs QSM and exchange images with the scanner using the DICOM standard is demonstrated using a multi-site, multi-vendor reproducibility study and a large, single-site, multi-scanner image quality review study in a clinical environment. METHODS: A single healthy subject was scanned with a 3D multi-echo gradient echo sequence at nine sites around the world using scanners from three manufacturers. A high-resolution (HiRes, .5 × .5 × 1 mm3 reconstructed) and standard-resolution (StdRes, .5 × .5 × 3 mm3 ) protocol was performed. ROI analysis of various white matter and gray matter regions was performed to investigate reproducibility across sites. At one institution, a retrospective multi-scanner image quality review was carried out of all clinical QSM images acquired consecutively in 1 month. RESULTS: Reconstruction times using a GPU were 29 ± 22 seconds (StdRes) and 55 ± 39 seconds (HiRes). ROI standard deviation across sites was below 24 ppb (StdRes) and 17 ppb (HiRes). Correlations between ROI averages across sites were on average .92 (StdRes) and .96 (HiRes). Image quality review of 873 consecutive patients revealed diagnostic or excellent image quality in 96% of patients. CONCLUSION: Online QSM reconstruction for a variety of sites and scanner platforms with low cross-site ROI standard deviation is demonstrated. Image quality review revealed diagnostic or excellent image quality in 96% of 873 patients.

European Ultrahigh-Field Imaging Network for Neurodegenerative Diseases (EUFIND).

INTRODUCTION: The goal of European Ultrahigh-Field Imaging Network in Neurodegenerative Diseases (EUFIND) is to identify opportunities and challenges of 7 Tesla (7T) MRI for clinical and research applications in neurodegeneration. EUFIND comprises 22 European and one US site, including over 50 MRI and dementia experts as well as neuroscientists. METHODS: EUFIND combined consensus workshops and data sharing for multisite analysis, focusing on 7 core topics: clinical applications/clinical research, highest resolution anatomy, functional imaging, vascular systems/vascular pathology, iron mapping and neuropathology detection, spectroscopy, and quality assurance. Across these topics, EUFIND considered standard operating procedures, safety, and multivendor harmonization. RESULTS: The clinical and research opportunities and challenges of 7T MRI in each subtopic are set out as a roadmap. Specific MRI sequences for each subtopic were implemented in a pilot study presented in this report. Results show that a large multisite 7T imaging network with highly advanced and harmonized imaging sequences is feasible and may enable future multicentre ultrahigh-field MRI studies and clinical trials. DISCUSSION: The EUFIND network can be a major driver for advancing clinical neuroimaging research using 7T and for identifying use-cases for clinical applications in neurodegeneration.