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Quality assessment, including inspecting the images for artifacts, is a critical step during magnetic resonance imaging (MRI) data acquisition to ensure data quality and downstream analysis or interpretation success. This study demonstrates a deep learning (DL) model to detect rigid motion in T1-weighted brain images. We leveraged a 2D convolutional neural network (CNN) trained on motion-synthesized data for three-class classification and tested it on publicly available retrospective and prospective datasets. Grad-CAM heatmaps enabled the identification of failure modes and provided an interpretation of the model's results. The model achieved average precision and recall metrics of 85% and 80% on six motion-simulated retrospective datasets. Additionally, the model's classifications on the prospective dataset showed 93% agreement with the labeling of a radiologist a strong inverse correlation (-0.84) compared to average edge strength, an image quality metric indicative of motion. This model is aimed at inline automatic detection of motion artifacts, accelerating part of the time-consuming quality assessment (QA) process and augmenting expertise on-site, particularly relevant in low-resource settings where local MR knowledge is scarce.
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BACKGROUND: Very low-field MR has emerged as a promising complementary device to high-field MRI scanners, offering several advantages. One of the key benefits is that very low-field scanners are generally more portable and affordable to purchase and maintain, making them an attractive option for medical facilities looking to reduce costs. Very low-field MRI systems also have lower RF power deposition, making them safer and less likely to cause tissue heating or other safety concerns. They are also simpler to maintain, as they do not require cooling agents such as liquid helium. However, these portable MR scanners are impacted by temperature, lower magnetic field strength, and inhomogeneity, resulting in images with lower signal-to-noise ratio (SNR) and higher geometric distortions. It is essential to investigate and tabulate the variations in these parameters to establish bounds so that subsequent in vivo studies and deployment of these portable systems can be well informed. PURPOSE: The aim of this work is to investigate the repeatability of image quality metrics such as SNR and geometrical distortion at 0.05 T over 10 days and three sessions per day. METHODS: We acquired repeatability data over 10 days with three sessions per day. The measurements included temperature, humidity, transmit frequency, off-resonance maps, and 3D turbo spin echo (TSE) images of an in vitro phantom. This resulted in a protocol with 11 sequences. We also acquired a 3 T data set for reference. The image quality metrics included computing SNR and eccentricity (to assess geometrical distortion) to investigate the repeatability of 0.05 T image quality. The image reconstruction included drift correction, k-space filtering, and off-resonance correction. We computed the experimental parameters' coefficient of variation (CV) and the resulting image quality metrics to assess repeatability. We have explored the impact of electromagnetic interference (EMI) on image quality in very low-field MRI. The investigation involved varying both the distance and amplitude of the EMI-producing coil from the signal generator to analyze their effects on image quality. RESULTS: The range of temperature measured during the study was within 1.5 °C. The off-resonance maps acquired before and after the 3D TSE showed similar hotspots and were changed mainly by a global constant. The SNR measurements were highly repeatable across sessions and over the 10 days, quantified by a CV of 6.7%. The magnetic field inhomogeneity effects quantified by eccentricity showed a CV of 13.7%, but less than 5.1% in two of the three sessions over 10 days. The use of conjugate phase reconstruction mitigated geometrical distortion artifacts. Temperature and humidity did not significantly affect SNR or mean frequency drift within the ranges of these environmental factors investigated. The EMI experiment showed that as the amplitude increased the SNR decreased, and concurrently the root mean square of the background increased with a rise in EMI amplitude or a reduction in distance. CONCLUSIONS: We found that humidity and temperature in the range investigated did not impact SNR or frequency. Based on the CV values computed session-wise and for the overall study, our findings indicate high repeatability for SNR and magnetic field homogeneity.
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Imageamento por Ressonância Magnética , Razão Sinal-Ruído , Imageamento por Ressonância Magnética/métodos , Reprodutibilidade dos Testes , Imagens de Fantasmas , HumanosRESUMO
This study presents a tool that introduces the fundamental concepts of magnetic resonance (MR) by integrating related science, technology, engineering, arts, and mathematical (STEAM) topics in the form of games to improve the access to MR education.
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Imageamento por Ressonância Magnética , Espectroscopia de Ressonância MagnéticaRESUMO
Magnetic resonance imaging (MRI) of the brain has benefited from deep learning (DL) to alleviate the burden on radiologists and MR technologists, and improve throughput. The easy accessibility of DL tools has resulted in a rapid increase of DL models and subsequent peer-reviewed publications. However, the rate of deployment in clinical settings is low. Therefore, this review attempts to bring together the ideas from data collection to deployment in the clinic, building on the guidelines and principles that accreditation agencies have espoused. We introduce the need for and the role of DL to deliver accessible MRI. This is followed by a brief review of DL examples in the context of neuropathologies. Based on these studies and others, we collate the prerequisites to develop and deploy DL models for brain MRI. We then delve into the guiding principles to develop good machine learning practices in the context of neuroimaging, with a focus on explainability. A checklist based on the United States Food and Drug Administration's good machine learning practices is provided as a summary of these guidelines. Finally, we review the current challenges and future opportunities in DL for brain MRI.
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Aprendizado Profundo , Imageamento por Ressonância Magnética , Encéfalo/diagnóstico por imagem , Neuroimagem , Espectroscopia de Ressonância MagnéticaRESUMO
Magnetic Resonance Imaging (MR Imaging) is routinely employed in diagnosing Alzheimer's Disease (AD), which accounts for up to 60-80% of dementia cases. However, it is time-consuming, and protocol optimization to accelerate MR Imaging requires local expertise since each pulse sequence involves multiple configurable parameters that need optimization for contrast, acquisition time, and signal-to-noise ratio (SNR). The lack of this expertise contributes to the highly inefficient utilization of MRI services diminishing their clinical value. In this work, we extend our previous effort and demonstrate accelerated MRI via intelligent protocolling of the modified brain screen protocol, referred to as the Gold Standard (GS) protocol. We leverage deep learning-based contrast-specific image-denoising to improve the image quality of data acquired using the accelerated protocol. Since the SNR of MR acquisitions depends on the volume of the object being imaged, we demonstrate subject-specific (SS) image-denoising. The accelerated protocol resulted in a 1.94 × gain in imaging throughput. This translated to a 72.51% increase in MR Value-defined in this work as the ratio of the sum of median object-masked local SNR values across all contrasts to the protocol's acquisition duration. We also computed PSNR, local SNR, MS-SSIM, and variance of the Laplacian values for image quality evaluation on 25 retrospective datasets. The minimum/maximum PSNR gains (measured in dB) were 1.18/11.68 and 1.04/13.15, from the baseline and SS image-denoising models, respectively. MS-SSIM gains were: 0.003/0.065 and 0.01/0.066; variance of the Laplacian (lower is better): 0.104/-0.135 and 0.13/-0.143. The GS protocol constitutes 44.44% of the comprehensive AD imaging protocol defined by the European Prevention of Alzheimer's Disease project. Therefore, we also demonstrate the potential for AD-imaging via automated volumetry of relevant brain anatomies. We performed statistical analysis on these volumetric measurements of the hippocampus and amygdala from the GS and accelerated protocols, and found that 27 locations were in excellent agreement. In conclusion, accelerated brain imaging with the potential for AD imaging was demonstrated, and image quality was recovered post-acquisition using DL-based image denoising models.
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PURPOSE: Brain and spinal cord tumors are the second most common cancer in children and account for one out of four cancers diagnosed. However, the long acquisition times associated with acquiring both data types prohibit using quantitative MR (qMR) in pediatric imaging protocols. This study aims to demonstrate the tailored magnetic resonance fingerprinting's (TMRF) ability to simultaneously provide quantitative maps (T1, T2) and multi-contrast qualitative images (T1 weighted, T1 FLAIR, T2 weighted) rapidly in pediatric brain tumor patients. METHODS: In this work, we imaged five pediatric patients with brain tumors (resected/residual) using TMRF at 3 T. We compared the TMRF-derived T2 weighted images with those from the vendor-supplied sequence (as the gold standard, GS) for healthy and pathological tissue signal intensities. The relaxometric maps from TMRF were subjected to a region of interest (ROI) analysis to differentiate between healthy and pathological tissues. We performed the Wilcoxon rank sum test to check for significant differences between the two tissue types. RESULTS: We found significant differences (p < 0.05) in both T1 and T2 ROI values between the two tissue types. A strong correlation was found between the TMRF-based T2 weighted and GS signal intensities for the healthy (correlation coefficient, r = 0.99) and pathological tissues (r = 0.88). CONCLUSION: The TMRF implementation provides the two relaxometric maps and can potentially save ~2 min if it replaces the T2-weighted imaging in the current protocol.
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Neoplasias Encefálicas , Imageamento por Ressonância Magnética , Humanos , Criança , Imageamento por Ressonância Magnética/métodos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/cirurgia , Espectroscopia de Ressonância Magnética , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Estatísticas não ParamétricasRESUMO
The purpose of this study is to demonstrate the first work ofT1-based magnetic resonance thermometry using magnetic resonance fingerprinting (dubbed MRFT). We compared temperature estimation of MRFT with proton resonance frequency shift (PRFS) thermometry onex vivobovine muscle. We demonstrated MRFT's feasibility in predicting temperature onex vivobovine muscles with deep brain stimulation (DBS) lead.B0maps generated from MRFT were compared with gold standardB0maps near the DBS lead. MRFT and PRFS estimated temperatures were compared in the presence of motion. All experiments were performed on a 3 Tesla whole-body GE Premier system with a 21-channel receive head coil (GE Healthcare, Milwaukee, WI). Four fluoroptic probes were used to measure the temperature at the center of a cold muscle (probe 1), the room temperature water bottle (probe 2), and the center and periphery of the heated muscle (probes 3 and 4). We selected regions of interest (ROIs) around the location of the probes and used simple linear regression to generate the temperature sensitivity calibration equations that convertT1maps and Δsmaps to temperature maps. We then repeated the same setup and compared MRFT and PRFS thermometry temperature estimation with gold standard probe measurements. For the MRFT experiment on DBS lead, we taped the probe to the tip of the DBS lead and used a turbo spin echo sequence to induce heating near the lead. We selected ROIs around the tip of the lead to compare MRFT temperature estimation with probe measurements and compared with PRFS temperature estimation. Vendor-suppliedB0mapping sequence was acquired to compare with MRFT-generatedB0maps. We found strong linear relationships (R2> 0.958) betweenT1and temperature and Δsand temperatures in our temperature sensitivity calibration experiment. MRFT and PRFS thermometry both accurately predict temperature (RMSE < 1.55 °C) compared to probe measurements. MRFT estimated temperature near DBS lead has a similar trend as the probe temperature. BothB0maps show inhomogeneities around the lead. MRFT estimated temperature is less sensitive to motion.
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Chumbo , Termometria , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética , Termometria/métodos , Temperatura , Imagens de FantasmasRESUMO
Presently, magnetic resonance imaging (MRI) magnets must deliver excellent magnetic field (B0 ) uniformity to achieve optimum image quality. Long magnets can satisfy the homogeneity requirements but require considerable superconducting material. These designs result in large, heavy, and costly systems that aggravate as field strength increases. Furthermore, the tight temperature tolerance of niobium titanium magnets adds instability to the system and requires operation at liquid helium temperature. These issues are crucial factors in the disparity of MR density and field strength use across the globe. Low-income settings show reduced access to MRI, especially to high field strengths. This article summarizes the proposed modifications to MRI superconducting magnet design and their impact on accessibility, including compact, reduced liquid helium, and specialty systems. Reducing the amount of superconductor inevitably entails shrinking the magnet size, resulting in higher field inhomogeneity. This work also reviews the state-of-the-art imaging and reconstruction methods to overcome this issue. Finally, we summarize the current and future challenges and opportunities in the design of accessible MRI.
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Neuroimaging of certain pathologies requires both multi-parametric qualitative and quantitative imaging. The role of the quantitative MRI (qMRI) is well accepted but suffers from long acquisition times leading to patient discomfort, especially in geriatric and pediatric patients. Previous studies show that synthetic MRI can be used in order to reduce the scan time and provide qMRI as well as multi-contrast data. However, this approach suffers from artifacts such as partial volume and flow. In order to increase the scan efficiency (the number of contrasts and quantitative maps acquired per unit time), we designed, simulated, and demonstrated rapid, simultaneous, multi-contrast qualitative (T1 weighted, T1 fluid attenuated inversion recovery (FLAIR), T2 weighted, water, and fat), and quantitative imaging (T1 and T2 maps) through the approach of tailored MR fingerprinting (TMRF) to cover whole-brain in approximately four minutes. We performed TMRF on in vivo four healthy human brains and in vitro ISMRM/NIST phantom and compared with vendor supplied gold standard (GS) and MRF sequences. All scans were performed on a 3 T GE Premier system and images were reconstructed offline using MATLAB. The reconstructed qualitative images were then subjected to custom DL denoising and gradient anisotropic diffusion denoising. The quantitative tissue parametric maps were reconstructed using a dense neural network to gain computational speed compared to dictionary matching. The grey matter and white matter tissues in qualitative and quantitative data for the in vivo datasets were segmented semi-automatically. The SNR and mean contrasts were plotted and compared across all three methods. The GS images show better SNR in all four subjects compared to MRF and TMRF (GS > TMRF>MRF). The T1 and T2 values of MRF are relatively overestimated as compared to GS and TMRF. The scan efficiency for TMRF is 1.72 min-1 which is higher compared to GS (0.32 min-1) and MRF (0.90 min-1).
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Encéfalo , Imageamento por Ressonância Magnética , Humanos , Criança , Idoso , Imageamento por Ressonância Magnética/métodos , Neuroimagem , Imagens de Fantasmas , Espectroscopia de Ressonância Magnética , Processamento de Imagem Assistida por Computador/métodosRESUMO
Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low-resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2-year period. The 68-question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub-Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low-field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher-field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up-to-date data on MRI density in Africa and offers a unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high-value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low-resource settings.
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Imageamento por Ressonância Magnética , Humanos , África Subsaariana , Inquéritos e QuestionáriosRESUMO
Raw data, simulated and acquired phantom images, and quantitative longitudinal and transverse relaxation times (T1/T2) maps from two open-source Magnetic Resonance Imaging (MRI) pulse sequences are presented in this dataset along with corresponding ".seq" files, sequence implementation scripts, and reconstruction/analysis scripts [1]. Real MRI data were collected from a 3T Siemens Prisma Fit and a 1.5T Siemens Aera via the Pulseq open-source MR sequence platform, and corresponding in silico data were generated using the simulation module of Virtual Scanner [2]. This dataset and its associated code can be used to validate the pipeline for using the same pulse sequences at other research sites using Pulseq, to provide guidelines for documenting and sharing open-source pulse sequences in general, and to demonstrate practical, customizable acquisition scripts using the PyPulseq library.
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Low-field MR scanners are more accessible in resource-constrained settings where skilled personnel are scarce. Images acquired in such scenarios are prone to artifacts such as wrap-around and Gibbs ringing. Such artifacts negatively affect the diagnostic quality and may be confused with pathology or reduce the region of interest visibility. As a first step solution, ArtifactID identifies wrap-around and Gibbs ringing in low-field brain MRI. We utilized two datasets: 179 T1-weighted pathological brain images from a 0.36 T scanner and 581 publicly available T1-weighted brain images. Individual binary classification models were trained to identify through-plane wrap-around, in-plane wrap-around, and Gibbs ringing. Visual explanations obtained via the GradCAM method helped develop trust in the wrap-around model. The mean precision and recall metrics across the four implemented models were 97.6% and 92.83% respectively. Agreement analysis of the models and the radiologists' labels returned Cohen's kappa values of 0.768 ± 0.062, 1.00 ± 0.000, 0.89 ± 0.085, and 0.878 ± 0.103 for the through-plane wrap-around, in-plane wrap-around, and Gibbs ringing models, respectively.
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Artefatos , Aprendizado Profundo , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , NeuroimagemRESUMO
PURPOSE: The goals of this study include: (a) generating tailored magnetic resonance fingerprinting (TMRF) based non-synthetic imaging; (b) assessing the repeatability of TMRF and deep learning-based mapping of in vitro ISMRM/NIST phantom and in vivo brain data of healthy human subjects. METHODS: We have acquired qualitative images obtained from the vendor-supplied gold standard (GS), MRF (synthetic), and TMRF (non-synthetic) on one representative healthy human brain. We also acquired 30 datasets on the ISMRM/NIST phantom for the in vitro repeatability study on a GE Discovery 3T MR750w scanner using the TMRF sequence. We compared T1 and T2 maps generated from 30 ISMRM/NIST phantom datasets to the spin-echo (SE) based GS method as part of the in vitro repeatability study. R-squared coefficient of determination in a simple linear regression and Bland-Altman analysis were computed for 30 datasets of ISMRM/NIST phantom to assess the accuracy of in vitro quantitative TMRF data. The repeatability of T1 and T2 estimates by TMRF was evaluated by calculating the standard deviation (SD) divided by the average of 30 datasets for each sphere, respectively. We acquired 10 volunteers for the in vivo repeatability study on the same scanner using the same TMRF sequence. These volunteers were imaged five times with two runs per repetition, resulting in 100 in vivo datasets. Five contrasts, T1 and T2 maps of 10 human volunteers acquired over five repetitions, were evaluated in the in vivo repeatability study. We computed the intraclass correlation coefficient (ICC) of the signal-to-noise ratio (SNR), signal intensities, T1 and T2 relaxation times in white matter (WM), and gray matter (GM). RESULTS: The synthetic images generated from MRF show partial volume and flow artifacts compared to non-synthetic images obtained from TMRF images and the GS. In vitro studies show that TMRF estimates have less than 5% variations except sphere 14 in the T2 array (6.36%). TMRF and SE relaxometry measurements were strongly correlated; R2 values were 0.9958 and 0.9789 for T1 and T2 estimates, respectively. Based on the ICC values, SNR, mean intensity values, and relaxation times of WM and GM for the in vivo studies were consistent. T1 and T2 values of WM and GM were similar to previously published values. The mean ± SD of T1 and T2 for WM for ten subjects and five repeats are 992 ± 41 ms and 99 ± 6 ms, while the corresponding values for T1 and T2 for GM are 1598 ± 73 ms and 152 ± 14 ms. CONCLUSION: TMRF and deep learning-based reconstruction produce repeatable, non-synthetic multi-contrast images, and parametric maps simultaneously.
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Encéfalo , Imageamento por Ressonância Magnética , Encéfalo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética , Imagens de Fantasmas , Reprodutibilidade dos TestesRESUMO
Open-source pulse sequence programs offer an accessible and transparent approach to sequence development and deployment. However, a common framework for testing, documenting, and sharing open-source sequences is still needed to ensure sequence usability and repeatability. We propose and demonstrate such a framework by implementing two sequences, Inversion Recovery Spin Echo (IRSE) and Turbo Spin Echo (TSE), with PyPulseq, and testing them on a commercial 3 T scanner. We used the ACR and ISMRM/NIST phantoms for qualitative imaging and T1/T2 mapping, respectively. The qualitative sequences show good agreement with vendor-provided counterparts (mean Structural Similarity Index Measure (SSIM) = 0.810 for IRSE and 0.826 for TSE). Both sequences passed five out of the seven standard ACR tests, performing at similar levels to vendor counterparts. Compared to reference values, the coefficient of determination R2 was 0.9946 for IRSE T1 mapping and 0.9331 for TSE T2 mapping. All sequences passed the scanner safety check for a 70 kg, 175 cm subject. The framework was demonstrated by packaging the sequences and sharing them on GitHub with data and documentation on the file generation, acquisition, reconstruction, and post-processing steps. The same sequences were tested at a second site using a 1.5 T scanner with the information shared. PDF templates for both sequence developers and users were created and filled.
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Imageamento por Ressonância Magnética , Imageamento por Ressonância Magnética/métodos , Imagens de FantasmasRESUMO
Smaller, more affordable, and more portable MRI brain scanners offer exciting opportunities to address unmet research needs and long-standing health inequities in remote and resource-limited international settings. Field-based neuroimaging research in low- and middle-income countries (LMICs) can improve local capacity to conduct both structural and functional neuroscience studies, expand knowledge of brain injury and neuropsychiatric and neurodevelopmental disorders, and ultimately improve the timeliness and quality of clinical diagnosis and treatment around the globe. Facilitating MRI research in remote settings can also diversify reference databases in neuroscience, improve understanding of brain development and degeneration across the lifespan in diverse populations, and help to create reliable measurements of infant and child development. These deeper understandings can lead to new strategies for collaborating with communities to mitigate and hopefully overcome challenges that negatively impact brain development and quality of life. Despite the potential importance of research using highly portable MRI in remote and resource-limited settings, there is little analysis of the attendant ethical, legal, and social issues (ELSI). To begin addressing this gap, this paper presents findings from the first phase of an envisioned multi-staged and iterative approach for creating ethical and legal guidance in a complex global landscape. Section 1 provides a brief introduction to the emerging technology for field-based MRI research. Section 2 presents our methodology for generating plausible use cases for MRI research in remote and resource-limited settings and identifying associated ELSI issues. Section 3 analyzes core ELSI issues in designing and conducting field-based MRI research in remote, resource-limited settings and offers recommendations. We argue that a guiding principle for field-based MRI research in these contexts should be including local communities and research participants throughout the research process in order to create sustained local value. Section 4 presents a recommended path for the next phase of work that could further adapt these use cases, address ethical and legal issues, and co-develop guidance in partnership with local communities.
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Imageamento por Ressonância Magnética/ética , Neuroimagem/ética , Países em Desenvolvimento , Ética em Pesquisa , HumanosRESUMO
CONTEXT AND AIMS: Effects of practicing yoga in diabetic mellitus (DM) patients have been identified to improve in control of blood glucose levels. The purpose of this work is to evaluate changes in blood flow of calf muscles after specific yoga postures for patients with DM using magnetic resonance imaging (MRI) techniques. Time of flight (TOF) magnetic resonance angiography maximum intensity projection (MIP), T1 maps, T2 maps, and diffusion-weighted Imaging are performed on volunteers and DM patients both pre- and post-exercise. MATERIALS AND METHODS: TOF MIP, T1 maps with variable flip angles, and T2-weighted spin-echo imaging were performed on four volunteers (aged 30 ± 5) and DM patients (aged 32-68) preexercise, on a 1.5 T Siemens scanner. The total acquisition time was 6 min 20 s. Each volunteer and DM patient were then requested to perform yoga postures Supta Padangusthasana, Utkatasana, and Calf raise for 6 min 30 s at maximum effort, outside the scanner, and subsequently rescanned. To calculate significant signal increase, region of interests was drawn on TOF MIP coronal images in arteries of calf muscles. Student t-tests were performed to determine statistical significance. RESULTS: Among volunteers, a significant signal increase in arteries of calf muscles was noticed, signal intensity graphs were plotted. In DM patients, signal increase in TOF MIP, T2-weighted images were seen in specific arteries (posterior, anterior tibial, and posterior tibial) of calf muscles postexercise. DISCUSSION AND CONCLUSIONS: The study indicates that yoga has a positive short-term effect on multiple DM-related foot complications. This study depicts that MRI provides potential insight into the benefits of yoga for DM patients through deriving biomarkers for preventive medicine relevant to yoga interception.
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PURPOSE: To compare the bias and inherent reliability of the quantitative (T1 and T2 ) imaging metrics generated from the magnetic resonance fingerprinting (MRF) technique using the ISMRM/NIST system phantom in an international multicenter setting. METHOD: ISMRM/NIST MRI system phantom provides standard reference T1 and T2 relaxation values (vendor-provided) for each of the 14 vials in T1 and T2 arrays. MRF-SSFP scans repeated over 30 days on GE 1.5 and 3.0 T scanners at three collaborative centers. MRF estimated T1, and T2 values averaged over 30 days were compared with the phantom vendor-provided and spin-echo (SE) based convention gold standard (GS) method. Repeatability and reproducibility were characterized by the within-case coefficient of variation (wCV) of the MRF data acquired over 30 days, along with the biases. RESULT: For the wide ranges of MRF estimated T1 values, vials #1-8 (T1 relaxation time between 2033 and 184 ms) exhibited a wCV less than 3% and 4%, respectively, on 3.0 and 1.5 T scanners. T2 values in vials #1-8 (T2 relaxation, 1044-45 ms) have shown wCV to be <7% on both 3.0 and 1.5 T scanners. A stronger linear correlation overall for T1 (R2 = 0.9960 and 0.9963 at center-1 and center-2 on 3.0 T scanner, and R2 = 0.9951 and 0.9988 at center-1 and center-3 on 1.5 T scanner) compared to T2 (R2 = 0.9971 and 0.9972 at center-1 and center-2 on 3.0 T scanner, and R2 = 0.9815 and 0.9754 at center-1 and center-3 on 1.5 T scanner). Bland-Altman (BA) analysis showed MRF based T1 and T2 values were within the limit of agreement (LOA) except for one data point. The mean difference or bias and 95% lower bound (LB) and upper bound (UB) LOA are reported in the format; mean bias: 95% LB LOA: 95% UB LOA. The biases for T1 values were 21.34: -50.00: 92.69, 21.32: -47.29: 89.94 ms, and for T2 values were -19.88: -42.37: 2.61, -19.06: -43.58: 5.45 ms on 3.0 T scanner at center-1 and center-2, respectively. Similarly, on 1.5 T scanner biases for T1 values were 26.54: -53.41: 106.50, 9.997: -51.94: 71.94 ms, and for T2 values were -23.84: -135.40: 87.76, -37.30: 134.30: 59.73 ms at center-1 and center-3, respectively. Additionally, the correlation between the SE based GS and MRF estimated T1 and T2 values (R2 = 0.9969 and 0.9977) showed a similar trend as we observed between vendor-provided and MRF estimated T1 and T2 values (R2 = 0.9963 and 0.9972). In addition to correlation, BA analysis showed that all the vials are within the LOA between the GS and vendor-provided for the T1 values and except one vial for T2 . All the vials are within the LOA between GS and MRF except one vial in T1 and T2 array. The wCV for reproducibility was <3% for both T1 and T2 values in vials #1-8, for all the 14 vials, wCV calculated for reproducibility was <4% for T1 values and <5% for T2 . CONCLUSION: This study shows that MRF is highly repeatable (wCV <4% for T1 and <7% for T2 ) and reproducible (wCV < 3% for both T1 and T2 ) in certain vials (vials #1-8).