Feasibility of online non-rigid motion correction for high-resolution supine breast MRI.

PURPOSE: Conventional breast MRI is performed in the prone position with a dedicated coil. This allows high-resolution images without breast motion, but the patient position is inconsistent with that of other breast imaging modalities or interventions. Supine breast MRI may be an interesting alternative, but respiratory motion becomes an issue. Motion correction methods have typically been performed offline, for instance, the corrected images were not directly accessible from the scanner console. In this work, we seek to show the feasibility of a fast, online, motion-corrected reconstruction integrated into the clinical workflow. METHODS: Fully sampled T2 -weighted (T2 w) and accelerated T1 -weighted (T1 w) breast supine MR images were acquired during free-breathing and were reconstructed using a non-rigid motion correction technique (generalized reconstruction by inversion of coupled systems). Online reconstruction was implemented using a dedicated system combining the MR raw data and respiratory signals from an external motion sensor. Reconstruction parameters were optimized on a parallel computing platform, and image quality was assessed by objective metrics and by radiologist scoring. RESULTS: Online reconstruction time was 2 to 2.5 min. The metrics and the scores related to the motion artifacts significantly improved for both T2 w and T1 w sequences. The overall quality of T2 w images was approaching that of the prone images, whereas the quality of T1 w images remained significantly lower. CONCLUSION: The proposed online algorithm allows a noticeable reduction of motion artifacts and an improvement of the diagnostic quality for supine breast imaging with a clinically acceptable reconstruction time. These findings serve as a starting point for further development aimed at improving the quality of T1 w images.

A hardware and software system for MRI applications requiring external device data.

PURPOSE: Numerous MRI applications require data from external devices. Such devices are often independent of the MRI system, so synchronizing these data with the MRI data is often tedious and limited to offline use. In this work, a hardware and software system is proposed for acquiring data from external devices during MR imaging, for use online (in real-time) or offline. METHODS: The hardware includes a set of external devices - electrocardiography (ECG) devices, respiration sensors, microphone, electronics of the MR system etc. - using various channels for data transmission (analog, digital, optical fibers), all connected to a server through a universal serial bus (USB) hub. The software is based on a flexible client-server architecture, allowing real-time processing pipelines to be configured and executed. Communication protocols and data formats are proposed, in particular for transferring the external device data to an open-source reconstruction software (Gadgetron), for online image reconstruction using external physiological data. The system performance is evaluated in terms of accuracy of the recorded signals and delays involved in the real-time processing tasks. Its flexibility is shown with various applications. RESULTS: The real-time system had low delays and jitters (on the order of 1 ms). Example MRI applications using external devices included: prospectively gated cardiac cine imaging, multi-modal acquisition of the vocal tract (image, sound, and respiration) and online image reconstruction with nonrigid motion correction. CONCLUSION: The performance of the system and its versatile architecture make it suitable for a wide range of MRI applications requiring online or offline use of external device data.

Magnetic Resonance Elastography for Assessing Fibrosis in Patients with Crohn's Disease: A Pilot Study.

BACKGROUND: Patients with Crohn's disease can develop intestinal strictures, containing various degrees of inflammation and fibrosis. Differentiation of the main component of a stricturing lesion is the key for defining the therapeutic management. AIMS: We assessed for the first time the accuracy of magnetic resonance elastography in detecting intestinal fibrosis and predicting clinical course in patients with Crohn's disease. METHODS: This was a prospective study of adult patients with Crohn's disease and magnetic resonance imaging examination, including magnetic resonance elastography, between April 2019 and February 2020. The association between the bowel stiffness value and the degree of fibrosis was evaluated. The relationship between the stiffness value and the occurrence of clinical events was also investigated. RESULTS: A total of 69 patients were included. The stiffness value measured by magnetic resonance elastography was correlated with the degree of fibrosis (p < 0.001). A bowel stiffness ≥ 3.57 kPa predicted the occurrence of clinical events with an area under the curve of 0.82 (95% CI 0.71-0.93). Bowel stiffness ≥ 3.57 kPa was associated with an increased risk of clinical events (p < 0.0001). CONCLUSION: In Crohn's disease, magnetic resonance elastography is a reliable tool for detecting intestinal fibrosis and predicting a worse disease outcome.

MR electrical properties imaging using a generalized image-based method.

PURPOSE: To develop a fast and easy-to-use electrical properties tomography (EPT) method based on a single MR scan, avoiding both the need of a B1 -map and transceive phase assumption, and that is robust against noise. THEORY: Derived from Maxwell's equations, conductivity, and permittivity are reconstructed from a new partial differential equation involving the product of the RF fields and its derivatives. This also allows us to clarify and revisit the relevance of common assumptions of MREPT. METHODS: Our new governing equation is solved using a 3D finite-difference scheme and compared to previous frameworks. The benefits of our method over selected existing MREPT methods are demonstrated for different simulation models, as well as for both an inhomogeneous agar phantom gel and in vivo brain data at 3T. RESULTS: Simulation and experimental results are illustrated to highlight the merits of the proposed method over existing methods. We show the validity of our algorithm in versatile configurations, with many transition regions notably. Complex admittivity maps are also provided as a complementary MR contrast. CONCLUSION: Because it avoids time-consuming RF field mapping and generalizes the use of standard MR image for electrical properties reconstruction, this contribution is promising as a new step forward for clinical applications.

Coupled transfer function model for the evaluation of implanted cables safety in MRI.

PURPOSE: Multiple medical-device leads implanted next to each other are often encountered in clinical practice. The aim of this work is to study a coupled transfer function model to evaluate the safety of these coupled leads submitted to the RF field of a 1.5T MRI scanner for a constant distance between both leads. METHODS: The effect of coupling on the heating of 2 cables with different termination conditions is evaluated experimentally. The coupled and single transfer functions are determined experimentally and used to predict the relative temperature increases of both cables alone and coupled. Two different coupled models, an additive model and a global model, are proposed. The coupled transfer functions are also simulated. RESULTS: The coupling between cables has a strong influence on the resulting heating at the electrodes. The coupled additive transfer function model is a relevant tool to evaluate the heating of coupled leads separated by a constant distance. The global model underestimates the heating in one of the coupled cases by about 30%. The measured coupled transfer functions coincide with the simulated models. CONCLUSION: It is necessary to take into account the coupling effect between leads to evaluate the safety of implanted devices. This work shows that, in the case of 2 cables separated by a constant distance, that an experimentally determined coupled transfer function allows estimation of the heating of the 2 electrodes for a given incident field. Further work should take into account the in vivo varying distance between the 2 cables.

An efficient algorithm based on electrograms characteristics to identify ventricular tachycardia isthmus entrance in post-infarct patients.

AIMS: Our study assesses the value of electrograms (EGMs) characteristics to identify a ventricular tachycardia (VT) isthmus entrance in patients with post-infarct VT. Post-infarct VTs are mostly due to a re-entrant circuit. A pacemapping (PM) approach is able to localize the VT isthmus during sinus rhythm. Limited data are available about the role of local EGMs in defining VT isthmus location. METHODS AND RESULTS: Twenty consecutive patients (70% male) referred for post-infarct VT catheter ablation were included in the present study. The VT isthmus was defined according to the PM method. At each recording site, 10 characteristics of the local EGM were assessed to predict the location of the VT isthmus entrance. In total, 924 EGMs were acquired, of which 127 were located in the VT isthmus entrance. Logistic regression analysis showed that bipolar voltage, number of EGM positive peaks, and sQRS interval were independently associated with VT isthmus entrance location. The ROC curve best fitted the model at the cut-off 0.1641 (sensitivity 72%, specificity 75.2%, positive predictive value 31.3%, negative predictive value 94.4%, area under the curve 0.78, P < 0.001). Based upon these results, we developed an algorithm implemented in an automatic calculator to determine the likelihood that an EGM is located at a VT isthmus entrance. CONCLUSION: Our study suggests that three EGM characteristics: bipolar voltage, number of positive peaks, and sQRS interval can successfully identify a VT isthmus entrance in post-infarct patients.

One-millimeter isotropic breast diffusion-weighted imaging: Evaluation of a superresolution strategy in terms of signal-to-noise ratio, sharpness and apparent diffusion coefficient.

PURPOSE: To quantitatively evaluate a superresolution technique for 3D, one-millimeter isotropic diffusion-weighted imaging (DWI) of the whole breasts. METHODS: Isotropic 3D DWI datasets are obtained using a combination of (i) a readout-segmented diffusion-weighted-echo-planar imaging (DW-EPI) sequence (rs-EPI), providing high in-plane resolution, and (ii) a superresolution (SR) strategy, which consists of acquiring 3 datasets with thick slices (3 mm) and 1-mm shifts in the slice direction, and combining them into a 1 × 1 × 1-mm3 dataset using a dedicated reconstruction. Two SR reconstruction schemes were investigated, based on different regularization schemes: conventional Tikhonov or Beltrami (an edge-preserving constraint). The proposed SR strategy was compared to native 1 × 1 × 1-mm3 acquisitions (i.e. with 1-mm slice thickness) in 8 healthy subjects, in terms of signal-to-noise ratio (SNR) efficiency, using a theoretical framework, Monte Carlo simulations and region-of-interest (ROI) measurements, and image sharpness metrics. Apparent diffusion coefficient (ADC) values in normal breast tissue were also compared. RESULTS: The SR images resulted in an SNR gain above 3 compared to native 1 × 1 × 1-mm3 using the same acquisition duration (acquisition gain 3 and reconstruction gain >1). Beltrami-SR provided the best results in terms of SNR and image sharpness. The ADC values in normal breast measured from Beltrami-SR were preserved compared to low-resolution images (1.91 versus 1.97 ×10-3 mm2 /s, P = .1). CONCLUSION: A combination of rs-EPI and SR allows 3D, 1-mm isotropic breast DWI data to be obtained with better SNR than a native 1-mm isotropic acquisition. The proposed DWI protocol might be of interest for breast cancer monitoring/screening without injection.

Reconstruction of the 12-lead ECG using a novel MR-compatible ECG sensor network.

PURPOSE: Current electrocardiography (ECG) devices in MRI use non-conventional electrode placement, have a narrow bandwidth, and suffer from signal distortions including magnetohydrodynamic (MHD) effects and gradient-induced artifacts. In this work a system is proposed to obtain a high-quality 12-lead ECG. METHODS: A network of N electrically independent MR-compatible ECG sensors was developed (N = 4 in this study). Each sensor uses a safe technology - short cables, preamplification/digitization close to the patient, and optical transmission - and provides three bipolar voltage leads. A matrix combination is applied to reconstruct a 12-lead ECG from the raw network signals. A subject-specific calibration is performed to identify the matrix coefficients, maximizing the similarity with a true 12-lead ECG, acquired with a conventional 12-lead device outside the scan room. The sensor network was subjected to radiofrequency heating phantom tests at 3T. It was then tested in four subjects, both at 1.5T and 3T. RESULTS: Radiofrequency heating at 3T was within the MR-compatibility standards. The reconstructed 12-lead ECG showed minimal MHD artifacts and its morphology compared well with that of the true 12-lead ECG, as measured by correlation coefficients above 93% (respectively, 84%) for the QRS complex shape during steady-state free precession (SSFP) imaging at 1.5T (respectively, 3T). CONCLUSION: High-quality 12-lead ECG can be reconstructed by the proposed sensor network at 1.5T and 3T with reduced MHD artifacts compared to previous systems. The system might help improve patient monitoring and triggering and might also be of interest for interventional MRI and advanced cardiac MR applications.

Pretreatment lesional volume impacts clinical outcome and thrombectomy efficacy.

OBJECTIVE: We aimed to characterize the association between pretreatment lesional volume measured on diffusion-weighted images and functional outcome, and estimate the impact on thrombectomy efficacy for ischemic stroke with anterior proximal intracranial arterial occlusion. METHODS: Anterior circulation ischemic stroke patients who had pretreatment diffusion-weighted imaging in the THRACE study were included. Lesional volume was semiautomatically segmented. Logistic regression was applied to model clinical outcome as a function of lesional volume. Outcomes included functional independence (modified Rankin Scale [mRS] 0-2), degree of disability (ordinal mRS 0-6), and mortality at 3 months. RESULTS: Of 298 included patients, with median lesional volume 17.2ml (interquartile range [IQR], 9.2-51.8) and median mRS 2 (IQR, 1-4), 51.0% achieved functional independence. Increased lesional volume was an independent predictor for a lower probability of functional independence (odds ratio [OR], 0.90 [95% confidence interval {CI}, 0.81-0.99] per 10ml; p < 0.001), a less favorable degree of disability (common OR, 0.86 [95% CI, 0.81-0.90] per 10ml; p < 0.001), and a higher mortality rate (OR, 1.21 [95% CI, 1.08-1.37] per 10ml; p < 0.001). For additional thrombectomy, the number of patients needed to treat to achieve functional independence in 1 patient increased with lesional volume (10 for a volume of 80ml; 15 for 135ml). No significant treatment-by-dichotomized volume interaction for functional independence and mortality was observed. INTERPRETATION: Pretreatment lesional volume is an independent predictor for functional outcome in acute ischemic stroke with proximal intracranial occlusion. The clinical benefit of adding mechanical thrombectomy to thrombolysis decreased with the increase of lesional volume. Ann Neurol 2018;83:178-185.

Finite difference transmission line model for the design of safe multi-section cables in MRI.

OBJECTIVE: To show the relevance of a simple finite difference transmission line model to help design safe implanted cables in 1.5T MRI's using the multi-section cable approach. MATERIALS AND METHODS: The transfer function and heating under a given incident field predicted by the finite difference model for two-section cables are compared to full-wave and experimental results. The finite difference model was then used to design a three-section cable considering the phase effects. RESULTS: The differences between the predicted transfer function given by the transmission line model with the full-wave results and the experimental results are, respectively, less than 10% and less than 5%. The predicted heating differed by less than 7% with the full-wave results and less than 25% with the experimental results. The optimum lengths of the three-section cable reduces by 51% the worst case heating at the electrodes compared to the best case unique section wire. DISCUSSION: The multi-section cable design can reduce the heating of cables in MRI taking into account phase effects. The finite difference transmission line model presented is a simple valuable tool to estimate the worst case heating of simple multi-section cables.

Myocardial volume change during cardiac cycle derived from three orthogonal systolic strains: towards a quality assessment of strains.

BACKGROUND: The relative modification of the myocardial volume between end-systole and end-diastole ( Vs/d=Vend-systole/Vend-diastole ) has already been assessed with different methods and falls in a range of 0.9-0.97 (mean value = 0.93). PURPOSE: To estimate Vs/d from the three longitudinal ( ɛl) , circumferential ( ɛc ), and radial ( ɛr ) strains of the left ventricle using the formula: Vs/d=(1+ɛc)(1+ɛr)(1+ɛl) and to test whether this estimate of Vs/d can be used as a marker of the echocardiography quality. MATERIAL AND METHODS: Two hundred manuscripts, including a total of 34,690 patients or healthy volunteers, were identified in the Medline database containing values of ɛl , ɛc , and ɛr measured from echocardiography. RESULTS: The median value of was 0.93, in accordance with the literature, with no significant difference between patients or healthy volunteers ( P = 0.38). The proportion of studies with Vs/d=0.93±0.1 was 79%. When only considering groups of healthy volunteers, the studies failing this test had higher standard deviations for the three individual strains: 0.038 vs. 0.029 ( P = 0.02) for ɛl ; 0.060 vs. 0.034 ( P < 10-6) for ɛc , and 0.243 vs. 0.101 ( P < 10-14) for ɛr . CONCLUSION: The median ratio of the left ventricular myocardial volumes between end-systole and end-diastole in the investigated studies was Vs/d=0.93 . The formula (1+ɛc)(1+ɛr)(1+ɛl)∉[0.83;1.03] could be used to detect studies with inaccurate strain measurements.

MR safety assessment of active implantable medical devices.

BACKGROUND: Increasing numbers of patients with active implantable medical devices (AIMDs) require magnetic resonance (MR) examinations. The manufacturers are continuing to improve the MR compatibility of their AIMDs. To this end, a variety of measurement methods and numerical simulations are used to evaluate the risks associated with magnetic resonance imaging (MRI). OBJECTIVE: In this article, test methods used to investigate interactions between AIMDs with radio frequency fields and time-varying magnetic gradient fields are reviewed. MATERIALS AND METHODS: A literature review of known test methods for radio frequency and gradient field exposure of AIMDs with leads, in particular for neurostimulators, cochlear implants, and implanted infusion pumps, is presented. The state of the art and promising methods are discussed. RESULTS: ISO/TS 10974 describes the design of high frequency and gradient injection setups to test conductive materials. A large number of sensor designs have been published to measure the induced voltages and currents through radio frequency and gradient fields and for monitoring AIMDs during MR examinations in in vitro tests. CONCLUSION: The test methods should be planned to be as conservative as possible to cover the worst case scenario. However, in vitro measurements and computer simulation are far from being able to cover all possible configurations in their complexity and uniqueness. For safer MR examinations, current research recommends in vivo testing prior to MR, parallel radiofrequency transmission techniques, and new sequences with reduced energy input in the presence of AIMDs.

[MR safety assessment of active implanted medical devices. German version]. / MR-Sicherheitsbewertung von aktiven implantierbaren medizinischen Geräten.

BACKGROUND: Increasing numbers of patients with active implantable medical devices (AIMDs) require magnetic resonance (MR) examinations. The manufacturers are continuing to improve the MR compatibility of their AIMDs. To this end, a variety of measurement methods and numerical simulations are used to evaluate the risks associated with magnetic resonance imaging (MRI). OBJECTIVE: In this article, test methods used to investigate interactions between AIMDs with radio frequency fields and time-varying magnetic gradient fields are reviewed. MATERIALS AND METHODS: A literature review of known test methods for radio frequency and gradient field exposure of AIMDs with leads, in particular for neurostimulators, cochlear implants, and implanted infusion pumps, is presented. The state of the art and promising methods are discussed. RESULTS: ISO/TS 10974 describes the design of high frequency and gradient injection setups to test conductive materials. A large number of sensor designs have been published to measure the induced voltages and currents through radio frequency and gradient fields and for monitoring AIMDs during MR examinations in in vitro tests. CONCLUSION: The test methods should be planned to be as conservative as possible to cover the worst case scenario. However, in vitro measurements and computer simulation are far from being able to cover all possible configurations in their complexity and uniqueness. For safer MR examinations, current research recommends in vivo testing prior to MR, parallel radiofrequency transmission techniques, and new sequences with reduced energy input in the presence of AIMDs.

Isotropic 3D cardiac cine MRI allows efficient sparse segmentation strategies based on 3D surface reconstruction.

PURPOSE: Segmentation of cardiac cine MRI data is routinely used for the volumetric analysis of cardiac function. Conventionally, 2D contours are drawn on short-axis (SAX) image stacks with relatively thick slices (typically 8 mm). Here, an acquisition/reconstruction strategy is used for obtaining isotropic 3D cine datasets; reformatted slices are then used to optimize the manual segmentation workflow. METHODS: Isotropic 3D cine datasets were obtained from multiple 2D cine stacks (acquired during free-breathing in SAX and long-axis (LAX) orientations) using nonrigid motion correction (cine-GRICS method) and super-resolution. Several manual segmentation strategies were then compared, including conventional SAX segmentation, LAX segmentation in three views only, and combinations of SAX and LAX slices. An implicit B-spline surface reconstruction algorithm is proposed to reconstruct the left ventricular cavity surface from the sparse set of 2D contours. RESULTS: All tested sparse segmentation strategies were in good agreement, with Dice scores above 0.9 despite using fewer slices (3-6 sparse slices instead of 8-10 contiguous SAX slices). When compared to independent phase-contrast flow measurements, stroke volumes computed from four or six sparse slices had slightly higher precision than conventional SAX segmentation (error standard deviation of 5.4 mL against 6.1 mL) at the cost of slightly lower accuracy (bias of -1.2 mL against 0.2 mL). Functional parameters also showed a trend to improved precision, including end-diastolic volumes, end-systolic volumes, and ejection fractions). CONCLUSION: The postprocessing workflow of 3D isotropic cardiac imaging strategies can be optimized using sparse segmentation and 3D surface reconstruction. Magn Reson Med 79:2665-2675, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Impact of microvascular obstruction on left ventricular local remodeling after reperfused myocardial infarction.

PURPOSE: To evaluate by cardiac magnetic resonance imaging (MRI) the impact of microvascular obstruction (MVO) on regional left ventricular (LV) wall characteristics and local remodeling after acute myocardial infarction (AMI). MATERIALS AND METHODS: In all, 114 AMI patients underwent cardiac MRI at 3T within 2-4 days (baseline) and at 6 months (follow-up) after reperfusion. Late gadolinium enhancement and cine sequences were performed. The impact of MVO (ie, presence and extent) on regional wall thickening (WT, %), end-diastolic wall thickness (EDWT, mm), and local cavity change (mm) of LV were quantitatively analyzed. Local cavity change, calculated as surface-to-surface distance from registered endocardial surface meshes of cine imaging datasets acquired initially and at follow-up, was used to assess local remodeling. RESULTS: MVO was detected in 69 patients (60.5%). WT was significantly lower when MVO was present (P < 0.05); and it was inversely related to MVO transmural extent (P < 0.0001). WT improvement was significantly worsened when MVO was present in segments with infarct transmural extent exceeding 50%. Significant wall thinning occurred at follow-up in segments with infarct transmural extent >75% with further thinning by MVO presence; and EDWT decreased with increasing MVO transmural extent (P < 0.0001). LV cavity shrank in patients without MVO, whereas it dilated in those with MVO. Local cavity changes were not significantly different by a region-to-region analysis throughout the LV within each group (P = 0.57 and 0.74, respectively). CONCLUSION: MVO has a significant adverse effect on LV wall characteristics and LV remodeling. Postinfarct remodeling seems to be globally mediated rather than locally mediated during the first 6 months. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:499-510.

A novel MR-compatible sensor to assess active medical device safety: stimulation monitoring, rectified radio frequency pulses, and gradient-induced voltage measurements.

PURPOSE: To evaluate the function of an active implantable medical device (AIMD) during magnetic resonance imaging (MRI) scans. The induced voltages caused by the switching of magnetic field gradients and rectified radio frequency (RF) pulse were measured, along with the AIMD stimulations. MATERIALS AND METHODS: An MRI-compatible voltage probe with a bandwidth of 0-40 kHz was designed. Measurements were carried out both on the bench with an overvoltage protection circuit commonly used for AIMD and with a pacemaker during MRI scans on a 1.5 T (64 MHz) MR scanner. RESULTS: The sensor exhibits a measurement range of ± 15 V with an amplitude resolution of 7 mV and a temporal resolution of 10 µs. Rectification was measured on the bench with the overvoltage protection circuit. Linear proportionality was confirmed between the induced voltage and the magnetic field gradient slew rate. The pacemaker pacing was recorded successfully during MRI scans. CONCLUSION: The characteristics of this low-frequency voltage probe allow its use with extreme RF transmission power and magnetic field gradient positioning for MR safety test of AIMD during MRI scans.

Evaluation of occupational exposure to static magnetic field in MRI sites based on body pose estimation and SMF analytical computation.

This paper tackles the problem of estimating exposure to static magnetic field (SMF) in magnetic resonance imaging (MRI) sites using a non-invasive approach. The proposed approach relies on a vision-based system to detect people's body parts and on a mathematical model to compute SMF exposure. A multi-view camera system was used to capture the MRI room, and a vision-based system was applied to detect body parts. The detected localization was then fed into a mathematical model to compute SMF exposure. In this study, we focused on exposure at the neck due to two main reasons. First, according to regulations, the limit of exposure at head and trunk for MR workers is higher than that for the general public. Second, it was easier to attach a dosimeter at the neck to perform measurements, which allowed a quantitative evaluation of our approach. This approach was applied to two scenarios simulating the daily movements of medical workers for which dosimeter measurements were also recorded. The results indicated that the proposed approach predicted occupational SMF exposure with reasonable accuracy compared with the dosimeter measurements. The proposed approach is a simple safe working procedure to estimate the exposure of MR workers at different parts of the body without wearing any marker detection. It can be applied to reduce occupational SMF exposure, without changes in workers' performances. For that reason, our non-invasive proposed method can be used as a simple safety tool to estimate occupational SMF exposure in MR sites. Bioelectromagnetics. 39:503-515, 2018.© 2018 Wiley Periodicals, Inc.

Calibration and non-orthogonality correction of three-axis Hall sensors for the monitoring of MRI workers' exposure to static magnetic fields.

A Magnetic Resonance Imaging (MRI) scanner uses three different electromagnetic fields (EMF) to produce body images: a static permanent magnetic field (MF), several pulsed magnetic gradients, and a radiofrequency pulse. As a result, any occupation that includes an MRI exposes workers to a strong MF. The World Health Organization has now given the monitoring of occupational EMF exposure a high priority. One design for a low-cost, compact MF exposure monitor (« MR exposimeter ¼) uses a set of three orthogonally assembled Hall sensors. However, at such a strong EMF exposure intensity, the non-linearity and non-orthogonality (misalignment between the three Hall sensors) have an impact on the accuracy of EMF measurement. Therefore, a sensor characterization was performed in order to link Hall-effect output voltage to MF intensity. The sensor was then calibrated using an orthogonalization matrix and an offset vector. For each sensor configuration, the matrix and vector parameters were optimized with a calibration set generated by the movement of a three-axis sensor inside homogeneous MF areas. Once calibrated, the sensor was tested at different MF intensities and returned accuracy improvements. This calibration procedure was tested on synthetic data and performed on experimental data. The calibration parameters can be easily reused by the user, and their stability could be used as a quality control sensor. Finally, real-time monitoring test for static MF exposure was completed and validated on an MRI worker during a typical working day. Bioelectromagnetics. 39:108-119, 2018. © 2018 Wiley Periodicals, Inc.

Can MRI detect pulmonary hypertension in a population pre-selected by echocardiography?

Background The place of magnetic resonance imaging (MRI) in the assessment of pulmonary hypertension (PH) remains controversial. Several studies proposed to use MRI to assess pulmonary pressure but the level of proof is low. Purpose To evaluate the diagnostic power of cardiac MRI within a non-selected population of patients suspected of PH after an echocardiography. Material and Methods Fifty-six consecutive patients, suspected of PH after an echocardiography, were assessed with right heart catheterization and cardiac MRI (including a high temporal resolution pulmonary flow curve). We extracted from the MRI data the main parameters proposed by all precedent studies available in the literature. We looked for multivariate linear relations between those parameters and the mean pulmonary arterial pressure (mPAP), and eventually assessed with a logit regression the ability of those parameters to diagnose PH in our population. Results The multivariate model retained only two parameters: the right ventricle ejection fraction and the pulmonary trunk minimum area. The prediction of mPAP (r2 = 0.5) yielded limits of agreement of 15 mmHg. However, the prediction of PH within the population was feasible and the method yielded a specificity of 80% for a sensitivity of 100%. Conclusion The performance of MRI to assess mPAP is too low to be used as a replacement for right heart catheterization but MRI could be used as second line examination after echocardiography to avoid right heart catheterization for normal patients.

Impact of denoising on precision and accuracy of saturation-recovery-based myocardial T1 mapping.

PURPOSE: To evaluate the impact of a novel postprocessing denoising technique on accuracy and precision in myocardial T1 mapping. MATERIALS AND METHODS: This study introduces a fast and robust denoising method developed for magnetic resonance T1 mapping. The technique imposes edge-preserving regularity and exploits the co-occurence of spatial gradients in the acquired T1 -weighted images. The proposed approach was assessed in simulations, ex vivo data and in vivo imaging on a cohort of 16 healthy volunteers (12 males, average age 39 ± 8 years, 62 ± 9 bpm) both in pre- and postcontrast injection. The method was evaluated in myocardial T1 mapping at 3T with a saturation-recovery technique that is accurate but sensitive to noise. ROIs in the myocardium and left-ventricle blood pool were analyzed by an experienced reader. Mean T1 values and standard deviation were extracted and compared in all studies. RESULTS: Simulations on synthetic phantom showed signal-to-noise ratio and sharpness improvement with the proposed method in comparison with conventional denoising. In vivo results demonstrated that our method preserves accuracy, as no difference in mean T1 values was observed in the myocardium (precontrast: 1433/1426 msec, 95%CI: [-40.7, 55.9], p = 0.75, postcontrast: 766/759 msec, 95%CI: [-60.7, 77.2], p = 0.8). Meanwhile, precision was improved with standard deviations of T1 values being significantly decreased (precontrast: 223/151 msec, 95%CI: [27.3, 116.5], p = 0.003, postcontrast: 176/135 msec, 95%CI: [5.5, 77.1], p = 0.03). CONCLUSION: The proposed denoising method preserves accuracy and improves precision in myocardial T1 mapping, with the potential to offer better map visualization and analysis. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1377-1388.