Average SAR prediction, validation, and evaluation for a compact MR scanner head-sized RF coil.

A recently developed compact 3 T (C3T) MRI scanner with high performance gradients [1, 2] has a dedicated radiofrequency (RF) transmit coil that exposes only the head, neck and a small portion of the upper body region during head-first scanning. Due to the unique coil geometry and patient positioning, the established SAR model used for a conventional whole-body scanner cannot be directly translated to the C3T. Here a specific absorption rate (SAR) estimation and validation framework was developed and used to implement a dedicated and accurate SAR prediction model for the C3T. Two different SAR prediction models for the C3T were defined and evaluated: one based on an anatomically derived exposed mass, and one using a fixed anatomical position located caudally to the RF coil to determine the exposed mass. After coil modeling and virtual human body simulation, the designed SAR prediction model was implemented on the C3T and verified with calorimetry and in vivo scan power monitoring. The fixed-demarcation exposed mass model was selected as appropriate exposed mass region to accurately estimate the SAR deposition in the patient on the C3T.

Compromised BRCA1-PALB2 interaction is associated with breast cancer risk.

The major breast cancer suppressor proteins BRCA1 and BRCA2 play essential roles in homologous recombination (HR)-mediated DNA repair, which is thought to be critical for tumor suppression. The two BRCA proteins are linked by a third tumor suppressor, PALB2, in the HR pathway. While truncating mutations in these genes are generally pathogenic, interpretation of missense variants remains a challenge. To date, patient-derived missense variants that disrupt PALB2 binding have been identified in BRCA1 and BRCA2; however, there has not been sufficient evidence to prove their pathogenicity in humans, and no variants in PALB2 that disrupt either its BRCA1 or BRCA2 binding have been reported. Here we report on the identification of a novel PALB2 variant, c.104T>C (p.L35P), that segregates in a family with a strong history of breast cancer. Functional analyses showed that L35P abrogates the PALB2-BRCA1 interaction and completely disables its abilities to promote HR and confer resistance to platinum salts and PARP inhibitors. Whole-exome sequencing of a breast cancer from a c.104T>C carrier revealed a second, somatic, truncating mutation affecting PALB2, and the tumor displays hallmark genomic features of tumors with BRCA mutations and HR defects, cementing the pathogenicity of L35P. Parallel analyses of other germline variants in the PALB2 N-terminal BRCA1-binding domain identified multiple variants that affect HR function to varying degrees, suggesting their possible contribution to cancer development. Our findings establish L35P as the first pathogenic missense mutation in PALB2 and directly demonstrate the requirement of the PALB2-BRCA1 interaction for breast cancer suppression.

Lung calcium-dependent phospholipid-binding proteins: structure and function.

Distinct peptide maps of two rabbit lung Ca2(+)-dependent phospholipid-binding proteins (PLBPs), 36,000 and 33,000, were generated by cyanogen bromide (CNBr) cleavage, trypsin or Staphylococcus aureus V8 proteinase digestion. The amino acid sequence of a CNBr-cleaved peptide of the 36,000 PLBP was aligned to the amino terminus of human lipocortin I with more than 77% identity, but had no identity with the known amino terminal sequence of other known annexins. Partial amino acid sequence of a 33,000 PLBP peptide demonstrated a close (56%) relationship to endonexin II, human placental anticoagulant protein, and porcine intestine protein II, but shared only 32% identity with lipocortin I, 30% with lipocortin II. Antiserum generated against purified 36,000 PLBP reacted strongly with the 33,000 PLBP, but did not react with any other rabbit lung cytosolic proteins. Both PLBPs inhibited the phospholipase A2 reaction when dioleoyl phosphatidylcholine and phosphatidylglycerol vesicles or monolayers were used as substrates. In the vesicle assay, the phospholipase A2 reaction was inhibited at lower substrate phospholipid concentrations but not at nearly saturating substrate concentrations. In the monolayer assay, the phospholipid-binding proteins did not inhibit phospholipase A2 at a low phospholipid surface concentration of 3.8.10(-3) molecules/A2, but they did at higher surface concentrations between 1.1 x 10(-2) and 3.8 x 10(-2) molecules/A2. The inhibition of phospholipase A2 by rabbit lung phospholipid-binding proteins is most likely due to the prevention of penetration by phospholipase A2 into the interface, a requirement for the enzyme to act on the substrate.

Myocardial first-pass perfusion magnetic resonance imaging: a multicenter dose-ranging study.

BACKGROUND: MRI can identify patients with obstructive coronary artery disease by imaging the left ventricular myocardium during a first-pass contrast bolus in the presence and absence of pharmacologically induced myocardial hyperemia. The purpose of this multicenter dose-ranging study was to determine the minimally efficacious dose of gadopentetate dimeglumine injection (Magnevist Injection; Berlex Laboratories) for detecting obstructive coronary artery disease. METHOD AND RESULTS: A total of 99 patients scheduled for coronary artery catheterization as part of their clinical evaluation were enrolled in this study. Patients were randomized to 1 of 3 doses of gadopentate dimeglumine: 0.05, 0.10, or 0.15 mmol/kg. First-pass perfusion imaging was performed during hyperemia (induced by a 4-minute infusion of adenosine at a rate of 140 microg x kg(-1) x min(-1)) and then again in the absence of adenosine with otherwise identical imaging parameters and the same contrast dose. Perfusion defects were evaluated subjectively by 4 blinded reviewers. Receiver-operating curve analysis showed that the areas under the receiver-operating curve were 0.90, 0.72, and 0.83 for the low-, medium-, and high-contrast doses, respectively, compared with quantitative coronary angiography (diameter stenosis > or =70%). For the low-dose group, mean sensitivity was 93+/-0%, mean specificity was 75+/-7%, and mean accuracy was 85+/-3%. CONCLUSIONS: First-pass perfusion MRI is a safe and accurate test for identifying patients with obstructive coronary artery disease. A low dose of 0.05 mmol/kg gadopentetate dimeglumine is at least as efficacious as higher doses.

Inductively coupled wireless RF coil arrays.

As the number of coils increases in multi-channel MRI receiver-coil arrays, RF cables and connectors become increasingly bulky and heavy, degrading patient comfort and slowing workflow. Inductive coupling of signals provides an attractive "wireless" approach, with the potential to reduce coil weight and cost while simplifying patient setup. In this work, multi-channel inductively coupled anterior arrays were developed and characterized for 1.5T imaging. These comprised MR receiver coils inductively (or "wirelessly") linked to secondary or "sniffer" coils whose outputs were transmitted via preamps to the MR system cabinet. The induced currents in the imaging coils were blocked by passive diode circuits during RF transmit. The imaging arrays were totally passive, obviating the need to deliver power to the coils, and providing lightweight, untethered signal reception with easily positioned coils. Single-shot fast spin echo images were acquired from 5 volunteers using a 7-element inductively coupled coil array and a conventionally cabled 7-element coil array of identical geometry, with the inductively-coupled array showing a relative signal-to-noise ratio of 0.86 +/- 0.07. The concept was extended to a larger 9-element coil array to demonstrate the effect of coil element size on signal transfer and RF-transmit blocking.

Measurement of coronary blood flow velocity during handgrip exercise using breath-hold velocity encoded cine magnetic resonance imaging.

Coronary blood flow velocity was measured during handgrip exercise using breath-hold velocity encoded cine magnetic resonance imaging. Peak diastolic coronary flow velocity in the left anterior descending artery was 20.6 +/- 9.3 cm/s (mean +/- SD) at baseline and increased significantly to 31.1 +/- 16.4 cm/s after exercise (50.7 +/- 31.3% increase, p <0.01).

Optimization of gadolinium-enhanced magnetic resonance angiography using an automated bolus-detection algorithm (MR SmartPrep). Original investigation.

Gadolinium (Gd)-enhanced three-dimensional (3D) magnetic resonance angiography (MRA) is a quick method for performing noninvasive diagnostic angiography. A major technical obstacle to the successful implementation of this technique, however, is the proper coordination of the data acquisition with the contrast bolus. In this article, the use of an automated bolus-detection algorithm (MR SmartPrep), which triggers the initiation of data acquisition for Gd-enhanced 3D MRA is reviewed. Potential applications of this evolving technique are illustrated.

Thick-section, single breath-hold magnetic resonance pulmonary angiography.

RATIONALE AND OBJECTIVES: Approaches to performing magnetic resonance angiography (MRA) of the pulmonary vasculature are described using very fast (repetition time [TR] less than 13 mseconds) radiofrequency (rf)-spoiled, gradient-recalled pulse sequences and the standard quadrature body imaging coil of a commercial 1.5-T MR imaging system. METHODS AND RESULTS: Signal-to-noise (SNR) is improved by signal averaging (Nex greater than or equal to 4) in a two-dimensional, single thick-section approach and by volume acquisition (Nex = 1) in a three-dimensional approach. Blood signal loss is minimized by using short, asymmetric echoes (echo time [TE] less than or equal to 2.7 mseconds). Respiratory motion is eliminated by keeping the scan time short enough (approximately 15 seconds) for image acquisition within a single breath-hold. Cardiac motion artifacts are reduced with section orientations that avoid intersecting the heart and/or use of small flip angle (alpha less than or equal to 25 degrees). CONCLUSIONS: Images of healthy volunteers showed that while single thick sections have superior SNR, the three-dimensional approach appears to produce better visualization of the peripheral vascular segments and offers improved ability to process the images to remove overlapping structures.

Single breath-hold pulmonary magnetic resonance angiography. Optimization and comparison of three imaging strategies.

RATIONALE AND OBJECTIVES: Ultrafast gradient-recalled-echo techniques for obtaining high-quality pulmonary magnetic resonance angiograms within a single breath-hold were optimized. METHODS: Fourteen subjects were imaged with both the body coil and a phased-array surface coil, using three gradient-recalled-echo pulse sequences: 1) two-dimensional sequential; 2) two-dimensional interleaved; and 3) volumetric acquisitions. Image quality was assessed with varied flip angle, receiver bandwidth, slice thickness/number, and matrix size. Cardiac compensation diminished ghost artifacts in the interleaved sequence. Individual sagittal sections and maximum intensity projections were reviewed. RESULTS: Pulmonary magnetic resonance angiograms acquired with volumetric and two-dimensional interleaved gradient-recalled-echo pulse sequences benefit greatest from intravenous gadolinium and result in greater pulmonary arterial visualization than traditional time-of-flight techniques. Phased-array coils result in improved vessel detection. CONCLUSIONS: High-quality breath-held pulmonary magnetic resonance angiography can be obtained with an intravenous contrast-enhanced gradient-recalled-echo acquisition; however, image quality is dependent on the pulse sequence.

Comparison of lesion enhancement on spin-echo and gradient-echo images.

PURPOSE: To compare lesion enhancement after injection of gadopentetate dimeglumine on spin-echo and gradient-echo T1-weighted images. METHODS: A total of 48 contrast-enhancing intracranial lesions were evaluated using a spin-echo and two gradient-echo T1-weighted pulse sequences. Percent contrast, contrast-to-noise, and signal-to-noise measurements were made on the spin-echo T1-weighted, three-dimensional gradient-echo, and multiplanar gradient-echo sequences. RESULTS: The measurements were somewhat different for the following categories of lesions: extraaxial, intraaxial with edema, and intraaxial without edema. The latter group provided the greatest diagnostic challenge: three of 19 such lesions 1 cm in size or smaller could not be identified on three-dimensional gradient-echo images, and one could not be identified on multi-planar gradient-echo images. The spin-echo T1-weighted sequence demonstrated significantly higher percent contrast (P < .05) and greater contrast to noise (P < .03) than either gradient-echo sequence for these small intraaxial lesions without edema. For extraaxial and intraaxial lesions with edema, percent C was similar for spin-echo T1-weighted and three-dimensional gradient-echo images, while contrast to noise was greater for spin-echo T1-weighted images. This reflected greater tissue noise with gradient-echo sequences. CONCLUSION: The T1-weighted spin-echo sequence was preferred for detecting the full spectrum of contrast-enhancing lesions of the central nervous system.

Technique for arterial-phase contrast-enhanced three-dimensional MR angiography of the carotid and vertebral arteries.

Our goal was to evaluate whether contrast-enhanced three-dimensional MR angiography using the MR Smartprep technique would enable us to obtain arterial-phase MR angiograms of the carotid and vertebral arteries. The study included 35 patients with suspected lesions of the neck in whom the MR Smartprep technique was used for MR angiography performed with a 1.5-T superconducting system. The tracker volume was placed primarily in the middle part of the right common carotid artery. The imaging volume was placed in a coronal direction to include the carotid and vertebral arteries from the aortic arch to the skull base. A centric phase-ordering scheme was used. Imaging times were 20 to 38 seconds for 14 patients and 11 to 16 seconds for 21 patients. By using a smaller tracker volume and an imaging time of less than 16 seconds, we were able to achieve a 100% successful triggering rate and to delineate selectively arterial-phase carotid and vertebral arteries with almost no venous contamination. Contract-enhanced 3-D MR angiography with the MR Smartprep technique was useful for showing arterial-phase carotid and vertebral arteries selectively.

Arteriovenous malformation hemodynamics: a transcranial Doppler study.

Congenital arteriovenous malformation (AVM) of the brain represents a defect in capillary development resulting in a high flow fistula between arterial and venous systems. In this study, AVM hemodynamics were related with clinical findings. Volume flow was calculated based on transcranial Doppler (TCD) and angiographic data. Forty patients admitted to the Massachusetts General Hospital for proton beam therapy (33 +/- 10 yr old; mean +/- SD) were studied. Four symptoms were considered: intracranial bleeding, progressive neurological deficit, seizures, and headache. Fourteen control subjects aged 30 +/- 7 years (mean +/- SD) were normal volunteers. Angiography with calibrated markers permitting magnification correction was available for all patients. Lateral and medial depth limits of the intracranial basal arteries in relation to the TCD temporal window were determined by TCD and angiogram with excellent correlation. Selected depth for data acquisition was determined independently in the angiogram and by TCD. The difference between the two techniques was less than 4 mm. Mean flow velocity, pulsatility index, and vessel diameter were studied. Flow volume was calculated from these data. Mean flow velocity, pulsatility index, vessel diameter, and flow volume were significantly different among AVM feeders, non-feeders, and control arteries. The non-feeding middle cerebral artery, anterior cerebral artery, and posterior cerebral artery flows were 254 +/- 13, 136 +/- 14, and 79 +/- 8 ml/min, respectively. Accordingly, the estimated cerebral flow volume was 938 ml/min. The feeding middle cerebral artery, anterior cerebral artery, and posterior cerebral artery flows were 552 +/- 47, 369 +/- 70, and 484 +/- 67 ml/min, respectively (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary artery magnetic resonance imaging: a patient-tailored approach.

Coronary artery magnetic resonance imaging strategies have tended to focus on the use of a single method performed during either breath-holding or free-breathing for all patients. However, significant variations exist among patients in terms of breath-holding ability and respiratory regularity that make the use of a single technique alone not universally successful. Therefore, it is prudent to make available a number of magnetic resonance imaging methods such that an appropriate respiratory motion reduction strategy can be tailored to suit the patient's respiratory pattern and characteristics. A tailored approach that can draw on different image acquisition techniques for coronary artery imaging is presented. A decision tree is proposed to triage patients into imaging regimes with the greatest probability of success, according to the patient's ability to breath-hold or exhibit steady respiration. Methods include volume free-breathing acquisitions using navigator echoes for respiratory monitoring in the 8- to 10-min scan time range, two-dimensional spiral navigators (2- to 3-min scan time), breath-held multislice and vessel-tracking spirals (16- to 20-second scan time), and real-time imaging approaches incorporating adaptive signal averaging. The development of multiple acquisition strategies substantially improves the opportunities to generate high-quality, diagnostic images of the coronary arteries.

Contrast-enhanced magnetic resonance angiography: technical considerations for optimized clinical implementation.

Contrast-enhanced magnetic resonance angiography (CE MR angiography) has benefited from advancements in MR imaging speed, pulse sequence design, and dedicated equipment and algorithms for its performance. These improvements have greatly expanded the number of options available to the operator and enabled the application of CE MR angiography to a broader range of clinical applications. In this article, the various timing options, pulse sequence innovations, and contrast administration concerns related to clinical CE MR angiography are reviewed. Pertinent issues related to multiphase and multistation bolus chase CE MR angiography also will be discussed.

Contrast-enhanced carotid MR angiography. Imaging principles and physics.

Arterial contrast enhancement on MR angiography images is dependent on the adequate timing of the contrast bolus arrival to the acquisition of the center of k-space. Different strategies for achieving this goal are described. The more advanced techniques are aimed at making the detection of the peak arrival and the start of data acquisition more robust in order to generate images with maximal arterial-background contrast with minimal venous signal contamination.

Detection of pulmonary embolism: comparison of contrast-enhanced spiral CT and time-of-flight MR techniques.

We compared the conspicuity of acute pulmonary emboli with contrast-enhanced spiral computed tomography (CT) and two- and three-dimensional time-of-flight magnetic resonance (MR) techniques. Seven dogs who received experimental pulmonary emboli and one control were imaged with spiral CT and with 2-D (FMPVAS and FASTCARD) and 3-D time-of-flight MR. Blinded, independent, prospective evaluations of the CT and MR images by two MR radiologists and two chest radiologists were then compared to the location of the emboli as determined by subsequent pathologic evaluation of the excised lungs. Embolus/blood contrast-to-noise ratios (CNRs) were calculated on both MR and CT images for pulmonary emboli that could be identified. Fifty emboli ranging from 1.0 to 5.5 mm (mean, 2.7, +/- 0.14 SEM) in diameter and from 3.0 to 60 mm (mean, 28.1 +/- 1.9 SEM) in length were found in the seven embolized dogs on pathologic examination. Three of the four radiologists identified more thrombi on CT images than they did on their best MR pulse sequence (FASTCARD) and with greater confidence. The fourth radiologist identified an equal percentage of clot on CT and FASTCARD images with confidence slightly greater on FASTCARD MR than on spiral CT. Mean CNR for the best MR technique was 43.4 (+/- 3.9 SEM) and for CT was 20.7 (+/- 1.3 SEM). In general, pulmonary emboli were detected more accurately on contrast-enhanced spiral CT than on MR. This occurred although the embolus/blood CNR was higher on MR than on CT. Better pulmonary embolus conspicuity on CT images was attributed to better spatial resolution and fewer artifacts on CT than on MR. One MR radiologist performed equally well with both spiral CT and FASTCARD techniques, suggesting that experience may be a factor in performance.

A computationally efficient method for tracking reference position displacements for motion compensation in magnetic resonance imaging.

A fast and computationally efficient method for detecting and tracking the displacement of a reference structure within the body using MR imaging is described. This method is used to determine the position of the diaphragm in order to synchronize the data acquisition to the same relative position of the abdominal and thoracic organs, thereby minimizing or eliminating respiratory motion artifacts. The method described uses the time domain linear phase shift of a reference structure to determine its spatial positional displacement as a function of the respiratory cycle. The signal from a two-dimensional rectangular excitation column is first Fourier-transformed to the image domain, apodized, and then transformed back to the time domain. The relative displacement of a target edge in the image domain is determined from an autocorrelation of the resulting time domain information. This technique was found to require between three and eight times less computation than either cross-correlation or least-squares analysis, depending on the navigator parameters. Magn Reson Med 42:548-553, 1999.

Phase-correction method for reduction of B0 instability artifacts.

View-to-view phase shifts due to B0 instability are corrected by applying a phase correction to the low-spatial-frequency views. The algorithm described herein assumes that the signal intensity in the space outside of an object represents only noise. A set of phases for the low-spatial-frequency views are calculated by minimizing, in the image, the intensity of the induced artifacts in the space outside of the object.

Optimized gradient waveforms for spiral scanning.

Spiral scanning gradient waveforms can be optimized with respect to blurring from off-resonance effects by minimizing the readout time. This is achieved by maximizing the gradient amplitude during the scan so that the edge of k-space is reached as quickly as possible. Gradient hardware constraints are incorporated by considering a circuit model for the gradient coil and amplifier. The optimized gradient waveforms are determined by a set of coupled differential equations. The resulting solutions have shorter readout time than solutions that do not consider the circuit model.