OARSI Clinical Trials Recommendations: Hand imaging in clinical trials in osteoarthritis.

Tremendous advances have occurred in our understanding of the pathogenesis of hand osteoarthritis (OA) and these are beginning to be applied to trials targeted at modification of the disease course. The purpose of this expert opinion, consensus driven exercise is to provide detail on how one might use and apply hand imaging assessments in disease modifying clinical trials. It includes information on acquisition methods/techniques (including guidance on positioning for radiography, sequence/protocol recommendations/hardware for MRI); commonly encountered problems (including positioning, hardware and coil failures, sequences artifacts); quality assurance/control procedures; measurement methods; measurement performance (reliability, responsiveness, validity); recommendations for trials; and research recommendations.

Radiofrequency (RF) coil impacts the value and reproducibility of cartilage spin-spin (T2) relaxation time measurements.

INTRODUCTION: T2 (spin-spin) relaxation time is frequently used for compositional assessment of articular cartilage. However little is known about the influence of magnetic resonance (MR) system components on these measurements. The reproducibility and range of cartilage T2 values were evaluated using different extremity radiofrequency (RF) coils with potential differences in flip angle uniformity and signal-to-noise ratio (SNR). METHOD: Ten knees underwent 3 T MR exams using RF coils with different SNR: quadrature transmit/receive (QTR); quadrature transmit/eight-channel phased-array receive (QT8PAR). Each knee was scanned twice per coil (four exams total). T2 values were calculated for the central medial and lateral femoral (cMF, cLF) and medial and lateral tibial (MT, LT) cartilage. RESULTS: The flip angle varied across a central 40 mm diameter region-of-interest of each coil by <1.5%. However SNR was significantly higher using QT8PAR than QTR (P < 0.001). T2 values for cMF (50.7 msec/45.9 msec) and MT (48.2 msec/41.6 msec) were significantly longer with QT8PAR than QTR (P < 0.05). T2 reproducibility was improved using QT8PAR for cMF and cLF (4.8%/5.8% and 4.1%/6.5%; P < 0.001), similar for LT (3.8%/3.6%; P = 1.0), and worse for MT (3.7%/3.3%; P < 0.001). T2 varied spatially, with cLF having the longest (52.0 msec) and the LT having the shortest (40.6 msec) values. All deep cartilage had significantly longer, and less variable, T2 values using QT8PAR (higher SNR; P < 0.03). CONCLUSIONS: SNR varied spatially (significant) depending upon coil, but refocusing flip angle only slightly. With higher SNR, significantly longer T2 values were measured for deep (all plates) and global (MT, cMF) cartilage. T2 values varied by depth and plate, in agreement with prior studies.

Short-term in vivo precision of BMD and parameters of trabecular architecture at the distal forearm and tibia.

UNLABELLED: In vivo hr-pQCT precision was determined in 42 postmenopausal women using double baseline measurements from a multicenter trial of odanacatib. Errors, e.g., at the radius below 1.3% for BMD and below 6.3% for trabecular structure, were comparable to single-center results. Motion artifacts remain a challenge, particularly at the forearm. INTRODUCTION: The short-term in vivo precision of BMD, trabecular bone structure, cortical thickness and porosity of the forearm and tibia was measured by hr-pQCT. Also the effect of image quality on precision was evaluated. METHODS: In 42 postmenopausal women (age 64.4 ± 6.8 years) out of 214 subjects enrolled in a multi center advanced imaging phase III study of odanacatib (DXA spine or hip T-scores between -1.5 and -3.5), double baseline hr-pQCT (XtremeCT) measurements with repositioning were performed. The standard ultradistal location and a second, more proximally located VOI were measured at the radius and tibia to better assess cortical thickness and porosity. Image analysis and quality grading (grades: perfect, slight artifacts, pronounced artifacts, unacceptable) were performed centrally. RESULTS: At the radius RMS%CV values varied from 0.7% to 1.3% for BMD and BV/TV and from 5.6% to 6.3% for Tb.Sp, Tb.Th, Tb.N, and cortical porosity. Numerically at the tibia, precision errors were approx. 0.5% lower for BMD and 1% to 2% lower for structural parameters although most differences were insignificant. In the radius but not in the tibia, precision errors for cortical thickness were smaller at the distal compared to the ultradistal location (1% versus 2%). CONCLUSIONS: BMD precision errors were lower than those for trabecular architecture and cortical porosity. Motion artifacts remain a challenge, particularly at the forearm. Quality grading remains subjective, and more objective evaluation methods are needed. Precision in the context of a multicenter clinical trial, with centralized training and scan analysis, was comparable to single-center results previously reported.

Comparison of SNR and CNR for in vivo mouse brain imaging at 3 and 7 T using well matched scanner configurations.

Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for magnetic resonance microimaging were measured using two nearly identical magnetic resonance imaging (MRI) scanners operating at field strengths of 3 and 7 T. Six mice were scanned using two imaging protocols commonly applied for in vivo imaging of small animal brain: RARE and FLASH. An accounting was made of the field dependence of relaxation times as well as a small number of hardware disparities between scanner systems. Standard methods for relaxometry were utilized to measure T1 and T2 for two white matter (WM) and two gray matter (GM) regions in the mouse brain. An average increase in T1 between 3 and 7 T of 28% was observed in the brain. T2 was found to decrease by 27% at 7 T in agreement with theoretical models. The SNR was found to be uniform throughout the mouse brain, increasing at higher field by a factor statistically indistinguishable from the ratio of Larmor frequencies when imaging with either method. The CNR between GM and WM structures was found to adhere to the expected field dependence for the RARE imaging sequence. Improvement in the CNR for the FLASH imaging sequence between 3 and 7 T was observed to be greater than the Larmor ratio, reflecting a greater susceptibility to partial volume effects at the lower SNR values at 3 T. Imaging at 7 T versus 3 T in small animals clearly provides advantages with respect to the CNR, even beyond the Larmor ratio, especially in lower SNR regimes. This careful multifaceted assessment of the benefits of higher static field is instructive for those newly embarking on small animal imaging. Currently the number of 7 T MRI scanners in use for research in human subjects is increasing at a rapid pace with approximately 30 systems deployed worldwide in 2008. The data presented in this article verify that if system performance and radio frequency uniformity is optimized at 7 T, it should be possible to realize the expected improvements in the CNR and SNR compared with MRI at 3 T.

Temperature dependent change of apparent diffusion coefficient of water in normal and ischemic brain of rats.

To identify the temperature dependent change of the apparent diffusion coefficient (ADC) of water in brain tissue, the ADC values of normal rat brain were measured over a range of body temperatures with monitoring of head temperature using a small water reference implanted under the temporalis muscle. An initial experiment using thermocouples implanted into the cortex, caudate-putamen, temporalis muscle, and rectum demonstrated that temperature in all regions were highly correlated over a temperature range from 33 to 39 degrees C. In another group of normal rats, brain ADC values varied almost uniformly with body temperature over the temperature range 33-39 degrees C, implying that brain ADC values accurately reflect changes in brain temperature. The effects of focal ischemia and administration of the noncompetitive N-methyl-D-aspartate (NMDA) antagonist, CNS-1102, on ADC were also examined, using the suture middle cerebral artery (MCA) occlusion model while maintaining the body temperature at 37 degrees C. ADC values and therefore brain temperature in the nonischemic and ischemic hemispheres were not affected by the drug. These experiments suggest that brain ADC measurement could be useful in animal studies and, potentially, in humans to assess the effects of pharmacologic intervention on brain temperature.

Multislice diffusion mapping for 3-D evolution of cerebral ischemia in a rat stroke model.

Diffusion-weighted magnetic resonance imaging (DWI) can quantitatively demonstrate cerebral ischemia within minutes after the onset of ischemia. The use of a DWI echo-planar multislice technique in this study and the mapping of the apparent diffusion coefficient (ADC) of water, a reliable indicator of ischemic regions, allow for the detection of the three-dimensional (3-D) evolution of ischemia in a rat stroke model. We evaluated 13 time points from 5 to 180 minutes after occlusion of the middle cerebral artery (MCA) and monitored the 3-D spread of ischemia. Within 5 minutes after the onset of ischemia, regions with reduced ADC values occurred. The core of the lesion, with the lowest absolute ADC values, first appeared in the lateral caudoputamen and frontoparietal cortex, then spread to adjacent areas. The volume of ischemic tissue was 224 +/- 48.5 mm3 (mean +/- SEM) after 180 minutes, ranging from 92 to 320 mm3, and this correlated well with the corrected infarct volume at postmortem (194 +/- 23.1 mm3, r = 0.72, p < 0.05). This experiment demonstrated that 3-D multislice diffusion mapping can detect ischemic regions noninvasively 5 minutes after MCA occlusion and follow the development of ischemia. The distribution of changes in absolute ADC values within the ischemic region can be followed over time, giving important information about the evolution of focal ischemia.

MRI diffusion mapping of reversible and irreversible ischemic injury in focal brain ischemia.

The reduction of the apparent diffusion coefficient (ADC) of water shortly after a focal ischemic insult is thought to reflect intracellular water accumulation (cytotoxic edema) related to high-energy metabolism failure and loss of ion homeostasis. We attempted to clarify whether varying ranges of ADC measurements in ischemic brain tissue can be used to differentiate between reversible and irreversible ischemic lesions before reperfusion in a temporary ischemia model. We induced 45 minutes of temporary ischemia in 12 rats using the middle cerebral artery suture occlusion method. Regional changes of ADC values were serially measured in seven regions of interest in each hemisphere and evaluated by delta ADC, defined as the difference between ADC value in an ischemic region and that in a contralateral homologous region. We acquired dynamic contrast-enhanced perfusion images 2 minutes before and after reperfusion to document reduced perfusion and its restoration. We confirmed the infarct area by 2,3,5-triphenyltetrazolium chloride staining 24 hours after occlusion and correlated this with the MRI studies. Recovery of initially reduced ADC values occurred only in ischemic regions where delta ADC values were not below -0.25 x 10(-5) cm2/sec. Although the extent of infarction at postmortem examination varied in regions with moderately decreased prereperfusion ADC values, more than 70% of regions of interest with slight declines of prereperfusion ADC values exhibited no infarction. ADC values progressively decreased after reperfusion in regions that initially had severely decreased prereperfusion ADC values, and postmortem examination always demonstrated infarction in such regions.(ABSTRACT TRUNCATED AT 250 WORDS)

A birdcage coil tuned by RF shielding for application at 9.4 T.

The design and performance of an inductively fed low-pass birdcage radiofrequency (RF) coil for applications at 9.4 T are described where tuning is accomplished by mechanically moving a concentric RF shield about the longitudinal axis of an RF coil. Moving the shield about the RF coil effectively changes the mutual inductance of the system, providing a mechanism for adjusting the resonant frequency. RF shield tuning eliminates adjustable capacitors on the legs of the RF coil, eliminates current imbalances and field distortions, and results in improved B1 field homogeneity and high quality (Q) factors. RF shield tuning and inductive matching provide an isolated resonance structure which is both physically and electrically unattached. Experimental analysis of shield position on both B1 field homogeneity and resonant frequency is provided. Computer simulations of B1 field homogeneity as a function of shield position and shield diameter are also presented. Magnetic resonance microimaging substantiates the usefulness of this design.

Simultaneous correction of ghost and geometric distortion artifacts in EPI using a multiecho reference scan.

A computationally efficient technique is described for the simultaneous removal of ghosting and geometrical distortion artifacts in echo-planar imaging (EPI) utilizing a multiecho, gradient-echo reference scan. Nyquist ghosts occur in EPI reconstructions because odd and even lines of k-space are acquired with opposite polarity, and experimental imperfections such as gradient eddy currents, imperfect pulse sequence timing, B0 field inhomogeneity, susceptibility, and chemical shift result in the even and odd lines of k-space being offset by different amounts relative to the true center of the acquisition window. Geometrical distortion occurs due to the limited bandwidth of the EPI images in the phase-encode direction. This distortion can be problematic when attempting to overlay an activation map from a functional magnetic resonance imaging experiment generated from EPI data on a high-resolution anatomical image. The method described here corrects for geometrical distortion related to B0 inhomogeneity, gradient eddy currents, radio-frequency pulse frequency offset, and chemical shift effect. The algorithm for removing ghost artifacts utilizes phase information in two dimensions and is, thus, more robust than conventional one-dimensional methods. An additional reference scan is required which takes approximately 2 min for a matrix size of 64 X 64 and a repetition time of 2 s. Results from a water phantom and a human brain at 3 T demonstrate the effectiveness of the method for removing ghosts and geometric distortion artifacts.

MR imaging of murine arthritis using ultrasmall superparamagnetic iron oxide particles.

The objective of this work was to determine the ability of magnetic resonance (MR) imaging with ultrasmall superparamagnetic iron oxide (USPIO) particles to provide quantitative measures of inflammation in autoimmune arthritis. Mice were injected intravenously or intra-articularly with USPIO followed by magnetic resonance and histological assessment of the knee joint. Comparisons were made between MR microimages and histology in naïve mice and mice with collagen-induced arthritis.Following intravenous administration, accumulation of USPIO was observed in the popliteal lymph nodes, but not the joint. Administration of USPIO intra-articularly resulted in signal loss in the joint. The MR signal intensity could be quantified and correlated with iron staining in the synovial lining. A marked increase in USPIO uptake and a corresponding decrease in signal intensity were observed in arthritic, compared to naïve mice. Areas of focal signal loss corresponded to foci of iron staining by histology. These studies may provide a basis for the clinical application of USPIO in arthritis for assessing disease severity and monitoring response to therapy.

MRI protocols for whole-organ assessment of the knee in osteoarthritis.

One of the critical challenges in developing structure-modifying therapies for arthritis, especially osteoarthritis (OA), is measuring changes in progression of joint destruction. Magnetic resonance imaging (MRI) offers considerable promise in this regard. Not only can MRI quantify articular cartilage volume and morphology with high precision and accuracy, but it can also examine several other important articular components, and thus offer a unique opportunity to evaluate the knee and other joints as whole organs. On December 5 and 6, 2002, OMERACT (Outcome Measures in Rheumatology Clinical Trials) and OARSI (Osteoarthritis Research Society International), with support from various pharmaceutical companies listed at the beginning of this supplement, held a Workshop for Consensus on Osteoarthritis Imaging in Bethesda, MD. The aim of the Workshop was to provide a state-of-the-art review of imaging outcome measures for OA of the knee to help guide scientists and pharmaceutical companies who want to use MRI in multi-site studies of OA. Applications of MRI were initially reviewed by a multidisciplinary, international panel of expert scientists and physicians from academia, the pharmaceutical industry and regulatory agencies. The findings of the panel were then presented to a wider group of participants for open discussion. The following report summarizes the results of these discussions with respect to MRI acquisition techniques for whole-organ assessment of the knee in OA. The discussion reviews the selection and qualification of imaging sites for clinical trials, designing imaging protocols for whole-organ assessment of OA, and key considerations in image quality (IQ) control and data management.

Proposal for a nomenclature for magnetic resonance imaging based measures of articular cartilage in osteoarthritis.

OBJECTIVE: Magnetic resonance imaging (MRI) of articular cartilage has evolved to be an important tool in research on cartilage (patho)physiology and osteoarthritis (OA). MRI provides a wealth of novel and quantitative information, but there exists no commonly accepted terminology for reporting these metrics. The objective of this initiative was to propose a nomenclature for definitions and names to be used in scientific communications and to give recommendations as to which minimal methodological information should be provided when reporting MRI-based measures of articular cartilage in OA. METHODS: An international group of experts with direct experience in MRI measurement of cartilage morphology or composition reviewed the existing literature. Through an iterative process that included a meeting with a larger group of scientists and clinicians (December 2nd, 2004, Chicago, IL, USA), they discussed, refined, and proposed a nomenclature for MRI-based measures of articular cartilage in OA. RESULTS: The group proposes a nomenclature that describes: (1) the anatomical location and (2) the structural feature being measured, each name consisting of a metric variable combined with a tissue label. In addition, the group recommends minimal methodological information that should be described. CONCLUSIONS: Utilization of this nomenclature should facilitate communication within the scientific community. Further, the uniform adoption of comprehensive nomenclature to describe quantitative MRI- features of articular cartilage should strengthen epidemiological, clinical, and pharmacological studies in OA.

Rapid tissue oxygen tension mapping using 19F inversion-recovery echo-planar imaging of perfluoro-15-crown-5-ether.

Fluorine-19 inversion-recovery, echo-planar imaging (IR-EPI) was used in conjunction with a new PFC emulsion, perfluoro-15-crown-5-ether, to map the spatial distribution of oxygen tension in murine liver, spleen and radiation induced fibrosarcoma (RIF-1) tumors. Intravenously administered PFC emulsions were allowed to sequester in the liver, spleen, and tumor 3 to 7 days prior to imaging experiments. Seven, 64 x 64 IR-EPIs were acquired with successively increasing inversion times (TI). A nonlinear least-squares regression algorithm was used to fit the seven two-dimensional matrices, on a pixel-by-pixel basis, to solve for the relaxation rate, R1, of the sequestered PFC. From in vitro calibration curves, the oxygen tension (pO2) was calculated from the measured R1. Oxygen tension maps were then murine liver and spleen were produced (in 2.5 min) to demonstrate the technique and changes in tissue oxygenation as a function of breathing gas (air and carbogen (95% O2-5% CO2)) are presented. Tissue pO2 maps from RIF-1 tumors (n = 5) were obtained in less than 10 min and changes in tumor pO2 were studied when the breathing gas was switched from air to carbogen. The results from tumor pO2 maps were compared with 19F MR spectroscopy measurements to check for consistency. Histogram analysis yielded an average liver and spleen pO2 of 43 torr and 26 torr for RIF-1 tumors when the animals were breathing air. Statistically significant changes in tumor oxygenation as a function of breathing gas were obtained from both pO2 maps (6 +/- 2 torr, P < 0.05) and 19F MR spectroscopy (13 +/- 3 torr, P < 0.01) as evaluated using the Student's paired t test.

The application of porous-media theory to the investigation of time-dependent diffusion in in vivo systems.

Recent developments in solid-boundary porous-media theory have shown that useful structural information can be extracted from the time-dependent diffusion coefficient, D(t), of the fluid filling the interstitial space. This theoretical framework provides a basis from which to understand the results from diffusion experiments performed in other types of systems (e.g. biological). Structural information about porous media can be obtained from the short-time behavior of D(t) in the form of the ratio of the surface area to pore volume, S/V. The long-time behavior of D(t) in porous media provides an indirect measure of the macroscopic structure. In this case, the long-time diffusion coefficient, D(eff), reflects the tortuosity, T, of the medium; a property of both the connectivity of the diffusion paths and the volume fraction of the sample. Measurements of D(t) were performed in RIF-1 tumors, using both spectroscopy and imaging, and the data were used to calculate S/V and T. The results were compared with histological sections in order to correlate S/V and T with differences in tissue structure (i.e. necrotic vs non-necrotic tumor tissue). Based on spectroscopic measurements, there is a trend towards decreasing S/V and T with increasing tumor volume, consistent with the interpretation that water in necrotic tissue is experiencing relatively fewer restricting barriers (as compared to non-necrotic tumor tissue). Based on D(t) maps generated from RIF-1 tumors, D(eff), and hence T appears to be much more sensitive than S/V in differentiating between necrotic and non-necrotic tissue. In addition to characterizing diseased tissue, S/V and particularly T appear to be sensitive to structural changes that would accompany tumor treatment and should therefore provide a useful tool for monitoring the progress of therapeutic interventions.

Human articular cartilage: influence of aging and early symptomatic degeneration on the spatial variation of T2--preliminary findings at 3 T.

PURPOSE: To determine if age and early symptomatic degeneration alter the spatial dependency of cartilage T2. MATERIALS AND METHODS: In 25 asymptomatic volunteers and six volunteers with symptoms of patellar chondromalacia, quantitative T2 maps of patellar cartilage were obtained with a multiecho, spin-echo magnetic resonance imaging sequence at 3.0 T. Spatial variation in T2 was evaluated as a function of participant age and symptoms. RESULTS: All asymptomatic volunteers demonstrated a continuous increase in T2 from the radial zone to the articular surface. In the population aged 46-60 years compared with younger volunteers, there was a statistically significant (P < .05) increase in T2 of the transitional zone. In symptomatic volunteers, the increase in T2 was larger in magnitude and focal in distribution. In five of the six symptomatic volunteers, the increase in T2 was greater than the 95% prediction interval determined from data in the corresponding age-matched asymptomatic population. CONCLUSION: Aging is associated with an asymptomatic increase in T2 of the transitional zone of articular cartilage. Preliminary results indicate this diffuse increase in T2 in senescent cartilage is different in appearance than the focally increased T2 observed in damaged articular cartilage.

MR imaging and T2 mapping of femoral cartilage: in vivo determination of the magic angle effect.

OBJECTIVE: The purpose of this study was to perform a quantitative evaluation of the effect of static magnetic field orientation on cartilage transverse (T2) relaxation time in the intact living joint and to determine the magnitude of the magic angle effect on in vivo femoral cartilage. MATERIALS AND METHODS: Quantitative T2 maps of the femoral-tibial joint were obtained in eight asymptomatic male volunteers using a 3-T magnet. Cartilage T2 profiles (T2 vs normalized distance from subchondral bone) were evaluated as a function of orientation of the radial zone of cartilage with the applied static magnetic field (B(0)). RESULTS: At a normalized distance of 0.3 from bone, cartilage T2 is 8.6% longer in cartilage oriented 55 degrees to B(0) compared with cartilage oriented parallel with B(0). Greater orientation variation is observed in more superficial cartilage. At a normalized distance of 0.6, cartilage T2 is 18.3% longer. The greatest orientation effect is observed near the articular surface where T2 is 29.1% longer at 55 degrees. CONCLUSION: The effect of orientation on cartilage T2 is substantially less than that predicted from prior ex vivo studies. The greatest variation in cartilage T2 is observed in the superficial 20% of cartilage. Given the small orientation effect, it is unlikely that the "magic angle effect" accounts for regional differences in cartilage signal intensity observed in clinical imaging. We hypothesize that regional differences in the degree of cartilage compression are primarily responsible for the observed regional differences in cartilage T2.

Apparent diffusion coefficient mapping of experimental focal cerebral ischemia using diffusion-weighted echo-planar imaging.

Diffusion-weighted, echo-planar imaging (EPI) was used to map regional changes in the apparent diffusion coefficient (ADC) during experimental focal ischemia in the rat brain following permanent middle cerebral arterial occlusion (MCAO). Sixteen 64 x 64 diffusion-weighted EPIs were acquired in 32 s with successively increasing amplitudes of the diffusion-sensitive gradient pulses. A linear least-squares regression algorithm was used to fit 15 of the 16 two-dimensional matrices, on a pixel-by-pixel basis, to solve for the slope from which the ADC value was calculated. The correlation coefficient of the fit, R2, was used to filter the final ADC maps, and the ADCs were then scaled appropriately to be displayed in a 256 gray level format. Ranges (bins) of 0.05 x 10(-3) mm2/s were then grouped and color coded to qualify and quantify the evolution of ischemia in the MCA territory. The percentage of area in the ischemic and contralateral hemispheres in seven ADC bins were calculated at 30, 60, and 120 min after MCAO for 10 animals and demonstrated a significant increase in ADC bins below 0.45 x 10(-3) mm2/s and a decrease in bins above 0.50 x 10(-3) mm2/s over time. The postmortem infarct area, as measured by TTC staining, was highly correlated with the portion of the ischemic hemisphere falling below ADC values of 0.55 x 10(-3) mm2/s at 2 h after stroke onset. These studies suggest that focally ischemic brain tissue can be quantitatively subdivided according to ADC values and that ADC values below 0.55 x 10(-3) mm2/s 2 h following ischemia highly predict infarction in a rat permanent occlusion stroke model.

Multi-gradient echo with susceptibility inhomogeneity compensation (MGESIC): demonstration of fMRI in the olfactory cortex at 3.0 T.

Short image acquisition times and sensitivity to magnetic susceptibility favor the use of gradient echo imaging methods in functional MRI (fMRI). However, magnetic susceptibility effects attributed to air-tissue interfaces also lead to severe signal loss in images of the large inferior frontal and lateral temporal cortices of the human brain, which renders these regions inaccessible to fMRI. The signal loss is caused by the local field gradients in the silce selection direction. A multigradient echo with magnetic susceptibility inhomogeneity compensation method (MGESIC) is proposed to overcome this problem. The MGESIC method effectively corrects the susceptibility artifacts and maintains the advantages of gradient echo methods to both BOLD sensitivity and fast image acquisition. The effectiveness of the MGESIC method is demonstrated by fMRI experimental results within the olfactory cortex.

A method to create an optimum current distribution and homogeneous B1 field for elliptical birdcage coils.

For a birdcage coil with elliptical cross-section, a sinusoidal current pattern does not provide a homogeneous B1 field. A simple theory was developed to create an optimized current distribution for elliptical birdcage coils. This optimized current pattern can create a perfectly homogeneous B1 field inside any elliptical shape. To verify the theory, a 16-element high-pass elliptical birdcage coil was built inside a circular RF shield. The current was optimized by using the inductance characteristics of the coil components to calculate the end-ring capacitances. The B1 field was theoretically calculated and experimentally mapped for the optimized elliptical bird-cage coil and a nonoptimized coil. The results demonstrate that by optimizing the current distribution, a very homogeneous B1 field is produced. This method can be directly applied in design and construction of elliptical birdcage coils for imaging of the naturally occurring elliptical cross-sectional geometries in the human body.