Deep learning-based super-resolution of structural brain MRI at 1.5 T: application to quantitative volume measurement.

OBJECTIVE: This study investigated the feasibility of using deep learning-based super-resolution (DL-SR) technique on low-resolution (LR) images to generate high-resolution (HR) MR images with the aim of scan time reduction. The efficacy of DL-SR was also assessed through the application of brain volume measurement (BVM). MATERIALS AND METHODS: In vivo brain images acquired with 3D-T1W from various MRI scanners were utilized. For model training, LR images were generated by downsampling the original 1 mm-2 mm isotropic resolution images. Pairs of LR and HR images were used for training 3D residual dense net (RDN). For model testing, actual scanned 2 mm isotropic resolution 3D-T1W images with one-minute scan time were used. Normalized root-mean-square error (NRMSE), peak signal-to-noise ratio (PSNR), and structural similarity (SSIM) were used for model evaluation. The evaluation also included brain volume measurement, with assessments of subcortical brain regions. RESULTS: The results showed that DL-SR model improved the quality of LR images compared with cubic interpolation, as indicated by NRMSE (24.22% vs 30.13%), PSNR (26.19 vs 24.65), and SSIM (0.96 vs 0.95). For volumetric assessments, there were no significant differences between DL-SR and actual HR images (p > 0.05, Pearson's correlation > 0.90) at seven subcortical regions. DISCUSSION: The combination of LR MRI and DL-SR enables addressing prolonged scan time in 3D MRI scans while providing sufficient image quality without affecting brain volume measurement.

Improved reconstruction for highly accelerated propeller diffusion 1.5 T clinical MRI.

PURPOSE: Propeller fast-spin-echo diffusion magnetic resonance imaging (FSE-dMRI) is essential for the diagnosis of Cholesteatoma. However, at clinical 1.5 T MRI, its signal-to-noise ratio (SNR) remains relatively low. To gain sufficient SNR, signal averaging (number of excitations, NEX) is usually used with the cost of prolonged scan time. In this work, we leveraged the benefits of Locally Low Rank (LLR) constrained reconstruction to enhance the SNR. Furthermore, we enhanced both the speed and SNR by employing Convolutional Neural Networks (CNNs) for the accelerated PROPELLER FSE-dMRI on a 1.5 T clinical scanner. METHODS: Residual U-Net (RU-Net) was found to be efficient for propeller FSE-dMRI data. It was trained to predict 2-NEX images obtained by Locally Low Rank (LLR) constrained reconstruction and used 1-NEX images obtained via simplified reconstruction as the inputs. The brain scans from healthy volunteers and patients with cholesteatoma were performed for model training and testing. The performance of trained networks was evaluated with normalized root-mean-square-error (NRMSE), structural similarity index measure (SSIM), and peak SNR (PSNR). RESULTS: For 4 × under-sampled with 7 blades data, online reconstruction appears to provide suboptimal images-some small details are missing due to high noise interferences. Offline LLR enables suppression of noises and discovering some small structures. RU-Net demonstrated further improvement compared to LLR by increasing 18.87% of PSNR, 2.11% of SSIM, and reducing 53.84% of NRMSE. Moreover, RU-Net is about 1500 × faster than LLR (0.03 vs. 47.59 s/slice). CONCLUSION: The LLR remarkably enhances the SNR compared to online reconstruction. Moreover, RU-Net improves propeller FSE-dMRI as reflected in PSNR, SSIM, and NRMSE. It requires only 1-NEX data, which allows a 2 × scan time reduction. In addition, its speed is approximately 1500 times faster than that of LLR-constrained reconstruction.

Does Articular Disc Position Change Following Mandibular Setback Surgery?

BACKGROUND: Maintaining condyle position following bilateral sagittal split ramus osteotomy (BSSO) is crucial to minimizing postoperative relapse. However, the impact of BSSO on the articular disc position remains inconclusive. PURPOSE: This study aimed to investigate the changes in articular disc position following setback BSSO surgery. STUDY DESIGN, SETTING, AND SAMPLING: In this prospective cohort study, subjects with mandibular prognathism requiring setback BSSO were enrolled between August 2021 and June 2022 at the Oral and Maxillofacial Surgery Clinic, Faculty of Dentistry, Chiang Mai University, Thailand. Patients with surgical complications, loss of follow-up, or significant artifacts in their MR images were excluded. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLES: The predictor variable was time. The articular disc position was assessed at 3 time points, preoperatively (T0), 3 months postsurgery (T1), and 6 months postsurgery (T2). MAIN OUTCOME: The primary and secondary outcome variables were the changes in articular disc position between T0-T2 and T0-T1, respectively. Articular disc position was coded as normal, anterior disc displacement with reduction (ADDwR), anterior disc displacement without reduction (ADDwoR), and anterior disc displacement without reduction and degenerative joint disease (ADDwoR + DJD). COVARIATES: Covariate variables collected included age (years), sex (male or female), asymmetry (present or absent), surgical procedure (single jaw (BSSO) or bimaxillary surgery), and setback distance (millimeters). ANALYSES: Friedman's test with 80% power and a significance level of 0.05 was employed. Pairwise comparisons were performed using the Dunn-Bonferroni posthoc test to identify statistically significant differences. RESULTS: The study included 16 subjects, 6 females and 10 males, with a total of 32 TMJs. Subjects had a mean age of 23.75 (4.57) years. The proportion of TMJs with normal disc position postoperatively increased from 3 (9.4%) to 19 (59.4%). Statistically significant differences were found in the changes in disc position over time (P < .001). CONCLUSIONS: Following setback BSSO, the articular discs underwent changes, with a majority of ADDwR cases transitioning to a normal position. Cases with ADDwoR also demonstrated disc reduction capability after surgery. The combined orthodontic treatment and setback BSSO appear to have an effect on articular disc position in skeleton class III patients.

High-fidelity mesoscale in-vivo diffusion MRI through gSlider-BUDA and circular EPI with S-LORAKS reconstruction.

PURPOSE: To develop a high-fidelity diffusion MRI acquisition and reconstruction framework with reduced echo-train-length for less T2* image blurring compared to typical highly accelerated echo-planar imaging (EPI) acquisitions at sub-millimeter isotropic resolution. METHODS: We first proposed a circular-EPI trajectory with partial Fourier sampling on both the readout and phase-encoding directions to minimize the echo-train-length and echo time. We then utilized this trajectory in an interleaved two-shot EPI acquisition with reversed phase-encoding polarity, to aid in the correction of off-resonance-induced image distortions and provide complementary k-space coverage in the missing partial Fourier regions. Using model-based reconstruction with structured low-rank constraint and smooth phase prior, we corrected the shot-to-shot phase variations across the two shots and recover the missing k-space data. Finally, we combined the proposed acquisition/reconstruction framework with an SNR-efficient RF-encoded simultaneous multi-slab technique, termed gSlider, to achieve high-fidelity 720 µm and 500 µm isotropic resolution in-vivo diffusion MRI. RESULTS: Both simulation and in-vivo results demonstrate the effectiveness of the proposed acquisition and reconstruction framework to provide distortion-corrected diffusion imaging at the mesoscale with markedly reduced T2*-blurring. The in-vivo results of 720 µm and 500 µm datasets show high-fidelity diffusion images with reduced image blurring and echo time using the proposed approaches. CONCLUSIONS: The proposed method provides high-quality distortion-corrected diffusion-weighted images with ∼40% reduction in the echo-train-length and T2* blurring at 500µm-isotropic-resolution compared to standard multi-shot EPI.

Feasibility of accelerated 3D T1-weighted MRI using compressed sensing: application to quantitative volume measurements of human brain structures.

OBJECTIVE: Scan time reduction is necessary for volumetric acquisitions to improve workflow productivity and to reduce motion artifacts during MRI procedures. We explored the possibility that Compressed Sensing-4 (CS-4) can be employed with 3D-turbo-field-echo T1-weighted (3D-TFE-T1W) sequence without compromising subcortical measurements on clinical 1.5 T MRI. MATERIALS AND METHODS: Thirty-three healthy volunteers (24 females, 9 males) underwent imaging scans on a 1.5 T MRI equipped with a 12-channel head coil. 3D-TFE-T1W for whole-brain coverage was performed with different acceleration factors, including SENSE-2, SENSE-4, CS-4. Freesurfer, FSL's FIRST, and volBrain packages were utilized for subcortical segmentation. All processed data were assessed using the Wilcoxon signed-rank test. RESULTS: The results obtained from SENSE-2 were considered as references. For SENSE-4, the maximum signal-to-noise ratio (SNR) drop was detected in the Accumbens (51.96%). For CS-4, the maximum SNR drop was detected in the Amygdala (10.55%). Since the SNR drop in CS-4 is relatively small, the SNR in all of the subcortical volumes obtained from SENSE-2 and CS-4 are not statistically different (P > 0.05), and their Pearson's correlation coefficients are larger than 0.90. The maximum biases of SENSE-4 and CS-4 were found in the Thalamus with the mean of differences of 1.60 ml and 0.18 ml, respectively. CONCLUSION: CS-4 provided sufficient quality of 3D-TFE-T1W images for 1.5 T MRI equipped with a 12-channel receiver coil. Subcortical volumes obtained from the CS-4 images are consistent among different post-processing packages.

The effect of spiral trajectory correction on pseudo-continuous arterial spin labeling with high-performance gradients on a compact 3T scanner.

PURPOSE: To demonstrate the feasibility of pseudo-continuous arterial-spin-labeled (pCASL) imaging with 3D fast-spin-echo stack-of-spirals on a compact 3T scanner (C3T), to perform trajectory correction for eddy-current-induced deviations in the spiral readout of pCASL imaging, and to assess the correction effect on perfusion-related images with high-performance gradients (80 mT/m, 700T/m/s) of the C3T. METHODS: To track eddy-current-induced artifacts with Archimedean spiral readout, the spiral readout in pCASL imaging was performed with 5 different peak gradient slew rate (Smax ) values ranging from 70 to 500 T/m/s. The trajectory for each Smax was measured using a dynamic field camera and applied in a density-compensated gridding image reconstruction in addition to the nominal trajectory. The effect of the trajectory correction was assessed with perfusion-weighted (ΔM) images and proton-density-weighted images as well as cerebral blood flow (CBF) maps, obtained from 10 healthy volunteers. RESULTS: Blurring artifact on ΔM images was mitigated by the trajectory correction. CBF values on the left and right calcarine cortices showed no significant difference after correction. Also, the signal-to-noise ratio of ΔM images improved, on average, by 7.6% after correction (P < .001). The greatest improvement of 12.1% on ΔM images was achieved with a spiral readout using Smax of 300~400 T/m/s. CONCLUSION: Eddy currents can cause spiral trajectory deviation, which leads to deformation of the CBF map even in cases of low value Smax . The trajectory correction for spiral-readout-based pCASL produces more reliable results for perfusion imaging. These results suggest that pCASL is feasible on C3T with high-performance gradients.

Distortion-free imaging: A double encoding method (DIADEM) combined with multiband imaging for rapid distortion-free high-resolution diffusion imaging on a compact 3T with high-performance gradients.

BACKGROUND: Distortion-free, high-resolution diffusion imaging using DIADEM (Distortion-free Imaging: A Double Encoding Method), proposed recently, has great potential for clinical applications. However, it can suffer from prolonged scan times and its reliability for quantitative diffusion imaging has not been evaluated. PURPOSE: To investigate the clinical feasibility of DIADEM-based high-resolution diffusion imaging on a novel compact 3T (C3T) by evaluating the reliability of quantitative diffusion measurements and utilizing both the high-performance gradients (80 mT/m, 700 T/m/s) and the sequence optimization with the navigator acquisition window reduction and simultaneous multislice (multiband) imaging. STUDY TYPE: Prospective feasibility study. PHANTOM/SUBJECTS: Diffusion quality control phantom scans to evaluate the reliability of quantitative diffusion measurements; 36 normal control scans for B0 -field mapping; six healthy and two patient subject scans with a brain tumor for comparisons of diffusion and anatomical imaging. FIELD STRENGTH/SEQUENCE: 3T; the standard single-shot echo-planar-imaging (EPI), multishot DIADEM diffusion, and anatomical (2D-FSE [fast-spin-echo], 2D-FLAIR [fluid-attenuated-inversion-recovery], and 3D-MPRAGE [magnetization prepared rapid acquisition gradient echo]) imaging. ASSESSMENT: The scan time reduction, the reliability of quantitative diffusion measurements, and the clinical efficacy for high-resolution diffusion imaging in healthy control and brain tumor volunteers. STATISTICAL TEST: Bland-Altman analysis. RESULTS: The scan time for high in-plane (0.86 mm2 ) resolution, distortion-free, and whole brain diffusion imaging were reduced from 10 to 5 minutes with the sequence optimizations. All of the mean apparent diffusion coefficient (ADC) values in phantom were within the 95% confidence interval in the Bland-Altman plot. The proposed acquisition with a total off-resonance coverage of 597.2 Hz wider than the expected bandwidth of 500 Hz in human brain could yield a distortion-free image without foldover artifacts. Compared with EPI, therefore, this approach allowed direct image matching with the anatomical images and enabled improved delineation of the tumor boundaries. DATA CONCLUSION: The proposed high-resolution diffusion imaging approach is clinically feasible on C3T due to a combination of hardware and sequence improvements. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 1 J. Magn. Reson. Imaging 2020;51:296-310.

Dynamic 2D self-phase-map Nyquist ghost correction for simultaneous multi-slice echo planar imaging.

PURPOSE: To develop a reconstruction pipeline that intrinsically accounts for both simultaneous multislice echo planar imaging (SMS-EPI) reconstruction and dynamic slice-specific Nyquist ghosting correction in time-series data. METHODS: After 1D slice-group average phase correction, the separate polarity (i.e., even and odd echoes) SMS-EPI data were unaliased by slice GeneRalized Autocalibrating Partial Parallel Acquisition. Both the slice-unaliased even and odd echoes were jointly reconstructed using a model-based framework, extended for SMS-EPI reconstruction that estimates a 2D self-phase map, corrects dynamic slice-specific phase errors, and combines data from all coils and echoes to obtain the final images. RESULTS: The percentage ghost-to-signal ratios (%GSRs) and its temporal variations for MB3Ry 2 with a field of view/4 shift in a human brain obtained by the proposed dynamic 2D and standard 1D phase corrections were 1.37 ± 0.11 and 2.66 ± 0.16, respectively. Even with a large regularization parameter λ applied in the proposed reconstruction, the smoothing effect in fMRI activation maps was comparable to a very small Gaussian kernel size 1 × 1 × 1 mm3 . CONCLUSION: The proposed reconstruction pipeline reduced slice-specific phase errors in SMS-EPI, resulting in reduction of GSR. It is applicable for functional MRI studies because the smoothing effect caused by the regularization parameter selection can be minimal in a blood-oxygen-level-dependent activation map.

Model-based iterative reconstruction for single-shot EPI at 7T.

PURPOSE: To describe a model-based reconstruction strategy for single-shot echo planar imaging (EPI) that intrinsically accounts for k-space nonuniformity, Nyquist ghosting, and geometric distortions during rather than before or after image reconstruction. METHODS: Ramp sampling and inhomogeneous B0 field-induced distortion cause the EPI samples to lie on a non-Cartesian grid, thus requiring the nonuniform fast Fourier transform. Additionally, a 2D Nyquist ghost phase correction without the need for extra navigator acquisition is included in the proposed reconstruction. Coil compression is also incorporated to reduce the computational load. The proposed method is applied to phantom and human brain MRI data. RESULTS: The results demonstrate that Nyquist ghosting and geometric distortions are reduced by the proposed reconstruction. The proposed 2D phase correction is superior to a conventional 1D correction. The reductions of both artifacts lead to improved temporal signal-to-noise ratio (tSNR). The virtual coil results suggest that the processing time can be reduced by up to 75%, with a mean tSNR loss of only 3.2% when using 8-virtual instead of 32-physical coils for twofold undersampled data. CONCLUSION: The proposed reconstruction improves the quality (ghosting, geometry, and tSNR) of EPI without requiring calibration data for Nyquist ghost correction. Magn Reson Med 78:2250-2264, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Correction of B 0-induced geometric distortion variations in prospective motion correction for 7T MRI.

OBJECTIVE: Prospective motion correction can effectively fix the imaging volume of interest. For large motion, this can lead to relative motion of coil sensitivities, distortions associated with imaging gradients and B 0 field variations. This work accounts for the B 0 field change due to subject movement, and proposes a method for correcting tissue magnetic susceptibility-related distortion in prospective motion correction. MATERIALS AND METHODS: The B 0 field shifts at the different head orientations were characterized. A volunteer performed large motion with prospective motion correction enabled. The acquired data were divided into multiple groups according to the object positions. The correction of B 0-related distortion was applied to each group of data individually via augmented sensitivity encoding with additionally integrated gradient nonlinearity correction. RESULTS: The relative motion of the gradients, B 0 field and coil sensitivities in prospective motion correction results in residual spatial distortion, blurring, and coil artifacts. These errors can be mitigated by the proposed method. Moreover, iterative conjugate gradient optimization with regularization provided superior results with smaller RMSE in comparison to standard conjugate gradient. CONCLUSION: The combined correction of B 0-related distortion and gradient nonlinearity leads to a reduction of residual motion artifacts in prospective motion correction data.

Correction of gradient nonlinearity artifacts in prospective motion correction for 7T MRI.

PURPOSE: To demonstrate the effect of gradient nonlinearity and develop a method for correction of gradient nonlinearity artifacts in prospective motion correction (Mo-Co). METHODS: Nonlinear gradients can induce geometric distortions in magnetic resonance imaging, leading to pixel shifts with errors of up to several millimeters, thereby interfering with precise localization of anatomical structures. Prospective Mo-Co has been extended by conventional gradient warp correction applied to individual phase encoding steps/groups during the reconstruction. The gradient-related displacements are approximated using spherical harmonic functions. In addition, the combination of this method with a retrospective correction of the changes in the coil sensitivity profiles relative to the object (augmented sensitivity encoding (SENSE) reconstruction) was evaluated in simulation and experimental data. RESULTS: Prospective Mo-Co under gradient fields and coils sensitivity inconsistencies results in residual blurring, spatial distortion, and coil sensitivity mismatch artifacts. These errors can be considerably mitigated by the proposed method. High image quality with very little remaining artifacts was achieved after a few iterations. The relative image errors decreased from 25.7% to below 17.3% after 10 iterations. CONCLUSION: The combined correction of gradient nonlinearity and sensitivity map variation leads to a pronounced reduction of residual motion artifacts in prospectively motion-corrected data.

Minimizing susceptibility-induced BOLD sensitivity loss in multi-band accelerated fMRI using point spread function mapping and gradient reversal.

Objective. Interleaved reverse-gradient fMRI (RG-fMRI) with a point-spread-function (PSF) mapping-based distortion correction scheme has the potential to minimize signal loss in echo-planar-imaging (EPI). In this work, the RG-fMRI is further improved by imaging protocol optimization and application of reverse Fourier acquisition.Approach. Multi-band imaging was adapted for RG-fMRI to improve the temporal and spatial resolution. To better understand signal dropouts in forward and reverse EPIs, a simple theoretical relationship between echo shift and geometric distortion was derived and validated by the reliable measurements using PSF mapping method. After examining practical imaging protocols for RG-fMRI in three subjects on both a conventional whole-body and a high-performance compact 3 T, the results were compared and the feasibility to further improve the RG-fMRI scheme were explored. High-resolution breath-holding RG-fMRI was conducted with nine subjects on the compact 3 T and the fMRI reliability improvement in high susceptibility brain regions was demonstrated. Finally, reverse Fourier acquisition was applied to RG-fMRI, and its benefit was assessed by a simulation study based on the breath-holding RG-fMRI data.Main results. The temporal and spatial resolution of the multi-band RG-fMRI became feasible for whole-brain fMRI. Echo shift measurements from PSF mapping well estimated signal dropout effects in the EPI pair and were useful to further improve the RG-fMRI scheme. Breath-holding RG-fMRI demonstrated improved fMRI reliability in high susceptibility brain regions. Reverse partial Fourier acquisition omitting the late echoes could further improve the temporal or spatial resolution for RG-fMRI without noticeable signal degradation and spatial resolution loss.Significance. With the improved imaging scheme, RG-fMRI could reliably investigate the functional mechanisms of the human brain in the temporal and frontal areas suffering from susceptibility-induced functional sensitivity loss.

Circulating Lipocalin-2 level is positively associated with cognitive impairment in patients with metabolic syndrome.

The association between Lipocalin-2 (LCN2) and cognition in patients with metabolic syndrome (MetS) has not been thoroughly investigated. We aimed to evaluate whether serum LCN2 levels are associated with the alteration of cognitive function in patients with MetS. The total of 191 non-demented participants with MetS were enrolled onto the study in 2015, and a cohort study was conducted in a subpopulation in 2020. After adjustment for sex, age, waist circumference, creatinine levels, and HbA1C, an association between the higher serum LCN2 levels and the lower Montreal cognitive assessment (MoCA) scores was observed (B = - 0.045; 95%CI - 0.087, - 0.004; p 0.030). A total of 30 participants were followed-up in 2020. Serum LCN2 levels were decreased in correlation with age (23.31 ± 12.32 ng/ml in 2015 and 15.98 ± 11.28 ng/ml in 2020, p 0.024), while other metabolic parameters were unchanged. Magnetic resonance imaging studies were conducted on a subsample of patients in 2020 (n = 15). Associations between high serum LCN2 levels from 2015 and 2020 and changes in brain volume of hippocampus and prefrontal cortex from 2020 have been observed. These findings suggest a relationship between changes of the level of circulating LCN2, cognitive impairment, and changes in brain volume in patients with MetS. However, further investigation is still needed to explore the direct effect of circulating LCN2 on the cognition of MetS patients.

Reducing PNS with minimal performance penalties via simple pulse sequence modifications on a high-performance compact 3T scanner.

One of the major concerns associated with high-performance gradients is peripheral nerve stimulation (PNS) of the subject during MRI exams. Since the installation, more than 680 volunteer subjects (patients and controls) have been scanned on a compact 3 T MRI system with high-performance gradients, capable of 80 mT m-1 gradient amplitude and 700 T m-1 s-1 slew rate simultaneously. Despite PNS concerns associated with the high-performance gradients, due to the smaller physical dimensions of the gradient coils, minimal or no PNS sensation was reported with most pulse sequences. The exception was PNS reported by only five of 252 subjects (about 2%) scanned with a specific 3D fast spin echo pulse sequence (3DFLAIR). Rather than derating the entire system performance across all pulse sequences and all gradient lobes, we addressed reported PNS effect with a simple and specific modification to the targeted lobes of the problematic pulse sequence. in addition, the PNS convolutional model was adapted to predict sequence-specific PNS threshold level and its reduction after derating. The effectiveness of the targeted pulse sequence modification was demonstrated by successfully re-scanning four of the subjects who previously reported PNS sensations without further reported PNS. The pulse sequence modification did not result in noticeable degradation of image quality or substantial increase in scan time. The results demonstrated that PNS was rarely reported on the compact 3 T, and when it was, utilizing a specific modification of the gradient waveform causing PNS was an effective strategy, rather than derating the performance of the entire gradient system.

The benefit of high-performance gradients on echo planar imaging for BOLD-based resting-state functional MRI.

Improved gradient performance in an MRI system reduces distortion in echo planar imaging (EPI), which has been a key imaging method for functional studies. A lightweight, low-cryogen compact 3T MRI scanner (C3T) is capable of achieving 80 mT m-1 gradient amplitude with 700 T m-1 s-1 slew rate, in comparison with a conventional whole-body 3T MRI scanner (WB3T, 50 mT m-1 with 200 T m-1 s-1). We investigated benefits of the high-performance gradients in a high-spatial-resolution (1.5 mm isotropic) functional MRI study. Reduced echo spacing in the EPI pulse sequence inherently leads to less severe geometric distortion, which provided higher accuracy than with WB3T for registration between EPI and anatomical images. The cortical coverage of C3T datasets was improved by more accurate signal depiction (i.e. less dropout or pile-up). Resting-state functional analysis results showed that greater magnitude and extent in functional connectivity (FC) for the C3T than the WB3T when the selected seed region is susceptible to distortions, while the FC matrix for well-known brain networks showed little difference between the two scanners. This shows that the improved quality in EPI is particularly valuable for studying certain brain regions typically obscured by severe distortion.