Inversion-recovery ultrashort-echo-time (IR-UTE) MRI-based detection of radiation dose heterogeneity in gynecologic cancer patients treated with HDR brachytherapy.

PURPOSE: To evaluate the relationship between delivered radiation (RT) and post-RT inversion-recovery ultrashort-echo-time (IR-UTE) MRI signal-intensity (SI) in gynecologic cancer patients treated with high-dose-rate (HDR) brachytherapy (BT). METHODS: Seven patients underwent whole-pelvis RT (WPRT) followed by BT to the high-risk clinical target volume (HR-CTV). MR images were acquired at three time-points; pre-RT, post-WPRT/pre-BT, and 3-6 months post-BT. Diffuse-fibrosis (FDiffuse) was imaged with a non-contrast dual-echo IR (inversion time [TI] = 60 ms) UTE research application, with image-subtraction of the later echo, only retaining the ultrashort-echo SI. Dense-fibrosis (FDense) imaging utilized single-echo Late-Gadolinium-Enhanced IR-UTE, acquired ∼ 15 min post-Gadavist injection. Resulting FDiffuse and FDense SI were normalized to the corresponding gluteal-muscle SI. Images were deformably registered between time-points based on normal tissue anatomy. The remnant tumor at both time-points was segmented using multi-parametric MRI. Contours corresponding to the 50%, 100%, 150%, and 200% isodose lines (IDLs) of the prescription BT-dose were created. Mean FDiffuse and FDense SI within (i) each IDL contour and (ii) the remnant tumor were calculated. Post-BT FDiffuse and FDense SI were correlated with prescribed BT-dose. To determine the relationship between BT-dose and IR-UTE SI, the differences in the post-BT FDense across IDLs was determined using paired t-tests with Bonferroni correction. RESULTS: FDense was higher in regions of higher dose for 6/7 patients, with mean ± SD values of 357 ± 103% and 331 ± 97% (p = .03) in the 100% and 50% IDL, respectively. FDense was higher in regions of higher dose in the responsive regions with mean ± SD values of 380 ± 122% and 356 ± 135% (p = .03) in the 150% and 50% IDL, respectively. Within the segmented remnant tumor, an increase in prescribed dose correlated with an increase in FDense post-BT (n = 5, r = .89, p = .04). Post-BT FDiffuse inversely correlated (n = 7, r = -.83, p = .02) with prescribed BT-dose within the 100% IDL. CONCLUSIONS: Results suggest that FDense SI 3-6 months post-BT is a sensitive measure of tissue response to heterogeneous BT radiation-dose. Future studies will validate whether FDiffuse and FDense are accurate biomarkers of fibrotic radiation response.

Self-gated 3D stack-of-spirals UTE pulmonary imaging at 0.55T.

PURPOSE: To develop an isotropic high-resolution stack-of-spirals UTE sequence for pulmonary imaging at 0.55 Tesla by leveraging a combination of robust respiratory-binning, trajectory correction, and concomitant-field corrections. METHODS: A stack-of-spirals golden-angle UTE sequence was used to continuously acquire data for 15.5 minutes. The data was binned to a stable respiratory phase based on superoinferior readout self-navigator signals. Corrections for trajectory errors and concomitant field artifacts, along with image reconstruction with conjugate gradient SENSE, were performed inline within the Gadgetron framework. Finally, data were retrospectively reconstructed to simulate scan times of 5, 8.5, and 12 minutes. Image quality was assessed using signal-to-noise, image sharpness, and qualitative reader scores. The technique was evaluated in healthy volunteers, patients with coronavirus disease 2019 infection, and patients with lung nodules. RESULTS: The technique provided diagnostic quality images with parenchymal lung SNR of 3.18 ± 0.0.60, 4.57 ± 0.87, 5.45 ± 1.02, and 5.89 ± 1.28 for scan times of 5, 8.5, 12, and 15.5 minutes, respectively. The respiratory binning technique resulted in significantly sharper images (p < 0.001) as measured with relative maximum derivative at the diaphragm. Concomitant field corrections visibly improved sharpness of anatomical structures away from iso-center. The image quality was maintained with a slight loss in SNR for simulated scan times down to 8.5 minutes. Inline image reconstruction and artifact correction were achieved in <5 minutes. CONCLUSION: The proposed pulmonary imaging technique combined efficient stack-of-spirals imaging with robust respiratory binning, concomitant field correction, and trajectory correction to generate diagnostic quality images with 1.75 mm isotropic resolution in 8.5 minutes on a high-performance 0.55 Tesla system.

Combined Use of X-ray Angiography and Intraprocedural MRI Enables Tissue-based Decision Making Regarding Revascularization during Acute Ischemic Stroke Intervention.

Background For patients with acute ischemic stroke undergoing endovascular mechanical thrombectomy with x-ray angiography, the use of adjuncts to maintain vessel patency, such as stents or antiplatelet medications, can increase risk of periprocedural complications. Criteria for using these adjuncts are not well defined. Purpose To evaluate use of MRI to guide critical decision making by using a combined biplane x-ray neuroangiography 3.0-T MRI suite during acute ischemic stroke intervention. Materials and Methods This retrospective observational study evaluated consecutive patients undergoing endovascular intervention for acute ischemic stroke between July 2019 and May 2020 who underwent either angiography with MRI or angiography alone. Cerebral tissue viability was assessed by using MRI as the reference standard. For statistical analysis, Fisher exact test and Student t test were used to compare groups. Results Of 47 patients undergoing acute stroke intervention, 12 patients (median age, 69 years; interquartile range, 60-77 years; nine men) underwent x-ray angiography with MRI whereas the remaining 35 patients (median age, 80 years; interquartile range, 68-86 years; 22 men) underwent angiography alone. MRI results influenced clinical decision making in one of three ways: whether or not to perform initial or additional mechanical thrombectomy, whether or not to place an intracranial stent, and administration of antithrombotic or blood pressure medications. In this initial experience, decision making during endovascular acute stroke intervention in the combined angiography-MRI suite was better informed at MRI, such that therapy was guided in real time by the viability of the at-risk cerebral tissue. Conclusion Integrating intraprocedural 3.0-T MRI into acute ischemic stroke treatment was feasible and guided decisions of whether or not to continue thrombectomy, to place stents, or to administer antithrombotic medication or provide blood pressure medications. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Lev and Leslie-Mazwi in this issue.

Opportunities in Interventional and Diagnostic Imaging by Using High-Performance Low-Field-Strength MRI.

Background Commercial low-field-strength MRI systems are generally not equipped with state-of-the-art MRI hardware, and are not suitable for demanding imaging techniques. An MRI system was developed that combines low field strength (0.55 T) with high-performance imaging technology. Purpose To evaluate applications of a high-performance low-field-strength MRI system, specifically MRI-guided cardiovascular catheterizations with metallic devices, diagnostic imaging in high-susceptibility regions, and efficient image acquisition strategies. Materials and Methods A commercial 1.5-T MRI system was modified to operate at 0.55 T while maintaining high-performance hardware, shielded gradients (45 mT/m; 200 T/m/sec), and advanced imaging methods. MRI was performed between January 2018 and April 2019. T1, T2, and T2* were measured at 0.55 T; relaxivity of exogenous contrast agents was measured; and clinical applications advantageous at low field were evaluated. Results There were 83 0.55-T MRI examinations performed in study participants (45 women; mean age, 34 years ± 13). On average, T1 was 32% shorter, T2 was 26% longer, and T2* was 40% longer at 0.55 T compared with 1.5 T. Nine metallic interventional devices were found to be intrinsically safe at 0.55 T (<1°C heating) and MRI-guided right heart catheterization was performed in seven study participants with commercial metallic guidewires. Compared with 1.5 T, reduced image distortion was shown in lungs, upper airway, cranial sinuses, and intestines because of improved field homogeneity. Oxygen inhalation generated lung signal enhancement of 19% ± 11 (standard deviation) at 0.55 T compared with 7.6% ± 6.3 at 1.5 T (P = .02; five participants) because of the increased T1 relaxivity of oxygen (4.7e-4 mmHg-1sec-1). Efficient spiral image acquisitions were amenable to low field strength and generated increased signal-to-noise ratio compared with Cartesian acquisitions (P < .02). Representative imaging of the brain, spine, abdomen, and heart generated good image quality with this system. Conclusion This initial study suggests that high-performance low-field-strength MRI offers advantages for MRI-guided catheterizations with metal devices, MRI in high-susceptibility regions, and efficient imaging. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Grist in this issue.

Simultaneous multi-slice accelerated turbo spin echo of the knee in pediatric patients.

PURPOSE: To compare knee MRI performed with the integrated parallel acquisition technique (PAT) and simultaneous multislice (SMS) turbo spin echo (TSE) T2-weighted (T2w) sequences with conventional TSE sequences in pediatric patients. MATERIALS AND METHODS: This was a retrospective IRB-approved study. Seventy-four subjects (26 male, 48 female, mean age 15.3 years, range 8-20) underwent 3-T MRI of the knee with a T2w TSE pulse sequence prototype with four-fold PAT and SMS acceleration as well as the standard PAT-only accelerated sequences. Images were anonymized and two study folders were created: one examination with only T2w PAT2 images (conventional examination) and one examination with only T2w SMS2/PAT2 sequences (SMS examination). Two readers rated examinations for 15 specific imaging findings and 5 quality metrics. Interreader agreement was measured. Signal to noise (SNR) and contrast to noise (CNR) were measured for SMS and conventional T2w sequences. RESULTS: Consensus review demonstrated diagnostic quality performance of SMS examinations with respect to all 15 structures. Average area under the curve (AROC) was 0.95 and 0.97 for readers 1 and 2, respectively. The conventional sequence was favored over SMS for four out of five quality metrics (p < 0.001). SNR and CNR were higher for the conventional sequences compared to SMS. CONCLUSION: SMS accelerated T2w TSE sequences offer a faster alternative for knee imaging in pediatric patients without compromise in diagnostic performance despite diminished SNR. The four-fold acceleration of SMS is beneficial to pediatric patients who often have difficulty staying still for long MRI examinations.

Wave-CAIPI for highly accelerated MP-RAGE imaging.

PURPOSE: To introduce a highly accelerated T1-weighted magnetization-prepared rapid gradient echo (MP-RAGE) acquisition that uses wave-controlled aliasing in parallel imaging (wave-CAIPI) encoding to retain high image quality. METHODS: Significant acceleration of the MP-RAGE sequence is demonstrated using the wave-CAIPI technique. Here, sinusoidal waveforms are used to spread aliasing in all three directions to improve the g-factor. Combined with a rapid (2 s) coil sensitivity acquisition and data-driven trajectory calibration, we propose an online integrated acquisition-reconstruction pipeline for highly efficient MP-RAGE imaging. RESULTS: The 9-fold accelerated MP-RAGE acquisition can be performed in 71 s, with a maximum and average g-factor of gmax = 1.27 and gavg = 1.06 at 3T. Compared with the state-of-the-art method controlled aliasing in parallel imaging results in higher acceleration (2D-CAIPIRINHA), this is a factor of 4.6/1.4 improvement in gmax /gavg . In addition, we demonstrate a 57 s acquisition at 7T with 12-fold acceleration. This acquisition has a g-factor performance of gmax = 1.15 and gavg = 1.04. CONCLUSION: Wave encoding overcomes the g-factor noise amplification penalty and allows for an order of magnitude acceleration of MP-RAGE acquisitions. Magn Reson Med 79:401-406, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Simultaneous Multislice-Based 5-Minute Lumbar Spine MRI Protocol: Initial Experience in a Clinical Setting.

BACKGROUND AND PURPOSE: Previous studies have used parallel imaging (PI) techniques to decrease spine magnetic resonance imaging (MRI) protocol acquisition times. Recently developed MRI sequences allow even faster acquisitions. Our purpose was to develop a lumbar spine MRI protocol using PI with GRAPPA (generalized autocalibrating partially parallel acquisition) and a simultaneous multislice (SMS)-based sequence and to evaluate its diagnostic performance compared to a standard lumbar spine MRI protocol. METHODS: Ten patients were scanned in a 3-Tesla scanner (MAGNETOM Skyra, Siemens Healthcare). Each patient was imaged using a standard protocol and an optimized fast protocol acquiring the same contrasts and planes. The fast protocol included sagittal T1, T2, and fat suppressed T2 sequences accelerated with GRAPPA and an SMS-based axial T2-weighted sequence using a high-density spine coil (Siemens MR, 30 channel spine). Two blinded neuroradiologists independently assessed image quality and diagnostic accuracy for clinically relevant imaging findings. RESULTS: The fast protocol acquisition time was 5:28 minutes, compared with 16:30 minutes for the standard protocol. Both protocols had a similar performance for definition of anatomical structures, diagnostic quality, and identification of clinically relevant imaging findings. There were more artifacts in the SMS Turbo Spin Echo (P = .014) sequence without compromising diagnostic performance. Artifacts in the remaining non-SMS sequences were similar in both protocols (P > .180). The sensitivity, specificity, and accuracy of the 5-minute protocol were 92.3%, 100.0%, and 99.6%, respectively, for the clinically relevant findings (P = 1.0, interrater agreement .57). CONCLUSIONS: A 5-minute SMS-based MRI protocol for lumbar spine imaging is feasible and can be achieved without significant impact in the overall diagnostic quality.

Reduction of across-run variability of temporal SNR in accelerated EPI time-series data through FLEET-based robust autocalibration.

Temporal signal-to-noise ratio (tSNR) is a key metric for assessing the ability to detect brain activation in fMRI data. A recent study has shown substantial variation of tSNR between multiple runs of accelerated EPI acquisitions reconstructed with the GRAPPA method using protocols commonly used for fMRI experiments. Across-run changes in the location of high-tSNR regions could lead to misinterpretation of the observed brain activation patterns, reduced sensitivity of the fMRI studies, and biased results. We compared conventional EPI autocalibration (ACS) methods with the recently-introduced FLEET ACS method, measuring their tSNR variability, as well as spatial overlap and displacement of high-tSNR clusters across runs in datasets acquired from human subjects at 7T and 3T. FLEET ACS reconstructed data had higher tSNR levels, as previously reported, as well as better temporal consistency and larger overlap of the high-tSNR clusters across runs compared with reconstructions using conventional multi-shot (ms) EPI ACS data. tSNR variability across two different runs of the same protocol using ms-EPI ACS data was about two times larger than for the protocol using FLEET ACS for acceleration factors (R) 2 and 3, and one and half times larger for R=4. The level of across-run tSNR consistency for data reconstructed with FLEET ACS was similar to within-run tSNR consistency. The displacement of high-tSNR clusters across two runs (inter-cluster distance) decreased from ∼8mm in the time-series reconstructed using conventional ms-EPI ACS data to ∼4mm for images reconstructed using FLEET ACS. However, the performance gap between conventional ms-EPI ACS and FLEET ACS narrowed with increasing parallel imaging acceleration factor. Overall, the FLEET ACS method provides a simple solution to the problem of varying tSNR across runs, and therefore helps ensure that an assumption of fMRI analysis-that tSNR is largely consistent across runs-is met for accelerated acquisitions.

Diffusion Tractography of the Entire Left Ventricle by Using Free-breathing Accelerated Simultaneous Multisection Imaging.

Purpose To develop a clinically feasible whole-heart free-breathing diffusion-tensor (DT) magnetic resonance (MR) imaging approach with an imaging time of approximately 15 minutes to enable three-dimensional (3D) tractography. Materials and Methods The study was compliant with HIPAA and the institutional review board and required written consent from the participants. DT imaging was performed in seven healthy volunteers and three patients with pulmonary hypertension by using a stimulated echo sequence. Twelve contiguous short-axis sections and six four-chamber sections that covered the entire left ventricle were acquired by using simultaneous multisection (SMS) excitation with a blipped-controlled aliasing in parallel imaging readout. Rate 2 and rate 3 SMS excitation was defined as two and three times accelerated in the section axis, respectively. Breath-hold and free-breathing images with and without SMS acceleration were acquired. Diffusion-encoding directions were acquired sequentially, spatiotemporally registered, and retrospectively selected by using an entropy-based approach. Myofiber helix angle, mean diffusivity, fractional anisotropy, and 3D tractograms were analyzed by using paired t tests and analysis of variance. Results No significant differences (P > .63) were seen between breath-hold rate 3 SMS and free-breathing rate 2 SMS excitation in transmural myofiber helix angle, mean diffusivity (mean ± standard deviation, [0.89 ± 0.09] × 10-3 mm2/sec vs [0.9 ± 0.09] × 10-3 mm2/sec), or fractional anisotropy (0.43 ± 0.05 vs 0.42 ± 0.06). Three-dimensional tractograms of the left ventricle with no SMS and rate 2 and rate 3 SMS excitation were qualitatively similar. Conclusion Free-breathing DT imaging of the entire human heart can be performed in approximately 15 minutes without section gaps by using SMS excitation with a blipped-controlled aliasing in parallel imaging readout, followed by spatiotemporal registration and entropy-based retrospective image selection. This method may lead to clinical translation of whole-heart DT imaging, enabling broad application in patients with cardiac disease. © RSNA, 2016 Online supplemental material is available for this article.

Diffusion MRI in the heart.

Diffusion MRI provides unique information on the structure, organization, and integrity of the myocardium without the need for exogenous contrast agents. Diffusion MRI in the heart, however, has proven technically challenging because of the intrinsic non-rigid deformation during the cardiac cycle, displacement of the myocardium due to respiratory motion, signal inhomogeneity within the thorax, and short transverse relaxation times. Recently developed accelerated diffusion-weighted MR acquisition sequences combined with advanced post-processing techniques have improved the accuracy and efficiency of diffusion MRI in the myocardium. In this review, we describe the solutions and approaches that have been developed to enable diffusion MRI of the heart in vivo, including a dual-gated stimulated echo approach, a velocity- (M1 ) or an acceleration- (M2 ) compensated pulsed gradient spin echo approach, and the use of principal component analysis filtering. The structure of the myocardium and the application of these techniques in ischemic heart disease are also briefly reviewed. The advent of clinical MR systems with stronger gradients will likely facilitate the translation of cardiac diffusion MRI into clinical use. The addition of diffusion MRI to the well-established set of cardiovascular imaging techniques should lead to new and complementary approaches for the diagnosis and evaluation of patients with heart disease. © 2015 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.

Autocalibrated wave-CAIPI reconstruction; Joint optimization of k-space trajectory and parallel imaging reconstruction.

PURPOSE: Fast MRI acquisitions often rely on efficient traversal of k-space and hardware limitations, or other physical effects can cause the k-space trajectory to deviate from a theoretical path in a manner dependent on the image prescription and protocol parameters. Additional measurements or generalized calibrations are typically needed to characterize the discrepancies. We propose an autocalibrated technique to determine these discrepancies. METHODS: A joint optimization is used to estimate the trajectory simultaneously with the parallel imaging reconstruction, without the need for additional measurements. Model reduction is introduced to make this optimization computationally efficient, and to ensure final image quality. RESULTS: We demonstrate our approach for the wave-CAIPI fast acquisition method that uses a corkscrew k-space path to efficiently encode k-space and spread the voxel aliasing. Model reduction allows for the 3D trajectory to be automatically calculated in fewer than 30 s on standard vendor hardware. The method achieves equivalent accuracy to full-gradient calibration scans. CONCLUSIONS: The proposed method allows for high-quality wave-CAIPI reconstruction across wide ranges of protocol parameters, such as field of view (FOV) location/orientation, bandwidth, echo time (TE), resolution, and sinusoidal amplitude/frequency. Our framework should allow for the autocalibration of gradient trajectories from many other fast MRI techniques in clinically relevant time. Magn Reson Med 78:1093-1099, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Use of pattern recognition for unaliasing simultaneously acquired slices in simultaneous multislice MR fingerprinting.

PURPOSE: The purpose of this study is to accelerate an MR fingerprinting (MRF) acquisition by using a simultaneous multislice method. METHODS: A multiband radiofrequency (RF) pulse was designed to excite two slices with different flip angles and phases. The signals of two slices were driven to be as orthogonal as possible. The mixed and undersampled MRF signal was matched to two dictionaries to retrieve T1 and T2 maps of each slice. Quantitative results from the proposed method were validated with the gold-standard spin echo methods in a phantom. T1 and T2 maps of in vivo human brain from two simultaneously acquired slices were also compared to the results of fast imaging with steady-state precession based MRF method (MRF-FISP) with a single-band RF excitation. RESULTS: The phantom results showed that the simultaneous multislice imaging MRF-FISP method quantified the relaxation properties accurately compared to the gold-standard spin echo methods. T1 and T2 values of in vivo brain from the proposed method also matched the results from the normal MRF-FISP acquisition. CONCLUSION: T1 and T2 values can be quantified at a multiband acceleration factor of two using our proposed acquisition even in a single-channel receive coil. Further acceleration could be achieved by combining this method with parallel imaging or iterative reconstruction. Magn Reson Med 78:1870-1876, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

The pulsatility volume index: an indicator of cerebrovascular compliance based on fast magnetic resonance imaging of cardiac and respiratory pulsatility.

The influence of cardiac activity on the viscoelastic properties of intracranial tissue is one of the mechanisms through which brain-heart interactions take place, and is implicated in cerebrovascular disease. Cerebrovascular disease risk is not fully explained by current risk factors, including arterial compliance. Cerebrovascular compliance is currently estimated indirectly through Doppler sonography and magnetic resonance imaging (MRI) measures of blood velocity changes. In order to meet the need for novel cerebrovascular disease risk factors, we aimed to design and validate an MRI indicator of cerebrovascular compliance based on direct endogenous measures of blood volume changes. We implemented a fast non-gated two-dimensional MRI pulse sequence based on echo-planar imaging (EPI) with ultra-short repetition time (approx. 30-50 ms), which stepped through slices every approximately 20 s. We constrained the solution of the Bloch equations for spins moving faster than a critical speed to produce an endogenous contrast primarily dependent on spin volume changes, and an approximately sixfold signal gain compared with Ernst angle acquisitions achieved by the use of a 90° flip angle. Using cardiac and respiratory peaks detected on physiological recordings, average cardiac and respiratory MRI pulse waveforms in several brain compartments were obtained at 7 Tesla, and used to derive a compliance indicator, the pulsatility volume index (pVI). The pVI, evaluated in larger cerebral arteries, displayed significant variation within and across vessels. Multi-echo EPI showed the presence of significant pulsatility effects in both S0 and [Formula: see text] signals, compatible with blood volume changes. Lastly, the pVI dynamically varied during breath-holding compared with normal breathing, as expected for a compliance indicator. In summary, we characterized and performed an initial validation of a novel MRI indicator of cerebrovascular compliance, which might prove useful to investigate brain-heart interactions in cerebrovascular disease and other disorders.

Accelerated magnetic resonance diffusion tensor imaging of the median nerve using simultaneous multi-slice echo planar imaging with blipped CAIPIRINHA.

PURPOSE: To investigate the feasibility of MR diffusion tensor imaging (DTI) of the median nerve using simultaneous multi-slice echo planar imaging (EPI) with blipped CAIPIRINHA. MATERIALS AND METHODS: After federal ethics board approval, MR imaging of the median nerves of eight healthy volunteers (mean age, 29.4 years; range, 25-32) was performed at 3 T using a 16-channel hand/wrist coil. An EPI sequence (b-value, 1,000 s/mm(2); 20 gradient directions) was acquired without acceleration as well as with twofold and threefold slice acceleration. Fractional anisotropy (FA), mean diffusivity (MD) and quality of nerve tractography (number of tracks, average track length, track homogeneity, anatomical accuracy) were compared between the acquisitions using multivariate ANOVA and the Kruskal-Wallis test. RESULTS: Acquisition time was 6:08 min for standard DTI, 3:38 min for twofold and 2:31 min for threefold acceleration. No differences were found regarding FA (standard DTI: 0.620 ± 0.058; twofold acceleration: 0.642 ± 0.058; threefold acceleration: 0.644 ± 0.061; p ≥ 0.217) and MD (standard DTI: 1.076 ± 0.080 mm(2)/s; twofold acceleration: 1.016 ± 0.123 mm(2)/s; threefold acceleration: 0.979 ± 0.153 mm(2)/s; p ≥ 0.074). Twofold acceleration yielded similar tractography quality compared to standard DTI (p > 0.05). With threefold acceleration, however, average track length and track homogeneity decreased (p = 0.004-0.021). CONCLUSION: Accelerated DTI of the median nerve is feasible. Twofold acceleration yields similar results to standard DTI. KEY POINTS: • Standard DTI of the median nerve is limited by its long acquisition time. • Simultaneous multi-slice acquisition is a new technique for accelerated DTI. • Accelerated DTI of the median nerve yields similar results to standard DTI.

Reducing sensitivity losses due to respiration and motion in accelerated echo planar imaging by reordering the autocalibration data acquisition.

PURPOSE: To reduce the sensitivity of echo-planar imaging (EPI) auto-calibration signal (ACS) data to patient respiration and motion to improve the image quality and temporal signal-to-noise ratio (tSNR) of accelerated EPI time-series data. METHODS: ACS data for accelerated EPI are generally acquired using segmented, multishot EPI to distortion-match the ACS and time-series data. The ACS data are, therefore, typically collected over multiple TR periods, leading to increased vulnerability to motion and dynamic B0 changes. The fast low-angle excitation echo-planar technique (FLEET) is adopted to reorder the ACS segments so that segments within any given slice are acquired consecutively in time, thereby acquiring ACS data for each slice as rapidly as possible. RESULTS: Subject breathhold and motion phantom experiments demonstrate that artifacts in the ACS data reduce tSNR and produce tSNR discontinuities across slices in the accelerated EPI time-series data. Accelerated EPI data reconstructed using FLEET-ACS exhibit improved tSNR and increased tSNR continuity across slices. Additionally, image quality is improved dramatically when bulk motion occurs during the ACS acquisition. CONCLUSION: FLEET-ACS provides reduced respiration and motion sensitivity in accelerated EPI, which yields higher tSNR and image quality. Benefits are demonstrated in both conventional-resolution 3T and high-resolution 7T EPI time-series data.

Simultaneous Multislice Accelerated Free-Breathing Diffusion-Weighted Imaging of the Liver at 3T.

PURPOSE: To perform image quality comparison between accelerated multiband diffusion acquisition (mb2-DWI) and conventional diffusion acquisition (c-DWI) in patients undergoing clinically indicated liver MRI. METHODS: In this prospective study 22 consecutive patients undergoing clinically indicated liver MRI on a 3-T scanner equipped to perform multiband diffusion-weighed imaging (mb-DWI) were included. DWI was performed with single-shot spin-echo echo-planar technique with fat-suppression in free breathing with matching parameters when possible using c-DWI, mb-DWI, and multiband DWI with a twofold acceleration (mb2-DWI). These diffusion sequences were compared with respect to various parameters of image quality, lesion detectability, and liver ADC measurements. RESULTS: Accelerated mb2-DWI was 40.9% faster than c-DWI (88 vs. 149 s). Various image quality parameter scores were similar or higher on mb2-DWI when compared to c-DWI. The overall image quality score (averaged over the three readers) was significantly higher for mb-2 compared to c-DWI for b = 0 s/mm(2) (3.48 ± 0.52 vs. 3.21 ± 0.54; p = 0.001) and for b = 800 s/mm(2) (3.24 ± 0.76 vs. 3.06 ± 0.86; p = 0.010). Total of 25 hepatic lesions were visible on mb2-DWI and c-DWI, with identical lesion detectability. There was no significant difference in liver ADC between mb2-DWI and c-DWI (p = 0.12). Bland-Altman plot demonstrates lower mean liver ADC with mb2-DWI compared to c-DWI (by 0.043 × 10(-3) mm(2)/s or 3.7% of the average ADC). CONCLUSION: Multiband technique can be used to increase acquisition speed nearly twofold for free-breathing DWI of the liver with similar or improved overall image quality and similar lesion detectability compared to conventional DWI.

RARE/turbo spin echo imaging with Simultaneous Multislice Wave-CAIPI.

PURPOSE: To enable highly accelerated RARE/Turbo Spin Echo (TSE) imaging using Simultaneous MultiSlice (SMS) Wave-CAIPI acquisition with reduced g-factor penalty. METHODS: SMS Wave-CAIPI incurs slice shifts across simultaneously excited slices while playing sinusoidal gradient waveforms during the readout of each encoding line. This results in an efficient k-space coverage that spreads aliasing in all three dimensions to fully harness the encoding power of coil sensitivities. The novel MultiPINS radiofrequency (RF) pulses dramatically reduce the power deposition of multiband (MB) refocusing pulse, thus allowing high MB factors within the Specific Absorption Rate (SAR) limit. RESULTS: Wave-CAIPI acquisition with MultiPINS permits whole brain coverage with 1 mm isotropic resolution in 70 s at effective MB factor 13, with maximum and average g-factor penalties of gmax = 1.34 and gavg = 1.12, and without √R penalty. With blipped-CAIPI, the g-factor performance was degraded to gmax = 3.24 and gavg = 1.42; a 2.4-fold increase in gmax relative to Wave-CAIPI. At this MB factor, the SAR of the MultiBand and PINS pulses are 4.2 and 1.9 times that of the MultiPINS pulse, while the peak RF power are 19.4 and 3.9 times higher. CONCLUSION: Combination of the two technologies, Wave-CAIPI and MultiPINS pulse, enables highly accelerated RARE/TSE imaging with low SNR penalty at reduced SAR.

3D GABA imaging with real-time motion correction, shim update and reacquisition of adiabatic spiral MRSI.

Gamma-aminobutyric acid (GABA) and glutamate (Glu) are the major neurotransmitters in the brain. They are crucial for the functioning of healthy brain and their alteration is a major mechanism in the pathophysiology of many neuro-psychiatric disorders. Magnetic resonance spectroscopy (MRS) is the only way to measure GABA and Glu non-invasively in vivo. GABA detection is particularly challenging and requires special MRS techniques. The most popular is MEscher-GArwood (MEGA) difference editing with single-voxel Point RESolved Spectroscopy (PRESS) localization. This technique has three major limitations: a) MEGA editing is a subtraction technique, hence is very sensitive to scanner instabilities and motion artifacts. b) PRESS is prone to localization errors at high fields (≥3T) that compromise accurate quantification. c) Single-voxel spectroscopy can (similar to a biopsy) only probe steady GABA and Glu levels in a single location at a time. To mitigate these problems, we implemented a 3D MEGA-editing MRS imaging sequence with the following three features: a) Real-time motion correction, dynamic shim updates, and selective reacquisition to eliminate subtraction artifacts due to scanner instabilities and subject motion. b) Localization by Adiabatic SElective Refocusing (LASER) to improve the localization accuracy and signal-to-noise ratio. c) K-space encoding via a weighted stack of spirals provides 3D metabolic mapping with flexible scan times. Simulations, phantom and in vivo experiments prove that our MEGA-LASER sequence enables 3D mapping of GABA+ and Glx (Glutamate+Gluatmine), by providing 1.66 times larger signal for the 3.02ppm multiplet of GABA+ compared to MEGA-PRESS, leading to clinically feasible scan times for 3D brain imaging. Hence, our sequence allows accurate and robust 3D-mapping of brain GABA+ and Glx levels to be performed at clinical 3T MR scanners for use in neuroscience and clinical applications.

Whole brain mapping of water pools and molecular dynamics with rotating frame MR relaxation using gradient modulated low-power adiabatic pulses.

Nuclear magnetic resonance (NMR) relaxation in the rotating frame is sensitive to molecular dynamics on the time scale of water molecules interacting with macromolecules or supramolecular complexes, such as proteins, myelin and cell membranes. Hence, longitudinal (T1ρ) and transverse (T2ρ) relaxation in the rotating frame may have a great potential to probe the macromolecular fraction of tissues. This stimulated a large interest in using this MR contrast to image brain under healthy and disease conditions. However, experimental challenges related to the use of intense radiofrequency irradiation have limited the widespread use of T1ρ and T2ρ imaging. Here, we present methodological development to acquire 3D high-resolution or 2D (multi-)slice selective T1ρ and T2ρ maps of the entire human brain within short acquisition times. These improvements are based on a class of gradient modulated adiabatic pulses that reduce the power deposition, provide slice selection, and mitigate artifacts resulting from inhomogeneities of B1 and B0 magnetic fields. Based on an analytical model of the T1ρ and T2ρ relaxation we compute the maps of macromolecular bound water fraction, correlation and exchange time constants as quantitative biomarkers informative of tissue macromolecular content. Results obtained from simulations, phantoms and five healthy subjects are included.