In vivo assessment of cold stimulation effects on the fat fraction of brown adipose tissue using DIXON MRI.

PURPOSE: To evaluate the volume and changes of human brown adipose tissue (BAT) in vivo following exposure to cold using magnetic resonance imaging (MRI). MATERIALS AND METHODS: The clavicular region of 10 healthy volunteers was examined with a 3T MRI system. One volunteer participated twice. A cooling vest that was circulated with temperature-controlled water was used to expose each volunteer to a cold environment. Three different water temperature phases were employed: baseline (23°C, 20 min), cooling (12°C, 90 min), and a final warming phase (37°C, 30 min). Temperatures of the water in the circuit, of the body, and at the back skin of the volunteers were monitored with fiberoptic temperature probes. Applying the 2-point DIXON pulse sequence every 5 minutes, fat fraction (FF) maps were determined and evaluated over time to distinguish between brown and white adipose tissue. RESULTS: Temperature measurements showed a decrease of 3.8 ± 1.0°C of the back skin temperature, while the body temperature stayed constant at 37.2 ± 0.9°C. Focusing on the two interscapular BAT depots, a mean FF decrease of -2.9 ± 2.0%/h (P < 0.001) was detected during cold stimulation in a mean absolute volume of 1.31 ± 1.43 ml. Also, a correlation of FF decrease to back skin temperature decrease was observed in all volunteers (correlation coefficients: |r| = [0.51; 0.99]). CONCLUSION: We found that FF decreases in BAT begin immediately with mild cooling of the body and continue during long-time cooling. LEVEL OF EVIDENCE: 2 J. Magn. Reson. Imaging 2017;45:369-380.

Iterative reconstruction of radially-sampled 31P bSSFP data using prior information from 1H MRI.

The purpose of this study is to improve direct phosphorus (31P) MR imaging. Therefore, 3D density-adapted radially-sampled balanced steady-state free precession (bSSFP) sequences were developed and an iterative approach exploiting additional anatomical information from hydrogen (1H) data was evaluated. Three healthy volunteers were examined at B0=7T in order to obtain the spatial distribution of the phosphocreatine (PCr) intensities in the human calf muscle with a nominal isotropic resolution of 10mm in an acquisition time of 10min. Three different bSSFP gradient schemes were investigated. The highest signal-to-noise ratio (SNR) was obtained for a scheme with two point-reflected density-adapted gradients. Furthermore, the conventional reconstruction based on a gridding algorithm was compared to an iterative method using an 1H MRI constraint in terms of a segmented binary mask, which comprises prior knowledge. The parameters of the iterative approach were optimized and evaluated by simulations featuring 31P MRI parameters. Thereby, partial volume effects as well as Gibbs ringing artifacts could be reduced. In conclusion, the iterative reconstruction of 31P bSSFP data using an 1H MRI constraint is appropriate for investigating regions where sharp tissue boundaries occur and leads to images that represent the real PCr distributions better than conventionally reconstructed images.

Nuclear-Overhauser-enhanced MR imaging of (31)P-containing metabolites: multipoint-Dixon vs. frequency-selective excitation.

The purpose of this study is to develop nuclear-Overhauser-enhanced (NOE) [(1)H]-(31)P magnetic resonance imaging (MRI) based on 3D fully-balanced steady-state free precession (fbSSFP). Therefore, two implementations of a 3D fbSSFP sequence are compared using frequency-selective excitation (FreqSel) and multipoint-Dixon (MP-Dixon). (31)P-containing model solutions and four healthy volunteers were examined at field strengths of B0=3T and 7T. Maps of the distribution of phosphocreatine (PCr), inorganic phosphate (Pi), and adenosine 5´-triphosphate (ATP) in the human calf were obtained with an isotropic resolution of 1.5cm (1.0cm) in an acquisition time of 5min (10min). NOE-pulses had the highest impact on the PCr acquisitions enhancing the signal up to (82 ± 13) % at 3T and up to (37 ± 9) % at 7T. An estimation of the level of PCr in muscle tissue from [(1)H]-(31)P MRI data yielded a mean value of (33 ± 8) mM. In conclusion, direct [(1)H]-(31)P imaging using FreqSel as well as MP-Dixon is possible in clinically feasible acquisition times. FreqSel should be preferred for measurements where only a single metabolite resonance is considered. MP-Dixon performs better in terms of SNR if a larger spectral width is of interest.

Investigating the feasibility of photon-counting K-edge imaging at high x-ray fluxes using nonlinearity corrections.

PURPOSE: Pulse pileup occurring at high x-ray fluxes can severely degrade the energy resolution provided by a photon counting detector, which can represent a problem in spectroscopic CT when performing quantitative material discrimination tasks. As the effects of pileup can be most easily seen as a degradation of a detector's count rate linearity at high fluxes, it has been proposed previously to quantify and correct these nonlinearities. While this strategy has been applied successfully to materials without K-edges, it is currently unknown if this still prevails when using medical contrast agents. The purpose of this study is to close this gap. METHODS: A Medipix2MXR Hexa detector was employed, featuring a pixel pitch of 165 [micro sign]m and a 1 mm thick CdTe sensor. A phantom containing various concentrations of iodine and gadolinium contrast agents was subject to energy selective CT acquisitions, using a pulsable x-ray source operated at 70 kVp. These acquisitions were obtained at low and high photon fluxes of 1.0 × 10(6) and 1.3 × 10(7) mm(-2) s(-1), respectively. Nonlinearity corrections were applied to the high-flux projections and for each pixel separately. The results were compared to the results at low photon fluxes. RESULTS: At high fluxes, a general reduction of the reconstructed attenuation coefficients was observed, which could be partially recovered using the correction strategy applied. The spectroscopic separation of iodine from the phantom material, however, degraded with increasing x-ray flux. In contrast to this, gadolinium could still be discriminated almost as well as in the low flux case. CONCLUSIONS: Nonlinearity corrections applied to high flux measurements can help to recover attenuation coefficients normally obtained at low fluxes for low-Z materials, which do not exhibit an absorption edge in the relevant energy range. However, as a result of a significant change of the x-ray spectrum, the spectroscopic contrast normally observed for iodine was found to vanish with increasing x-ray flux. In other words, the authors' results indicate that nonlinearity corrections may be feasible only when the K-edge of interest is sufficiently high compared to the mean photon energy, and that spectroscopic CT at high x-ray fluxes may suffer from less limitations when using high-Z materials as contrast agents. A future study should aim to confirm these findings under clinical conditions.

Imaging properties of small-pixel spectroscopic x-ray detectors based on cadmium telluride sensors.

Spectroscopic x-ray imaging by means of photon counting detectors has received growing interest during the past years. Critical to the image quality of such devices is their pixel pitch and the sensor material employed. This paper describes the imaging properties of Medipix2 MXR multi-chip assemblies bump bonded to 1 mm thick CdTe sensors. Two systems were investigated with pixel pitches of 110 and 165 µm, which are in the order of the mean free path lengths of the characteristic x-rays produced in their sensors. Peak widths were found to be almost constant across the energy range of 10 to 60 keV, with values of 2.3 and 2.2 keV (FWHM) for the two pixel pitches. The average number of pixels responding to a single incoming photon are about 1.85 and 1.45 at 60 keV, amounting to detective quantum efficiencies of 0.77 and 0.84 at a spatial frequency of zero. Energy selective CT acquisitions are presented, and the two pixel pitches' abilities to discriminate between iodine and gadolinium contrast agents are examined. It is shown that the choice of the pixel pitch translates into a minimum contrast agent concentration for which material discrimination is still possible. We finally investigate saturation effects at high x-ray fluxes and conclude with the finding that higher maximum count rates come at the cost of a reduced energy resolution.