A Highly Selective Schiff Base Based Chemodosimeter for the Detection of Perfluorooctanoic Acid by Optical Biosensor.

A simple imine derivative based sensor (IDP) has been synthesized and characterized by 1 H NMR, 13 C NMR and mass spectral techniques. IDP is more capable of detecting perfluorooctanoic acid (PFOA) in a selective and sensitive manner. The PFOA as a biomarker interacts with IDP and shows "TURN-ON" response by colorimetric and fluorimetric method. Under optimized experimental observations, the selective determination of PFOA using IDP among other competitors as biomolecules has been noticed. The detection limit is 0.31 × 10- 8 mol/L. The practical applications of the IDP is effectively evaluated in human biofluids and water samples.

Highly Sensitive and Selective Detection of Melatonin in Biofluids by Antipyrine Based Fluorophore.

A simple fluorescent based organic fluorophore was synthesized and it shows significant fluorescent intensity with melatonin (MLN). Hence, it was applicable to the detection of MLN by colorimetric and fluorimetric techniques at neutral pH. Under optimized experimental condition, the synthesized organic fluorophore detects MLN selectively in the presence of other interfering biomolecules through ICT mechanism. The melatonin sensing mechanism is supported by DFT and 1H-NMR titration. Based on the findings, this method can be applied to design a simple clinical diagnostic tool for MLN.

Implementation of a Quality Improvement Initiative to Decrease Opioid Prescribing in General Surgery.

BACKGROUND: There is increasing need to avoid excess opioid prescribing after surgery. We prospectively assessed overprescription in our hospital system and used these data to design a quality improvement intervention to reduce overprescription. MATERIALS AND METHODS: Beginning in January 2017, an e-mail-based survey to assess the quantity of opioids used postoperatively as well as patient-reported pain control was sent to all surgical patients in a 23-hospital system. In January 2018, as a quality improvement initiative, guidelines were given to surgeons based on patient consumption data. Prescription and consumption were then tracked prospectively. Wilcoxon signed-rank, analysis of variance, and Cuzick trend tests were used to assess for overprescription and changes over time in opioid prescribing and consumption. RESULTS: We included 2239 patients in our cohort. The amount prescribed (median [IQR]: 30 [24-45] versus 18 [12-30], P < 0.001) and consumed (median [IQR]: 12 [7-20] versus 8 [3-15], P < 0.001) each decreased between the first and last quarter studied. Academic hospitals prescribed fewer opioids than nonacademic hospitals (median [IQR]: 24[15-40] versus median [IQR]: 30 [20-45], P < 0.001). There was no difference in the quantity of opioids consumed between patients treated at academic and nonacademic facilities (median [IQR]: 10[3-19] versus 10.5 [4-20], P = 0.08). Patients consumed a median of 42% of the opioids prescribed, and there was no significant trend in the percent consumed over time (P = 0.8). CONCLUSIONS: Patients used far fewer opioids than prescribed after common adult general surgery procedures. When surgeons were provided with patient consumption data, the number of opioids prescribed decreased significantly.

Acute noncontrast T1-weighted magnetic resonance imaging predicts chronic radiofrequency ablation lesions.

BACKGROUND: Magnetic resonance imaging (MRI) has been used to visualize radiofrequency (RF) ablation lesions but the relationship between volumes that enhance in acute MRI and the chronic lesion size is unknown. OBJECTIVES: The main goal was to use noncontrast (native) T1-weighted (T1w) MRI and late gadolinium enhancement (LGE)-MRI to visualize lesions acutely and chronically and correlate the acute area of enhancement with chronic lesion size in histology. MATERIALS AND METHODS: In a canine (n = 9) model RF ablation lesions were created in both ventricles. Native T1w MRI and LGE-MRI were acquired acutely after the ablation procedure. After 8 weeks, another set of RF ablations was performed, and the MRI study was repeated. Volume and depth of enhancement in native T1w MRI and LGE-MRI acquired after the initial ablation procedure were correlated with chronic lesion volume and depth in histology. RESULTS: Thirty-three lesions were analyzed. Native T1w MRI visualized the acute lesions but not the chronic lesions. LGE-MRI showed both acute and chronic lesions. Acute native T1w MRI volume (average of 102.1 ± 48.5 mm3 ) and depth (4.9 ± 1.2 mm) correlated well with chronic histological volume (105.9 ± 51.8 mm3 ) and depth (4.8 ± 1.3 mm) with R2 of 0.881 (P < 0.001) and 0.874 (P < 0.001), respectively. Acute LGE-MRI had a significantly higher volume of enhancement of 499.7 ± 214.4 mm3 (P < 0.001) and depth of 7.5 ± 1.8 mm ( P < 0.001) when compared with chronic histological lesion volume and depth. CONCLUSIONS: Native T1w MRI acquired acutely after RF ablation is a good predictor of chronic lesion size. Acute LGE-MRI significantly overestimates the chronic lesion size.

Surgeon and hospital cost variability for septoplasty and inferior turbinate reduction.

BACKGROUND: Septoplasty and turbinate reduction (STR) is a common procedure for which cost reduction efforts may improve value. The purpose of this study was to identify sources of variation in medical facility and surgeon costs associated with STR, and whether these costs correlated with short-term complications. METHODS: An observational cohort study was performed in a multifacility network using a standardized cost-accounting system to determine costs associated with adult STR from January 1, 2008 to July 31, 2015. A total of 4007 cases, performed at 21 facilities, by 72 different surgeons were included in the study. Total costs, variable costs, operating room (OR) time, and 30-day complications (eg, epistaxis) were compared among surgeons, facilities, and specialties. RESULTS: Total procedure cost: (mean ± standard deviation [SD]) $2503 ± $790 (range, $852 to $10,559). Mean total variable cost: $1147 ± $423 (range, $400 to $5,081). Intersurgeon and interfacility variability was significant for total cost (p < 0.0001) and OR time (p < 0.0001). Intersurgeon OR supply cost variability was also significant (p < 0.0001). Otolaryngologists had less total cost (p < 0.0001), OR time/cost (p < 0.0001), and complications (p = 0.0164), but greater supply cost (p < 0.0001), than other specialties. CONCLUSION: There is wide variation in cost associated with STR. Significant variance in OR time and supply cost between surgeons suggests these are potential areas for cost reduction. Although no increased 30-day complications were seen with faster and less costly surgeries, further research is needed to evaluate how time and cost relate to quality of care.

Surgical stabilization of severe rib fractures decreases incidence of retained hemothorax and empyema.

BACKGROUND: Retained hemothorax (RH) is relatively common after chest trauma and can lead to empyema. We hypothesized that patients who have surgical fixation of rib fractures (SSRF) have less RH and empyema than those who have medical management of rib fractures (MMRF). METHODS: Admitted rib fracture patients from January 2009 to June 2013 were identified. A 2:1 propensity score model identified MMRF patients who were similar to SSRF. RH, and empyema and readmissions, were recorded. Variables were compared using Fisher exact test and Wilcoxon rank-sum tests. RESULTS: One hundred thirty-seven SSRF and 274 MMRF were analyzed; 31 (7.5%) had RH requiring 35 interventions; 3 (2.2%) SSRF patients had RH compared with 28 (10.2%) MMRF (P = .003). Four (14.3%) MMRF subjects with RH developed empyema versus zero in the SSRF group (P = .008); 6 (19.3%) RH patients required readmission versus 14 (3.7%) in the non-RH group (P = .002). CONCLUSIONS: Patients with rib fractures who have SSRF have less RH compared with similar MMRF patients. Although not a singular reason to perform SSRF, this clinical benefit should not be overlooked.

Post-contrast myocardial T(1) and ECV disagree in a longitudinal canine study.

Both post-contrast myocardial T1 and extracellular volume (ECV) measurements have been associated with diffuse interstitial fibrosis. The cardiovascular magnetic resonance (CMR) field is migrating towards ECV, because it is largely insensitive to confounders that affect post-contrast myocardial T1 . Despite the theoretical advantages of myocardial ECV over post-contrast myocardial T1 , systematic experimental studies comparing the two measurements are largely lacking. We sought to measure the temporal changes in post-contrast myocardial T1 and ECV in an established canine model with chronic atrial fibrillation. Seventeen mongrel dogs, implanted with a pacemaker to induce chronic atrial fibrillation via rapid atrial pacing, were scanned multiple times for a total of 46 CMR scans at 3T. These dogs with different disease durations (0-22 months) were part of a separate longitudinal study aimed at studying the relationship between AF and pathophysiology. In each animal, we measured native and post-contrast T1 values and hematocrit. Temporal changes in post-contrast myocardial T1 and ECV, as well as other CMR parameters, were modeled with linear mixed effect models to account for repeated measurements over disease duration. In 17 animals, post-contrast myocardial T1 decreased significantly from 872 to 698 ms (p < 0.001), which corresponds to a 24.9% relative reduction. In contrast, ECV increased from 21.0 to 22.0% (p = 0.38), which corresponds to only a 4.5% relative increase. To partially investigate this discrepancy, we quantified collagen volume fraction (CVF) in post-mortem heart tissues of six canines sacrificed at different disease durations (0-22 months). CVF quantified by histology increased from 0.9 to 1.9% (p = 0.56), which agrees better with ECV than with post-contrast myocardial T1 . This study shows that post-contrast myocardial T1 and ECV may disagree in a longitudinal canine study. A more comprehensive study, including histologic, cardiac, and renal functional analyses, is warranted to test rigorously which CMR parameter (ECV or post-contrast myocardial T1 ) agrees better with CVF.

Arrhythmia insensitive rapid cardiac T1 mapping pulse sequence.

PURPOSE: To develop an arrhythmia-insensitive rapid (AIR) cardiac T1 mapping pulse sequence for quantification of diffuse fibrosis. METHODS: An arrhythmia-insensitive cardiac T1 mapping pulse sequence was developed based on saturation recovery T1 weighting, which is inherently insensitive to heart rate and rhythm, and two single-shot balanced steady-state free precession image acquisitions with centric k-space ordering, where T1 calculation is inherently insensitive to T2 effects. Its performance against conventional cardiac T1 mapping based on inversion recovery (i.e., MOLLI) is compared. Phantom experiments (T1 ranging from 535 to 2123 ms) were performed with heart rate and rhythm simulated at 60 and 120 beats per minute (bpm) and arrhythmia using an external triggering device. Ten human subjects and 17 large animals were scanned precontrast and 5, 10, and 15 min after contrast agent administration. RESULTS: Compared with the reference T1 mapping, AIR yielded lower normalized root-mean-square error than MOLLI (8% vs. 3%, respectively, at 60 bpm, 28% vs. 3%, respectively, at 120 bpm, and 22% vs. 3%, respectively, at arrhythmia). In vivo studies showed that T1 measurements made by MOLLI and AIR were strongly correlated (r = 0.99) but in poor agreement (mean difference = 161.8 ms, upper and lower 95% limits of agreements = 347.5 ms and -24.0 ms). CONCLUSION: Our AIR pulse sequence may be clinically useful for assessment of diffuse myocardial fibrosis in patients.

Identification and acute targeting of gaps in atrial ablation lesion sets using a real-time magnetic resonance imaging system.

BACKGROUND: Radiofrequency ablation is routinely used to treat cardiac arrhythmias, but gaps remain in ablation lesion sets because there is no direct visualization of ablation-related changes. In this study, we acutely identify and target gaps using a real-time magnetic resonance imaging (RT-MRI) system, leading to a complete and transmural ablation in the atrium. METHODS AND RESULTS: A swine model was used for these studies (n=12). Ablation lesions with a gap were created in the atrium using fluoroscopy and an electroanatomic system in the first group (n=5). The animal was then moved to a 3-tesla MRI system where high-resolution late gadolinium enhancement MRI was used to identify the gap. Using an RT-MRI catheter navigation and visualization system, the gap area was ablated in the MR scanner. In a second group (n=7), ablation lesions with varying gaps in between were created under RT-MRI guidance, and gap lengths determined using late gadolinium enhancement MR images were correlated with gap length measured from gross pathology. Gaps up to 1.0 mm were identified using gross pathology, and gaps up to 1.4 mm were identified using late gadolinium enhancement MRI. Using an RT-MRI system with active catheter navigation gaps can be targeted acutely, leading to lesion sets with no gaps. The correlation coefficient (R(2)) between the gap length was identified using MRI, and the gross pathology was 0.95. CONCLUSIONS: RT-MRI system can be used to identify and acutely target gaps in atrial ablation lesion sets. Acute targeting of gaps in ablation lesion sets can potentially lead to significant improvement in clinical outcomes.

Dark regions of no-reflow on late gadolinium enhancement magnetic resonance imaging result in scar formation after atrial fibrillation ablation.

OBJECTIVES: The aim of this study was to assess acute ablation injuries seen on late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) immediately post-ablation (IPA) and the association with permanent scar 3 months post-ablation (3moPA). BACKGROUND: Success rates for atrial fibrillation catheter ablation vary significantly, in part because of limited information about the location, extent, and permanence of ablation injury at the time of procedure. Although the amount of scar on LGE MRI months after ablation correlates with procedure outcomes, early imaging predictors of scar remain elusive. METHODS: Thirty-seven patients presenting for atrial fibrillation ablation underwent high-resolution MRI with a 3-dimensional LGE sequence before ablation, IPA, and 3moPA using a 3-T scanner. The acute left atrial wall injuries on IPA scans were categorized as hyperenhancing (HE) or nonenhancing (NE) and compared with scar 3moPA. RESULTS: Heterogeneous injuries with HE and NE regions were identified in all patients. Dark NE regions in the left atrial wall on LGE MRI demonstrate findings similar to the "no-reflow" phenomenon. Although the left atrial wall showed similar amounts of HE, NE, and normal tissue IPA (37.7 ± 13%, 34.3 ± 14%, and 28.0 ± 11%, respectively; p = NS), registration of IPA injuries with 3moPA scarring demonstrated that 59.0 ± 19% of scar resulted from NE tissue, 30.6 ± 15% from HE tissue, and 10.4 ± 5% from tissue identified as normal. Paired t-test comparisons were all statistically significant among NE, HE, and normal tissue types (p < 0.001). Arrhythmia recurrence at 1-year follow-up correlated with the degree of wall enhancement 3moPA (p = 0.02). CONCLUSIONS: Radiofrequency ablation results in heterogeneous injury on LGE MRI with both HE and NE wall lesions. The NE lesions demonstrate no-reflow characteristics and reveal a better predictor of final scar at 3 months. Scar correlates with procedure outcomes, further highlighting the importance of early scar prediction.

Real-time magnetic resonance imaging-guided radiofrequency atrial ablation and visualization of lesion formation at 3 Tesla.

BACKGROUND: Magnetic resonance imaging (MRI) allows visualization of location and extent of radiofrequency (RF) ablation lesion, myocardial scar formation, and real-time (RT) assessment of lesion formation. In this study, we report a novel 3-Tesla RT -RI based porcine RF ablation model and visualization of lesion formation in the atrium during RF energy delivery. OBJECTIVE: The purpose of this study was to develop a 3-Tesla RT MRI-based catheter ablation and lesion visualization system. METHODS: RF energy was delivered to six pigs under RT MRI guidance. A novel MRI-compatible mapping and ablation catheter was used. Under RT MRI, this catheter was safely guided and positioned within either the left or right atrium. Unipolar and bipolar electrograms were recorded. The catheter tip-tissue interface was visualized with a T1-weighted gradient echo sequence. RF energy was then delivered in a power-controlled fashion. Myocardial changes and lesion formation were visualized with a T2-weighted (T2W) half Fourier acquisition with single-shot turbo spin echo (HASTE) sequence during ablation. RESULTS: RT visualization of lesion formation was achieved in 30% of the ablations performed. In the other cases, either the lesion was formed outside the imaged region (25%) or the lesion was not created (45%) presumably due to poor tissue-catheter tip contact. The presence of lesions was confirmed by late gadolinium enhancement MRI and macroscopic tissue examination. CONCLUSION: MRI-compatible catheters can be navigated and RF energy safely delivered under 3-Tesla RT MRI guidance. Recording electrograms during RT imaging also is feasible. RT visualization of lesion as it forms during RF energy delivery is possible and was demonstrated using T2W HASTE imaging.

Left atrial strain and strain rate in patients with paroxysmal and persistent atrial fibrillation: relationship to left atrial structural remodeling detected by delayed-enhancement MRI.

BACKGROUND: Atrial fibrillation (AF) is a progressive condition that begins with hemodynamic and/or structural changes in the left atrium (LA) and evolves through paroxysmal and persistent stages. Because of limitations with current noninvasive imaging techniques, the relationship between LA structure and function is not well understood. METHODS AND RESULTS: Sixty-five patients (age, 61.2+/-14.2 years; 67% men) with paroxysmal (44%) or persistent (56%) AF underwent 3D delayed-enhancement MRI. Segmentation of the LA wall was performed and degree of enhancement (fibrosis) was determined using a semiautomated quantification algorithm. Two-dimensional echocardiography and longitudinal LA strain and strain rate during ventricular systole with velocity vector imaging were obtained. Mean fibrosis was 17.8+/-14.5%. Log-transformed fibrosis values correlated inversely with LA midlateral strain (r=-0.5, P=0.003) and strain rate (r=-0.4, P<0.005). Patients with persistent AF as compared with paroxysmal AF had more fibrosis (22+/-17% versus 14+/-9%, P=0.04) and lower midseptal (27+/-14% versus 38+/-16%, P=0.01) and midlateral (35+/-16% versus 45+/-14% P=0.03) strains. Multivariable stepwise regression showed that midlateral strain (r=-0.5, P=0.006) and strain rate (r=-0.4, P=0.01) inversely predicted the extent of fibrosis independent of other echocardiographic parameters and the rhythm during imaging. CONCLUSIONS: LA wall fibrosis by delayed-enhancement MRI is inversely related to LA strain and strain rate, and these are related to the AF burden. Echocardiographic assessment of LA structural and functional remodeling is quick and feasible and may be helpful in predicting outcomes in AF.

Magnetic resonance imaging-confirmed ablative debulking of the left atrial posterior wall and septum for treatment of persistent atrial fibrillation: rationale and initial experience.

INTRODUCTION: Though pulmonary vein (PV) isolation has been widely adopted for treatment of atrial fibrillation (AF), recurrence rates remain unacceptably high with persistent and longstanding AF. As evidence emerges for non-PV substrate changes in the pathogenesis of AF, more extensive ablation strategies need further study. METHODS: We modified our PV antrum isolation procedure to include abatement of posterior and septal wall potentials. We also employed recently described image-processing techniques using delayed-enhancement (DE) MRI to characterize tissue injury patterns 3 months after ablation, to assess whether each PV was encircled with scar, and to assess the impact of these parameters on procedural success. RESULTS: 118 consecutive patients underwent debulking procedure and completed follow-up, of which 86 underwent DE-MRI. The total left atrial (LA) radiofrequency delivery correlated with percent LA scarring by DE-MRI (r = 0.6, P < 0.001). Based on DE patterns, complete encirclement was seen in only 131 of 335 PVs (39.1%). As expected, Cox regression analysis showed a significant relationship between the number of veins encircled by delayed enhancement and clinical success (hazard ratio of 0.62, P = 0.015). Also, progressive quartile increases in postablation posterior and septal wall scarring reduced recurrences rates with a HR of 0.65, P = 0.022 and 0.66, P = 0.026, respectively. CONCLUSION: Pathologic remodeling in the septal and posterior walls of the LA helps form the pathogenic substrate for AF, and these early results suggest that more aggressive treatment of these regions appears to correlate with improved ablation outcomes. Noninvasive imaging to characterize tissue changes after ablation may prove essential to stratifying recurrence risk.

Temporal left atrial lesion formation after ablation of atrial fibrillation.

BACKGROUND: Atrial fibrillation (AF) ablation uses radiofrequency (RF) energy to induce thermal damage to the left atrium (LA) in an attempt to isolate AF circuits. This injury can be seen using delayed enhancement magnetic resonance imaging (DE-MRI). OBJECTIVE: The purpose of this study was to describe DE-MRI findings of the LA in the acute and chronic stages postablation. METHODS: Twenty-five patients were scanned at two time points postablation. The first group (n = 10) underwent DE-MRI at 24 hours and at 3 months. The second group (n = 16) was scanned at 3 months and at 6 or 9 months. One patient had three scans (24 hours, 3 months, 9 months) and was included in both groups. The location and extent of enhancement were then analyzed between both groups. RESULTS: The median change in LA wall injury between 24 hours and 3 months was -6.38% (range -11.7% to 12.58%). The median change in LA wall injury between 3 months and later follow-up was +2.0% (range -4.0% to 6.58%). There appears to be little relationship between the enhancement at 24 hours and 3 months (R(2) = 0.004). In contrast, a strong correlation is seen at 3 months and later follow-up (R(2) = 0.966). Qualitative comparison revealed a stronger qualitative relationship between MRI findings at 3 months and later follow-up than at 24 hours and 3 months. CONCLUSION: RF-induced scar appears to have formed by 3 months postablation. At 24 hours postablation, DE-MRI enhancement appears consistent with a transient inflammatory response rather than stable LA scar formation.

High-pass GRAPPA: an image support reduction technique for improved partially parallel imaging.

Partially parallel imaging (PPI) is a widely used technique in clinical applications. A limitation of this technique is the strong noise and artifact in the reconstructed images when high reduction factors are used. This work aims to increase the clinical applicability of PPI by improving its performance at high reduction factors. A new concept, image support reduction, is introduced. A systematic filter-design approach for image support reduction is proposed. This approach shows more advantages when used with an important existing PPI technique, GRAPPA. An improved GRAPPA method, high-pass GRAPPA (hp-GRAPPA), was developed based on this approach. The new technique does not involve changing the original GRAPPA kernel and performs reconstruction in almost the same amount of time. Experimentally, it is demonstrated that the reconstructed images using hp-GRAPPA have much lower noise/artifact level than those reconstructed using GRAPPA.

Reconstruction in image space using basis functions for partially parallel imaging.

General theory of a new reconstruction technique for partially parallel imaging (PPI) is presented in this study. Reconstruction in Image space using Basis functions (RIB) is based on the general principle that the PPI reconstruction in image space can be represented by a pixel-wise weighted summation of the aliased images directly from undersampled data. By assuming that these weighting coefficients for unaliasing can be approximated from the linear combination of a few predefined basis functions, RIB is capable of reconstructing the image within an arbitrary region. This paper discusses the general theory of RIB and its relationship to the classical reconstruction method, GRAPPA. The presented experiments demonstrate RIB with several MRI applications. It is shown that the performance of RIB is comparable to that of GRAPPA. In some cases, RIB shows advantages of increasing reconstruction efficiency, suppressing artifacts and alleviating the nonuniformity of noise distribution. It is anticipated that RIB would be especially useful for cardiac and prostate imaging, where the field of view during data acquisition is required to be much larger than the region of interest.

A software channel compression technique for faster reconstruction with many channels.

In magnetic resonance imaging, highly parallel imaging using coil arrays with a large number of elements is an area of growing interest. With increasing channel numbers for parallel acquisition, the increased reconstruction time and extensive computer memory requirements have become significant concerns. In this work, principal component analysis (PCA) is used to develop a channel compression technique. This technique efficiently reduces the size of parallel imaging data acquired from a multichannel coil array, thereby significantly reducing the reconstruction time and computer memory requirement without undermining the benefits of multichannel coil arrays. Clinical data collected with a 32-channel cardiac coil are used in all of the experiments. The performance of the proposed method on parallel, partially acquired data, as well as fully acquired data, was evaluated. Experimental results show that the proposed method dramatically reduces the processing time without considerable degradation in the quality of reconstructed images. It is also demonstrated that this PCA technique can be used to perform intensity correction in parallel imaging applications.

Self-calibration method for radial GRAPPA/k-t GRAPPA.

Generalized autocalibrating partially parallel acquisitions (GRAPPA), an important parallel imaging technique, can be easily applied to radial k-space data by segmenting the k-space. The previously reported radial GRAPPA method requires extra calibration data to determine the relative shift operators. In this work it is shown that pseudo-full k-space data can be generated from the partially acquired radial data by filtering in image space followed by inverse gridding. The relative shift operators can then be approximated from the pseudo-full k-space data. The self-calibration method using pseudo-full k-space data can be applied in both k and k-t space. This technique avoids the prescans and hence improves the applicability of radial GRAPPA to image static tissue, and makes k-t GRAPPA applicable to radial trajectory. Experiments show that radial GRAPPA calibrated with pseudo-full calibration data generates results similar to radial GRAPPA calibrated with the true full k-space data for that image. If motion occurs during acquisition, self-calibrated radial GRAPPA protects structural information better than externally calibrated GRAPPA. However, radial GRAPPA calibrated with pseudo-full calibration data suffers from residual streaking artifacts when the reduction factor is high. Radial k-t GRAPPA calibrated with pseudo-full calibration data generates reduced errors compared to the sliding-window method and temporal GRAPPA (TGRAPPA).

k-t GRAPPA: a k-space implementation for dynamic MRI with high reduction factor.

A novel technique called "k-t GRAPPA" is introduced for the acceleration of dynamic magnetic resonance imaging. Dynamic magnetic resonance images have significant signal correlations in k-space and time dimension. Hence, it is feasible to acquire only a reduced amount of data and recover the missing portion afterward. Generalized autocalibrating partially parallel acquisitions (GRAPPA), as an important parallel imaging technique, linearly interpolates the missing data in k-space. In this work, it is shown that the idea of GRAPPA can also be applied in k-t space to take advantage of the correlations and interpolate the missing data in k-t space. For this method, no training data, filters, additional parameters, or sensitivity maps are necessary, and it is applicable for either single or multiple receiver coils. The signal correlation is locally derived from the acquired data. In this work, the k-t GRAPPA technique is compared with our implementation of GRAPPA, TGRAPPA, and sliding window reconstructions, as described in Methods. The experimental results manifest that k-t GRAPPA generates high spatial resolution reconstruction without significant loss of temporal resolution when the reduction factor is as high as 4. When the reduction factor becomes higher, there might be a noticeable loss of temporal resolution since k-t GRAPPA uses temporal interpolation. Images reconstructed using k-t GRAPPA have less residue/folding artifacts than those reconstructed by sliding window, much less noise than those reconstructed by GRAPPA, and wider temporal bandwidth than those reconstructed by GRAPPA with residual k-space. k-t GRAPPA is applicable to a wide range of dynamic imaging applications and is not limited to imaging parts with quasi-periodic motion. Since only local information is used for reconstruction, k-t GRAPPA is also preferred for applications requiring real time reconstruction, such as monitoring interventional MRI.