Feasibility of 3D-Printed Locking Compression Plates with Polyether Ether Ketone (PEEK) in Tibial Comminuted Diaphyseal Fractures.

The applicability of a polyether ether ketone locking compression plate (PEEK LCP) fabricated using FDM (fused deposition modeling)-based 3D printing to treat actual patients was studied. Three different tests-bending, axial compression, and axial torsion-were conducted on tibial non-osteoporotic comminuted diaphyseal fracture samples fixed with the commercial titanium alloy LCP and 3D-printed PEEK LCP. Comparing the outcomes of these tests revealed that the commercial titanium alloy LCP underwent plastic deformation in the bending and axial torsion tests, though the LCP did not fail even when an external force greater than the maximum allowable load of the tibia fixture of the LCP was applied. Elastic deformation occurred in the 3D-printed PEEK LCP in the bending and axial torsion tests. However, deformation occurred even under a small external force, and its stiffness was 10% compared to commercial titanium alloy LCP. Thus, 3D-printed PEEK LCP can be applied to the fracture conditions in non-weight-bearing regions. The experimental results reveal detailed insights into the treatment of actual patients by considering the stiffness and high toughness of 3D-printed PEEK LCP.

Image quality and acquisition time assessments for phase oversampling in compressed sensing sensitivity encoding: Comparison with conventional SENSE.

This study compared sensitivity encoding (SENSE) and compressed sensing sensitivity encoding (CS-SENSE) for phase oversampling distance and assessed its impact on image quality and image acquisition time. The experiment was performed with a large diameter phantom using 16-channel anterior body coils. All imaging data were divided into three groups according to the parallel imaging technique and oversampling distances: groups A (SENSE with phase oversampling distance of 150 mm), B (CS-SENSE with phase oversampling distance of 100 mm), and C (CS-SENSE with phase oversampling distance of 75 mm). No statistically significant differences were observed among groups A, B, and C regarding both T2 and T1 turbo spin-echo (TSE) sequences using an acceleration factor (AF) of 2 (p = 0.301 and 0.289, respectively). In comparison with AF 2 of group A, the scan time of AF 2 of groups B and C was reduced by 11.2% and 23.5% (T2 TSE) and 15.8% and 22.7% (T1 TSE), respectively, while providing comparable image quality. Significant image noise and aliasing artifact were more evident at AF ≥ $ \ge $ 2 in group A compared with groups B and C. CS-SENSE with a less phase oversampling distance can reduce image acquisition time without image quality degradation compared with that of SENSE, despite the increase in aliasing artifact as the AF increased in both CS-SENSE and SENSE.

Image quality assessments according to the angle of tilt of a flex tilt coil supporting device: An ACR phantom study.

In this study, we assessed how image quality depends on the angle of tilt of a flex tilt coil supporting device during an MRI examination. All measurements were performed with an American College of Radiology (ACR) MRI phantom using a flex tilt coil supporting device. All images were analyzed using an automatic assessment method following the ACR MRI accreditation guidance. Image quality was compared between acquisitions grouped according to the angle of tilt of the coil supporting device: group A (Flat mode), group B (10˚), and group C (18˚). All measured image qualities were within the ACR recommended criteria, regardless of the angle of tilt of the flex tilt coil supporting device. However, statistically significant differences between the three groups were found for slice thickness, position accuracy, image intensity uniformity, and SNR (P < 0.05, ANOVA). The flex tilt coil supporting device can provide sufficient image quality, passing the criteria of the ACR MRI guideline, despite differences in slice thickness, slice position accuracy, image intensity uniformity, and SNR according to the angle of tilt.

Comparative Value of 2-Hydroxyglutarate-to-Lipid and Lactate Ratio versus 2-Hydroxyglutarate Concentration on MR Spectroscopic Images for Predicting Isocitrate Dehydrogenase Mutation Status in Gliomas.

Purpose: To compare the ability of 2-hydroxyglutarate (2HG)-to-lipid and lactate (2HG/[lipid + lactate]) ratio with the ability of 2HG concentration alone to predict the isocitrate dehydrogenase (IDH) mutation status in patients with glioma. Materials and Methods: In this retrospective study, consecutive patients with histopathologically proven glioma were enrolled between July 2016 and February 2019. A total of 79 patients were enrolled (mean age, 44 years; 49 men). The 2HG concentration and other MR spectroscopic parameters were measured by single-voxel point-resolved spectroscopy before surgery. The diagnostic performance of the 2HG concentration and 2HG/(lipid + lactate) ratio were calculated. Internal validation was assessed by the bootstrap approach with 1000 bootstrap resamples. Differences in the predictive accuracy of 2HG/(lipid + lactate) ratio and 2HG concentration were determined by calculating the integrated discrimination improvement. The diagnostic accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve [AUC]) of these measures was also compared separately in patients with glioblastomas and patients with lower-grade gliomas. Results: Of the 79 enrolled patients, 28 had IDH mutations and 51 had wild-type IDH. The sensitivity, specificity, and AUC of 2HG concentration for predicting IDH-mutant gliomas were 89% (25 of 28), 67% (34 of 51), and 0.80 (95% confidence interval [CI]: 0.70, 0.88; C statistic, 0.80), respectively. The sensitivity, specificity, and AUC of the 2HG/(lipid + lactate) ratio for predicting IDH-mutant gliomas were 79% (22 of 28), 92% (47 of 51), and 0.90 (95% CI: 0.81, 0.96; C statistics, 0.90), respectively. The optimal cutoff value for the 2HG/(lipid + lactate) ratio was 0.63. The 2HG/(lipid + lactate) ratio was significantly better for predicting IDH mutation status than the 2HG concentration alone (P < .01). In glioblastoma, the 2HG/(lipid + lactate) ratio was also better for predicting IDH mutations than the 2HG concentration alone, with borderline significance (P = .052). In lower-grade glioma, the 2HG/(lipid + lactate) ratio and the 2HG concentration showed comparable diagnostic performance (P = .72). Conclusion: The 2HG/(lipid + lactate) ratio is more accurate for predicting IDH mutation status in patients with glioma than the 2HG concentration alone.Keywords: Brain/Brain Stem, CNS, MR-Imaging, MR-Spectroscopy, Neoplasms-Primary, Neuro-Oncology© RSNA, 2020.

High-Resolution Magnetic Resonance Imaging Using Compressed Sensing for Intracranial and Extracranial Arteries: Comparison with Conventional Parallel Imaging.

OBJECTIVE: To compare conventional sensitivity encoding (SENSE) to compressed sensing plus SENSE (CS) for high-resolution magnetic resonance imaging (HR-MRI) of intracranial and extracranial arteries. MATERIALS AND METHODS: HR-MRI was performed in 14 healthy volunteers. Three-dimensional T1-weighted imaging (T1WI) and proton density-weighted imaging (PD) were acquired using CS or SENSE under the same total acceleration factors (AFt)-5.5, 6.8, and 9.7 for T1WI and 3.2, 4.0, and 5.8 for PD-to achieve reduced scanning times in comparison with the original imaging sequence (SENSE T1WI, AFt 3.5; SENSE PD, AFt 2.0) using the 3-tesla system. Two neuroradiologists measured signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), and used visual scoring systems to assess image quality. Acceptable imaging was defined as a visual score ≥ 2. Repeated measures analysis of variance and Cochran's Q test were performed. RESULTS: CS yielded better image quality and vessel delineation than SENSE in T1WI with AFt of 5.5, 6.8, and 9.7, and in PD with AFt of 5.8 (p < 0.05). CS T1WI with AFt of 5.5 and CS PD with AFt of 3.2 and 4.0 did not differ significantly from original imaging (p > 0.05). SNR and CNR in CS were higher than they were in SENSE, but lower than they were in the original images (p < 0.05). CS yielded higher proportions of acceptable imaging than SENSE (CS T1WI with AFt of 6.8 and PD with AFt of 5.8; p < 0.0167). CONCLUSION: CS is superior to SENSE, and may be a reliable acceleration method for vessel HR-MRI using AFt of 5.5 for T1WI, and 3.2 and 4.0 for PD.

Effectiveness of a silicone device for foot MRI in order to obtain homogeneous fat suppression images.

BACKGROUND: Incomplete fat suppression induced by magnetic field inhomogeneity is difficult to compensate for with hardware magnetic-field shimming. PURPOSE: To evaluate the effectiveness of a silicone device used to obtain homogeneous fat suppression during 3T magnetic resonance imaging (MRI) scans of the foot. MATERIAL AND METHODS: Thirty-eight healthy volunteers were enrolled and examined twice, before (group A) and after (group B) the application of a silicone device. Fat-saturated, T2-weighted, fast spin-echo images were acquired using the same scanning protocol at both examinations. Signal- and contrast-to-noise ratios (SNR and CNR) were calculated and compared in the four regions of interest (ROIs). ROI 1 and 2 were selected from toe-side bone and soft tissue, while ROI 3 and 4 were selected from proximal bone and soft tissue. Qualitative analysis using a four-point scale was performed for three categories. The categories are as follows: the overall image quality, homogeneity of the first phalange and metatarsal bone, respectively. RESULTS: The SNR and CNR in ROI 1 and 2 were significantly higher in group A than in group B (SNR; P < 0.001, CNR; P < 0.001), and there were no significant difference in ROI 3 and 4. The qualitative score of the overall fat suppression in group B was significantly higher than that in group A (P < 0.001). Homogeneity of the first phalange in group B was also significantly higher than that in group A (P < 0.001). On the other hand, the homogeneity of the metatarsal bone was not significantly different in the two groups. CONCLUSION: The use of a silicone device provides homogeneous fat suppression in 3T MRI of the foot and can significantly improve image quality.