Steer-PROP: a GRASE-PROPELLER sequence with interecho steering gradient pulses.

PURPOSE: This study demonstrates a novel PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) pulse sequence, termed Steer-PROP, based on gradient and spin echo (GRASE), to reduce the imaging times and address phase errors inherent to GRASE. The study also illustrates the feasibility of using Steer-PROP as an alternative to single-shot echo planar imaging (SS-EPI) to produce distortion-free diffusion images in all imaging planes. METHODS: Steer-PROP uses a series of blip gradient pulses to produce N (N = 3-5) adjacent k-space blades in each repetition time, where N is the number of gradient echoes in a GRASE sequence. This sampling strategy enables a phase correction algorithm to systematically address the GRASE phase errors as well as the motion-induced phase inconsistency. Steer-PROP was evaluated on phantoms and healthy human subjects at both 1.5T and 3.0T for T2 - and diffusion-weighted imaging. RESULTS: Steer-PROP produced similar image quality as conventional PROPELLER based on fast spin echo (FSE), while taking only a fraction (e.g., 1/3) of the scan time. The robustness against motion in Steer-PROP was comparable to that of FSE-based PROPELLER. Using Steer-PROP, high quality and distortion-free diffusion images were obtained from human subjects in all imaging planes, demonstrating a considerable advantage over SS-EPI. CONCLUSION: The proposed Steer-PROP sequence can substantially reduce the scan times compared with FSE-based PROPELLER while achieving adequate image quality. The novel k-space sampling strategy in Steer-PROP not only enables an integrated phase correction method that addresses various sources of phase errors, but also minimizes the echo spacing compared with alternative sampling strategies. Steer-PROP can also be a viable alternative to SS-EPI to decrease image distortion in all imaging planes. Magn Reson Med 79:2533-2541, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Improved Computational Efficiency of Locally Low Rank MRI Reconstruction Using Iterative Random Patch Adjustments.

This paper presents and analyzes an alternative formulation of the locally low-rank (LLR) regularization framework for magnetic resonance image (MRI) reconstruction. Generally, LLR-based MRI reconstruction techniques operate by dividing the underlying image into a collection of matrices formed from image patches. Each of these matrices is assumed to have low rank due to the inherent correlations among the data, whether along the coil, temporal, or multi-contrast dimensions. The LLR regularization has been successful for various MRI applications, such as parallel imaging and accelerated quantitative parameter mapping. However, a major limitation of most conventional implementations of the LLR regularization is the use of multiple sets of overlapping patches. Although the use of overlapping patches leads to effective shift-invariance, it also results in high-computational load, which limits the practical utility of the LLR regularization for MRI. To circumvent this problem, alternative LLR-based algorithms instead shift a single set of non-overlapping patches at each iteration, thereby achieving shift-invariance and avoiding block artifacts. A novel contribution of this paper is to provide a mathematical framework and justification of LLR regularization with iterative random patch adjustments (LLR-IRPA). This method is compared with a state-of-the-art LLR regularization algorithm based on overlapping patches, and it is shown experimentally that results are similar but with the advantage of much reduced computational load. We also present theoretical results demonstrating the effective shift invariance of the LLR-IRPA approach, and we show reconstruction examples and comparisons in both retrospectively and prospectively undersampled MRI acquisitions, and in T1 parameter mapping.

Magnetization transfer from inhomogeneously broadened lines (ihMT): Improved imaging strategy for spinal cord applications.

PURPOSE: Inhomogeneous magnetization transfer (ihMT) shows great promise for specific imaging of myelinated tissues. Whereas the ihMT technique has been previously applied in brain applications, the current report presents a strategy for cervical spinal cord (SC) imaging free of cerebrospinal fluid (CSF) pulsatility artifacts. METHODS: A pulsed ihMT preparation was combined with a single-shot HASTE readout. Electrocardiogram (ECG) synchronization was used to acquire all images during the quiescent phase of SC motion. However ihMT signal quantification errors may occur when a variable recovery delay is introduced in the sequence as a consequence of variable cardiac cycle. A semiautomatic retrospective correction algorithm, based on repetition time (TR) -matching, is proposed to correct for signal variations of long T1 -components (e.g., CSF). RESULTS: The proposed strategy combining ECG synchronization and retrospective data pairing led to clean SC images free of CSF artifacts. Lower variability of the ihMT metrics were obtained with the correction algorithm, and allowed for shorter TR to be used, hence improving signal-to-noise ratio efficiency. CONCLUSION: The proposed methodology enabled faster acquisitions, while offering robust ihMT quantification and exquisite SC image quality. This opens great perspectives for widening the in vivo characterization of SC physiopathology using MRI, such as studying white matter tracts microstructure or impairment in degenerative pathologies. Magn Reson Med 77:581-591, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Optimization and evaluation of reference region variable flip angle (RR-VFA) B1+ and T1 Mapping in the Prostate at 3T.

PURPOSE: To optimize and evaluate the reference region variable flip angle (RR-VFA) technique for simultaneous B1+ and T1 mapping of the prostate at 3 Tesla (T). MATERIALS AND METHODS: The fat region surrounding the prostate was first identified using a fractional fat segmentation constant (tF ) and a signal fat-fraction threshold (rF ), and the relative flip angle (FA) was characterized using an effective fat T1 (T1f ) within the fat region. Optimal values of tF , rF , and T1f were chosen by comparing relative FA maps using RR-VFA (ARR-VFA ) with a reference relative FA maps (AREF ) in the surrounding fat and evaluating interpolation errors within the prostate. The optimized RR-VFA was evaluated in volunteers at 3T on a single scanner (n = 10) and across three scanners (n = 4). RESULTS: tF , rF and T1f were optimized as 0.5, 90%, and 320 ms, respectively. Prostate ARR-VFA showed differences of 30% among volunteers on one scanner, with no significant differences between ARR-VFA and AREF (P = 0.41). Prostate T1 after B1+ correction was 1998 ± 113 ms with significantly (P = 0.004) lower standard deviation than T1 before B1+ correction. The average coefficient of variation of prostate T1 across multiple scanners decreased from 15% to 5% after B1+ correction. CONCLUSION: The optimized RR-VFA can simultaneously measure B1+ and T1 in the prostate without the need for an additional scan and improve T1 consistency within and across MRI scanners at 3T. LEVEL OF EVIDENCE: 3 J. Magn. Reson. Imaging 2017;45:751-760.

Rapid quantitative T2 mapping of the prostate using three-dimensional dual echo steady state MRI at 3T.

PURPOSE: To develop and evaluate a rapid three-dimensional (3D) quantitative T2 mapping method for prostate cancer imaging using dual echo steady state (DESS) MRI at 3T. METHODS: In simulations, DESS-T2 mapping in the presence of T1 and B1+ variations was evaluated. In a phantom and in healthy volunteers (n = 4), 3D DESS-T2 mapping was compared with a two-dimensional turbo spin echo (TSE) approach. In volunteers and a pilot patient study (n = 29), quantitative T2 in normal prostate anatomical zones and in suspected cancerous lesions was evaluated. RESULTS: The simulated bias for DESS-T2 was < 2% (5%) for typically observed T1 ( B1+) variations. In phantoms and in vivo, high correlation of DESS-T2 and TSE-T2 (r2 = 0.98 and 0.88, P < 0.001) was found. DESS-T2 in the normal peripheral zone and transition zone was 115 ± 26 ms and 64 ± 7 ms, respectively, in healthy volunteers and 129 ± 39 ms and 83 ± 12 ms, respectively, in patients. In suspected cancerous lesions, DESS-T2 was 72 ± 14 ms, which was significantly decreased from the normal peripheral zone (P < 0.001) but not from the transition zone. CONCLUSION: Rapid 3D T2 mapping in the entire prostate can be performed in 1 min using DESS MRI. Magn Reson Med 76:1720-1729, 2016. © 2016 International Society for Magnetic Resonance in Medicine.

Trail Making Test Elucidates Neural Substrates of Specific Poststroke Executive Dysfunctions.

BACKGROUND AND PURPOSE: Poststroke cognitive impairment is typified by prominent deficits in processing speed and executive function. However, the underlying neuroanatomical substrates of executive deficits are not well understood, and further elucidation is needed. There may be utility in fractionating executive functions to delineate neural substrates. METHODS: One test amenable to fine delineation is the Trail Making Test (TMT), which emphasizes processing speed (TMT-A) and set shifting (TMT-B-A difference, proportion, quotient scores, and TMT-B set-shifting errors). The TMT was administered to 2 overt ischemic stroke cohorts from a multinational study: (1) a chronic stroke cohort (N=61) and (2) an acute-subacute stroke cohort (N=45). Volumetric quantification of ischemic stroke and white matter hyperintensities was done on magnetic resonance imaging, along with ratings of involvement of cholinergic projections, using the previously published cholinergic hyperintensities projections scale. Damage to the superior longitudinal fasciculus, which colocalizes with some cholinergic projections, was also documented. RESULTS: Multiple linear regression analyses were completed. Although larger infarcts (ß=0.37, P<0.0001) were associated with slower processing speed, cholinergic hyperintensities projections scale severity (ß=0.39, P<0.0001) was associated with all metrics of set shifting. Left superior longitudinal fasciculus damage, however, was only associated with the difference score (ß=0.17, P=0.03). These findings were replicated in both cohorts. Patients with ≥2 TMT-B set-shifting errors also had greater cholinergic hyperintensities projections scale severity. CONCLUSIONS: In this multinational stroke cohort study, damage to lateral cholinergic pathways and the superior longitudinal fasciculus emerged as significant neuroanatomical correlates for executive deficits in set shifting.

Diffusion restriction in the human spinal cord characterized in vivo with high b-value STEAM diffusion imaging.

Restricted or hindered motion of water across axonal membranes as characterized with diffusion-weighted (DW) imaging may be a potential marker of axonal damage in white matter (WM) injury due to trauma, neurodegeneration, or other causes. This study sought to determine whether high b-value DW imaging with a stimulated echo (STEAM) sequence could improve the spatially resolved assessment of tissue architecture in the human spinal cord in vivo. Diffusion times from 76 ms to 1000 ms and b-values of up to 14,750 s/mm(2) were used to acquire axial DW images in six healthy volunteers, and four additional healthy volunteers were studied with a protocol focused on high b-value, higher-resolution imaging. Mono-exponential, diffusional kurtosis, and mono-exponential with an additive constant (MEC) models were fit individually to diffusion decay curves obtained at different diffusion times. Diffusion restriction, characterized with the diffusional kurtosis and MEC models, was measured more precisely using higher b-value ranges. DW images at high b-value and fitting parameters using the large range of b-values available at the diffusion time of 1000 ms demonstrated signal and restriction differences between gray and white matter and even across white matter regions. These white matter differences may reflect variations in axonal density, diameter, or alignment. We conclude that high b-value DW imaging with a STEAM sequence on a conventional clinical scanner can provide accurate measures of diffusion hindrance and restriction in human spinal cord in vivo.

Reduction of fast spin echo cusp artifact using a slice-tilting gradient.

A "featherlike" artifact, termed a cusp artifact, is sometimes seen along the phase-encoding direction in sagittal or coronal fast spin echo images. This artifact arises from the spins, at a location distant from the magnet isocenter, that are excited and aliased to the field of view because their precession frequency is similar to those at the isocenter. Such a situation is created due to a combination of excessive gradient nonlinearity and rapid change of the main magnetic field near the edge of the magnet where the artifact-producing spins are located. A novel technique is proposed to reduce this artifact, in which a fast spin echo pulse sequence is modified to slightly tilt the slice selected by the radiofrequency excitation pulse away from the slice selected by the radiofrequency refocusing pulses. At the edge of the field of view, the incomplete overlap between the slices selected by the excitation and refocusing pulses effectively reduces the signals from the artifact-prone region. In contrast, the slices overlap substantially within the field of view so that the signals are largely retained. This slice-tilting technique has been implemented on two commercial MRI scanners operating at 3.0 T and 1.5 T, respectively, and evaluated on phantoms and human spine and extremities using clinical protocols. Both phantom and human results showed that the technique decreased the strength of the cusp artifact by at least 65% and substantially limited the spatial extent of the artifact. This technique, which can be further enhanced by a simple postprocessing step, offers significant advantages over a number of other techniques for reducing the fast spin echo cusp artifact. It can be implemented on virtually any scanner without hardware modification, complicated calibration, sophisticated image reconstruction, or patient-handling alteration.