2.5-Minute Fast Brain MRI with Multiple Contrasts in Acute Ischemic Stroke.

PURPOSE: To assess the performance of a 2.5-minute multi-contrast brain MRI sequence (NeuroMix) in diagnosing acute cerebral infarctions. METHODS: Adult patients with a clinical suspicion of acute ischemic stroke were retrospectively included. Brain MRI at 3 T included NeuroMix and routine clinical MRI (cMRI) sequences, with DWI/ADC, T2-FLAIR, T2-weighted, T2*, SWI-EPI, and T1-weighted contrasts. Three radiologists (R1-3) independently assessed NeuroMix and cMRI for the presence of acute infarcts (DWI ↑, ADC = or ↓) and infarct-associated abnormalities on other image contrasts. Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC) were calculated and compared using DeLong's test. Inter- and intra-rater agreements were studied with kappa statistics. Relative DWI (rDWI) and T2-FLAIR (rT2-FLAIR) signal intensity for infarctions were semi-automatically rendered, and the correlation between methods was evaluated. RESULTS: According to the reference standard, acute infarction was present in 34 out of 44 (77%) patients (63 ± 17 years, 31 men). Other infarct-associated signal abnormalities were reported in similar frequencies on NeuroMix and cMRI (p > .08). Sensitivity for infarction detection was 94%, 100%, and 94% evaluated by R1, R2, R3, for NeuroMix and 94%, 100%, and 100% for cMRI. Specificity was 100%, 90%, and 100% for NeuroMix and 100%, 100%, and 100% for cMRI. AUC for NeuroMix was .97, .95, and .97 and .97, 1, and 1 for cMRI (DeLong p = 1, .32, .15), respectively. Inter- and intra-rater agreement was κ = .88-1. The correlation between NeuroMix and cMRI was R = .73 for rDWI and R = .83 for rT2-FLAIR. CONCLUSION: Fast multi-contrast MRI NeuroMix has high diagnostic performance for detecting acute cerebral infarctions.

A 78 Seconds Complete Brain MRI Examination in Ischemic Stroke: A Prospective Cohort Study.

BACKGROUND: Fast 78-second multicontrast echo-planar MRI (EPIMix) has shown good diagnostic performance for detecting infarctions at a comprehensive stroke center, but its diagnostic performance has not been evaluated in a prospective study at a primary stroke center. PURPOSE: To prospectively determine whether EPIMix was noninferior in detecting ischemic lesions compared to routine clinical MRI. STUDY TYPE: Prospective cohort study. POPULATION: A total of 118 patients with acute MRI and symptoms of ischemic stroke. FIELD STRENGTH AND SEQUENCE: A 3 T. EPIMix (echo-planar based: T1-FLAIR, T2-weighted, T2-FLAIR, T2*, DWI) and routine clinical MRI sequences (T1-weighted fast spin echo, T2-weighted PROPELLER, T2-weighted-FLAIR fast spin echo, T2* gradient echo echo-planar, and DWI spin echo echo-planar). ASSESSMENT: Three radiologists, blinded for clinical information, assessed signs of ischemic lesions (DWI↑, ADC↓, and T2/T2-FLAIR↑) on EPIMix and routine clinical MRI, with disagreements solved in consensus with a fourth reader to establish the reference standard. STATISTICAL TESTS: Diagnostic performance including sensitivity and specificity against the reference standard was evaluated. EPIMix sensitivity was tested for noninferiority compared to the reference standard using Nam's restricted maximum likelihood estimation (RMLE) Score. A P-value < 0.05 was considered statistically significant. RESULTS: Of 118 patients (mean age 62 ± 16 years, 58% males), 25% (n = 30) had MRI signs of acute infarcts. EPIMix was noninferior with 97% (95% CI 83-100) sensitivity for reader 1, 100% (95% CI 88-100) sensitivity for reader 2, and 90% (95% CI 88-98) sensitivity for reader 3 vs. 93% (95% CI 78-99) sensitivity for readers 1 and 2 and 90% (95% CI 74-98) for reader 3 on routine clinical MRI. Specificity was 99% (95% CI 94-100) for reader 1, 100% (95% CI 96-100) for reader 2, and 98% (95% CI 92-100) for reader 3 on EPIMix vs. 100% (95% CI 96-100) for all readers on routine clinical MRI. CONCLUSION: EPIMix was noninferior to routine clinical MRI for the diagnosis of acute ischemic stroke. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.

Control of a wireless sensor using the pulse sequence for prospective motion correction in brain MRI.

PURPOSE: To synchronize and pass information between a wireless motion-tracking device and a pulse sequence and show how this can be used to implement customizable navigator interleaving schemes that are part of the pulse sequence design. METHODS: The device tracks motion by sampling the voltages induced in 3 orthogonal pickup coils by the changing gradient fields. These coils were modified to also detect RF-transmit events using a 3D RF-detection circuit. The device could then detect and decode a set RF signatures while ignoring excitations in the parent pulse sequence. A set of unique RF signatures were then paired with a collection of navigators and used to trigger readouts on the wireless device synchronous to the pulse sequence execution. Navigator interleaving schemes were then demonstrated in 3D RF-spoiled gradient echo, T1 -FLAIR (fluid-attenuated inversion recovery) PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction), and T2 -FLAIR PROPELLER pulse sequences. RESULTS: Excitations in the parent pulse sequences were successfully rejected and the RF signatures successfully decoded. For the 3D gradient echo sequence, distortions were removed by interleaving flipped polarity navigators and taking the difference between consecutive readouts. The impact on scan duration was reduced by 54% by breaking up the navigators into smaller parts. Successful motion correction was performed using the PROPELLER pulse sequences in 3 Tesla and 1.5 Tesla MRI scanners without modifications to the device hardware or software. CONCLUSION: The proposed RF signature-based triggering scheme enables complex interactions between the pulse sequence and a wireless device. Thus, enabling prospective motion correction that is repeatable, versatile, and minimally invasive with respect to hardware setup.

NeuroMix-A single-scan brain exam.

PURPOSE: Implement a fast, motion-robust pulse sequence that acquires T1 -weighted, T2 -weighted, T2* -weighted, T2 fluid-attenuated inversion recovery, and DWI data in one run with only one prescription and one prescan. METHODS: A software framework was developed that configures and runs several sequences in one main sequence. Based on that framework, the NeuroMix sequence was implemented, containing motion robust single-shot sequences using EPI and fast spin echo (FSE) readouts (without EPI distortions). Optional multi-shot sequences that provide better contrast, higher resolution, or isotropic resolution could also be run within the NeuroMix sequence. An optimized acquisition order was implemented that minimizes times where no data is acquired. RESULTS: NeuroMix is customizable and takes between 1:20 and 4 min for a full brain scan. A comparison with the predecessor EPIMix revealed significant improvements for T2 -weighted and T2 fluid-attenuated inversion recovery, while taking only 8 s longer for a similar configuration. The optional contrasts were less motion robust but offered a significant increase in quality, detail, and contrast. Initial clinical scans on 1 pediatric and 1 adult patient showed encouraging image quality. CONCLUSION: The single-shot FSE readouts for T2 -weighted and T2 fluid-attenuated inversion recovery and the optional multishot FSE and 3D-EPI contrasts significantly increased diagnostic value compared with EPIMix, allowing NeuroMix to be considered as a standalone brain MRI application.

Motion-insensitive susceptibility weighted imaging.

PURPOSE: To enable SWI that is robust to severe head movement. METHODS: Prospective motion correction using a markerless optical tracker was applied to all pulse sequences. Three-dimensional gradient-echo and 3D EPI were used as reference sequences, but were expected to be sensitive to motion-induced B0 changes, as the long TE required for SWI allows phase discrepancies to accumulate between shots. Therefore, 2D interleaved snapshot EPI was investigated for motion-robust SWI and compared with conventional 2D EPI. Repeated signal averages were retrospectively corrected for motion. The sequences were evaluated at 3 T through controlled motion experiments involving two cooperative volunteers and SWI of a tumor patient. RESULTS: The performed continuous head motion was in the range of 5-8° rotations. The image quality of the 3D sequences and conventional 2D EPI was poor unless the rotational motion axis was parallel to B0 . Interleaved snapshot EPI had minimal intraslice phase discrepancies due to its small temporal footprint. Phase inconsistency between signal averages was well tolerated due to the high-pass filter effect of the SWI processing. Interleaved snapshot EPI with prospective and retrospective motion correction demonstrated similar image quality, regardless of whether motion was present. Lesion depiction was equal to 3D EPI with matching resolution. CONCLUSION: Susceptibility-based imaging can be severely corrupted by head movement despite accurate prospective motion correction. Interleaved snapshot EPI is a superior alternative for patients who are prone to move and offers SWI which is insensitive to motion when combined with prospective and retrospective motion correction.

Prospective motion correction for diffusion weighted EPI of the brain using an optical markerless tracker.

PURPOSE: To enable motion-robust diffusion weighted imaging of the brain using well-established imaging techniques. METHODS: An optical markerless tracking system was used to estimate and correct for rigid body motion of the head in real time during scanning. The imaging coordinate system was updated before each excitation pulse in a single-shot EPI sequence accelerated by GRAPPA with motion-robust calibration. Full Fourier imaging was used to reduce effects of motion during diffusion encoding. Subjects were imaged while performing prescribed motion patterns, each repeated with prospective motion correction on and off. RESULTS: Prospective motion correction with dynamic ghost correction enabled high quality DWI in the presence of fast and continuous motion within a 10° range. Images acquired without motion were not degraded by the prospective correction. Calculated diffusion tensors tolerated the motion well, but ADC values were slightly increased. CONCLUSIONS: Prospective correction by markerless optical tracking minimizes patient interaction and appears to be well suited for EPI-based DWI of patient groups unable to remain still including those who are not compliant with markers.

T1 -FLAIR imaging during continuous head motion: Combining PROPELLER with an intelligent marker.

PURPOSE: The purpose of this work is to describe a T1 -weighted fluid-attenuated inversion recovery (FLAIR) sequence that is able to produce sharp magnetic resonance images even if the subject is moving their head throughout the acquisition. METHODS: The robustness to motion artifacts and retrospective motion correction capabilities of the PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) trajectory were combined with prospective motion correction. The prospective correction was done using an intelligent marker attached to the subject. This marker wirelessly synchronizes to the pulse sequence to measure the directionality and magnitude of the magnetic fields present in the MRI machine during a short navigator, thus enabling it to determine its position and orientation in the scanner coordinate frame. Three approaches to incorporating the marker-navigator into the PROPELLER sequence were evaluated. The specific absorption rate, and subsequent scan time, of the T1 -weighted FLAIR PROPELLER sequence, was reduced using a variable refocusing flip-angle scheme. Evaluations of motion correction performance were done with 4 volunteers and 3 types of head motion. RESULTS: During minimal out-of-plane movement, retrospective PROPELLER correction performed similarly to the prospective correction. However, the prospective clearly outperformed the retrospective correction when there was out-of-plane motion. Finally, the combination of retrospective and prospective correction produced the sharpest images even during large continuous motion. CONCLUSION: Prospective motion correction of a PROPELLER sequence makes it possible to handle continuous, large, and high-speed head motions with only minor reductions in image quality.

Toward nonparametric diffusion- T1 characterization of crossing fibers in the human brain.

PURPOSE: To estimate T1 for each distinct fiber population within voxels containing multiple brain tissue types. METHODS: A diffusion- T1 correlation experiment was carried out in an in vivo human brain using tensor-valued diffusion encoding and multiple repetition times. The acquired data were inverted using a Monte Carlo algorithm that retrieves nonparametric distributions P(D,R1) of diffusion tensors and longitudinal relaxation rates R1=1/T1 . Orientation distribution functions (ODFs) of the highly anisotropic components of P(D,R1) were defined to visualize orientation-specific diffusion-relaxation properties. Finally, Monte Carlo density-peak clustering (MC-DPC) was performed to quantify fiber-specific features and investigate microstructural differences between white matter fiber bundles. RESULTS: Parameter maps corresponding to P(D,R1) 's statistical descriptors were obtained, exhibiting the expected R1 contrast between brain tissue types. Our ODFs recovered local orientations consistent with the known anatomy and indicated differences in R1 between major crossing fiber bundles. These differences, confirmed by MC-DPC, were in qualitative agreement with previous model-based works but seem biased by the limitations of our current experimental setup. CONCLUSIONS: Our Monte Carlo framework enables the nonparametric estimation of fiber-specific diffusion- T1 features, thereby showing potential for characterizing developmental or pathological changes in T1 within a given fiber bundle, and for investigating interbundle T1 differences.

RARE two-point Dixon with dual bandwidths.

PURPOSE: To investigate the impact of dual readout bandwidths (dBW) in a dual echo fat/water acquisition and describe a dBW-rapid acquisition relaxation enhanced, or turbo spin echo sequence where the concept is used to improve SNR by removing dead times between refocusing pulses and avoiding redundant Chemical-shift encoded. METHODS: Cramér-Rao bounds and Monte Carlo simulations were used to investigate a two-point fat/water model where the difference in bandwidths is incorporated. In vivo images were acquired at 1.5 and 3 T with the dBW-rapid acquisition relaxation enhanced, or turbo spin echo sequence. Typical bandwidth ratios were 1:2. SNR was compared with a single bandwidth sequence under identical scan parameters at 3T. RESULTS: Monte Carlo simulations and Cramér-Rao analysis demonstrate that number of signal averages can be improved with dual bandwidths compared to conventional single bandwidth acquisitions. The dBW-rapid acquisition relaxation enhanced, or turbo spin echo sequence can acquire images with high readout resolutions with well-conditioned sampling. An SNR improvement of 52% was measured, in line with the theoretical gain of 54%. CONCLUSIONS: The proposed dBW-rapid acquisition relaxation enhanced, or turbo spin echo sequence is a highly SNR-efficient two-point rapid acquisition relaxation enhanced, or turbo spin echo sequence without dead times, and can acquire images at higher resolutions than current vendor-supplied alternatives.

Projection-based 3D/2D registration for prospective motion correction.

PURPOSE: To develop a registration method that is capable of estimating the full range of rigid body motion from three orthogonal collapsed images of the head. These images can be obtained using the collapsed FatNav, a previously introduced navigator for prospective motion correction. It combines a short duration with wide compatibility with different main sequences due to its robustness against spin history effects. THEORY AND METHODS: A projection-based 3D/2D registration method is presented and then modified to take into account the peculiarities of the collapsed FatNav. Water/fat separated volumes were used in simulations to assess the accuracy of the proposed method at different resolutions by comparison with high-resolution 3D registration. The sensitivity with respect to masking strategies and starting motion parameters was investigated. Finally, prospective experiments with a healthy volunteer were performed with different types of motion patterns. A PROPELLER main sequence was chosen to compare the prospective correction with PROPELLER's own retrospective correction. RESULTS: In the simulations the proposed method has shown comparable performance to 3D registration. Furthermore, evidence of its robustness with respect to masking strategies and starting motion parameters was presented. The combination with collapsed FatNav has performed well in correcting most of the motion artifacts prospectively with improved image quality compared to only using PROPELLER's retrospective motion correction. CONCLUSIONS: The proposed 3D/2D registration together with collapsed FatNav is characterized by a good balance between navigator duration and estimate accuracy. Further work is needed to validate the method across a wider variety of subject anatomies.

Optimizing 3D EPI for rapid T1 -weighted imaging.

PURPOSE: To investigate the use of 3D EPI for rapid T1 -weighted brain imaging, focusing on the RF pulse's influence on the contrast between gray and white matter. METHODS: An interleaved 3D EPI sequence use partial Fourier and CAIPIRINHA sampling was used to acquire T1 -weighted brain volumes with isotropic resolution, low echo times, and low geometric distortions. Five different RF pulses were evaluated in terms of fat suppression performance and gray-white matter contrast. Two binomial RF pulses were compared to a single rectangular (WE-rect) RF pulse exciting only water, and two new RF pulses developed in this work, where one was an extension of the WE-rect, and the other was an SLR pulse. The technique was demonstrated in three clinical cases, where brain tumor patients were imaged before and after gadolinium administration. RESULTS: A fat-suppressed 3D EPI sequence with a phase encoding bandwidth of around 100 Hz was found to exhibit a good trade-off between geometrical distortions and scan duration. Whole-brain T1 -weighted 3D EPI images with 1.2 mm isotropic voxel size could be acquired in 24 seconds. The WE-rect, its extension, and the SLR RF pulses resulted in reduced magnetization transfer effects and provided a 20% mean increase in gray-white matter contrast. CONCLUSION: Using a high phase encoding bandwidth and RF pulses that reduce magnetization transfer effects, a fat-suppressed multi-shot 3D EPI sequence can be used to rapidly acquire isotropic T1 -weighted volumes.

Oscillating diffusion-encoding with a high gradient-amplitude and high slew-rate head-only gradient for human brain imaging.

PURPOSE: We investigate the importance of high gradient-amplitude and high slew-rate on oscillating gradient spin echo (OGSE) diffusion imaging for human brain imaging and evaluate human brain imaging with OGSE on the MAGNUS head-gradient insert (200 mT/m amplitude and 500 T/m/s slew rate). METHODS: Simulations with cosine-modulated and trapezoidal-cosine OGSE at various gradient amplitudes and slew rates were performed. Six healthy subjects were imaged with the MAGNUS gradient at 3T with OGSE at frequencies up to 100 Hz and b = 450 s/mm2 . Comparisons were made against standard pulsed gradient spin echo (PGSE) diffusion in vivo and in an isotropic diffusion phantom. RESULTS: Simulations show that to achieve high frequency and b-value simultaneously for OGSE, high gradient amplitude, high slew rates, and high peripheral nerve stimulation limits are required. A strong linear trend for increased diffusivity (mean: 8-19%, radial: 9-27%, parallel: 8-15%) was observed in normal white matter with OGSE (20 Hz to 100 Hz) as compared to PGSE. Linear fitting to frequency provided excellent correlation, and using a short-range disorder model provided radial long-term diffusivities of D∞,MD = 911 ± 72 µm2 /s, D∞,PD = 1519 ± 164 µm2 /s, and D∞,RD = 640 ± 111 µm2 /s and correlation lengths of lc,MD = 0.802 ± 0.156 µm, lc,PD = 0.837 ± 0.172 µm, and lc,RD = 0.780 ± 0.174 µm. Diffusivity changes with OGSE frequency were negligible in the phantom, as expected. CONCLUSION: The high gradient amplitude, high slew rate, and high peripheral nerve stimulation thresholds of the MAGNUS head-gradient enables OGSE acquisition for in vivo human brain imaging.

Fat/water separation in k-space with real-valued estimates and its combination with POCS.

PURPOSE: To develop reconstruction methods for improved image quality of chemical shift displacement-corrected fat/water imaging combined with partial Fourier acquisition. THEORY: Fat/water separation in k-space enables correction of chemical shift displacement. Modeling fat and water as real-valued rather than complex improves the conditionality of the inverse problem. This advantage becomes essential for k-space separation. In this work, it was described how to perform regularized fat/water imaging with real estimates in k-space, and how fat/water imaging can be combined with partial Fourier reconstruction using Projection Onto Convex Sets (POCS). METHODS: The reconstruction methods were demonstrated on chemical shift encoded gradient echo and fast spin echo data from volunteers, acquired at 1.5 T and 3 T. Both fully sampled and partial Fourier acquisitions were made. Data was retrospectively rejected from the fully sampled dataset to evaluate POCS and homodyne reconstruction. RESULTS: Fat/water separation in k-space eliminated chemical shift displacement, while real-valued estimates considerably reduced the noise amplification compared to complex estimates. POCS reconstruction could recover high spatial frequency information in the fat and water images with lower reconstruction error than homodyne. Partial Fourier in the readout direction enabled more flexible choice of gradient echo imaging parameters, in particular image resolution. CONCLUSION: Chemical shift displacement-corrected fat/water imaging can be performed with regularization and real-valued estimates to improve image quality by reducing ill-conditioning of the inverse problem in k-space. Fat/water imaging can be combined with POCS, which offers improved image quality over homodyne reconstruction.

Multi-shot Echo Planar Imaging for accelerated Cartesian MR Fingerprinting: An alternative to conventional spiral MR Fingerprinting.

PURPOSE: To develop an accelerated Cartesian MRF implementation using a multi-shot EPI sequence for rapid simultaneous quantification of T1 and T2 parameters. METHODS: The proposed Cartesian MRF method involved the acquisition of highly subsampled MR images using a 16-shot EPI readout. A linearly varying flip angle train was used for rapid, simultaneous T1 and T2 quantification. The results were compared to a conventional spiral MRF implementation. The acquisition time per slice was 8s and this method was validated on two different phantoms and three healthy volunteer brains in vivo. RESULTS: Joint T1 and T2 estimations using the 16-shot EPI readout are in good agreement with the spiral implementation using the same acquisition parameters (<4% deviation for T1 and <6% deviation for T2). The T1 and T2 values also agree with the conventional values previously reported in the literature. The visual qualities of fine brain structures in the multi-parametric maps generated by multi-shot EPI-MRF and Spiral-MRF implementations were comparable. CONCLUSION: The multi-shot EPI-MRF method generated accurate quantitative multi-parametric maps similar to conventional Spiral-MRF. This multi-shot approach achieved considerable k-space subsampling and comparatively short TRs in a similar manner to spirals and therefore provides an alternative for performing MRF using an accelerated Cartesian readout; thereby increasing the potential usability of MRF.

Diagnostic performance of a new multicontrast one-minute full brain exam (EPIMix) in neuroradiology: A prospective study.

BACKGROUND: Clinical MRI protocols are time-consuming; hence, new faster techniques are needed. One new fast multicontrast MRI technique, called echo planar image mix (EPIMix) (including contrasts T1 -FLAIR, T2 -weighted, diffusion-weighted images [DWI], apparent diffusion coefficient [ADC], T2 *-weighted, and T2 -FLAIR images) needs to be tested. PURPOSE: To assess if EPIMix has comparable diagnostic performance as routine clinical brain MRI. STUDY TYPE: Prospective. POPULATION: A consecutive series of 103 patients' brain MRI (January 2018 to May 2018). FIELD STRENGTH/SEQUENCE: 1.5 T or 3T. EPIMix and routine clinical protocol (clinical MRI included all or some of the contrasts T1 -FLAIR, T2 -weighted, DWI, T2 *-weighted, T2 -FLAIR, 3D-FSE). ASSESSMENT: Two neuroradiologists assessed EPIMix and clinical scans and categorized the images as abnormal or normal and described diagnosis, artifacts, diagnostic confidence image quality, and comparison of imaging time. STATISTICAL TESTS: Pivot tables with diagnostic performance calculated by receiver operating characteristics (ROC) and the area under curve (AUC). Disease categorization and image quality measures were evaluated. The study protocol is published at ClinicalTrials.gov NCT03338270. RESULTS: After exclusion of 21 patients, 82 patients had a routine clinical MRI with comparable contrasts to EPIMix and were evaluated. The diagnostic performance to categorize a full brain MRI investigation as abnormal or normal was comparable between EPIMix (AUC 0.99 (95% confidence interval [CI] 0.97-1.00) and 0.99 (95% CI 0.97-1.00)) and routine clinical MRI (n = 82). Sensitivity was 95% (95% CI 88-95) and 93% (95% CI 86-98), and specificity 100% (95% CI 97-100) and 100% (95% CI 90-100). Disease categorization was congruent between EPIMix and clinical routine MRI in 90% (reader 2) and 93% (reader 1). Image quality was generally rated lower for EPIMix (P < 0.001). Imaging time was 78 seconds for EPIMix and for the same contrasts 12 minutes 29 seconds for conventional 3T MRI. DATA CONCLUSION: EPIMix has comparable diagnostic performance (disease identification and categorization) for most patients investigated in clinical routine. Level of Evidence 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1824-1833.

A 1-minute full brain MR exam using a multicontrast EPI sequence.

PURPOSE: A new multicontrast echo-planar imaging (EPI)-based sequence is proposed for brain MRI, which can directly generate six MR contrasts (T1 -FLAIR, T2 -w, diffusion-weighted (DWI), apparent diffusion coefficient (ADC), T2*-w, T2 -FLAIR) in 1 min with full brain coverage. This could enable clinical MR clinical screening in similar time as a conventional CT exam but with more soft-tissue information. METHODS: Eleven sequence modules were created as dynamic building blocks for the sequence. Two EPI readout modules were reused throughout the sequence and were prepended by other modules to form the desired MR contrasts. Two scan protocols were optimized with scan times of 55-75 s. Motion experiments were carried out on two volunteers to investigate the robustness against head motion. Scans on patients were carried out and compared to conventional clinical images. RESULTS: The pulse sequence is found to be robust against motion given its single-shot nature of each contrast. For excessive out-of-plane head motion, the T1 -FLAIR and T2 -FLAIR contrasts suffer from incomplete inversion. Despite lower signal-to-noise ratio (SNR) and resolution, the 1-min multicontrast EPI data show promising correspondence with conventional diagnostic scans on patients. CONCLUSION: A 1 min multicontrast brain MRI scan based on EPI readouts has been presented in this feasibility study. Preliminary data show potential for clinical brain MRI use with minimal bore time for the patient. Such short examination time could be useful (e.g., for screening and acute stroke). The sequence may also help planning conventional brain MRI scans if run at the beginning of an examination. Magn Reson Med 79:3045-3054, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Model-based denoising in diffusion-weighted imaging using generalized spherical deconvolution.

PURPOSE: Diffusion MRI often suffers from low signal-to-noise ratio, especially for high b-values. This work proposes a model-based denoising technique to address this limitation. METHODS: A generalization of the multi-shell spherical deconvolution model using a Richardson-Lucy algorithm is applied to noisy data. The reconstructed coefficients are then used in the forward model to compute denoised diffusion-weighted images (DWIs). The proposed method operates in the diffusion space and thus is complementary to image-based denoising methods. RESULTS: We demonstrate improved image quality on the DWIs themselves, maps of neurite orientation dispersion and density imaging, and diffusional kurtosis imaging (DKI), as well as reduced spurious peaks in deterministic tractography. For DKI in particular, we observe up to 50% error reduction and demonstrate high image quality using just 30 DWIs. This corresponds to greater than fourfold reduction in scan time if compared to the widely used 140-DWI acquisitions. We also confirm consistent performance in pathological data sets, namely in white matter lesions of a multiple sclerosis patient. CONCLUSION: The proposed denoising technique termed generalized spherical deconvolution has the potential of significantly improving image quality in diffusion MRI. Magn Reson Med 78:2428-2438, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Real valued diffusion-weighted imaging using decorrelated phase filtering.

PURPOSE: Because of the intrinsic low signal-to-noise ratio in diffusion-weighted imaging (DWI), magnitude processing often causes an overestimation of the signal's amplitude. This results in low-estimation accuracy of diffusion models and reduced contrast because of a superposition of the image signal and the noise floor. We adopt a new phase correction (PC) technique that yields real valued diffusion data while maintaining a Gaussian noise distribution. METHODS: We conduct simulations of the noise propagation in the echo-planar imaging reconstruction chain to determine the spatial noise correlation in the image. Using the correlation pattern, optimized filter kernels are derived to estimate the true phase of the signal in each voxel. Furthermore, we adopt an outlier detection technique to replace the real value by the magnitude in case of substantial signal loss resulting from incorrect PC. RESULTS: The benefits of our method are demonstrated on Monte Carlo simulations, DWI data acquired from healthy volunteer experiments, estimated parameters of the diffusion kurtosis imaging model, and the model-free diffusion spectrum imaging technique. The improved PC approach significantly reduces the noise bias and only slightly increases the sensitivity to local phase variations. CONCLUSION: PC can enhance the usefulness of higher b-values, allowing deeper insights into tissue microstructure. Magn Reson Med 77:559-570, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Bias and precision analysis of diffusional kurtosis imaging for different acquisition schemes.

PURPOSE: Diffusional kurtosis imaging (DKI) is an approach to characterizing the non-Gaussian fraction of water diffusion in biological tissue. However, DKI is highly susceptible to the low signal-to-noise ratio of diffusion-weighted images, causing low precision and a significant bias due to Rician noise distribution. Here, we evaluate precision and bias using weighted linear least squares fitting of different acquisition schemes including several multishell schemes, a diffusion spectrum imaging (DSI) scheme, as well as a compressed sensing reconstruction of undersampled DSI scheme. METHODS: Monte Carlo simulations were performed to study the three-dimensional distribution of the apparent kurtosis coefficient (AKC). Experimental data were acquired from one healthy volunteer with multiple repetitions, using the same acquisition schemes as for the simulations. RESULTS: The angular distribution of the bias and precision were very inhomogeneous. While axial kurtosis was significantly overestimated, radial kurtosis was underestimated. The precision of radial kurtosis was up to 10-fold lower than axial kurtosis. CONCLUSION: The noise bias behavior of DKI is highly complex and can cause overestimation as well as underestimation of the AKC even within one voxel. The acquisition scheme with three shells, suggested by Poot et al, provided overall the best performance. Magn Reson Med 76:1684-1696, 2016. © 2016 International Society for Magnetic Resonance in Medicine.

Diffusion in realistic biophysical systems can lead to aliasing effects in diffusion spectrum imaging.

PURPOSE: Diffusion spectrum imaging (DSI) is an imaging technique that has been successfully applied to resolve white matter crossings in the human brain. However, its accuracy in complex microstructure environments has not been well characterized. THEORY AND METHODS: Here we have simulated different tissue configurations, sampling schemes, and processing steps to evaluate DSI performances' under realistic biophysical conditions. A novel approach to compute the orientation distribution function (ODF) has also been developed to include biophysical constraints, namely integration ranges compatible with axial fiber diffusivities. RESULTS: Performed simulations identified several DSI configurations that consistently show aliasing artifacts caused by fast diffusion components for both isotropic diffusion and fiber configurations. The proposed method for ODF computation showed some improvement in reducing such artifacts and improving the ability to resolve crossings, while keeping the quantitative nature of the ODF. CONCLUSION: In this study, we identified an important limitation of current DSI implementations, specifically the presence of aliasing due to fast diffusion components like those from pathological tissues, which are not well characterized, and can lead to artifactual fiber reconstructions. To minimize this issue, a new way of computing the ODF was introduced, which removes most of these artifacts and offers improved angular resolution. Magn Reson Med 76:1837-1847, 2016. © 2015 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.