Dental-dedicated MRI, a novel approach for dentomaxillofacial diagnostic imaging: technical specifications and feasibility.

MRI is a noninvasive, ionizing radiation-free imaging modality that has become an indispensable medical diagnostic method. The literature suggests MRI as a potential diagnostic modality in dentomaxillofacial radiology. However, current MRI equipment is designed for medical imaging (eg, brain and body imaging), with general-purpose use in radiology. Hence, it appears expensive for dentists to purchase and maintain, besides being complex to operate. In recent years, MRI has entered some areas of dentistry and has reached a point in which it can be provided following a tailored approach. This technical report introduces a dental-dedicated MRI (ddMRI) system, describing how MRI can be adapted to fit dentomaxillofacial radiology through the appropriate choice of field strength, dental radiofrequency surface coil, and pulse sequences. Also, this technical report illustrates the possible application and feasibility of the suggested ddMRI system in some relevant diagnostic tasks in dentistry. Based on the presented cases, it is fair to consider the suggested ddMRI system as a feasible approach to introducing MRI to dentists and dentomaxillofacial radiology specialists. Further studies are needed to clarify the diagnostic accuracy of ddMRI considering the various diagnostic tasks relevant to the practice of dentistry.

Ultra short time to Echo (UTE) MRI for cephalometric analysis-Potential of an x-ray free fast cephalometric projection technique.

OBJECTIVES: A novel magnetic resonance imaging (MRI) scan protocol is presented on the basis of ultra-short time to echo (UTE). By this MRI cephalometric projections (MCPs) can be acquired without the need of post processing in one shot. Different technical parameterizations of the protocol are performed. Their impact on the performance of MCPs is evaluated in comparison to the gold standard-the lateral cephalometric radiography (LCR) for cephalometric analysis (CA) in orthodontics. METHODS: Seven MCPs with various scan parameters influencing the scan duration and one LCR are used from one subject. 40 expert assessors performed CA for 14 predefined cephalometric landmarks. Relative metric distances and absolute angular measurements were calculated. Statistical analysis is presented and the deviations are highlighted to demonstrate the potential of the method for further analysis. RESULTS: The MCPs are acquired in 5-154 seconds, depending on resolution and contrast. Mean relative distances were 2.4-2.7 mm in MCPs and 1.6 mm in LCR, which demonstrate the accuracy and level of agreement of the expert assessors in identifying anatomical landmarks. In comparison to other studies, the presented MCP performed similar in angular analysis and demonstrated on average deviation of 1.2° ±1.1° in comparison to LCR. Despite the point articulare (Ar) and the related gonial angle the calculate distances and angles show outcomes in the range of ±2°/2mm. CONCLUSIONS: MCPs can be acquired much faster in comparison to other techniques known from literature for CA. This study demonstrated the potential of the new method and showed first feasible results. Further research is needed to analyze the performance on a broad range of patients.

A Signal Acquisition Setup for Ultrashort Echo Time Imaging Operating in Parallel on Unmodified Clinical MRI Scanners Achieving an Acquisition Delay of [Formula: see text].

Ultrashort echo time imaging on clinical systems is still limited by the rather long radio frequency switching times achievable with standard front end concepts. In this contribution, an independent parallel receive-only system is interfaced to an unmodified clinical MRI system, enabling imaging of species with ultrashort relaxation times, such as bone, tendon, teeth, or lung tissue. Synchronization of the system is achieved by an electronically decoupled one-way trigger line, a clock reference signal, and RF pulse tracking, thus ensuring minimal interference with the host system. With the proposed system, an acquisition delay of [Formula: see text] is experimentally demonstrated.

An EM Simulation-Based Design Flow for Custom-Built MR Coils Incorporating Signal and Noise.

Developing custom-built MR coils is a cumbersome task, in which an a priori prediction of the coils' SNR performance, their sensitivity pattern, and their depth of penetration helps to greatly speed up the design process by reducing the required hardware manufacturing iterations. The simulation-based design flow presented in this paper takes the entire MR imaging process into account. That is, it includes all geometric and material properties of the coil and the phantom, the thermal noise as well as the target MR sequences. The proposed simulation-driven design flow is validated using a manufactured prototype coil, whose performance was optimized regarding its SNR performance, based on the presented design flow, by comparing the coil's measured performance against the simulated results. In these experiments, the mean and the standard deviation of the relative error between the simulated and measured coil sensitivity pattern were found to be and . Moreover, the peak deviation between the simulated and measured voxel SNR was found to be less than 4%, indicating that simulations are in good accordance with the measured results, validating the proposed software-based design approach.

Characterisation of apical bone lesions: Comparison of MRI and CBCT with histological findings - a case series.

PURPOSE: The aim of this case series was to compare magnetic resonance imaging (MRI) with cone beam computed tomography (CBCT) in the representation of periapical osteolyses. Based on the histological findings, the potential of MRI for further lesion characterisation was investigated. MATERIALS AND METHODS: Thirteen patients (average age: 41 ±â€…27 years) with a total of 15 periapical lesions (five molars, five premolars, and five front teeth) were examined. Lesion characterisation was based on the homogeneity/heterogeneity of the lesions, the signal intensity within the lesion compared to the surrounding tissue and differences in the signal intensities between different MRI contrast weightings. Results were compared with CBCT and histological findings. RESULTS: Although all patients presented with dental restorations, such as fixed partial dentures and filling materials, all periapical lesions could be diagnosed with either imaging modality. Histologically, 13 cysts and two apical granuloma were confirmed. In CBCT, the similar appearance of all lesions did not allow any further characterisation. In MRI, radicular cysts and granuloma could be characterised by their appearance in the MRI images with different contrast weightings. The MRI-derived characterisations were consistent with the histological findings. CONCLUSIONS: The presented study shows that the application of multi-contrast MRI may lead to better characterisation of apical lesions, thus enabling an improved patient-specific selection of the optimal treatment option. Conflict-of-interest statement: MAG, ESS, and LKS do not report any potential conflict-of-interest; EH and JU are employees of Sirona Dental Systems; VR is receiving a research grant by Sirona Dental Systems.

A self-gating method for time-resolved imaging of nonuniform motion.

PURPOSE: To develop a self-gating method capable of assessing nonuniform motion, e.g., in cardiovascular magnetic resonance imaging of patients with severe arrhythmia, or for imaging of the temporomandibular joint. METHODS: The proposed method allows cyclic motion trajectories with a nonuniform pace by replacing the one-dimensional gating signal of conventional image-based self-gating with a two-dimensional gating matrix. The resulting image quality is compared with conventional self-gating and real-time MRI. RESULTS: Nonuniform self-gating resulted in superior image quality compared with conventional self-gating and the feasibility study showed significantly improved image sharpness (P < 0.01). Further, improvements in image quality were shown compared with golden angle radial parallel sparse MRI. CONCLUSION: A new self-gating method was proposed that allows cardiovascular magnetic resonance of arrhythmic patients, which is a common problem in clinical practice. Further, the proposed method enables self-gated imaging of the temporomandibular joint. Magn Reson Med 76:919-925, 2016. © 2015 Wiley Periodicals, Inc.

Golden ratio sparse MRI using tiny golden angles.

PURPOSE: The combination of fully balanced SSFP sequences with iterative golden angle radial sparse parallel (iGRASP) MRI leads to strong image artifacts due to eddy currents caused by the large angular increment of the golden angle ordering. The purpose of this work is to enable the combination of iterative golden angle radial sparse parallel MRI with balanced SSFP using the recently presented tiny golden angles. METHODS: The tiny golden angle trajectories are analyzed for their incoherence properties in relation to sparse imaging using the time-resolved point-spread functions. Tiny golden angle radial sparse parallel (tyGRASP) MRI is introduced and evaluated with applications in cardiac imaging and dynamic imaging of the temporomandibular joint. The results are analyzed in detail for 3 T and verified for 1.5 T. RESULTS: The incoherence properties of the tiny golden angle trajectory are comparable to the incoherence properties of the golden angle trajectory and are well suited for sparse MRI reconstruction. The proposed tiny golden angle radial sparse parallel MRI method strongly reduces eddy current related artifacts for both applications. CONCLUSION: This work enables sparse, golden-ratio-based imaging with balanced SSFP sequences. Magn Reson Med 75:2372-2378, 2016. © 2015 Wiley Periodicals, Inc.

Segmentation-free empirical beam hardening correction for CT.

PURPOSE: The polychromatic nature of the x-ray beams and their effects on the reconstructed image are often disregarded during standard image reconstruction. This leads to cupping and beam hardening artifacts inside the reconstructed volume. To correct for a general cupping, methods like water precorrection exist. They correct the hardening of the spectrum during the penetration of the measured object only for the major tissue class. In contrast, more complex artifacts like streaks between dense objects need other techniques of correction. If using only the information of one single energy scan, there are two types of corrections. The first one is a physical approach. Thereby, artifacts can be reproduced and corrected within the original reconstruction by using assumptions in a polychromatic forward projector. These assumptions could be the used spectrum, the detector response, the physical attenuation and scatter properties of the intersected materials. A second method is an empirical approach, which does not rely on much prior knowledge. This so-called empirical beam hardening correction (EBHC) and the previously mentioned physical-based technique are both relying on a segmentation of the present tissues inside the patient. The difficulty thereby is that beam hardening by itself, scatter, and other effects, which diminish the image quality also disturb the correct tissue classification and thereby reduce the accuracy of the two known classes of correction techniques. The herein proposed method works similar to the empirical beam hardening correction but does not require a tissue segmentation and therefore shows improvements on image data, which are highly degraded by noise and artifacts. Furthermore, the new algorithm is designed in a way that no additional calibration or parameter fitting is needed. METHODS: To overcome the segmentation of tissues, the authors propose a histogram deformation of their primary reconstructed CT image. This step is essential for the proposed algorithm to be segmentation-free (sf). This deformation leads to a nonlinear accentuation of higher CT-values. The original volume and the gray value deformed volume are monochromatically forward projected. The two projection sets are then monomially combined and reconstructed to generate sets of basis volumes which are used for correction. This is done by maximization of the image flatness due to adding additionally a weighted sum of these basis images. sfEBHC is evaluated on polychromatic simulations, phantom measurements, and patient data. The raw data sets were acquired by a dual source spiral CT scanner, a digital volume tomograph, and a dual source micro CT. Different phantom and patient data were used to illustrate the performance and wide range of usability of sfEBHC across different scanning scenarios. The artifact correction capabilities are compared to EBHC. RESULTS: All investigated cases show equal or improved image quality compared to the standard EBHC approach. The artifact correction is capable of correcting beam hardening artifacts for different scan parameters and scan scenarios. CONCLUSIONS: sfEBHC generates beam hardening-reduced images and is furthermore capable of dealing with images which are affected by high noise and strong artifacts. The algorithm can be used to recover structures which are hardly visible inside the beam hardening-affected regions.

A Small Surrogate for the Golden Angle in Time-Resolved Radial MRI Based on Generalized Fibonacci Sequences.

In golden angle radial magnetic resonance imaging a constant azimuthal radial profile spacing of 111.246...(°) guarantees a nearly uniform azimuthal profile distribution in k-space for an arbitrary number of radial profiles. Even though this profile order is advantageous for various real-time imaging methods, in combination with balanced steady-state free precession (SSFP) sequences the large azimuthal angle increment may lead to strong image artifacts, due to the varying eddy currents introduced by the rapidly switching gradient scheme. Based on a generalized Fibonacci sequence, a new sequence of smaller irrational angles is introduced ( 49.750...(°), 32.039...(°), 27.198...(°), 23.628...(°), ... ). The subsequent profile orders guarantee the same sampling efficiency as the golden angle if at least a minimum number of radial profiles is used for reconstruction. The suggested angular increments are applied for dynamic imaging of the heart and the temporomandibular joint. It is shown that for balanced SSFP sequences, trajectories using the smaller golden angle surrogates strongly reduce the image artifacts, while the free retrospective choice of the reconstruction window width is maintained.

Feasibility of ultra-short echo time (UTE) magnetic resonance imaging for identification of carious lesions.

The objective of this study was to investigate the potential of ultra short echo time imaging for the assessment of caries lesions and early demineralization. 12 patients with suspected caries lesions underwent a dental magnetic resonance imaging investigation comprising ultra short echo time imaging (echo time=50 µs) and spin echo imaging. Before the dental magnetic resonance imaging, all patients underwent a conventional clinical dental investigation including visual assessment of the teeth as well as dental x-ray imaging. All lesions identifiable in the x-ray could be clearly identified in the ultra short echo time images, but only about 19% of the lesions were visible in the spin echo images. In 19% of all lesions, the lesions could be more clearly delineated in the ultra short echo time images than in the x-ray images. This was especially the case for secondary lesions. In direct comparison with the x-ray images, all lesions appeared substantially larger in the dental magnetic resonance imaging data. The presented data provide evidence that caries lesions can be identified in ultra short echo time magnetic resonance imaging with high sensitivity. The apparent larger volume of the lesions in dental magnetic resonance imaging may be attributed to fluid accumulation in demineralized areas without substantial breakdown of mineral structures.