Deep learning-based single image super-resolution for low-field MR brain images.

Low-field MRI scanners are significantly less expensive than their high-field counterparts, which gives them the potential to make MRI technology more accessible all around the world. In general, images acquired using low-field MRI scanners tend to be of a relatively low resolution, as signal-to-noise ratios are lower. The aim of this work is to improve the resolution of these images. To this end, we present a deep learning-based approach to transform low-resolution low-field MR images into high-resolution ones. A convolutional neural network was trained to carry out single image super-resolution reconstruction using pairs of noisy low-resolution images and their noise-free high-resolution counterparts, which were obtained from the publicly available NYU fastMRI database. This network was subsequently applied to noisy images acquired using a low-field MRI scanner. The trained convolutional network yielded sharp super-resolution images in which most of the high-frequency components were recovered. In conclusion, we showed that a deep learning-based approach has great potential when it comes to increasing the resolution of low-field MR images.

Characterization of displacement forces and image artifacts in the presence of passive medical implants in low-field (<100 mT) permanent magnet-based MRI systems, and comparisons with clinical MRI systems.

PURPOSE: To investigate the displacement forces and image artifacts associated with passive medical implants for recently-developed low-field (<100 mT) MRI systems, and to compare these with values from higher field strengths used for clinical diagnosis. METHODS: Setups were constructed to measure displacement forces in a permanent magnet-based Halbach array used for in vivo MRI at 50 mT, and results compared with measurements at 7 T. Image artifacts were assessed using turbo (fast) spin echo imaging sequences for four different passive medical implants: a septal occluder, iliac stent, pedicle screw and (ferromagnetic) endoscopic clip. Comparisons were made with artifacts produced at 1.5, 3 and 7 T. Finally, specific absorption rate (SAR) simulations were performed to determine under what operating conditions the limits might be approached at low-field. RESULTS: Displacement forces at 50 mT on all but the ferromagnetic implant were between 1 and 10 mN. Image artifacts at 50 mT were much less than at clinical field strengths for all passive devices, and with the exception of the ferromagnetic clip. SAR simulations show that very long echo train (>128) turbo spin echo sequences can be run with short inter-pulse times (5-10 ms) within SAR limits. CONCLUSIONS: This work presents the first evaluation of the effects of passive implants at field strengths less than 100 mT in terms of displacement forces, image artifacts and SAR. The results support previous claims that such systems can be used safely and usefully in challenging enviroments such as the intensive care unit.

Performance of the Emprint and Amica Microwave Ablation Systems in ex vivo Porcine Livers: Sphericity and Reproducibility Versus Size.

PURPOSE: To investigate the performance of two microwave ablation (MWA) systems regarding ablation volume, ablation shape and variability. MATERIALS AND METHODS: In this ex vivo study, the Emprint and Amica MWA systems were used to ablate porcine livers at 4 different settings of time and power (3 and 5 minutes at 60 and 80 Watt). In total, 48 ablations were analysed for ablation size and shape using Vitrea Advanced Visualization software after acquisition of a 7T MRI scan. RESULTS: Emprint ablations were smaller (11,1 vs. 21,1 mL p < 0.001), more spherical (sphericity index of 0.89 vs. 0.59 p < 0.001) and showed less variability than Amica ablations. In both systems, longer ablation time and higher power resulted in significantly larger ablation volumes. CONCLUSION: Emprint ablations were more spherical, and the results showed a lower variability than those of Amica ablations. This comes at the price of smaller ablation volumes.

Three-dimensional MRI in a homogenous 27 cm diameter bore Halbach array magnet.

Modern clinical MRI systems utilise very high magnetic fields strengths to produce high resolution images of the human body. The high up-front and maintenance cost of these systems means that much of the world lacks access to this technology. In this paper we propose a low cost, head-only, homogenous Halbach magnet array with the potential for paediatric neuroimaging in low-resource settings. The homogeneity of the Halbach array is improved by allowing the diameter of the Halbach array to vary along its length, and also adding smaller internal shim magnets. The constructed magnet has a bore diameter of 27 cm, mean B0 field strength of 50.4 mT and a homogeneity of 2400 ppm over a 20 cm diameter spherical volume. The level of homogeneity of the system means that coil-based gradients can be used for spatial encoding which greatly increases the flexibility in image acquisition. 3D images of a "brain phantom" were acquired over a 22 × 22 × 22 cm field of view with a 3.5 mm isotropic resolution using a spin-echo sequence. Future development of a low-cost gradient amplifier and an open-source spectrometer has the potential of offering a fully open-source, low-cost MRI system for paediatric neuroimaging in low-resource settings.

High-Permittivity Pad Design for Dielectric Shimming in Magnetic Resonance Imaging Using Projection-Based Model Reduction and a Nonlinear Optimization Scheme.

Inhomogeneities in the transmit radio frequency magnetic field ( ) reduce the quality of magnetic resonance (MR) images. This quality can be improved by using high-permittivity pads that tailor the fields. The design of an optimal pad is application-specific and not straightforward and would therefore benefit from a systematic optimization approach. In this paper, we propose such a method to efficiently design dielectric pads. To this end, a projection-based model order reduction technique is used that significantly decreases the dimension of the design problem. Subsequently, the resulting reduced-order model is incorporated in an optimization method in which a desired field in a region of interest can be set. The method is validated by designing a pad for imaging the cerebellum at 7 T. The optimal pad that is found is used in an MR measurement to demonstrate its effectiveness in improving the image quality.

Spatially localized phosphorous metabolism of skeletal muscle in Duchenne muscular dystrophy patients: 24-month follow-up.

OBJECTIVES: To assess the changes in phosphodiester (PDE)-levels, detected by 31P magnetic resonance spectroscopy (MRS), over 24-months to determine the potential of PDE as marker for muscle tissue changes in Duchenne Muscular Dystrophy (DMD) patients. METHODS: Spatially resolved phosphorous datasets were acquired in the right lower leg of 18 DMD patients (range: 5-15.4 years) and 12 age-matched healthy controls (range: 5-14 years) at three time-points (baseline, 12-months, and 24-months) using a 7T MR-System (Philips Achieva). 3-point Dixon images were acquired at 3T (Philips Ingenia) to determine muscle fat fraction. Analyses were done for six muscles that represent different stages of muscle wasting. Differences between groups and time-points were assessed with non-parametric tests with correction for multiple comparisons. Coefficient of variance (CV) were determined for PDE in four healthy adult volunteers in high and low signal-to-noise ratio (SNR) datasets. RESULTS: PDE-levels were significantly higher (two-fold) in DMD patients compared to controls in all analyzed muscles at almost every time point and did not change over the study period. Fat fraction was significantly elevated in all muscles at all time points compared to healthy controls, and increased significantly over time, except in the tibialis posterior muscle. The mean within subject CV for PDE-levels was 4.3% in datasets with high SNR (>10:1) and 5.7% in datasets with low SNR. DISCUSSION AND CONCLUSION: The stable two-fold increase in PDE-levels found in DMD patients in muscles with different levels of muscle wasting over 2-year time, including DMD patients as young as 5.5 years-old, suggests that PDE-levels may increase very rapidly early in the disease process and remain elevated thereafter. The low CV values in high and low SNR datasets show that PDE-levels can be accurately and reproducibly quantified in all conditions. Our data confirms the great potential of PDE as a marker for muscle tissue changes in DMD patients.

Non-uniform muscle fat replacement along the proximodistal axis in Duchenne muscular dystrophy.

The progressive replacement of muscle tissue by fat in Duchenne muscular dystrophy (DMD) has been studied using quantitative MRI between, but not within, individual muscles. We studied fat replacement along the proximodistal muscle axis using the Dixon technique on a 3T MR scanner in 22 DMD patients and 12 healthy controls. Mean fat fractions per muscle per slice for seven lower and upper leg muscles were compared between and within groups assuming a parabolic distribution. Average fat fraction for a small central slice stack and a large coverage slice stack were compared to the value when the stack was shifted one slice (15 mm) up or down. Higher fat fractions were observed in distal and proximal muscle segments compared to the muscle belly in all muscles of the DMD subjects (p <0.001). A shift of 15 mm resulted in a difference in mean fat fraction which was on average 1-2% ranging up to 12% (p <0.01). The muscle end regions are exposed to higher mechanical strain, which points towards mechanical disruption of the sarcolemma as one of the key factors in the pathophysiology. Overall, this non-uniformity in fat replacement needs to be taken into account to prevent sample bias when applying quantitative MRI as biomarker in clinical trials for DMD.

Elevated phosphodiester and T2 levels can be measured in the absence of fat infiltration in Duchenne muscular dystrophy patients.

Quantitative MRI and MRS are increasingly important as non-invasive outcome measures in therapy development for Duchenne muscular dystrophy (DMD). Many studies have focussed on individual measures such as fat fraction and metabolite levels in relation to age and functionality, but much less attention has been given to how these indices relate to each other. Here, we assessed spatially resolved metabolic changes in leg muscles of DMD patients, and classified muscles according to the degree of fat replacement compared with healthy controls. Quantitative MRI (three-point Dixon and multi-spin echo without fat suppression and a tri-exponential fit) and 2D-CSI 31 P MRS scans were obtained from 18 DMD patients and 12 healthy controls using a 3 T and a 7 T MR scanner. Metabolite levels, T2 values and fat fraction were individually assessed for five lower leg muscles. In muscles with extensive fat replacement, phosphodiester over adenosine triphosphate (PDE/ATP), inorganic phosphate over phosphocreatine, intracellular tissue pH and T2 were significantly increased compared with healthy controls. In contrast, in muscles without extensive fat replacement, only PDE/ATP and T2 values were significantly elevated. Overall, our results show that PDE levels and T2 values increase prior to the occurrence of fat replacement and remain elevated in later stages of the disease. This suggests that these individual measures could not only function as early markers for muscle damage but also reflect potentially reversible pathology in the more advanced stages.

Practical improvements in the design of high permittivity pads for dielectric shimming in neuroimaging at 7T.

Improvements are proposed for practical design and use of high permittivity materials in high field neuroimaging in three different areas: (i) a simple formula to predict the permittivity of tri-component aqueous-based perovskite suspensions with relative permittivities between 110 and 300, (ii) characterization of addition of a hydroxyethyl-cellulose gelling agent to improve the long-term stability and material properties of "dielectric pads", and (iii) investigation of the integration of, for example, headphones into the dielectric pads to increase patient comfort within tightly-fitting receive coil arrays.

The technological future of 7 T MRI hardware.

In this article we present our projections of future hardware developments on 7 T human MRI systems. These include compact cryogen-light magnets, improved gradient performance, integrated RF-receive and direct current shimming coil arrays, new RF technology with adaptive impedance matching, patient-specific specific absorption rate estimation and monitoring, and increased integration of physiological monitoring systems. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluation of plasma-based transmit coils for magnetic resonance.

In this work a new concept for designing transmit coils for magnetic resonance using a plasma is introduced. Unlike conventional coils, a plasma can be turned on and off, eliminating electrical interactions between coils, and enabling radiofrequency-invisibility when desired. A surfatron has been designed to produce a surface-mode wave which propagates along the inner surface of a commercial fluorescent lighting tube. NMR spectra and images have been produced using the plasma as the transmit coil and a copper-based monopole to receive the signal. The transmit efficiency of the plasma tube was estimated, and is currently much lower than that of an equivalently-sized metal-based structure: however, there are many potential methods for increasing the efficiency using a custom-built plasma tube.

Evaluation of skeletal muscle DTI in patients with duchenne muscular dystrophy.

Diffusion tensor imaging (DTI) is a popular method to assess differences in fiber organization in diseased and healthy muscle tissue. Previous work has shown that muscle DTI measurements depend on signal-to-noise ratio (SNR), %fat, and tissue T2. The goal of this study was to evaluate the potential biasing effects of these factors on skeletal muscle DTI data in patients with Duchenne Muscular Dystrophy (DMD). MR images were obtained of the right lower leg of 21 DMD patients and 12 healthy controls on a Philips 3T system. DTI measurements were combined with quantitative in-vivo measures of mean water T2, %fat and SNR to evaluate their effect on DTI parameter estimation. All outcome measures were determined within ROIs drawn for six lower leg muscles. Between group analysis, using all ROIs, revealed a significantly elevated FA in the GCL, SOL and PER muscles (p<0.05) and an increased mean diffusivity (p<0.05) and λ3 (p<0.05) in the TA muscle of DMD patients. In-vivo evaluation of the individual confounders showed behaviour in line with predictions from previous simulation work. To account for these confounders, subsequent analysis used only ROIs with SNR greater than 20. With this criterion we found significantly greater MD in the TA muscle of DMD patient (p<0.009) and λ3 in the TA and GCL muscles (p<0.001) of DMD patients, but no differences in FA. As both increased %fat and lower SNR are expected to reduce the apparent MD and λ3, these between-group differences are likely due to pathophysiology. However, the increased FA, observed when using all ROIs, likely reflects the effect of low SNR and %fat on the DTI parameter estimation. These findings suggest that measuring mean water T2, %fat and SNR is essential to ascribe changes in DTI measures to intrinsic diffusion changes or to confounding influences.

Visualization of human inner ear anatomy with high-resolution MR imaging at 7T: initial clinical assessment.

BACKGROUND AND PURPOSE: In many centers, MR imaging of the inner ear and auditory pathway performed on 1.5T or 3T systems is part of the preoperative work-up of cochlear implants. We investigated the applicability of clinical inner ear MR imaging at 7T and compared the visibility of inner ear structures and nerves within the internal auditory canal with images acquired at 3T. MATERIALS AND METHODS: Thirteen patients with sensorineural hearing loss eligible for cochlear implantation underwent examinations on 3T and 7T scanners. Two experienced head and neck radiologists evaluated the 52 inner ear datasets. Twenty-four anatomic structures of the inner ear and 1 overall score for image quality were assessed by using a 4-point grading scale for the degree of visibility. RESULTS: The visibility of 11 of the 24 anatomic structures was rated higher on the 7T images. There was no significant difference in the visibility of 13 anatomic structures and the overall quality rating. A higher incidence of artifacts was observed in the 7T images. CONCLUSIONS: The gain in SNR at 7T yielded a more detailed visualization of many anatomic structures, especially delicate ones, despite the challenges accompanying MR imaging at a high magnetic field.

Quantifying the effects of inactin vs Isoflurane anesthesia on gastrointestinal motility in rats using dynamic magnetic resonance imaging and spatio-temporal maps.

BACKGROUND: Anesthetics are commonly applied in animal studies of gastrointestinal (GI) function. Different anesthetics alter smooth-muscle motility in different ways. The aim of this study is to quantify and compare non-invasively with magnetic resonance imaging (MRI) the motility patterns of the rat gut when anesthetized with inactin vs isoflurane anesthetics in the fed state. METHODS: Rats were given an oral gavage of MRI contrast agent for improved visualization of the GI tract. Two-dimensional images through the jejunum of the pre- and postanesthetized rat in the fed state were acquired every 168 ms. Image registration, segmentation, and postprocessing algorithms were applied to produce spatio-temporal maps that were used to quantify peristaltic and segmental motions in the jejunum region interspersed between periods of inactivity. KEY RESULTS: There were significantly longer periods of inactivity in the rats treated with isoflurane than in those treated with inactin (179.9 ± 22.4 s vs 17.7 ± 10.3 s). The speed of propagation and wavelength of peristalsis, and the frequency and speed of pattern switching of segmental motility, were higher (p < 0.05) in rats treated with inactin. CONCLUSIONS & INFERENCES: Isoflurane and inactin anesthetics produce significantly different motility behavior with the rat's GI tract in the fed state. Isoflurane anesthetic, results in a reduced frequency of occurrence of motility periods and an overall reduced level of motility in comparison with inactin.

A multi-purpose open-source triggering platform for magnetic resonance.

Many MR scans need to be synchronised with external events such as the cardiac or respiratory cycles. For common physiological functions commercial trigger equipment exists, but for more experimental inputs these are not available. This paper describes the design of a multi-purpose open-source trigger platform for MR systems. The heart of the system is an open-source Arduino Due microcontroller. This microcontroller samples an analogue input and digitally processes these data to determine the trigger. The output of the microcontroller is programmed to mimic a physiological signal which is fed into the electrocardiogram (ECG) or pulse oximeter port of MR scanner. The microcontroller is connected to a Bluetooth dongle that allows wireless monitoring and control outside the scanner room. This device can be programmed to generate a trigger based on various types of input. As one example, this paper describes how it can be used as an acoustic cardiac triggering unit. For this, a plastic stethoscope is connected to a microphone which is used as an input for the system. This test setup was used to acquire retrospectively-triggered cardiac scans in ten volunteers. Analysis showed that this platform produces a reliable trigger (>99% triggers are correct) with a small average 8 ms variation between the exact trigger points.

Muscle MRS detects elevated PDE/ATP ratios prior to fatty infiltration in Becker muscular dystrophy.

Becker muscular dystrophy (BMD) is characterized by progressive muscle weakness. Muscles show structural changes (fatty infiltration, fibrosis) and metabolic changes, both of which can be assessed using MRI and MRS. It is unknown at what stage of the disease process metabolic changes arise and how this might vary for different metabolites. In this study we assessed metabolic changes in skeletal muscles of Becker patients, both with and without fatty infiltration, quantified via Dixon MRI and (31) P MRS. MRI and (31) P MRS scans were obtained from 25 Becker patients and 14 healthy controls using a 7 T MR scanner. Five lower-leg muscles were individually assessed for fat and muscle metabolite levels. In the peroneus, soleus and anterior tibialis muscles with non-increased fat levels, PDE/ATP ratios were higher (P < 0.02) compared with controls, whereas in all muscles with increased fat levels PDE/ATP ratios were higher compared with healthy controls (P ≤ 0.05). The Pi /ATP ratio in the peroneus muscles was higher in muscles with increased fat fractions (P = 0.005), and the PCr/ATP ratio was lower in the anterior tibialis muscles with increased fat fractions (P = 0.005). There were no other significant changes in metabolites, but an increase in tissue pH was found in all muscles of the total group of BMD patients in comparison with healthy controls (P < 0.05). These findings suggest that (31) P MRS can be used to detect early changes in individual muscles of BMD patients, which are present before the onset of fatty infiltration.

An eight-channel transmit/receive array of TE01 mode high permittivity ceramic resonators for human imaging at 7T.

This study describes the design, construction and operation of a new type of transmit/receive array using ceramic resonators operating in a transverse electromagnetic (TE) mode. Single element function and performance at 298.1MHz (7T) are analyzed and compared to a lumped element design loop coil with comparable geometry. The results show that ceramic resonators working in the TE01δ mode configuration produce similar efficiency, defined as the transmit magnetic field (B1(+)) per square root of the specific absorption rate (SAR), to conventional surface coils. An array consisting of eight ceramic elements was then designed to operate in transmit/receive mode. This array was driven via power/phase splitters by two independent transmit channels and functional cardiac images were produced from a number of healthy volunteers.

MR-monitored focused ultrasound using the acoustic-coupling water bath as an intrinsic high-mode dielectric resonator.

The conventional set-up for MR-monitored focused ultrasound surgery includes a piezoelectric transducer and an acoustic-coupling water bath integrated into the MR patient table; a large surface RF coil is placed close to the patient or, alternatively, the body coil is used as the MR receiver. Potential disadvantages of this approach are that the body coil has low sensitivity because of its low filling factor and the local RF coil can interfere with and cause reflections of the ultrasound irradiation. In this article, a completely new approach is presented, in which an MR transmit/receive coil is not needed at all. Instead, the dimensions of the water bath are adjusted so that a high-order dielectric mode is excited, resulting in efficient MR excitation and reception at the transducer focal point. An example of monitoring ultrasound-mediated heating in a phantom is shown on a 7-T human system, although the new method can also be applied at lower fields.

Quantitative MRI and strength measurements in the assessment of muscle quality in Duchenne muscular dystrophy.

The purpose of this study was to assess leg muscle quality and give a detailed description of leg muscle involvement in a series of Duchenne muscular dystrophy patients using quantitative MRI and strength measurements. Fatty infiltration, as well as total and contractile (not fatty infiltrated) cross sectional areas of various leg muscles were determined in 16 Duchenne patients and 11 controls (aged 8-15). To determine specific muscle strength, four leg muscle groups (quadriceps femoris, hamstrings, anterior tibialis and triceps surae) were measured and related to the amount of contractile tissue. In patients, the quadriceps femoris showed decreased total and contractile cross sectional area, attributable to muscle atrophy. The total, but not the contractile, cross sectional area of the triceps surae was increased in patients, corresponding to hypertrophy. Specific strength decreased in all four muscle groups of Duchenne patients, indicating reduced muscle quality. This suggests that muscle hypertrophy and fatty infiltration are two distinct pathological processes, differing between muscle groups. Additionally, the quality of remaining muscle fibers is severely reduced in the legs of Duchenne patients. The combination of quantitative MRI and quantitative muscle testing could be a valuable outcome parameter in longitudinal studies and in the follow-up of therapeutic effects.