Highly efficient image navigator based 3D whole-heart cardiac MRA at 0.55T.

PURPOSE: To develop and evaluate a highly efficient free-breathing and contrast-agent-free three-dimensional (3D) whole-heart Cardiac Magnetic Resonance Angiography (CMRA) sequence at 0.55T. METHODS: Free-breathing whole-heart CMRA has been previously proposed at 1.5 and 3T. Direct application of this sequence to 0.55T is not possible due to changes in the magnetic properties of the tissues. To enable free-breathing CMRA at 0.55T, pulse sequence design and acquisition parameters of a previously proposed whole-heart CMRA framework are optimized via Bloch simulations. Image navigators (iNAVs) are used to enable nonrigid respiratory motion-correction and 100% respiratory scan efficiency. Patch-based low-rank denoising is employed to accelerate the scan and account for the reduced signal-to-noise ratio at 0.55T. The proposed approach was evaluated on 11 healthy subjects. Image quality was assessed by a clinical expert (1: poor to 5: excellent) for all intrapericardiac structures. Quantitative evaluation was performed by assessing the vessel sharpness of the proximal right coronary artery (RCA). RESULTS: Optimization resulted in an imaging flip angle of 11 0 ∘ $$ 11{0}^{\circ } $$ , fat saturation flip angle of 18 0 ∘ $$ 18{0}^{\circ } $$ , and six k-space lines for iNAV encoding. The relevant cardiac structures and main coronary arteries were visible in all subjects, with excellent image quality (mean 4 . 9 / 5 . 0 $$ 4.9/5.0 $$ ) and minimal artifacts (mean 4 . 9 / 5 . 0 $$ 4.9/5.0 $$ ), with RCA vessel sharpness ( 50 . 3 % ± 9 . 8 % $$ 50.3\%\pm 9.8\% $$ ) comparable to previous studies at 1.5T. CONCLUSION: The proposed approach enables 3D whole-heart CMRA at 0.55T in a 6-min scan ( 5 . 9 ± 0 . 7 min $$ 5.9\pm 0.7\;\min $$ ), providing excellent image quality, minimal artifacts, and comparable vessel sharpness to previous 1.5T studies. Future work will include the evaluation of the proposed approach in patients with cardiovascular disease.

Spatiotemporal encoding MRI in a portable low-field system.

PURPOSE: Demonstrate the potential of spatiotemporal encoding (SPEN) MRI to deliver largely undistorted 2D, 3D, and diffusion weighted images on a 110 mT portable system. METHODS: SPEN's quadratic phase modulation was used to subsample the low-bandwidth dimension of echo planar acquisitions, delivering alias-free images with an enhanced immunity to image distortions in a laboratory-built, low-field, portable MRI system lacking multiple receivers. RESULTS: Healthy brain images with different SPEN time-bandwidth products and subsampling factors were collected. These compared favorably to EPI acquisitions including topup corrections. Robust 3D and diffusion weighted SPEN images of diagnostic value were demonstrated, with 2.5 mm isotropic resolutions achieved in 3 min scans. This performance took advantage of the low specific absorption rate and relative long TEs associated with low-field MRI. CONCLUSION: SPEN MRI provides a robust and advantageous fast acquisition approach to obtain faithful 3D images and DWI data in low-cost, portable, low-field systems without parallel acceleration.

Diffusion tensor brain imaging at 0.55T: A feasibility study.

PURPOSE: To investigate the feasibility of diffusion tensor brain imaging at 0.55T with comparisons against 3T. METHODS: Diffusion tensor imaging data with 2 mm isotropic resolution was acquired on a cohort of five healthy subjects using both 0.55T and 3T scanners. The signal-to-noise ratio (SNR) of the 0.55T data was improved using a previous SNR-enhancing joint reconstruction method that jointly reconstructs the entire set of diffusion weighted images from k-space using shared-edge constraints. Quantitative diffusion tensor parameters were estimated and compared across field strengths. We also performed a test-retest assessment of repeatability at each field strength. RESULTS: After applying SNR-enhancing joint reconstruction, the diffusion tensor parameters obtained from 0.55T data were strongly correlated ( R 2 ≥ 0 . 70 $$ {R}^2\ge 0.70 $$ ) with those obtained from 3T data. Test-retest analysis showed that SNR-enhancing reconstruction improved the repeatability of the 0.55T diffusion tensor parameters. CONCLUSION: High-resolution in vivo diffusion MRI of the human brain is feasible at 0.55T when appropriate noise-mitigation strategies are applied.

A new approach for multislice spatiotemporal encoding MRI in a portable low-field system.

PURPOSE: Spatiotemporal encoding (SPEN) MRI offers a unique alternative to address image distortion problems in echo planar acquisition-based techniques, at portable low-field systems that lack multiple receiver coils. However, existing 2-π multislice SPEN schemes fail to keep consistent SNRs and contrasts with different numbers of slice settings. This work proposes a new multislice SPEN scheme (SPENms) to achieve stable quality imaging in portable low-field MRI systems. METHODS: The proposed SPENms includes the insertion of one selective π pulse and one non-selective π pulse, closely arranged together, before the frequency-swept π pulse in the original 2D SPEN sequence. Theoretical simulations and experiments on phantoms and human brains were conducted to validate its SNR and contrast performances under different parameters compared to the existing 2-π multislice SPEN scheme. RESULTS: Both simulations and experiments demonstrate the consistent image quality of SPENms with different scanning parameters and targets, as well as good distortion resistance and scan efficiency. Robust diffusion weighted multislice SPEN images of diagnostic value were also highlighted. CONCLUSION: SPENms provides a robust fast echo planar acquisition approach to obtain multislice 2D images with less distortions, consistent SNRs and contrasts at portable low-field MRI systems.

Increasing the scan-efficiency of pulmonary imaging at 0.55 T using iterative concomitant field and motion-corrected reconstruction.

PURPOSE: To develop an iterative concomitant field and motion corrected (iCoMoCo) reconstruction for isotropic high-resolution UTE pulmonary imaging at 0.55 T. METHODS: A free-breathing golden-angle stack-of-spirals UTE sequence was used to acquire data for 8 min with prototype and commercial 0.55 T MRI scanners. The data was binned into 12 respiratory phases based on superior-inferior navigator readouts. The previously published iterative motion corrected (iMoCo) reconstruction was extended to include concomitant field correction directly in the cost function. The reconstruction was implemented within the Gadgetron framework for inline reconstruction. Data were retrospectively reconstructed to simulate scan times of 2, 4, 6, and 8 min. Image quality was assessed using apparent SNR and image sharpness. The technique was evaluated in healthy volunteers and patients with known lung pathology including coronavirus disease 2019 infection, chronic granulomatous disease, lymphangioleiomyomatosis, and lung nodules. RESULTS: The technique provided diagnostic-quality images, and image quality was maintained with a slight loss in SNR for simulated scan times down to 4 min. Parenchymal apparent SNR was 4.33 ± 0.57, 5.96 ± 0.65, 7.36 ± 0.64, and 7.87 ± 0.65 using iCoMoCo with scan times of 2, 4, 6, and 8 min, respectively. Image sharpness at the diaphragm was comparable between iCoMoCo and reference images. Concomitant field corrections visibly improved the sharpness of anatomical structures away from the isocenter. Inline image reconstruction and artifact correction were achieved in <5 min. CONCLUSION: The proposed iCoMoCo pulmonary imaging technique can generate diagnostic quality images with 1.75 mm isotropic resolution in less than 5 min using a 6-min acquisition, on a 0.55 T scanner.

Elliptical Halbach magnet and gradient modules for low-field portable magnetic resonance imaging.

This study aims to develop methods to design the complete magnetic system for a truly portable MRI scanner for neurological and musculoskeletal (MSK) applications, optimized for field homogeneity, field of view (FoV), and gradient performance compared to existing low-weight configurations. We explore optimal elliptic-bore Halbach configurations based on discrete arrays of permanent magnets. In this way, we seek to improve the field homogeneity and remove constraints to the extent of the gradient coils typical of Halbach magnets. Specifically, we have optimized a tightly packed distribution of magnetic Nd2Fe14B cubes with differential evolution algorithms and a second array of shimming magnets with interior point and differential evolution methods. We have also designed and constructed an elliptical set of gradient coils that extend over the whole magnet length, maximizing the distance between the lobe centers. These are optimized with a target field method minimizing a cost function that considers also heat dissipation. We have employed the new toolbox to build the main magnet and gradient modules for a portable MRI scanner designed for point-of-care and residential use. The elliptical Halbach bore has semi-axes of 10 and 14& cm, and the magnet generates a field of 87& mT homogeneous down to 5700& ppm (parts per million) in a 20-cm diameter FoV; it weighs 216& kg and has a width of 65& cm and a height of 72& cm. Gradient efficiencies go up to around 0.8& mT/m/A, for a maximum of 12& mT/m within 0.5& ms with 15& A and 15& V amplifier. The distance between lobes is 28& cm, significantly increased with respect to other Halbach-based scanners. Heat dissipation is around 25& W at maximum power, and gradient deviations from linearity are below 20% in a 20-cm sphere. Elliptic-bore Halbach magnets enhance the ergonomicity and field distribution of low-cost portable MRI scanners, while allowing for full-length gradient support to increase the FoV. This geometry can be potentially adapted for a prospective low-cost whole-body technology.

Linear Bloch-Siegert phase-encoded low-field MRI: RF coils, pulse sequence, and image reconstruction.

Conventional B 0 $$ {B}_0 $$ gradient systems have several weaknesses including high cost and bulk. As a step towards addressing these while providing new degrees of freedom for spatial encoding and system design in Magnetic Resonance Imaging (MRI), a radio frequency (RF) gradient encoding system and pulse sequence for phase encoding using the Bloch-Siegert (BS) shift were developed. Optimized BS spatial encoding coils with bucking windings (counter-wound loops) were designed and constructed, along with compatible homogeneous imaging coils for excitation and signal reception. Two coil systems were developed: one for phantom imaging and a second for human wrist imaging. BS phase-encoded imaging and BS RF pulse simulations were performed. Pulse sequences were designed for linear stepping in k-space and implemented on a 47.5-mT scanner to image resolution phantoms in both coil setups. Reconstructions were performed using both the full B 1 + $$ {B}_1^{+} $$ -based encoding fields for each BS pulse amplitude and using inverse discrete Fourier transforms. A B 0 $$ {B}_0 $$ gradient was used for frequency encoding during signal readout, and the third axis was projected. Specific absorption ratio (SAR) calculations were performed for the wrist coil to determine the safety of BS-based RF encoding for B 0 $$ {B}_0 $$ fields in the low field MRI regime. The optimized RF spatial encoding coils resulted in higher linearity ( R 2 = 0.9981 $$ {R}^2=0.9981 $$ and 0.9921 in the phantom and wrist coils, respectively) than coils used in previous work. The phantom and wrist imaging coils were validated in simulations and experimentally to produce a peak B 1 + = 1.35 $$ {B}_1^{+}=1.35 $$ G and 0.8 G with 12-W input power, respectively, in the field-of-view (length = 11 cm) used for imaging. Nominal imaging resolutions of 5.22 and 7.21 mm were, respectively, achieved by the two-coil systems in the RF phase-encoded dimension. Coil systems, pulse sequences, and image reconstructions were developed for linear RF phase encoding using the BS shift and validated using a 47.5-mT open low field scanner, establishing a key component required for B 0 $$ {B}_0 $$  gradient-free imaging at low B 0 $$ {B}_0 $$  field strengths.

Feasibility of 3D MRI fingerprinting for rapid knee cartilage T1, T2, and T1ρ mapping at 0.55T: Comparison with 3T.

Low-field strength scanners present an opportunity for more inclusive imaging exams and bring several challenges including lower signal-to-noise ratio (SNR) and longer scan times. Magnetic resonance fingerprinting (MRF) is a rapid quantitative multiparametric method that can enable multiple quantitative maps simultaneously. To demonstrate the feasibility of an MRF sequence for knee cartilage evaluation in a 0.55T system we performed repeatability and accuracy experiments with agar-gel phantoms. Additionally, five healthy volunteers (age 32 ± 4 years old, 2 females) were scanned at 3T and 0.55T. The MRI acquisition protocols include a stack-of-stars T1ρ-enabled MRF sequence, a VIBE sequence with variable flip angles (VFA) for T1 mapping, and fat-suppressed turbo flash (TFL) sequences for T2 and T1ρ mappings. Double-Echo steady-state (DESS) sequence was also used for cartilage segmentation. Acquisitions were performed at two different field strengths, 0.55T and 3T, with the same sequences but protocols were slightly different to accommodate differences in signal-to-noise ratio and relaxation times. Cartilage segmentation was done using five compartments. T1, T2, and T1ρ values were measured in the knee cartilage using both MRF and conventional relaxometry sequences. The MRF sequence demonstrated excellent repeatability in a test-retest experiment with model agar-gel phantoms, as demonstrated with correlation and Bland-Altman plots. Underestimation of T1 values was observed on both field strengths, with the average global difference between reference values and the MRF being 151 ms at 0.55T and 337 ms at 3T. At 0.55T, MRF measurements presented significant biases but strong correlations with the reference measurements. Although a larger error was present in T1 measurements, MRF measurements trended similarly to the conventional measurements for human subjects and model agar-gel phantoms.

MRI at low field: A review of software solutions for improving SNR.

Low magnetic field magnetic resonance imaging (MRI) ( B 0 $$ {B}_0 $$  < 1 T) is regaining interest in the magnetic resonance (MR) community as a complementary, more flexible, and cost-effective approach to MRI diagnosis. Yet, the impaired signal-to-noise ratio (SNR) per square root of time, or SNR efficiency, leading in turn to prolonged acquisition times, still challenges its relevance at the clinical level. To address this, researchers investigate various hardware and software solutions to improve SNR efficiency at low field, including the leveraging of latest advances in computing hardware. However, there may not be a single recipe for improving SNR at low field, and it is key to embrace the challenges and limitations of each proposed solution. In other words, suitable solutions depend on the final objective or application envisioned for a low-field scanner and, more importantly, on the characteristics of a specific low B 0 $$ {B}_0 $$ field. In this review, we aim to provide an overview on software solutions to improve SNR efficiency at low field. First, we cover techniques for efficient k-space sampling and reconstruction. Then, we present post-acquisition techniques that enhance MR images such as denoising and super-resolution. In addition, we summarize recently introduced electromagnetic interference cancellation approaches showing great promises when operating in shielding-free environments. Finally, we discuss the advantages and limitations of these approaches that could provide directions for future applications.

Evaluation of 12-lead electrocardiogram at 0.55T for improved cardiac monitoring in magnetic resonance imaging.

BACKGROUND: The 12-lead electrocardiogram (ECG) is a standard diagnostic tool for monitoring cardiac ischemia and heart rhythm during cardiac interventional procedures and stress testing. These procedures can benefit from magnetic resonance imaging (MRI) information; however, the MRI scanner magnetic field leads to ECG distortion that limits ECG interpretation. This study evaluated the potential for improved ECG interpretation in a "low field" 0.55T MRI scanner. METHODS: The 12-lead ECGs were recorded inside 0.55T, 1.5T, and 3T MRI scanners, as well as at scanner table "home" position in the fringe field and outside the scanner room (seven pigs). To assess interpretation of ischemic ECG changes in a 0.55T MRI scanner, ECGs were recorded before and after coronary artery occlusion (seven pigs). ECGs was also recorded for five healthy human volunteers in the 0.55T scanner. ECG error and variation were assessed over 2-minute recordings for ECG features relevant to clinical interpretation: the PR interval, QRS interval, J point, and ST segment. RESULTS: ECG error was lower at 0.55T compared to higher field scanners. Only at 0.55T table home position, did the error approach the guideline recommended 0.025 mV ceiling for ECG distortion (median 0.03 mV). At scanner isocenter, only in the 0.55T scanner did J point error fall within the 0.1 mV threshold for detecting myocardial ischemia (median 0.03 mV in pigs and 0.06 mV in healthy volunteers). Correlation of J point deviation inside versus outside the 0.55T scanner following coronary artery occlusion was excellent at scanner table home position (r2 = 0.97), and strong at scanner isocenter (r2 = 0.92). CONCLUSION: ECG distortion is improved in 0.55T compared to 1.5T and 3T MRI scanners. At scanner home position, ECG distortion at 0.55T is low enough that clinical interpretation appears feasible without need for more cumbersome patient repositioning. At 0.55T scanner isocenter, ST segment changes during coronary artery occlusion appear detectable but distortion is enough to obscure subtle ST segment changes that could be clinically relevant. Reduced ECG distortion in 0.55T scanners may simplify the problem of suppressing residual distortion by ECG cable positioning, averaging, and filtering and could reduce current restrictions on ECG monitoring during interventional MRI procedures.

Evaluation of epilepsy lesion visualisation enhancement in low-field MRI using image quality transfer: a preliminary investigation of clinical potential for applications in developing countries.

PURPOSE: Low-field (LF) MRI scanners are common in many Low- and middle-Income countries, but they provide images with worse spatial resolution and contrast than high-field (HF) scanners. Image Quality Transfer (IQT) is a machine learning framework to enhance images based on high-quality references that has recently adapted to LF MRI. In this study we aim to assess if it can improve lesion visualisation compared to LF MRI scans in children with epilepsy. METHODS: T1-weighted, T2-weighted and FLAIR were acquired from 12 patients (5 to 18 years old, 7 males) with clinical diagnosis of intractable epilepsy on a 0.36T (LF) and a 1.5T scanner (HF). LF images were enhanced with IQT. Seven radiologists blindly evaluated the differentiation between normal grey matter (GM) and white matter (WM) and the extension and definition of epileptogenic lesions in LF, HF and IQT-enhanced images. RESULTS: When images were evaluated independently, GM-WM differentiation scores of IQT outputs were 26% higher, 17% higher and 12% lower than LF for T1, T2 and FLAIR. Lesion definition scores were 8-34% lower than LF, but became 3% higher than LF for FLAIR and T1 when images were seen side by side. Radiologists with expertise at HF scored IQT images higher than those with expertise at LF. CONCLUSION: IQT generally improved the image quality assessments. Evaluation of pathology on IQT-enhanced images was affected by familiarity with HF/IQT image appearance. These preliminary results show that IQT could have an important impact on neuroradiology practice where HF MRI is not available.

New clinical opportunities of low-field MRI: heart, lung, body, and musculoskeletal.

Contemporary whole-body low-field MRI scanners (< 1 T) present new and exciting opportunities for improved body imaging. The fundamental reason is that the reduced off-resonance and reduced SAR provide substantially increased flexibility in the design of MRI pulse sequences. Promising body applications include lung parenchyma imaging, imaging adjacent to metallic implants, cardiac imaging, and dynamic imaging in general. The lower cost of such systems may make MRI favorable for screening high-risk populations and population health research, and the more open configurations allowed may prove favorable for obese subjects and for pregnant women. This article summarizes promising body applications for contemporary whole-body low-field MRI systems, with a focus on new platforms developed within the past 5 years. This is an active area of research, and one can expect many improvements as MRI physicists fully explore the landscape of pulse sequences that are feasible, and as clinicians apply these to patient populations.

Signal-to-noise trade-offs between magnet diameter and shield-to-coil distance for cylindrical Halbach-based portable MRI systems for neuroimaging.

OBJECTIVE: To investigate the trade-off between magnet bore diameter and the distance between the conductive Faraday shield and RF head coil for low-field point-of-care neuroimaging systems. METHODS: Electromagnetic simulations were performed for three different Faraday shield geometries and two commonly used RF coil designs (spiral and solenoid) to assess the effects of a close-fitting shield on the RF coil's transmit and receive efficiencies. Experimental measurements were performed to confirm the accuracy of the simulations. Parallel simulations were performed to assess the static magnet ( B 0 ) field as a function of the magnet bore diameter. The obtainable SNR was then calculated as a function of these two related variables. RESULTS: Simulations of the RF coil characteristics and B 1 + transmit efficiencies agreed well with corresponding experimentally determined parameters. Overall, the RF coil transmit efficiency was, as expected, higher when the gap between the shield and coil increased. The calculated intrinsic SNR showed that maximum SNR would be obtained for a cylindrical shield of diameter 310 mm with an inner diameter of the magnet of 320 mm (assuming 10 mm for the gradient coils). CONCLUSION: This work presents an overview of the trade-offs in transmit efficiencies for RF coils used for POC MRI neuroimaging as a function of coil-to-shield distance and inner diameter of the Halbach magnet. Results show that there is a relatively shallow optimum between a magnet diameter of 290 and 330 mm, with values falling more than 10% if either smaller or larger magnets are used.

Fast, high-quality, and unshielded 0.2 T low-field mobile MRI using minimal hardware resources.

OBJECTIVE: To propose a deep learning-based low-field mobile MRI strategy for fast, high-quality, unshielded imaging using minimal hardware resources. METHODS: Firstly, we analyze the correlation of EMI signals between the sensing coil and the MRI coil to preliminarily verify the feasibility of active EMI shielding using a single sensing coil. Then, a powerful deep learning EMI elimination model is proposed, which can accurately predict the EMI components in the MRI coil signals using EMI signals from at least one sensing coil. Further, deep learning models with different task objectives (super-resolution and denoising) are strategically stacked for multi-level post-processing to enable fast and high-quality low-field MRI. Finally, extensive phantom and brain experiments were conducted on a home-built 0.2 T mobile brain scanner for the evaluation of the proposed strategy. RESULTS: 20 healthy volunteers were recruited to participate in the experiment. The results show that the proposed strategy enables the 0.2 T scanner to generate images with sufficient anatomical information and diagnostic value under unshielded conditions using a single sensing coil. In particular, the EMI elimination outperforms the state-of-the-art deep learning methods and numerical computation methods. In addition, 2 × super-resolution (DDSRNet) and denoising (SwinIR) techniques enable further improvements in imaging speed and quality. DISCUSSION: The proposed strategy enables low-field mobile MRI scanners to achieve fast, high-quality imaging under unshielded conditions using minimal hardware resources, which has great significance for the widespread deployment of low-field mobile MRI scanners.

Improved metal suppression using new generation low-field MRI: a biophantom feasibility study.

OBJECTIVE: Novel 0.55 MRI scanners have the potential to reduce metal artifacts around orthopedic implants. The purpose of this study was to compare metal artifact size and depiction of anatomy between 0.55 T and 3.0 T MRI in a biophantom. MATERIALS AND METHODS: Steel and titanium screws were implanted in 12 porcine knee specimens and imaging at 0.55 T and 3 T MRI was performed using the following sequences: turbo spin-echo (TSE), TSE with view angle tilting (VAT), and slice encoding for metal artifact correction (SEMAC) with proton-density (PD) and T2-weighted short-tau inversion-recovery (T2w-STIR) contrasts. Artifacts were measured, and visualization of anatomy (cartilage, bone, growth plates, cruciate ligaments) was assessed and compared between groups. RESULTS: Metal artifacts were significantly smaller at 0.55 T. The smallest artifact sizes were achieved with SEMAC at 0.55 T for both PD and T2w-STIR sequences; corresponding relative size reductions vs. 3.0 T were 78.7% and 79.4% (stainless steel) and 45.3% and 1.4% (titanium). Depiction of anatomical structures was superior at 0.55 T. CONCLUSION: Substantial reduction of artifact size resulting in superior depiction of anatomical structures is possible on novel 0.55 T MRI systems. Further clinical studies are required to elucidate patient-relevant advantages.

Feasibility and preliminary clinical tolerability of low-field MRI-guided prostate biopsy.

OBJECTIVE: We evaluate the clinical feasibility of a portable, low-field magnetic resonance imaging (MRI) system for prostate cancer (PCa) biopsy. METHODS: A retrospective analysis of men who underwent a 12-core systematic transrectal ultrasound-guided prostate biopsy (SB) and a low-field MRI guided transperineal targeted biopsy (MRI-TB). Comparison of the detection of clinically significant PCa (csPCa) (Gleason Grade [GG] ≥ 2) by SB and low field MRI-TB, stratified by Prostate Imaging Reporting & Data System (PI-RADS) score, prostate volume, and prostate serum antigen (PSA) was performed. RESULTS: A total of 39 men underwent both the MRI-TB and SB biopsy. Median (interquartile range [IQR]) age was 69.0 (61.5-73) years, body mass index (BMI) was 28.9 kg/m2 (25.3-34.3), prostate volume was 46.5 cc (32-72.7), and PSA was 9.5 ng/ml (5.5-13.2). The majority (64.4%) of patients had PI-RADS ≥ 4 lesions and 25% of lesions were anterior on pre-biopsy MRII. Cancer detection rate (CDR) was greatest when combining SB and MRI-TB (64.1%). MRI-TB detected 74.3% (29/39) cancers. Of which, 53.8% (21/39) were csPCa while SB detected 42.5% (17/39) csPCa (p = 0.21). In 32.5% (13/39) of cases, MRI-TB upstaged the final diagnosis, compared to 15% (6/39) of cases in which SB upstaged the final diagnosis (p = 0.11). CONCLUSION: Low-field MRI-TB is clinically feasible. Although future studies on the accuracy of MRI-TB system are needed, the initial CDR is comparable to those seen with fusion-based prostate biopsies. A transperineal and targeted approach may be beneficial in patients with higher BMI and anterior lesions.

Enhanced 129 Xe T1 relaxation in whole blood and in the presence of SPIONs at low magnetic field strengths.

PURPOSE: To compare the effect of superparamagnetic iron oxide nanoparticles (SPIONs) on the T1 of 129 Xe and 1 H and to measure the relaxation of 129 Xe in blood at low and high magnetic field strengths. METHODS: 129 Xe and 1 H T1 relaxometry was performed at low- and high-field strengths in samples containing different SPION concentrations, while imaging was used to compare the contrast obtainable in these two field regimes. In vivo experiments at variable field strengths were performed to determine the depolarization of 129 Xe in blood and the feasibility of in vivo dissolved-phase spectroscopy and imaging at low field. RESULTS: The SPION relaxivity was substantially greater at low field for 1 H, increasing from 0.92 ± 0.06 mM s-1 at 11.7T to 31.5 ± 1.8 mM s-1 at 0.6 mT, and for 129 Xe, which increased from 0.13 ± 0.03 mM s-1 at 11.7T to 7.32 ± 0.71 mM s-1 at 2.1 mT. The additional MR signal loss increased from 0.7% at 9.4T to 20.6 ± 4.2% at 0.6 mT for 1 H and from -0.7 ± 3.4% at 9.4T to 12.7 ± 3.5% at 2.1 mT for 129 Xe. Blood was found to depolarize 129 Xe below 3T in a manner inversely proportional to the field strength. In vitro studies at 2.1 mT suggest 129 Xe relaxation times below 5 s in blood dilutions as low as 0.4% volume. CONCLUSION: SPIONs longitudinal relaxivity increases at low field both for 1 H and 129 Xe. The depolarization of xenon in blood, which is found to increase below 3T, effectively prevents in vivo dissolved-phase spectroscopy and imaging at low-field strengths.

Dynamic lung water MRI during exercise stress.

PURPOSE: Exercise-induced dyspnea caused by lung water is an early heart failure symptom. Dynamic lung water quantification during exercise is therefore of interest to detect early stage disease. This study developed a time-resolved 3D MRI method to quantify transient lung water dynamics during rest and exercise stress. METHODS: The method was evaluated in 15 healthy subjects and 2 patients with heart failure imaged in transitions between rest and exercise, and in a porcine model of dynamic extravascular lung water accumulation through mitral regurgitation (n = 5). Time-resolved images were acquired at 0.55T using a continuous 3D stack-of-spirals proton density weighted sequence with 3.5 mm isotropic resolution, and derived using a motion corrected sliding-window reconstruction with 90-s temporal resolution in 20-s increments. A supine MRI-compatible pedal ergometer was used for exercise. Global and regional lung water density (LWD) and percent change in LWD (ΔLWD) were automatically quantified. RESULTS: A ΔLWD increase of 3.3 ± 1.5% was achieved in the animals. Healthy subjects developed a ΔLWD of 7.8 ± 5.0% during moderate exercise, peaked at 16 ± 6.8% during vigorous exercise, and remained unchanged over 10 min at rest (-1.4 ± 3.5%, p = 0.18). Regional LWD were higher posteriorly compared the anterior lungs (rest: 33 ± 3.7% vs 20 ± 3.1%, p < 0.0001; peak exercise: 36 ± 5.5% vs 25 ± 4.6%, p < 0.0001). Accumulation rates were slower in patients than healthy subjects (2.0 ± 0.1%/min vs 2.6 ± 0.9%/min, respectively), whereas LWD were similar at rest (28 ± 10% and 28 ± 2.9%) and peak exercise (ΔLWD 17 ± 10% vs 16 ± 6.8%). CONCLUSION: Lung water dynamics can be quantified during exercise using continuous 3D MRI and a sliding-window image reconstruction.

Low-field MRI: A report on the 2022 ISMRM workshop.

In March 2022, the first ISMRM Workshop on Low-Field MRI was held virtually. The goals of this workshop were to discuss recent low field MRI technology including hardware and software developments, novel methodology, new contrast mechanisms, as well as the clinical translation and dissemination of these systems. The virtual Workshop was attended by 368 registrants from 24 countries, and included 34 invited talks, 100 abstract presentations, 2 panel discussions, and 2 live scanner demonstrations. Here, we report on the scientific content of the Workshop and identify the key themes that emerged. The subject matter of the Workshop reflected the ongoing developments of low-field MRI as an accessible imaging modality that may expand the usage of MRI through cost reduction, portability, and ease of installation. Many talks in this Workshop addressed the use of computational power, efficient acquisitions, and contemporary hardware to overcome the SNR limitations associated with low field strength. Participants discussed the selection of appropriate clinical applications that leverage the unique capabilities of low-field MRI within traditional radiology practices, other point-of-care settings, and the broader community. The notion of "image quality" versus "information content" was also discussed, as images from low-field portable systems that are purpose-built for clinical decision-making may not replicate the current standard of clinical imaging. Speakers also described technical challenges and infrastructure challenges related to portability and widespread dissemination, and speculated about future directions for the field to improve the technology and establish clinical value.

An interventional MRI guidewire combining profile and tip conspicuity for catheterization at 0.55T.

PURPOSE: We describe a clinical grade, "active", monopole antenna-based metallic guidewire that has a continuous shaft-to-tip image profile, a pre-shaped tip-curve, standard 0.89 mm (0.035″) outer diameter, and a detachable connector for catheter exchange during cardiovascular catheterization at 0.55T. METHODS: Electromagnetic simulations were performed to characterize the magnetic field around the antenna whip for continuous tip visibility. The active guidewire was manufactured using medical grade materials in an ISO Class 7 cleanroom. RF-induced heating of the active guidewire prototype was tested in one gel phantom per ASTM 2182-19a, alone and in tandem with clinical metal-braided catheters. Real-time MRI visibility was tested in one gel phantom and in-vivo in two swine. Mechanical performance was compared with commercial equivalents. RESULTS: The active guidewire provided continuous "profile" shaft and tip visibility in-vitro and in-vivo, analogous to guidewire shaft-and-tip profiles under X-ray. The MRI signal signature matched simulation results. Maximum unscaled RF-induced temperature rise was 5.2°C and 6.5°C (3.47 W/kg local background specific absorption rate), alone and in tandem with a steel-braided catheter, respectively. Mechanical characteristics matched commercial comparator guidewires. CONCLUSION: The active guidewire was clearly visible via real-time MRI at 0.55T and exhibits a favorable geometric sensitivity profile depicting the guidewire continuously from shaft-to-tip including a unique curved-tip signature. RF-induced heating is clinically acceptable. This design allows safe device navigation through luminal structures and heart chambers. The detachable connector allows delivery and exchange of cardiovascular catheters while maintaining guidewire position. This enhanced guidewire design affords the expected performance of X-ray guidewires during human MRI catheterization.