¹⁹F-MRI of inhaled perfluoropropane for quantitative imaging of pulmonary ventilation

PhD ThesisMRI of exogenous imaging agents offers a safely repeatable modality to assess regional pulmonary ventilation. A small number of studies have validated the safety and potential utility of 19F imaging of inhaled thermally polarised perfluoropropane. However, the relative scarcity of signal in restrictive breath hold length acquisition times inhibits translation of this technique to clinical application. This work presents methods used to maximise the attainable image quality of inhaled perfluoropropane. Novel quantitative measures of ventilation and perfusion have been investigated and discussed. A preliminary healthy volunteer study was conducted to verify the efficacy of the imaging technique and to assess perfluoropropane wash-in and wash-out rates. Quantitative assessment of the suitability of four RF coil designs was performed, comparing power efficiency with loading and signal homogeneity within the sensitive volume of each coil. The 3D spoiled gradient echo sequence was simulated, accounting for the power performance of the chosen birdcage coil design, for calculation of acquisition parameter values required to achieve the highest SNR in a fixed acquisition period for 19F-MRI of inhaled perfluoropropane. Studies on resolution phantoms and healthy volunteers assessed the performance of the optimised imaging protocol, in combination with a compressed sensing technique that permitted up to three-fold acceleration. Two novel lung-representative phantoms were fabricated and used to investigate the behaviour of the MR properties of inhaled perfluoropropane with changing structural and magnetic environments. Finally, a method for lengthening the T2* of inhaled perfluoropropane by susceptibility matching the alveolar tissue to the inhaled gas by intravenous injection of a highly paramagnetic contrast agent is presented. Initial development work was conducted in phantoms and rodents before translation to healthy volunteers. This technique offers the potential to concurrently acquire images reflecting both pulmonary ventilation and perfusion

Lung Imaging and Function Assessment using Non-Contrast-Enhanced Magnetic Resonance Imaging

Measurement of pulmonary ventilation and perfusion has significant clinical value for the diagnosis and monitoring of prevalent lung diseases. To this end, non-contrast-enhanced MRI techniques have emerged as a promising alternative to scintigraphical measurements, computed tomography, and contrast-enhanced MRI. Although these techniques allow the acquisition of both structural and functional information in the same scan session, they are prone to robustness issues related to imaging artifacts and post-processing techniques, limiting their clinical utilization. In this work, new acquisition and post-processing techniques were introduced for improving the robustness of non-contrast-enhanced MRI based functional lung imaging. Furthermore, pulmonary functional maps were acquired in 2-year-old congenital diaphragmatic hernia (CDH) patients to demonstrate the feasibility of non-contrast-enhanced MRI methods for functional lung imaging. In the first study, a multi-acquisition framework was developed to improve robustness against field inhomogeneity artifacts. This method was evaluated at 1.5T and 3T field strengths via acquisitions obtained from healthy volunteers. The results demonstrate that the proposed acquisition framework significantly improved ventilation map homogeneity p<0.05. In the second study, a post-processing method based on dynamic mode decomposition (DMD) was developed to accurately identify dominant spatiotemporal patterns in the acquisitions. This method was demonstrated on digital lung phantoms and in vivo acquisitions. The findings indicate that the proposed method led to a significant reduction in dispersion of estimated ventilation and perfusion map amplitudes across different number of measurements when compared with competing methods p<0.05. In the third study, the free-breathing non-contrast-enhanced dynamic acquisitions were obtained from 2-year-old patients after CDH repair, and then processed using the DMD to obtain pulmonary functional maps. Afterwards, functional differences between ipsilateral and contralateral lungs were assessed and compared with results obtained using contrast-enhanced MRI measurements. The results demonstrate that pulmonary ventilation and perfusion maps can be generated from dynamic acquisitions successfully without the need for ionizing radiation or contrast agents. Furthermore, lung perfusion parameters obtained with DMD MRI correlate very strongly with parameters obtained using dynamic contrast-enhanced MRI. In conclusion, the presented work improves the robustness and accuracy of non-contrast-enhanced functional lung imaging using MRI. Overall, the methods introduced in this work may serve as a valuable tool in the clinical adaptation of non-contrast-enhanced imaging methods and may be used for longitudinal assessments of pulmonary functional changes

Entwicklung von Fluor-19 und Protonen-Magnetresonanztomographie und ihre Anwendung bei Neuroentzündung

The experimental autoimmune encephalomyelitis (EAE) is used to study multiple sclerosis (MS) pathology and develop novel technologies to quantify inflammation over time. Magnetic resonance imaging (MRI) with gadolinium-based contrast agents (GBCAs) is the state-of-the-art method to assess inflammation in MS patients and its animal model. Fluorine (19F)-MRI is one novel technology to quantify inflammatory immune cells in vivo using 19F-nanoparticles. T1 mapping of contrast-enhancing images is another method that could be implemented to quantify inflammatory lesions. Transient macroscopic changes in the EAE brain confound quantification and necessitate registration methods to spatially align images in longitudinal studies. For 19F-MRI, an additional challenge is the low signal-to-noise ratio (SNR) due to low number of 19F-labeled immune cells in vivo. Transceive surface radiofrequency (RF) probes and SNR-efficient imaging techniques such as RARE (Rapid Acquisition with Relaxation Enhancement) are combined to increase sensitivity in 19F-MRI. However, the strong spatially-varying RF field (B1 inhomogeneity) of transceive surface RF probes further hampers quantification. Retrospective B1 correction methods typically use signal intensity equations, unavailable for complex acquisition methods like RARE. The main goal of this work is to investigate novel B1 correction and registration methods to enable the study of inflammatory diseases using 1H- and 19F-MRI following GBCA and 19F-nanoparticle administration, respectively. For correcting B1 inhomogeneities in 1H- and 19F-MR transceive surface RF probes, a model-based method was developed using empirical measurements and simulations, and then validated and compared with a sensitivity method and a hybrid of both. For 19F-MRI, a workflow to measure anatomical images in vivo and a method to compute 19F-concentration uncertainty after correction using Monte Carlo simulations were developed. To overcome the challenges of EAE brain macroscopic changes, a pipeline for registering images throughout longitudinal studies was developed. The proposed B1 correction methods demonstrated dramatic improvements in signal quantification and T1 contrast on images of test phantoms and mouse brains, allowing quantitative measurement with transceive surface RF probes. For low-SNR scenarios, the model-based method yielded reliable 19F-quantifications when compared to volume resonators. Uncertainty after correction depended linearly on the SNR (≤10% with SNR≥10.1, ≤25% when SNR≥4.25). The implemented registration approach provided successful image alignment despite substantial morphological changes in the EAE brain over time. Consequently, T1 mapping was shown to objectively quantify gadolinium lesion burden as a measure of inflammatory activity in EAE. The 1H- and 19F-MRI methods proposed here are highly relevant for quantitative MR of neuroinflammatory diseases, enabling future (pre)clinical investigations.Die experimentelle Autoimmun-Enzephalomyelitis (EAE) wird zur Untersuchung Multipler Sklerose (MS) und zur Entwicklung neuer Technologien zur Entzündungsquantifizierung eingesetzt. Magnetresonanztomographie (MRT) mit Gadolinium-haltigen Kontrastmitteln (GBCAs) ist die modernste Methode zur Beurteilung von Entzündungen bei MS-Patienten und im Tiermodell. Fluor (19F)-MRT unter Verwendung von 19F-Nanopartikeln ist eine neue Technologie zur Quantifizierung entzündlicher Immunzellen in vivo. T1-Kartierung ist eine MRT-Methode, die zur Quantifizierung entzündlicher Läsionen eingesetzt werden könnte. Temporäremorphologische Veränderungen im EAE-Gehirn erschweren die Quantifizierung und erfordern Registrierungsmethoden, um MRT-Bilder in Längsschnittstudien räumlichabzugleichen. Das niedrige Signal-Rausch-Verhältnis (SNR) ist aufgrund der geringen Anzahl 19F-markierter Immunzellen in vivo eine zusätzliche Herausforderung der 19F-MRT. Um deren Empfindlichkeit zu erhöhen, werden Sende-/Empfangsoberflächen-Hochfrequenzspulen (TX/RX-HF-Spule) und SNR-effiziente MRT-Techniken wie RARE (Rapid Acquisition with Relaxation Enhancement) kombiniert. Jedoch verhindert die starke räumliche Variation des HF-Feldes (B1-Inhomogenität) dieser Spulen die Signalquantifizierung. Retrospektive B1-Korrekturmethoden verwenden in der Regel Signalintensitätsgleichungen, die für komplexe MRT-Techniken wie RARE nicht existieren. Das Hauptziel dieser Arbeit ist die Untersuchung neuartiger B1-Korrektur- und Bildregistrierungsmethoden, um in vivo 1H- und 19F-MRT Studien von Entzündungsprozessen zu ermöglichen. Zur Korrektur von B1-Inhomogenitäten wurde eine modellbasierte Methode entwickelt. Diese verwendet empirische Messungen und Simulationen, wurde in Phantomexperimenten validiert und mit Referenzmethoden verglichen. Für 19F-MRT wurden ein Protokoll zur Messung anatomischer Bilder in vivo und eine Methode zur Berechnung der 19F-Konzentrationsunsicherheit nach Korrektur mittels Monte-Carlo-Simulationen entwickelt. Um morphologische Veränderungen im EAE-Gehirn in longitudinalen Studien zu kompensieren, wurde zur Bildregistrierung eine Software-Bibliothek entwickelt. Die B1-Korrekturmethoden zeigten in Testobjekten und Mäusehirnen drastische Verbesserungen der Signal- und T1 Quantifizierung und ermöglichten so quantitative Messungen mit TX/RX-HF-Spulen. Die modellbasierte Methode lieferte für geringe SNRs zuverlässige 19F-Quantifizierungen, deren Genauigkeit mit dem SNR korrelierte. Die implementierte Registrierungsmethode ermöglichte einen erfolgreichen Abgleich von Bildserientrotz erheblicher morphologischer Veränderungen im EAE-Hirn. Folglich wurde gezeigt, dass MRT basierte T1-Kartierung die Gadolinium-Läsionslast als Maß entzündlicher Aktivität bei EAE objektiv quantifizieren kann. Die hier unterscuhten Methoden sind für quantitative 1H- und 19F-MRT neuroinflammatorischer Erkrankungen sehr relevant und ermöglichen künftige (prä)klinische Untersuchungen

7 T renal MRI: challenges and promises

The progression to 7 Tesla (7 T) magnetic resonance imaging (MRI) yields promises of substantial increase in signal-to-noise (SNR) ratio. This increase can be traded off to increase image spatial resolution or to decrease acquisition time. However, renal 7 T MRI remains challenging due to inhomogeneity of the radiofrequency field and due to specific absorption rate (SAR) constraints. A number of studies has been published in the field of renal 7 T imaging. While the focus initially was on anatomic imaging and renal MR angiography, later studies have explored renal functional imaging. Although anatomic imaging remains somewhat limited by inhomogeneous excitation and SAR constraints, functional imaging results are promising. The increased SNR at 7 T has been particularly advantageous for blood oxygen level-dependent and arterial spin labelling MRI, as well as sodium MR imaging, thanks to changes in field-strength-dependent magnetic properties. Here, we provide an overview of the currently available literature on renal 7 T MRI. In addition, we provide a brief overview of challenges and opportunities in renal 7 T MR imaging

Hyperpolarized Xenon-129 Magnetic Resonance Imaging of Functional Lung Microstructure

Hyperpolarized 129Xe (HXe) is a non-invasive contrast agent for lung magnetic resonance imaging (MRI), which upon inhalation follows the functional pathway of oxygen in the lung by dissolving into lung tissue structures and entering the blood stream. HXe MRI therefore provides unique opportunities for functional lung imaging of gas exchange which occurs from alveolar air spaces across the air-blood boundary into parenchymal tissue. However challenges in acquisition speed and signal-to-noise ratio have limited the development of a HXe imaging biomarker to diagnose lung disease. This thesis addresses these challenges by introducing parallel imaging to HXe MRI. Parallel imaging requires dedicated hardware. This work describes design, implementation, and characterization of a 32-channel phased-array chest receive coil with an integrated asymmetric birdcage transmit coil tuned to the HXe resonance on a 3 Tesla MRI system. Using the newly developed human chest coil, a functional HXe imaging method, multiple exchange time xenon magnetization transfer contrast (MXTC) is implemented. MXTC dynamically encodes HXe gas exchange into the image contrast. This permits two parameters to be derived regionally which are related to gas-exchange functionality by characterizing tissue-to-alveolar-volume ratio and alveolar wall thickness in the lung parenchyma. Initial results in healthy subjects demonstrate the sensitivity of MXTC by quantifying the subtle changes in lung microstructure in response to orientation and lung inflation. Our results in subjects with lung disease show that the MXTC-derived functional tissue density parameter exhibits excellent agreement with established imaging techniques. The newly developed dynamic parameter, which characterizes the alveolar wall, was elevated in subjects with lung disease, most likely indicating parenchymal inflammation. In light of these observations we believe that MXTC has potential as a biomarker for the regional quantification of 1) emphysematous tissue destruction in chronic obstructive pulmonary disease (using the tissue density parameter) and 2) parenchymal inflammation or thickening (using the wall thickness parameter). By simultaneously quantifying two lung function parameters, MXTC provides a more comprehensive picture of lung microstructure than existing lung imaging techniques and could become an important non-invasive and quantitative tool to characterize pulmonary disease

Quantification of bone using a 3.0 tesla clinical magnetic resonance scanner

The work in this thesis examines the potential of using magnetic resonance imaging and spectroscopy (MRI & MRS) as a quantitative tool for diagnosing bone abnormalities at multiple skeletal sites, which could be used in conjunction with routine clinical imaging.MRI and MRS are routinely used in the clinical setting for the diagnosis of various types of diseases and abnormalities due to its advantages of providing excellent soft tissue contrast and also providing physiological and metabolic information. The use of MRI and MRS as a direct diagnostic tool for bone abnormalities is very limited at the moment due to issues of costs and standardisation. The aim in this thesis was to use the clinical 3.0 T MR scanner to acquire data from bone and bone marrow for identification of structural and chemical properties and to use those features to identify differences in bone strength and condition. The volunteers in this thesis were part of the high bone mass (HBM) study and they had additional acquisitions from dual-energy X-ray absorptiometry (DEXA) and peripheral quantitative computed tomography (pQCT).MR acquisition protocols have been successfully optimised for each type of bone region and in-house software has also been created to process the acquired data and quantify various types of structural and chemical properties.The MR data from distal radius and tibia demonstrated good correlation with pQCT data (e.g. Figure 8-2 & Figure 8-3) and were also able to differentiate between HBM-affected and control populations (e.g. Figure 8-26). The MR data from lumbar vertebrae also demonstrated good correlation with DEXA data and some of the measurements were also able to differentiate between the HBM-affected and control populations.The combined results from this thesis demonstrate that both MRI and MRS are sensitive techniques for measurement of bone quantity and quality, and they are ready to be applied for clinical investigation as part of routine clinical imaging to identify bone strength in relation to abnormalities and treatments

A novel receive-only liquid nitrogen (LN2)-cooled RF coil for high-resolution in vivo imaging on a 3-Tesla whole-body scanner

The design and operation of a receive-only liquid nitrogen (LN2)-cooled coil and cryostat suitable for medical imaging on a 3-T whole-body magnetic resonance scanner is presented. The coil size, optimized for murine imaging, was determined by using electromagnetic (EM) simulations. This process is therefore easier and more cost effective than building a range of coils. A nonmagnetic cryostat suitable for small-animal imaging was developed having good vacuum and cryogenic temperature performance. The LN2-cooled probe had an active detuning circuit allowing the use with the scanner's built-in body coil. External tuning and matching was adopted to allow for changes to the coil due to temperature and loading. The performance of the probe was evaluated by comparison of signal-to-noise ratio (SNR) with the same radio-frequency RF) coil operating at room temperature (RT). The performance of the RF coil at RT was also benchmarked against a commercial surface coil with a similar dimension to ensure a fair SNR comparison. The cryogenic coil achieved a 1.6- to twofold SNR gain for several different medical imaging applications: For mouse-brain imaging, a 100-mu m resolution was achieved in an imaging time of 3.5 min with an SNR of 25-40, revealing fine anatomical details unseen at lower resolutions for the same time. For heavier loading conditions, such as imaging of the hind legs and liver, the SNR enhancement was slightly reduced to 1.6-fold. The observed SNR was in good agreement with the expected SNR gain correlated with the loaded-quality factor of RF coils from the EM simulations. With the aid of this end-user-friendly and economically attractive cryogenic RF coil, the enhanced SNR available can be used to improve resolution or reduce the duration of individual scans in a number of biomedical applications

Double volumetric navigators for real-time simultaneous shim and motion measurement and correction in Glycogen Chemical Exchange Saturation Transfer (GlycoCEST) MRI

Glycogen is the primary glucose storage mechanism in in living systems and plays a central role in systemic glucose homeostasis. The study of muscle glycogen concentrations in vivo still largely relies on tissue sampling methods via needle biopsy. However, muscle biopsies are invasive and limit the frequency of measurements and the number of sites that can be assessed. Non-invasive methods for quantifying glycogen in vivo are therefore desirable in order to understand the pathophysiology of common diseases with dysregulated glycogen metabolism such as obesity, insulin resistance, and diabetes, as well as glycogen metabolism in sports physiology. Chemical Exchange Saturation Transfer (CEST) MRI has emerged as a non-invasive contrast enhancement technique that enables detection of molecules, like glycogen, whose concentrations are too low to impact the contrast of standard MR imaging. CEST imaging is performed by selectively saturating hydrogen nuclei of the metabolites that are in chemical exchange with those of water molecules and detecting a reduction in MRI signal in the water pool resulting from continuous chemical exchange. However, CEST signal can easily be compromised by artifacts. Since CEST is based on chemical shift, it is very sensitive to field inhomogeneity which may arise from poor initial shimming, subject respiration, heating of shim iron, mechanical vibrations or subject motion. This is a particular problem for molecules that resonate close to water, such as - OH protons in glycogen, where small variations in chemical shift cause misinterpretation of CEST data. The purpose of this thesis was to optimize the CEST MRI sequence for glycogen detection and implement a real-time simultaneous motion and shim correction and measurement method. First, analytical solution of the Bloch-McConnell equations was used to find optimal continuous wave RF pulse parameters for glycogen detection, and results were validated on a phantom with varying glycogen concentrations and in vivo on human calf muscle. Next, the CEST sequence was modified with double volumetric navigators (DvNavs) to measure pose changes and update field of view and zero- and first-order shim parameters. Finally, the impact of B0 field fluctuations on the scan-rescan reproducibility of CEST was evaluated in vivo in 9 volunteers across 10 different scans. Simulation results showed an optimal RF saturation power of 1.5µT and duration of 1s for glycoCEST. These parameters were validated experimentally in vivo and the ability to detect varying glycogen concentrations was demonstrated in a phantom. Phantom data showed that the DvNav-CEST sequence accurately estimates system frequency and linear shim gradient changes due to motion and corrects resulting image distortions. In addition, DvNav-CEST was shown to yield improved CEST quantification in vivo in the presence of motion and motion-induced field inhomogeneity. B0 field fluctuations were found to lower the reproducibility of CEST measures: the mean coefficient of variation (CoV) for repeated scans was 83.70 ± 70.79 % without shim correction. However, the DvNav-CEST sequence was able to measure and correct B0 variations, reducing the CoV to 2.6 ± 1.37 %. The study confirms the possibility of detecting glycogen using CEST MRI at 3 T and shows the potential of the real-time shim and motion navigated CEST sequence for producing repeatable results in vivo by reducing the effect of B0 field fluctuations