Gastric Bypass Promotes More Lipid Mobilization Than a Similar Weight Loss Induced by Low-Calorie Diet

Background. Recently, we found large reductions in visceral and subcutaneous fat one month after gastric bypass (GBP), without any change in liver fat content. Purpose. Firstly to characterize weight loss-induced lipid mobilization after one month with preoperative low-calorie diet (LCD) and a subsequent month following GBP, and secondly, to discuss the observations with reference to our previous published findings after GBP intervention alone. Methods. 15 morbidly obese women were studied prior to LCD, at GBP, and one month after GBP. Effects on metabolism were measured by magnetic resonance techniques and blood tests. Results. Body weight was similarly reduced after both months (mean: −8.0 kg, n = 13). Relative body fat changes were smaller after LCD than after GBP (−7.1 ± 3.6% versus −10 ± 3.2%, P = .029, n = 13). Liver fat fell during the LCD month (−41%, P = .001, n = 13) but was unaltered one month after GBP (+12%). Conclusion. Gastric bypass seems to cause a greater lipid mobilization than a comparable LCD-induced weight loss. One may speculate that GBP-altered gastrointestinal signalling sensitizes adipose tissue to lipolysis, promoting the changes observed

Joint Intensity Inhomogeneity Correction for Whole-Body MR Data

Abstract. Whole-body MR receives increasing interest as potential alternative to many conventional diagnostic methods. Typical whole-body MR scans contain multiple data channels and are acquired in a multistation manner. Quantification of such data typically requires correction of two types of artefacts: different intensity scaling on each acquired image stack, and intensity inhomogeneity (bias) within each stack. In this work, we present an all-in-one method that is able to correct for both mentioned types of acquisition artefacts. The most important properties of our method are: 1) All the processing is performed jointly on all available data channels, which is necessary for preserving the relation between them, and 2) It allows easy incorporation of additional knowledge for estimation of the bias field. Performed validation on two types of whole-body MR data confirmed superior performance of our approach in comparison with state-of-the-art bias removal methods

Correcting gradient chain induced fat quantification errors in radial multi-echo Dixon imaging using a gradient modulation transfer function

Purpose: Multi-echo Stack-of-stars (SoS) radial k-space trajectories with golden angle ordering are becoming popular for free-breathing abdominal Dixon imaging and proton density fat fraction (PDFF) mapping. Gradient chain imperfections including eddy currents and system delays are known to affect the image quality of radial imaging and to confound the estimation of PDFF mapping. This work proposes a retrospective trajectory correction method based on a simple gradient modulation transfer function (GMTF) measurement to predict and correct gradient chain induced k-space trajectory errors.Methods: The GMTF was measured using the standard hardware of a 3 Tesla scanner on a phantom using the thin slice method and was applied to a 3D radial SoS Dixon imaging sequence. The impact of the GMTF-based correction on image reconstruction and PDFF quantification was investigated using numerical simulations and validated on experimental phantom data as well as on in vivo leg and liver data of healthy volunteers.Results: Correcting the k-space trajectories with the measured GMTF during image reconstruction reduced PDFF quantification errors for phantom and in vivo acquisitions. A Bland-Altman comparison of the measured PDFF phantom and reference data confirmed that the GMTF correction narrowed down the limits of agreement (LoA) from 1.3% ± 8.1% (uncorrected) to 1.9% ± 5.4% (GMTF-corrected) over the full PDFF range (0%–100%) and from −0.26% ± 2.8% (uncorrected) to 0.12% ± 1.5% (GMTF-corrected) within the 0%–50% PDFF range. Liver PDFF estimation was improved by reducing the standard deviation of the mean liver PDFF and the bias of the mean liver PDFF for all subjects.Conclusion: The proposed GMTF-based k-space trajectory correction is a fast alternative method for avoiding PDFF quantitation errors caused by gradient-system induced k-space trajectory errors in 3D radial multi-echo gradient-echo acquisitions

Coronary MR angiography at 3T: fat suppression versus water-fat separation

Objectives: To compare Dixon water-fat suppression with spectral pre-saturation with inversion recovery (SPIR) at 3T for coronary magnetic resonance angiography (MRA) and to demonstrate the feasibility of fat suppressed coronary MRA at 3T without administration of a contrast agent. Materials and methods: Coronary MRA with Dixon water-fat separation or with SPIR fat suppression was compared on a 3T scanner equipped with a 32-channel cardiac receiver coil. Eight healthy volunteers were examined. Contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), right coronary artery (RCA), and left anterior descending (LAD) coronary artery sharpness and length were measured and statistically compared. Two experienced cardiologists graded the visual image quality of reformatted Dixon and SPIR images (1: poor quality to 5: excellent quality). Results: Coronary MRA images in healthy volunteers showed improved contrast with the Dixon technique compared to SPIR (CNR blood-fat: Dixon = 14.9 ± 2.9 and SPIR = 13.9 ± 2.1; p = 0.08, CNR blood-myocardium: Dixon = 10.2 ± 2.7 and SPIR = 9.11 ± 2.6; p = 0.1). The Dixon method led to similar fat suppression (fat SNR with Dixon: 2.1 ± 0.5 vs. SPIR: 2.4 ± 1.2, p = 0.3), but resulted in significantly increased SNR of blood (blood SNR with Dixon: 19.9 ± 4.5 vs. SPIR: 15.5 ± 3.1, p < 0.05). This means the residual fat signal is slightly lower with the Dixon compared to the SIPR technique (although not significant), while the SNR of blood is significantly higher with the Dixon technique. Vessel sharpness of the RCA was similar for Dixon and SPIR (57 ± 7 % vs. 56 ± 9 %, p = 0.2), while the RCA visualized vessel length was increased compared to SPIR fat suppression (107 ± 21 vs. 101 ± 21 mm, p < 0.001). For the LAD, vessel sharpness (50 ± 13 % vs. 50 ± 7 %, p = 0.4) and vessel length (92 ± 46 vs. 90 ± 47 mm, p = 0.4) were similar with both techniques. Consequently, the Dixon technique resulted in an improved visual score of the coronary arteries in the water fat separated images of healthy subjects (RCA: 4.6 ± 0.5 vs. 4.1 ± 0.7, p = 0.01, LAD: 4.1 ± 0.7 vs. 3.5 ± 0.8, p = 0.007). Conclusions: Dixon water-fat separation can significantly improve coronary artery image quality without the use of a contrast agent at 3T

A half-century of innovation in technology-preparing MRI for the 21st century

MRI developed during the last half-century from a very basic concept to an indispensable non-ionising medical imaging technique that has found broad application in diagnostics, therapy control and far beyond. Due to its excellent soft-tissue contrast and the huge variety of accessible tissue- and physiological-parameters, MRI is often preferred to other existing modalities. In the course of its development, MRI underwent many substantial transformations. From the beginning, starting as a proof of concept, much effort was expended to develop the appropriate basic scanning technology and methodology, and to establish the many clinical contrasts (e.g., T1, T2, flow, diffusion, water/fat, etc.) that MRI is famous for today. Beyond that, additional prominent innovations to the field have been parallel imaging and compressed sensing, leading to significant scanning time reductions, and the move towards higher static magnetic field strengths, which led to increased sensitivity and improved image quality. Improvements in workflow and the use of artificial intelligence are among many current trends seen in this field, paving the way for a broad use of MRI. The 125th anniversary of the BJR is a good point to reflect on all these changes and developments and to offer some slightly speculative ideas as to what the future may bring