Neuromelanin-MRI using 2D GRE and deep learning: considerations for improving the visualization of substantia nigra and locus coeruleus

An optimized clinically feasible neuromelanin-MRI imaging protocol for visualising the SN and LC simultaneously using deep learning reconstruction is presented. We optimize flip-angle for optimal combined SN and LC depiction. We also experimented with combinations of anisotropic and isotropic in-plane resolution, partial vs full echoes and the number of averages. Phantom and in-vivo experiments on three healthy volunteers illustrate that high-resolution imaging combined with deep-learning denoising shows good depiction of the SN and LC with a clinically feasible sequence of around 7 minutes.Comment: An article based on ECR and ISMRM abstracts, with more text & figure

APIR4EMC: Autocalibrated parallel imaging reconstruction for extended multi-contrast imaging

Purpose: To improve image quality of multi-contrast imaging with the proposed Autocalibrated Parallel Imaging Reconstruction for Extended Multi-Contrast Imaging (APIR4EMC). Methods: APIR4EMC reconstructs multi-contrast images in an autocalibrated parallel imaging reconstruction framework by adding contrasts as virtual coils. Compensation of signal evolution along the echo train of different contrasts is performed to improve signal prediction for missing samples. As a proof of concept, we performed prospectively accelerated phantom and in-vivo brain acquisitions with T1, T1-fat saturated (Fatsat), T2, PD, and FLAIR contrasts. The k-space sampling patterns of these acquisitions were jointly optimized. Images were jointly reconstructed with the proposed APIR4EMC method as well as individually with GRAPPA. Root mean square error (RMSE) to fully sampled reference images and g-factor maps were computed for both methods in the phantom experiment. Visual evaluation was performed in the in-vivo experiment. Results: Compared to GRAPPA, APIR4EMC reduced artifacts and improved SNR of the reconstructed images in the phantom acquisitions. Quantitatively, APIR4EMC substantially reduced noise amplification (g-factor) as well as RMSE compared to GRAPPA. Signal evolution compensation reduced artifacts. In the in-vivo experiments, 1 mm3 isotropic 3D images with contrasts of T1, T1-Fatsat, T2, PD, and FLAIR were acquired in as little as 7.5 min with the acceleration factor of 9. Reconstruction quality was consistent with the phantom results. Conclusion: Compared to single contrast reconstruction with GRAPPA, APIR4EMC reduces artifacts and noise amplification in accelerated multi-contrast imaging

An optimal acquisition and post-processing pipeline for hybrid IVIM-DKI in head and neck

Purpose: To optimize the diffusion-weighting b values and postprocessing pipeline for hybrid intravoxel incoherent motion diffusion kurtosis imaging in the head and neck region. Methods: Optimized diffusion-weighting b value sets ranging between 5 and 30 b values were constructed by optimizing the Cramér-Rao lower bound of the hybrid intravoxel incoherent motion diffusion kurtosis imaging model. With this model, the perfusion fraction, pseudodiffusion coefficient, diffusion coefficient, and kurtosis were estimated. Sixteen volunteers were scanned with a reference b value set and 3 repeats of the optimized sets, of which 1 with volunteers swallowing on purpose. The effects of (1) b value optim

Implementation and validation of ASL perfusion measurements for population imaging

Purpose: Pseudocontinuous arterial spin labeling (pCASL) allows for noninvasive measurement of regional cerebral blood flow (CBF), which has the potential to serve as biomarker for neurodegenerative and cardiovascular diseases. This work aimed to implement and validate pCASL on the dedicated MRI system within the population-based Rotterdam Study, which was installed in 2005 and for which software and hardware configurations have remained fixed. Methods: Imaging was performed on two 1.5T MRI systems (General Electric); (I) the Rotterdam Study system, and (II) a hospital-based system with a product pCASL sequence. An in-house implementation of pCASL was created on scanner I. A flow phantom and three healthy volunteers (<27 years) were scanned on both systems for validation purposes. The data of the first 30 participants (86 ± 4 years) of the Rotterdam Study undergoing pCASL scans on scanner I only were analyzed with and without partial volume correction for gray matter. Results: The validation study showed a difference in blood flow velocity, sensitivity, and spatial coefficient of variation of the perfusion-weighted signal between the two scanners, which was accounted for during post-processing. Gray matter CBF for the Rotterdam Study participants was 52.4 ± 8.2 ml/100 g/min, uncorrected for partial volume effects of gray matter. In this elderly cohort, partial volume correction for gray matter had a variable effect on measured CBF in a range of cortical and sub-cortical regions of interest. Conclusion: Regional CBF measurements are now included to investigate novel biomarkers in the Rotterdam Study. This work highlights that when it is not feasible to purchase a novel ASL sequence, an in-house implementation is valuable

Autocalibrated parallel imaging reconstruction with sampling pattern optimization for GRASE: APIR4GRASE

Purpose: To reduce artifacts and scan time of GRASE imaging by selecting an optimal sampling pattern and jointly reconstructing gradient echo and spin echo images. Methods: We jointly reconstruct images for the different echo types by considering these as additional virtual coil channels in the novel Autocalibrated Parallel Imaging Reconstruction with Sampling Pattern Optimization for GRASE (APIR4GRASE) method. Besides image reconstruction, we identify optimal sampling patterns for the acquisition. The selected optimal patterns were validated on phantom and in-vivo acquisitions. Comparison to the conventional GRASE without acceleration, and to the GRAPPA reconstruction with a single echo type was also performed. Results: Using identified optimal sampling patterns, APIR4GRASE eliminated modulation artifacts in both phantom and in-vivo experiments; mean square error (MSE) was reduced by 78% and 94%, respectively, compared to the conventional GRASE with similar scan time. Both artifacts and g-factor were reduced compared to the GRAPPA reconstruction with a single echo type. Conclusion: APIR4GRASE substantially improves the speed and quality of GRASE imaging over the state-of-the-art, and is able to reconstruct both spin echo and gradient echo images

Clinical performance and future potential of magnetic resonance thermometry in hyperthermia

Hyperthermia treatments in the clinic rely on accurate temperature measurements to guide treatments and evaluate clinical outcome. Currently, magnetic resonance thermometry (MRT) is the only clinical option to non-invasively measure 3D temperature distributions. In this review, we evaluate the status quo and emerging approaches in this evolving technology for replacing conventional dosimetry based on intraluminal or invasively placed probes. First, we define standard-ized MRT performance thresholds, aiming at facilitating transparency in this field when comparing MR temperature mapping performance for the various scenarios that hyperthermia is currently applied in the clinic. This is based upon our clinical experience of treating nearly 4000 patients with superficial and deep hyperthermia. Second, we perform a systematic literature review, assessing MRT performance in (I) clinical and (II) pre-clinical papers. From (I) we identify the current clinical status of MRT, including the problems faced and from (II) we extract promising new techniques with the potential to accelerate progress. From (I) we found that the basic requirements for MRT during hyperthermia in the clinic are largely met for regions without motion, for example extremities. In more challenging regions (abdomen and thorax), progress has been stagnating after the clinical introduction of MRT-guided hyperthermia over 20 years ago. One clear difficulty for advancement is that performance is not or not uniformly reported, but also that studies often omit important details regarding their approach. Motion was found to be the common main issue hindering accurate MRT. Based on (II), we reported and highlighted promising developments to tackle the issues resulting from motion (directly or indirectly), including new developments as well as optimization of already existing strategies. Combined, these may have the potential to facilitate improvement in MRT in the form of more stable and reliable measurements via better stability and accuracy

Relating pre-treatment non-Gaussian intravoxel incoherent motion diffusion-weighted imaging to human papillomavirus status and response in oropharyngeal carcinoma

Background and purpose:Diffusion-weighted imaging (DWI) is a promising technique for response assessment in head-and-neck cancer. Recently, we optimized Non-Gaussian Intravoxel Incoherent Motion Imaging (NG-IVIM), an extension of the conventional apparent diffusion coefficient (ADC) model, for the head and neck. In the current study, we describe the first application in a group of patients with human papillomavirus (HPV)-positive and HPV-negative oropharyngeal squamous cell carcinoma. The aim of this study was to relate ADC and NG-IVIM DWI parameters to HPV status and clinical treatment response. Materials and methods: Thirty-six patients (18 HPV-positive, 18 HPV-negative) were prospectively included. Presence of progressive disease was scored within one year. The mean pre-treatment ADC and NG-IVIM parameters in the gross tumor volume were compared between HPV-positive and HPV-negative patients. In HPV-negative patients, ADC and NG-IVIM parameters were compared between patients with and without progressive disease.Results: ADC, the NG-IVIM diffusion coefficient D, and perfusion fraction f were significantly higher, while pseudo-diffusion coefficient D* and kurtosis K were significantly lower in the HPV-negative compared to HPV-positive patients. In the HPV-negative group, a significantly lower D was found for patients with progressive disease compared to complete responders. No relation with ADC was observed. Conclusion: The results of our single-center study suggest that ADC is related to HPV status, but not an independent response predictor. The NG-IVIM parameter D, however, was independently associated to response in the HPV-negative group. Noteworthy in the opposite direction as previously thought based on ADC.</p

Partial volume correction in arterial spin labeling perfusion MRI: A method to disentangle anatomy from physiology or an analysis step too far?

The mismatch in the spatial resolution of Arterial Spin Labeling (ASL) MRI perfusion images and the anatomy of functionally distinct tissues in the brain leads to a partial volume effect (PVE), which in turn confounds the estimation of perfusion into a specific tissue of interest such as gray or white matter. This confound occurs because the image voxels contain a mixture of tissues with disparate perfusion properties, leading to estimated perfusion values that reflect primarily the volume proportions of tissues in the voxel rather than the perfusion of any particular tissue of interest within that volume. It is already recognized that PVE influences studies of brain perfusion, and that its effect might be even more evident in studies where changes in perfusion are co-incident with alterations in brain structure, such as studies involving a comparison between an atrophic patient population vs control subjects, or studies comparing subjects over a wide range of ages. However, the application of PVE correction (PVEc) is currently limited and the employed methodologies remain inconsistent.In this article, we outline the influence of PVE in ASL measurements of perfusion, explain the main principles of PVEc, and provide a critique of the current state of the art for the use of such methods. Furthermore, we examine the current use of PVEc in perfusion studies and whether there is evidence to support its wider adoption.We conclude that there is sound theoretical motivation for the use of PVEc alongside conventional, ‘uncorrected’, images, and encourage such combined reporting. Methods for PVEc are now available within standard neuroimaging toolboxes, which makes our recommendation straightforward to implement. However, there is still more work to be done to establish the value of PVEc as well as the efficacy and robustness of existing PVEc methods