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

Fractional order vs. exponential fitting in UTE MR imaging of the patellar tendon

Purpose: Quantification of the T2 ∗ relaxation time constant is relevant in various magnetic resonance imaging applications. Mono- or bi-exponential models are typically used to determine these parameters. However, in case of complex, heterogeneous tissues these models could lead to inaccurate results. We compared a model, provided by the fractional-order extension of the Bloch equation with the conventional models. Methods: Axial 3D ultra-short echo time (UTE) scans were acquired using a 3.0 T MRI and a 16-channel surface coil. After image registration, voxel-wise T2 ∗ was quantified with mono-exponential, bi-exponential and fractional-order fitting. We evaluated all three models repeatability and the bias of their derived parameters by fitting at various noise levels. To investigate the effect of the SNR for the different models, a Monte-Carlo experiment with 1000 repeats was performed for different noise levels for one subject. For a cross-sectional investigation, we used the mean fitted values of the ROIs in five volunteers. Results: Comparing the mono-exponential and the fractional order T2 ∗ maps, the fractional order fitting method yielded enhanced contrast and an improved delineation of the different tissues. In the case of the bi-exponential method, the long T2 ∗ component map demonstrated the anatomy clearly with high contrast. Simulations showed a nonzero bias of the parameters for all three mathematical models. ROI based fitting showed that the T2 ∗ values were different depending on the applied method, and they differed most for the patellar tendon in all subjects. Conclusions: In high SNR cases, the fractional order and bi-exponential models are both performing well with low bias. However, in all observed cases, one of the bi-exponential components has high standard deviation in T2 ∗. The bi-exponential model is suitable for T2 ∗ mapping, but we recommend using the fractional order model for cases of low SNR

T1 mapping in the rat myocardium at 7 Tesla using a modified CINE inversion recovery sequence

Purpose To evaluate the reproducibility and sensitivity of the modified CINE inversion recovery (mCINE-IR) acquisition on rats for measuring the myocardial T1 at 7 Tesla. Materials and Methods The recently published mCINE-IR acquisition on humans was applied on rats for the first time, enabling the possibility of translational studies with an identical sequence. Simulations were used to study signal evolution and heart rate dependency. Gadolinium phantoms, a heart specimen and a healthy rat were used to study reproducibility. Two cryo-infarcted rats were scanned to measure late gadolinium enhancement (LGE). Results In the phantom reproducibility studies the T1 measurements had a maximum coefficient of variation (COV) of 1.3%. For the in vivo reproducibility the COV was below 5% in the anterior cardiac segments. In simulations with phantoms and specimens, a heart rate dependency of approximately 0.5 ms/bpm was present. The T1 maps of the cryo-infarcted rats showed a clear lowering of T1 in de LGE region. Conclusion The results show that mCINE-IR is highly reproducible and that the sensitivity allows detecting T1 changes in the rat myocardium

Tissue-Specific T2* Biomarkers in Patellar Tendinopathy by Subregional Quantification Using 3D Ultrashort Echo Time MRI

Background: Quantitative MRI of patellar tendinopathy (PT) can be challenging due to spatial variation of T2* relaxation times. Purpose: 1) To compare T2* quantification using a standard approach with analysis in specific tissue compartments of the patellar tendon. 2) To evaluate test–retest reliability of different methods for fitting ultrashort echo time (UTE)-relaxometry data. Study Type: Prospective. Subjects: Sixty-five athletes with PT. Field Strength/Sequence: 3D UTE scans covering the patellar tendon were acquired using a 3.0T scanner and a 16-channel surface coil. Assessment: Voxelwise median T2* was quantified with monoexponential, fractional-order, and biexponential fitting. We applied two methods for T2* analysis: first, a standard approach by analyzing all voxels covering the proximal patellar tendon. Second, within subregions of the patellar tendon, by using thresholds on biexponential fitting parameter percentage short T2* (0–30% for mostly long T2*, 30–60% for mixed T2*, and 60–100% for mostly short T2*). Statistical Tests: Average test–retest reliability was assessed in three athletes using coefficients-of-variation (CV) and coefficients-of-repeatability (CR). Results: With standard image analysis, we found a median [interquartile range, IQR] monoexponential T2* of 6.43 msec [4.32–8.55] and fractional order T2* 4.39 msec [3.06–5.78]. The percentage of short T2* components was 52.9% [35.5–69.6]. Subregional monoexponential T2* was 13.78 msec [12.11–16.46], 7.65 msec [6.49–8.61], and 3.05 msec [2.52–3.60] and fractional order T2* 11.82 msec [10.09–14.44], 5.14 msec [4.25–5.96], and 2.19 msec [1.82–2.64] for 0–30%, 30–60%, and 60–100% short T2*, respectively. Biexponential component short T2* was 1.693 msec [1.417–2.003] for tissue with mostly short T2* and long T2* of 15.79 msec [13.47–18.61] for mostly long T2*. The average CR (CV) was 2 msec (15%), 2 msec (19%) and 10% (22%) for monoexponential, fractional order and percentage short T2*, respectively. Data Conclusion: Patellar tendinopathy is characterized by regional variability in binding states of water. Quantitative multicompartment T2* analysis in PT can be facilitated using a voxel selection method based on using biexponential fitting parameters. Level of Evidence: 1. Technical Efficacy Stage: 1

Quantitative subchondral bone perfusion imaging in knee osteoarthritis using dynamic contrast enhanced MRI

Objective: Subchondral bone changes, characterized by increased bone turnover and vascularity, are believed to stimulate progression and pain in knee osteoarthritis (OA). The objective of this study was to evaluate the bone perfusion in knee OA using quantitative dynamic contrast enhanced MRI (DCE-MRI). Design: Unicompartmental knee OA patients were included and underwent 3 Tesla DCE-MRI and T2-weighted MRI. Quantitative DCE-MRI analysis of Ktrans and Kep, representing perfusion parameters, was performed to evaluate differences between the most and least affected knee compartment. First, DCE-MRI parameter differences between epimetaphyseal and subchondral bone in both femur and tibia were assessed. Second, DCE-MRI parameters in subchondral bone marrow lesions (BMLs) were compared to surrounding subchondral bone without BMLs. Results: Twenty-three patients were analyzed. Median Ktrans and Kep in epimetaphyseal bone were significantly higher (p < 0.05) in the most affected (Ktrans: 0.014; Kep: 0.054 min−1) compared to least affected (Ktrans: 0.010; Kep: 0.016 min−1) compartment. For subchondral bone, DCE-MRI parameters were significantly higher (p < 0.05) in the most affected (Ktrans: 0.019; Kep: 0.091 min−1) compared to least affected (Ktrans: 0.014; Kep: 0.058 min−1) compartment as well. Subchondral BMLs detected on fat-saturated T2-weighted images were present in all patients. Median Ktrans (0.091 vs 0.000 min−1) and Kep (0.258 vs 0.000 min−1) were significantly higher within subchondral BMLs compared to surrounding subchondral bone without BMLs (p < 0.001). Conclusions: Increased perfusion parameters in epimetaphyseal bone, subchondral bone and BMLs are observed in unicompartmental knee OA. BMLs likely account for most of the effect of the higher bone perfusion in knee OA

Blood perfusion of patellar bone measured by dynamic contrast-enhanced MRI in patients with patellofemoral pain: A case-control study

Background: Altered perfusion might play an important role in the pathophysiology of patellofemoral pain (PFP), a common knee complaint with unclear pathophysiology. Purpose: To investigate differences in dynamic contrast-enhanced (DCE)-MRI perfusion parameters between patients with PFP and healthy control subjects. Population/Subjects/Phantom/Specimen

From signal-based to comprehensive magnetic resonance imaging

We present and evaluate a new insight into magnetic resonance imaging (MRI). It is based on the algebraic description of the magnetization during the transient response—including intrinsic magnetic resonance parameters such as longitudinal and transverse relaxation times (T1, T2) and proton density (PD) and experimental conditions such as radiofrequency field (B1) and constant/homogeneous magnetic field (B0) from associated scanners. We exploit the correspondence among three different elements: the signal evolution as a result of

Super-resolution methods in MRI: Can they improve the trade-off between resolution, signal-to-noise ratio, and acquisition time?

Improving the resolution in magnetic resonance imaging comes at the cost of either lower signal-to-noise ratio, longer acquisition time or both. This study investigates whether so-called super-resolution reconstruction methods can increase the resolution in the slice selection direction and, as such, are a viable alternative to direct high-resolution acquisition in terms of the signal-to-noise ratio and acquisition time trade-offs. The performance of six super-resolution reconstruction methods and direct high-resolution acquisitions was compared with respect to these trade-offs. The methods are based on iterative back-projection, algebraic reconstruction, and regularized least squares. The algorithms were applied to low-resolution data sets within which the images were rotated relative to each other. Quantitative experiments involved a computational phantom and a physical phantom containing structures of known dimensions. To visually validate the quantitative evaluations, qualitative experiments were performed, in which images of three different subjects (a phantom, an ex vivo rat knee, and a postmortem mouse) were acquired with different magnetic resonance imaging scanners. The results show that super-resolution reconstruction can indeed improve the resolution, signal-to-noise ratio and acquisition time trade-offs compared with direct high-resolution acquisition. Magn Reson Med, 2012. (c) 2012 Wiley Periodicals, Inc

Accuracy and repeatability of QRAPMASTER and MRF-vFA

Our purpose is to evaluate bias and repeatability of the quantitative MRI sequences QRAPMASTER, based on steady-state imaging, and variable Flip Angle MRF (MRF-VFA), based on the transient response. Both techniques are assessed with a standardiz

Does obstetric brachial plexus injury influence speech dominance?

Objective: Right-handedness and left-sided language lateralization is an unresolved mystery With unknown cause/effect relations. Most studies suggest that the language lateralization is related to a fundamental brain asymmetry: right-handedness may be secondary. We analyzed the possibility of an opposite cause/effect relation: whether asymmetric hand usage (as a cause) call influence language lateralization (as a consequence). Methods: We determined language lateralization by functional magnetic resonance imaging in 15 subjects whose upper limb (UL) had been injured at birth because of unilateral damage of the brachial plexus. These subjects were able to use only one (the noninjured) UL perfectly. Results: We found correlation between the severity of right-sided UL injuries and hand usage dysfunction and the degree of left-to-right shift of language lateralization. There was, however, not a complete switch of language lateralization. Interpretation: Right-sided UL injury can induce a left-to-right shift in language lateralization, suggesting that hand usage can influence language lateralization. These findings may contradict the broadly accepted theory that right-handedness is a secondary phenomenon caused by left-sided hemispheric language lateralization. However, the cause/effect problem between asymmetric hand usage and language lateralization is not resolved in this study. Our Findings may support the theory that gestures had a crucial role in human language evolution and is a part of the language system even today