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The divided subtracted inversion recovery (dSIR) is a high T1 contrast technique that shows changes in white matter in patients with traumatic brain injury and hypoxic injury. The changes can be explained by small differences in T1; however, to date, there has been no independent validation of the technique using a standard reference. The present study develops the theory of the dSIR signal and performs validation using the NIST/ISMRM T1 phantom. Non‐idealities are explored, including the influence of noise bias and finite repetition time (TR), which leads to the introduction of an optimally efficient TR for inversion recovery acquisitions. Results show excellent agreement with theoretical calculations. [ABSTRACT FROM AUTHOR]

Purpose: Balanced steady‐state free precession (bSSFP) imaging is susceptible to outflow effects where excited spins leaving the slice as part of the blood stream are misprojected back onto the imaging plane. Previous work proposed using slice‐encoding steps to localize these outflow effects from corrupting the target slice, at the expense of prolonged scan time. This present study extends this idea by proposing a means of significantly reducing most of the outflowing signal from the imaged slice using a coil localization method that acquires a slice‐encoded calibration scan in addition to the 2D data, without being nearly as time‐demanding as our previous method. This coil localization method is titled UNfolding Coil Localized Errors from an imperfect slice profile using a Structured Autocalibration Matrix (UNCLE SAM). Methods: Retrospective and prospective evaluations were carried out. Both featured a 2D acquisition and a separate slice‐encoded calibration of the center in‐plane k‐space lines across all desired slice‐encoding steps. Results: Retrospective results featured a slice‐by‐slice comparison of the slice‐encoded images with UNCLE SAM. UNCLE SAM's subtraction from the slice‐encoded image was compared with a subtraction from the flow‐corrupted 2D image, to demonstrate UNCLE SAM's capability to unfold outflowing spins. UNCLE SAM's comparison with slice encoding showed that UNCLE SAM was able to unfold up to 74% of what slice encoding achieved. Prospective results showed significant reduction in outflow effects with only a marginal increase in scan time from the 2D acquisition. Conclusions: We developed a method that effectively unfolds most outflowing spins from corrupting the target slice and does not require the explicit use of slice‐encoding gradients. This development offers a method to reduce most outflow effects from the target slice within a clinically feasible scan duration compared with the fully sampled slice‐encoding technique. [ABSTRACT FROM AUTHOR]

Purpose: To develop a new sequence to simultaneously acquire Cartesian sodium (23Na) MRI and accelerated Cartesian single (SQ) and triple quantum (TQ) sodium MRI of in vivo human brain at 7 T by leveraging two dedicated low‐rank reconstruction frameworks. Theory and Methods: The Double Half‐Echo technique enables short echo time Cartesian 23Na MRI and acquires two k‐space halves, reconstructed by a low‐rank coupling constraint. Additionally, three‐dimensional (3D) 23Na Multi‐Quantum Coherences (MQC) MRI requires multi‐echo sampling paired with phase‐cycling, exhibiting a redundant multidimensional space. Simultaneous Autocalibrating and k‐Space Estimation (SAKE) were used to reconstruct highly undersampled 23Na MQC MRI. Reconstruction performance was assessed against five‐dimensional (5D) CS, evaluating structural similarity index (SSIM), root mean squared error (RMSE), signal‐to‐noise ratio (SNR), and quantification of tissue sodium concentration and TQ/SQ ratio in silico, in vitro, and in vivo. Results: The proposed sequence enabled the simultaneous acquisition of fully sampled 23Na MRI while leveraging prospective undersampling for 23Na MQC MRI. SAKE improved TQ image reconstruction regarding SSIM by 6% and reduced RMSE by 35% compared to 5D CS in vivo. Thanks to prospective undersampling, the spatial resolution of 23Na MQC MRI was enhanced from 8×8×15$$ 8\times 8\times 15 $$ mm3 to 8×8×8$$ 8\times 8\times 8 $$ mm3 while reducing acquisition time from 2×31$$ 2\times 31 $$ min to 2×23$$ 2\times 23 $$ min. Conclusion: The proposed sequence, coupled with low‐rank reconstructions, provides an efficient framework for comprehensive whole‐brain sodium MRI, combining TSC, T2*, and TQ/SQ ratio estimations. Additionally, low‐rank matrix completion enables the reconstruction of highly undersampled 23Na MQC MRI, allowing for accelerated acquisition or enhanced spatial resolution. [ABSTRACT FROM AUTHOR]

Ultra-high contrast (UHC) MRI describes forms of MRI in which little or no contrast is seen on conventional MRI images but very high contrast is seen with UHC techniques. One of these techniques uses the divided subtracted inversion recovery (dSIR) sequence, which, in modelling studies, can produce ten times the contrast of conventional inversion recovery (IR) sequences. When used in cases of mild traumatic brain injury (mTBI), the dSIR sequence frequently shows extensive abnormalities in white matter that appears normal when imaged with conventional T2-fluid-attenuated IR (T2-FLAIR) sequences. The changes are bilateral and symmetrical in white matter of the cerebral and cerebellar hemispheres. They partially spare the anterior and posterior central corpus callosum and peripheral white matter of the cerebral hemispheres and are described as the whiteout sign. In addition to mTBI, the whiteout sign has also been seen in methamphetamine use disorder and Grinker's myelinopathy (delayed post-hypoxic leukoencephalopathy) in the absence of abnormalities on T2-FLAIR images, and is a central component of post-insult leukoencephalopathy syndromes. This paper describes the concept of ultra-high contrast MRI, the whiteout sign, the theory underlying the use of dSIR sequences and post-insult leukoencephalopathy syndromes. [ABSTRACT FROM AUTHOR]

Divided and subtracted MRI is a novel imaging processing technique, where the difference of two images is divided by their sum. When the sequence parameters are chosen properly, this results in images with a high T1 or T2 weighting over a small range of tissues with specific T1 and T2 values. In the T1 domain, we describe the implementation of the divided Subtracted Inversion Recovery Sequence (dSIR), which is used to image very small changes in T1 from normal in white matter. dSIR has shown widespread changes in otherwise normal-appearing white matter in patients suffering from mild traumatic brain injury (mTBI), substance abuse, and ischemic leukoencephalopathy. It can also be targeted to measure small changes in T1 from normal in other tissues. In the T2 domain, we describe the divided echo subtraction (dES) sequence that is used to image musculoskeletal tissues with a very short T2*. These tissues include fascia, tendons, and aponeuroses. In this manuscript, we explain how this contrast is generated, review how these techniques are used in our research, and discuss the current challenges and limitations of this technique. [ABSTRACT FROM AUTHOR]

Background: Delayed Post-Hypoxic Leukoencephalopathy (DPHL), or Grinker's myelinopathy, is a syndrome in which extensive changes are seen in the white matter of the cerebral hemispheres with MRI weeks or months after a hypoxic episode. T2-weighted spin echo (T2-wSE) and/or T2-Fluid Attenuated Inversion Recovery (T2-FLAIR) images classically show diffuse hyperintensities in white matter which are thought to be near pathognomonic of the condition. The clinical features include Parkinsonism and akinetic mutism. DPHL is generally regarded as a rare condition. Methods and Results: Two cases of DPHL imaged with MRI nine months and two years after probable hypoxic episodes are described. No abnormalities were seen on the T2-FLAIR images with MRI, but very extensive changes were seen in the white matter of the cerebral and cerebellar hemisphere on divided Subtraction Inversion Recovery (dSIR) images. dSIR sequences may produce ten times the contrast of conventional inversion recovery (IR) sequences from small changes in T1. The clinical findings in both cases were of cognitive impairment without Parkinsonism or akinetic mutism. Conclusion: The classic features of DPHL may only represent the severe end of a spectrum of diseases in white matter following global hypoxic injury to the brain. The condition may be much more common than is generally thought but may not be recognized using conventional clinical and MRI criteria for diagnosis. Reappraisal of the syndrome of DPHL to include clinically less severe cases and to encompass recent advances in MRI is advocated. [ABSTRACT FROM AUTHOR]

The present study describes a model-based approach for correcting off-resonance in the context of double half-echo k-space acquisitions. This technique employs center-out readouts in forward and reverse directions to reduce echo-times but is sensitive to off-resonance, which manifests as pixel shifts in both directions. Demodulating the k-space signal with a constant off-resonance term per slice removes pixel shifts and results in a marked reduction in blurring. Phantom and in vivo datasets are demonstrated from low bandwidth sodium imaging. [ABSTRACT FROM AUTHOR]

Sodium imaging typically employs ultrashort echo time radial, density adapted and cones trajectories to capture the rapidly decaying short T2 signal. The present study considers the parameter choices involved in the use of these trajectories in terms of their impact on the resolution and signal to noise ratio. Many parameters have a strong effect on these image properties, particularly the number of spokes which impacts voxel size. The present article develops an understanding of the trade-offs involved and how to choose optimal (or at least reasonable) parameter values. This has a practical role in designing clinical protocols for imaging sodium. [ABSTRACT FROM AUTHOR]

Purpose: Develop a novel three‐dimensional (3D) generative adversarial network (GAN)‐based technique for simultaneous image reconstruction and respiratory motion compensation of 4D MRI. Our goal was to enable high‐acceleration factors 10.7X‐15.8X, while maintaining robust and diagnostic image quality superior to state‐of‐the‐art self‐gating (SG) compressed sensing wavelet (CS‐WV) reconstruction at lower acceleration factors 3.5X‐7.9X. Methods: Our GAN was trained based on pixel‐wise content loss functions, adversarial loss function, and a novel data‐driven temporal aware loss function to maintain anatomical accuracy and temporal coherence. Besides image reconstruction, our network also performs respiratory motion compensation for free‐breathing scans. A novel progressive growing‐based strategy was adapted to make the training process possible for the proposed GAN‐based structure. The proposed method was developed and thoroughly evaluated qualitatively and quantitatively based on 3D cardiac cine data from 42 patients. Results: Our proposed method achieved significantly better scores in general image quality and image artifacts at 10.7X‐15.8X acceleration than the SG CS‐WV approach at 3.5X‐7.9X acceleration (4.53 ± 0.540 vs. 3.13 ± 0.681 for general image quality, 4.12 ± 0.429 vs. 2.97 ± 0.434 for image artifacts, P <.05 for both). No spurious anatomical structures were observed in our images. The proposed method enabled similar cardiac‐function quantification as conventional SG CS‐WV. The proposed method achieved faster central processing unit‐based image reconstruction (6 s/cardiac phase) than the SG CS‐WV (312 s/cardiac phase). Conclusion: The proposed method showed promising potential for high‐resolution (1 mm3) free‐breathing 4D MR data acquisition with simultaneous respiratory motion compensation and fast reconstruction time. [ABSTRACT FROM AUTHOR]

Purpose: Standard balanced SSFP (bSSFP) cine MRI often suffers from blood outflow artifacts. We propose a method that spatially encodes these outflowing spins to reduce their effects in the intended slice. Methods: Bloch simulations were performed to characterize through‐plane flow and to investigate how the use of phase encoding along the slice select's direction ("slice encoding") could alleviate its issues. Phantom scans and in vivo cines were acquired on a 3T system, comparing the standard 2D acquisition to the proposed slice‐encoding method. Nineteen healthy volunteers were recruited for short‐axis and horizontal long‐axis oriented scans. An expert radiologist evaluated each slice‐encoded/standard cine pairs in a rank comparison test and graded their quality on a 1‐5 scale. The grades were used for a nonparametric paired evaluation for independent samples with a null hypothesis that there was no statistical difference between the two quality‐grade distributions for α = 0.05 significance. Results: Bloch simulation results demonstrated this technique's feasibility, showing a fully resolved slice profile given a sufficient number of slice encodes. These results were confirmed with the phantom experiments. Each in vivo slice‐encoded cine had a higher quality than its corresponding standard acquisition. The nonparametric paired evaluation came to 0.01 significance, encouraging us to reject the null hypothesis and conclude that slice‐encoding effectively works in reducing outflow effects. Conclusion: The slice‐encoding balanced SSFP technique is helpful in mitigating outflow effects and is achievable within a single breath hold, being a useful alternative for cases in which the flow artifacts are significant. [ABSTRACT FROM AUTHOR]

Purpose: Chemical shift-encoded MRI (CSE-MRI) is well-established to quantify proton density fat fraction (PDFF) as a quantitative biomarker of hepatic steatosis. However, temperature is known to bias PDFF estimation in phantom studies. In this study, strategies were developed and evaluated to correct for the effects of temperature on PDFF estimation through simulations, temperature-controlled experiments, and a multi-center, multi-vendor phantom study. Theory and Methods: A technical solution that assumes and automatically estimates a uniform, global temperature throughout the phantom is proposed. Computer simulations modeled the effect of temperature on PDFF estimation using magnitude-, complex-, and hybrid-based CSE-MRI methods. Phantom experiments were performed to assess the temperature correction on PDFF estimation at controlled phantom temperatures. To assess the temperature correction method on a larger scale, the proposed method was applied to data acquired as part of a nine-site multi-vendor phantom study and compared to temperature-corrected PDFF estimation using an a priori guess for ambient room temperature. Results: Simulations and temperature-controlled experiments show that as temperature deviates further from the assumed temperature, PDFF bias increases. Using the proposed correction method and a reasonable a priori guess for ambient temperature, PDFF bias and variability were reduced using magnitude-based CSE-MRI, across MRI systems, field strengths, protocols, and varying phantom temperature. Complex and hybrid methods showed little PDFF bias and variability both before and after correction. Conclusion: Correction for temperature reduces temperature-related PDFF bias and variability in phantoms across MRI vendors, sites, field strengths, and protocols for magnitude-based CSE-MRI, even without a priori information about the temperature. [ABSTRACT FROM AUTHOR]

Sampling k‐space asymmetrically (ie, partial Fourier sampling) in the readout direction is a common way to reduce the echo time (TE) during magnetic resonance image acquisitions. This technique requires overlap around the center of k‐space to provide a calibration region for reconstruction, which limits the minimum fractional echo to ~60% before artifacts are observed. The present study describes a method for reconstructing images from exact half echoes using two separate acquisitions with reversed readout polarity, effectively providing a full line of k‐space without additional data around central k‐space. This approach can benefit sequences or applications that prioritize short TE, short inter‐echo spacing or short repetition time. An example of the latter is demonstrated to reduce banding artifacts in balanced steady‐state free precession. [ABSTRACT FROM AUTHOR]

The aim of this study was to develop a deep neural network for respiratory motion compensation in free‐breathing cine MRI and evaluate its performance. An adversarial autoencoder network was trained using unpaired training data from healthy volunteers and patients who underwent clinically indicated cardiac MRI examinations. A U‐net structure was used for the encoder and decoder parts of the network and the code space was regularized by an adversarial objective. The autoencoder learns the identity map for the free‐breathing motion‐corrupted images and preserves the structural content of the images, while the discriminator, which interacts with the output of the encoder, forces the encoder to remove motion artifacts. The network was first evaluated based on data that were artificially corrupted with simulated rigid motion with regard to motion‐correction accuracy and the presence of any artificially created structures. Subsequently, to demonstrate the feasibility of the proposed approach in vivo, our network was trained on respiratory motion‐corrupted images in an unpaired manner and was tested on volunteer and patient data. In the simulation study, mean structural similarity index scores for the synthesized motion‐corrupted images and motion‐corrected images were 0.76 and 0.93 (out of 1), respectively. The proposed method increased the Tenengrad focus measure of the motion‐corrupted images by 12% in the simulation study and by 7% in the in vivo study. The average overall subjective image quality scores for the motion‐corrupted images, motion‐corrected images and breath‐held images were 2.5, 3.5 and 4.1 (out of 5.0), respectively. Nonparametric‐paired comparisons showed that there was significant difference between the image quality scores of the motion‐corrupted and breath‐held images (P <.05); however, after correction there was no significant difference between the image quality scores of the motion‐corrected and breath‐held images. This feasibility study demonstrates the potential of an adversarial autoencoder network for correcting respiratory motion‐related image artifacts without requiring paired data. [ABSTRACT FROM AUTHOR]

The study evaluates four physically motivated constraints in the estimation of the proton density fat fraction (PDFF). Least squares approaches were developed for constraining the parameters in PDFF quantification based on the physics of magnetic resonance imaging. These were smooth fieldmap, smooth initial phase, nonnegative proton density and moderate R 2 ∗ values. The constraints were evaluated in terms of their influence on the bias and standard deviation of the estimated parameters using numerical simulations and in vivo data acquired at 0.35 T. Results show that unconstrained least squares estimation is noisy and biased and that constraints can be effective at reducing both the standard deviation and bias. [ABSTRACT FROM AUTHOR]

Background: Improving the signal-to-noise ratio (SNR) of chemical-shift-encoded MRI acquisition with complex reconstruction (MRI-C) may improve the accuracy and precision of noninvasive proton density fat fraction (PDFF) quantification in patients with hepatic steatosis.Purpose: To assess the accuracy of high SNR (Hi-SNR) MRI-C versus standard MRI-C acquisition to estimate hepatic PDFF in adult and pediatric nonalcoholic fatty liver disease (NAFLD) using an MR spectroscopy (MRS) sequence as the reference standard.Study Type: Prospective.Population/subjects: In all, 231 adult and pediatric patients with known or suspected NAFLD.Field Strength/sequence: PDFF estimated at 3T by three MR techniques: standard MRI-C; a Hi-SNR MRI-C variant with increased slice thickness, decreased matrix size, and no parallel imaging; and MRS (reference standard).Assessment: MRI-PDFF was measured by image analysts using a region of interest coregistered with the MRS-PDFF voxel.Statistical Tests: Linear regression analyses were used to assess accuracy and precision of MRI-estimated PDFF for MRS-PDFF as a function of MRI-PDFF using the standard and Hi-SNR MRI-C for all patients and for patients with MRS-PDFF <10%.Results: In all, 271 exams from 231 patients were included (mean MRS-PDFF: 12.6% [SD: 10.4]; range: 0.9-41.9). High agreement between MRI-PDFF and MRS-PDFF was demonstrated across the overall range of PDFF, with a regression slope of 1.035 for the standard MRI-C and 1.008 for Hi-SNR MRI-C. Hi-SNR MRI-C, compared to standard MRI-C, provided small but statistically significant improvements in the slope (respectively, 1.008 vs. 1.035, P = 0.004) and mean bias (0.412 vs. 0.673, P < 0.0001) overall. In the low-fat patients only, Hi-SNR MRI-C provided improvements in the slope (1.058 vs. 1.190, P = 0.002), mean bias (0.168 vs. 0.368, P = 0.007), intercept (-0.153 vs. -0.796, P < 0.0001), and borderline improvement in the R2 (0.888 vs. 0.813, P = 0.01).Data Conclusion: Compared to standard MRI-C, Hi-SNR MRI-C provides slightly higher MRI-PDFF estimation accuracy across the overall range of PDFF and improves both accuracy and precision in the low PDFF range.Level Of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:229-238. [ABSTRACT FROM AUTHOR]

The purpose of this work was to investigate sources of bias in magnetic resonance imaging (MRI) liver fat quantification that lead to a dependence of the proton density fat fraction (PDFF) on the number of echoes. This was a retrospective analysis of liver MRI data from 463 subjects. The magnitude signal variation withTE from spoiled gradient echo images was curve fitted to estimate the PDFF using a model that included monoexponential R2* decay and a multi-peak fat spectrum. Additional corrections for non-exponential decay (Gaussian), bi-exponential decay, degree of fat saturation, water frequency shift and noise bias were introduced. The fitting error was minimized with respect to 463 x 3 = 1389 subject-specific parameters and seven additional parameters associated with these corrections. The effect on PDFF was analyzed, notably the dependence on the number of echoes. The effects on R2* were also analyzed. The results showed that the inclusion of bias corrections resulted in an increase in the quality of fit (r²) in 427 of 463 subjects (i.e. 92.2%) and a reduction in the total fitting error (residual norm) of 43.6%. This was largely a result of the Gaussian decay (57.8% of the reduction), fat spectrum (31.0%) and biexponential decay (8.8%) terms. The inclusion of corrections was also accompanied by a decrease in the dependence of PDFF on the number of echoes. Similar analysis of R2* showed a decrease in the dependence on the number of echoes. Comparison of PDFF with spectroscopy indicated excellent agreement before and after correction, but the latter exhibited lower bias on a Bland--Altman plot (1.35% versus 0.41%). In conclusion, correction for known and expected biases in PDFF quantification in liver reduces the fitting error, decreases the dependence on the number of echoes and increases the accuracy. [ABSTRACT FROM AUTHOR]

Purpose Parallel imaging allows the reconstruction of undersampled data from multiple coils. This provides a means to reject and regenerate corrupt data (e.g. from motion artefact). The purpose of this work is to approach this problem using the SAKE parallel imaging method. Theory and methods Parallel imaging methods typically require calibration by fully sampling the center of k-space. This is a challenge in the presence of corrupted data, since the calibration data may be corrupted which leads to an errors-in-variables problem that cannot be solved by least squares or even iteratively reweighted least squares. The SAKE method, based on matrix completion and structured low rank approximation, was modified to detect and trim these errors from the data. Results Simulated and actual corrupted datasets were reconstructed with SAKE, the proposed approach and a more standard reconstruction method (based on solving a linear equation) with a data rejection criterion. The proposed approach was found to reduce artefacts considerably in comparison to the other two methods. Conclusion SAKE with data trimming improves on previous methods for reconstructing images from grossly corrupted data. [ABSTRACT FROM AUTHOR]

Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common hereditary muscular disorders. Currently FSHD has no known effective treatment and detailed data on the natural history are lacking. Determination of the efficacy of a given therapeutic approach might be difficult in FSHD given the slow and highly variable disease progression. Magnetic resonance imaging (MRI) has been widely used to qualitatively and quantitatively evaluate in vivo the muscle alterations in various neuromuscular disorders. The main aim of the present study was to investigate longitudinally the time-dependent changes occurring in thigh muscles of FSHD patients using quantitative MRI and to assess the potential relationships with the clinical findings. Thirty-five FSHD1 patients (17 females) were enrolled. Clinical assessment tools including manual muscle testing using medical research council score (MRC), and motor function measure (MFM) were recorded each year for a period ranging from 1 to 2 years. For the MRI measurements, we used a new quantitative index, i.e., the mean pixel intensity (MPI) calculated from the pixel-intensity distribution in T1 weighted images. The corresponding MPI scores were calculated for each thigh, for each compartment and for both thighs totally (MPItotal). The total mean pixel intensity (MPItotal) refers to the sum of each pixel signal intensity divided by the corresponding number of pixels. An increased MPItotal indicates both a raised fat infiltration together with a reduced muscle volume thereby illustrating disease progression. Clinical scores did not change significantly over time whereas MPItotal increased significantly from an initial averaged value of 39.6 to 41.1 with a corresponding rate of 0.62/year. While clinical scores and MPItotal measured at the start of the study were significantly related, no correlation was found between the rate of MPItotal and MRC sum score changes, MFMtotal and MFM subscores. The relative rate of MPItotal change was 2.3% (0.5–4.3)/year and was significantly higher than the corresponding rates measured for MRCS 0% (0–1.7) /year and MFMtotal 0% (0–2.0) /year (p = 0.000). On the basis of these results, we suggested that muscle MRI and more particularly the MPItotal index could be used as a reliable biomarker and outcome measure of disease progression. In slowly progressive myopathies such as FSHD, the MPItotal index might reveal subclinical changes, which could not be evidenced using clinical scales over a short period of time. [ABSTRACT FROM AUTHOR]

Purpose: To test the hypothesis that intensity modulated radiation therapy (IMRT) can reduce radiation dose to functional bone marrow (BM) in patients with pelvic malignancies (phase IA) and estimate the clinical feasibility and acute toxicity associated with this technique (phase IB). Methods and Materials: We enrolled 31 subjects (19 with gynecologic cancer and 12 with anal cancer) in an institutional review board-approved prospective trial (6 in the pilot study, 10 in phase IA, and 15 in phase IB). The mean age was 52 years; 8 of 31 patients (26%) were men. Twenty-one subjects completed 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) simulation and magnetic resonance imaging by use of quantitative IDEAL (IDEAL IQ; GE Healthcare, Waukesha, WI). The PET/CT and IDEAL IQ were registered, and BM subvolumes were segmented above the mean standardized uptake value and below the mean fat fraction within the pelvis and lumbar spine; their intersection was designated as functional BM for IMRT planning. Functional BM-sparing vs total BM-sparing IMRT plans were compared in 12 subjects; 10 were treated with functional BM-sparing pelvic IMRT per protocol. Results: In gynecologic cancer patients, the mean functional BM V10 (volume receiving ≥10 Gy) and V20 (volume receiving ≥20 Gy) were 85% vs 94% (P<.0001) and 70% vs 82% (P<.0001), respectively, for functional BM-sparing IMRT vs total BM-sparing IMRT. In anal cancer patients, the corresponding values were 75% vs 77% (P=.06) and 62% vs 67% (P=.002), respectively. Of 10 subjects treated with functional BM-sparing pelvic IMRT, 3 (30%) had acute grade 3 hematologic toxicity or greater. Conclusions: IMRT can reduce dose to BM subregions identified by 18F-fluorodeoxyglucose-PET/CT and IDEAL IQ. The efficacy of BM-sparing IMRT is being tested in a phase II trial. [Copyright &y& Elsevier]

Abstract: This study presents and validates a theoretical model for estimating the number of double bonds in triglyceride molecules using magnetic resonance imaging. The model enables reliable estimation of the number of double bonds from a small number of time points, as are typically acquired with chemical shift imaging. Prior knowledge from the US Department of Agriculture (USDA) is used to constrain the properties of triglyceride. Validation in oil phantoms shows agreement between the measured number of double bonds and USDA reference values (correlation 0.95, significance P=.0003, slope 0.95±0.31, intercept 0.08±1.24). Feasibility in a human subject was demonstrated using a long breath-hold (43 s) scan. [Copyright &y& Elsevier]

A theoretical triglyceride model was developed for in vivo human liver fat 1H MRS characterization, using the number of double bonds (CHCH), number of methylene-interrupted double bonds (CHCHCH2CHCH) and average fatty acid chain length. Five 3 T, single-voxel, stimulated echo acquisition mode spectra (STEAM) were acquired consecutively at progressively longer TEs in a fat-water emulsion phantom and in 121 human subjects with known or suspected nonalcoholic fatty liver disease. T2-corrected peak areas were calculated. Phantom data were used to validate the model. Human data were used in the model to determine the complete liver fat spectrum. In the fat-water emulsion phantom, the spectrum predicted by the model (based on known fatty acid chain distribution) agreed closely with spectroscopic measurement. In human subjects, areas of CH2 peaks at 2.1 and 1.3 ppm were linearly correlated (slope, 0.172; r = 0.991), as were the 0.9 ppm CH3 and 1.3 ppm CH2 peaks (slope, 0.125; r = 0.989). The 2.75 ppm CH2 peak represented 0.6% of the total fat signal in high-liver-fat subjects. These values predict that 8.6% of the total fat signal overlies the water peak. The triglyceride model can characterize human liver fat spectra. This allows more accurate determination of liver fat fraction from MRI and MRS. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: There is increasing interest in imaging short T2 species which show little or no signal with conventional magnetic resonance (MR) pulse sequences. In this paper, we describe the use of three-dimensional ultrashort echo time (3D UTE) sequences with TEs down to 8 μs for imaging of these species. Image contrast was generated with acquisitions using dual echo 3D UTE with echo subtraction, dual echo 3D UTE with rescaled subtraction, long T2 saturation 3D UTE, long T2 saturation dual echo 3D UTE with echo subtraction, single adiabatic inversion recovery 3D UTE, single adiabatic inversion recovery dual echo 3D UTE with echo subtraction and dual adiabatic inversion recovery 3D UTE. The feasibility of using these approaches was demonstrated in in vitro and in vivo imaging of calcified cartilage, aponeuroses, menisci, tendons, ligaments and cortical bone with a 3-T clinical MR scanner. Signal-to-noise ratios and contrast-to-noise ratios were used to compare the techniques. [Copyright &y& Elsevier]

Abstract: An algorithm is described for use in chemical shift-based water–fat separation to constrain the phase of both species to be equal at an echo time of zero. This constraint is physically reasonable since the initial phase should be a property of the excitation pulse and receiver coil only. The advantages of phase constrained water–fat separation, namely, improved noise performance and/or reduced data requirements (fewer echos), are demonstrated in simulations and experiments. [Copyright &y& Elsevier]

Ultrashort echo time MRI requires specialized pulse sequences to overcome the short T2 of the MR signal encountered in tissues such as ligaments, tendon, or cortical bone. Theoretical work is presented, supported by simulations and experimental data on optimizing the radiofrequency excitation to maximize signal-to-noise ratio and contrast-to-noise ratio. The theoretical calculations and simulations are based on the classic Bloch equations and lead to a closed form expression for the optimal radiofrequency pulse parameters to maximize the MR signal in the presence of rapid T2 decay. In the steady state, the spoiled gradient recalled echo signal amplitude in response to the radiofrequency excitation pulses is not maximized by the classic Ernst angle but by a more general criterion we call 'generalized Ernst angle.' Finally, it is shown that T2 contrast is maximized by flipping the magnetization at the Ernst angle with a radiofrequency pulse duration proportional to the targeted T2. Experimental studies on short T2 phantoms confirm these optimization criteria for both signal-to-noise ratio and contrast-to-noise ratio. Magn Reson Med, 2010. © 2010 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Abstract: This study assesses the stability of magnetic resonance liver fat measurements against changes in T2* due to the presence of iron, which is a confound for accurate quantification. The liver T2* was experimentally shortened by intravenous infusion of a super paramagnetic iron oxide contrast agent. Low flip angle multiecho gradient echo sequences were performed before, during and after infusion. The liver fat fraction (FF) was calculated in co-localized regions-of-interest using T2* models that assumed no decay, monoexponential decay and biexponential decay. Results show that, when T2* was neglected, there was a strong underestimation of FF and with monoexponential decay there was a weak overestimation of FF. Curve-fitting using the biexponential decay was found to be problematic. The overestimation of FF may be due to remaining deficiencies in the model, although is unlikely to be important for clinical diagnosis of steatosis. [Copyright &y& Elsevier]

Short T2 species such as the Achilles tendon and cortical bone cannot be imaged with conventional MR sequences. They have a much broader absorption lineshape than long T2 species, therefore they are more sensitive to an appropriately placed off-resonance irradiation. In this work, a technique termed ultrashort TE (UTE) with off-resonance saturation contrast (UTE-OSC) is proposed to image short T2 species. A high power saturation pulse was placed +1 to +2 kHz off the water peak to preferentially saturate signals from short T2 species, leaving long T2 water and fat signals largely unaffected. The subtraction of UTE images with and without an off-resonance saturation pulse effectively suppresses long T2 water and fat signals, creating high contrast for short T2 species. The UTE-OSC technique was validated on a phantom, and applied to bone samples and healthy volunteers on a clinical 3T scanner. High-contrast images of the Achilles tendon and cortical bone were generated with a high contrast-to-noise ratio (CNR) of the order of 12 to 20 between short T2 and long T2 species within a total scan time of 4 to 10 min. Magn Reson Med, 2009. © 2009 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Abstract: A regularization strategy is described for generalized autocalibrating partially parallel acquisition (GRAPPA) that allows successful calibration using a small number of autocalibration signals (ACS). The approach requires certain nonlinear relationships between the GRAPPA coefficients to be satisfied, which increases the redundancy so that fewer ACS need to be acquired. [Copyright &y& Elsevier]

Abstract: A method for making weighted linear combinations of the spectra acquired by a phased-array coil is described. Unlike most previous combination methods, no special reference points in the data are chosen to represent the coil weights. Instead, all the data points are used, which results in optimal signal-to-noise ratio more reliable estimation. The method uses singular value decomposition to identify the coil weights and extract the principal component of variation in the signal. Subsequent processing of the combined signal (e.g., Fourier transform, baseline correction, phasing) may proceed as per a single coil acquisition. [Copyright &y& Elsevier]