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High-resolution post-contrast T1-weighted imaging is a workhorse sequence in the evaluation of neurological disorders. The T1-MPRAGE sequence has been widely adopted for the visualization of enhancing pathology in the brain. However, this three-dimensional (3D) acquisition is lengthy and prone to motion artifact, which often compromises diagnostic quality. The goal of this study was to compare a highly accelerated wave-controlled aliasing in parallel imaging (CAIPI) post-contrast 3D T1-MPRAGE sequence (Wave-T1-MPRAGE) with the standard 3D T1-MPRAGE sequence for visualizing enhancing lesions in brain imaging at 3 T.This study included 80 patients undergoing contrast-enhanced brain MRI. The participants were scanned with a standard post-contrast T1-MPRAGE sequence (acceleration factor [R] = 2 using GRAPPA parallel imaging technique, acquisition time [TA] = 5 min 18 s) and a prototype post-contrast Wave-T1-MPRAGE sequence (R = 4, TA = 2 min 32 s). Two neuroradiologists performed a head-to-head evaluation of both sequences and rated the visualization of enhancement, sharpness, noise, motion artifacts, and overall diagnostic quality. A 15% noninferiority margin was used to test whether post-contrast Wave-T1-MPRAGE was noninferior to standard T1-MPRAGE. Inter-rater and intra-rater agreement were calculated. Quantitative assessment of CNR/SNR was performed.Wave-T1-MPRAGE was noninferior to standard T1-MPRAGE for delineating enhancing lesions with unanimous agreement in all cases between raters. Wave-T1-MPRAGE was noninferior in the perception of noise (p0.001), motion artifact (p0.001), and overall diagnostic quality (p0.001).High-accelerated post-contrast Wave-T1-MPRAGE enabled a two-fold reduction in acquisition time compared to the standard sequence with comparable performance for visualization of enhancing pathology and equivalent perception of noise, motion artifacts and overall diagnostic quality without loss of clinically important information.• Post-contrast wave-controlled aliasing in parallel imaging (CAIPI) T1-MPRAGE accelerated the acquisition of three-dimensional (3D) high-resolution post-contrast images by more than two-fold. • Post-contrast Wave-T1-MPRAGE was noninferior to standard T1-MPRAGE with unanimous agreement between reviewers (100% in 80 cases) for the visualization of intracranial enhancing lesions. • Wave-T1-MPRAGE was equivalent to the standard sequence in the perception of noise in 94% (75 of 80) of cases and was preferred in 16% (13 of 80) of cases for decreased motion artifact.

Multiparametric magnetic resonance imaging (mpMRI) has been adopted as the key tool for detection, localization, characterization, and risk stratification of patients suspected to have prostate cancer. Despite advantages over systematic biopsy, the interpretation of prostate mpMRI has limitations including a steep learning curve, leading to considerable interobserver variation. There is growing interest in clinical translation of quantitative imaging techniques for more objective lesion assessment. However, traditional mapping techniques are slow, precluding their use in the clinic. Magnetic Resonance Fingerprinting (MRF) is an efficient approach for quantitative maps of multiple tissue properties simultaneously. The T(1) and T(2) values obtained with MRF have been validated with phantom studies as well as in normal volunteers and patients. Studies have shown that MRF-derived T(1) and T(2) along with ADC values are all significant independent predictors in the differentiation between normal prostate tissue and prostate cancer, and hold promise in differentiating low and intermediate/high grade cancers. This review seeks to introduce the basics of the prostate MRF technique, discuss the potential applications of prostate MRF for the characterization of prostate cancer, and describes ongoing areas of research.

To evaluate the impact of magnetization transfer (MT) on brain tissue contrast in turbo-spin-echo (TSE) and EPI fluid-attenuated inversion recovery (FLAIR) images, and to optimize an MT-prepared EPI FLAIR pulse sequence to match the tissue contrast of a clinical reference TSE FLAIR protocol.Five healthy volunteers underwent 3T brain MRI, including single slice TSE FLAIR, multi-slice TSE FLAIR, EPI FLAIR without MT-preparation, and MT-prepared EPI FLAIR with variations of the MT-preparation parameters, including number of preparation pulses, pulse amplitude, and resonance offset. Automated co-registration and gray matter (GM) versus white matter (WM) segmentation was performed using a T1-MPRAGE acquisition, and the GM versus WM signal intensity ratio (contrast ratio) was calculated for each FLAIR acquisition.Without MT preparation, EPI FLAIR showed poor tissue contrast (contrast ratio = 0.98), as did single slice TSE FLAIR. Multi-slice TSE FLAIR provided high tissue contrast (contrast ratio = 1.14). MT-prepared EPI FLAIR closely approximated the contrast of the multi-slice TSE FLAIR images for two combinations of the MT-preparation parameters (contrast ratio = 1.14). Optimized MT-prepared EPI FLAIR provided a 50% reduction in scan time compared to the reference TSE FLAIR acquisition.Optimized MT-prepared EPI FLAIR provides comparable brain tissue contrast to the multi-slice TSE FLAIR images used in clinical practice.

We introduce and validate an artificial intelligence (AI)-accelerated multi-shot echo-planar imaging (msEPI)-based method that provides T1w, T2w,The rapid imaging technique combines a novel machine learning (ML) scheme to limit g-factor noise amplification and improve SNR, a magnetization transfer preparation module to provide clinically desirable contrast, and high per-shot EPI undersampling factors to reduce distortion. The ML training and image reconstruction incorporates a tunable parameter for controlling the level of denoising/smoothness. The performance of the reconstruction method is evaluated across various acceleration factors, contrasts, and SNR conditions. The 2-minute protocol is directly compared to a 10-minute clinical reference protocol through deployment in a clinical setting, where five representative cases with pathology are examined.Optimization of custom msEPI sequences and protocols was performed to balance acquisition efficiency and image quality compared to the five-fold longer clinical reference. Training data from 16 healthy subjects across multiple contrasts and orientations were used to produce ML networks at various acceleration levels. The flexibility of the ML reconstruction was demonstrated across SNR levels, and an optimized regularization was determined through radiological review. Network generalization toward novel pathology, unobserved during training, was illustrated in five clinical case studies with clinical reference images provided for comparison.The rapid 2-minute msEPI-based protocol with tunable ML reconstruction allows for advantageous trade-offs between acquisition speed, SNR, and tissue contrast when compared to the five-fold slower standard clinical reference exam.

PURPOSE: Fetal brain Magnetic Resonance Imaging suffers from unpredictable and unconstrained fetal motion that causes severe image artifacts even with half-Fourier single-shot fast spin echo (HASTE) readouts. This work presents the implementation of a closed-loop pipeline that automatically detects and reacquires HASTE images that were degraded by fetal motion without any human interaction. METHODS: A convolutional neural network that performs automatic image quality assessment (IQA) was run on an external GPU-equipped computer that was connected to the internal network of the MRI scanner. The modified HASTE pulse sequence sent each image to the external computer, where the IQA convolutional neural network evaluated it, and then the IQA score was sent back to the sequence. At the end of the HASTE stack, the IQA scores from all the slices were sorted, and only slices with the lowest scores (corresponding to the slices with worst image quality) were reacquired. RESULTS: The closed-loop HASTE acquisition framework was tested on 10 pregnant mothers, for a total of 73 acquisitions of our modified HASTE sequence. The IQA convolutional neural network, which was successfully employed by our modified sequence in real time, achieved an accuracy of 85.2% and area under the receiver operator characteristic of 0.899. CONCLUSION: The proposed acquisition/reconstruction pipeline was shown to successfully identify and automatically reacquire only the motion degraded fetal brain HASTE slices in the prescribed stack. This minimizes the overall time spent on HASTE acquisitions by avoiding the need to repeat the entire stack if only few slices in the stack are motion-degraded.

Intra-scan rigid-body motion is a costly and ubiquitous problem in clinical magnetic resonance imaging (MRI) of the head.State-of-the-art methods for retrospective motion correction in MRI are often computationally expensive or in the case of image-to-image deep learning (DL) based methods can be prone to undesired alterations of the image (hallucinations). In this work we introduce a novel rigid-body motion correction method which combines the advantages of classical model-driven and data-consistency (DC) preserving approaches with a novel DL algorithm, to provide fast and robust retrospective motion correction.The proposed Motion Parameter Estimating Densenet (MoPED) retrospectively estimates subject head motion during MRI acquisitions using a DL network with DenseBlocks and multitask learning. It quantifies the 2D rigid in-plane motion parameters slice-wise for each echo train (ET) of a Cartesian T2-weighted 2D Turbo-Spin-Echo sequence. The network receives a center patch of the motion corrupted k-space as well as an additional motion-free low-resolution reference scan to provide the ground truth orientation. The supervised training utilizes motion simulations based on 28 acquisitions with subject-wise training, validation, and test data splits of 70%, 23%, and 7%. During inference, MoPED is embedded in an iterative DC-driven motion correction algorithm which alternatingly updates estimates of the motion parameters and motion-corrected low-resolution k-space data. The estimated motion parameters are then used to reconstruct the final motion corrected image. The mean absolute/squared error and the Pearson correlation coefficient were used to analyze the motion parameter estimation quality on in-silico data in a quantitative evaluation. Structural similarity (SSIM), DC error and root mean squared error (RMSE) were used as metrics of image quality improvement. Furthermore, the generalization capability of the network was analyzed on 2 in-vivo motion volumes with 28 slices each and on one simulated T1-weighted volume.The motion estimation achieves a Pearson correlation of 0.968 to the simulated ground-truth of the 2,433 test data slices used. In-silico results indicate that MoPED decreases the time for the optimization by a factor of around 27 compared to a conventional method and is able to reduce the RMSE of the reconstructions and average DC error by more than a factor of two compared to uncorrected images. In-vivo experiments show a decrease in computation time by a factor of around 20, a RMSE decrease from 0.055 to 0.033 and an SSIM increase from 0.795 to 0.862. Furthermore, contrast independence is demonstrated as MoPED is also able to correct T1-weighted images in simulations without retraining. Due to the model-based correction, no hallucinations were observed.Incorporating DL in a model-based motion correction algorithm shows great benefit on the optimization and computation time. The k-space-based estimation also allows a data consistent correction and therefore avoids the risk of hallucinations of image-to-image approaches. This article is protected by copyright. All rights reserved.

PURPOSE: To introduce wave-encoded acquisition and reconstruction techniques for highly accelerated EPI with reduced g-factor penalty and image artifacts.THEORY AND METHODS: Wave-EPI involves application of sinusoidal gradients during the EPI readout, which spreads the aliasing in all spatial directions, thereby taking better advantage of 3D coil sensitivity profiles. The amount of voxel spreading that can be achieved by the wave gradients during the short EPI readout period is constrained by the slew rate of the gradient coils and peripheral nerve stimulation monitor. We propose to use a "half-cycle" sinusoidal gradient to increase the amount of voxel spreading that can be achieved while respecting the slew and stimulation constraints. Extending wave-EPI to multi-shot acquisition minimizes geometric distortion and voxel blurring at high in-plane resolutions, while structured low-rank regularization mitigates shot-to-shot phase variations. To address gradient imperfections, we propose to use different point spread functions for the k-space lines with positive and negative polarities, which are calibrated with a FLEET-based reference scan.RESULTS: Wave-EPI enabled whole-brain single-shot gradient-echo (GE) and multi-shot spin-echo (SE) EPI acquisitions at high acceleration factors at 3T and was combined with g-Slider encoding to boost the SNR level in 1 mm isotropic diffusion imaging. Relative to blipped-CAIPI, wave-EPI reduced average and maximum g-factors by up to 1.21- and 1.37-fold at Rin × Rsms = 3 × 3, respectively.CONCLUSION: Wave-EPI allows highly accelerated single- and multi-shot EPI with reduced g-factor and artifacts and may facilitate clinical and neuroscientific applications of EPI by improving the spatial and temporal resolution in functional and diffusion imaging.

Background Cardiac MR fingerprinting (cMRF) is a novel technique for simultaneous T1 and T2 mapping. Purpose To compare T1 /T2 measurements, repeatability, and map quality between cMRF and standard mapping techniques in healthy subjects. Study type Prospective. Population In all, 58 subjects (ages 18-60). FIELD STRENGTH/SEQUENCE: cMRF, modified Look-Locker inversion recovery (MOLLI), and T2 -prepared balanced steady-state free precession (bSSFP) at 1.5T. Assessment T1 /T2 values were measured in 16 myocardial segments at apical, medial, and basal slice positions. Test-retest and intrareader repeatability were assessed for the medial slice. cMRF and conventional mapping sequences were compared using ordinal and two alternative forced choice (2AFC) ratings. Statistical tests Paired t-tests, Bland-Altman analyses, intraclass correlation coefficient (ICC), linear regression, one-way analysis of variance (ANOVA), and binomial tests. Results Average T1 measurements were: basal 1007.4±96.5 msec (cMRF), 990.0±45.3 msec (MOLLI); medial 995.0±101.7 msec (cMRF), 995.6±59.7 msec (MOLLI); apical 1006.6±111.2 msec (cMRF); and 981.6±87.6 msec (MOLLI). Average T2 measurements were: basal 40.9±7.0 msec (cMRF), 46.1±3.5 msec (bSSFP); medial 41.0±6.4 msec (cMRF), 47.4±4.1 msec (bSSFP); apical 43.5±6.7 msec (cMRF), 48.0±4.0 msec (bSSFP). A statistically significant bias (cMRF T1 larger than MOLLI T1 ) was observed in basal (17.4 msec) and apical (25.0 msec) slices. For T2 , a statistically significant bias (cMRF lower than bSSFP) was observed for basal (-5.2 msec), medial (-6.3 msec), and apical (-4.5 msec) slices. Precision was lower for cMRF-the average of the standard deviation measured within each slice was 102 msec for cMRF vs. 61 msec for MOLLI T1 , and 6.4 msec for cMRF vs. 4.0 msec for bSSFP T2 . cMRF and conventional techniques had similar test-retest repeatability as quantified by ICC (0.87 cMRF vs. 0.84 MOLLI for T1 ; 0.85 cMRF vs. 0.85 bSSFP for T2 ). In the ordinal image quality comparison, cMRF maps scored higher than conventional sequences for both T1 (all five features) and T2 (four features). Data conclusion This work reports on myocardial T1 /T2 measurements in healthy subjects using cMRF and standard mapping sequences. cMRF had slightly lower precision, similar test-retest and intrareader repeatability, and higher scores for map quality. Evidence level 2 TECHNICAL EFFICACY: Stage 1 J. Magn. Reson. Imaging 2020;52:1044-1052.

The goal of this study is to leverage an advanced fast imaging technique, wave-controlled aliasing in parallel imaging (Wave-CAIPI), and a generative adversarial network (GAN) for denoising to achieve accelerated high-quality high-signal-to-noise-ratio (SNR) volumetric magnetic resonance imaging (MRI).Three-dimensional (3D) THDnGAN effectively denoised low-SNR Wave-CAIPI images with sharpness and rich textural details, which could be adjusted by controlling the contribution of the adversarial loss to the total loss when training the generator. Quantitatively, HDnGAN (λ = 10HDnGAN provides robust and feasible denoising while preserving rich textural detail in empirical volumetric MRI data. Our study using empirical patient data and systematic evaluation supports the use of HDnGAN in combination with modern fast imaging techniques such as Wave-CAIPI to achieve high-fidelity fast volumetric MRI and represents an important step to the clinical translation of GANs.

BACKGROUND AND PURPOSE: Our aim was to evaluate an ultrafast 3D-FLAIR sequence using Wave–controlled aliasing in parallel imaging encoding (Wave-FLAIR) compared with standard 3D-FLAIR in the visualization and volumetric estimation of cerebral white matter lesions in a clinical setting. MATERIALS AND METHODS: Forty-two consecutive patients underwent 3T brain MR imaging, including standard 3D-FLAIR (acceleration factor = 2, scan time = 7 minutes 50 seconds) and resolution-matched ultrafast Wave-FLAIR sequences (acceleration factor = 6, scan time = 2 minutes 45 seconds for the 20-channel coil; acceleration factor = 9, scan time = 1 minute 50 seconds for the 32-channel coil) as part of clinical evaluation for demyelinating disease. Automated segmentation of cerebral white matter lesions was performed using the Lesion Segmentation Tool in SPM. Student t tests, intraclass correlation coefficients, relative lesion volume difference, and Dice similarity coefficients were used to compare volumetric measurements among sequences. Two blinded neuroradiologists evaluated the visualization of white matter lesions, artifacts, and overall diagnostic quality using a predefined 5-point scale. RESULTS: Standard and Wave-FLAIR sequences showed excellent agreement of lesion volumes with an intraclass correlation coefficient of 0.99 and mean Dice similarity coefficient of 0.97 (SD, 0.05) (range, 0.84–0.99). Wave-FLAIR was noninferior to standard FLAIR for visualization of lesions and motion. The diagnostic quality for Wave-FLAIR was slightly greater than for standard FLAIR for infratentorial lesions (P

PURPOSE To demonstrate a navigator/tracking-free retrospective motion estimation technique that facilitates clinically acceptable reconstruction time. METHODS Scout accelerated motion estimation and reduction (SAMER) uses a single 3-5 s, low-resolution scout scan and a novel sequence reordering to independently determine motion states by minimizing the data-consistency error in a SENSE plus motion forward model. This eliminates time-consuming alternating optimization as no updates to the imaging volume are required during the motion estimation. The SAMER approach was assessed quantitatively through extensive simulation and was evaluated in vivo across multiple motion scenarios and clinical imaging contrasts. Finally, SAMER was synergistically combined with advanced encoding (Wave-CAIPI) to facilitate rapid motion-free imaging. RESULTS The highly accelerated scout provided sufficient information to achieve accurate motion trajectory estimation (accuracy ~0.2 mm or degrees). The novel sequence reordering improved the stability of the motion parameter estimation and image reconstruction while preserving the clinical imaging contrast. Clinically acceptable computation times for the motion estimation (~4 s/shot) are demonstrated through a fully separable (non-alternating) motion search across the shots. Substantial artifact reduction was demonstrated in vivo as well as corresponding improvement in the quantitative error metric. Finally, the extension of SAMER to Wave-encoding enabled rapid high-quality imaging at up to R = 9-fold acceleration. CONCLUSION SAMER significantly improved the computational scalability for retrospective motion estimation and correction.

Wave-CAIPI (Controlled Aliasing in Parallel Imaging) enables dramatic reduction in acquisition time of 3D MRI sequences such as 3D susceptibility-weighted imaging (SWI) but has not been clinically evaluated at 1.5 T. We sought to compare highly accelerated Wave-CAIPI SWI (Wave-SWI) with two alternative standard sequences, conventional three-dimensional SWI and two-dimensional T2*-weighted Gradient-Echo (T2*w-GRE), in patients undergoing routine brain MRI at 1.5 T.In this study, 172 patients undergoing 1.5 T brain MRI were scanned with a more commonly used susceptibility sequence (standard SWI or T2*w-GRE) and a highly accelerated Wave-SWI sequence. Two radiologists blinded to the acquisition technique scored each sequence for visualization of pathology, motion and signal dropout artifacts, image noise, visualization of normal anatomy (vessels and basal ganglia mineralization), and overall diagnostic quality. Superiority testing was performed to compare Wave-SWI to T2*w-GRE, and non-inferiority testing with 15% margin was performed to compare Wave-SWI to standard SWI.Wave-SWI performed superior in terms of visualization of pathology, signal dropout artifacts, visualization of normal anatomy, and overall image quality when compared to T2*w-GRE (all p0.001). Wave-SWI was non-inferior to standard SWI for visualization of normal anatomy and pathology, signal dropout artifacts, and overall image quality (all p0.001). Wave-SWI was superior to standard SWI for motion artifact (p0.001), while both conventional susceptibility sequences were superior to Wave-SWI for image noise (p0.001).Wave-SWI can be performed in a 1.5 T clinical setting with robust performance and preservation of diagnostic quality.• Wave-SWI accelerated the acquisition of 3D high-resolution susceptibility images in 70% of the acquisition time of the conventional T2*GRE. • Wave-SWI performed superior to T2*w-GRE for visualization of pathology, signal dropout artifacts, and overall diagnostic image quality. • Wave-SWI was noninferior to standard SWI for visualization of normal anatomy and pathology, signal dropout artifacts, and overall diagnostic image quality.

BACKGROUND: Preliminary studies have shown that MR fingerprinting–based relaxometry combined with apparent diffusion coefficient (ADC) mapping can be used to differentiate normal peripheral zone from prostate cancer and prostatitis. The utility of relaxometry and ADC mapping for the transition zone (TZ) is unknown. PURPOSE: To evaluate the utility of MR fingerprinting combined with ADC mapping for characterizing TZ lesions. MATERIALS AND METHODS: TZ lesions that were suspicious for cancer in men who underwent MRI with T2-weighted imaging and ADC mapping (b values, 50–1400 sec/mm(2)), MR fingerprinting with steady-state free precession, and targeted biopsy (60 in-gantry and 15 cognitive targeting) between September 2014 and August 2018 in a single university hospital were retrospectively analyzed. Two radiologists blinded to Prostate Imaging Reporting and Data System (PI-RADS) scores and pathologic diagnosis drew regions of interest on cancer-suspicious lesions and contralateral visually normal TZs (NTZs) on MR fingerprinting and ADC maps. Linear mixed models compared two-reader means of T1, T2, and ADC. Generalized estimating equations logistic regression analysis was used to evaluate both MR fingerprinting and ADC in differentiating NTZ, cancers and noncancers, clinically significant (Gleason score ≥ 7) cancers from clinically insignificant lesions (noncancers and Gleason 6 cancers), and characterizing PI-RADS version 2 category 3 lesions. RESULTS: In 67 men (mean age, 66 years ± 8 [standard deviation]) with 75 lesions, targeted biopsy revealed 37 cancers (six PI-RADS category 3 cancers and 31 PI-RADS category 4 or 5 cancers) and 38 noncancers (31 PI-RADS category 3 lesions and seven PI-RADS category 4 or 5 lesions). The T1, T2, and ADC of NTZ (1800 msec ± 150, 65 msec ± 22, and [1.13 ± 0.19] × 10(−3) mm(2)/sec, respectively) were higher than those in cancers (1450 msec ± 110, 36 msec ± 11, and [0.57 ± 0.13] × 10(−3) mm(2)/sec, respectively; P < .001 for all). The T1, T2, and ADC in cancers were lower than those in noncancers (1620 msec ± 120, 47 msec ± 16, and [0.82 ± 0.13] × 10(−3) mm(2)/sec, respectively; P = .001 for T1 and ADC and P = .03 for T2). The area under the receiver operating characteristic curve (AUC) for T1 plus ADC was 0.94 for separation. T1 and ADC in clinically significant cancers (1440 msec ± 140 and [0.58 ± 0.14] × 10(−3) mm(2)/sec, respectively) were lower than those in clinically insignificant lesions (1580 msec ± 120 and [0.75 ± 0.17] × 10(−3) mm(2)/sec, respectively; P = .001 for all). The AUC for T1 plus ADC was 0.81 for separation. Within PI-RADS category 3 lesions, T1 and ADC of cancers (1430 msec ± 220 and [0.60 ± 0.17] × 10(−3) mm(2)/sec, respectively) were lower than those of noncancers (1630 msec ± 120 and [0.81 ± 0.13] × 10(−3) mm(2)/sec, respectively; P = .006 for T1 and P = .004 for ADC). The AUC for T1 was 0.79 for differentiating category 3 lesions. CONCLUSION: MR fingerprinting–based relaxometry combined with apparent diffusion coefficient mapping may improve transition zone lesion characterization. © RSNA, 2019 Online supplemental material is available for this article.

BACKGROUND AND PURPOSE: High-resolution three-dimensional (3D) post-contrast imaging of the brain is essential for comprehensive evaluation of inflammatory, neoplastic, and neurovascular diseases of the brain. 3D T1-weighted spin-echo-based sequences offer increased sensitivity for the detection of enhancing lesions but are relatively prolonged examinations. We evaluated whether a highly accelerated Wave-controlled aliasing in parallel imaging (Wave-CAIPI) post-contrast 3D T1-sampling perfection with application-optimized contrasts using different flip angle evolutions (T1-SPACE) sequence (Wave-T1-SPACE) was noninferior to the standard high-resolution 3D T1-SPACE sequence for visualizing enhancing lesions with comparable diagnostic quality. METHODS: One hundred and three consecutive patients were prospectively evaluated with a standard post-contrast 3D T1-SPACE sequence (acquisition time [TA] = 4 min 19 s) and an optimized Wave-CAIPI 3D T1-SPACE sequence (TA = 1 min 40 s) that was nearly three times faster than the standard sequence. Two blinded neuroradiologists performed a head-to-head comparison to evaluate the visualization of enhancing pathology, perception of artifacts, and overall diagnostic quality. A 15% margin was used to test whether post-contrast Wave-T1-SPACE was noninferior to standard T1-SPACE. RESULTS: Wave-T1-SPACE was noninferior to standard T1-SPACE for delineating parenchymal and meningeal enhancing pathology (p

Introduction Clinical validation studies have demonstrated the ability of accelerated MRI sequences to decrease acquisition time and motion artifact while preserving image quality. The operational benefits, however, have been less explored. Here, we report our initial clinical experience in implementing fast MRI techniques for outpatient brain imaging during the COVID-19 pandemic. Methods Aggregate acquisition times were extracted from the medical record on consecutive imaging examinations performed during matched pre-implementation (7/1/2019-12/31/2019) and post-implementation periods (7/1/2020-12/31/2020). Expected acquisition time reduction for each MRI protocol was calculated through manual collection of acquisition times for the conventional and accelerated sequences performed during the pre- and post-implementation periods. Aggregate and expected acquisition times were compared for the five most frequently performed brain MRI protocols: brain without contrast (BR-), brain with and without contrast (BR+), multiple sclerosis (MS), memory loss (MML), and epilepsy (EPL). Results The expected time reductions for BR-, BR+, MS, MML, and EPL protocols were 6.6 min, 11.9 min, 14 min, 10.8 min, and 14.1 min, respectively. The overall median aggregate acquisition time was 31 [25, 36] min for the pre-implementation period and 18 [15, 22] min for the post-implementation period, with a difference of 13 min (42%). The median acquisition time was reduced by 4 min (25%) for BR-, 14.0 min (44%) for BR+, 14 min (38%) for MS, 11 min (52%) for MML, and 16 min (35%) for EPL. Conclusion The implementation of fast brain MRI sequences significantly reduced the acquisition times for the most commonly performed outpatient brain MRI protocols.

Purpose We combine SNR-efficient acquisition and model-based reconstruction strategies with newly available hardware instrumentation to achieve distortion-free in vivo diffusion MRI of the brain at submillimeter-isotropic resolution with high fidelity and sensitivity on a clinical 3T scanner. Methods We propose blip-up/down acquisition (BUDA) for multishot EPI using interleaved blip-up/blip-down phase encoding and incorporate B0 forward-modeling into structured low-rank reconstruction to enable distortion-free and navigator-free diffusion MRI. We further combine BUDA-EPI with an SNR-efficient simultaneous multislab acquisition (generalized slice-dithered enhanced resolution ["gSlider"]), to achieve high-isotropic-resolution diffusion MRI. To validate gSlider BUDA-EPI, whole-brain diffusion data at 860-μm and 780-μm data sets were acquired. Finally, to improve the conditioning and minimize noise penalty in BUDA reconstruction at very high resolutions where B0 inhomogeneity can have a detrimental effect, the level of B0 inhomogeneity was reduced by incorporating slab-by-slab dynamic shimming with a 32-channel AC/DC coil into the acquisition. Whole-brain 600-μm diffusion data were then acquired with this combined approach of gSlider BUDA-EPI with dynamic shimming. Results The results of 860-μm and 780-μm datasets show high geometry fidelity with gSlider BUDA-EPI. With dynamic shimming, the BUDA reconstruction's noise penalty was further alleviated. This enables whole-brain 600-μm isotropic resolution diffusion imaging with high image quality. Conclusions The gSlider BUDA-EPI method enables high-quality, distortion-free diffusion imaging across the whole brain at submillimeter resolution, where the use of multicoil dynamic B0 shimming further improves reconstruction performance, which can be particularly useful at very high resolutions.

BACKGROUND AND PURPOSETo evaluate an ultrafast 3D-FLAIR sequence using Wave-CAIPI encoding (Wave-FLAIR) compared to standard 3D-FLAIR in the visualization and volumetric estimation of cerebral white matter lesions in a clinical setting.MATERIALS AND METHODS42 consecutive patients underwent 3T brain MRI including standard 3D-FLAIR (acceleration factor R=2, scan time TA=7:15 minutes) and resolution-matched ultrafast Wave-FLAIR sequences (R=6, TA=2:45 minutes for the 20-ch coil; R=9, TA=1:50 minutes for the 32-ch coil) as part of clinical evaluation for demyelinating disease. Automated segmentation of cerebral white matter lesions was performed using the Lesion Segmentation Tool in SPM. Student’s t-test, intra-class correlation coefficient (ICC), relative lesion volume difference (LVD) and Dice similarity coefficients (DSC) were used to compare volumetric measurements between sequences. Two blinded neuroradiologists evaluated the visualization of white matter lesions, artifact and overall diagnostic quality using a predefined 5-point scale.RESULTSStandard and Wave-FLAIR sequences showed excellent agreement of lesion volumes with an ICC of 0.99 and DSC of 0.97±0.05 (range 0.84 to 0.99). Wave-FLAIR was non-inferior to standard-FLAIR for visualization of lesions and motion. The diagnostic quality for Wave-FLAIR was slightly greater than standard-FLAIR for infratentorial lesions (pCONCLUSIONSUltrafast Wave-FLAIR provides superior visualization of infratentorial lesions while preserving overall diagnostic quality and yields comparable white matter lesion volumes to those estimated using standard-FLAIR. The availability of ultrafast Wave-FLAIR may facilitate the greater use of 3D-FLAIR sequences in the evaluation of patients with suspected demyelinating disease.

Purpose: Reducing scan times is important for wider adoption of high-resolution volumetric MRI in research and clinical practice. Emerging fast imaging and deep learning techniques provide promising strategies to accelerate volumetric MRI without compromising image quality. In this study, we aim to leverage an advanced fast imaging technique, wave-controlled aliasing in parallel imaging (Wave-CAIPI), and a novel denoising generative adversarial network (GAN) to achieve accelerated high-fidelity, high-signal-to-noise-ratio (SNR) volumetric MRI. Methods: 3D T2-weighted fluid-attenuated inversion recovery (FLAIR) image data were acquired on 33 multiple sclerosis (MS) patients using a prototype Wave-CAIPI sequence (acceleration factor R=3×2, 2.75 minutes) and a standard T2-SPACE FLAIR sequence (R=2, 7.25 minutes). A hybrid denoising GAN entitled "HDnGAN" composed of a 3D generator (i.e., a modified 3D U-Net entitled MU-Net) and a 2D discriminator was proposed to denoise Wave-CAIPI images with the standard FLAIR images as the target. HDnGAN was trained and validated on data from 25 MS patients by minimizing a combined content loss (i.e., mean squared error (MSE)) and adversarial loss with adjustable weight λ, and evaluated on data from 8 patients unseen during training. The quality of HDnGAN-denoised images was compared to those from other denoising methods including AONLM, BM4D, MU-Net, and 3D GAN in terms of their similarity to standard FLAIR images, quantified using MSE and VGG perceptual loss. The images from different methods were assessed by two neuroradiologists using a five-point score regarding sharpness, SNR, lesion conspicuity, and overall quality. Finally, the performance of these denoising methods was compared at higher noise levels using simulated data with added Rician noise. Results: HDnGAN effectively denoised noisy Wave-CAIPI images with sharpness and rich textural details, which could be adjusted by controlling λ. Quantitatively, HDnGAN (λ=10-3) achieved low MSE (7.43×10-4±0.94×10-4) and the lowest VGG perceptual loss (1.09×10-2±0.18×10-2). The reader study showed that HDnGAN (λ=10-3) significantly improved the SNR of Wave-CAIPI images (4.19±0.39 vs. 2.94±0.24, P-3) (3.31±0.46, P-3) (3.5±0.82, P=0.001) regarding lesion conspicuity. The overall quality score of HDnGAN (λ=10-3) (4.25±0.43) was significantly higher than those from Wave-CAIPI (3.69±0.46, P=0.003), BM4D (3.50±0.71, P=0.001), MU-Net (3.25±0.75, P-3) (3.50±0.50, P

Purpose This work presents a 4D numerical abdominal phantom, which includes T1 and T2 relaxation times, proton density fat fraction, perfusion, and diffusion, as well as respiratory motion for the evaluation and comparison of acquisition and reconstruction techniques. Methods The 3D anatomical mesh models were non-rigidly scaled and shifted by respiratory motion derived from an in vivo scan. A time series of voxelized 3D abdominal phantom images were obtained with contrast determined by the tissue properties and pulse sequence parameters. Two example simulations: (1) 3D T1 mapping under breath-hold and free-breathing acquisition conditions and (2) two different reconstruction techniques for accelerated 3D dynamic contrast-enhanced MRI, are presented. The source codes can be found at https://github.com/SeiberlichLab/Abdominal_MR_Phantom. Results The proposed 4D abdominal phantom can successfully simulate images and MRI data with nonrigid respiratory motion and specific contrast settings and data sampling schemes. In example 1, the use of a numerical 4D abdominal phantom was demonstrated to aid in the comparison between different approaches for volumetric T1 mapping. In example 2, the average arterial fraction over the healthy hepatic parenchyma as calculated with spiral generalized autocalibrating partial parallel acquisition was closer to that from the fully sampled data than the arterial fraction from conjugate gradient sensitivity encoding, although both are elevated compared to the gold-standard reference. Conclusion This realistic abdominal MR phantom can be used to simulate different pulse sequences and data sampling schemes for the comparison of acquisition and reconstruction methods under controlled conditions that are impossible or prohibitively difficult to perform in vivo.

Purpose To evaluate the feasibility of through-time spiral generalized autocalibrating partial parallel acquisition (GRAPPA) for low-latency accelerated real-time MRI of speech. Methods Through-time spiral GRAPPA (spiral GRAPPA), a fast linear reconstruction method, is applied to spiral (k-t) data acquired from an eight-channel custom upper-airway coil. Fully sampled data were retrospectively down-sampled to evaluate spiral GRAPPA at undersampling factors R = 2 to 6. Pseudo-golden-angle spiral acquisitions were used for prospective studies. Three subjects were imaged while performing a range of speech tasks that involved rapid articulator movements, including fluent speech and beat-boxing. Spiral GRAPPA was compared with view sharing, and a parallel imaging and compressed sensing (PI-CS) method. Results Spiral GRAPPA captured spatiotemporal dynamics of vocal tract articulators at undersampling factors ≤4. Spiral GRAPPA at 18 ms/frame and 2.4 mm2/pixel outperformed view sharing in depicting rapidly moving articulators. Spiral GRAPPA and PI-CS provided equivalent temporal fidelity. Reconstruction latency per frame was 14 ms for view sharing and 116 ms for spiral GRAPPA, using a single processor. Spiral GRAPPA kept up with the MRI data rate of 18ms/frame with eight processors. PI-CS required 17 minutes to reconstruct 5 seconds of dynamic data. Conclusion Spiral GRAPPA enabled 4-fold accelerated real-time MRI of speech with a low reconstruction latency. This approach is applicable to wide range of speech RT-MRI experiments that benefit from real-time feedback while visualizing rapid articulator movement. Magn Reson Med 78:2275–2282, 2017. © 2017 International Society for Magnetic Resonance in Medicine.

Purpose: To rapidly obtain high isotropic-resolution T2 maps with whole-brain coverage and high geometric fidelity. Methods: A T2 blip-up/down echo planar imaging (EPI) acquisition with generalized Slice-dithered enhanced resolution (T2-BUDA-gSlider) is proposed. A radiofrequency (RF)-encoded multi-slab spin-echo EPI acquisition with multiple echo times (TEs) was developed to obtain high SNR efficiency with reduced repetition time (TR). This was combined with an interleaved 2-shot EPI acquisition using blip-up/down phase encoding. An estimated field map was incorporated into the joint multi-shot EPI reconstruction with a structured low rank constraint to achieve distortion-free and robust reconstruction for each slab without navigation. A Bloch simulated subspace model was integrated into gSlider reconstruction and utilized for T2 quantification. Results: In vivo results demonstrated that the T2 values estimated by the proposed method were consistent with gold standard spin-echo acquisition. Compared to the reference 3D fast spin echo (FSE) images, distortion caused by off-resonance and eddy current effects were effectively mitigated. Conclusion: BUDA-gSlider SE-EPI acquisition and gSlider-subspace joint reconstruction enabled distortion-free whole-brain T2 mapping in 2 min at ~1 mm3 isotropic resolution, which could bring significant benefits to related clinical and neuroscience applications., 20 pages, 7 figures

BACKGROUND: Cardiac MR fingerprinting (cMRF) is a novel technique for simultaneous T(1) and T(2) mapping. PURPOSE: To compare T(1)/T(2) measurements, repeatability, and map quality between cMRF and standard mapping techniques in healthy subjects. STUDY TYPE: Prospective. POPULATION: In all, 58 subjects (ages 18–60). FIELD STRENGTH/SEQUENCE: cMRF, modified Look-Locker inversion recovery (MOLLI), and T(2)-prepared balanced steady-state free precession (bSSFP) at 1.5T. ASSESSMENT: T(1)/T(2) values were measured in 16 myocardial segments at apical, medial, and basal slice positions. Test–retest and intrareader repeatability were assessed for the medial slice. cMRF and conventional mapping sequences were compared using ordinal and two alternative forced choice (2AFC) ratings. STATISTICAL TESTS: Paired t-tests, Bland-Altman analyses, intraclass correlation coefficient (ICC), linear regression, one-way analysis of variance (ANOVA), and binomial tests. RESULTS: Average T(1) measurements were: basal 1007.4±96.5 msec (cMRF), 990.0±45.3 msec (MOLLI); medial 995.0±101.7 msec (cMRF), 995.6±59.7 msec (MOLLI); apical 1006.6±111.2 msec (cMRF); and 981.6±87.6 msec (MOLLI). Average T(2) measurements were: basal 40.9±7.0 msec (cmRf), 46.1±3.5 msec (bSSFP); medial 41.0±6.4 msec (cMRF), 47.4±4.1 msec (bSSFP); apical 43.5±6.7 msec (cMRF), 48.0±4.0 msec (bSSFP). A statistically significant bias (cMRFT(1) larger than MOLLI T(1)) was observed in basal (17.4 msec) and apical (25.0 msec) slices. For T(2), a statistically significant bias (cMRF lower than bSSFP) was observed for basal (−5.2 msec), medial (−6.3 msec), and apical (−4.5 msec) slices. Precision was lower for cMRF—the average of the standard deviation measured within each slice was 102 msec for cMRF vs. 61 msec for MOLLI T(1), and 6.4 msec for cMRF vs. 4.0 msec for bSSFP T(2). cMRF and conventional techniques had similar test-retest repeatability as quantified by ICC (0.87 cMRF vs. 0.84 MOLLI for T(1); 0.85 cMRF vs. 0.85 bSSFP for T(2)). In the ordinal image quality comparison, cMRF maps scored higher than conventional sequences for both T(1) (all five features) and T(2) (four features). DATA CONCLUSION: This work reports on myocardial T(1)/T(2) measurements in healthy subjects using cMRF and standard mapping sequences. cMRF had slightly lower precision, similar test-retest and intrareader repeatability, and higher scores for map quality. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 1

This study aims for targeted biopsy validation of magnetic resonance fingerprinting (MRF) and diffusion mapping for characterizing peripheral zone (PZ) prostate cancer and noncancers.One hundred four PZ lesions in 85 patients who underwent magnetic resonance imaging were retrospectively analyzed with apparent diffusion coefficient (ADC) mapping, MRF, and targeted biopsy (cognitive or in-gantry). A radiologist blinded to pathology drew regions of interest on targeted lesions and visually normal peripheral zone on MRF and ADC maps. Mean T1, T2, and ADC were analyzed using linear mixed models. Generalized estimating equations logistic regression analyses were used to evaluate T1 and T2 relaxometry combined with ADC in differentiating pathologic groups.Targeted biopsy revealed 63 cancers (low-grade cancer/Gleason score 6 = 10, clinically significant cancer/Gleason score ≥7 = 53), 15 prostatitis, and 26 negative biopsies. Prostate cancer T1, T2, and ADC (mean ± SD, 1660 ± 270 milliseconds, 56 ± 20 milliseconds, 0.70 × 10 ± 0.24 × 10 mm/s) were significantly lower than prostatitis (mean ± SD, 1730 ± 350 milliseconds, 77 ± 36 milliseconds, 1.00 × 10 ± 0.30 × 10 mm/s) and negative biopsies (mean ± SD, 1810 ± 250 milliseconds, 71 ± 37 milliseconds, 1.00 × 10 ± 0.33 × 10 mm/s). For cancer versus prostatitis, ADC was sensitive and T2 specific with comparable area under curve (AUC; (AUCT2 = 0.71, AUCADC = 0.79, difference between AUCs not significant P = 0.37). T1 + ADC (AUCT1 + ADC = 0.83) provided the best separation between cancer and negative biopsies. Low-grade cancer T2 and ADC (mean ± SD, 75 ± 29 milliseconds, 0.96 × 10 ± 0.34 × 10 mm/s) were significantly higher than clinically significant cancers (mean ± SD, 52 ± 16 milliseconds, 0.65 ± 0.18 × 10 mm/s), and T2 + ADC (AUCT2 + ADC = 0.91) provided the best separation.T1 and T2 relaxometry combined with ADC mapping may be useful for quantitative characterization of prostate cancer grades and differentiating cancer from noncancers for PZ lesions seen on T2-weighted images.

This study introduces a technique for simultaneous multislice (SMS) cardiac Magnetic Resonance Fingerprinting (cMRF), which improves the slice coverage when quantifying myocardial T(1,) T(2), and M(0). The single-slice cMRF pulse sequence was modified to use multiband RF pulses for SMS imaging. Different RF phase schedules were used to excite each slice, similar to POMP or CAIPIRINHA, which imparts tissues with a distinguishable and slice-specific magnetization evolution over time. Because of the high net acceleration factor (R=48 in-plane combined with the slice acceleration), images were first reconstructed with a low rank technique before matching data to a dictionary of signal timecourses generated by a Bloch equation simulation. The proposed method was tested in simulations with a numerical relaxation phantom. Phantom and in vivo cardiac scans of ten healthy volunteers were also performed at 3T. With single-slice acquisitions, the mean relaxation times obtained using the low rank cMRF reconstruction agree with reference values. The low rank method improves the precision in T(1) and T(2) for both single-slice and SMS cMRF, and it enables the acquisition of maps with fewer artifacts when using SMS cMRF at higher multiband factors. With this technique, in vivo cardiac maps were acquired from three slices simultaneously during a breathhold lasting 16 heartbeats. SMS cMRF improves the efficiency and slice coverage of myocardial T(1) and T(2) mapping compared to both single-slice cMRF and conventional cardiac mapping sequences. Thus, this technique is a first step toward whole-heart simultaneous T(1) and T(2) quantification with cMRF.

This study aims to improve the accuracy and consistency of T(1) and T(2) measurements using cardiac MR Fingerprinting (cMRF) by investigating and accounting for the effects of confounding factors including slice profile, inversion and T(2) preparation pulse efficiency, and B(1)(+). The goal is to understand how measurements with different pulse sequences are affected by these factors. This can be used to determine which factors must be taken into account for accurate measurements, and which may be mitigated by the selection of an appropriate pulse sequence. Simulations were performed using a numerical cardiac phantom to assess the accuracy of over 600 cMRF sequences with different flip angles, TRs, and preparation pulses. A subset of sequences, including one with the lowest errors in T(1) and T(2) maps, was used in subsequent analyses. Errors due to non-ideal slice profile, preparation pulse efficiency, and B(1)(+) were quantified in Bloch simulations. Corrections for these effects were included in the dictionary generation and demonstrated in phantom and in vivo cardiac imaging at 3T. Neglecting to model slice profile and preparation pulse efficiency led to underestimated T(1) and overestimated T(2) for most cMRF sequences. Sequences with smaller maximum flip angles were less affected by slice profile and B(1)(+). Simulating all corrections in the dictionary improved the accuracy of T(1) and T(2) phantom measurements, regardless of acquisition pattern. More consistent myocardial T(1) and T(2) values were measured using different sequences after corrections. Based on these results, a pulse sequence which is minimally affected by confounding factors can be selected, and the appropriate residual corrections included for robust T(1) and T(2) mapping.

The quantification of cardiac T1 relaxation time holds great potential for the detection of various cardiac diseases. However, as a result of both cardiac and respiratory motion, only one two-dimensional T1 map can be acquired in one breath-hold with most current techniques, which limits its application for whole heart evaluation in routine clinical practice. In this study, an electrocardiogram (ECG)-triggered three-dimensional Look-Locker method was developed for cardiac T1 measurement. Fast three-dimensional data acquisition was achieved with a spoiled gradient-echo sequence in combination with a stack-of-spirals trajectory and through-time non-Cartesian generalized autocalibrating partially parallel acquisition (GRAPPA) acceleration. The effects of different magnetic resonance parameters on T1 quantification with the proposed technique were first examined by simulating data acquisition and T1 map reconstruction using Bloch equation simulations. Accuracy was evaluated in studies with both phantoms and healthy subjects. These results showed that there was close agreement between the proposed technique and the reference method for a large range of T1 values in phantom experiments. In vivo studies further demonstrated that rapid cardiac T1 mapping for 12 three-dimensional partitions (spatial resolution, 2 × 2 × 8 mm3 ) could be achieved in a single breath-hold of ~12 s. The mean T1 values of myocardial tissue and blood obtained from normal volunteers at 3 T were 1311 ± 66 and 1890 ± 159 ms, respectively. In conclusion, a three-dimensional T1 mapping technique was developed using a non-Cartesian parallel imaging method, which enables fast and accurate T1 mapping of cardiac tissues in a single short breath-hold.

The purpose of this study is to evaluate the predictive performance of magnetic resonance imaging (MRI) markers in breast cancer patients by subtype. Sixty-four patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy were enrolled in this study. Each patient received a dynamic contrast-enhanced (DCE-MRI) at baseline, after 1 cycle of chemotherapy and before surgery. Functional tumor volume (FTV), the imaging marker measured by DCE-MRI, was computed at various thresholds of percent enhancement (PEt) and signal-enhancement ratio (SERt). Final FTV before surgery and percent changes of FTVs at the early and final treatment time points were used to predict patients' recurrence-free survival. The full cohort and each subtype defined by the status of hormone receptor and human epidermal growth factor receptor 2 (HR+/HER2-, HER2+, triple negative) were analyzed. Predictions were evaluated using the Cox proportional hazard model when PEt changed from 30% to 200% in steps of 10% and SERt changed from 0 to 2 in steps of 0.2. Predictions with high hazard ratios and low p-values were considered as strong. Different profiles of FTV as predictors for recurrence-free survival were observed in each breast cancer subtype and strong associations with survival were observed at different PEt/SERt combinations that resulted in different FTVs. Findings from this retrospective study suggest that the predictive performance of imaging markers based on FTV may be improved with enhancement thresholds being optimized separately for clinically-relevant subtypes defined by HR and HER2 receptor expression.

Children with cerebral palsy (CP) have been reported to have various levels of deficits in balance control, which can be described using the relationship between the body's centre of mass (COM) and the centre of pressure (COP). This study aimed to investigate the balance control of children with spastic diplegic CP during level walking. The COM-COP inclination angles and angular velocities, as well as temporal-spatial variables from 12 children with spastic diplegic CP (seven girls and five boys, aged 12.4 ± 4.4 years) and 12 normal controls (eight girls and four boys, aged 11.2 ± 4.4 years) were obtained using a motion analysis system and two forceplates. With compromised balance control as a result of neuromusculoskeletal pathologies, the CP group walked with reduced walking speed and stride length (p < 0.05), but increased stride time and step width (p < 0.05), indicating reduced gait efficiency. They also showed significantly reduced anterioposterior COM-COP inclination angles and angular velocities (p < 0.05), but increased mediolateral COM-COP inclination angles and angular velocities (p < 0.05) when compared to the normal controls. The latter phenomenon may be related to an increased risk of falling in these patients. Therefore, it appears that programs and/or devices for preventing falls are needed for children with spastic diplegic CP.

Adequate pattern and consistency of the muscle recruitment is essential to symbolize the destruction of the opponent with high movement velocities and precise targeting of the opponent's head and body during a karate jab. The purpose of this study was to evaluate the reaction time (RT), motor time (MT), and total response time (TRT), as well as their correlation during a karate jab, and to investigate the recruitment pattern and consistency of muscles during motor time. As many as 14 professional karate athletes (age: 23.67 ± 2.64 years; height: 174.57 ± 7.13 cm; and weight: 72.75 ± 10.65 kg) participated in the current study. Each subject was instructed to pose in combat stance first and then to use their left hand to jab at an instrumented kicking target as soon as they saw the start signal. Surface electromyograms (EMGs) were recorded from 16 muscles, namely the pronator teres, biceps brachii, triceps brachii, and deltoid of the left upper limb, right erector spinae, left rectus abdominis, and gluteus maximus, rectus femoris, biceps femoris, tibialis anterior, and medial gastrocnemius of the right and left lower limbs. Start and stop signals from the instrumented target were also recorded synchronously to obtain the TRT. Significant correlation between MT and TRT indicated that MT was a key determinant for the TRT of the jab. When performing a karate jab, the karate athletes initiated the movement with postural adjustments of the legs and trunk prior to the onset of the voluntary jab by the upper limb, and with a proximal-to-distal sequence of muscle activation in the left arm. Good consistencies of muscle recruitment of the trunk, left arm, and leg, and cocontraction of the left triceps and biceps brachii also indicated a well-controlled jab by the left arm. These results provide important information on the patterns and the consistencies of the muscle recruitment for coaching a karate jab, which should be helpful for a better understanding of the motor control strategies of a karate jab and for developing a suitable training protocol.

Dyspnea and exercise intolerance are common symptoms among patients with HIV. Cardiac magnetic resonance imaging (CMR) has emerged as a versatile tool in the evaluation of cardiovascular disorders including pulmonary arterial hypertension (PAH). We sought to determine the utility of a novel

To introduce a two-dimensional MR fingerprinting (MRF) technique for quantification of TAn electrocardiograph-triggered MRF method is introduced for mapping myocardial TTMRF can provide quantitative single slice T

Palladium (Pd(2+)) and platinum (Pt(2+)) ions were found to inhibit erythrocyte membrane-bound acetylcholinesterase (AChE) with Ki values of 6.0 and 6.5 microg/ml, respectively. Lineweaver-Burke plots revealed that the inhibition of erythrocyte AChE by both metal ions was competitive in nature. Binding studies using alkaline phosphatase as a reporting enzyme confirmed that both metal ions indeed did bind to the enzyme molecules. In the process of red cell vesiculation, membrane-bound AChE is shed along with vesicles. The measurement of AChE activities in the medium containing vesiculated RBC could potentially be served as an index of vesiculation. Inhibition of AChE activities by both metal ions can thus constitute a potential source of error in vesiculation measurement. To illustrate these effects, a simulated vesiculation system, using green tea polyphenol in the presence (25 microg/ml) or absence of Pd(2+) ion was simultaneously examined by the electronmicrography and the AChE method. We observed vesiculation under the experimental condition in Pd(2+)-free controls that was associated with a time-dependent increase in AChE activity were barely detected in the Pd(2+)-spiked specimen because of the masking effect exerted by the metal ions themselves.

Purpose To introduce a two-dimensional MR fingerprinting (MRF) technique for quantification of T1, T2, and M0 in myocardium. Methods An electrocardiograph-triggered MRF method is introduced for mapping myocardial T1, T2, and M0 during a single breath-hold in as short as four heartbeats. The pulse sequence uses variable flip angles, repetition times, inversion recovery times, and T2 preparation dephasing times. A dictionary of possible signal evolutions is simulated for each scan that incorporates the subject's unique variations in heart rate. Aspects of the sequence design were explored in simulations, and the accuracy and precision of cardiac MRF were assessed in a phantom study. In vivo imaging was performed at 3 Tesla in 11 volunteers to generate native parametric maps. Results T1 and T2 measurements from the proposed cardiac MRF sequence correlated well with standard spin echo measurements in the phantom study (R2 > 0.99). A Bland-Altman analysis revealed good agreement for myocardial T1 measurements between MRF and MOLLI (bias 1 ms, 95% limits of agreement −72 to 72 ms) and T2 measurements between MRF and T2-prepared balanced steady-state free precession (bias, −2.6 ms; 95% limits of agreement, −8.5 to 3.3 ms). Conclusion MRF can provide quantitative single slice T1, T2, and M0 maps in the heart within a single breath-hold. Magn Reson Med 77:1446–1458, 2017. © 2016 International Society for Magnetic Resonance in Medicine

This study probed into tourism satisfaction for the Taipei International Flora Expo using Hybrid MCDM, and the findings can serve as references for decision-makers in festival planning. This study summarized 4 dimensions and 21 factors that affect festivals and mega events, identified their structural relationship using DEMATEL (decision-making trial and evaluation laboratory), and obtained the key factors and improvement points., DANP (the DEMATEL-based analytic network process)was employed for calculating influential weights to obtain the influential weights among critical factors. The subject was the 2011 Taipei International Flora Expo, and data collection was based on a questionnaire survey of 26 experts. The results showed that the first dimension of festivals and mega events is “entertainment” and the second is “transport”. Thus, by improving these two dimensions, the tourists' satisfaction and revisit intention will be enhanced. In addition, according to weighting, the influential weight of information (0.2784) is the highest; this is because clear indication of information, such as the event flow, location, and routes, can improve public satisfaction.

Individual joint deviations are often identified in the analysis of cerebral palsy (CP) gait. However, knowledge is limited as to how these deviations affect the control of the locomotor system as a whole when striving to meet the demands of walking. The current study aimed to bridge the gap by describing the control of the locomotor system in children with diplegic CP in terms of their leg stiffness, both skeletal and muscular components, and associated joint stiffness during gait. Twelve children with spastic diplegia CP and 12 healthy controls walked at a self-selected pace in a gait laboratory while their kinematic and forceplate data were measured and analyzed during loading response, mid-stance, terminal stance and pre-swing. For calculating the leg stiffness, each of the lower limbs was modeled as a non-linear spring, connecting the hip joint center and the corresponding center of pressure, with varying stiffness that was calculated as the slope (gradient) of the axial force vs. the deformation curve. The leg stiffness was further decomposed into skeletal and muscular components considering the alignment of the lower limb. The ankle, knee and hip of the limb were modeled as revolute joints with torsional springs whose stiffness was calculated as the slope of the moment vs. the angle curve of the joint. Independent t-tests were performed for between-group comparisons of all the variables. The CP group significantly decreased the leg stiffness but increased the joint stiffness during stance phase, except during terminal stance where the leg stiffness was increased. They appeared to rely more on muscular contributions to achieve the required leg stiffness, increasing the muscular demands in maintaining the body posture against collapse. Leg stiffness plays a critical role in modulating the kinematics and kinetics of the locomotor system during gait in the diplegic CP.

Objective: Change in functional tumor volume (FTV) measured by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), has been shown to be associated with response to neoadjuvant chemotherapy (NACT) for patients with stage II/III breast cancer. FTV reflects the vascularized volume of tumor and is calculated by applying minimum thresholds PEt for the initial percent enhancement and SERt for the early-to-late signal enhancement ratio following gadolinium contrast injection. In this retrospective study, we investigate the association of FTV influenced by PEt and SERt values with recurrence-free survival (RFS) in breast cancer subtypes defined by hormone receptor (HR) and HER2 status. Materials and Methods: 64 patients with locally advanced breast cancer were imaged by DCE-MRI before treatment (MRI1), after one cycle of adriamycin-cytoxan (AC) therapy (MRI2), inter-regimen (MRI3, taxane receivers only) and at the completion of chemotherapy prior to surgery (MRI4). Because treatment length and regimen varied among patients, the MRI exam performed after all NACT and before surgery was designated as final MRI (MRIf). FTV was calculated with varying PEt (30–200% in steps of 10%) and SERt (0–2 in steps of 0.2) values. A Cox proportional hazard model was used to analyze association with RFS, defined as the time between surgery and disease recurrence or last disease-free follow-up, for the following imaging predictors: early percent change in FTV (ΔFTV2: MRI1 vs. MRI2), final percent change (ΔFTVf: MRI1 vs. MRIf), and final FTV in MRIf (FTVf). RFS association was evaluated for the full cohort and within subsets defined by tumor subtype (HR+/HER2-, HER2+, triple negative). Estimated hazard ratios per unit change in predictors, associated 95% confidence intervals (CI) and p-values were evaluated. The cutoff of p Citation Format: Wen Li, Wei-Ching Lo, Ella F Jones, David C Newitt, John Kornak, Lisa J Wilmes, Nola M Hylton. Optimization of magnetic resonance imaging predictive performance by breast cancer subtypes for predicting response to neoadjuvant chemotherapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-01-09.