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The non-invasively measured initial systolic time interval (ISTI) reflects a time difference between the electrical and pumping activity of the heart and depends on cardiac preload, afterload, autonomic nervous control and training level. However, the duration of the ISTI has not yet been compared to other time markers of the heart cycle. The present study gauges the duration of the ISTI by comparing the end point of this interval, the C-point, with heart cycle markers obtained by echocardiography. The heart rate of 16 healthy subjects was varied by means of an exercise stimulus. It was found that the C-point, and therefore the end point of ISTI, occurred around the moment of the maximum diameter of the aortic arch in all subjects and at all heart rates. However, while the time difference between the opening of the aortic valves and the maximum diameter of the aortic arch decreased significantly with decreasing RR-interval, the time difference with respect to the moment of the C-point remained constant within the subjects. This means that the shortening of the ISTI with increasing heart rate in response to an exercise stimulus was caused by a shortening of the pre-ejection period (PEP). It is concluded that the ISTI can be used as a non-invasive parameter indicating the time difference between the electrical and mechanical pumping activity of the heart, both inside and outside the clinic.

Background: Differences in imaging parameters influence computer-extracted parenchymal enhancement measures from breast MRI.Purpose: To investigate the effect of differences in dynamic contrast-enhanced MRI acquisition parameter settings on quantitative parenchymal enhancement of the breast, and to evaluate harmonization of contrast-enhancement values with respect to flip angle and repetition time.Study Type: Retrospective.Phantom/populations: We modeled parenchymal enhancement using simulations, a phantom, and two cohorts (N = 398 and N = 302) from independent cancer centers.Sequence Field/strength: 1.5T dynamic contrast-enhanced T1 -weighted spoiled gradient echo MRI. Vendors: Philips, Siemens, General Electric Medical Systems.Assessment: We assessed harmonization of parenchymal enhancement in simulations and phantom by varying the MR parameters that influence the amount of T1 -weighting: flip angle (8°-25°) and repetition time (4-12 msec). We calculated the median and interquartile range (IQR) of the enhancement values before and after harmonization. In vivo, we assessed overlap of quantitative parenchymal enhancement in the cohorts before and after harmonization using kernel density estimations. Cohort 1 was scanned with flip angle 20° and repetition time 8 msec; cohort 2 with flip angle 10° and repetition time 6 msec.Statistical Tests: Paired Wilcoxon signed-rank-test of bootstrapped kernel density estimations.Results: Before harmonization, simulated enhancement values had a median (IQR) of 0.46 (0.34-0.49). After harmonization, the IQR was reduced: median (IQR): 0.44 (0.44-0.45). In the phantom, the IQR also decreased, median (IQR): 0.96 (0.59-1.22) before harmonization, 0.96 (0.91-1.02) after harmonization. Harmonization yielded significantly (P < 0.001) better overlap in parenchymal enhancement between the cohorts: median (IQR) was 0.46 (0.37-0.58) for cohort 1 vs. 0.37 (0.30-0.44) for cohort 2 before harmonization (57% overlap); and 0.35 (0.28-0.43) vs. .0.37 (0.30-0.44) after harmonization (85% overlap).Data Conclusion: The proposed practical harmonization method enables an accurate comparison between patients scanned with differences in imaging parameters.Level Of Evidence: 3 TECHNICAL EFFICACY STAGE: 4. [ABSTRACT FROM AUTHOR]

Dynamic contrast‐enhanced MRI is the workhorse of breast MRI, where the diagnosis of lesions is largely based on the enhancement curve shape. However, this curve shape is biased by RF transmit (B1+) field inhomogeneities. B1+ field information is required in order to correct these. The use of a generic, coil‐specific B1+ template is proposed and tested. Finite‐difference time‐domain simulations for B1+ were performed for healthy female volunteers with a wide range of breast anatomies. A generic B1+ template was constructed by averaging simulations based on four volunteers. Three‐dimensional B1+ maps were acquired in 15 other volunteers. Root mean square error (RMSE) metrics were calculated between individual simulations and the template, and between individual measurements and the template. The agreement between the proposed template approach and a B1+ mapping method was compared against the agreement between acquisition and reacquisition using the same mapping protocol. RMSE values (% of nominal flip angle) comparing individual simulations with the template were in the range 2.00‐4.01%, with mean 2.68%. RMSE values comparing individual measurements with the template were in the range8.1‐16%, with mean 11.7%. The agreement between the proposed template approach and a B1+ mapping method was only slightly worse than the agreement between two consecutive acquisitions using the same mapping protocol in one volunteer: the range of agreement increased from ±16% of the nominal angle for repeated measurement to ±22% for the B1+ template. With local RF transmit coils, intersubject differences in B1+ fields of the breast are comparable to the accuracy of B1+ mapping methods, even at 7 T. Consequently, a single generic B1+ template suits subjects over a wide range of breast anatomies, eliminating the need for a time‐consuming B1+ mapping protocol. [ABSTRACT FROM AUTHOR]

Separating the decay signal from diffusion-weighted scans into two or more components can be challenging. The phasor technique is well established in the field of optical microscopy for visualization and separation of fluorescent dyes with different lifetimes. The use of the phasor technique for separation of diffusion-weighted decay signals was recently proposed. In this study, we investigate the added value of this technique for fitting decay models and visualization of decay rates. Phasor visualization was performed in five glioblastoma patients. Using simulations, the influence of incorrect diffusivity values and of the number of b-values on fitting a three-component model with fixed diffusivities (dubbed "unmixing") was investigated for both a phasor-based fit and a linear least squares (LLS) fit. Phasor-based intravoxel incoherent motion (IVIM) fitting was compared with nonlinear least squares (NLLS) and segmented fitting (SF) methods in terms of accuracy and precision. The distributions of the parameter estimates of simulated data were compared with those obtained in a healthy volunteer. In the phasor visualizations of two glioblastoma patients, a cluster of points was observed that was not seen in healthy volunteers. The identified cluster roughly corresponded to the enhanced edge region of the tumor of two glioblastoma patients visible on fluid-attenuated inversion recovery (FLAIR) images. For fitting decay models the usefulness of the phasor transform is less pronounced, but the additional knowledge gained from the geometrical configuration of phasor space can aid fitting routines. This has led to slightly improved fitting results for the IVIM model: phasor-based fitting yielded parameter maps with higher precision than the NLLS and SF methods for parameters f and D (interquartile range [IQR] for f: NLLS 27, SF 12, phasor 5.7%; IQR for D: NLLS 0.28, SF 0.18, phasor 0.10 μm 2 /s). For unmixing, LLS fitting slightly but consistently outperformed phasor-based fitting in all of the tested scenarios., (© 2020 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)

Background: Differences in imaging parameters influence computer-extracted parenchymal enhancement measures from breast MRI., Purpose: To investigate the effect of differences in dynamic contrast-enhanced MRI acquisition parameter settings on quantitative parenchymal enhancement of the breast, and to evaluate harmonization of contrast-enhancement values with respect to flip angle and repetition time., Study Type: Retrospective., Phantom/populations: We modeled parenchymal enhancement using simulations, a phantom, and two cohorts (N = 398 and N = 302) from independent cancer centers., Sequence Field/strength: 1.5T dynamic contrast-enhanced T 1 -weighted spoiled gradient echo MRI. Vendors: Philips, Siemens, General Electric Medical Systems., Assessment: We assessed harmonization of parenchymal enhancement in simulations and phantom by varying the MR parameters that influence the amount of T 1 -weighting: flip angle (8°-25°) and repetition time (4-12 msec). We calculated the median and interquartile range (IQR) of the enhancement values before and after harmonization. In vivo, we assessed overlap of quantitative parenchymal enhancement in the cohorts before and after harmonization using kernel density estimations. Cohort 1 was scanned with flip angle 20° and repetition time 8 msec; cohort 2 with flip angle 10° and repetition time 6 msec., Statistical Tests: Paired Wilcoxon signed-rank-test of bootstrapped kernel density estimations., Results: Before harmonization, simulated enhancement values had a median (IQR) of 0.46 (0.34-0.49). After harmonization, the IQR was reduced: median (IQR): 0.44 (0.44-0.45). In the phantom, the IQR also decreased, median (IQR): 0.96 (0.59-1.22) before harmonization, 0.96 (0.91-1.02) after harmonization. Harmonization yielded significantly (P < 0.001) better overlap in parenchymal enhancement between the cohorts: median (IQR) was 0.46 (0.37-0.58) for cohort 1 vs. 0.37 (0.30-0.44) for cohort 2 before harmonization (57% overlap); and 0.35 (0.28-0.43) vs. .0.37 (0.30-0.44) after harmonization (85% overlap)., Data Conclusion: The proposed practical harmonization method enables an accurate comparison between patients scanned with differences in imaging parameters., Level of Evidence: 3 TECHNICAL EFFICACY STAGE: 4., (© 2020 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: Inhomogeneous excitation at ultrahigh field strengths (7T and above) compromises the reliability of quantified dynamic contrast-enhanced breast MRI. This can hamper the introduction of ultrahigh field MRI into the clinic. Compensation for this non-uniformity effect can consist of both hardware improvements and post-acquisition corrections. This paper investigated the correctable radiofrequency transmit ( B 1 + ) range post-acquisition in both simulations and patient data for 7T MRI., Methods: Simulations were conducted to determine the minimum B 1 + level at which corrections were still beneficial because of noise amplification. Two correction strategies leading to differences in noise amplification were tested. The effect of the corrections on a 7T patient data set (N = 38) with a wide range of B 1 + levels was investigated in terms of time-intensity curve types as well as washin, washout and peak enhancement values., Results: In simulations assuming a common amount of T 1 saturation, the lowest B 1 + level at which the SNR of the corrected images was at least that of the original precontrast image was 43% of the nominal angle. After correction, time-intensity curve types changed in 24% of included patients, and the distribution of curve types corresponded better to the distribution found in literature. Additionally, the overlap between the distributions of washin, washout, and peak enhancement values for grade 1 and grade 2 tumors was slightly reduced., Conclusion: Although the correctable range varies with the amount of T 1 saturation, post-acquisition correction for inhomogeneous excitation was feasible down to B 1 + levels of 43% of the nominal angle in vivo., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Dynamic contrast-enhanced MRI is the workhorse of breast MRI, where the diagnosis of lesions is largely based on the enhancement curve shape. However, this curve shape is biased by RF transmit (B 1 + ) field inhomogeneities. B 1 + field information is required in order to correct these. The use of a generic, coil-specific B 1 + template is proposed and tested. Finite-difference time-domain simulations for B 1 + were performed for healthy female volunteers with a wide range of breast anatomies. A generic B 1 + template was constructed by averaging simulations based on four volunteers. Three-dimensional B 1 + maps were acquired in 15 other volunteers. Root mean square error (RMSE) metrics were calculated between individual simulations and the template, and between individual measurements and the template. The agreement between the proposed template approach and a B 1 + mapping method was compared against the agreement between acquisition and reacquisition using the same mapping protocol. RMSE values (% of nominal flip angle) comparing individual simulations with the template were in the range 2.00-4.01%, with mean 2.68%. RMSE values comparing individual measurements with the template were in the range8.1-16%, with mean 11.7%. The agreement between the proposed template approach and a B 1 + mapping method was only slightly worse than the agreement between two consecutive acquisitions using the same mapping protocol in one volunteer: the range of agreement increased from ±16% of the nominal angle for repeated measurement to ±22% for the B 1 + template. With local RF transmit coils, intersubject differences in B 1 + fields of the breast are comparable to the accuracy of B 1 + mapping methods, even at 7 T. Consequently, a single generic B 1 + template suits subjects over a wide range of breast anatomies, eliminating the need for a time-consuming B 1 + mapping protocol., (© 2018 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)