Real-time motion detection in spiral MRI using navigators

Effectiveness of visual biofeedback-guided respiratory-correlated 4D-MRI for radiotherapy guidance on the MR-linac

PURPOSE

Respiratory-correlated 4D-MRI may provide motion characteristics for radiotherapy but is susceptible to irregular breathing. This study investigated the effectiveness of visual biofeedback (VBF) guidance for breathing regularization during 4D-MRI acquisitions on an MR-linac.

METHODS

A simultaneous multislice-accelerated 4D-MRI sequence was interleaved with a one-dimensional respiratory navigator (1D-RNAV) in 10 healthy volunteers on a 1.5T Unity MR-linac (Elekta AB, Stockholm, Sweden). Volunteer-specific breathing amplitudes and periods were derived from the 1D-RNAV signal obtained during unguided 4D-MRI acquisitions. These were used for the guidance waveform, while the 1D-RNAV positions were overlayed as VBF. VBF effectiveness was quantified by calculating the change in coefficient of variation (CV diff $$ {\mathrm{CV}}^{\mathrm{diff}} $$ ) for the breathing amplitude and period, the position SD of end-exhale, end-inhale and midposition locations, and the agreement between the 1D-RNAV signals and guidance waveforms. The 4D-MRI quality was assessed by quantifying amounts of missing data.

RESULTS

VBF had an average latency of 520 ± 2 ms. VBF reduced median breathing variations by 18% to 35% (amplitude) and 29% to 57% (period). Median position SD reductions ranged from -3% to 35% (end-exhale), 29% to 38% (end-inhale), and 25% to 37% (midposition). Average differences between guidance waveforms and 1D-RNAV signals were 0.0 s (period) and +1.7 mm (amplitude). VBF also decreased the median amount of missing data by 11% and 29%.

CONCLUSION

A VBF system was successfully implemented, and all volunteers were able to adapt to the guidance waveform. VBF during 4D-MRI acquisitions drastically reduced breathing variability but had limited effect on missing data in respiratory-correlated 4D-MRI.

Adaptive model-based Magnetic Resonance

PURPOSE

Conventional sequences are static in nature, fixing measurement parameters in advance in anticipation of a wide range of expected tissue parameter values. We set out to design and benchmark a new, personalized approach-termed adaptive MR-in which incoming subject data is used to update and fine-tune the pulse sequence parameters in real time.

METHODS

We implemented an adaptive, real-time multi-echo (MTE) experiment for estimating T₂ s. Our approach combined a Bayesian framework with model-based reconstruction. It maintained and continuously updated a prior distribution of the desired tissue parameters, including T₂ , which was used to guide the selection of sequence parameters in real time.

RESULTS

Computer simulations predicted accelerations between 1.7- and 3.3-fold for adaptive multi-echo sequences relative to static ones. These predictions were corroborated in phantom experiments. In healthy volunteers, our adaptive framework accelerated the measurement of T₂ for n-acetyl-aspartate by a factor of 2.5.

CONCLUSION

Adaptive pulse sequences that alter their excitations in real time could provide substantial reductions in acquisition times. Given the generality of our proposed framework, our results motivate further research into other adaptive model-based approaches to MRI and MRS.

PET/MR Technology: Advancement and Challenges

When this article was written, it coincided with the 11th anniversary of the installation of our PET/MR device in Munich. In fact, this was the first fully integrated device to be in clinical use. During this time, we have observed many interesting behaviors, to put it kindly. However, it is more critical that in this process, our understanding of the system also improved - including the advantages and limitations from a technical, logistical, and medical perspective. The last decade of PET/MRI research has certainly been characterized by most sites looking for a "key application." There were many ideas in this context and before and after the devices became available, some of which were based on the earlier work with integrating data from single devices. These involved validating classical PET methods with MRI (eg, perfusion or oncology diagnostics). More important, however, were the scenarios where intermodal synergies could be expected. In this review, we look back on this decade-long journey, at the challenges overcome and those still to come.

Co-Clinical Imaging Resource Program (CIRP): Bridging the Translational Divide to Advance Precision Medicine

The National Institutes of Health’s (National Cancer Institute) precision medicine initiative emphasizes the biological and molecular bases for cancer prevention and treatment. Importantly, it addresses the need for consistency in preclinical and clinical research. To overcome the translational gap in cancer treatment and prevention, the cancer research community has been transitioning toward using animal models that more fatefully recapitulate human tumor biology. There is a growing need to develop best practices in translational research, including imaging research, to better inform therapeutic choices and decision-making. Therefore, the National Cancer Institute has recently launched the Co-Clinical Imaging Research Resource Program (CIRP). Its overarching mission is to advance the practice of precision medicine by establishing consensus-based best practices for co-clinical imaging research by developing optimized state-of-the-art translational quantitative imaging methodologies to enable disease detection, risk stratification, and assessment/prediction of response to therapy. In this communication, we discuss our involvement in the CIRP, detailing key considerations including animal model selection, co-clinical study design, need for standardization of co-clinical instruments, and harmonization of preclinical and clinical quantitative imaging pipelines. An underlying emphasis in the program is to develop best practices toward reproducible, repeatable, and precise quantitative imaging biomarkers for use in translational cancer imaging and therapy. We will conclude with our thoughts on informatics needs to enable collaborative and open science research to advance precision medicine.

Non-invasive quantification of cardiac stroke volume in the edible crab Cancer pagurus

Background

Brachyuran crabs can effectively modulate cardiac stroke volume independently of heart rate in response to abiotic drivers. Non-invasive techniques can help to improve the understanding of cardiac performance parameters of these animals. This study demonstrates the in vivo quantification of cardiac performance parameters through magnetic resonance imaging (MRI) on the edible crab Cancer pagurus. Furthermore, the suitability of signal integrals of infra-red photoplethysmographs as a qualitative tool is assessed under severe hypoxia.

Results

Multi-slice self-gated cardiac cinematic (CINE) MRI revealed the structure and motion of the ventricle to quantify heart rates, end-diastolic volume, end-systolic volume, stroke volume and ejection fraction. CINE MRI showed that stroke volumes increased under hypoxia because of a reduction of end-systolic volumes at constant end-diastolic volumes. Plethysmograph recordings allowed for automated heart rate measurements but determination of a qualitative stroke volume proxy strongly depended on the position of the sensor on the animal. Both techniques revealed a doubling in stroke volumes after 6 h under severe hypoxia (water PO₂ = 15% air saturation).

Conclusions

MRI has allowed for detailed descriptions of cardiac performance in intact animals under hypoxia. The temporal resolution of quantitative non-invasive CINE MRI is limited but should encourage further refining. The stroke volume proxy based on plethysmograph recordings is feasible to complement other cardiac measurements over time. The presented methods allow for non-destructive in vivo determinations of multiple cardiac performance parameters, with the possibility to study neuro-hormonal or environmental effects on decapod cardio physiology.

Continuous prospectively navigated multi-echo GRE for improved BOLD imaging of the kidneys

The objective of this study is to develop improved methods for renal blood oxygenation level dependent (BOLD) imaging. T2* mapping of the kidneys, or renal BOLD imaging, may depict renal oxygen levels and may be valuable as a noninvasive means of following the progression of renal disease. Current renal BOLD data is limited by imaging in a single breath hold, which results in low resolution and low signal-to-noise ratio (SNR). We compare a new free-breathing renal BOLD method with conventional breath-hold BOLD (BH-BOLD). A multi-echo GRE sequence with continuous prospective respiratory navigation and real-time feedback was developed that allows high resolution and high SNR renal BOLD imaging with constant sequence repetition time (TR) during free-breathing BOLD (FB-BOLD). The sequence was evaluated in 10 normal volunteers and compared with conventional BH-BOLD. Scan time for the FB-BOLD sequence was approximately three minutes, compared with 15 seconds for the BH-BOLD sequence. SNR of source images and residual error of T2* fitting were compared between the two methods. The FB-BOLD sequence produced motion-free T2* maps of the kidneys with SNR 1.9 times higher than BH-BOLD images. Residual error of T2* fitting was consistently lower in the right kidney with FB-BOLD (30% less than BH-BOLD) but higher in the left kidney (80% more than BH-BOLD), likely related to placement of the navigator on the right hemidiaphragm. A free-breathing prospectively navigated renal BOLD sequence allows flexible tradeoff between scan time, resolution, and SNR.

Two-Dimensional Spoiled Gradient-Recalled Echo Magnetic Resonance Imaging of the Liver Using Respiratory Navigator-Gating Techniques

OBJECTIVE

We assessed the feasibility of T1-weighted 2-dimensional spoiled gradient-recalled (2D SPGR) acquisition in steady-state imaging of the liver with various respiratory navigator gating techniques.

METHODS

A total of 12 healthy volunteers underwent in-phase and out-of-phase 2D SPGR imaging of the liver during breath-holding and free-breathing. Four techniques for respiratory navigation, 2 conventional navigator techniques and 2 self-navigator techniques, were used for free-breathing imaging.

RESULTS

Good navigator waveforms were obtained in conventional navigation, whereas fluctuations were evident in self navigation. All of the 4 navigator-based methods provided better images in terms of background signals and visual image quality compared with images obtained with no respiratory control. However, differences remained in comparison with breath-holding. Superiority of self-navigation to conventional navigation was not shown.

CONCLUSIONS

Navigator-gating techniques improved 2D SPGR images of the liver acquired during free-breathing, suggesting feasibility and beneficial effects, although navigator-based images were still inferior to breath-hold images.

Maximum likelihood estimation of cardiac fiber bundle orientation from arbitrarily spaced diffusion weighted images

We propose an estimation scheme for local fiber bundle direction in the left ventricle directly from gray values of arbitrarily spaced cardiac diffusion weighted images (DWI). The approach is based on a parametric and space-dependent mathematical representation of the myocardial fiber bundle orientation and hence the diffusion tensor (DT) for the ventricular geometry. By solving a nonlinear inverse problem derived from a maximum likelihood estimator, the degrees of freedom of the fiber and DT model can be estimated from the measured gray values of the DWIs. The continuity of the DT model allows to relax the restriction to the individual DWIs to match spatially like for voxelwise DT calculation. Hence, the spatial misalignment between image slices with different diffusion encoding directions, that is encountered in-vivo cardiac imaging practice can be integrated into the estimation scheme. This feature results then in a negligible impact of the spatial misalignment on the reconstructed solution. We illustrate the methodology using synthetic data and compare it against a previously reported fiber bundle reconstruction technique. To show the potential for real data, we also present results for multi-slice data constructed from ex-vivo cardiac diffusion weighted measurements in both mono- and bi-ventricular configurations.

Can multi-slice or navigator-gated R2* MRI replace single-slice breath-hold acquisition for hepatic iron quantification?

BACKGROUND

Liver R2* values calculated from multi-gradient echo (mGRE) magnetic resonance images (MRI) are strongly correlated with hepatic iron concentration (HIC) as shown in several independently derived biopsy calibration studies. These calibrations were established for axial single-slice breath-hold imaging at the location of the portal vein. Scanning in multi-slice mode makes the exam more efficient, since whole-liver coverage can be achieved with two breath-holds and the optimal slice can be selected afterward. Navigator echoes remove the need for breath-holds and allow use in sedated patients.

OBJECTIVE

To evaluate if the existing biopsy calibrations can be applied to multi-slice and navigator-controlled mGRE imaging in children with hepatic iron overload, by testing if there is a bias-free correlation between single-slice R2* and multi-slice or multi-slice navigator controlled R2*.

MATERIALS AND METHODS

This study included MRI data from 71 patients with transfusional iron overload, who received an MRI exam to estimate HIC using gradient echo sequences. Patient scans contained 2 or 3 of the following imaging methods used for analysis: single-slice images (n = 71), multi-slice images (n = 69) and navigator-controlled images (n = 17). Small and large blood corrected region of interests were selected on axial images of the liver to obtain R2* values for all data sets. Bland-Altman and linear regression analysis were used to compare R2* values from single-slice images to those of multi-slice images and navigator-controlled images.

RESULTS

Bland-Altman analysis showed that all imaging method comparisons were strongly associated with each other and had high correlation coefficients (0.98 ≤ r ≤ 1.00) with P-values ≤0.0001. Linear regression yielded slopes that were close to 1.

CONCLUSION

We found that navigator-gated or breath-held multi-slice R2* MRI for HIC determination measures R2* values comparable to the biopsy-validated single-slice, single breath-hold scan. We conclude that these three R2* methods can be interchangeably used in existing R2*-HIC calibrations.

Comparison of spoiled gradient echo and steady-state free-precession imaging for native myocardial T1 mapping using the slice-interleaved T1 mapping (STONE) sequence

Cardiac T1 mapping allows non-invasive imaging of interstitial diffuse fibrosis. Myocardial T1 is commonly calculated by voxel-wise fitting of the images acquired using balanced steady-state free precession (SSFP) after an inversion pulse. However, SSFP imaging is sensitive to B1 and B0 imperfection, which may result in additional artifacts. A gradient echo (GRE) imaging sequence has been used for myocardial T1 mapping; however, its use has been limited to higher magnetic field to compensate for the lower signal-to-noise ratio (SNR) of GRE versus SSFP imaging. A slice-interleaved T1 mapping (STONE) sequence with SSFP readout (STONE-SSFP) has been recently proposed for native myocardial T1 mapping, which allows longer recovery of magnetization (>8 R-R) after each inversion pulse. In this study, we hypothesize that a longer recovery allows higher SNR and enables native myocardial T1 mapping using STONE with GRE imaging readout (STONE-GRE) at 1.5T. Numerical simulations and phantom and in vivo imaging were performed to compare the performance of STONE-GRE and STONE-SSFP for native myocardial T1 mapping at 1.5T. In numerical simulations, STONE-SSFP shows sensitivity to both T2 and off resonance. Despite the insensitivity of GRE imaging to T2 , STONE-GRE remains sensitive to T2 due to the dependence of the inversion pulse performance on T2 . In the phantom study, STONE-GRE had inferior accuracy and precision and similar repeatability as compared with STONE-SSFP. In in vivo studies, STONE-GRE and STONE-SSFP had similar myocardial native T1 times, precisions, repeatabilities and subjective T1 map qualities. Despite the lower SNR of the GRE imaging readout compared with SSFP, STONE-GRE provides similar native myocardial T1 measurements, precision, repeatability, and subjective image quality when compared with STONE-SSFP at 1.5T.

Prospective MR image alignment between breath-holds: Application to renal BOLD MRI

PURPOSE

To present an image registration method for renal blood oxygen level-dependent (BOLD) measurements that enables semiautomatic assessment of parenchymal and medullary R2* changes under a functional challenge.

METHODS

In a series of breath-hold acquisitions, three-dimensional data were acquired initially for prospective image registration of subsequent BOLD measurements. An algorithm for kidney alignment for BOLD renal imaging (KALIBRI) was implemented to detect the positions of the left and right kidney so that the kidneys were acquired in the subsequent BOLD measurement at consistent anatomical locations. Residual in-plane distortions were corrected retrospectively so that semiautomatic dynamic R2* measurements of the renal cortex and medulla become feasible. KALIBRI was tested in six healthy volunteers during a series of BOLD experiments, which included a 600- to 1000-mL water challenge.

RESULTS

Prospective image registration and BOLD imaging of each kidney was achieved within a total measurement time of about 17 s, enabling its execution within a single breath-hold. KALIBRI improved the registration by up to 35% as found with mutual information measures. In four volunteers, a medullary R2* decrease of up to 40% was observed after water ingestion.

CONCLUSION

KALIBRI improves the quality of two-dimensional time-resolved renal BOLD MRI by aligning local renal anatomy, which allows for consistent R2* measurements over many breath-holds. Magn Reson Med 77:1573-1582, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Total liver fat quantification using three-dimensional respiratory self-navigated MRI sequence

PURPOSE

MRI can produce quantitative liver fat fraction (FF) maps noninvasively, which can help to improve diagnoses of fatty liver diseases. However, most sequences acquire several two-dimensional (2D) slices during one or more breath-holds, which may be difficult for patients with limited breath-holding capacity. A whole-liver 3D FF map could also be obtained in a single acquisition by applying a reliable breathing-motion correction method. Several correction techniques are available for 3D imaging, but they use external devices, interrupt acquisition, or jeopardize the spatial resolution. To overcome these issues, a proof-of-concept study introducing a self-navigated 3D three-point Dixon sequence is presented here.

METHODS

A respiratory self-gating strategy acquiring a center k-space profile was integrated into a three-point Dixon sequence. We obtained 3D FF maps from a water-fat emulsions phantom and fifteen volunteers. This sequence was compared with multi-2D breath-hold and 3D free-breathing approaches.

RESULTS

Our 3D three-point Dixon self-navigated sequence could correct for respiratory-motion artifacts and provided more precise FF measurements than breath-hold multi-2D and 3D free-breathing techniques.

CONCLUSION

Our 3D respiratory self-gating fat quantification sequence could correct for respiratory motion artifacts and yield more-precise FF measurements. Magn Reson Med 76:1400-1409, 2016. © 2015 International Society for Magnetic Resonance in Medicine.

Accuracy and Precision of Head Motion Information in Multi-Channel Free Induction Decay Navigators for Magnetic Resonance Imaging

Free induction decay (FID) navigators were found to qualitatively detect rigid-body head movements, yet it is unknown to what extent they can provide quantitative motion estimates. Here, we acquired FID navigators at different sampling rates and simultaneously measured head movements using a highly accurate optical motion tracking system. This strategy allowed us to estimate the accuracy and precision of FID navigators for quantification of rigid-body head movements. Five subjects were scanned with a 32-channel head coil array on a clinical 3T MR scanner during several resting and guided head movement periods. For each subject we trained a linear regression model based on FID navigator and optical motion tracking signals. FID-based motion model accuracy and precision was evaluated using cross-validation. FID-based prediction of rigid-body head motion was found to be with a mean translational and rotational error of 0.14±0.21 mm and 0.08±0.13°, respectively. Robust model training with sub-millimeter and sub-degree accuracy could be achieved using 100 data points with motion magnitudes of ±2 mm and ±1° for translation and rotation. The obtained linear models appeared to be subject-specific as inter-subject application of a "universal" FID-based motion model resulted in poor prediction accuracy. The results show that substantial rigid-body motion information is encoded in FID navigator signal time courses. Although, the applied method currently requires the simultaneous acquisition of FID signals and optical tracking data, the findings suggest that multi-channel FID navigators have a potential to complement existing tracking technologies for accurate rigid-body motion detection and correction in MRI.

Respiratory-induced venous blood flow effects using flexible retrospective double-gating

BACKGROUND

To demonstrate a novel velocity sensitive acquisition and retrospective cardiorespiratory double-gated reconstruction scheme to examine respiratory effect on venous blood flow in healthy volunteers.

METHODS

Radial two dimensional (2D) phase contrast MR is performed at 3 Tesla in the internal jugular vein (IJV) of healthy volunteers (n = 6). Data are retrospectively partitioned based on respiratory waveforms using three schemes: moving average for respiration plateaus, gradient for active respiration, and ten respiratory phases that are cardiac time-averaged. A single 4D flow MR scan is performed in the neck of a healthy volunteer. After gradient operation, blood velocity measurements are made along the IJV length. Percent changes from expiration to inspiration for moving average and gradient techniques are statistically compared with paired t-tests.

RESULTS

Percent change increase in summed IJV mean and peak blood flow during active inspiration versus active expiration in 2D was significant (mean flow: 11.5 ± 8.0%, peak flow: 11.9 ± 5.9%, P < 0.01). Smallest cross-sectional area and largest blood velocity are seen during inspiration phases (phase number: area-6.5 ± 3.6, velocity-6.2 ± 3.2). Significant increase in mean velocity along the length of the IJV was observed in 3D, with increasing percent changes more proximal to the chest (mean, 39 ± 30%; range, 0-93%, P = 0.001).

CONCLUSION

With a radial acquisition, this pilot study demonstrates feasibility of simultaneous retrospective cardiorespiratory gating in IJV flow. Greatest differences in flow occur between active respiration phases, increasing in magnitude more proximal to the chest.

Free-breathing cardiac MR stress perfusion with real-time slice tracking

PURPOSE

To develop a free-breathing cardiac MR perfusion sequence with slice tracking for use after physical exercise.

METHODS

We propose to use a leading navigator, placed immediately before each 2D slice acquisition, for tracking the respiratory motion and updating the slice location in real-time. The proposed sequence was used to acquire CMR perfusion datasets in 12 healthy adult subjects and 8 patients. Images were compared with the conventional perfusion (i.e., without slice tracking) results from the same subjects. The location and geometry of the myocardium were quantitatively analyzed, and the perfusion signal curves were calculated from both sequences to show the efficacy of the proposed sequence.

RESULTS

The proposed sequence was significantly better compared with the conventional perfusion sequence in terms of qualitative image scores. Changes in the myocardial location and geometry decreased by 50% in the slice tracking sequence. Furthermore, the proposed sequence had signal curves that are smoother and less noisy.

CONCLUSION

The proposed sequence significantly reduces the effect of the respiratory motion on the image acquisition in both rest and stress perfusion scans.

Three-dimensional heart locator for whole-heart coronary magnetic resonance angiography

PURPOSE

Coronary magnetic resonance angiography (MRA) is commonly performed with diaphragmatic navigator (NAV) gating to compensate for respiratory motion, but this approach is inefficient as data must be reacquired when it is outside the acceptance window. We therefore developed and validated a motion compensation technique based on three-dimensional (3D) spatial registration in which data are accepted throughout the respiratory cycle.

METHODS

A novel respiratory motion compensation method was implemented that acquires a low-resolution 3D-image of the heart (3D-LOC) just prior to coronary MRA data acquisition. 3D-LOC volumes were registered to the first 3D-LOC to estimate the respiratory-induced heart motion and to modify the coronary MRA data and reconstruct motion-corrected images. Whole-heart coronary MRA datasets were acquired from nine healthy subjects using a diaphragmatic NAV and using 3D-LOC.

RESULTS

There was no significant difference between the subjective image score of NAV and 3D-LOC in three main coronary branches. The vessel sharpness of 3D-LOC was higher than NAV in the right (0.44 ± 0.08 vs. 0.49 ± 0.08; P = 0.055) and left circumflex arteries (0.49 ± 0.05 vs. 0.52 ± 0.04; P = 0.039). Scan time for 3D-LOC was significantly shorter than NAV (4.3 ± 0.6 vs. 8.3 ± 2.3 min; P = 0.004).

CONCLUSION

Compared to NAV gating, 3D-LOC for coronary MRA reduces scan time by nearly 50% without compromising image quality.

Advanced respiratory motion compensation for coronary MR angiography

Despite technical advances, respiratory motion remains a major impediment in a substantial amount of patients undergoing coronary magnetic resonance angiography (CMRA). Traditionally, respiratory motion compensation has been performed with a one-dimensional respiratory navigator positioned on the right hemi-diaphragm, using a motion model to estimate and correct for the bulk respiratory motion of the heart. Recent technical advancements has allowed for direct respiratory motion estimation of the heart, with improved motion compensation performance. Some of these new methods, particularly using image-based navigators or respiratory binning, allow for more advanced motion correction which enables CMRA data acquisition throughout most or all of the respiratory cycle, thereby significantly reducing scan time. This review describes the three components typically involved in most motion compensation strategies for CMRA, including respiratory motion estimation, gating and correction, and how these processes can be utilized to perform advanced respiratory motion compensation.

Physics of MRI: a primer

This article is based on an introductory lecture given for the past many years during the "MR Physics and Techniques for Clinicians" course at the Annual Meeting of the ISMRM. This introduction is not intended to be a comprehensive overview of the field, as the subject of magnetic resonance imaging (MRI) physics is large and complex. Rather, it is intended to lay a conceptual foundation by which magnetic resonance image formation can be understood from an intuitive perspective. The presentation is nonmathematical, relying on simple models that take the reader progressively from the basic spin physics of nuclei, through descriptions of how the magnetic resonance signal is generated and detected in an MRI scanner, the foundations of nuclear magnetic resonance (NMR) relaxation, and a discussion of the Fourier transform and its relation to MR image formation. The article continues with a discussion of how magnetic field gradients are used to facilitate spatial encoding and concludes with a development of basic pulse sequences and the factors defining image contrast.

Free-breathing cardiac MR with a fixed navigator efficiency using adaptive gating window size

A respiratory navigator with a fixed acceptance gating window is commonly used to reduce respiratory motion artifacts in cardiac MR. This approach prolongs the scan time and occasionally yields an incomplete dataset due to respiratory drifts. To address this issue, we propose an adaptive gating window approach in which the size and position of the gating window are changed adaptively during the acquisition based on the individual's breathing pattern. The adaptive gating window tracks the breathing pattern of the subject throughout the scan and adapts the size and position of the gating window such that the gating efficiency is always fixed at a constant value. To investigate the image quality and acquisition time, free breathing cardiac MRI, including both targeted coronary MRI and late gadolinium enhancement imaging, was performed in 67 subjects using the proposed navigator technique. Targeted coronary MRI was acquired from eleven healthy adult subjects using both the conventional and proposed adaptive gating window techniques. Fifty-six patients referred for cardiac MRI were also imaged using late gadolinium enhancement with the proposed adaptive gating window technique. Subjective and objective image assessments were used to evaluate the proposed method. The results demonstrate that the proposed technique allows free-breathing cardiac MRI in a relatively fixed time without compromising imaging quality due to respiratory motion artifacts.

Compressed-sensing motion compensation (CosMo): a joint prospective-retrospective respiratory navigator for coronary MRI

Prospective right hemidiaphragm navigator (NAV) is commonly used in free-breathing coronary MRI. The NAV results in an increase in acquisition time to allow for resampling of the motion-corrupted k-space data. In this study, we are presenting a joint prospective-retrospective NAV motion compensation algorithm called compressed-sensing motion compensation (CosMo). The inner k-space region is acquired using a prospective NAV; for the outer k-space, a NAV is only used to reject the motion-corrupted data without reacquiring them. Subsequently, those unfilled k-space lines are retrospectively estimated using compressed sensing reconstruction. We imaged right coronary artery in nine healthy adult subjects. An undersampling probability map and sidelobe-to-peak ratio were calculated to study the pattern of undersampling, generated by NAV. Right coronary artery images were then retrospectively reconstructed using compressed-sensing motion compensation for gating windows between 3 and 10 mm and compared with the ones fully acquired within the gating windows. Qualitative imaging score and quantitative vessel sharpness were calculated for each reconstruction. The probability map and sidelobe-to-peak ratio show that the NAV generates a random undersampling k-space pattern. There were no statistically significant differences between the vessel sharpness and subjective score of the two reconstructions. Compressed-sensing motion compensation could be an alternative motion compensation technique for free-breathing coronary MRI that can be used to reduce scan time.

Comparison of a single shot T1-weighted in- and out-of-phase magnetization prepared gradient recalled echo with a standard two-dimensional gradient recalled echo: preliminary findings

PURPOSE

To compare in-phase (IP)/out-of-phase (OP) single shot magnetization-prepared gradient-recalled-echo (MP-GRE) with a standard two-dimensional gradient-recalled-echo (2D-GRE), and to compare image quality of MP-GRE in cooperative and noncooperative subjects.

MATERIALS AND METHODS

Ninety-six consecutive subjects (52 males, 44 females; mean age, 53.2 ± 16.7 years), both cooperative (n = 73) and noncooperative (n = 23) subjects who had MRI examinations including precontrast T1-weighted IP/OP MP-GRE with or without IP/OP 2D-GRE were included in the study. The sequences were independently qualitatively evaluated by two radiologists. Quantitative analysis of liver fat index, signal-to-noise ratio (SNR) and liver-lesion contrast-to-noise ratio (CNR) was also performed. Data were subjected to statistical analysis.

RESULTS

The visual detection of the presence or absence of liver steatosis showed no differences between 2D-GRE and MP-GRE imaging (k = 1). Minor differences were observed on image quality between MP-GRE and 2D-GRE in cooperative subjects, and between MP-GRE sequences performed in cooperative and noncooperative subjects. Liver fat index results were strongly positively correlated (r = .98; 95% confidence interval [CI] 0.97 to 0.98; P < .0001). Intercept (.14; 95% CI .13 to .15; P < .0001) and slope (.83; 95% CI .79 to .86; P < .0001) were statistically significant.

CONCLUSION

IP/OP MP-GRE and 2D-GRE comparably demonstrate the presence or absence of hepatic steatosis. Image quality of MP-GRE was also comparable to 2D-GRE, and was not substantially adversely affected if subjects were unable to cooperate with breathholding instructions.

Advances in pediatric body MRI

MRI offers an alternative to CT, and thus is central to an ALARA strategy. However, long exam times, limited magnet availability, and motion artifacts are barriers to expanded use of MRI. This article reviews developments in pediatric body MRI that might reduce these barriers: high field systems, acceleration, navigation and newer contrast agents.

Subject-specific estimation of respiratory navigator tracking factor for free-breathing cardiovascular MR

A mean respiratory navigator tracking factor of 0.6 is commonly used to estimate the respiratory motion of the heart from the displacement of the right hemi-diaphragm. A constant tracking factor can generate significant residual error in estimation of the respiratory motion of the heart for the cases where the actual tracking factor highly deviates from 0.6. In this study, we implemented and evaluated a robust method to calculate a subject-specific tracking factor for free-breathing high resolution cardiac MR. The subject-specific tracking factor was calculated from two consecutive navigator signals placed on the right hemi-diaphragm and the basal left ventricle in a training phase. To verify the accuracy of the estimated subject-specific tracking factor, nineteen subjects were recruited for comparing the estimated tracking factor in real-time with an image-based tracking factor, calculated off-line. Subsequently, in seven adult subjects, whole-heart or targeted coronary artery MR images were acquired using the estimated subject-specific tracking factor and visually compared with those acquired using a constant (0.6) tracking factor. It was shown that the proposed method can accurately estimate the subject-specific tracking factor and improve the quality of coronary images when the subject-specific tracking factor differs from 0.6.

Utility of free-breathing, whole-heart, three-dimensional magnetic resonance imaging in the assessment of coronary anatomy for congenital heart disease

The incidence of coronary anomalies is increased in congenital heart disease (CHD). Whole-heart magnetic resonance imaging (MRI) has been proposed as a robust approach to coronary artery imaging without ionizing radiation. The proximal coronary arteries were imaged in 112 CHD patients (63 males) age 17 ± 13 years (range 11 days-68 years) using a navigator-gated, whole-heart, three-dimensional (3D) technique at 1.5 T. Two observers assessed image quality overall and for left anterior descending coronary artery (LAD), left circumflex coronary artery (LCX), and right coronary artery (RCA) using a 5-point scale ranging from 0 (not visible) to 4 (clear margins). Weighted kappa was used to assess interobserver agreement. Coronary artery origins were visible in 99% of the patients. The left main origin was not visualized in one patient, although the LAD, LCX, and RCA were visualized. Eight patients (7%) had anomalies. The overall image quality was 3.3 ± 0.8 for reader 1 and 3.1 ± 1.0 for reader 2. Age had a significant effect on image quality, with younger patients having lower scores. Agreement between readers was moderate (overall kappa, 0.60). Free-breathing, navigator-gated, whole-heart 3D MRI is a useful, robust, and reliable noninvasive technique for assessing coronary artery origins and their proximal course with diagnostic quality in CHD patients.

Beat-to-beat respiratory motion correction with near 100% efficiency: a quantitative assessment using high-resolution coronary artery imaging

This study quantitatively assesses the effectiveness of retrospective beat-to-beat respiratory motion correction (B2B-RMC) at near 100% efficiency using high-resolution coronary artery imaging. Three-dimensional (3D) spiral images were obtained in a coronary respiratory motion phantom with B2B-RMC and navigator gating. In vivo, targeted 3D coronary imaging was performed in 10 healthy subjects using B2B-RMC spiral and navigator gated balanced steady-state free-precession (nav-bSSFP) techniques. Vessel diameter and sharpness in proximal and mid arteries were used as a measure of respiratory motion compensation effectiveness and compared between techniques. Phantom acquisitions with B2B-RMC were sharper than those acquired with navigator gating (B2B-RMC vs. navigator gating: 1.01±0.02 mm(-1) vs. 0.86±0.08 mm(-1), P<.05). In vivo B2B-RMC respiratory efficiency was significantly and substantially higher (99.7%±0.5%) than nav-bSSFP (44.0%±8.9%, P<.0001). Proximal and mid vessel sharpnesses were similar (B2B-RMC vs. nav-bSSFP, proximal: 1.00±0.14 mm(-1) vs. 1.08±0.11 mm(-1), mid: 1.01±0.11 mm(-1) vs. 1.05±0.12 mm(-1); both P=not significant [ns]). Mid vessel diameters were not significantly different (2.85±0.39 mm vs. 2.80±0.35 mm, P=ns), but proximal B2B-RMC diameters were slightly higher (2.85±0.38 mm vs. 2.70±0.34 mm, P<.05), possibly due to contrast differences. The respiratory efficiency of B2B-RMC is less variable and significantly higher than navigator gating. Phantom and in vivo vessel sharpness and diameter values suggest that respiratory motion compensation is equally effective.

Prospective motion correction of high-resolution magnetic resonance imaging data in children

Motion artifacts pose significant problems for the acquisition and analysis of high-resolution magnetic resonance imaging data. These artifacts can be particularly severe when studying pediatric populations, where greater patient movement reduces the ability to clearly view and reliably measure anatomy. In this study, we tested the effectiveness of a new prospective motion correction technique, called PROMO, as applied to making neuroanatomical measures in typically developing school-age children. This method attempts to address the problem of motion at its source by keeping the measurement coordinate system fixed with respect to the subject throughout image acquisition. The technique also performs automatic rescanning of images that were acquired during intervals of particularly severe motion. Unlike many previous techniques, this approach adjusts for both in-plane and through-plane movement, greatly reducing image artifacts without the need for additional equipment. Results show that the use of PROMO notably enhances subjective image quality, reduces errors in Freesurfer cortical surface reconstructions, and significantly improves the subcortical volumetric segmentation of brain structures. Further applications of PROMO for clinical and cognitive neuroscience are discussed.

State-of-the-art in pediatric body and musculoskeletal magnetic resonance imaging

Pediatric body and musculoskeletal MRI has seen tremendous advances over the past few years. These advances have enabled high-quality imaging in even the smallest children and expanded the range of clinical problems amenable to MRI. In this review, we highlight some advances: transition to 3 Tesla, parallel imaging, motion compensation, and new contrast agents. Given the increasing saliency of concerns regarding ionizing radiation from computed tomography, these advances could not be more welcome.

Navigated abdominal T1-W MRI permits free-breathing image acquisition with less motion artifact

T1-W imaging of the pediatric abdomen is often limited by respiratory motion artifacts. Although navigation has been commonly employed for coronary MRA and T2-W imaging, navigation for T1-W imaging is less developed. Thus, we incorporated a navigator pulse into a fat-suppressed T1-W SPGR sequence such that steady-state contrast was not disrupted. Ten children were scanned after gadolinium administration three times in immediate succession: breath-hold with no navigation, free-breathing with navigation, and free-breathing without navigation. Motion artifacts were scored for each sequence by two radiologists,showing fewer motion artifacts with navigation compared to free-breathing and greater motion artifacts than with breath-holding. This work demonstrates the feasibility and potential utility of navigation for pediatric abdominal T1-W imaging.

Feasibility of cardiac gating free of interference with electro-magnetic fields at 1.5 Tesla, 3.0 Tesla and 7.0 Tesla using an MR-stethoscope

OBJECTIVES

To circumvent the challenges of conventional electrocardiographic (ECG)-gating by examining the efficacy of an MR stethoscope, which offers (i) no risk of high voltage induction or patient burns, (ii) immunity to electromagnetic interference, (iii) suitability for all magnetic field strengths, and (iv) patient comfort together with ease of use for the pursuit of reliable and safe (ultra)high field cardiac gated magnetic resonance imaging (MRI).

MATERIALS AND METHODS

The acoustic gating device consists of 3 main components: an acoustic sensor, a signal processing unit, and a coupler unit to the MRI system. Signal conditioning and conversion are conducted outside the 0.5 mT line using dedicated electronic circuits. The final waveform is delivered to the internal physiological signal controller circuitry of a clinical MR scanner. Cardiovascular MRI was performed of normal volunteers (n = 17) on 1.5 T, 3.0 T and 7.0 T whole body MR systems. Black blood imaging, 2D CINE imaging, 3D phase contrast MR angiography, and myocardial T2* mapping were carried out.

RESULTS

The MR-stethoscope provided cardiograms at 1.5 T, 3.0 T and 7.0 T free of interference from electromagnetic fields and magneto-hydrodynamic effects. In comparison, ECG waveforms were susceptible to T-wave elevation and other distortions, which were more pronounced at higher fields. Acoustically gated black blood imaging at 1.5 T and 3.0 T provided image quality comparable with or even superior to that obtained from the ECG-gated approach. In the case of correct R-wave recognition, ECG-gated 2D CINE SSFP imaging was found to be immune to cardiac motion effects -even at 3.0 T. However, ECG-gated 2D SSFP CINE imaging was prone to cardiac motion artifacts if R-wave mis-registration occurred because of T-wave elevation. Acoustically gated 3D PCMRA at 1.5 T, 3.0 T and 7.0 T resulted in images free of blood pulsation artifacts because the acoustic gating approach provided cardiac signal traces free of interference with electromagnetic fields or magneto-hydrodynamic effects even at 7.0 Tesla. Severe ECG-trace distortions and T-wave elevations occurred at 3.0 T and 7.0 T. Acoustically cardiac gated T2* mapping at 3.0 T yielded a T2* value of 22.3 +/- 4.8 ms for the inferoseptal myocardium.

CONCLUSIONS

The proposed MR-stethoscope presents a promising alternative to currently available techniques for cardiac gating of (ultra)high field MRI. Its intrinsic insensitivity to interference from electromagnetic fields renders it suitable for clinical imaging because of its excellent trigger reliability, even at 7.0 Tesla.

Three-dimensional, in vivo MRI with self-gating and image coregistration in the mouse

Motion during magnetic resonance imaging (MRI) scans routinely results in undesirable image artifact or blurring. Since high-resolution, three-dimensional (3D) imaging of the mouse requires long scan times for satisfactory signal-to-noise ratio (SNR) and image quality, motion-related artifacts are likely over much of the body and limit applications of mouse MRI. In this investigation, we explored the use of self-gated imaging methods and image coregistration for improving image quality in the presence of motion. Self-gated signal results from a modified 3D gradient-echo sequence showed detection of periodic respiratory and cardiac motion in the adult mouse-with excellent comparison to traditional measurements, sensitivity to respiration-induced tissue changes in the brain, and even detection of embryonic cardiac motion in utero. Serial image coregistration with rapidly-acquired, low-SNR volumes further enabled detection and correction of bulk changes in embryo location during in utero imaging sessions and subsequent reconstruction of high-quality images. These methods, in combination, are shown to expand the range of applications for 3D mouse MRI, enabling late-stage embryonic heart imaging and introducing the possibility of longitudinal developmental studies from embryonic stages through adulthood.

Free-breathing 3-dimensional steady-state free precession coronary magnetic resonance angiography: comparison of four navigator gating techniques

This work compared the performance of four navigator gating algorithms [accept/reject (A/R), diminishing variance algorithm (DVA), phase ordering with automatic window selection (PAWS) and retrospective gating (RETRO)] in suppressing respiratory motion artifacts in free-breathing 3D balanced steady-state free precession coronary MRA. In 10 volunteers, the right coronary artery (RCA) or the left anterior descending artery (LAD) was imaged (both if time permitted) at 1.5 T with the four gating techniques in random order. Vessel signal, vessel contrast and motion suppression were scored by the consensus of two blinded readers. In 15 imaged vessels (nine RCA and six LAD), PAWS provided significantly better image quality than A/R (P<.05), DVA (P=.02) and RETRO (P=.002). While the quality difference between A/R and DVA was not statistically significant, both algorithms yielded significantly better image quality than RETRO. PAWS and DVA were the most efficient algorithms, providing an approximately 20% and 40% relative increase in average navigator efficiency compared to A/R and RETRO, respectively.

Lung imaging under free-breathing conditions

Respiratory motion and pulsatile blood flow can generate artifacts in morphological and functional lung imaging. Total acquisition time, and thus the achievable signal to noise ratio, is limited when performing breath-hold and/or electrocardiogram-triggered imaging. To overcome these limitations, imaging during free respiration can be performed using respiratory gating/triggering devices or navigator echoes. However, these techniques provide only poor gating resolution and can induce saturation bands and signal fluctuations into the lung volume. In this work, acquisition schemes for nonphase encoded navigator echoes were implemented into different sequences for morphological and functional lung imaging at 1.5 Tesla (T) and 0.2T. The navigator echoes allow monitoring of respiratory motion and provide an ECG-trigger signal for correction of the heart cycle without influencing the imaged slices. Artifact free images acquired during free respiration using a 3D GE, 2D multislice TSE or multi-Gradient Echo sequence for oxygen-enhanced T(2)(*) quantification are presented.

Motion in cardiovascular MR imaging

Modern rapid magnetic resonance (MR) imaging techniques have led to widespread use of the modality in cardiac imaging. Despite this progress, many MR studies suffer from image degradation due to involuntary motion during the acquisition. This review describes the type and extent of the motion of the heart due to the cardiac and respiratory cycles, which create image artifacts. Methods of eliminating or reducing the problems caused by the cardiac cycle are discussed, including electrocardiogram gating, subject-specific acquisition windows, and section tracking. Similarly, for respiratory motion of the heart, techniques such as breath holding, respiratory gating, section tracking, phase-encoding ordering, subject-specific translational models, and a range of new techniques are considered.

Free-breathing cine MRI

Standard MRI cine exams for the study of cardiac function are segmented over several heartbeats and thus require a breath-hold to minimize breathing motion artifacts, which is a current limitation of this approach. The purpose of this study was to develop a method for the measurement and correction of respiratory motion that is compatible with cine imaging. Real-time images were used to measure the respiratory motion of heart, to allow translations, rotations, and shears to be measured and corrected in the k-space domain prior to a final gated-segmented reconstruction, using the same data for both purposes. A method for data rejection to address the effects of through-plane motion and complex deformations is described (respiratory gating). A radial k-space trajectory was used in this study to allow direct reconstruction of undersampled real-time images, although the techniques presented are applicable with Cartesian k-space trajectories. Corrected and uncorrected free-breathing gated-segmented images acquired over 18 sec were compared to the current standard breath-hold Cartesian images using both quantitative sharpness profiles (mm(-1)) and clinical scoring (1 to 5 scale, 3: clinically acceptable). Free-breathing, free-breathing corrected, and breath-hold images had average sharpness values of 0.23 +/- 0.04, 0.38 +/- 0.04, and 0.44 +/- 0.04 mm(-1) measured at the blood-endocardium interface, and clinical scores of 2.2 +/- 0.5, 4.2 +/- 0.4, and 4.7 +/- 0.5, respectively.

Advances in pediatric MR imaging

This article describes the considerable technical achievements that have been made in MR imaging in the evaluation of pediatric patients. The latest techniques in improving signal intensity, resolution, and speed are discussed. The multitude of new options for pediatric MR imaging are illustrated, including higher field strength imaging, multi-channel coil technology coupled with parallel imaging, and new pulse sequence designs. Several future directions in the field of pediatric body and musculoskeletal imaging also are highlighted.

Free-breathing 3D steady-state free precession coronary magnetic resonance angiography: comparison of diaphragm and cardiac fat navigators

PURPOSE

To compare the performance of the conventional diaphragm navigator (DNAV) and the recently developed cardiac fat navigator (FatNAV) in suppressing respiration-induced cardiac motion in free-breathing 3D balanced steady-state free precession coronary MRA (SSFP CMRA).

MATERIALS AND METHODS

In 16 healthy volunteers the right coronary artery (RCA) was imaged at 1.5T using a navigator-gated 3D SSFP CMRA sequence. DNAV and FatNAV gating were performed in random order. Image quality difference was scored by three experienced readers blinded to the gating technique. Blood signal-to-noise ratio (SNR), blood-to-myocardium contrast-to-noise ratio (CNR), and navigator efficiency were calculated.

RESULTS

Diagnostically interpretable CMRA was obtained successfully in all 16 subjects with FatNAV gating (0% failure rate) and only 14 subjects with DNAV gating (12% failure rate). Compared to DNAV gating, FatNAV gating provided similar SNR and CNR, better image quality (P < 0.01), and 28% improvement in navigator efficiency (P = 0.002).

CONCLUSION

FatNAV gating provides more effective motion suppression and better image quality than DNAV gating for free-breathing 3D SSFP CMRA of the RCA in healthy subjects.

Whole-heart cine MRI using real-time respiratory self-gating

Two-dimensional (2D) breath-hold cine MRI is used to assess cardiac anatomy and function. However, this technique requires cooperation from the patient, and in some cases the scan planning is complicated. Isotropic nonangulated three-dimensional (3D) cardiac MR can overcome some of these problems because it requires minimal planning and can be reformatted in any plane. However, current methods, even those that use undersampling techniques, involve breath-holding for periods that are too long for many patients. Free-breathing respiratory gating sequences represent a possible solution for realizing 3D cine imaging. A real-time respiratory self-gating technique for whole-heart cine MRI is presented. The technique enables assessment of cardiac anatomy and function with minimum planning or patient cooperation. Nonangulated isotropic 3D data were acquired from five healthy volunteers and then reformatted into 2D clinical views. The respiratory self-gating technique is shown to improve image quality in free-breathing scanning. In addition, ventricular volumetric data obtained using the 3D approach were comparable to those acquired with the conventional multislice 2D approach.

Parallel magnetic resonance imaging

Parallel MRI started with the introduction of coil arrays in improving radiofrequency (RF) acquisition (what is called parallel imaging) and continued with an analogous development for RF transmission (parallel transmission). Based on differences in the spatial sensitivity distributions of the involved array elements, both techniques try to shorten the respective k-space trajectory. Parallel imaging refers to the acquisition of k-space data, whereas parallel transmission is dealing with the deposition of RF energy packages in the excitation k-space. However, parallel transmission is not simply the reciprocal of parallel imaging. The main goal of parallel imaging is the shortening of the acquisition time. The main goal of parallel transmission is the shortening of the pulse duration of spatially selective RF pulses. The present article describes the basic concept, the state of the art, and the similarities and differences of both technologies.

Dual-contrast single breath-hold 3D abdominal MR imaging

OBJECT

Multiple contrasts are often helpful for a comprehensive diagnosis. In 3D abdominal MRI, breath-hold techniques are preferred for single contrast acquisitions to avoid respiratory artifacts. In this paper, highly accelerated parallel MRI is used to acquire large 3D abdominal volumes with two different contrasts within a single breath-hold.

MATERIAL AND METHODS

In vivo studies have been performed on six healthy volunteers, combining T (1)- and T (2)-weighted, gradient- or spin-echo based scans, as well as water/fat resolved imaging in a single breath-hold. These 3D scans were acquired with an acceleration factor of six, using a prototype 32-element receive array.

RESULTS

The presented approach was tested successfully on all volunteers. The whole liver area was covered by a FOV of 350 x 250 x 200 mm(3) for all scans with reasonable spatial resolution. Arbitrary scan protocols generating different contrasts have been shown to be combinable in this single breath-hold approach. Good spatial correspondence with negligible spatial offset was achieved for all different scan combinations acquired in overall breath-hold times between 15 and 25 s.

CONCLUSION

Enabled by highly parallel imaging technology, this study demonstrates the technical feasibility and the promising image quality of single breath-hold dual contrast MRI.

Spatially encoded pulse sequences for the acquisition of high resolution NMR spectra in inhomogeneous fields

We have recently proposed a protocol for retrieving nuclear magnetic resonance (NMR) spectra based on a spatially-dependent encoding of the MR interactions. It has also been shown that the spatial selectivity with which spins are manipulated during such encoding opens up new avenues towards the removal of magnetic field inhomogeneities; not by demanding extreme Bo field uniformities, but rather by compensating for the dephasing effects introduced by the field distribution at a radiofrequency excitation and/or refocusing level. The present study discusses in further detail a number of strategies deriving from this principle, geared at acquiring both uni- as well as multi-dimensional spectroscopic data at high resolution conditions. Different variants are presented, tailored according to the relative sensitivity and chemical nature of the spin system being explored. In particular a simple multi-scan experiment is discussed capable of affording substantial improvements in the spectral resolution, at nearly no sensitivity or scaling penalties. This new compensation scheme is therefore well-suited for the collection of high-resolution data in low-field systems possessing limited signal-to-noise ratios, where magnetic field heterogeneities might present a serious obstacle. Potential areas of applications of these techniques include high-field in vivo NMR studies in regions near tissue/air interfaces, clinical low field MR spectroscopy on relatively large off-center volumes difficult to shim, and ex situ NMR. The principles of the different compensation methods are reviewed and experimentally demonstrated for one-dimensional inhomogeneities; further improvements and extensions are briefly discussed.

Generalized self-navigated motion detection technique: Preliminary investigation in abdominal imaging

Patient motion remains a primary obstacle to diagnostic image quality, especially in the abdomen, despite the existence of various motion artifact reduction techniques. This work presents a self-navigated motion detection method that can be generalized for most pulse sequences and k-space trajectories. Motion information is extracted directly from raw MR data, requiring no additional gradient or RF pulses, no physiologic monitoring equipment, and minimal--if any--impact on scan time. Initial feasibility results with a two-dimensional gradient echo sequence are shown in phantom studies and in vivo volunteer abdominal studies, demonstrating the sensitivity of the method to both respiratory motion and cardiovascular pulsatility. Prospectively gated images were acquired using the self-navigated data to synchronize image acquisition with motion. These preliminary results suggest that the self-navigated method is a promising technique for reducing motion artifacts in clinical abdominal and cardiac applications.

Parallel RF transmission in MRI

Following the development of parallel imaging, parallel transmission describes the use of multiple RF transmit coils. Parallel transmission can be applied to improve RF excitation, in particular, multidimensional, spatially selective RF excitation. For instance, parallel transmission is able to shorten spatially selective RF pulses in two or three dimensions, or to minimize the occurring SAR. One potential major application might be the compensation of patient-induced B(1) inhomogeneities, particularly at high main fields. This paper provides an overview of selected aspects of this new transmission approach. The basic principles of parallel transmission are discussed, initial experimental proofs are described, and the impact of error propagation on coil design for parallel transmission is outlined.

Parallel imaging in cardiovascular MRI: methods and applications

Cardiovascular MR imaging (CVMR) has become a valuable modality for the non-invasive detection and characterization of cardiovascular diseases. CVMR requires high imaging speed and efficiency, which is fundamentally limited in conventional cardiovascular MRI studies. With the introduction of parallel imaging, alternative means for increasing acquisition speed beyond these limits have become available. In parallel imaging some image data are acquired simultaneously, using RF detector coil sensitivities to encode simultaneous spatial information that complements the information gleaned from sequential application of magnetic field gradients. The resulting improvements in imaging speed can be used in various ways, including shortening long examinations, improving spatial resolution and/or anatomic coverage, improving temporal resolution, enhancing image quality, overcoming physiological constraints, detecting and correcting for physiologic motion, and streamlining work flow. Examples of each of these strategies will be provided in this review. First, basic principles and key concepts of parallel MR are described. Second, practical considerations such as coil array design, coil sensitivity calibrations, customized pulse sequences and tailored imaging parameters are outlined. Next, cardiovascular applications of parallel MR are reviewed, ranging from cardiac anatomical and functional assessment to myocardial perfusion and viability to MR angiography of the coronary arteries and the large vessels. Finally, current trends and future directions in parallel CVMR are considered.

Analysis of residual coronary artery motion for breath hold and navigator approaches using real-time coronary MRI

Coronary artery MRI methods utilize breath holds, or diaphragmatic navigators, to compensate for respiratory motion. To increase image quality and navigator (NAV) gating efficiency, slice tracking is used, with more sophisticated affine motion models recently introduced. This study assesses the extent of remaining coronary artery motion in free breathing NAV and single and multi breath hold coronary artery MRI. Additionally, the effect of the NAV gating window size was examined. To visualize and measure the respiratory induced motion, an image containing a coronary artery cross section was acquired at each heartbeat. The amount of residual coronary artery displacement was used as a direct measure for the performance of the respiratory motion correction method. Free breathing studies with motion compensation (slice tracking with 5 mm gating window) had a similar amount of residual motion (0.76+/-0.17 mm) as a single breath hold (0.52+/-0.20 mm) and were superior to multiple breath holds (1.22+/-0.60 mm). Affine NAV methods allowed for larger gating windows ( approximately 10 mm windows) with similar residual motion (0.74+/-0.17 mm). In this healthy adult cohort (N=10), free-breathing NAV methods offered respiratory motion suppression similar to a single breath hold.

Spiral coronary angiography using a blood pool agent

PURPOSE

To experimentally investigate the optimum dose of an iron-oxide-based blood pool agent for spiral coronary MR angiography (MRA), and the difference between single and multiple spiral excitations in each cardiac cycle.

MATERIALS AND METHODS

Images using single and triple spiral excitations in each cardiac cycle were obtained in late diastole of the left main coronary artery in eight pigs following an inversion prepulse. Measurements were obtained before and after injection of increasing doses of an iron oxide blood pool agent (Clariscan) corresponding to concentrations of 0.8, 2.2, and 3.9 mg Fe/kg BW. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured.

RESULTS

For 0.8 mg Fe/kg BW relative to precontrast values, a significant increase was observed for both one (SNR: 2.3, CNR: 3.8) and three (SNR: 1.4, CNR: 2.2) excitations (P < 0.01). When the dose was increased from 0.8 mg Fe/kg BW to 2.2 mg Fe/kg BW, only the SNR (P < 0.01) increased further. Significantly higher CNR (1.6-1.8) and SNR (1.4-1.6) values were seen for one excitation relative to three excitations at all concentrations (P < 0.05).

CONCLUSION

At low concentrations, an iron oxide blood pool agent can increase SNR and CNR significantly with both single excitation and triple excitations using an inversion-prepared spiral acquisition scheme. At higher concentrations, T2* effects reduce image quality.

Using the axis of rotation of polar navigator echoes to rapidly measure 3D rigid-body motion

An improved technique to prospectively correct three-dimensional rigid-body motion using polar spherical navigator (pNAV) echoes is presented. The technique is based on acquiring pNAVs of an object in a baseline and rotated position and determining the axis of rotation (AOR) between data sets, thereby reducing 3D rotations to a 2D, planar rotation. Finding the AOR is simplified by prerotating the baseline trajectory, which forces the axis to lie within a specific polar region of a spherical shell in k-space. Orbital navigator echoes are interpolated from the pNAV data in planes orthogonal to the AOR and cross-correlated to determine the 2D rotation. The rotation about the AOR is used in conjunction with its orientation to calculate the overall 3D rotation. The pNAV-AOR technique was tested for its precision, accuracy, and processing speed in detecting compound rotations and translations of varying magnitude. In comparison to the spherical navigator echo technique, the pNAV-AOR technique is noniterative, fast, and independent of rotation magnitude and direction. At low SNR, the technique can detect compound rotations to 0.5 degrees accuracy in an estimated 100 msec, indicating that prospective 3D rigid-body motion correction may be feasible with this technique.