Robust GRAPPA-accelerated diffusion-weighted readout-segmented (RS)-EPI

Romer-EPTI: rotating-view motion-robust super-resolution EPTI for SNR-efficient distortion-free in-vivo mesoscale dMRI and microstructure imaging

Purpose

To overcome the major challenges in dMRI acquisition, including low SNR, distortion/blurring, and motion vulnerability.

Methods

A novel Romer-EPTI technique is developed to provide distortion-free dMRI with significant SNR gain, high motion-robustness, sharp spatial resolution, and simultaneous multi-TE imaging. It introduces a ROtating-view Motion-robust supEr-Resolution technique (Romer) combined with a distortion/blurring-free EPTI encoding. Romer enhances SNR by a simultaneous multi-thick-slice acquisition with rotating-view encoding, while providing high motion-robustness through a motion-aware super-resolution reconstruction, which also incorporates slice-profile and real-value diffusion, to resolve high-isotropic-resolution volumes. The in-plane encoding is performed using distortion/blurring-free EPTI, which further improves effective spatial resolution and motion robustness by preventing not only T2/T2*-blurring but also additional blurring resulting from combining encoded volumes with inconsistent geometries caused by dynamic distortions. Self-navigation was incorporated to enable efficient phase correction. Additional developments include strategies to address slab-boundary artifacts, achieve minimal TE for SNR gain at 7T, and achieve high robustness to strong phase variations at high b-values.

Results

Using Romer-EPTI, we demonstrate distortion-free whole-brain mesoscale in-vivo dMRI at both 3T (500-μm-iso) and 7T (485-μm-iso) for the first time, with high SNR efficiency (e.g., 25 × ), and high image quality free from distortion and slab-boundary artifacts with minimal blurring. Motion experiments demonstrate Romer-EPTI's high motion-robustness and ability to recover sharp images in the presence of motion. Romer-EPTI also demonstrates significant SNR gain and robustness in high b-value (b=5000s/mm2) and time-dependent dMRI.

Conclusion

Romer-EPTI significantly improves SNR, motion-robustness, and image quality, providing a highly efficient acquisition for high-resolution dMRI and microstructure imaging.

Single-shot Echo Planar Time-resolved Imaging for multi-echo functional MRI and distortion-free diffusion imaging

Purpose

To develop EPTI, a multi-shot distortion-free multi-echo imaging technique, into a single-shot acquisition to achieve improved robustness to motion and physiological noise, increased temporal resolution, and high SNR efficiency for dynamic imaging applications.

Methods

A new spatiotemporal encoding was developed to achieve single-shot EPTI by enhancing spatiotemporal correlation in k-t space. The proposed single-shot encoding improves reconstruction conditioning and sampling efficiency, with additional optimization under various accelerations to achieve optimized performance. To achieve high SNR efficiency, continuous readout with minimized deadtime was employed that begins immediately after excitation and extends for an SNR-optimized length. Moreover, k-t partial Fourier and simultaneous multi-slice acquisition were integrated to further accelerate the acquisition and achieve high spatial and temporal resolution.

Results

We demonstrated that ss-EPTI achieves higher tSNR efficiency than multi-shot EPTI, and provides distortion-free imaging with densely-sampled multi-echo images at resolutions ~1.25-3 mm at 3T and 7T-with high SNR efficiency and with comparable temporal resolutions to ss-EPI. The ability of ss-EPTI to eliminate dynamic distortions common in EPI also further improves temporal stability. For fMRI, ss-EPTI also provides early-TE images (e.g., 2.9ms) to recover signal-intensity and functional-sensitivity dropout in challenging regions. The multi-echo images provide TE-dependent information about functional fluctuations, successfully distinguishing noise-components from BOLD signals and further improving tSNR. For diffusion MRI, ss-EPTI provides high-quality distortion-free diffusion images and multi-echo diffusion metrics.

Conclusion

ss-EPTI provides distortion-free imaging with high image quality, rich multi-echo information, and enhanced efficiency within comparable temporal resolution to ss-EPI, offering a robust and efficient acquisition for dynamic imaging.

Accelerating acquisition of readout-segmented echo planar imaging (rs-EPI) with a simultaneous multislice (SMS) technique for diffusion-weighted (DW) breast MRI: Evaluation of image quality factors

PURPOSE

This study aims to compare the image quality, apparent diffusion coefficient (ADC), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) values, and scan time between readout-segmented echo planar imaging (rs-EPI) and simultaneous multislice (SMS) rs-EPI sequences.

METHODS

A total of 80 consecutive women who underwent breast diffusion-weighted imaging (DWI) were included, and two rs-EPI DWI sequences with and without SMS were acquired and compared. Qualitative analysis involved three radiologists independently scoring image quality and radiologist preference. For quantitative comparison, the radiologists independently measured the ADC values in patients, while SNR, CNR, and ADC values were measured on a phantom.

RESULTS

The acquisition time was 5:47 min for rs-EPI and 3:20 min for SMS rs-EPI. In terms of image quality, scores were similar between rs-EPI and SMS rs-EPI sequences in the pooled data set, with the exception of skin-line distinction (p = 0.001) and background noise (p < 0.001). All radiologists considered SMS rs-EPI as equal or superior to rs-EPI in more than 70 % of cases. SMS rs-EPI demonstrated significantly higher ADC values than rs-EPI by all radiologists (p ≤ 0.002). For the phantom measurement, ADC (SMS: 1.26 ± 0.68 and RS: 1.26 ± 0.68, p = 0.198), SNR (SMS: 540.6 ± 342.1 and RS: 558.8 ± 523.2, p = 0.927), and CNR (SMS: 235.5 ± 38.9 and RS: 252.8 ± 108.0, p = 0.784) values did not significantly differ between the two sequences.

CONCLUSION

SMS rs-EPI exhibited comparable image quality and similar ADC, SNR, and CNR values to rs-EPI while reducing the scan time by 42%.

Diffusion Weighted Imaging in Spine Tumors

Diffusion weighted imaging (DWI) has developed into a powerful tool for the evaluation of spine tumors, particularly for the assessment of vertebral marrow lesions and intramedullary tumors. Advances in magnetic resonance techniques have improved the quality of spine DWI and diffusion tensor imaging (DTI) in recent years, with increased reproducibility and utilization. DTI, with quantitative parameters such as fractional anisotropy and qualitative visual assessment of nerve fiber tracts, can play a valuable role in the evaluation and surgical planning of spinal cord tumors. These widely available techniques can be used to enhance the diagnostic evaluation of spinal tumors.

Spatiotemporal encoding MRI using subspace-constrained sampling and locally-low-rank regularization: Applications to diffusion weighted and diffusion kurtosis imaging of human brain and prostate

The benefits of performing locally low-rank (LLR) reconstructions on subsampled diffusion weighted and diffusion kurtosis imaging data employing spatiotemporal encoding (SPEN) methods, is investigated. SPEN allows for self-referenced correction of motion-induced phase errors in case of interleaved diffusion-oriented acquisitions, and allows one to overcome distortions otherwise observed along EPI's phase-encoded dimension. In combination with LLR-based reconstructions of the pooled imaging data and with a joint subsampling of b-weighted and interleaved images, additional improvements in terms of sensitivity as well as shortened acquisition times are demonstrated, without noticeable penalties. Details on how the LLR-regularized, subspace-constrained image reconstructions were adapted to SPEN are given; the improvements introduced by adopting these reconstruction frameworks for the accelerated acquisition of diffusivity and of kurtosis imaging data in both relatively homogeneous regions like the human brain and in more challenging regions like the human prostate, are presented and discussed within the context of similar efforts in the field.

Comparison of TGSE-BLADE DWI, RESOLVE DWI, and SS-EPI DWI in healthy volunteers and patients after cerebral aneurysm clipping

Diffusion-weighted magnetic resonance imaging is prone to have susceptibility artifacts in an inhomogeneous magnetic field. We compared distortion and artifacts among three diffusion acquisition techniques (single-shot echo-planar imaging [SS-EPI DWI], readout-segmented EPI [RESOLVE DWI], and 2D turbo gradient- and spin-echo diffusion-weighted imaging with non-Cartesian BLADE trajectory [TGSE-BLADE DWI]) in healthy volunteers and in patients with a cerebral aneurysm clip. Seventeen healthy volunteers and 20 patients who had undergone surgical cerebral aneurysm clipping were prospectively enrolled. SS-EPI DWI, RESOLVE DWI, and TGSE-BLADE DWI of the brain were performed using 3 T scanners. Distortion was the least in TGSE-BLADE DWI, and lower in RESOLVE DWI than SS-EPI DWI near air-bone interfaces in healthy volunteers (P < 0.001). Length of clip-induced artifact and distortion near the metal clip were the least in TGSE-BLADE DWI, and lower in RESOLVE DWI than SS-EPI DWI (P < 0.01). Image quality scores for geometric distortion, susceptibility artifacts, and overall image quality in both healthy volunteers and patients were the best in TGSE-BLADE DWI, and better in RESOLVE DWI than SS-EPI DWI (P < 0.001). Among the three DWI sequences, image quality was the best in TGSE-BLADE DWI in terms of distortion and artifacts, in both healthy volunteers and patients with an aneurysm clip.

Sheared two-dimensional radiofrequency excitation for off-resonance robustness and fat suppression in reduced field-of-view imaging

PURPOSE

Two-dimensional (2D) echo-planar radiofrequency (RF) pulses are widely used for reduced field-of-view (FOV) imaging in applications such as diffusion-weighted imaging. However, long pulse durations render the 2D RF pulses sensitive to off-resonance effects, causing local signal losses in reduced-FOV images. This work aims to achieve off-resonance robustness for 2D RF pulses via a sheared trajectory design.

THEORY AND METHODS

A sheared 2D RF pulse design is proposed to reduce pulse durations while covering identical excitation k-space extent as a standard 2D RF pulse. For a given shear angle, the number of sheared trajectory lines is minimized to obtain the shortest pulse duration, such that the excitation replicas are repositioned outside the slice stack to guarantee unlimited slice coverage. A target fat/water signal ratio of 5% is chosen to achieve robust fat suppression.

RESULTS

Simulations, imaging experiments on a custom head and neck phantom, and in vivo imaging experiments in the spinal cord at 3 T demonstrate that the sheared 2D RF design provides significant improvement in image quality while preserving profile sharpnesses. In regions with high off-resonance effects, the sheared 2D RF pulse improves the signal by more than 50% when compared to the standard 2D RF pulse.

CONCLUSION

The proposed sheared 2D RF design successfully reduces pulse durations, exhibiting significantly improved through-plane off-resonance robustness, while providing unlimited slice coverage and high fidelity fat suppression. This method will be especially beneficial in regions suffering from a variety of off-resonance effects, such as spinal cord and breast.

Diagnostic value of multi-model high-resolution diffusion-weighted MR imaging in breast lesions: Based on simultaneous multi-slice readout-segmented echo-planar imaging

PURPOSE

To investigate the diagnostic value of multi-model high-resolution diffusion-weighted MR imaging (DWI) in breast lesions, with a comparison of simultaneous multi-slice readout-segmented echo-planar imaging (SMS rs-EPI) and single-shot EPI (ss-EPI).

MATERIALS AND METHODS

This retrospective study was approved by the institutional ethics committee and included 120 patients with 122 breast lesions (25 benign and 97 malignant). All patients underwent breast DWI with multi-b values (0, 50, 100, 200, 400, 800, 1200, and 2000 s/mm²) based on both SMS rs-EPI and ss-EPI on a 3.0 T MR scanner. Quantitative DWI-derived parameters including ADC, MK, MD, D, D*, and f were calculated based on mono-exponential (Mono), intravoxel incoherent motion (IVIM), diffusion kurtosis (DKI) models. Meanwhile, both DWI sequences were qualitatively evaluated with respect to overall image quality, lesion conspicuity, image artifact, geometric distortion, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and lesion contrast. The differences in DW-derived parameters, image quality, and diagnostic performance were statistically compared between SMS rs-EPI and ss-EPI groups.

RESULTS

The SMS rs-EPI produced higher Contrast, CNR and lower SNR than ss-EPI (p < 0.01). The image quality of SMS rs-EPI was superior to ss-EPI either in subjective or objective evaluation. There was no significant difference between the SMS rs-EPI and ss-EPI for either MD or the D* (p > 0.05). However, the MK and f between the two sequences showed significant differences (p < 0.05). Spearman's correlation coefficient displayed good linear correlation for MK values (r = 0.73, 95% CI 0.617-0.857), MD values (r = 0.88, 95% CI 0.814-0.926), ADC values (r = 0.93, 95% CI 0.869-0.948) and D values (r = 0.93, 95% CI 0.856-0.948) between SMS rs-EPI and ss-EPI. Spearman's correlation coefficient for f values (r = 0.25, 95% CI 0.226-0.559) and D* values (r = 0.22, 95% CI 0.025-0.348) were fair and no correlation between the two sequences. MK values have the highest diagnostic value in differentiating benign and malignant breast lesions.

CONCLUSIONS

High-resolution multi-model DWI based on SMS rs-EPI technique can provide superior image quality and lesion characterization, with comparable diagnostic performance as compared with ss-EPI DWI in differentiating benign and malignant breast lesions. Of different DWI-derived parameters, MK values showed the best diagnostic performance.

High-Resolution DWI with Simultaneous Multi-Slice Readout-Segmented Echo Planar Imaging for the Evaluation of Malignant and Benign Breast Lesions

To investigate the feasibility and effectiveness of high-resolution readout-segmented echo planar imaging (rs-EPI), diffusion-weighted imaging (DWI) is used simultaneously with multi-slice (SMS) imaging (SMS rs-EPI) for the differentiation of breast malignant and benign lesions in comparison to conventional rs-EPI on a 3T MR scanner. A total of 102 patients with 113 breast lesions underwent bilateral breast MRI using a prototype SMS rs-EPI sequence and a conventional rs-EPI sequence. Subjective image quality was assessed using a 5-point Likert scale (1 = poor, 5 = excellent). Signal-to-noise ratio (SNR), lesion contrast-to-noise ratio (CNR) and apparent diffusion coefficients (ADC) value of the lesion were measured for comparison. Receiver operating characteristic curve analysis was performed to evaluate the diagnosis performance of ADC, and the corresponding area under curve (AUC) was calculated. The image quality scores in anatomic distortion, lesion conspicuity, sharpness of anatomical details and overall image quality of SMS rs-EPI were significantly higher than those of conventional rs-EPI. CNR was enhanced in the high-resolution SMS rs-EPI acquisition (6.48 ± 1.71 vs. 4.23 ± 1.49; p < 0.001). The mean ADC value was comparable in SMS rs-EPI and conventional rs-EPI (benign 1.45 × 10⁻³ vs. 1.43 × 10⁻³ mm²/s, p = 0.702; malignant 0.91 × 10⁻³ vs. 0.89 × 10⁻³ mm²/s, p = 0.076). The AUC was 0.957 in SMS rs-EPI and 0.983 in conventional rs-EPI. SMS rs-EPI technique allows for higher spatial resolution and slight reduction of scan time in comparison to conventional rs-EPI, which has potential for better differentiation between malignant and benign lesions of the breast.

Machine-Learning Approach to Differentiation of Benign and Malignant Peripheral Nerve Sheath Tumors: A Multicenter Study

BACKGROUND

Clinicoradiologic differentiation between benign and malignant peripheral nerve sheath tumors (PNSTs) has important management implications.

OBJECTIVE

To develop and evaluate machine-learning approaches to differentiate benign from malignant PNSTs.

METHODS

We identified PNSTs treated at 3 institutions and extracted high-dimensional radiomics features from gadolinium-enhanced, T1-weighted magnetic resonance imaging (MRI) sequences. Training and test sets were selected randomly in a 70:30 ratio. A total of 900 image features were automatically extracted using the PyRadiomics package from Quantitative Imaging Feature Pipeline. Clinical data including age, sex, neurogenetic syndrome presence, spontaneous pain, and motor deficit were also incorporated. Features were selected using sparse regression analysis and retained features were further refined by gradient boost modeling to optimize the area under the curve (AUC) for diagnosis. We evaluated the performance of radiomics-based classifiers with and without clinical features and compared performance against human readers.

RESULTS

A total of 95 malignant and 171 benign PNSTs were included. The final classifier model included 21 imaging and clinical features. Sensitivity, specificity, and AUC of 0.676, 0.882, and 0.845, respectively, were achieved on the test set. Using imaging and clinical features, human experts collectively achieved sensitivity, specificity, and AUC of 0.786, 0.431, and 0.624, respectively. The AUC of the classifier was statistically better than expert humans (P = .002). Expert humans were not statistically better than the no-information rate, whereas the classifier was (P = .001).

CONCLUSION

Radiomics-based machine learning using routine MRI sequences and clinical features can aid in evaluation of PNSTs. Further improvement may be achieved by incorporating additional imaging sequences and clinical variables into future models.

High-fidelity diffusion tensor imaging of the cervical spinal cord using point-spread-function encoded EPI

Diffusion tensor imaging (DTI) of the spinal cord is technically challenging due to the size of its structure and susceptibility-induced field inhomogeneity, which impedes clinical applications. This study aimed to achieve high-fidelity spinal cord DTI with reasonable SNR and practical acquisition efficiency. Particularly, a distortion-free multi-shot EPI technique, namely point-spread-function encoded EPI (PSF-EPI), was adopted for diffusion imaging of the cervical spinal cord (CSC). The shot number can be reduced to six for sagittal scans through titled-CAIPI acceleration and partial Fourier undersampling, consequently rendering this technique beneficial in clinics. Fifteen healthy volunteers and seven patients with metallic implants underwent sagittal scans using tilted-CAIPI PSF-EPI at 3T. Unsuppressed fat signals were further removed by retrospective water/fat separation using the intrinsic chemical-shift encoded signals. Compared with multi-shot interleaved EPI method, highly accelerated PSF-EPI method provided evidently improved distortion reduction and higher consistency with anatomical references even with metallic implants. Additionally, axial DTI scans using PSF-EPI were also evaluated quantitatively, and the measured DTI metrics are similar to those obtained from the zonal oblique multi-slice EPI (ZOOM-EPI) method and reported values. The high anatomical consistency, practical scan time and quantitative reliability indicate PSF-EPI's clinical potential for CSC diffusion imaging.

Quiet Diffusion-weighted MR Imaging of the Brain for Pediatric Patients with Moyamoya Disease

PURPOSE

Diffusion-weighted MRI (DWI) is an essential sequence for evaluating pediatric patients with moyamoya disease (MMD); however, acoustic noise associated with DWI may lead to motion artifact. Compared with conventional DWI (cDWI), quiet DWI (qDWI) is considered less noisy and able to keep children more relaxed and stable. This study aimed to evaluate the suitability of qDWI compared with cDWI for pediatric patients with MMD.

METHODS

In this observational study, MR examinations of the brain were performed either with or without sedation in pediatric patients with MMD between September 2017 and August 2018. Three neuroradiologists independently evaluated the images for artifacts and restricted diffusion in the brain. The differences between qDWI and cDWI were compared statistically using a chi-square test.

RESULTS

One-hundred and six MR scans of 56 patients with MMD (38 scans of 15 sedated patients: 6 boys and 9 girls; mean age, 5.2 years; range, 1-9 years; and 68 scans of 42 unsedated patients: 19 boys and 23 girls; mean age, 10.7 years; range, 7-16 years) were evaluated. MR examinations were performed either with or without sedation (except in one patient). In sedated patients, no artifact other than susceptibility was observed on qDWI, whereas four artifacts were observed on cDWI (P = .04). One patient awoke from sedation during cDWI scanning, while no patient awoke from sedation during qDWI acquisition. For unsedated patients, three scans showed artifacts on qDWI, whereas two scans showed artifacts on cDWI (P = .65). Regarding restricted diffusion, qDWI revealed three cases, while two cases were found on cDWI (P = .66).

CONCLUSION

qDWI induced fewer artifacts compared with cDWI in sedated patients, and similar frequencies of artifacts were induced by qDWI and by cDWI in unsedated patients. qDWI showed restricted diffusion comparable to cDWI.

Improving distortion correction for isotropic high-resolution 3D diffusion MRI by optimizing Jacobian modulation

PURPOSE

To improve distortion correction for isotropic high-resolution whole-brain 3D diffusion MRI when in a time-saving acquisition scenario.

THEORY AND METHODS

Data were acquired using simultaneous multi-slab (SMSlab) acquisitions, with a b = 0 image pair encoded by reversed polarity gradients (RPG) for phase encoding (PE) and diffusion weighted images encoded by a single PE direction. Eddy current-induced distortions were corrected first. During the following susceptibility distortion correction, image deformation was first corrected by the field map estimated from the b = 0 image pair. Intensity variation was subsequently corrected by Jacobian modulation. Two Jacobian modulation methods were compared. They calculated the Jacobian modulation map from the field map, or from the deformation corrected b = 0 image pair, termed as J_Field and J_RPG , respectively. A modified version of the J_RPG method, with proper smoothing, was further proposed for improved correction performance, termed as J_RPG-smooth .

RESULTS

Compared to J_Field modulation, less remaining distortions are observed when using the J_RPG and J_RPG-smooth methods, especially in areas with large B0 field inhomogeneity. The original J_RPG method causes signal-to-noise ratio (SNR) deficiency problem, which manifests as degraded SNR of the diffusion weighted images, while the J_RPG-smooth method maintains the original image SNR. Less estimation errors of diffusion metrics are observed when using the J_RPG-smooth method.

CONCLUSION

This study improves the distortion correction for isotropic high-resolution whole-brain 3D diffusion MRI by optimizing Jacobian modulation. The optimized method outperforms the conventional J_Field method regarding intensity variation correction and accuracy of diffusion metrics estimation, and outperforms the original J_RPG method regarding SNR performance.

Multishot Diffusion-Weighted MRI of the Breast With Multiplexed Sensitivity Encoding (MUSE) and Shot Locally Low-Rank (Shot-LLR) Reconstructions

BACKGROUND

Diffusion-weighted imaging (DWI) has shown promise to screen for breast cancer without a contrast injection, but image distortion and low spatial resolution limit standard single-shot DWI. Multishot DWI methods address these limitations but introduce shot-to-shot phase variations requiring correction during reconstruction.

PURPOSE

To investigate the performance of two multishot DWI reconstruction methods, multiplexed sensitivity encoding (MUSE) and shot locally low-rank (shot-LLR), compared to single-shot DWI in the breast.

STUDY TYPE

Prospective.

POPULATION

A total of 45 women who consented to have multishot DWI added to a clinically indicated breast MRI.

FIELD STRENGTH/SEQUENCES

Single-shot DWI reconstructed by parallel imaging, multishot DWI with four or eight shots reconstructed by MUSE and shot-LLR, 3D T2 -weighted imaging, and contrast-enhanced MRI at 3T.

ASSESSMENT

Three blinded observers scored images for 1) general image quality (perceived signal-to-noise ratio [SNR], ghosting, distortion), 2) lesion features (discernment and morphology), and 3) perceived resolution. Apparent diffusion coefficient (ADC) of the lesion was also measured and compared between methods.

STATISTICAL TESTS

Image quality features and perceived resolution were assessed with a mixed-effects logistic regression. Agreement among observers was estimated with a Krippendorf's alpha using linear weighting. Lesion feature ratings were visualized using histograms, and correlation coefficients of lesion ADC between different methods were calculated.

RESULTS

MUSE and shot-LLR images were rated to have significantly better perceived resolution (P < 0.001), higher SNR (P < 0.005), and a lower level of distortion (P < 0.05) with respect to single-shot DWI. Shot-LLR showed reduced ghosting artifacts with respect to both MUSE (P < 0.001) and single-shot DWI (P < 0.001). Eight-shot DWI had improved perceived SNR and perceived resolution with respect to four-shot DWI (P < 0.005).

DATA CONCLUSION

Multishot DWI enables increased resolution and improved image quality with respect to single-shot DWI in the breast. Shot-LLR reconstructs multishot DWI with minimal ghosting artifacts. The improvement of multishot DWI in image quality increases with an increased number of shots.

LEVEL OF EVIDENCE

2 TECHNICAL EFFICACY STAGE: 2.

Diffusion-weighted double-echo steady-state with a three-dimensional cones trajectory for non-contrast-enhanced breast MRI

The image quality limitations of echo-planar diffusion-weighted imaging (DWI) are an obstacle to its widespread adoption in the breast. Steady-state DWI is an alternative DWI method with more robust image quality but its contrast for imaging breast cancer is not well-understood. The aim of this study was to develop and evaluate diffusion-weighted double-echo steady-state imaging with a three-dimensional cones trajectory (DW-DESS-Cones) as an alternative to conventional DWI for non-contrast-enhanced MRI in the breast. This prospective study included 28 women undergoing clinically indicated breast MRI and six asymptomatic volunteers. In vivo studies were performed at 3 T and included DW-DESS-Cones, DW-DESS-Cartesian, DWI, and CE-MRI acquisitions. Phantom experiments (diffusion phantom, High Precision Devices) and simulations were performed to establish framework for contrast of DW-DESS-Cones in comparison to DWI in the breast. Motion artifacts of DW-DESS-Cones were measured with artifact-to-noise ratio in volunteers and patients. Lesion-to-fibroglandular tissue signal ratios were measured, lesions were categorized as hyperintense or hypointense, and an image quality observer study was performed in DW-DESS-Cones and DWI in patients. Effect of DW-DESS-Cones method on motion artifacts was tested by mixed-effects generalized linear model. Effect of DW-DESS-Cones on signal in phantom was tested by quadratic regression. Correlation was calculated between DW-DESS-Cones and DWI lesion-to-fibroglandular tissue signal ratios. Inter-observer agreement was assessed with Gwet's AC. Simulations predicted hyperintensity of lesions with DW-DESS-Cones but at a 3% to 67% lower degree than with DWI. Motion artifacts were reduced with DW-DESS-Cones versus DW-DESS-Cartesian (p < 0.05). Lesion-to-fibroglandular tissue signal ratios were not correlated between DW-DESS-Cones and DWI (r = 0.25, p = 0.38). Concordant hyperintensity/hypointensity was observed between DW-DESS-Cones and DWI in 11/14 lesions. DW-DESS-Cones improved sharpness, distortion, and overall image quality versus DWI. DW-DESS-Cones may be able to eliminate motion artifacts in the breast allowing for investigation of higher degrees of steady-state diffusion weighting. Malignant breast lesions in DW-DESS-Cones demonstrated hyperintensity with respect to surrounding tissue without an injection of contrast. LEVEL OF EVIDENCE: 2. TECHNICAL EFFICACY STAGE: 1.

Accelerating acquisition of readout-segmented echo planar imaging with a simultaneous multi-slice (SMS) technique for diagnosing breast lesions

OBJECTIVES

To investigate the feasibility and effectiveness of SMS rs-EPI for evaluating breast lesions.

METHODS

This prospective study was approved by IRB. Ninety-six patients had 102 histopathologically verified lesions (80 malignant and 22 benign) that were evaluated. Conventional rs-EPI and SMS rs-EPI data were acquired on a 3T scanner. Mean kurtosis (MK), mean diffusion (MD), and apparent diffusion coefficient (ADC) values were quantitatively calculated for each lesion on both sequences. Images were qualitatively and quantitatively analyzed with respect to image sharpness, geometric distortion, lesion conspicuity, anatomic structure, overall image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Student's t test, Pearson correlation, receiver operating characteristic curve, Wilcoxon rank sum test, and paired-sample t tests were used for statistical analysis.

RESULTS

Compared to conventional rs-EPI, the acquisition time of SMS rs-EPI was markedly reduced (2:17 min vs 4:27 min). Pearson's correlations showed excellent linear relationships for each parameter between conventional rs-EPI and SMS rs-EPI (MK, r = 0.908; MD, r = 0.938; and ADC, r = 0.975; p < 0.01 for all). Furthermore, SMS rs-EPI had similar diagnostic performance compared with conventional rs-EPI. SMS rs-EPI had comparable visual image quality as conventional rs-EPI, with excellent inter-reader reliability (ICC = 0.851-0.940). No differences existed between conventional rs-EPI and SMS rs-EPI for either SNR or CNR (p > 0.05).

CONCLUSIONS

Applying the SMS technique can significantly reduce the acquisition time and produce similar diagnostic accuracy while generating comparable image quality as the conventional rs-EPI.

KEY POINTS

• SMS rs-EPI reduces scan time from 4:27 min to 2:17 min compared with conventional rs-EPI. • SMS rs-EPI has a comparable diagnostic performance to conventional rs-EPI in the differentiation between malignant and benign breast lesions. • SMS rs-EPI demonstrates comparable image quality to conventional rs-EPI with shorter scan time.

Optimization of Simultaneous Multislice, Readout-Segmented Echo Planar Imaging for Accelerated Diffusion-Weighted Imaging of the Head and Neck: A Preliminary Study

RATIONALE AND OBJECTIVES

To evaluate the feasibility of simultaneous multislice (SMS)-accelerated, readout-segmented echo-planar imaging (rs-EPI, RESOLVE) with the use of special-purpose coils for head and neck assessment, particularly in patients diagnosed with head and neck malignant tumors, through comparison with the conventional RESOLVE and RESOLVE with readout partial-Fourier technique (RESOLVE-RPF).

MATERIALS AND METHODS

Twenty-five healthy volunteers and 24 patients with histologically proven malignant head and neck tumors were included in this prospective study. The MR exam included conventional RESOLVE, RESOLVE-RPF, prototypic SMS-RESOLVE, and prototypic SMS-RESOLVE with special-purpose coils (SMS-RESOLVE + Coils), acquired at b-values of both 0 and 800 s/mm². Image quality was evaluated qualitatively (reader score) and quantitatively (tumor distortion, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), SNR efficiency) and compared. For volunteer imaging, the image quality of target tissues at three different typical levels (oropharyngeal, hypopharyngeal, and thyroid level) were evaluated. For patient imaging, the image quality of primary tumors and metastatic lymph nodes was evaluated.

RESULTS

The acquisition time was 3:37 minutes for RESOLVE, 2:58 minutes for RESOLVE-RFP, 2:01 minutes for SMS-RESOLVE and 2:01 minutes for SMS-RESOLVE + Coils, with a 44% reduction compared to the conventional RESOLVE. No significant differences in the reader scores, tumor distortion, or ADC values of the lesions were found among the protocols. The SNR and CNR at the oropharyngeal and hypopharyngeal level of SMS-RESOLVE + Coils were markedly improved and significantly higher than those of RESOLVE, as well as the SNR, SNR efficiency of tumors and lymph nodes. No significant differences in quantitative measurements were found at the thyroid level.

CONCLUSION

SMS-RESOLVE + Coils protocol is an effective and promising approach to optimally reducing the total acquisition time, and could be a good alternative with a superior SNR and SNR efficiency in comparison with conventional RESOLVE. However, the limited application in the lower neck region needs further investigation.

Prospective motion correction for diffusion weighted EPI of the brain using an optical markerless tracker

PURPOSE

To enable motion-robust diffusion weighted imaging of the brain using well-established imaging techniques.

METHODS

An optical markerless tracking system was used to estimate and correct for rigid body motion of the head in real time during scanning. The imaging coordinate system was updated before each excitation pulse in a single-shot EPI sequence accelerated by GRAPPA with motion-robust calibration. Full Fourier imaging was used to reduce effects of motion during diffusion encoding. Subjects were imaged while performing prescribed motion patterns, each repeated with prospective motion correction on and off.

RESULTS

Prospective motion correction with dynamic ghost correction enabled high quality DWI in the presence of fast and continuous motion within a 10° range. Images acquired without motion were not degraded by the prospective correction. Calculated diffusion tensors tolerated the motion well, but ADC values were slightly increased.

CONCLUSIONS

Prospective correction by markerless optical tracking minimizes patient interaction and appears to be well suited for EPI-based DWI of patient groups unable to remain still including those who are not compliant with markers.

Optimization of high-channel count, switch matrices for multinuclear, high-field MRI

Modern magnetic resonance imaging systems are equipped with a large number of receive connectors in order to optimally support a large field-of-view and/or high acceleration in parallel imaging using high-channel count, phased array coils. Given that the MR system is equipped with a limited number of digitizing receivers and in order to support operation of multinuclear coil arrays, these connectors need to be flexibly routed to the receiver outside the RF shielded examination room. However, for a number of practical, economic and safety reasons, it is better to only route a subset of the connectors. This is usually accomplished with the use of switch matrices. These exist in a variety of topologies and differ in routing flexibility and technological implementation. A highly flexible implementation is a crossbar topology that allows to any one input to be routed to any one output and can use single PIN diodes as active elements. However, in this configuration, long open-ended transmission lines can potentially remain connected to the signal path leading to high transmission losses. Thus, especially for high-field systems compensation mechanisms are required to remove the effects of open-ended transmission line stubs. The selection of a limited number of lumped element reactance values to compensate for the for the effect of transmission line stubs in large-scale switch matrices capable of supporting multi-nuclear operation is non-trivial and is a combinatorial problem of high order. Here, we demonstrate the use of metaheuristic approaches to optimize the circuit design of these matrices that additionally carry out the optimization of distances between the parallel transmission lines. For a matrix with 128 inputs and 64 outputs a realization is proposed that displays a worst-case insertion loss of 3.8 dB.

Accelerated Segmented Diffusion-Weighted Prostate Imaging for Higher Resolution, Higher Geometric Fidelity, and Multi-b Perfusion Estimation

PURPOSE

The aim of this study was to improve the geometric fidelity and spatial resolution of multi-b diffusion-weighted magnetic resonance imaging of the prostate.

MATERIALS AND METHODS

An accelerated segmented diffusion imaging sequence was developed and evaluated in 25 patients undergoing multiparametric magnetic resonance imaging examinations of the prostate. A reduced field of view was acquired using an endorectal coil. The number of sampled diffusion weightings, or b-factors, was increased to allow estimation of tissue perfusion based on the intravoxel incoherent motion (IVIM) model. Apparent diffusion coefficients measured with the proposed segmented method were compared with those obtained with conventional single-shot echo-planar imaging (EPI).

RESULTS

Compared with single-shot EPI, the segmented method resulted in faster acquisition with 2-fold improvement in spatial resolution and a greater than 3-fold improvement in geometric fidelity. Apparent diffusion coefficient values measured with the novel sequence demonstrated excellent agreement with those obtained from the conventional scan (R = 0.91 for bmax = 500 s/mm and R = 0.89 for bmax = 1400 s/mm). The IVIM perfusion fraction was 4.0% ± 2.7% for normal peripheral zone, 6.6% ± 3.6% for normal transition zone, and 4.4% ± 2.9% for suspected tumor lesions.

CONCLUSIONS

The proposed accelerated segmented prostate diffusion imaging sequence achieved improvements in both spatial resolution and geometric fidelity, along with concurrent quantification of IVIM perfusion.

Distortion correction for high-resolution single-shot EPI DTI using a modified field-mapping method

PURPOSE

The widely used single-shot EPI (SS-EPI) diffusion tensor imaging (DTI) suffers from strong image distortion due to B₀ inhomogeneity, especially for high-resolution imaging. Traditional methods such as the field-mapping method and the top-up method have various deficiencies in high-resolution SS-EPI DTI distortion correction. This study aims to propose a robust distortion correction approach, which combines the advantages of traditional methods and overcomes their deficiencies, for high-resolution SS-EPI DTI.

METHODS

The proposed correction method is based on the echo planar spectroscopic imaging field-mapping followed by an intensity correction procedure. To evaluate the efficacy of distortion correction, the proposed method was compared with the conventional field-mapping method and the top-up method, using a newly developed quantitative evaluation framework. The correction results were also compared with multi-shot EPI DTI to investigate whether the proposed method can provide high-resolution SS-EPI DTI with high geometric fidelity and high time efficiency.

RESULTS

The results show that accurate field-mapping and intensity correction are critical to distortion correction in high-resolution SS-EPI DTI. The proposed method can provide more precise field maps and better correction results than the other two methods (p < 0.0001), and the corrected images show higher geometric fidelity than those from MS-EPI DTI.

CONCLUSION

An effective method is proposed to reduce image distortion in high-resolution SS-EPI DTI. It is practical to achieve high-resolution DTI with high time efficiency and high structure accuracy using this method.

SMS MUSSELS: A navigator-free reconstruction for simultaneous multi-slice-accelerated multi-shot diffusion weighted imaging

PURPOSE

To introduce a novel reconstruction method for simultaneous multi-slice (SMS)-accelerated multi-shot diffusion weighted imaging (ms-DWI).

METHODS

SMS acceleration using blipped-CAIPI schemes have been proposed to speed up the acquisition of ms-DWIs. The reconstruction of the data requires (a) phase compensation to combine data from different shots and (b) slice unfolding to separate the data of different slices. The traditional approaches first estimate the phase maps corresponding to each shot and slice which are then employed to iteratively recover the slice unfolded DWIs without phase artifacts. In contrast, the proposed reconstruction directly recovers the slice-unfolded k-space data of the multiple shots for each slice in a single-step recovery scheme. The proposed method is enabled by the low-rank property inherent in the k-space samples of ms-DW acquisition. This enabled to formulate a joint recovery scheme that simultaneously (a) unfolds the k-space data of each slice using a SENSE-based scheme and (b) recover the missing k-space samples in each slice of the multi-shot acquisition employing a structured low-rank matrix completion. Additional smoothness regularization is also utilized for higher acceleration factors. The proposed joint recovery is tested on simulated and in vivo data and compared to similar un-navigated methods.

RESULTS

Our experiments show effective slice unfolding and successful recovery of DWIs with minimal phase artifacts using the proposed method. The performance is comparable to existing methods at low acceleration factors and better than existing methods for higher acceleration factors.

CONCLUSIONS

For the slice accelerations considered in this study, the proposed method can successfully recover DWIs from SMS-accelerated ms-DWI acquisitions.

Accelerating cardiac diffusion tensor imaging combining local low-rank and 3D TV constraint

OBJECTIVE

Diffusion tensor magnetic resonance imaging (DT-MRI, or DTI) is a promising technique for invasively probing biological tissue structures. However, DTI is known to suffer from much longer acquisition time with respect to conventional MRI and the problem is worsened when dealing with in vivo acquisitions. Therefore, faster DTI for both ex vivo and in vivo scans is highly desired.

MATERIALS AND METHODS

This paper proposes a new compressed sensing (CS) reconstruction method that employs local low-rank (LLR) model and three-dimensional (3D) total variation (TV) constraint to reconstruct cardiac diffusion-weighted (DW) images from highly undersampled k-space data. The LLR model takes the set of DW images corresponding to different diffusion gradient directions as a 3D image volume and decomposes the latter into overlapping 3D blocks. Then, the 3D blocks are stacked as two-dimensional (2D) matrix. Finally, low-rank property is applied to each block matrix and the 3D TV constraint to the 3D image volume. The underlying constrained optimization problem is finally solved using the first-order fast method. The proposed method is evaluated on real ex vivo cardiac DTI data as a prerequisite to in vivo cardiac DTI applications.

RESULTS

The results on real human ex vivo cardiac DTI images demonstrate that the proposed method exhibits lower reconstruction errors for DTI indices, including fractional anisotropy (FA), mean diffusivities (MD), transverse angle (TA), and helix angle (HA), compared to existing CS-based DTI image reconstruction techniques.

CONCLUSION

The proposed method provides better reconstruction quality and more accurate DTI indices in comparison with the state-of-the-art CS-based DW image reconstruction methods.

Common Information Enhanced Reconstruction for Accelerated High-resolution Multi-shot Diffusion Imaging

PURPOSE

Multi-shot technique can effectively achieve high-resolution diffusion weighted images, but the acquisition time of multi-shot technique is prolonged, especially for multiple direction diffusion encoding. Thus, increasing acquisition efficiency is highly desirable for high-resolution diffusion tensor imaging (DTI). In this study, based on the assumption that different diffusion directions share the common information, image ratio constrained reconstruction (IRCR) combined with iterative self-consistent parallel imaging reconstruction (SPIRiT) is proposed to improve data sampling efficiency and image reconstruction fidelity for high-resolution DTI.

THEORY AND METHODS

The proposed reconstruction framework is named Common Information Enhanced Reconstruction (CIER). Inter-image correlation among different direction diffusion-weighted images is used through common information, which is an isotropic component and structure, for improving the performance of reconstruction. The framework consists of three steps. (i) Pre-processing: three intermediate multi-shot images, low-resolution composite image, high-resolution composite image and low-resolution diffusion weighted image, are generated based on the SPIRiT method. (ii) IRCR: the initial high-resolution diffusion weighted image is calculated from the images in step (i) based on that the ratio map between high-resolution images is approximated by the ratio map between the corresponding low-resolution images. (iii) Final SPIRiT reconstruction: the final image is generated with the image from IRCR as initialization by considering data consistency only in the SPIRiT calculation. A specific implementation based on multishot variable density spiral (VDS) DTI is used to demonstrate the method.

RESULTS

The proposed CIER method was compared with the traditional reconstruction methods, conjugate gradient SENSE (CG-SENSE), L1-regularized SPIRiT (L1-SPIRiT), and anisotropic-sparsity SPIRiT (AS-SPIRiT) in brain DTI at acceleration factors of 3 to 7. CIER provided better diffusion image quality than other methods shown by both qualitative and quantitative results, especially at higher undersampling acceleration factors.

CONCLUSION

CIER offers better diffusion image quality at higher undersampling acceleration factors for high-resolution DTI. Both qualitative and quantitative results prove that common information can be used to improve sampling efficiency and maintain the image quality of diffusion-weighted images.

The quest for high spatial resolution diffusion-weighted imaging of the human brain in vivo

Diffusion-weighted imaging, a contrast unique to MRI, is used for assessment of tissue microstructure in vivo. However, this exquisite sensitivity to finer scales far above imaging resolution comes at the cost of vulnerability to errors caused by sources of motion other than diffusion motion. Addressing the issue of motion has traditionally limited diffusion-weighted imaging to a few acquisition techniques and, as a consequence, to poorer spatial resolution than other MRI applications. Advances in MRI imaging methodology have allowed diffusion-weighted MRI to push to ever higher spatial resolution. In this review we focus on the pulse sequences and associated techniques under development that have pushed the limits of image quality and spatial resolution in diffusion-weighted MRI.

Evaluation of Submillimeter Diffusion Imaging of the Macaque Brain Using Readout-Segmented EPI at 7 T

OBJECTIVE

The purpose of the present study was to achieve submillimeter-level diffusion tensor imaging (DTI) of the macaque brain by using diffusion weighted (DW) readout-segmented echo planar imaging (rsEPI) with an optimized protocol at 7 T MRI.

METHODS

Three anesthetized macaques were included in this study. Under different scan settings, we compared the signal-to-noise ratio (SNR) and geometric distortion of DW images, implemented an optimized protocol for submillimeter-level DTI acquisition, and evaluated its performance.

RESULTS

The parallel-imaging-enabled (in GRAPPA mode) monopolar or monopolar+ diffusion scheme has higher SNR versus bipolar scheme, whereas trivial differences in SNR and image geometric distortion occurred when using increased readout segments with monopolar and monopolar+ that did not reach statistical significance. Submillimeter-level (0.8 mm isotropic) DTI data provide a sharper delineation of white matter contour than the 1 mm level.

CONCLUSION

The rsEPI technique with parallel imaging enabled, and with the shortest readout segments in conjunction with monopolar/monopolar+ diffusion encoding scheme, may be optimal for submillimeter-level diffusion imaging over macaque brains in vivo.

SIGNIFICANCE

rsEPI could effectively merit high-resolution DTI for in vivo macaque brain submillimeter structural architecture investigations at ultrahigh fields.

The diagnostic value of T2 maps and rs-EPI DWI in dermatomyositis

OBJECTIVE:

To explore and confirm feasibility the T₂ maps and readout-segmented echoplanar imaging (rs-EPI) diffusion-weighted imaging (DWI) characteristics of the thigh muscles for dermatomyositis (DM) patients.

METHODS:

This study was approved by the University Institutional Review and written informed consent was obtained from all subjects before enrollment (trial registration number: TJ-C20121221). 28 patients with DM proven by diagnostic criteria were enrolled in the study along with 9 healthy control subjects. Conventional MR, T₂ maps and rs-EPI DWI were obtained for all subjects. Both of T₂ and apparent diffusion coefficient (ADC) values for thigh muscles were compared between the DM and healthy control groups. The amount of inflammation and fatty infiltration were respectively assigned a score of 0 to 5 for all thigh muscles. The Kruskal-Wallis tests were utilized and the Spearman correlation coefficients models were used to correlate both of the T₂ and ADC value with non-quantitative MRI. P-values <0.05 reflected statistical significance.

RESULTS:

Both of the T₂ and ADC values among all affected muscles, unaffected muscles and the control groups were respectively statistical difference (p < 0.05 respectively), the T₂ value of affected muscles was greater than that of unaffected muscles in DM patients (p < 0.05). Differences of the T₂ value in DM patients among the combination the edematous with fatty infiltration score groups were statistically significant (p < 0.001). The T₂ value showed a significant correlation with the non-quantitative MRI score for edema and fatty infiltration.

CONCLUSIONS:

T₂ maps may have a specialized ability for the detection severity of damaged muscles in comparison to the rs-EPI DWI sequence.

ADVANCES IN KNOWLEDGE:

A new application of rs-EPI DWI is proposed for DM patients. First, comparison of T₂ maps and rs-EPI DWI technology are applied for DM. The results demonstrate that T₂ maps may be more potential value in determining the severity of diseased muscles for DM patients.

Diffusion Tensor Imaging of the Brachial Plexus: A Comparison between Readout-segmented and Conventional Single-shot Echo-planar Imaging

Purpose:

Diffusion tensor imaging (DTI) adds functional information to morphological magnetic resonance neurography (MRN) in the assessment of the brachial nerve plexus. To determine the most appropriate pulse sequence in scan times suited for diagnostic imaging in clinical routine, we compared image quality between simultaneous multi-slice readout-segmented (rs-DTI) and conventional single-shot (ss-DTI) echo-planar imaging techniques.

Methods:

Institutional Review Board (IRB) approved study including 10 healthy volunteers. The supraclavicular brachial plexus, covering the nerve roots and trunks from C5 to C7, was imaged on both sides with rs-DTI and ss-DTI. Both sequences were acquired in scan times <7 min with b-values of 900 s/mm² and with isotropic spatial resolution.

Results:

In rs-DTI image, the overall quality was significantly better and distortion artifacts were significantly lower (P = 0.001–0.002 and P = 0.001–0.002, respectively) for both readers. In ss-DTI, a trend toward lower degree of ghosting and motion artifacts was elicited (reader 1, P = 0.121; reader 2, P = 0.264). No significant differences between the two DTI techniques were found for signal-to-noise ratios (SNR), contrast-to-noise ratios (CNR) and fractional anisotropy (FA) (P ≥ 0.475, P ≥ 0.624, and P ≥ 0.169, respectively). Interreader agreement for all examined parameters and all sequences ranged from intraclass correlation coefficient (ICC) 0.064 to 0.905 and Kappa 0.40 to 0.851.

Conclusion:

Incomparable acquisition times rs-DTI showed higher image quality and less distortion artifacts than ss-DTI. The trend toward a higher degree of ghosting and motion artifacts in rs-DTI did not deteriorate image quality to a significant degree. Thus, rs-DTI should be considered for functional MRN of the brachial plexus.

Technical Note: Clustering-based motion compensation scheme for multishot diffusion tensor imaging

PURPOSE

To extend image reconstruction using image-space sampling function (IRIS) to address large-scale motion in multishot diffusion-weighted imaging (DWI).

METHODS

A clustered IRIS (CIRIS) algorithm that would extend IRIS was proposed to correct for large-scale motion. For DWI, CIRIS initially groups the shots into clusters without intracluster large-scale motion and reconstructs each cluster by using IRIS. Then, CIRIS registers these cluster images and combines the registered images by using a weighted average to correct for voxel mismatch caused by intercluster large-scale motion. For diffusion tensor imaging (DTI), CIRIS further reduces the effect of motion on diffusion directions by treating motion-induced direction changes as additional diffusion directions. CIRIS also introduces the detection and rejection of motion-corrupted data to avoid corresponding image degradation. The proposed method was evaluated by simulation and in vivo diffusion datasets.

RESULTS

Experiments demonstrated that CIRIS can reduce motion-induced blurring and artifacts in DWI and provide more accurate DTI estimations in the presence of large-scale motion, compared with IRIS.

CONCLUSION

The proposed method presents a novel approach to correct for large-scale in-plane motion for multishot DWI and is expected to benefit the practical application of high-resolution diffusion imaging.

Simultaneous and inherent correction of B0 and eddy-current induced distortions in high-resolution diffusion MRI using reversed polarity gradients and multiplexed sensitivity encoding (RPG-MUSE)

In diffusion MRI (dMRI), static magnetic field (B₀) inhomogeneity and time varying gradient eddy currents induce spatial distortions in reconstructed images. These distortions are exacerbated when high spatial resolutions are used, and many field-mapping based correction techniques often only acquire maps of static B₀ distortion, which are not adequate for correcting eddy current induced image distortions. This report presents a novel technique, termed RPG-MUSE, for achieving distortion-free high-resolution diffusion MRI by integrating reversed polarity gradients (RPG) into the multi-shot echo planar imaging acquisition scheme used in multiplexed sensitivity encoding (MUSE). By alternating the phase encoding direction between shots in both baseline and diffusion-weighted acquisitions, maps of both static B₀ and eddy current induced field inhomogeneities can be inherently derived, without the need for additional data acquisition. Through both 2D and 3D encoded dMRI acquisitions, it is shown that an RPG-MUSE reconstruction can simultaneously achieve high spatial resolution, high spatial fidelity, and subsequently, high accuracy in diffusion metrics.

Tilted-CAIPI for highly accelerated distortion-free EPI with point spread function (PSF) encoding

PURPOSE

To develop a method for fast distortion- and blurring-free imaging.

THEORY

EPI with point-spread-function (PSF) mapping can achieve distortion- and blurring-free imaging at a cost of long acquisition time. In this study, an acquisition/reconstruction technique, termed "tilted-CAIPI," is proposed to achieve >20× acceleration for PSF-EPI. The proposed method systematically optimized the k-space sampling trajectory with B₀ -inhomogeneity-informed reconstruction, to exploit the inherent signal correlation in PSF-EPI and take full advantage of coil sensitivity. Susceptibility-induced phase accumulation is regarded as an additional encoding that is estimated by calibration data and integrated into reconstruction. Self-navigated phase correction was developed to correct shot-to-shot phase variation in diffusion imaging.

METHODS

Tilted-CAIPI was implemented at 3T, with incorporation of partial Fourier and simultaneous multislice to achieve further accelerations. T₂ -weighted, T₂ ^* -weighted, and diffusion-weighted imaging experiments were conducted to evaluate the proposed method.

RESULTS

The ability of tilted-CAIPI to provide highly accelerated imaging without distortion and blurring was demonstrated through in vivo brain experiments, where only 8 shots per simultaneous slice group were required to provide high-quality, high-SNR imaging at 0.8-1 mm resolution.

CONCLUSION

Tilted-CAIPI achieved fast distortion- and blurring-free imaging with high SNR. Whole-brain T₂ -weighted, T₂ ^* -weighted, and diffusion imaging can be obtained in just 15-60 s.

Isotropic resolution diffusion tensor imaging of lumbosacral and sciatic nerves using a phase-corrected diffusion-prepared 3D turbo spin echo

PURPOSE

To perform in vivo isotropic-resolution diffusion tensor imaging (DTI) of lumbosacral and sciatic nerves with a phase-navigated diffusion-prepared (DP) 3D turbo spin echo (TSE) acquisition and modified reconstruction incorporating intershot phase-error correction and to investigate the improvement on image quality and diffusion quantification with the proposed phase correction.

METHODS

Phase-navigated DP 3D TSE included magnitude stabilizers to minimize motion and eddy-current effects on the signal magnitude. Phase navigation of motion-induced phase errors was introduced before readout in 3D TSE. DTI of lower back nerves was performed in vivo using 3D TSE and single-shot echo planar imaging (ss-EPI) in 13 subjects. Diffusion data were phase-corrected per kz plane with respect to T2 -weighted data. The effects of motion-induced phase errors on DTI quantification was assessed for 3D TSE and compared with ss-EPI.

RESULTS

Non-phase-corrected 3D TSE resulted in artifacts in diffusion-weighted images and overestimated DTI parameters in the sciatic nerve (mean diffusivity [MD] = 2.06 ± 0.45). Phase correction of 3D TSE DTI data resulted in reductions in all DTI parameters (MD = 1.73 ± 0.26) of statistical significance (P ≤ 0.001) and in closer agreement with ss-EPI DTI parameters (MD = 1.62 ± 0.21).

CONCLUSION

DP 3D TSE with phase correction allows distortion-free isotropic diffusion imaging of lower back nerves with robustness to motion-induced artifacts and DTI quantification errors. Magn Reson Med 80:609-618, 2018. © 2018 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Are ADC values of readout-segmented echo-planar diffusion-weighted imaging (RESOLVE) correlated with pathological prognostic factors in rectal adenocarcinoma?

Background

Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values as imaging biomarkers of rectal cancer are currently a hot research spot. The use of ADC values for preoperative judgment of pathological features in rectal cancer has been generally accepted. The image quality evaluation of conventional diffusion is severe deformation, and the measurement of ADC values can easily lead to bias. Readout-segmented echo-planar diffusion-weighted imaging (RESOLVE) provides high signal-to-noise ratio images and significantly reduces distortions caused by magnetosensitive effects. The purpose of this study was to explore the correlations between ADC values of RESOLVE and pathological prognostic factors in rectal adenocarcinoma.

Methods

We collected pathological data of 89 patients with pathologically confirmed rectal adenocarcinoma who directly underwent surgical resection without receiving adjuvant therapy. The patients were grouped according to the pathologic type, gross classification, degree of differentiation, TN stage, and immunohistochemical expression of epidermal growth factor receptor (EGFR).

Results

RESOLVE ADC values of rectal cancer were measured at b = 800, and correlations between the RESOLVE ADC values obtained in different groups were analysed. We found that RESOLVE ADC values in the ulcer-type group were significantly higher than those in the eminence-type group.

Conclusion

RESOLVE ADC values in different pathologic types of rectal cancer were significantly different. RESOLVE ADC values in the EGFR-positive group were significantly lower than those in the EGFR-negative group. There was no significant difference in RESOLVE ADC values between different degrees of pathologic differentiation, TN stages, and positive or negative lymph nodes. The quantitative description of RESOLVE ADC values could be used to assess the biological behaviour of rectal adenocarcinoma.

The Diagnostic Ability of rs-DWI to Detect Subtle Acute Infarction Lesion in the Different Regions of the Brain and the Comparison between Different b-Values

Objective

To evaluate the diagnostic ability of rs-DWI to detect subtle acute infarction lesion in the different regions of the brain in comparison to routine DWI and the comparison between different b-values.

Method

35 acute brain infarction patients were included. The subtle acute infarction lesions in ss-DWI and rs-DWI sequence were evaluated in 9 anatomical regions of the brain, and the ss-EPI DWI was also acquired with different b-values of 0, 1000, 2000, and 3000s/mm². The McNemar test was performed for comparing the diagnostic ability of ss-DWI and rs-DWI and different b-values. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the whole brain and in each anatomical region were calculated.

Result

A total of 406 subtle acute infarction lesions were confirmed. The ss-DWI detected 338 subtle lesions, out of which 318 were true positive and 20 were false positive lesions. The rs-DWI detected 386 subtle lesions, out of which 385 were true positive lesions and 1 was true negative lesion. Sensitivity, specificity, positive predictive value, and negative predictive value in rs-DWI were better than ss-DWI in all anatomical regions of the brain. In the comparison of different b-values, b2000 was found better among b1000, b2000, and b3000.

Conclusion

The rs-DWI offers a useful alternative to routine DWI for detecting the subtle acute infarctions, especially in the regions that are susceptible to distortion as in frontal cortex. In addition, high b-value can also provide benefit by increasing diffusion weighting but further raising can deteriorate image quality as SNR is decreased.

Motion-robust sub-millimeter isotropic diffusion imaging through motion corrected generalized slice dithered enhanced resolution (MC-gSlider) acquisition

PURPOSE

To develop an efficient MR technique for ultra-high resolution diffusion MRI (dMRI) in the presence of motion.

METHODS

gSlider is an SNR-efficient high-resolution dMRI acquisition technique. However, subject motion is inevitable during a prolonged scan for high spatial resolution, leading to potential image artifacts and blurring. In this study, an integrated technique termed Motion Corrected gSlider (MC-gSlider) is proposed to obtain high-quality, high-resolution dMRI in the presence of large in-plane and through-plane motion. A motion-aware reconstruction with spatially adaptive regularization is developed to optimize the conditioning of the image reconstruction under difficult through-plane motion cases. In addition, an approach for intra-volume motion estimation and correction is proposed to achieve motion correction at high temporal resolution.

RESULTS

Theoretical SNR and resolution analysis validated the efficiency of MC-gSlider with regularization, and aided in selection of reconstruction parameters. Simulations and in vivo experiments further demonstrated the ability of MC-gSlider to mitigate motion artifacts and recover detailed brain structures for dMRI at 860 μm isotropic resolution in the presence of motion with various ranges.

CONCLUSION

MC-gSlider provides motion-robust, high-resolution dMRI with a temporal motion correction sensitivity of 2 s, allowing for the recovery of fine detailed brain structures in the presence of large subject movements.

Comparison of DWI Methods in the Pediatric Brain: PROPELLER Turbo Spin-Echo Imaging Versus Readout-Segmented Echo-Planar Imaging Versus Single-Shot Echo-Planar Imaging

OBJECTIVE

The purpose of this study is to compare DWI for pediatric brain evaluation using single-shot echo-planar imaging (EPI), periodically rotated overlapping parallel lines with enhanced reconstruction (Blade), and readout-segmented EPI (Resolve).

MATERIALS AND METHODS

Blade, Resolve, and single-shot EPI were performed for 27 pediatric patients (median age, 9 years), and three datasets were independently reviewed by two radiologists. Qualitative analyses were performed for perceptive coarseness, image distortion, susceptibility-related changes, motion artifacts, and lesion conspicuity using a 5-point Likert scale. Quantitative analyses were conducted for spatial distortion and signal uniformity of each sequence.

RESULTS

Mean scores were 2.13, 3.17, and 3.76 for perceptive coarseness; 4.85, 3.96, and 2.19 for image distortion; 4.76, 3.96, and 2.30 for susceptibility-related change; 4.96, 3.83, and 4.69 for motion artifacts; and 2.71, 3.75, and 1.92 for lesion conspicuity, for Blade, Resolve, and single-shot EPI, respectively. Blade and Resolve showed better quality than did single-shot EPI for image distortion, susceptibility-related changes, and lesion conspicuity. Blade showed less image distortion, fewer susceptibility-related changes, and fewer motion artifacts than did Resolve, whereas lesion conspicuity was better with Resolve. Blade showed increased signal variation compared with Resolve and single-shot EPI (coefficients of variation were 0.10, 0.08, and 0.05 for lateral ventricle; 0.13, 0.09, and 0.05 for centrum semiovale; and 0.16, 0.09, and 0.06 for pons in Blade, Resolve, and single-shot EPI, respectively).

CONCLUSION

DWI with Resolve or Blade yields better quality regarding distortion, susceptibility-related changes, and lesion conspicuity, compared with single-shot EPI. Blade is less susceptible to motion artifacts than is Resolve, whereas Resolve yields less noise and better lesion conspicuity than does Blade.

3D-MB-MUSE: A robust 3D multi-slab, multi-band and multi-shot reconstruction approach for ultrahigh resolution diffusion MRI

Recent advances in achieving ultrahigh spatial resolution (e.g. sub-millimeter) diffusion MRI (dMRI) data have proven highly beneficial in characterizing tissue microstructures in organs such as the brain. However, the routine acquisition of in-vivo dMRI data at such high spatial resolutions has been largely prohibited by factors that include prolonged acquisition times, motion induced artifacts, and low SNR. To overcome these limitations, we present here a framework for acquiring and reconstructing 3D multi-slab, multi-band and interleaved multi-shot EPI data, termed 3D-MB-MUSE. Through multi-band excitations, the simultaneous acquisition of multiple 3D slabs enables whole brain dMRI volumes to be acquired in-vivo on a 3 T clinical MRI scanner at high spatial resolution within a reasonably short amount of time. Representing a true 3D model, 3D-MB-MUSE reconstructs an entire 3D multi-band, multi-shot dMRI slab at once while simultaneously accounting for coil sensitivity variations across the slab as well as motion induced artifacts commonly associated with both 3D and multi-shot diffusion imaging. Such a reconstruction fully preserves the SNR advantages of both 3D and multi-shot acquisitions in high resolution dMRI images by removing both motion and aliasing artifacts across multiple dimensions. By enabling ultrahigh resolution dMRI for routine use, the 3D-MB-MUSE framework presented here may prove highly valuable in both clinical and research applications.

Image formation in diffusion MRI: A review of recent technical developments

Diffusion magnetic resonance imaging (MRI) is a standard imaging tool in clinical neurology, and is becoming increasingly important for neuroscience studies due to its ability to depict complex neuroanatomy (eg, white matter connectivity). Single-shot echo-planar imaging is currently the predominant formation method for diffusion MRI, but suffers from blurring, distortion, and low spatial resolution. A number of methods have been proposed to address these limitations and improve diffusion MRI acquisition. Here, the recent technical developments for image formation in diffusion MRI are reviewed. We discuss three areas of advance in diffusion MRI: improving image fidelity, accelerating acquisition, and increasing the signal-to-noise ratio.

LEVEL OF EVIDENCE

5 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:646-662.

Analysis of phase error effects in multishot diffusion-prepared turbo spin echo imaging

BACKGROUND

To characterize the effect of phase errors on the magnitude and the phase of the diffusion-weighted (DW) signal acquired with diffusion-prepared turbo spin echo (dprep-TSE) sequences.

METHODS

Motion and eddy currents were identified as the main sources of phase errors. An analytical expression for the effect of phase errors on the acquired signal was derived and verified using Bloch simulations, phantom, and in vivo experiments.

RESULTS

Simulations and experiments showed that phase errors during the diffusion preparation cause both magnitude and phase modulation on the acquired data. When motion-induced phase error (MiPe) is accounted for (e.g., with motion-compensated diffusion encoding), the signal magnitude modulation due to the leftover eddy-current-induced phase error cannot be eliminated by the conventional phase cycling and sum-of-squares (SOS) method. By employing magnitude stabilizers, the phase-error-induced magnitude modulation, regardless of its cause, was removed but the phase modulation remained. The in vivo comparison between pulsed gradient and flow-compensated diffusion preparations showed that MiPe needed to be addressed in multi-shot dprep-TSE acquisitions employing magnitude stabilizers.

CONCLUSIONS

A comprehensive analysis of phase errors in dprep-TSE sequences showed that magnitude stabilizers are mandatory in removing the phase error induced magnitude modulation. Additionally, when multi-shot dprep-TSE is employed the inconsistent signal phase modulation across shots has to be resolved before shot-combination is performed.

Reducing slab boundary artifacts in three-dimensional multislab diffusion MRI using nonlinear inversion for slab profile encoding (NPEN)

PURPOSE

To propose a method to reduce the slab boundary artifacts in three-dimensional multislab diffusion MRI.

METHODS

Bloch simulation is used to investigate the effects of multiple factors on slab boundary artifacts, including characterization of residual errors on diffusion quantification. A nonlinear inversion method is proposed to simultaneously estimate the slab profile and the underlying (corrected) image.

RESULTS

Correction results of numerical phantom and in vivo data demonstrate that the method can effectively remove slab boundary artifacts for diffusion data. Notably, the nonlinear inversion is also successful at short TR, a regimen where previously proposed methods (slab profile encoding and weighted average) retain residual artifacts in both diffusion-weighted images and diffusion metrics (mean diffusion coefficient and fractional anisotropy).

CONCLUSION

The nonlinear inversion for removing slab boundary artifacts provides improvements over existing methods, particularly at the short TRs required to maximize SNR efficiency. Magn Reson Med 76:1183-1195, 2016. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Diffusion-weighted imaging outside the brain: Consensus statement from an ISMRM-sponsored workshop

The significant advances in magnetic resonance imaging (MRI) hardware and software, sequence design, and postprocessing methods have made diffusion-weighted imaging (DWI) an important part of body MRI protocols and have fueled extensive research on quantitative diffusion outside the brain, particularly in the oncologic setting. In this review, we summarize the most up-to-date information on DWI acquisition and clinical applications outside the brain, as discussed in an ISMRM-sponsored symposium held in April 2015. We first introduce recent advances in acquisition, processing, and quality control; then review scientific evidence in major organ systems; and finally describe future directions. J. Magn. Reson. Imaging 2016;44:521-540.