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Versteeg E, Liu H, van der Heide O, Fuderer M, van den Berg CAT, Sbrizzi A. High SNR full brain relaxometry at 7T by accelerated MR-STAT. Magn Reson Med 2024; 92:226-235. [PMID: 38326909 DOI: 10.1002/mrm.30052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/21/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE To demonstrate the feasibility and robustness of the Magnetic Resonance Spin TomogrAphy in Time-domain (MR-STAT) framework for fast, high SNR relaxometry at 7T. METHODS To deploy MR-STAT on 7T-systems, we designed optimized flip-angles using the BLAKJac-framework that incorporates the SAR-constraints. Transmit RF-inhomogeneities were mitigated by including a measuredB 1 + $$ {B}_1^{+} $$ -map in the reconstruction. Experiments were performed on a gel-phantom and on five volunteers to explore the robustness of the sequence and its sensitivity toB 1 + $$ {B}_1^{+} $$ inhomogeneities. The SNR-gain at 7T was explored by comparing phantom and in vivo results to MR-STAT at 3T in terms of SNR-efficiency. RESULTS The higher SNR at 7T enabled two-fold acceleration with respect to current 2D MR-STAT protocols at lower field strengths. The resulting scan had whole-brain coverage, with 1 x 1 x 3 mm3 resolution (1.5 mm slice-gap) and was acquired within 3 min including theB 1 + $$ {B}_1^{+} $$ -mapping. AfterB 1 + $$ {B}_1^{+} $$ -correction, the estimated T1 and T2 in a phantom showed a mean relative error of, respectively, 1.7% and 4.4%. In vivo, the estimated T1 and T2 in gray and white matter corresponded to the range of values reported in literature with a variation over the subjects of 1.0%-2.1% (WM-GM) for T1 and 4.3%-5.3% (WM-GM) for T2. We measured a higher SNR-efficiency at 7T (R = 2) than at 3T for both T1 and T2 with, respectively, a 4.1 and 2.3 times increase in SNR-efficiency. CONCLUSION We presented an accelerated version of MR-STAT tailored to high field (7T) MRI using a low-SAR flip-angle train and showed high quality parameter maps with an increased SNR-efficiency compared to MR-STAT at 3T.
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Affiliation(s)
- Edwin Versteeg
- Computational Imaging Group, Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hongyan Liu
- Computational Imaging Group, Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Oscar van der Heide
- Computational Imaging Group, Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Miha Fuderer
- Computational Imaging Group, Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cornelis A T van den Berg
- Computational Imaging Group, Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Alessandro Sbrizzi
- Computational Imaging Group, Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands
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Chekhonin IV, Cohen O, Otazo R, Young RJ, Holodny AI, Pronin IN. Magnetic resonance relaxometry in quantitative imaging of brain gliomas: A literature review. Neuroradiol J 2024; 37:267-275. [PMID: 37133228 PMCID: PMC11138331 DOI: 10.1177/19714009231173100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
Magnetic resonance (MR) relaxometry is a quantitative imaging method that measures tissue relaxation properties. This review discusses the state of the art of clinical proton MR relaxometry for glial brain tumors. Current MR relaxometry technology also includes MR fingerprinting and synthetic MRI, which solve the inefficiencies and challenges of earlier techniques. Despite mixed results regarding its capability for brain tumor differential diagnosis, there is growing evidence that MR relaxometry can differentiate between gliomas and metastases and between glioma grades. Studies of the peritumoral zones have demonstrated their heterogeneity and possible directions of tumor infiltration. In addition, relaxometry offers T2* mapping that can define areas of tissue hypoxia not discriminated by perfusion assessment. Studies of tumor therapy response have demonstrated an association between survival and progression terms and dynamics of native and contrast-enhanced tumor relaxometric profiles. In conclusion, MR relaxometry is a promising technique for glial tumor diagnosis, particularly in association with neuropathological studies and other imaging techniques.
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Affiliation(s)
- Ivan V Chekhonin
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
- Federal State Budgetary Institution V.P. Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ouri Cohen
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ricardo Otazo
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert J Young
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrei I Holodny
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
- Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY, USA
| | - Igor N Pronin
- Federal State Autonomous Institution N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
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Jun Y, Arefeen Y, Cho J, Fujita S, Wang X, Ellen Grant P, Gagoski B, Jaimes C, Gee MS, Bilgic B. Zero-DeepSub: Zero-shot deep subspace reconstruction for rapid multiparametric quantitative MRI using 3D-QALAS. Magn Reson Med 2024; 91:2459-2482. [PMID: 38282270 PMCID: PMC11005062 DOI: 10.1002/mrm.30018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/15/2023] [Accepted: 01/06/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE To develop and evaluate methods for (1) reconstructing 3D-quantification using an interleaved Look-Locker acquisition sequence with T2 preparation pulse (3D-QALAS) time-series images using a low-rank subspace method, which enables accurate and rapid T1 and T2 mapping, and (2) improving the fidelity of subspace QALAS by combining scan-specific deep-learning-based reconstruction and subspace modeling. THEORY AND METHODS A low-rank subspace method for 3D-QALAS (i.e., subspace QALAS) and zero-shot deep-learning subspace method (i.e., Zero-DeepSub) were proposed for rapid and high fidelity T1 and T2 mapping and time-resolved imaging using 3D-QALAS. Using an ISMRM/NIST system phantom, the accuracy and reproducibility of the T1 and T2 maps estimated using the proposed methods were evaluated by comparing them with reference techniques. The reconstruction performance of the proposed subspace QALAS using Zero-DeepSub was evaluated in vivo and compared with conventional QALAS at high reduction factors of up to nine-fold. RESULTS Phantom experiments showed that subspace QALAS had good linearity with respect to the reference methods while reducing biases and improving precision compared to conventional QALAS, especially for T2 maps. Moreover, in vivo results demonstrated that subspace QALAS had better g-factor maps and could reduce voxel blurring, noise, and artifacts compared to conventional QALAS and showed robust performance at up to nine-fold acceleration with Zero-DeepSub, which enabled whole-brain T1, T2, and PD mapping at 1 mm isotropic resolution within 2 min of scan time. CONCLUSION The proposed subspace QALAS along with Zero-DeepSub enabled high fidelity and rapid whole-brain multiparametric quantification and time-resolved imaging.
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Affiliation(s)
- Yohan Jun
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Yamin Arefeen
- Chandra Family Department of Electrical and Computer Engineering, The University of Texas, Austin, TX, United States
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jaejin Cho
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Shohei Fujita
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Xiaoqing Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - P. Ellen Grant
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children’s Hospital, Boston, MA, United States
| | - Borjan Gagoski
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children’s Hospital, Boston, MA, United States
| | - Camilo Jaimes
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
| | - Michael S. Gee
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
| | - Berkin Bilgic
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Harvard/MIT Health Sciences and Technology, Cambridge, MA, United States
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Arias-Ramos N, Vieira C, Pérez-Carro R, López-Larrubia P. Integrative Magnetic Resonance Imaging and Metabolomic Characterization of a Glioblastoma Rat Model. Brain Sci 2024; 14:409. [PMID: 38790388 PMCID: PMC11118082 DOI: 10.3390/brainsci14050409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 05/26/2024] Open
Abstract
Glioblastoma (GBM) stands as the most prevalent and lethal malignant brain tumor, characterized by its highly infiltrative nature. This study aimed to identify additional MRI and metabolomic biomarkers of GBM and its impact on healthy tissue using an advanced-stage C6 glioma rat model. Wistar rats underwent a stereotactic injection of C6 cells (GBM group, n = 10) or cell medium (sham group, n = 4). A multiparametric MRI, including anatomical T2W and T1W images, relaxometry maps (T2, T2*, and T1), the magnetization transfer ratio (MTR), and diffusion tensor imaging (DTI), was performed. Additionally, ex vivo magnetic resonance spectroscopy (MRS) HRMAS spectra were acquired. The MRI analysis revealed significant differences in the T2 maps, T1 maps, MTR, and mean diffusivity parameters between the GBM tumor and the rest of the studied regions, which were the contralateral areas of the GBM rats and both regions of the sham rats (the ipsilateral and contralateral). The ex vivo spectra revealed markers of neuronal loss, apoptosis, and higher glucose uptake by the tumor. Notably, the myo-inositol and phosphocholine levels were elevated in both the tumor and the contralateral regions of the GBM rats compared to the sham rats, suggesting the effects of the tumor on the healthy tissue. The MRI parameters related to inflammation, cellularity, and tissue integrity, along with MRS-detected metabolites, serve as potential biomarkers for the tumor evolution, treatment response, and impact on healthy tissue. These techniques can be potent tools for evaluating new drugs and treatment targets.
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Affiliation(s)
| | | | | | - Pilar López-Larrubia
- Instituto de Investigaciones Biomédicas Sols-Morreale, Consejo Superior de Investigaciones Científicas-Universidad Autónoma de Madrid (CSIC-UAM), 28029 Madrid, Spain; (N.A.-R.)
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Liu J, Jakary A, Villanueva-Meyer JE, Butowski NA, Saloner D, Clarke JL, Taylor JW, Oberheim Bush NA, Chang SM, Xu D, Lupo JM. Automatic Brain Tissue and Lesion Segmentation and Multi-Parametric Mapping of Contrast-Enhancing Gliomas without the Injection of Contrast Agents: A Preliminary Study. Cancers (Basel) 2024; 16:1524. [PMID: 38672606 PMCID: PMC11049314 DOI: 10.3390/cancers16081524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/08/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to develop a rapid, 1 mm3 isotropic resolution, whole-brain MRI technique for automatic lesion segmentation and multi-parametric mapping without using contrast by continuously applying balanced steady-state free precession with inversion pulses throughout incomplete inversion recovery in a single 6 min scan. Modified k-means clustering was performed for automatic brain tissue and lesion segmentation using distinct signal evolutions that contained mixed T1/T2/magnetization transfer properties. Multi-compartment modeling was used to derive quantitative multi-parametric maps for tissue characterization. Fourteen patients with contrast-enhancing gliomas were scanned with this sequence prior to the injection of a contrast agent, and their segmented lesions were compared to conventionally defined manual segmentations of T2-hyperintense and contrast-enhancing lesions. Simultaneous T1, T2, and macromolecular proton fraction maps were generated and compared to conventional 2D T1 and T2 mapping and myelination water fraction mapping acquired with MAGiC. The lesion volumes defined with the new method were comparable to the manual segmentations (r = 0.70, p < 0.01; t-test p > 0.05). The T1, T2, and macromolecular proton fraction mapping values of the whole brain were comparable to the reference values and could distinguish different brain tissues and lesion types (p < 0.05), including infiltrating tumor regions within the T2-lesion. Highly efficient, whole-brain, multi-contrast imaging facilitated automatic lesion segmentation and quantitative multi-parametric mapping without contrast, highlighting its potential value in the clinic when gadolinium is contraindicated.
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Affiliation(s)
- Jing Liu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; (A.J.); (D.X.)
| | - Angela Jakary
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; (A.J.); (D.X.)
| | - Javier E. Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; (A.J.); (D.X.)
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (N.A.B.); (J.L.C.); (S.M.C.)
| | - Nicholas A. Butowski
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (N.A.B.); (J.L.C.); (S.M.C.)
| | - David Saloner
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; (A.J.); (D.X.)
- Radiology Service, VA Medical Center, San Francisco, CA 94121, USA
| | - Jennifer L. Clarke
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (N.A.B.); (J.L.C.); (S.M.C.)
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Jennie W. Taylor
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (N.A.B.); (J.L.C.); (S.M.C.)
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Nancy Ann Oberheim Bush
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (N.A.B.); (J.L.C.); (S.M.C.)
- Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Susan M. Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; (N.A.B.); (J.L.C.); (S.M.C.)
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; (A.J.); (D.X.)
- UCSF/UC Berkeley Graduate Program in Bioengineering, University of California San Francisco and Berkeley, San Francisco, CA 94143, USA
| | - Janine M. Lupo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA; (A.J.); (D.X.)
- UCSF/UC Berkeley Graduate Program in Bioengineering, University of California San Francisco and Berkeley, San Francisco, CA 94143, USA
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Jun Y, Cho J, Wang X, Gee M, Grant PE, Bilgic B, Gagoski B. SSL-QALAS: Self-Supervised Learning for rapid multiparameter estimation in quantitative MRI using 3D-QALAS. Magn Reson Med 2023; 90:2019-2032. [PMID: 37415389 PMCID: PMC10527557 DOI: 10.1002/mrm.29786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/27/2023] [Accepted: 06/15/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE To develop and evaluate a method for rapid estimation of multiparametric T1 , T2 , proton density, and inversion efficiency maps from 3D-quantification using an interleaved Look-Locker acquisition sequence with T2 preparation pulse (3D-QALAS) measurements using self-supervised learning (SSL) without the need for an external dictionary. METHODS An SSL-based QALAS mapping method (SSL-QALAS) was developed for rapid and dictionary-free estimation of multiparametric maps from 3D-QALAS measurements. The accuracy of the reconstructed quantitative maps using dictionary matching and SSL-QALAS was evaluated by comparing the estimated T1 and T2 values with those obtained from the reference methods on an International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology phantom. The SSL-QALAS and the dictionary-matching methods were also compared in vivo, and generalizability was evaluated by comparing the scan-specific, pre-trained, and transfer learning models. RESULTS Phantom experiments showed that both the dictionary-matching and SSL-QALAS methods produced T1 and T2 estimates that had a strong linear agreement with the reference values in the International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology phantom. Further, SSL-QALAS showed similar performance with dictionary matching in reconstructing the T1 , T2 , proton density, and inversion efficiency maps on in vivo data. Rapid reconstruction of multiparametric maps was enabled by inferring the data using a pre-trained SSL-QALAS model within 10 s. Fast scan-specific tuning was also demonstrated by fine-tuning the pre-trained model with the target subject's data within 15 min. CONCLUSION The proposed SSL-QALAS method enabled rapid reconstruction of multiparametric maps from 3D-QALAS measurements without an external dictionary or labeled ground-truth training data.
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Affiliation(s)
- Yohan Jun
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Jaejin Cho
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Xiaoqing Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Michael Gee
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
| | - P. Ellen Grant
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children’s Hospital, Boston, MA, United States
| | - Berkin Bilgic
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Harvard/MIT Health Sciences and Technology, Cambridge, MA, United States
| | - Borjan Gagoski
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Fetal-Neonatal Neuroimaging & Developmental Science Center, Boston Children’s Hospital, Boston, MA, United States
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Poojar P, Qian E, Jin Z, Fung M, Maddocks AB, Geethanath S. Tailored magnetic resonance fingerprinting of post-operative pediatric brain tumor patients. Clin Imaging 2023; 102:53-59. [PMID: 37549563 DOI: 10.1016/j.clinimag.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE Brain and spinal cord tumors are the second most common cancer in children and account for one out of four cancers diagnosed. However, the long acquisition times associated with acquiring both data types prohibit using quantitative MR (qMR) in pediatric imaging protocols. This study aims to demonstrate the tailored magnetic resonance fingerprinting's (TMRF) ability to simultaneously provide quantitative maps (T1, T2) and multi-contrast qualitative images (T1 weighted, T1 FLAIR, T2 weighted) rapidly in pediatric brain tumor patients. METHODS In this work, we imaged five pediatric patients with brain tumors (resected/residual) using TMRF at 3 T. We compared the TMRF-derived T2 weighted images with those from the vendor-supplied sequence (as the gold standard, GS) for healthy and pathological tissue signal intensities. The relaxometric maps from TMRF were subjected to a region of interest (ROI) analysis to differentiate between healthy and pathological tissues. We performed the Wilcoxon rank sum test to check for significant differences between the two tissue types. RESULTS We found significant differences (p < 0.05) in both T1 and T2 ROI values between the two tissue types. A strong correlation was found between the TMRF-based T2 weighted and GS signal intensities for the healthy (correlation coefficient, r = 0.99) and pathological tissues (r = 0.88). CONCLUSION The TMRF implementation provides the two relaxometric maps and can potentially save ~2 min if it replaces the T2-weighted imaging in the current protocol.
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Affiliation(s)
- Pavan Poojar
- Accessible Magnetic Resonance Laboratory, Biomedical Imaging and Engineering Institute, Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Enlin Qian
- Columbia Magnetic Resonance Research Center, Columbia University, New York, NY, United States
| | - Zhezhen Jin
- Department of Biostatistics, Columbia University, New York, NY, United States
| | - Maggie Fung
- GE Healthcare Applied Sciences Laboratory East, New York, NY, United States
| | - Alexis B Maddocks
- Columbia University Irving Medical Center, New York, NY, United States
| | - Sairam Geethanath
- Accessible Magnetic Resonance Laboratory, Biomedical Imaging and Engineering Institute, Department of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
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Gruenebach N, Abello Mercado MA, Grauhan NF, Sanner A, Kronfeld A, Groppa S, Schoeffling VI, Hilbert T, Brockmann MA, Othman AE. Clinical feasibility and validation of the accelerated T2 mapping sequence GRAPPATINI in brain imaging. Heliyon 2023; 9:e15064. [PMID: 37096006 PMCID: PMC10121777 DOI: 10.1016/j.heliyon.2023.e15064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
Rationale and objectives To prospectively evaluate feasibility and robustness of an accelerated T2 mapping sequence (GRAPPATINI) in brain imaging and to assess its synthetic T2-weighted images (sT2w) in comparison with a standard T2-weighted sequence (T2 TSE). Material and methods Volunteers were included to evaluate the robustness and consecutive patients for morphological evaluation. They were scanned on a 3 T MR-scanner. Healthy volunteers underwent GRAPPATINI of the brain three times (day 1: scan/rescan; day 2: follow-up). Patients between the ages of 18 and 85 years who were able to provide written informed consent and who had no MRI contraindications were included. For morphological comparison two radiologists with 5 and 7 years of experience in brain MRI evaluated image quality using a Likert scale (1 being poor, 4 being excellent) in a blinded and randomized fashion. Results Images were successfully acquired in ten volunteers with a mean age of 25 years (ranging from 22 to 31 years) and 52 patients (23 men/29 women) with a mean age of 55 years (range of 22-83 years). Most brain regions showed repeatable and reproducible T2 values (rescan: CoV 0.75%-2.06%, ICC 69%-92.3%; follow-up: CoV 0.41%-1.59%, ICC 79.4%-95.8%), except for the caudate nucleus (rescan: CoV 7.25%, ICC 66.3%; follow-up: CoV 4.78%, ICC 80.9%). Image quality of sT2w was rated inferior to T2 TSE (median for T2 TSE: 3; sT2w: 1-2), but measurements revealed good interrater reliability of sT2w (lesion counting: ICC 0.85; diameter measure: ICC 0.68 and 0.67). Conclusion GRAPPATINI is a feasible and robust T2 mapping sequence of the brain on intra- and intersubject level. The resulting sT2w depict brain lesions comparable to T2 TSE despite its inferior image quality.
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Menon RG, Sharafi A, Muccio M, Smith T, Kister I, Ge Y, Regatte RR. Three-dimensional multi-parameter brain mapping using MR fingerprinting. RESEARCH SQUARE 2023:rs.3.rs-2675278. [PMID: 36993561 PMCID: PMC10055680 DOI: 10.21203/rs.3.rs-2675278/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
The purpose of this study was to develop and test a 3D multi-parameter MR fingerprinting (MRF) method for brain imaging applications. The subject cohort included 5 healthy volunteers, repeatability tests done on 2 healthy volunteers and tested on two multiple sclerosis (MS) patients. A 3D-MRF imaging technique capable of quantifying T1, T2 and T1ρ was used. The imaging sequence was tested in standardized phantoms and 3D-MRF brain imaging with multiple shots (1, 2 and 4) in healthy human volunteers and MS patients. Quantitative parametric maps for T1, T2, T1ρ, were generated. Mean gray matter (GM) and white matter (WM) ROIs were compared for each mapping technique, Bland-Altman plots and intra-class correlation coefficient (ICC) were used to assess repeatability and Student T-tests were used to compare results in MS patients. Standardized phantom studies demonstrated excellent agreement with reference T1/T2/T1ρ mapping techniques. This study demonstrates that the 3D-MRF technique is able to simultaneously quantify T1, T2 and T1ρ for tissue property characterization in a clinically feasible scan time. This multi-parametric approach offers increased potential to detect and differentiate brain lesions and to better test imaging biomarker hypotheses for several neurological diseases, including MS.
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Affiliation(s)
| | | | | | - Tyler Smith
- New York University Grossman School of Medicine
| | - Ilya Kister
- New York University Grossman School of Medicine
| | - Yulin Ge
- New York University Grossman School of Medicine
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Liu J, Li S, Cao Q, Zhang Y, Nickel MD, Wu Y, Zhu J, Cheng J. Risk factors for the recurrence of cervical cancer using MR-based T1 mapping: A pilot study. Front Oncol 2023; 13:1133709. [PMID: 37007135 PMCID: PMC10061013 DOI: 10.3389/fonc.2023.1133709] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectivesThis study aimed to identify risk factors for recurrence in patients with cervical cancer (CC) through quantitative T1 mapping.MethodsA cohort of 107 patients histopathologically diagnosed with CC at our institution between May 2018 and April 2021 was categorized into surgical and non-surgical groups. Patients in each group were further divided into recurrence and non-recurrence subgroups depending on whether they showed recurrence or metastasis within 3 years of treatment. The longitudinal relaxation time (native T1) and apparent diffusion coefficient (ADC) value of the tumor were calculated. The differences between native T1 and ADC values of the recurrence and non-recurrence subgroups were analyzed, and receiver operating characteristic (ROC) curves were drawn for parameters with statistical differences. Logistic regression was performed for analysis of significant factors affecting CC recurrence. Recurrence-free survival rates were estimated by Kaplan–Meier analysis and compared using the log-rank test.ResultsThirteen and 10 patients in the surgical and non-surgical groups, respectively, showed recurrence after treatment. There were significant differences in native T1 values between the recurrence and non-recurrence subgroups in the surgical and non-surgical groups (P<0.05); however, there was no difference in ADC values (P>0.05). The areas under the ROC curve of native T1 values for discriminating recurrence of CC after surgical and non-surgical treatment were 0.742 and 0.780, respectively. Logistic regression analysis indicated that native T1 values were risk factors for tumor recurrence in the surgical and non-surgical groups (P=0.004 and 0.040, respectively). Compared with cut-offs, recurrence-free survival curves of patients with higher native T1 values of the two groups were significantly different from those with lower ones (P=0.000 and 0.016, respectively).ConclusionQuantitative T1 mapping could help identify CC patients with a high risk of recurrence, supplementing information on tumor prognosis other than clinicopathological features and providing the basis for individualized treatment and follow-up schemes.
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Affiliation(s)
- Jie Liu
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Jie Liu,
| | - Shujian Li
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qinchen Cao
- Department of Radiotreatment, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Marcel Dominik Nickel
- Magnetic Resonance (MR) Application Predevelopment, Siemens Healthcare Gesellschaft mit beschrankter Haftung (GmbH), Erlangen, Germany
| | - Yanglei Wu
- Magnetic Resonance (MR) Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Jinxia Zhu
- Magnetic Resonance (MR) Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Jingliang Cheng
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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11
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A Multi-Disciplinary Approach to Diagnosis and Treatment of Radionecrosis in Malignant Gliomas and Cerebral Metastases. Cancers (Basel) 2022; 14:cancers14246264. [PMID: 36551750 PMCID: PMC9777318 DOI: 10.3390/cancers14246264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Radiation necrosis represents a potentially devastating complication after radiation therapy in brain tumors. The establishment of the diagnosis and especially the differentiation from progression and pseudoprogression with its therapeutic implications requires interdisciplinary consent and monitoring. Herein, we want to provide an overview of the diagnostic modalities, therapeutic possibilities and an outlook on future developments to tackle this challenging topic. The aim of this report is to provide an overview of the current morphological, functional, metabolic and evolving imaging tools described in the literature in order to (I) identify the best criteria to distinguish radionecrosis from tumor recurrence after the radio-oncological treatment of malignant gliomas and cerebral metastases, (II) analyze the therapeutic possibilities and (III) give an outlook on future developments to tackle this challenging topic. Additionally, we provide the experience of a tertiary tumor center with this important issue in neuro-oncology and provide an institutional pathway dealing with this problem.
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12
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Quantitative Relaxometry Metrics for Brain Metastases Compared to Normal Tissues: A Pilot MR Fingerprinting Study. Cancers (Basel) 2022; 14:cancers14225606. [PMID: 36428699 PMCID: PMC9688653 DOI: 10.3390/cancers14225606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022] Open
Abstract
The purpose of the present pilot study was to estimate T1 and T2 metric values derived simultaneously from a new, rapid Magnetic Resonance Fingerprinting (MRF) technique, as well as to assess their ability to characterize-brain metastases (BM) and normal-appearing brain tissues. Fourteen patients with BM underwent MRI, including prototype MRF, on a 3T scanner. In total, 108 measurements were analyzed: 42 from solid parts of BM's (21 each on T1 and T2 maps) and 66 from normal-appearing brain tissue (11 ROIs each on T1 and T2 maps for gray matter [GM], white matter [WM], and cerebrospinal fluid [CSF]). The BM's mean T1 and T2 values differed significantly from normal-appearing WM (p < 0.05). The mean T1 values from normal-appearing GM, WM, and CSF regions were 1205 ms, 840 ms, and 4233 ms, respectively. The mean T2 values were 108 ms, 78 ms, and 442 ms, respectively. The mean T1 and T2 values for untreated BM (n = 4) were 2035 ms and 168 ms, respectively. For treated BM (n = 17) the T1 and T2 values were 2163 ms and 141 ms, respectively. MRF technique appears to be a promising and rapid quantitative method for the characterization of free water content and tumor morphology in BMs.
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13
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Hasse A, Bertini J, Foxley S, Jeong Y, Javed A, Carroll TJ. Application of a novel T1 retrospective quantification using internal references (T1-REQUIRE) algorithm to derive quantitative T1 relaxation maps of the brain. INTERNATIONAL JOURNAL OF IMAGING SYSTEMS AND TECHNOLOGY 2022; 32:1903-1915. [PMID: 36591562 PMCID: PMC9796586 DOI: 10.1002/ima.22768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/05/2022] [Accepted: 05/23/2022] [Indexed: 06/17/2023]
Abstract
Most MRI sequences used clinically are qualitative or weighted. While such images provide useful information for clinicians to diagnose and monitor disease progression, they lack the ability to quantify tissue damage for more objective assessment. In this study, an algorithm referred to as the T1-REQUIRE is presented as a proof-of-concept which uses nonlinear transformations to retrospectively estimate T1 relaxation times in the brain using T1-weighted MRIs, the appropriate signal equation, and internal, healthy tissues as references. T1-REQUIRE was applied to two T1-weighted MR sequences, a spin-echo and a MPRAGE, and validated with a reference standard T1 mapping algorithm in vivo. In addition, a multiscanner study was run using MPRAGE images to determine the effectiveness of T1-REQUIRE in conforming the data from different scanners into a more uniform way of analyzing T1-relaxation maps. The T1-REQUIRE algorithm shows good agreement with the reference standard (Lin's concordance correlation coefficients of 0.884 for the spin-echo and 0.838 for the MPRAGE) and with each other (Lin's concordance correlation coefficient of 0.887). The interscanner studies showed improved alignment of cumulative distribution functions after T1-REQUIRE was performed. T1-REQUIRE was validated with a reference standard and shown to be an effective estimate of T1 over a clinically relevant range of T1 values. In addition, T1-REQUIRE showed excellent data conformity across different scanners, providing evidence that T1-REQUIRE could be a useful addition to big data pipelines.
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Affiliation(s)
- Adam Hasse
- Graduate Program in Medical PhysicsUniversity of ChicagoChicagoIllinoisUSA
- Department of RadiologyUniversity of ChicagoChicagoIllinois
| | - Julian Bertini
- Graduate Program in Medical PhysicsUniversity of ChicagoChicagoIllinoisUSA
- Department of RadiologyUniversity of ChicagoChicagoIllinois
| | - Sean Foxley
- Department of RadiologyUniversity of ChicagoChicagoIllinois
| | - Yong Jeong
- Department of RadiologyUniversity of ChicagoChicagoIllinois
| | - Adil Javed
- Department of NeurologyUniversity of ChicagoChicagoIllinoisUSA
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14
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Dong Z, Wang F, Setsompop K. Motion-corrected 3D-EPTI with efficient 4D navigator acquisition for fast and robust whole-brain quantitative imaging. Magn Reson Med 2022; 88:1112-1125. [PMID: 35481604 PMCID: PMC9246907 DOI: 10.1002/mrm.29277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To develop a motion estimation and correction method for motion-robust three-dimensional (3D) quantitative imaging with 3D-echo-planar time-resolved imaging. THEORY AND METHODS The 3D-echo-planar time-resolved imaging technique was designed with additional four-dimensional navigator acquisition (x-y-z-echoes) to achieve fast and motion-robust quantitative imaging of the human brain. The four-dimensional-navigator is inserted into the relaxation-recovery deadtime of the sequence in every pulse TR (∼2 s) to avoid extra scan time, and to provide continuous tracking of the 3D head motion and B0 -inhomogeneity changes. By using an optimized spatiotemporal encoding combined with a partial-Fourier scheme, the navigator acquires a large central k-t data block for accurate motion estimation using only four small-flip-angle excitations and readouts, resulting in negligible signal-recovery reduction to the 3D-echo-planar time-resolved imaging acquisition. By incorporating the estimated motion and B0 -inhomogeneity changes into the reconstruction, multi-contrast images can be recovered with reduced motion artifacts. RESULTS Simulation shows the cost to the SNR efficiency from the added navigator acquisitions is <1%. Both simulation and in vivo retrospective experiments were conducted, that demonstrate the four-dimensional navigator provided accurate estimation of the 3D motion and B0 -inhomogeneity changes, allowing effective reduction of image artifacts in quantitative maps. Finally, in vivo prospective undersampling acquisition was performed with and without head motion, in which the motion corrupted data after correction show close image quality and consistent quantifications to the motion-free scan, providing reliable quantitative measurements even with head motion. CONCLUSION The proposed four-dimensional navigator acquisition provides reliable tracking of the head motion and B0 change with negligible SNR cost, equips the 3D-echo-planar time-resolved imaging technique for motion-robust and efficient quantitative imaging.
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Affiliation(s)
- Zijing Dong
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Electrical Engineering and Computer Science, MIT, Cambridge, MA, USA
| | - Fuyixue Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Harvard-MIT Health Sciences and Technology, MIT, Cambridge, MA, USA
| | - Kawin Setsompop
- Department of Radiology, Stanford University, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
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15
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Li AY, Iv M. Conventional and Advanced Imaging Techniques in Post-treatment Glioma Imaging. FRONTIERS IN RADIOLOGY 2022; 2:883293. [PMID: 37492665 PMCID: PMC10365131 DOI: 10.3389/fradi.2022.883293] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/06/2022] [Indexed: 07/27/2023]
Abstract
Despite decades of advancement in the diagnosis and therapy of gliomas, the most malignant primary brain tumors, the overall survival rate is still dismal, and their post-treatment imaging appearance remains very challenging to interpret. Since the limitations of conventional magnetic resonance imaging (MRI) in the distinction between recurrence and treatment effect have been recognized, a variety of advanced MR and functional imaging techniques including diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), perfusion-weighted imaging (PWI), MR spectroscopy (MRS), as well as a variety of radiotracers for single photon emission computed tomography (SPECT) and positron emission tomography (PET) have been investigated for this indication along with voxel-based and more quantitative analytical methods in recent years. Machine learning and radiomics approaches in recent years have shown promise in distinguishing between recurrence and treatment effect as well as improving prognostication in a malignancy with a very short life expectancy. This review provides a comprehensive overview of the conventional and advanced imaging techniques with the potential to differentiate recurrence from treatment effect and includes updates in the state-of-the-art in advanced imaging with a brief overview of emerging experimental techniques. A series of representative cases are provided to illustrate the synthesis of conventional and advanced imaging with the clinical context which informs the radiologic evaluation of gliomas in the post-treatment setting.
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Affiliation(s)
- Anna Y. Li
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, United States
| | - Michael Iv
- Division of Neuroimaging and Neurointervention, Department of Radiology, Stanford University School of Medicine, Stanford, CA, United States
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16
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Trotier AJ, Dilharreguy B, Anandra S, Corbin N, Lefrançois W, Ozenne V, Miraux S, Ribot EJ. The Compressed Sensing MP2RAGE as a Surrogate to the MPRAGE for Neuroimaging at 3 T. Invest Radiol 2022; 57:366-378. [PMID: 35030106 PMCID: PMC9390231 DOI: 10.1097/rli.0000000000000849] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/08/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The magnetization-prepared 2 rapid acquisition gradient echo (MP2RAGE) sequence provides quantitative T1 maps in addition to high-contrast morphological images. Advanced acceleration techniques such as compressed sensing (CS) allow its acquisition time to be compatible with clinical applications. To consider its routine use in future neuroimaging protocols, the repeatability of the segmented brain structures was evaluated and compared with the standard morphological sequence (magnetization-prepared rapid gradient echo [MPRAGE]). The repeatability of the T1 measurements was also assessed. MATERIALS AND METHODS Thirteen healthy volunteers were scanned either 3 or 4 times at several days of interval, on a 3 T clinical scanner, with the 2 sequences (CS-MP2RAGE and MPRAGE), set with the same spatial resolution (0.8-mm isotropic) and scan duration (6 minutes 21 seconds). The reconstruction time of the CS-MP2RAGE outputs (including the 2 echo images, the MP2RAGE image, and the T1 map) was 3 minutes 33 seconds, using an open-source in-house algorithm implemented in the Gadgetron framework.Both precision and variability of volume measurements obtained from CAT12 and VolBrain were assessed. The T1 accuracy and repeatability were measured on phantoms and on humans and were compared with literature.Volumes obtained from the CS-MP2RAGE and the MPRAGE images were compared using Student t tests (P < 0.05 was considered significant). RESULTS The CS-MP2RAGE acquisition provided morphological images of the same quality and higher contrasts than the standard MPRAGE images. Similar intravolunteer variabilities were obtained with the CS-MP2RAGE and the MPRAGE segmentations. In addition, high-resolution T1 maps were obtained from the CS-MP2RAGE. T1 times of white and gray matters and several deep gray nuclei are consistent with the literature and show very low variability (<1%). CONCLUSIONS The CS-MP2RAGE can be used in future protocols to rapidly obtain morphological images and quantitative T1 maps in 3-dimensions while maintaining high repeatability in volumetry and relaxation times.
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Affiliation(s)
- Aurélien J. Trotier
- From the Centre de Résonance Magnétique des Systèmes Biologiques, UMR5536, CNRS/Université de Bordeaux
| | - Bixente Dilharreguy
- Biomedical Imaging Facility (pIBIO), UMS3767, CNRS/Université de Bordeaux, Bordeaux, France
| | - Serge Anandra
- Biomedical Imaging Facility (pIBIO), UMS3767, CNRS/Université de Bordeaux, Bordeaux, France
| | - Nadège Corbin
- From the Centre de Résonance Magnétique des Systèmes Biologiques, UMR5536, CNRS/Université de Bordeaux
- UCL Queen Square Institute of Neurology, Wellcome Centre for Human Neuroimaging, University College of London, London, United Kingdom
| | - William Lefrançois
- From the Centre de Résonance Magnétique des Systèmes Biologiques, UMR5536, CNRS/Université de Bordeaux
| | - Valery Ozenne
- From the Centre de Résonance Magnétique des Systèmes Biologiques, UMR5536, CNRS/Université de Bordeaux
| | - Sylvain Miraux
- From the Centre de Résonance Magnétique des Systèmes Biologiques, UMR5536, CNRS/Université de Bordeaux
| | - Emeline J. Ribot
- From the Centre de Résonance Magnétique des Systèmes Biologiques, UMR5536, CNRS/Université de Bordeaux
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17
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Johnson DR, Glenn CA, Javan R, Olson JJ. Congress of Neurological Surgeons systematic review and evidence-based guidelines update on the role of imaging in the management of progressive glioblastoma in adults. J Neurooncol 2022; 158:139-165. [PMID: 34694565 DOI: 10.1007/s11060-021-03853-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/21/2021] [Indexed: 12/27/2022]
Abstract
TARGET POPULATION These recommendations apply to adults with glioblastoma who have been previously treated with first-line radiation or chemoradiotherapy and who are suspected of experiencing tumor progression. QUESTION In patients with previously treated glioblastoma, is standard contrast-enhanced magnetic resonance imaging including diffusion weighted imaging useful for diagnosing tumor progression and differentiating progression from treatment-related changes? LEVEL II Magnetic resonance imaging with and without gadolinium enhancement including diffusion weighted imaging is recommended as the imaging surveillance method to detect the progression of previously diagnosed glioblastoma. QUESTION In patients with previously treated glioblastoma, does magnetic resonance spectroscopy add useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL II Magnetic resonance spectroscopy is recommended as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma. QUESTION In patients with previously treated glioblastoma, does magnetic resonance perfusion add useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL III Magnetic resonance perfusion is suggested as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma. QUESTION In patients with previously treated glioblastoma, does the addition of single-photon emission computed tomography (SPECT) provide additional useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL III Single-photon emission computed tomography imaging is suggested as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma. QUESTION In patients with previously treated glioblastoma, does 18F-fluorodeoxyglucose positron emission tomography add useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL III The routine use of 18F-fluorodeoxyglucose positron emission tomography to identify progression of glioblastoma is not recommended. QUESTION In patients with previously treated glioblastoma, does positron emission tomography with amino acid agents add useful information for diagnosing tumor progression and differentiating progression from treatment-related changes beyond that derived from standard magnetic resonance imaging with and without gadolinium enhancement? LEVEL III It is suggested that amino acid positron emission tomography be considered to assist in the differentiation of progressive glioblastoma from treatment related changes.
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Affiliation(s)
- Derek Richard Johnson
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Chad Allan Glenn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ramin Javan
- Department of Neuroradiology, George Washington University Hospital, Washington, DC, USA
| | - Jeffrey James Olson
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA
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18
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Del Signore F, Vignoli M, Della Salda L, Tamburro R, Paolini A, Cerasoli I, Chincarini M, Rossi E, Ferri N, Romanucci M, Falerno I, de Pasquale F. A Magnetic Resonance-Relaxometry-Based Technique to Identify Blood Products in Brain Parenchyma: An Experimental Study on a Rabbit Model. Front Vet Sci 2022; 9:802272. [PMID: 35711807 PMCID: PMC9195168 DOI: 10.3389/fvets.2022.802272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Magnetic resonance relaxometry is a quantitative technique that estimates T1/T2 tissue relaxation times. This has been proven to increase MRI diagnostic accuracy of brain disorders in human medicine. However, literature in the veterinary field is scarce. In this work, a T1 and T2-based relaxometry approach has been developed. The aim is to investigate its performance in characterizing subtle brain lesions obtained with autologous blood injections in rabbits. This study was performed with a low-field scanner, typically present in veterinary clinics. The approach consisted of a semi-automatic hierarchical classification of different regions, selected from a T2 map. The classification was driven according to the relaxometry properties extracted from a set of regions selected by the radiologist to compare the suspected lesion with the healthy parenchyma. Histopathological analyses were performed to estimate the performance of the proposed classifier through receiver operating characteristic curve analyses. The classifier resulted in moderate accuracy in terms of lesion characterization.
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Affiliation(s)
- Francesca Del Signore
- Veterinary Faculty, University of Teramo, Teramo, Italy
- *Correspondence: Francesca Del Signore
| | | | | | | | | | | | | | - Emanuela Rossi
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise Giuseppe Caporale, Teramo, Italy
| | - Nicola Ferri
- Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise Giuseppe Caporale, Teramo, Italy
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19
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Müller SJ, Khadhraoui E, Voit D, Riedel CH, Frahm J, Ernst M. First clinical application of a novel T1 mapping of the whole brain. Neuroradiol J 2022; 35:684-691. [PMID: 35446175 PMCID: PMC9626833 DOI: 10.1177/19714009221084244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study was to evaluate the reproducibility and clinical value
of the novel single-shot T1 mapping method for rapid and accurate
multi-slice coverage of the whole brain, described by Wang et al. 2015. Methods At a field strength of 3 Tesla, T1 mappings of 139 patients (51 of them
without pathologic findings) and two repeats of five volunteers were
performed at 0.5 mm in-plane resolution. Mean T1 values were determined in
18 manually segmented regions-of-interest without pathologic findings.
Reproducibility of the repeated scans was calculated using mean coefficient
of variations. Pathologies were grouped and separately evaluated. Results The mean age of the cohort was 49 (range 1–95 years). T1 relaxation times for
ordinary brain and pathologies were in accordance with the literature
values. Intra- and inter-subject reproducibility was excellent, and mean
coefficient of variations were 2.4% and 3.8%, respectively. Discussion The novel rapid T1 mapping method is a reliable magnetic resonance imaging
technique for identifying and quantifying normal brain structures and may
thus serve as a basis for assessing pathologies. The fast and parallel
online calculation enables a comfortable use in everyday clinical practice.
We see a possible clinical value in a large spectrum of diseases, which
should be investigated in further studies.
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Affiliation(s)
| | - Eya Khadhraoui
- Department of Neuroradiology, 84922University Medical Center Göttingen, Germany
| | - Dirk Voit
- 28282Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | | | - Jens Frahm
- 28282Max Planck Institute for Biophysical Chemistry, Göttingen, Germany
| | - Marielle Ernst
- Department of Neuroradiology, 84922University Medical Center Göttingen, Germany
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20
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Mickevicius NJ, Glide‐Hurst CK. Low‐rank
inversion reconstruction for
through‐plane
accelerated radial
MR
fingerprinting applied to relaxometry at 0.
35 T. Magn Reson Med 2022; 88:840-848. [PMID: 35403235 PMCID: PMC9324087 DOI: 10.1002/mrm.29244] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/31/2022] [Accepted: 03/03/2022] [Indexed: 11/15/2022]
Abstract
Purpose To reduce scan time, methods to accelerate phase‐encoded/non‐Cartesian MR fingerprinting (MRF) acquisitions for variable density spiral acquisitions have recently been developed. These methods are not applicable to MRF acquisitions, wherein a single k‐space spoke is acquired per frame. Therefore, we propose a low‐rank inversion method to resolve MRF contrast dynamics from through‐plane accelerated Cartesian/radial measurements applied to quantitative relaxation‐time mapping on a 0.35T system. Methods An algorithm was implemented to reconstruct through‐plane aliased low‐rank images describing the contrast dynamics occurring because of the transient‐state MRF acquisition. T1 and T2 times from accelerated acquisitions were compared with those from unaccelerated linear reconstructions in a standardized system phantom and within in vivo brain and prostate experiments on a hybrid 0.35T MRI/linear accelerator. Results No significant differences between T1 and T2 times for the accelerated reconstructions were observed compared to fully sampled acquisitions (p = 0.41 and p = 0.36, respectively). The mean absolute errors in T1 and T2 were 5.6% and 2.9%, respectively, between the full and accelerated acquisitions. The SDs in T1 and T2 decreased with the advanced accelerated reconstruction compared with the unaccelerated reconstruction (p = 0.02 and p = 0.03, respectively). The quality of the T1 and T2 maps generated with the proposed approach are comparable to those obtained using the unaccelerated data sets. Conclusions Through‐plane accelerated MRF with radial k‐space coverage was demonstrated at a low field strength of 0.35 T. This method enabled 3D T1 and T2 mapping at 0.35 T with a 3‐min scan.
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Affiliation(s)
| | - Carri K. Glide‐Hurst
- Department of Human Oncology University of Wisconsin‐Madison Madison Wisconsin USA
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21
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Berg RC, Leutritz T, Weiskopf N, Preibisch C. Multi-parameter quantitative mapping of R1, R2*, PD, and MTsat is reproducible when accelerated with Compressed SENSE. Neuroimage 2022; 253:119092. [PMID: 35288281 DOI: 10.1016/j.neuroimage.2022.119092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022] Open
Abstract
Multi-parameter mapping (MPM) magnetic resonance imaging (MRI) provides quantitative estimates of the longitudinal and effective transverse relaxation rates R1 and R2*, proton density (PD), and magnetization transfer saturation (MTsat). Thereby, MPM enables better comparability across sites and time than conventional weighted MRI. However, for MPM, several contrasts must be acquired, resulting in prolonged measurement durations and thus preventing MPM's application in clinical routines. State-of-the-art imaging acceleration techniques such as Compressed SENSE (CS), a combination of compressed sensing and sensitivity encoding, can be used to reduce the scan time of MPM. However, the accuracy and precision of the resulting quantitative parameter maps have not been systematically evaluated. In this study, we therefore investigated the effect of CS acceleration on the fidelity and reproducibility of MPM acquisitions. In five healthy volunteers and in a phantom, we compared MPM metrics acquired without imaging acceleration, with the standard acceleration (SENSE factor 2.5), and with Compressed SENSE with acceleration factors 4 and 6 using a 32-channel head coil. We evaluated the reproducibility and repeatability of accelerated MPM using data from three scan sessions in gray and white matter volumes-of-interest (VOIs). Accelerated MPM provided precise and accurate quantitative parameter maps. For most parameters, the results of the CS-accelerated protocols correlated more strongly with the non-accelerated protocol than the standard SENSE-accelerated protocols. Furthermore, for most VOIs and contrasts, coefficients of variation were lower when calculated from data acquired with different imaging accelerations within a single scan session than from data acquired in different scan sessions. These results suggest that MPM with Compressed SENSE acceleration factors up to at least 6 yields reproducible quantitative parameter maps that are highly comparable to those acquired without imaging acceleration. Compressed SENSE can thus be used to considerably reduce the scan duration of R1, R2*, PD, and MTsat mapping, and is highly promising for clinical applications of MPM.
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Affiliation(s)
- Ronja C Berg
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Neurology, Munich, Germany.
| | - Tobias Leutritz
- Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurophysics, Leipzig, Germany.
| | - Nikolaus Weiskopf
- Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurophysics, Leipzig, Germany; Felix Bloch Institute for Solid State Physics, Faculty of Physics and Earth Sciences, Leipzig University, Leipzig, Germany.
| | - Christine Preibisch
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Diagnostic and Interventional Neuroradiology, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Neurology, Munich, Germany; Technical University of Munich, School of Medicine, Klinikum rechts der Isar, TUM Neuroimaging Center, Munich, Germany.
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22
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Cao T, Ma S, Wang N, Gharabaghi S, Xie Y, Fan Z, Hogg E, Wu C, Han F, Tagliati M, Haacke EM, Christodoulou AG, Li D. Three-dimensional simultaneous brain mapping of T1, T2, T2∗ and magnetic susceptibility with MR Multitasking. Magn Reson Med 2022; 87:1375-1389. [PMID: 34708438 PMCID: PMC8776611 DOI: 10.1002/mrm.29059] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/08/2021] [Accepted: 10/07/2021] [Indexed: 01/24/2023]
Abstract
PURPOSE To develop a new technique that enables simultaneous quantification of whole-brain T1 , T2 , T 2 ∗ , as well as susceptibility and synthesis of six contrast-weighted images in a single 9.1-minute scan. METHODS The technique uses hybrid T2 -prepared inversion-recovery pulse modules and multi-echo gradient-echo readouts to collect k-space data with various T1, T2, and T 2 ∗ weightings. The underlying image is represented as a six-dimensional low-rank tensor consisting of three spatial dimensions and three temporal dimensions corresponding to T1 recovery, T2 decay, and multi-echo behaviors, respectively. Multiparametric maps were fitted from reconstructed image series. The proposed method was validated on phantoms and healthy volunteers, by comparing quantitative measurements against corresponding reference methods. The feasibility of generating six contrast-weighted images was also examined. RESULTS High quality, co-registered T1 , T2 , and T 2 ∗ susceptibility maps were generated that closely resembled the reference maps. Phantom measurements showed substantial consistency (R2 > 0.98) with the reference measurements. Despite the significant differences of T1 (p < .001), T2 (p = .002), and T 2 ∗ (p = 0.008) between our method and the references for in vivo studies, excellent agreement was achieved with all intraclass correlation coefficients greater than 0.75. No significant difference was found for susceptibility (p = .900). The framework is also capable of synthesizing six contrast-weighted images. CONCLUSION The MR Multitasking-based 3D brain mapping of T1 , T2 , T 2 ∗ , and susceptibility agrees well with the reference and is a promising technique for multicontrast and quantitative imaging.
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Affiliation(s)
- Tianle Cao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nan Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Sara Gharabaghi
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Elliot Hogg
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Chaowei Wu
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Fei Han
- Siemens Medical Solutions USA, Inc., Los Angeles, California, USA
| | - Michele Tagliati
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - E. Mark Haacke
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
- The MRI Institute for Biomedical Research, Bingham Farms, MI, USA
| | - Anthony G. Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, California, USA
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23
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3D Echo Planar Time-resolved Imaging (3D-EPTI) for ultrafast multi-parametric quantitative MRI. Neuroimage 2022; 250:118963. [PMID: 35122969 PMCID: PMC8920906 DOI: 10.1016/j.neuroimage.2022.118963] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/09/2021] [Accepted: 02/01/2022] [Indexed: 12/11/2022] Open
Abstract
Multi-parametric quantitative MRI has shown great potential to improve the sensitivity and specificity of clinical diagnosis and to enhance our understanding of complex brain processes, but suffers from long scan time especially at high spatial resolution. To address this longstanding challenge, we introduce a novel approach termed 3D Echo Planar Time-resolved Imaging (3D-EPTI), which significantly increases the acceleration capacity of MRI sampling, and provides high acquisition efficiency for multi-parametric MRI. This is achieved by exploiting the spatiotemporal correlation of MRI data at multiple timescales through new encoding strategies within and between efficient continuous readouts. Specifically, an optimized spatiotemporal CAIPI encoding within the readouts combined with a radial-block sampling strategy across the readouts enables an acceleration rate of 800 fold in the k-t space. A subspace reconstruction was employed to resolve thousands of high-quality multi-contrast images. We have demonstrated the ability of 3D-EPTI to provide robust and repeatable whole-brain simultaneous T1, T2, T2*, PD and B1+ mapping at high isotropic resolution within minutes (e.g., 1-mm isotropic resolution in 3 minutes), and to enable submillimeter multi-parametric imaging to study detailed brain structures.
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24
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Springer E, Cardoso PL, Strasser B, Bogner W, Preusser M, Widhalm G, Nittka M, Koerzdoerfer G, Szomolanyi P, Hangel G, Hainfellner JA, Marik W, Trattnig S. MR Fingerprinting-A Radiogenomic Marker for Diffuse Gliomas. Cancers (Basel) 2022; 14:cancers14030723. [PMID: 35158990 PMCID: PMC8833555 DOI: 10.3390/cancers14030723] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/22/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Advanced MR imaging (MRI) of brain tumors is mainly based on qualitative contrast images. MR Fingerprinting (MRF) offers a novel approach. The purpose of this study was to use MRF-derived T1 and T2 relaxation maps to differentiate diffuse gliomas according to isocitrate dehydrogenase (IDH) mutation. (2) Methods: Twenty-four patients with histologically verified diffuse gliomas (14 IDH-mutant, four 1p/19q-codeleted, 10 IDH-wildtype) were enrolled. MRF T1 and T2 relaxation times were compared to apparent diffusion coefficient (ADC), relative cerebral blood volume (rCBV) within solid tumor, peritumoral edema, and normal-appearing white matter (NAWM), using contrast-enhanced MRI, diffusion-, perfusion-, and susceptibility-weighted imaging. For perfusion imaging, a T2* weighted perfusion sequence with leakage correction was used. Correlations of MRF T1 and T2 times with two established conventional sequences for T1 and T2 mapping were assessed (a fast double inversion recovery-based MR sequence ('MP2RAGE') for T1 quantification and a multi-contrast spin echo-based sequence for T2 quantification). (3) Results: MRF T1 and T2 relaxation times were significantly higher in the IDH-mutant than in IDH-wildtype gliomas within the solid part of the tumor (p = 0.024 for MRF T1, p = 0.041 for MRF T2). MRF T1 and T2 relaxation times were significantly higher in the IDH-wildtype than in IDH-mutant gliomas within peritumoral edema less than or equal to 1cm adjacent to the tumor (p = 0.038 for MRF T1 mean, p = 0.010 for MRF T2 mean). In the solid part of the tumor, there was a high correlation between MRF and conventionally measured T1 and T2 values (r = 0.913, p < 0.001 for T1, r = 0.775, p < 0.001 for T2), as well as between MRF and ADC values (r = 0.813, p < 0.001 for T2, r = 0.697, p < 0.001 for T1). The correlation was weak between the MRF and rCBV values (r = -0.374, p = 0.005 for T2, r = -0.181, p = 0.181 for T1). (4) Conclusions: MRF enables fast, single-sequence based, multi-parametric, quantitative tissue characterization of diffuse gliomas and may have the potential to differentiate IDH-mutant from IDH-wildtype gliomas.
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Affiliation(s)
- Elisabeth Springer
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Institute of Radiology, Hietzing Hospital, 1130 Vienna, Austria
| | - Pedro Lima Cardoso
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
| | - Bernhard Strasser
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
| | - Wolfgang Bogner
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Correspondence: ; Tel.: +431-40-400-64710
| | - Matthias Preusser
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria;
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Mathias Nittka
- Siemens Healthineers, 91052 Erlangen, Germany; (M.N.); (G.K.)
| | | | - Pavol Szomolanyi
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, 84104 Bratislava, Slovakia
| | - Gilbert Hangel
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Johannes A. Hainfellner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Wolfgang Marik
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
| | - Siegfried Trattnig
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Christian Doppler Laboratory for Clinical Molecular MR Imaging, Medical University of Vienna, 1090 Vienna, Austria
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25
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Qiu S, Chen Y, Ma S, Fan Z, Moser FG, Maya MM, Christodoulou AG, Xie Y, Li D. Multiparametric mapping in the brain from conventional contrast-weighted images using deep learning. Magn Reson Med 2022; 87:488-495. [PMID: 34374468 PMCID: PMC8616775 DOI: 10.1002/mrm.28962] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/02/2021] [Accepted: 07/20/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To develop a deep-learning-based method to quantify multiple parameters in the brain from conventional contrast-weighted images. METHODS Eighteen subjects were imaged using an MR Multitasking sequence to generate reference T1 and T2 maps in the brain. Conventional contrast-weighted images consisting of T1 MPRAGE, T1 GRE, and T2 FLAIR were acquired as input images. A U-Net-based neural network was trained to estimate T1 and T2 maps simultaneously from the contrast-weighted images. Six-fold cross-validation was performed to compare the network outputs with the MR Multitasking references. RESULTS The deep-learning T1 /T2 maps were comparable with the references, and brain tissue structures and image contrasts were well preserved. A peak signal-to-noise ratio >32 dB and a structural similarity index >0.97 were achieved for both parameter maps. Calculated on brain parenchyma (excluding CSF), the mean absolute errors (and mean percentage errors) for T1 and T2 maps were 52.7 ms (5.1%) and 5.4 ms (7.1%), respectively. ROI measurements on four tissue compartments (cortical gray matter, white matter, putamen, and thalamus) showed that T1 and T2 values provided by the network outputs were in agreement with the MR Multitasking reference maps. The mean differences were smaller than ± 1%, and limits of agreement were within ± 5% for T1 and within ± 10% for T2 after taking the mean differences into account. CONCLUSION A deep-learning-based technique was developed to estimate T1 and T2 maps from conventional contrast-weighted images in the brain, enabling simultaneous qualitative and quantitative MRI without modifying clinical protocols.
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Affiliation(s)
- Shihan Qiu
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Bioengineering, UCLA, Los Angeles, California, USA
| | - Yuhua Chen
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Bioengineering, UCLA, Los Angeles, California, USA
| | - Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Departments of Radiology and Radiation Oncology, University of Southern California, Los Angeles, California, USA
| | - Franklin G. Moser
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Marcel M. Maya
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Anthony G. Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Bioengineering, UCLA, Los Angeles, California, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA,Department of Bioengineering, UCLA, Los Angeles, California, USA,Corresponding author: Debiao Li, address: 8700 Beverly Blvd, PACT 400, Los Angeles, CA 90048, , phone: 3104237743
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26
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Nonparametric D-R 1-R 2 distribution MRI of the living human brain. Neuroimage 2021; 245:118753. [PMID: 34852278 DOI: 10.1016/j.neuroimage.2021.118753] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
Diffusion-relaxation correlation NMR can simultaneously characterize both the microstructure and the local chemical composition of complex samples that contain multiple populations of water. Recent developments on tensor-valued diffusion encoding and Monte Carlo inversion algorithms have made it possible to transfer diffusion-relaxation correlation NMR from small-bore scanners to clinical MRI systems. Initial studies on clinical MRI systems employed 5D D-R1 and D-R2 correlation to characterize healthy brain in vivo. However, these methods are subject to an inherent bias that originates from not including R2 or R1 in the analysis, respectively. This drawback can be remedied by extending the concept to 6D D-R1-R2 correlation. In this work, we present a sparse acquisition protocol that records all data necessary for in vivo 6D D-R1-R2 correlation MRI across 633 individual measurements within 25 min-a time frame comparable to previous lower-dimensional acquisition protocols. The data were processed with a Monte Carlo inversion algorithm to obtain nonparametric 6D D-R1-R2 distributions. We validated the reproducibility of the method in repeated measurements of healthy volunteers. For a post-therapy glioblastoma case featuring cysts, edema, and partially necrotic remains of tumor, we present representative single-voxel 6D distributions, parameter maps, and artificial contrasts over a wide range of diffusion-, R1-, and R2-weightings based on the rich information contained in the D-R1-R2 distributions.
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27
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Serry FM, Ma S, Mao X, Han F, Xie Y, Han H, Li D, Christodoulou AG. Dual flip-angle IR-FLASH with spin history mapping for B1+ corrected T1 mapping: Application to T1 cardiovascular magnetic resonance multitasking. Magn Reson Med 2021; 86:3182-3191. [PMID: 34309072 PMCID: PMC8568626 DOI: 10.1002/mrm.28935] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/07/2021] [Accepted: 07/01/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE To develop a single-scan method for B 1 + -corrected T1 mapping and apply it for free-breathing (FB) cardiac MR multitasking without electrocardiogram (ECG) triggering. METHODS One dual flip-angle (2FA) inversion recovery (IR)-FLASH scan provides two observations of T 1 ∗ (apparent T1 ) corresponding to two distinct combinations of the nominal FA α and B 1 + . Spatiotemporally coregistered T1 and B 1 + spin history maps are obtained by fitting the 2FA signal model. T1 estimate accuracy and repeatability for single flip-angle (1FA) and 2FA IR-FLASH sequence MR multitasking were evaluated at 3T. A T1 phantom was first imaged on the scanner table, then on two human subjects' thoraxes in both breath-hold (BH) and FB conditions. IR-turbo spin echo (IR-TSE) static phantom T1 measurements served as reference. In 10 healthy subjects, myocardial T1 was evaluated with ECG-free, FB multitasking sequences alongside ECG-triggered BH MOLLI. RESULTS For phantom-on-table T1 estimates, 2FA agreed better with IR-TSE (intraclass correlation coefficient [ICC] = 0.996, mean error ± SD = -1.6% ± 1.9%) than did 1FA (ICC = 0.922; mean error ± SD = -4.3% ± 12%). For phantom-on-thorax, 2FA was more repeatable and robust to respiration than 1FA (coefficient of variation [CoV] = 1.2% 2FA, = 11.3% 1FA). In vivo, in intrasession T1 repeatability, 2FA (septal CoV = 2.4%, six-segment CoV = 4.4%) outperformed 1FA (septal CoV = 3.1%, six-segment CoV = 5.5%). In six-segment T1 homogeneity, 2FA (CoV = 7.9%) also outperformed 1FA (CoV = 11.1%). CONCLUSION The 2FA IR-FLASH improves T1 estimate accuracy and repeatability over 1FA IR-FLASH, and enables single-scan B 1 + -corrected T1 mapping without BHs or ECG when used with MR multitasking.
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Affiliation(s)
- Fardad Michael Serry
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Xianglun Mao
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Fei Han
- Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hui Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Maurer GD, Tichy J, Harter PN, Nöth U, Weise L, Quick-Weller J, Deichmann R, Steinbach JP, Bähr O, Hattingen E. Matching Quantitative MRI Parameters with Histological Features of Treatment-Naïve IDH Wild-Type Glioma. Cancers (Basel) 2021; 13:cancers13164060. [PMID: 34439213 PMCID: PMC8392045 DOI: 10.3390/cancers13164060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 11/16/2022] Open
Abstract
Quantitative MRI allows to probe tissue properties by measuring relaxation times and may thus detect subtle changes in tissue composition. In this work we analyzed different relaxation times (T1, T2, T2* and T2') and histological features in 321 samples that were acquired from 25 patients with newly diagnosed IDH wild-type glioma. Quantitative relaxation times before intravenous application of gadolinium-based contrast agent (GBCA), T1 relaxation time after GBCA as well as the relative difference between T1 relaxation times pre-to-post GBCA (T1rel) were compared with histopathologic features such as the presence of tumor cells, cell and vessel density, endogenous markers for hypoxia and cell proliferation. Image-guided stereotactic biopsy allowed for the attribution of each tissue specimen to its corresponding position in the respective relaxation time map. Compared to normal tissue, T1 and T2 relaxation times and T1rel were prolonged in samples containing tumor cells. The presence of vascular proliferates was associated with higher T1rel values. Immunopositivity for lactate dehydrogenase A (LDHA) involved slightly longer T1 relaxation times. However, low T2' values, suggesting high amounts of deoxyhemoglobin, were found in samples with elevated vessel densities, but not in samples with increased immunopositivity for LDHA. Taken together, some of our observations were consistent with previous findings but the correlation of quantitative MRI and histologic parameters did not confirm all our pathophysiology-based assumptions.
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Affiliation(s)
- Gabriele D. Maurer
- Senckenberg Institute of Neurooncology, Goethe University Hospital, 60528 Frankfurt am Main, Germany; (J.T.); (J.P.S.); (O.B.)
- Correspondence:
| | - Julia Tichy
- Senckenberg Institute of Neurooncology, Goethe University Hospital, 60528 Frankfurt am Main, Germany; (J.T.); (J.P.S.); (O.B.)
| | - Patrick N. Harter
- Institute of Neurology (Edinger Institute), Goethe University Hospital, 60528 Frankfurt am Main, Germany;
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, 60590 Frankfurt am Main, Germany
- German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Frankfurt Cancer Institute (FCI), 60596 Frankfurt am Main, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University, 60528 Frankfurt am Main, Germany; (U.N.); (R.D.)
| | - Lutz Weise
- Division of Neurosurgery, Dalhousie University Halifax, Halifax, NS B3H 4R2, Canada;
| | - Johanna Quick-Weller
- Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt am Main, Germany;
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, 60528 Frankfurt am Main, Germany; (U.N.); (R.D.)
| | - Joachim P. Steinbach
- Senckenberg Institute of Neurooncology, Goethe University Hospital, 60528 Frankfurt am Main, Germany; (J.T.); (J.P.S.); (O.B.)
| | - Oliver Bähr
- Senckenberg Institute of Neurooncology, Goethe University Hospital, 60528 Frankfurt am Main, Germany; (J.T.); (J.P.S.); (O.B.)
- Department of Neurology, Klinikum Aschaffenburg-Alzenau, 63739 Aschaffenburg, Germany
| | - Elke Hattingen
- Institute of Neuroradiology, Goethe University Hospital, 60528 Frankfurt am Main, Germany;
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Filice S, Ortenzia O, Crisi G. How tissue T1-variability influences DCE-MRI perfusion parameters estimation of recurrent high-grade glioma after surgery followed by radiochemotherapy. Acta Radiol 2021; 63:1262-1269. [PMID: 34342495 DOI: 10.1177/02841851211035911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Quantification of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) kinetic parameters (KPs) requires a determination of native tissue T1. Two approaches are adopted: (i) tissue T1-maps are acquired; and (ii) an a priori T1 value (fT1) is fixed for all patients (fT1-approach). Although it is more attractive, the fT1-approach might bias the results of KP calculations due to tissue T1 variability. PURPOSE To quantify the tissue T1 variability of recurrent high-grade glioma (HGG) and the error in KP estimation when the fT1-approach is adopted. MATERIAL AND METHODS We reviewed the postoperative MRI scans of 28 patients with recurrent HGG after radiochemotherapy. MRI study included T1-maps from multiple-dynamic multiple-echo imaging, DCE-MRI, and contrast enhanced T1-weighted images. KPs were calculated using T1-map and fT1-approach. RESULTS The tissue T1 variability of recurrent HGG was relevant. The absolute error in KP estimation, as a function of the deviation of fT1 from the true value, was 8% every 100 ms. The difference between the KPs obtained with fT1-approach from fT1 values of 1300, 1390, and 1500 ms and their reference values were mostly within the 95% confidence interval (± 1.96 standard deviation). Conversely, using fT1 values of 900, 1200, 1600, and 1900 ms causes a significant error in KP estimation (P<0.05). CONCLUSION Recurrent HGG is characterized by a substantial T1 variability. Although the fT1-approach does not account for this variability, it results in a minor effect on the KP estimations provided the fT1 value is in the range of 1300-1500 ms.
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Affiliation(s)
- Silvano Filice
- Medical Physics Unit, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Ornella Ortenzia
- Medical Physics Unit, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
| | - Girolamo Crisi
- Neuroradiology Unit, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy
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Jiang J, Cui L, Xiao Y, Zhou X, Fu Y, Xu G, Shao W, Chen W, Hu S, Hu C, Hao S. B 1 -Corrected T1 Mapping in Lung Cancer: Repeatability, Reproducibility, and Identification of Histological Types. J Magn Reson Imaging 2021; 54:1529-1540. [PMID: 34291852 DOI: 10.1002/jmri.27844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND T1 mapping can potentially quantitatively assess the intrinsic properties of tumors. B1 correction can reduce the magnetic field inhomogeneity. PURPOSE To assess the repeatability and reproducibility of B1 -corrected T1 mapping for lung cancer and the ability to identify pathological types. STUDY TYPE Prospective reproducibility study. POPULATION Sixty lung cancer patients (22 with emphysema) with a total of 60 lesions (adenocarcinoma [n = 23], squamous cell carcinoma [n = 19], and small-cell lung cancer [SCLC] [n = 18]). FIELD STRENGTH/SEQUENCE A 3 T/B1 -corrected 3D variable flip angle T1 mapping and free-breathing diffusion-weighted imaging. ASSESSMENT Intraobserver, interobserver, and test-retest reproducibility of minimum, maximum, mean, and SD of lung tumor T1 values were assessed. The correlation between mean T1 and apparent diffusion coefficient (ADC) and differences between different histological types of lung cancer were evaluated. STATISTICAL TESTS Intraclass correlation coefficients (ICCs), within-subject coefficients of variation (WCVs), Bland-Altman plots, Pearson's correlation coefficient (r), and analysis of variance (ANOVA). A P value <0.05 was considered to be statistically significant. RESULTS No significant differences were found in minimum, maximum, mean, and SD T1 values for repeated measurements (intraobserver and interobserver) and repeated examinations (P = 0.103-0.979). All parameters showed good intraobserver, interobserver and test-retest reproducibility (ICC, 0.780-0.978), except the maximum T1 value (ICC, 0.645-0.922). The mean T1 exhibited the best reproducibility and repeatability, with an average difference <6% for repeated measurements, <8% for repeated scans in lung cancer patients, and<10% for repeated scans in those with emphysema. The mean T1 correlated moderately with ADC (r = -0.580, -0.516, and -0.511 for observers A, B, and C). Both mean T1 and mean ADC were significantly different in SCLC patients compared with those in adenocarcinoma and squamous cell carcinoma patients. DATA CONCLUSION The mean T1 from B1 -corrected T1 mapping is a repeatable parameter with the potential to identify histological types of lung cancer and thus may be a promising imaging biomarker for characterizing lung cancer. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Jianqin Jiang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Lei Cui
- Department of Radiology, Affiliated Hospital 2 of Nantong University, Nantong, China
| | - Yong Xiao
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Xiao Zhou
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Yigang Fu
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Gaofeng Xu
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Weiwei Shao
- Department of Pathology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Wang Chen
- Department of Radiology, Affiliated Hospital 4 of Nantong University and The First people's Hospital of Yancheng, Yancheng, China
| | - Su Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Chunhong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Institute of Medical Imaging, Soochow University, Suzhou, China
| | - Shaowei Hao
- Siemens Healthineers Digital Technology Co., Ltd, Shanghai, China
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Cao X, Wang K, Liao C, Zhang Z, Srinivasan Iyer S, Chen Z, Lo WC, Liu H, He H, Setsompop K, Zhong J, Bilgic B. Efficient T 2 mapping with blip-up/down EPI and gSlider-SMS (T 2 -BUDA-gSlider). Magn Reson Med 2021; 86:2064-2075. [PMID: 34046924 DOI: 10.1002/mrm.28872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE To rapidly obtain high isotropic-resolution T2 maps with whole-brain coverage and high geometric fidelity. METHODS A T2 blip-up/down EPI acquisition with generalized slice-dithered enhanced resolution (T2 -BUDA-gSlider) is proposed. A RF-encoded multi-slab spin-echo (SE) EPI acquisition with multiple TEs was developed to obtain high SNR efficiency with reduced TR. This was combined with an interleaved 2-shot EPI acquisition using blip-up/down phase encoding. An estimated field map was incorporated into the joint multi-shot EPI reconstruction with a structured low rank constraint to achieve distortion-free and robust reconstruction for each slab without navigation. A Bloch simulated subspace model was integrated into gSlider reconstruction and used for T2 quantification. RESULTS In vivo results demonstrated that the T2 values estimated by the proposed method were consistent with gold standard spin-echo acquisition. Compared to the reference 3D fast spin echo (FSE) images, distortion caused by off-resonance and eddy current effects were effectively mitigated. CONCLUSION BUDA-gSlider SE-EPI acquisition and gSlider-subspace joint reconstruction enabled distortion-free whole-brain T2 mapping in 2 min at ~1 mm3 isotropic resolution, which could bring significant benefits to related clinical and neuroscience applications.
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Affiliation(s)
- Xiaozhi Cao
- Center for Brain Imaging Science and Technology, Department of Biomedical Engineering, Zhejiang University, Hangzhou, Zhejiang, China.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Kang Wang
- Department of Neurology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Congyu Liao
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Charlestown, Massachusetts, USA
| | - Zijing Zhang
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Siddharth Srinivasan Iyer
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Zhifeng Chen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Charlestown, Massachusetts, USA.,School of Biomedical Engineering, Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei-Ching Lo
- Siemens Medical Solutions, Boston, Massachusetts, USA
| | - Huafeng Liu
- State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hongjian He
- Center for Brain Imaging Science and Technology, Department of Biomedical Engineering, Zhejiang University, Hangzhou, Zhejiang, China
| | - Kawin Setsompop
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Charlestown, Massachusetts, USA.,Harvard-MIT Department of Health Sciences and Technology, Cambridge, Massachusetts, USA
| | - Jianhui Zhong
- Center for Brain Imaging Science and Technology, Department of Biomedical Engineering, Zhejiang University, Hangzhou, Zhejiang, China.,Department of Imaging Sciences, University of Rochester, Rochester, New York, USA
| | - Berkin Bilgic
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Department of Radiology, Harvard Medical School, Charlestown, Massachusetts, USA.,Harvard-MIT Department of Health Sciences and Technology, Cambridge, Massachusetts, USA
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32
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Accelerated 3D whole-brain T1, T2, and proton density mapping: feasibility for clinical glioma MR imaging. Neuroradiology 2021; 63:1831-1851. [PMID: 33835238 PMCID: PMC8528802 DOI: 10.1007/s00234-021-02703-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/28/2021] [Indexed: 12/04/2022]
Abstract
Purpose Advanced MRI-based biomarkers offer comprehensive and quantitative information for the evaluation and characterization of brain tumors. In this study, we report initial clinical experience in routine glioma imaging with a novel, fully 3D multiparametric quantitative transient-state imaging (QTI) method for tissue characterization based on T1 and T2 values. Methods To demonstrate the viability of the proposed 3D QTI technique, nine glioma patients (grade II–IV), with a variety of disease states and treatment histories, were included in this study. First, we investigated the feasibility of 3D QTI (6:25 min scan time) for its use in clinical routine imaging, focusing on image reconstruction, parameter estimation, and contrast-weighted image synthesis. Second, for an initial assessment of 3D QTI-based quantitative MR biomarkers, we performed a ROI-based analysis to characterize T1 and T2 components in tumor and peritumoral tissue. Results The 3D acquisition combined with a compressed sensing reconstruction and neural network-based parameter inference produced parametric maps with high isotropic resolution (1.125 × 1.125 × 1.125 mm3 voxel size) and whole-brain coverage (22.5 × 22.5 × 22.5 cm3 FOV), enabling the synthesis of clinically relevant T1-weighted, T2-weighted, and FLAIR contrasts without any extra scan time. Our study revealed increased T1 and T2 values in tumor and peritumoral regions compared to contralateral white matter, good agreement with healthy volunteer data, and high inter-subject consistency. Conclusion 3D QTI demonstrated comprehensive tissue assessment of tumor substructures captured in T1 and T2 parameters. Aiming for fast acquisition of quantitative MR biomarkers, 3D QTI has potential to improve disease characterization in brain tumor patients under tight clinical time-constraints.
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Cashmore MT, McCann AJ, Wastling SJ, McGrath C, Thornton J, Hall MG. Clinical quantitative MRI and the need for metrology. Br J Radiol 2021; 94:20201215. [PMID: 33710907 PMCID: PMC8010554 DOI: 10.1259/bjr.20201215] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
MRI has been an essential diagnostic tool in healthcare for several decades. It offers unique insights into most tissues without the need for ionising radiation. Historically, MRI has been predominantly used qualitatively, images are formed to allow visual discrimination of tissues types and pathologies, rather than providing quantitative measurements. Increasingly, quantitative MRI (qMRI) is also finding clinical application, where images provide the basis for physical measurements of, e.g. tissue volume measures and represent aspects of tissue composition and microstructure. This article reviews some common current research and clinical applications of qMRI from the perspective of measurement science. qMRI not only offers additional information for radiologists, but also the opportunity for improved harmonisation and calibration between scanners and as such it is well-suited to large-scale investigations such as clinical trials and longitudinal studies. Realising these benefits, however, presents a new kind of technical challenge to MRI practioners. When measuring a parameter quantitatively, it is crucial that the reliability and reproducibility of the technique are well understood. Strictly speaking, a numerical result of a measurement is meaningless unless it is accompanied by a description of the associated measurement uncertainty. It is therefore necessary to produce not just estimates of physical properties in a quantitative image, but also their associated uncertainties. As the process of determining a physical property from the raw MR signal is complicated and multistep, estimation of uncertainty is challenging and there are many aspects of the MRI process that require validation. With the clinical implementation of qMRI techniques and its continued expansion, there is a clear and urgent need for metrology in this field.
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Affiliation(s)
| | | | - Stephen J Wastling
- Neuroradiological Academic Unit, UCL Institute of Neurology, University College London, London, UK
| | | | - John Thornton
- Neuroradiological Academic Unit, UCL Institute of Neurology, University College London, London, UK
| | - Matt G Hall
- National Physical Laboratory, Teddington, UK
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Maziero D, Straza MW, Ford JC, Bovi JA, Diwanji T, Stoyanova R, Paulson ES, Mellon EA. MR-Guided Radiotherapy for Brain and Spine Tumors. Front Oncol 2021; 11:626100. [PMID: 33763361 PMCID: PMC7982530 DOI: 10.3389/fonc.2021.626100] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/12/2021] [Indexed: 12/19/2022] Open
Abstract
MRI is the standard modality to assess anatomy and response to treatment in brain and spine tumors given its superb anatomic soft tissue contrast (e.g., T1 and T2) and numerous additional intrinsic contrast mechanisms that can be used to investigate physiology (e.g., diffusion, perfusion, spectroscopy). As such, hybrid MRI and radiotherapy (RT) devices hold unique promise for Magnetic Resonance guided Radiation Therapy (MRgRT). In the brain, MRgRT provides daily visualizations of evolving tumors that are not seen with cone beam CT guidance and cannot be fully characterized with occasional standalone MRI scans. Significant evolving anatomic changes during radiotherapy can be observed in patients with glioblastoma during the 6-week fractionated MRIgRT course. In this review, a case of rapidly changing symptomatic tumor is demonstrated for possible therapy adaptation. For stereotactic body RT of the spine, MRgRT acquires clear isotropic images of tumor in relation to spinal cord, cerebral spinal fluid, and nearby moving organs at risk such as bowel. This visualization allows for setup reassurance and the possibility of adaptive radiotherapy based on anatomy in difficult cases. A review of the literature for MR relaxometry, diffusion, perfusion, and spectroscopy during RT is also presented. These techniques are known to correlate with physiologic changes in the tumor such as cellularity, necrosis, and metabolism, and serve as early biomarkers of chemotherapy and RT response correlating with patient survival. While physiologic tumor investigations during RT have been limited by the feasibility and cost of obtaining frequent standalone MRIs, MRIgRT systems have enabled daily and widespread physiologic measurements. We demonstrate an example case of a poorly responding tumor on the 0.35 T MRIgRT system with relaxometry and diffusion measured several times per week. Future studies must elucidate which changes in MR-based physiologic metrics and at which timepoints best predict patient outcomes. This will lead to early treatment intensification for tumors identified to have the worst physiologic responses during RT in efforts to improve glioblastoma survival.
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Affiliation(s)
- Danilo Maziero
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Michael W Straza
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - John C Ford
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Joseph A Bovi
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Tejan Diwanji
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Radka Stoyanova
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Eric S Paulson
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Eric A Mellon
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States
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35
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Jun Y, Shin H, Eo T, Kim T, Hwang D. Deep model-based magnetic resonance parameter mapping network (DOPAMINE) for fast T1 mapping using variable flip angle method. Med Image Anal 2021; 70:102017. [PMID: 33721693 DOI: 10.1016/j.media.2021.102017] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 02/19/2021] [Accepted: 02/22/2021] [Indexed: 11/15/2022]
Abstract
Quantitative tissue characteristics, which provide valuable diagnostic information, can be represented by magnetic resonance (MR) parameter maps using magnetic resonance imaging (MRI); however, a long scan time is necessary to acquire them, which prevents the application of quantitative MR parameter mapping to real clinical protocols. For fast MR parameter mapping, we propose a deep model-based MR parameter mapping network called DOPAMINE that combines a deep learning network with a model-based method to reconstruct MR parameter maps from undersampled multi-channel k-space data. DOPAMINE consists of two networks: 1) an MR parameter mapping network that uses a deep convolutional neural network (CNN) that estimates initial parameter maps from undersampled k-space data (CNN-based mapping), and 2) a reconstruction network that removes aliasing artifacts in the parameter maps with a deep CNN (CNN-based reconstruction) and an interleaved data consistency layer by an embedded MR model-based optimization procedure. We demonstrated the performance of DOPAMINE in brain T1 map reconstruction with a variable flip angle (VFA) model. To evaluate the performance of DOPAMINE, we compared it with conventional parallel imaging, low-rank based reconstruction, model-based reconstruction, and state-of-the-art deep-learning-based mapping methods for three different reduction factors (R = 3, 5, and 7) and two different sampling patterns (1D Cartesian and 2D Poisson-disk). Quantitative metrics indicated that DOPAMINE outperformed other methods in reconstructing T1 maps for all sampling patterns and reduction factors. DOPAMINE exhibited quantitatively and qualitatively superior performance to that of conventional methods in reconstructing MR parameter maps from undersampled multi-channel k-space data. The proposed method can thus reduce the scan time of quantitative MR parameter mapping that uses a VFA model.
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Affiliation(s)
- Yohan Jun
- School of Electrical and Electronic Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hyungseob Shin
- School of Electrical and Electronic Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Taejoon Eo
- School of Electrical and Electronic Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Taeseong Kim
- School of Electrical and Electronic Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Dosik Hwang
- School of Electrical and Electronic Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
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Gräfe D, Frahm J, Merkenschlager A, Voit D, Hirsch FW. Quantitative T1 mapping of the normal brain from early infancy to adulthood. Pediatr Radiol 2021; 51:450-456. [PMID: 33068131 PMCID: PMC7897197 DOI: 10.1007/s00247-020-04842-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/12/2020] [Accepted: 09/07/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Quantitative mapping of MRI relaxation times is expected to uncover pathological processes in the brain more subtly than standard MRI techniques with weighted contrasts. So far, however, most mapping techniques suffer from a long measuring time, low spatial resolution or even sensitivity to magnetic field inhomogeneity. OBJECTIVE To obtain T1 relaxation times of the normal brain from early infancy to adulthood using a novel technique for fast and accurate T1 mapping at high spatial resolution. MATERIALS AND METHODS We performed whole-brain T1 mapping within less than 3 min in 100 patients between 2 months and 18 years of age with normal brain at a field strength of 3 T. We analyzed T1 relaxation times in several gray-matter nuclei and white matter. Subsequently, we derived regression equations for mean value and confidence interval. RESULTS T1 relaxation times of the pediatric brain rapidly decrease in all regions within the first 3 years of age, followed by a significantly weaker decrease until adulthood. These characteristics are more pronounced in white matter than in deep gray matter. CONCLUSION Regardless of age, quantitative T1 mapping of the pediatric brain is feasible in clinical practice. Normal age-dependent values should contribute to improved discrimination of subtle intracerebral alterations.
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Affiliation(s)
- Daniel Gräfe
- Department of Pediatric Radiology, University of Leipzig, Liebigstraße 20a, 04103, Leipzig, Germany.
| | - Jens Frahm
- Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany
| | | | - Dirk Voit
- Biomedizinische NMR, Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany
| | - Franz Wolfgang Hirsch
- Department of Pediatric Radiology, University of Leipzig, Liebigstraße 20a, 04103, Leipzig, Germany
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37
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Advanced magnetic resonance imaging to support clinical drug development for malignant glioma. Drug Discov Today 2020; 26:429-441. [PMID: 33249294 DOI: 10.1016/j.drudis.2020.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/23/2020] [Accepted: 11/18/2020] [Indexed: 11/22/2022]
Abstract
Even though the treatment options and survival of patients with glioblastoma multiforme (GBM), the most common type of malignant glioma, have improved over the past decade, there is still a high unmet medical need to develop novel therapies. Complexity in pathology and therapy require biomarkers to characterize tumors, to define malignant and active areas, to assess disease prognosis, and to quantify and monitor therapy response. While conventional magnetic resonance imaging (MRI) techniques have improved these assessments, limitations remain. In this review, we evaluate the role of various non-invasive biomarkers based on advanced structural and functional MRI techniques in the context of GBM drug development over the past 5 years.
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Chan RW, Chen H, Myrehaug S, Atenafu EG, Stanisz GJ, Stewart J, Maralani PJ, Chan AKM, Daghighi S, Ruschin M, Das S, Perry J, Czarnota GJ, Sahgal A, Lau AZ. Quantitative CEST and MT at 1.5T for monitoring treatment response in glioblastoma: early and late tumor progression during chemoradiation. J Neurooncol 2020; 151:267-278. [PMID: 33196965 DOI: 10.1007/s11060-020-03661-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/07/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Quantitative MRI (qMRI) was performed using a 1.5T protocol that includes a novel chemical exchange saturation transfer/magnetization transfer (CEST/MT) approach. The purpose of this prospective study was to determine if qMRI metrics at baseline, at the 10th and 20th fraction during a 30 fraction/6 week standard chemoradiation (CRT) schedule, and at 1 month following treatment could be an early indicator of response for glioblastoma (GBM). METHODS The study included 51 newly diagnosed GBM patients. Four regions-of-interest (ROI) were analyzed: (i) the radiation defined clinical target volume (CTV), (ii) radiation defined gross tumor volume (GTV), (iii) enhancing-tumor regions, and (iv) FLAIR-hyperintense regions. Quantitative CEST, MT, T1 and T2 parameters were compared between those patients progressing within 6.9 months (early), and those progressing after CRT (late), using mixed modelling. Exploratory predictive modelling was performed to identify significant predictors of early progression using a multivariable LASSO model. RESULTS Results were dependent on the specific tumor ROI analyzed and the imaging time point. The baseline CEST asymmetry within the CTV was significantly higher in the early progression cohort. Other significant predictors included the T2 of the MT pools (for semi-solid at fraction 20 and water at 1 month after CRT), the exchange rate (at fraction 20) and the MGMT methylation status. CONCLUSIONS We observe the potential for multiparametric qMRI, including a novel pulsed CEST/MT approach, to show potential in distinguishing early from late progression GBM cohorts. Ultimately, the goal is to personalize therapeutic decisions and treatment adaptation based on non-invasive imaging-based biomarkers.
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Affiliation(s)
- Rachel W Chan
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada.
| | - Hanbo Chen
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Sten Myrehaug
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Eshetu G Atenafu
- Department of Biostatistics, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Greg J Stanisz
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
- Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University, Lublin, Poland
| | - James Stewart
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | | | - Aimee K M Chan
- Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Shadi Daghighi
- Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Mark Ruschin
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Sunit Das
- Division of Neurosurgery, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - James Perry
- Division of Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Gregory J Czarnota
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Arjun Sahgal
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Angus Z Lau
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
- Medical Biophysics, University of Toronto, Toronto, ON, Canada
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Ma S, Wang N, Fan Z, Kaisey M, Sicotte NL, Christodoulou AG, Li D. Three-dimensional whole-brain simultaneous T1, T2, and T1ρ quantification using MR Multitasking: Method and initial clinical experience in tissue characterization of multiple sclerosis. Magn Reson Med 2020; 85:1938-1952. [PMID: 33107126 DOI: 10.1002/mrm.28553] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To develop a 3D whole-brain simultaneous T1/T2/T1ρ quantification method with MR Multitasking that provides high quality, co-registered multiparametric maps in 9 min. METHODS MR Multitasking conceptualizes T1/T2/T1ρ relaxations as different time dimensions, simultaneously resolving all three dimensions with a low-rank tensor image model. The proposed method was validated on a phantom and in healthy volunteers, comparing quantitative measurements against corresponding reference methods and evaluating the scan-rescan repeatability. Initial clinical validation was performed in age-matched relapsing-remitting multiple sclerosis (RRMS) patients to examine the feasibility of quantitative tissue characterization and to compare with the healthy control cohort. The feasibility of synthesizing six contrast-weighted images was also examined. RESULTS Our framework produced high quality, co-registered T1/T2/T1ρ maps that closely resemble the reference maps. Multitasking T1/T2/T1ρ measurements showed substantial agreement with reference measurements on the phantom and in healthy controls. Bland-Altman analysis indicated good in vivo repeatability of all three parameters. In RRMS patients, lesions were conspicuously delineated on all three maps and on four synthetic weighted images (T2-weighted, T2-FLAIR, double inversion recovery, and a novel "T1ρ-FLAIR" contrast). T1 and T2 showed significant differences for normal appearing white matter between patients and controls, while T1ρ showed significant differences for normal appearing white matter, cortical gray matter, and deep gray matter. The combination of three parameters significantly improved the differentiation between RRMS patients and healthy controls, compared to using any single parameter alone. CONCLUSION MR Multitasking simultaneously quantifies whole-brain T1/T2/T1ρ and is clinically promising for quantitative tissue characterization of neurological diseases, such as MS.
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Affiliation(s)
- Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Nan Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Marwa Kaisey
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nancy L Sicotte
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Anthony G Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
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40
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Blystad I, Warntjes JBM, Smedby Ö, Lundberg P, Larsson EM, Tisell A. Quantitative MRI using relaxometry in malignant gliomas detects contrast enhancement in peritumoral oedema. Sci Rep 2020; 10:17986. [PMID: 33093605 PMCID: PMC7581520 DOI: 10.1038/s41598-020-75105-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 10/12/2020] [Indexed: 11/09/2022] Open
Abstract
Malignant gliomas are primary brain tumours with an infiltrative growth pattern, often with contrast enhancement on magnetic resonance imaging (MRI). However, it is well known that tumour infiltration extends beyond the visible contrast enhancement. The aim of this study was to investigate if there is contrast enhancement not detected visually in the peritumoral oedema of malignant gliomas by using relaxometry with synthetic MRI. 25 patients who had brain tumours with a radiological appearance of malignant glioma were prospectively included. A quantitative MR-sequence measuring longitudinal relaxation (R1), transverse relaxation (R2) and proton density (PD), was added to the standard MRI protocol before surgery. Five patients were excluded, and in 20 patients, synthetic MR images were created from the quantitative scans. Manual regions of interest (ROIs) outlined the visibly contrast-enhancing border of the tumours and the peritumoral area. Contrast enhancement was quantified by subtraction of native images from post GD-images, creating an R1-difference-map. The quantitative R1-difference-maps showed significant contrast enhancement in the peritumoral area (0.047) compared to normal appearing white matter (0.032), p = 0.048. Relaxometry detects contrast enhancement in the peritumoral area of malignant gliomas. This could represent infiltrative tumour growth.
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Affiliation(s)
- I Blystad
- Department of Radiology in Linköping and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. .,Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
| | - J B M Warntjes
- Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Division of Cardiovascular Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ö Smedby
- Department of Radiology in Linköping and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,School of Technology and Health, KTH Royal Institute of Technology, Stockholm, Sweden
| | - P Lundberg
- Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Radiation Physics and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - E-M Larsson
- Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - A Tisell
- Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Radiation Physics and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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41
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Reuter G, Lommers E, Balteau E, Simon J, Phillips C, Scholtes F, Martin D, Lombard A, Maquet P. Multiparameter quantitative histological MRI values in high-grade gliomas: a potential biomarker of tumor progression. Neurooncol Pract 2020; 7:646-655. [PMID: 33304600 PMCID: PMC7716186 DOI: 10.1093/nop/npaa047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Conventional MRI poorly distinguishes brain parenchyma microscopically invaded by high-grade gliomas (HGGs) from the normal brain. By contrast, quantitative histological MRI (hMRI) measures brain microstructure in terms of physical MR parameters influenced by histochemical tissue composition. We aimed to determine the relationship between hMRI parameters in the area surrounding the surgical cavity and the presence of HGG recurrence. Methods Patients were scanned after surgery with an hMRI multiparameter protocol that allowed for estimations of longitudinal relaxation rate (R1) = 1/T1, effective transverse relaxation rate (R2)*=1/T2*, magnetization transfer saturation (MTsat), and proton density. The initial perioperative zone (IPZ) was segmented on the postoperative MRI. Once recurrence appeared on conventional MRI, the area of relapsing disease was delineated (extension zone, EZ). Conventional MRI showing recurrence and hMRI were coregistered, allowing for the extraction of parameters R1, R2*, MTsat, and PD in 3 areas: the overlap area between the IPZ and EZ (OZ), the peritumoral brain zone, PBZ (PBZ = IPZ - OZ), and the area of recurrence (RZ = EZ - OZ). Results Thirty-one patients with HGG who underwent gross-total resection were enrolled. MTsat and R1 were the most strongly associated with tumor progression. MTsat was significantly lower in the OZ and RZ, compared to PBZ. R1 was significantly lower in RZ compared to PBZ. PD was significantly higher in OZ compared to PBZ, and R2* was higher in OZ compared to PBZ or RZ. These changes were detected 4 to 120 weeks before recurrence recognition on conventional MRI. Conclusions HGG recurrence was associated with hMRI parameters' variation after initial surgery, weeks to months before overt recurrence.
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Affiliation(s)
- Gilles Reuter
- GIGA Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium.,Department of Neurosurgery, University Hospital of Liège, Liège, Belgium
| | - Emilie Lommers
- GIGA Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium.,Department of Neurology, University Hospital of Liège, Liège, Belgium
| | - Evelyne Balteau
- GIGA Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Jessica Simon
- Psychology and Neuroscience of Cognition-PsyNCogn, University of Liège, Liège, Belgium
| | - Christophe Phillips
- GIGA Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium.,GIGA In Silico Medicine, University of Liège, Liège, Belgium
| | - Felix Scholtes
- Department of Neurosurgery, University Hospital of Liège, Liège, Belgium.,Laboratory of Developmental Neurobiology, GIGA-Neurosciences Research Center, University of Liège, Liège, Belgium.,Department of Neuroanatomy, University of Liège, Liège, Belgium
| | - Didier Martin
- Department of Neurosurgery, University Hospital of Liège, Liège, Belgium
| | - Arnaud Lombard
- Department of Neurosurgery, University Hospital of Liège, Liège, Belgium.,Laboratory of Developmental Neurobiology, GIGA-Neurosciences Research Center, University of Liège, Liège, Belgium
| | - Pierre Maquet
- GIGA Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium.,Department of Neurology, University Hospital of Liège, Liège, Belgium
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Nejad-Davarani SP, Zakariaei N, Chen Y, Haacke EM, Hurst NJ, Salim Siddiqui M, Schultz LR, Snyder JM, Walbert T, Glide-Hurst CK. Rapid multicontrast brain imaging on a 0.35T MR-linac. Med Phys 2020; 47:4064-4076. [PMID: 32434276 DOI: 10.1002/mp.14251] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/03/2020] [Accepted: 05/13/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Magnetic resonance-guided radiation therapy (MRgRT) has shown great promise for localization and real-time tumor monitoring. However, to date, quantitative imaging has been limited for low field MRgRT. This work benchmarks quantitative T1, R2*, and Proton Density (PD)mapping in a phantom on a 0.35 T MR-linac and implements a novel acquisition method, STrategically Acquired Gradient Echo (STAGE). To further validate STAGE in a clinical setting, a pilot study was undertaken in a cohort of brain tumor patients to elucidate opportunities for longitudinal functional imaging with an MR-linac in the brain. METHODS STAGE (two triple-echo gradient echo (GRE) acquisitions) was optimized for a 0.35T low-field MR-linac. Simulations were performed to choose two flip angles to optimize signal-to-noise ratio (SNR) and T1-mapping precision. Tradeoffs between SNR, scan time, and spatial resolution for whole-brain coverage were evaluated in healthy volunteers. Data were inputted into a STAGE processing pipeline to yield four qualitative images (T1-weighted, enhanced T1-weighted, proton-density (PD) weighted, and simulated FLuid-Attenuated Inversion Recovery (sFLAIR)), and three quantitative datasets (T1, PD, and R2*). A benchmarking ISMRM/NIST phantom consisting of vials with variable NiCl2 and MnCl2 concentrations was scanned using variable flip angles (VFA) (2-60 degrees) and inversion recovery (IR) methods at 0.35 T. STAGE and VFA T1 values of vials were compared to IR T1 values. As measures of agreement with reference values and repeatability, relative error (RE) and coefficient of variability (CV) were calculated, respectively, for quantitative MR values within the phantom vials (spheres). To demonstrate feasibility, longitudinal STAGE data (pretreatment, weekly, and ~ 2 months post-treatment) were acquired in an IRB-approved pilot study of brain tumor cases via the generation of temporal and differential quantitative MRI maps. RESULTS In the phantom, RE of measured VFA T1 and STAGE relative to IR reference values were 7.0 ± 2.5% and 9.5 ± 2.2% respectively. RE for the PD vials was 8.1 ± 6.8% and CV for phantom R2* measurements was 10.1 ± 9.9%. Simulations and volunteer experiments yielded final STAGE parameters of FA = 50°/10°, 1 × 1 × 3 mm3 resolution, TR = 40 ms, TE = 5/20/34 ms in 10 min (64 slices). In the pilot study of brain tumor patients, differential maps for R2* and T1 maps were sensitive to local tumor changes and appeared similar to 3 T follow-up MRI datasets. CONCLUSION Quantitative T1, R2*, and PD mapping are promising at 0.35 T agreeing well with reference data. STAGE phantom data offer quantitative representations comparable to traditional methods in a fraction of the acquisition time. Initial feasibility of implementing STAGE at 0.35 T in a patient brain tumor cohort suggests that detectable changes can be observed over time. With confirmation in a larger cohort, results may be implemented to identify areas of recurrence and facilitate adaptive radiation therapy.
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Affiliation(s)
- Siamak P Nejad-Davarani
- Department of Radiation Oncology, Henry Ford Cancer Institute, 2799 West Grand Blvd., Detroit, MI, 48202, USA
| | - Niloufar Zakariaei
- Department of Radiation Oncology, Henry Ford Cancer Institute, 2799 West Grand Blvd., Detroit, MI, 48202, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, 4201 St Antoine Blvd, 8C UHC, Detroit, MI, 48201, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, 48201, USA.,The MRI Institute for Biomedical Research, 30200 Telegraph Rd, STE 104, Bingham Farms, Detroit, MI, 48025, USA
| | - Newton J Hurst
- Department of Radiation Oncology, Henry Ford Cancer Institute, 2799 West Grand Blvd., Detroit, MI, 48202, USA
| | - M Salim Siddiqui
- Department of Radiation Oncology, Henry Ford Cancer Institute, 2799 West Grand Blvd., Detroit, MI, 48202, USA
| | - Lonni R Schultz
- Department of Public Health Sciences, Henry Ford Health System, One Ford Place, Ste 3E, Detroit, MI, 48202, USA
| | - James M Snyder
- Departments of Neurosurgery and Neurology, Henry Ford Health System, 2799 West Grand Blvd, Detroit, MI, 48202, USA
| | - Tobias Walbert
- Departments of Neurosurgery and Neurology, Henry Ford Health System, 2799 West Grand Blvd, Detroit, MI, 48202, USA
| | - Carri K Glide-Hurst
- Department of Radiation Oncology, Henry Ford Cancer Institute, 2799 West Grand Blvd., Detroit, MI, 48202, USA
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43
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Cai H, Dai X, Wang X, Tan P, Gu L, Luo Q, Zheng X, Li Z, Zhu H, Zhang H, Gu Z, Gong Q, Luo K. A Nanostrategy for Efficient Imaging-Guided Antitumor Therapy through a Stimuli-Responsive Branched Polymeric Prodrug. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2020; 7:1903243. [PMID: 32195104 PMCID: PMC7080516 DOI: 10.1002/advs.201903243] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/04/2020] [Indexed: 02/05/2023]
Abstract
A stimuli-responsive polymeric prodrug-based nanotheranostic system with imaging agents (cyanine5.5 and gadolinium-chelates) and a therapeutic agent paclitaxel (PTX) is prepared via polymerization and conjugating chemistry. The branched polymeric PTX-Gd-based nanoparticles (BP-PTX-Gd NPs) demonstrate excellent biocompatibility, and high stability under physiological conditions, but they stimuli-responsively degrade and release PTX rapidly in a tumor microenvironment. The in vitro behavior of NPs labeled with fluorescent dyes is effectively monitored, and the NPs display high cytotoxicity to 4T1 cells similar to free PTX by impairing the function of microtubules, downregulating anti-apoptotic protein Bcl-2, and upregulating the expression of Bax, cleaved caspase-3, cleaved caspase-9, cleaved-PARP, and p53 proteins. Great improvement in magnetic resonance imaging (MRI) is demonstrated by these NPs, and MRI accurately maps the temporal change profile of the tumor volume after injection of NPs and the tumor treatment process is also closely correlated with the T 1 values measured from MRI, demonstrating the capability of providing real-time feedback to the chemotherapeutic treatment effectiveness. The imaging-guided chemotherapy to the 4T1 tumor in the mice model achieves an excellent anti-tumor effect. This stimuli-responsive polymeric nano-agent opens a new door for efficient breast cancer treatment under the guidance of fluorescence/MRI.
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Affiliation(s)
- Hao Cai
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
| | - Xinghang Dai
- West China School of MedicineSichuan UniversityChengdu610041China
| | - Xiaoming Wang
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
| | - Ping Tan
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
| | - Lei Gu
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
| | - Qiang Luo
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
| | - Xiuli Zheng
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
| | - Zhiqian Li
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
| | - Hongyan Zhu
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
| | - Hu Zhang
- Amgen Bioprocessing CentreKeck Graduate InstituteClaremontCA91711USA
| | - Zhongwei Gu
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
- National Engineering Research Center for BiomaterialsSichuan UniversityChengdu610064China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
| | - Kui Luo
- Huaxi MR Research Center (HMRRC)Department of RadiologyFunctional and Molecular Imaging Key Laboratory of Sichuan ProvinceNational Clinical Research Center for GeriatricsState Key Laboratory of BiotherapyWest China HospitalSichuan UniversityChengdu610041China
- National Engineering Research Center for BiomaterialsSichuan UniversityChengdu610064China
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44
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Nöth U, Tichy J, Tritt S, Bähr O, Deichmann R, Hattingen E. Quantitative T1 mapping indicates tumor infiltration beyond the enhancing part of glioblastomas. NMR IN BIOMEDICINE 2020; 33:e4242. [PMID: 31880005 DOI: 10.1002/nbm.4242] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
The aim of this study was to evaluate whether maps of quantitative T1 (qT1) differences induced by a gadolinium-based contrast agent (CA) are better suited than conventional T1-weighted (T1w) MR images for detecting infiltration inside and beyond the peritumoral edema of glioblastomas. Conventional T1w images and qT1 maps were obtained before and after gadolinium-based CA administration in 33 patients with glioblastoma before therapy. The following data were calculated: (i) absolute qT1-difference maps (qT1 pre-CA - qT1 post-CA), (ii) relative qT1-difference maps, (iii) absolute and (iv) relative differences of conventional T1w images acquired pre- and post-CA. The values of these four datasets were compared in four different regions: (a) the enhancing tumor, (b) the peritumoral edema, (c) a 5 mm zone around the pathology (defined as the sum of regions a and b), and (d) the contralateral normal appearing brain tissue. Additionally, absolute qT1-difference maps (displayed with linear gray scaling) were visually compared with respective conventional difference images. The enhancing tumor was visible both in the difference of conventional pre- and post-CA T1w images and in the absolute qT1-difference maps, whereas only the latter showed elevated values in the peritumoral edema and in some cases even beyond. Mean absolute qT1-difference values were significantly higher (P < 0.01) in the enhancing tumor (838 ± 210 ms), the peritumoral edema (123 ± 74 ms) and in the 5 mm zone around the pathology (81 ± 31 ms) than in normal appearing tissue (32 ± 35 ms). In summary, absolute qT1-difference maps-in contrast to the difference of T1w images-of untreated glioblastomas appear to be able to visualize CA leakage, and thus might indicate tumor cell infiltration in the edema region and beyond. Therefore, the absolute qT1-difference maps are potentially useful for treatment planning.
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Affiliation(s)
- Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Julia Tichy
- Dr Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany
| | - Stephanie Tritt
- Institute of Neuroradiology, Goethe University, Frankfurt am Main, Germany
| | - Oliver Bähr
- Dr Senckenberg Institute of Neurooncology, Goethe University, Frankfurt am Main, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Elke Hattingen
- Institute of Neuroradiology, Goethe University, Frankfurt am Main, Germany
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45
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Ma S, Nguyen CT, Han F, Wang N, Deng Z, Binesh N, Moser FG, Christodoulou AG, Li D. Three-dimensional simultaneous brain T 1 , T 2 , and ADC mapping with MR Multitasking. Magn Reson Med 2019; 84:72-88. [PMID: 31765496 DOI: 10.1002/mrm.28092] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 10/01/2019] [Accepted: 10/31/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To develop a simultaneous T1 , T2 , and ADC mapping method that provides co-registered, distortion-free images and enables multiparametric quantification of 3D brain coverage in a clinically feasible scan time with the MR Multitasking framework. METHODS The T1 /T2 /diffusion weighting was generated by a series of T2 preparations and diffusion preparations. The underlying multidimensional image containing 3 spatial dimensions, 1 T1 weighting dimension, 1 T2 -preparation duration dimension, 1 b-value dimension, and 1 diffusion direction dimension was modeled as a 5-way low-rank tensor. A separate real-time low-rank model incorporating time-resolved phase correction was also used to compensate for both inter-shot and intra-shot phase inconsistency induced by physiological motion. The proposed method was validated on both phantom and 16 healthy subjects. The quantification of T1 /T2 /ADC was evaluated for each case. Three post-surgery brain tumor patients were scanned for demonstration of clinical feasibility. RESULTS Multitasking T1 /T2 /ADC maps were perfectly co-registered and free from image distortion. Phantom studies showed substantial quantitative agreement ( R 2 = 0.999 ) with reference protocols for T1 /T2 /ADC. In vivo studies showed nonsignificant T1 (P = .248), T2 (P = .97), ADC (P = .328) differences among the frontal, parietal, and occipital regions. Although Multitasking showed significant differences of T1 (P = .03), T2 (P < .001), and ADC (P = .001) biases against the references, the mean bias estimates were small (ΔT1 % < 5%, ΔT2 % < 7%, ΔADC% < 5%), with all intraclass correlation coefficients greater than 0.82 indicating "excellent" agreement. Patient studies showed that Multitasking T1 /T2 /ADC maps were consistent with the clinical qualitative images. CONCLUSION The Multitasking approach simultaneously quantifies T1 /T2 /ADC with substantial agreement with the references and is promising for clinical applications.
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Affiliation(s)
- Sen Ma
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California.,Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Christopher T Nguyen
- Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts
| | - Fei Han
- Siemens Healthcare, Los Angeles, California
| | - Nan Wang
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California.,Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Zixin Deng
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Nader Binesh
- S. Mark Taper Foundation Imaging Center, Cedars-Sinai Medical Center, Los Angeles, California
| | - Franklin G Moser
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Debiao Li
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California.,Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
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Falk Delgado A, Van Westen D, Nilsson M, Knutsson L, Sundgren PC, Larsson EM, Falk Delgado A. Diagnostic value of alternative techniques to gadolinium-based contrast agents in MR neuroimaging-a comprehensive overview. Insights Imaging 2019; 10:84. [PMID: 31444580 PMCID: PMC6708018 DOI: 10.1186/s13244-019-0771-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/12/2019] [Indexed: 12/16/2022] Open
Abstract
Gadolinium-based contrast agents (GBCAs) increase lesion detection and improve disease characterization for many cerebral pathologies investigated with MRI. These agents, introduced in the late 1980s, are in wide use today. However, some non-ionic linear GBCAs have been associated with the development of nephrogenic systemic fibrosis in patients with kidney failure. Gadolinium deposition has also been found in deep brain structures, although it is of unclear clinical relevance. Hence, new guidelines from the International Society for Magnetic Resonance in Medicine advocate cautious use of GBCA in clinical and research practice. Some linear GBCAs were restricted from use by the European Medicines Agency (EMA) in 2017. This review focuses on non-contrast-enhanced MRI techniques that can serve as alternatives for the use of GBCAs. Clinical studies on the diagnostic performance of non-contrast-enhanced as well as contrast-enhanced MRI methods, both well established and newly proposed, were included. Advantages and disadvantages together with the diagnostic performance of each method are detailed. Non-contrast-enhanced MRIs discussed in this review are arterial spin labeling (ASL), time of flight (TOF), phase contrast (PC), diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS), susceptibility weighted imaging (SWI), and amide proton transfer (APT) imaging. Ten common diseases were identified for which studies reported comparisons of non-contrast-enhanced and contrast-enhanced MRI. These specific diseases include primary brain tumors, metastases, abscess, multiple sclerosis, and vascular conditions such as aneurysm, arteriovenous malformation, arteriovenous fistula, intracranial carotid artery occlusive disease, hemorrhagic, and ischemic stroke. In general, non-contrast-enhanced techniques showed comparable diagnostic performance to contrast-enhanced MRI for specific diagnostic questions. However, some diagnoses still require contrast-enhanced imaging for a complete examination.
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Affiliation(s)
- Anna Falk Delgado
- Clinical neurosciences, Karolinska Institutet, Stockholm, Sweden. .,Department of Neuroradiology, Karolinska University Hospital, Eugeniavägen 3, Solna, Stockholm, Sweden.
| | - Danielle Van Westen
- Department of Clinical Sciences/Radiology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Markus Nilsson
- Department of Clinical Sciences/Radiology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,Russell H. Morgan Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Pia C Sundgren
- Department of Clinical Sciences/Radiology, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Elna-Marie Larsson
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
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Corbin N, Acosta-Cabronero J, Malik SJ, Callaghan MF. Robust 3D Bloch-Siegert based B 1 + mapping using multi-echo general linear modeling. Magn Reson Med 2019; 82:2003-2015. [PMID: 31321823 PMCID: PMC6771691 DOI: 10.1002/mrm.27851] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/16/2019] [Accepted: 05/19/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Quantitative MRI applications, such as mapping the T1 time of tissue, puts high demands on the accuracy and precision of transmit field ( B 1 + ) estimation. A candidate approach to satisfy these requirements exploits the difference in phase induced by the Bloch-Siegert frequency shift (BSS) of 2 acquisitions with opposite off-resonance frequency radiofrequency pulses. Interleaving these radiofrequency pulses ensures robustness to motion and scanner drifts; however, here we demonstrate that doing so also introduces a bias in the B 1 + estimates. THEORY AND METHODS It is shown here by means of simulation and experiments that the amplitude of the error depends on MR pulse sequence parameters, such as repetition time and radiofrequency spoiling increment, but more problematically, on the intrinsic properties, T1 and T2 , of the investigated tissue. To solve these problems, a new approach to BSS-based B 1 + estimation that uses a multi-echo acquisition and a general linear model to estimate the correct BSS-induced phase is presented. RESULTS In line with simulations, phantom and in vivo experiments confirmed that the general linear model-based method removed the dependency on tissue properties and pulse sequence settings. CONCLUSION The general linear model-based method is recommended as a more accurate approach to BSS-based B 1 + mapping.
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Affiliation(s)
- Nadège Corbin
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Julio Acosta-Cabronero
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Shaihan J Malik
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Martina F Callaghan
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
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Montelius M, Jalnefjord O, Spetz J, Nilsson O, Forssell‐Aronsson E, Ljungberg M. Multiparametric MR for non-invasive evaluation of tumour tissue histological characteristics after radionuclide therapy. NMR IN BIOMEDICINE 2019; 32:e4060. [PMID: 30693592 PMCID: PMC6590232 DOI: 10.1002/nbm.4060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 11/26/2018] [Accepted: 11/26/2018] [Indexed: 05/05/2023]
Abstract
Early non-invasive tumour therapy response assessment requires methods sensitive to biological and physiological tumour characteristics. The aim of this study was to find and evaluate magnetic resonance imaging (MRI) derived tumour tissue parameters that correlate with histological parameters and that reflect effects of radionuclide therapy. Mice bearing a subcutaneous human small-intestine neuroendocrine tumour were i.v. injected with 177 Lu-octreotate. MRI was performed (7 T Bruker Biospec) on different post-therapy intervals (1 and 13 days) using T2-weighted imaging, mapping of T2* and T1 relaxation time constants, as well as diffusion and dynamic contrast enhancement (DCE-MRI) techniques. After MRI, animals were killed and tumours excised. Four differently stained histological sections of the most central imaged tumour plane were digitized, and segmentation techniques were used to produce maps reflecting fibrotic and vascular density, apoptosis, and proliferation. Histological maps were aligned with MRI-derived parametric maps using landmark-based registration. Correlations and predictive power were evaluated using linear mixed-effects models and cross-validation, respectively. Several MR parameters showed statistically significant correlations with histological parameters. In particular, three DCE-MRI-derived parameters reflecting capillary function additionally showed high predictive power regarding apoptosis (2/3) and proliferation (1/3). T1 could be used to predict vascular density, and perfusion fraction derived from diffusion MRI could predict fibrotic density, although with lower predictive power. This work demonstrates the potential to use multiparametric MRI to retrieve important information on the tumour microenvironment after radiotherapy. The non-invasiveness of the method also allows longitudinal tumour tissue characterization. Further investigation is warranted to evaluate the parameters highlighted in this study longitudinally, in larger studies, and with additional histological methods.
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Affiliation(s)
- Mikael Montelius
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, Department of Radiation PhysicsUniversity of GothenburgGothenburgSweden
| | - Oscar Jalnefjord
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, Department of Radiation PhysicsUniversity of GothenburgGothenburgSweden
- Department of Medical Physics and Biomedical EngineeringSahlgrenska University HospitalGothenburgSweden
| | - Johan Spetz
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, Department of Radiation PhysicsUniversity of GothenburgGothenburgSweden
| | - Ola Nilsson
- Institute of Biomedicine, Sahlgrenska Cancer Center, Sahlgrenska Academy, Department of PathologyUniversity of GothenburgGothenburgSweden
| | - Eva Forssell‐Aronsson
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, Department of Radiation PhysicsUniversity of GothenburgGothenburgSweden
| | - Maria Ljungberg
- Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy, Department of Radiation PhysicsUniversity of GothenburgGothenburgSweden
- Department of Medical Physics and Biomedical EngineeringSahlgrenska University HospitalGothenburgSweden
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49
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de Blank P, Badve C, Gold DR, Stearns D, Sunshine J, Dastmalchian S, Tomei K, Sloan AE, Barnholtz-Sloan JS, Lane A, Griswold M, Gulani V, Ma D. Magnetic Resonance Fingerprinting to Characterize Childhood and Young Adult Brain Tumors. Pediatr Neurosurg 2019; 54:310-318. [PMID: 31416081 DOI: 10.1159/000501696] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/23/2019] [Indexed: 11/19/2022]
Abstract
OBJECT Magnetic resonance fingerprinting (MRF) allows rapid, simultaneous mapping of T1 and T2 relaxation times and may be an important diagnostic tool to measure tissue characteristics in pediatric brain tumors. We examined children and young adults with primary brain tumors to determine whether MRF can discriminate tumor from normal-appearing white matter and distinguish tumor grade. METHODS MRF was performed in 23 patients (14 children and 9 young adults) with brain tumors (19 low-grade glioma, 4 high-grade tumors). T1 and T2 values were recorded in regions of solid tumor (ST), peritumoral white matter (PWM), and contralateral white matter (CWM). Nonparametric tests were used for comparison between groups and regions. RESULTS Median scan time for MRF and a sequence for tumor localization was 11 min. MRF-derived T1 and T2 values distinguished ST from CWM (T1: 1,444 ± 254 ms vs. 938 ± 96 ms, p = 0.0002; T2: 61 ± 22 ms vs. 38 ± 9 ms, p = 0.0003) and separated high-grade tumors from low-grade tumors (T1: 1,863 ± 70 ms vs. 1,355 ± 187 ms, p = 0.007; T2: 90 ± 13 ms vs. 56 ± 19 ms, p = 0.013). PWM was distinct from CWM (T1: 1,261 ± 359 ms vs. 933 ± 104 ms, p = 0.0008; T2: 65 ± 51 ms vs. 38 ± 8 ms, p = 0.008), as well as from tumor (T1: 1,261 ± 371 ms vs. 1,462 ± 248 ms, p = 0.047). CONCLUSIONS MRF is a fast sequence that can rapidly distinguish important tissue components in pediatric brain tumor patients. MRF-derived T1 and T2 distinguished tumor from normal-appearing white matter, differentiated tumor grade, and found abnormalities in peritumoral regions. MRF may be useful for rapid quantitative measurement of tissue characteristics and distinguish tumor grade in children and young adults with brain tumors.
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Affiliation(s)
- Peter de Blank
- Department of Pediatrics, University of Cincinnati and the Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA,
| | - Chaitra Badve
- Department of Radiology, University Hospitals Cleveland, Cleveland, Ohio, USA
| | - Deborah Rukin Gold
- Department of Neurology, University Hospitals Cleveland, Cleveland, Ohio, USA
| | - Duncan Stearns
- Department of Pediatrics, University Hospitals Cleveland, Cleveland, Ohio, USA
| | - Jeffrey Sunshine
- Department of Radiology, University Hospitals Cleveland, Cleveland, Ohio, USA
| | - Sara Dastmalchian
- Department of Radiology, University Hospitals Cleveland, Cleveland, Ohio, USA
| | - Krystal Tomei
- Department of Neurosurgery, University Hospitals Cleveland, Cleveland, Ohio, USA
| | - Andrew E Sloan
- Department of Neurosurgery, University Hospitals Cleveland, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.,Case Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Adam Lane
- Department of Pediatrics, University of Cincinnati and the Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Mark Griswold
- Department of Radiology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Vikas Gulani
- Department of Radiology, University Hospitals Cleveland, Cleveland, Ohio, USA
| | - Dan Ma
- Department of Radiology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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50
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Warntjes M, Blystad I, Tisell A, Larsson EM. Synthesizing a Contrast-Enhancement Map in Patients with High-Grade Gliomas Based on a Postcontrast MR Imaging Quantification Only. AJNR Am J Neuroradiol 2018; 39:2194-2199. [PMID: 30409854 DOI: 10.3174/ajnr.a5870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 09/24/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Administration of a gadolinium-based contrast agent is an important diagnostic biomarker for blood-brain barrier damage. In clinical use, detection is based on subjective comparison of native and postgadolinium-based contrast agent T1-weighted images. Quantitative MR imaging studies have suggested a relation between the longitudinal relaxation rate and proton-density in the brain parenchyma, which is disturbed by gadolinium-based contrast agents. This discrepancy can be used to synthesize a contrast-enhancement map based solely on the postgadolinium-based contrast agent acquisition. The aim of this study was to compare synthetic enhancement maps with subtraction maps of native and postgadolinium-based contrast agent images. MATERIALS AND METHODS For 14 patients with high-grade gliomas, quantitative MR imaging was performed before and after gadolinium-based contrast agent administration. The quantification sequence was multidynamic and multiecho, with a scan time of 6 minutes. The 2 image stacks were coregistered using in-plane transformation. The longitudinal relaxation maps were subtracted and correlated with the synthetic longitudinal relaxation enhancement maps on the basis of the postgadolinium-based contrast agent images only. ROIs were drawn for tumor delineation. RESULTS Linear regression of the subtraction and synthetic longitudinal relaxation enhancement maps showed a slope of 1.02 ± 0.19 and an intercept of 0.05 ± 0.12. The Pearson correlation coefficient was 0.861 ± 0.059, and the coefficient of variation was 0.18 ± 0.04. On average, a volume of 1.71 ± 1.28 mL of low-intensity enhancement was detected in the synthetic enhancement maps outside the borders of the drawn ROI. CONCLUSIONS The study shows that there was a good correlation between subtraction longitudinal relaxation enhancement maps and synthetic longitudinal relaxation enhancement maps in patients with high-grade gliomas. The method may improve the sensitivity and objectivity for the detection of gadolinium-based contrast agent enhancement.
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Affiliation(s)
- M Warntjes
- From the Centre for Medical Image Science and Visualization (M.W., I.B.., A.T.) .,Division of Cardiovascular Medicine (M.W.).,SyntheticMR AB (M.W.), Linköping, Sweden
| | - I Blystad
- From the Centre for Medical Image Science and Visualization (M.W., I.B.., A.T.).,Departments of Radiology (I.B.)
| | - A Tisell
- From the Centre for Medical Image Science and Visualization (M.W., I.B.., A.T.).,Radiation Physics (A.T.), Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - E-M Larsson
- Department of Surgical Sciences and Radiology (E.-M.L.), Uppsala University, Uppsala, Sweden
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