Practical consideration for 3T imaging

Longitudinal Changes in the Sensorimotor Pathways of Very Preterm Infants During the First Year of Life With and Without Intervention: A Pilot Study

Objective: Evaluate longitudinal changes in brain microstructure and volumes in very preterm infants during the first year of life with and without intervention.Design: Descriptive pilot study.Methods: Five preterm infants in a three-arm clinical trial, one SPEEDI Early, two SPEEDI Late, and two usual care. Brain structural and diffusion MRI's were acquired within 72 hours after neonatal intensive care unit discharge (n = 5), three months post-baseline (n = 5), and six months post-baseline (n = 3). Fractional anisotropy (FA), Mean diffusivity (MD), and volume metrics were computed for five brain regions.Results: More than 60% of eligible participants completed 100% of the scheduled MRIs. FA and volume increased from baseline to six months across all brain regions. Rate of white matter volume change from baseline to six months was highest in SPEEDI Early.Conclusions: Non-sedated longitudinal MRI is feasible in very preterm infants and appears to demonstrate longitudinal changes in brain structure and connectivity.

Fat suppression strategies in MR imaging of breast cancer at 3.0 T: comparison of the two-point Dixon technique and the frequency selective inversion method

PURPOSE

To compare two fat suppression methods in contrast-enhanced MR imaging of breast cancer at 3.0 T: the two-point Dixon method and the frequency selective inversion method.

MATERIALS AND METHODS

Forty female patients with breast cancer underwent contrast-enhanced three-dimensional T1-weighted MR imaging at 3.0 T. Both the two-point Dixon method and the frequency selective inversion method were applied. Quantitative analyses of the residual fat signal-to-noise ratio and the contrast noise ratio (CNR) of lesion-to-breast parenchyma, lesion-to-fat, and parenchyma-to-fat were performed. Qualitative analyses of the uniformity of fat suppression, image contrast, and the visibility of breast lesions and axillary metastatic adenopathy were performed.

RESULTS

The signal-to-noise ratio was significantly lower in the two-point Dixon method (P < 0.001). All CNR values were significantly higher in the two-point Dixon method (P < 0.001 and P = 0.001, respectively). According to qualitative analysis, both the uniformity of fat suppression and image contrast with the two-point Dixon method were significantly higher (P < 0.001 and P = 0.002, respectively). Visibility of breast lesions and metastatic adenopathy was significantly better in the two-point Dixon method (P < 0.001 and P = 0.03, respectively).

CONCLUSION

The two-point Dixon method suppressed the fat signal more potently and improved contrast and visibility of the breast lesions and axillary adenopathy.

Pediatric high-field magnetic resonance imaging

High-field 3 T magnetic resonance (MR) imaging provides greater signal-to-noise ratio (SNR) compared with 1.5 T systems. Various MR imaging clinical applications in children can benefit from improvements resulting from this increased SNR. High-resolution imaging of the brain, arterial spin labeling perfusion imaging, diffusion imaging, MR spectroscopy, and imaging of small anatomic parts are some areas in which these improvements can increase our clinical diagnostic capabilities. However, challenges inherent to 3 T imaging become more relevant in children. The use of 3 T imaging in children has allowed better diagnostic efficacy in neuroimaging, but certain technique modifications may be required for optimal imaging.

Evaluation of meglumine gadoterate-enhanced MR angiography (MRA) compared with time-of-flight MRA in the diagnosis of clinically significant non-coronary arterial disease: a pooled analysis of data from two clinical trials

OBJECTIVES

We analysed pooled data from two clinical trials to assess the diagnostic accuracy and safety of meglumine gadoterate (Gd-DOTA)-enhanced MR angiography (MRA) relative to those of non-enhanced time-of-flight (TOF) MRA for non-coronary arterial disease. Both techniques were compared with X-ray angiography as the gold standard.

METHODS

Patients were of both sexes, were aged at least 18 years and had suspected non-coronary arterial disease. Each patient was his/her own control and underwent TOF MRA followed by Gd-DOTA-enhanced MRA, and then X-ray angiography. MRA was performed at 1.5 T (USA study) or 3 T (Republic of Korea study). The primary criterion used to evaluate efficacy was the degree to which the MRA examination agreed with X-ray angiography in assessing non-coronary arterial lesions. The performance of Gd-DOTA over TOF was assessed using a one-sided paired t-test. We also evaluated the specificity, sensitivity, image quality, examination duration and clinical safety of both MRA procedures.

RESULTS

In total, 192 patients were enrolled and received Gd-DOTA. In the intent-to-treat population (n=162), within-patient accuracy was significantly greater for Gd-DOTA than for TOF (85.8 ± 19.8% agreement between Gd-DOTA and X-ray angiography compared with 78.3 ± 24.9% agreement between TOF and X-ray angiography; p=0.0001). The sensitivity, specificity, image quality and examination duration were also better for Gd-DOTA than for TOF. There were no serious drug-related adverse events.

CONCLUSION

We conclude that Gd-DOTA-enhanced MRA is a safe and accurate procedure for detecting arterial stenosis at both 1.5 T and 3 T.

Special surgical considerations for functional brain mapping

The development of functional mapping techniques gives neurosurgeons many options for preoperative planning. Integrating functional and anatomic data can inform patient selection and surgical planning and makes functional mapping more accessible than when only invasive studies were available. However, the applications of functional mapping to neurosurgical patients are still evolving. Functional imaging remains complex and requires an understanding of the underlying physiologic and imaging characteristics. Neurosurgeons must be accustomed to interpreting highly processed data. Successful implementation of functional image-guided procedures requires efficient interactions between neurosurgeon, neurologist, radiologist, neuropsychologist, and others, but promises to enhance the care of patients.

A Moveable 3-Tesla Intraoperative Magnetic Resonance Imaging System

BACKGROUND:

Based on success with a prototype 1.5T intraoperative magnetic resonance imaging (iMRI) system and the desire for increased signal-to-noise ratio, along with its relationship to image quality and advanced applications, a 3.0T system that uses the same novel moveable magnet configuration was developed.

OBJECTIVE:

To assess clinical applicability by prospectively applying the higher-field system to a neurosurgical cohort.

METHODS:

Upgrading to 3.0T required substantial modification of an existing iMRI-equipped operating room. The 1.5T magnet was replaced with a ceiling-mounted, moveable 3.0T magnet with a 70-cm working aperture. Local radiofrequency shielding was replaced with whole-room shielding. A new hydraulic operating table, high-performance gradients, and advanced image processing software were also installed. The new system was used as an adjunct to standard neurosurgical practice.

RESULTS:

The iMRI system upgrade required 6 months. Since completion, the 3.0T iMRI system has successfully guided neurosurgery in 120 patients without system failure in a patient-focused environment. Intraoperative image quality was superior to that obtained at 1.5T and enabled intraoperative acquisition of advanced imaging sequences, including tractography. Intraoperative imaging was found to modify surgery in a substantial number of patients.

CONCLUSION:

Implementation of an iMRI system based on a moveable 3.0T magnet is feasible. From clinical experience with 120 patients, iMRI at 3.0T is safe, reliable, and capable of directing image-guided surgery with exceptional image quality.

Intra-operative MRI at 3.0 Tesla: a moveable magnet

This paper presents the development and implementation of an intra-operative magnetic resonance imaging (ioMRI) program using a moveable 3.0 T magnet with a large working aperture.

METHODS

A previously established prototype 1.5 T ioMRI program based on a ceiling-mounted moveable magnet was upgraded to 3.0 T. The upgrade included a short, 1.73 m, magnet with a large 70 cm working aperture (IMRIS, Winnipeg, Canada), whole-room radio-frequency shielding, and a fully functional MR-compatible operating room (OR) table. Between January and September 2009, 100 consecutive patients were evaluated at 3.0 T.

RESULTS

The ioMRI upgrade maintained a patient-focused environment. When not needed for surgery, the magnet was moved to an adjacent room. A large aperture and streamlined OR table allowed freedom of patient positioning while maintaining access and visibility. Working at 3.0 T enabled application of advanced imaging sequences to the full spectrum of neurosurgical pathology in the ioMRI environment. The use of ioMRI continues to show unsuspected residual tumor in up to 20% of cases. There were no adverse events or technical system failures.

CONCLUSION

An ioMRI program based a 3.0 T moveable magnet is feasible. By moving the magnet, the system maintains a patient-focused surgical environment and the ability to share the technology between medical disciplines.

Magnetic resonance angiography of abdominal vessels at 3 T

Magnetic resonance angiography (MRA) has evolved significantly since first described in the early 1990s. Unrivaled image quality and freedom from artifacts has made it a reliable and widely utilized technique. Imaging at 3 T offers the potential for higher resolutions images with better temporal resolution compared to 1.5 T. This article will review the technique and contrast agents required to perform MRA at 3 T and the relevant clinical applications. We also discuss non-contrast enhanced MRA in the era of nephrogenic systemic fibrosis and future prospect for MRA at 3 T.

Evaluation of contrast-enhanced magnetic resonance angiography (MRA) using Gd-DOTA compared with time-of-flight MRA in the diagnosis of clinically significant non-coronary arterial disease

OBJECTIVES

This trial assessed diagnostic accuracy of contrast-enhanced magnetic resonance angiography (MRA) with meglumine gadoterate (Gd-DOTA) at 3 Tesla (T) over unenhanced MRA at 3 T in non-coronary arterial diseases by comparing their accuracy with that of the gold standard, x-ray angiography.

METHODS

Ninety-two patients with suspected non-coronary arterial disease underwent in fixed sequence unenhanced time-of flight (TOF) MRA, contrast-enhanced MRA using a Gd-DOTA bolus (intravenous bolus 0.1 mmol/kg) and x-ray angiography.

RESULTS

Eighty-four patients (71 male, 13 female; median age 64.5 years) were included in an intent-to-treat efficacy analysis. Targeted vascular areas were aorto-iliac, calf, carotid, femoral, popliteal and renal. Within-patient accuracy was significantly higher with contrast-enhanced MRA using Gd-DOTA than with unenhanced MRA (p = 0.0003). There was 84.4 +/- 17.5% agreement between contrast-enhanced MRA (Gd-DOTA) and x-ray angiography, compared with 76.8 +/- 20.4% between non-enhanced MRA and x-ray angiography. Sensitivity and specificity were also better with Gd-DOTA compared with non-enhanced MRA at the segment level. Duration of the MRA procedure was 3.5 times shorter with Gd-DOTA compared with non-enhanced MRA. Six patients reported six mild or moderate adverse events. No serious adverse events occurred.

CONCLUSIONS

Contrast-enhanced MRA using Gd-DOTA at 3 T was superior to unenhanced TOF MRA in the vascular territories investigated.

MRI of the spine: image quality and normal-neoplastic bone marrow contrast at 3 T versus 1.5 T

OBJECTIVE

The objectives of our study were to compare image quality of the spine and visualization of spine abnormalities at 3 T and 1.5 T as well as to evaluate differences in quantitative assessment of normal and neoplastic vertebral bone marrow.

MATERIALS AND METHODS

One hundred nine MR examinations of the spine were performed at 1.5 T and 3 T in the same patients within a time interval of less than 3 months. Visualization of anatomic and pathologic structures was analyzed by two radiologists. Normal and pathologic bone marrow was assessed on T1-weighted fast spin-echo (FSE) sequences. The signal intensity contrast of neoplastic bone marrow versus normal vertebral bone marrow was measured at 1.5 T versus 3 T. Sensitivity, specificity, and accuracy with 95% CIs were computed to assess the performance of muscle and disk as standards to differentiate between neoplastic and normal bone marrow on T1-weighted sequences at 1.5 T and 3 T.

RESULTS

For all anatomic structures evaluated, image quality was rated significantly higher at 3 T than at 1.5 T, with 71.6% of the studies overall being superior at 3 T. The contrast between normal and pathologic bone marrow was significantly larger at 3 T (mean +/- SD, 0.33 +/- 0.13) than at 1.5 T (0.27 +/- 0.11). The highest accuracy was found using muscle signal at 3 T to differentiate between normal and pathologic bone marrow.

CONCLUSION

The use of 3-T MRI improves visualization of anatomic structures in the spine over 1.5-T MRI. As an internal standard on T1-weighted FSE images, skeletal muscle can be used to differentiate between infiltrative and normal bone marrow with higher accuracy at 3 T than at 1.5 T.

Advances in magnetic resonance neuroimaging

Interest in advanced neuroimaging is growing and is certain to continue; new and faster sequences, better image quality, higher magnetic fields, and improved models of diffusion, perfusion, and functional connectivity are in constant development. The purpose of this article is to highlight recent advances in neuroimaging from two aspects: (1) those advances directly benefited by increases in field strength (increased T1, signal-to-noise ratio, magnetic susceptibility-sensitivity, and chemical shift) and how the increased signal-to-noise ratio can be used to trade off for other advantages and (2) those advances made in response to attempts to try to reduce the inherent artifacts encountered at higher field strengths (eg, reducing specific radiofrequency absorption in tissue and magnetic susceptibility).

Bilateral ce-MR angiography of the hands at 3.0 T and 1.5 T: intraindividual comparison of quantitative and qualitative image parameters in healthy volunteers

The purpose of this study was to determine the benefit of bilateral contrast-enhanced MR angiography (ce-MRA) of the hands at 3.0 Tesla (T) compared with an established 1.5-T technique in healthy volunteers. Intraindividual bilateral ce-MRA of the hands was performed at 1.5 T and 3.0 T in 14 healthy volunteers using a timed ultra-fast GRE sequence featuring parallel acquisition. The evaluation comprised measurement of the vessel signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), rating of the image quality and the assessment of artefacts and venous contamination. At 3.0 T, SNR improved up to 95% and CNR up to 129%. The image quality of the larger inflow arteries, the palm arches and common digital arteries was good or sufficient at either magnetic field strengths. However, 3.0-T MRA was clearly superior in the depiction of the digital arteries. Ce-MRA of the hand clearly profits from the use of 3.0 T. Compared with 1.5 T, a substantial increase of CNR is found resulting in a significantly better delineation of the small digital arteries. Saturation affects more the SNR of the perivascular tissue than the contrast-enhanced blood, and thus leads to a marked increase of CNR at 3.0.

High-resolution myocardial stress perfusion at 3 T in patients with suspected coronary artery disease

To implement a high-resolution first-pass myocardial perfusion imaging protocol (HRPI) at 3 T, and to evaluate the feasibility, image quality and accuracy of this approach prospectively in patients with suspected CAD. We hypothesized that utilizing the gain in SNR at 3 T to increase spatial resolution would reduce partial volume effects and subendocardial dark rim artifacts in comparison to 1.5 T. HRPI studies were performed on 60 patients using a segmented k-space gradient echo sequence (in plane resolution 1.97 x 1.94 mm(2)). Semiquantitative assessment of dark rim artifacts was performed for the stress studies on a slice-by-slice basis. Qualitative visual analysis was compared to quantitative coronary angiography (QCA) results; hemodynamically significant CAD was defined as stenosis >or=70% at QCA. Dark rim artifacts appeared in 108 of 180 slices (average extent 1.3 +/- 1.2 mm representing 11.8 +/- 10.8% of the transmural myocardial thickness). Sensitivity, specifity, and test accuracy for the detection of significant CAD were 89%,79%, and 85%. HRPI studies at 3 T are feasible in a clinical setting, providing good image quality and high accuracy for detection of significant CAD. The presence of dark rim artifacts does not appear to represent a diagnostic problem when using a HRPI approach.

High-resolution myocardial perfusion imaging at 3 T: comparison to 1.5 T in healthy volunteers

The purpose of this study was to evaluate high-resolution (HR) myocardial first-pass perfusion in healthy volunteers at 3 T compared to a typical clinical imaging protocol at 1.5 T, with respect to overall image quality and the presence of subendocardial dark rim artifacts. Myocardial first-pass rest perfusion studies were performed at both field strengths using a T1-weighted saturation-recovery segmented k-space gradient-echo sequence combined with parallel imaging (Gd-DTPA 0.05 mmol/kg). Twenty-six healthy volunteers underwent (1) a HR perfusion scan at 3 T(pixel size 3.78 mm(2)) and (2) a standard perfusion approach at 1.5 T(pixel size 9.86 mm(2)). The contrast enhancement ratio (CER) and overall image quality (4-point grading scale: 4: excellent; 1: non-diagnostic) were assessed, and a semiquantitative analysis of dark rim artifacts was performed for all studies. CER was slightly higher (1.31 +/- 0.32 vs. 1.14 +/- 0.34; p<0.01), overall image quality was significantly improved (3.03 +/- 0.43 vs. 2.37 +/- 0.39; p<0.01), and the number of dark rim artifacts (139 +/- 2.09 vs. 243 +/- 2.33; p<0.01) was significantly reduced for HR perfusion imaging at 3 T compared to the standard approach at 1.5 T. HR myocardial rest perfusion at 3 T is superior to the typical clinical perfusion protocol performed at 1.5 T with respect to the overall image quality and presence of subendocardial dark rim artifacts.

Imaging artifacts at 3.0T

Clinical MRI at a field strength of 3.0T is finding increasing use. However, along with the advantages of 3.0T, such as increased SNR, there can be drawbacks, including increased levels of imaging artifacts. Although every imaging artifact observed at 3.0T can also be present at 1.5T, the intensity level is often higher at 3.0T and thus the artifact is more objectionable. This review describes some of the imaging artifacts that are commonly observed with 3.0T imaging, and their root causes. When possible, countermeasures that reduce the artifact level are described.

Shoulder MR arthrography: In vitro determination of optimal gadolinium dilution as a function of field strength

PURPOSE

To find the optimal contrast agent dilution to maximize signal intensity (SI), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in shoulder MR arthrography using MR systems operating at different magnetic field strengths.

MATERIALS AND METHODS

Autoptic human glenohumeral ligaments were inserted in eight egg-shaped 20-mL phantoms filled with saline and gadolinium diethylenetriaminepentaacetic acid bismethylamide (Gd-DTPA-BMA) in different dilutions of 0.5, 1, 2, 2.5, 5, 12.5, 50 mmol/liter, to simulate the shoulder articular capsule. These phantoms were inserted inside two plastic 240-mL phantoms filled with water. MRI was performed on 0.2-, 0.5-, 1.0-, 1.5-, and 3.0-T MR systems using a three-dimensional gradient echo (GRE)-T1-weighted pulse sequence. SI, SNR, and CNR were determined.

RESULTS

Peak SI and SNR were found at 5 mmol/liter, with the exception of the 0.2-T scanner, where the maximum was at 2 mmol/liter. Peak CNR was observed at 1 mmol/liter for the 3-T scanner, at 2 mmol/liter for the 0.2- and 0.5-T scanners, and at 5 mmol/liter for the remaining scanners.

CONCLUSION

The optimal SI and SNR are provided by 5 mmol/liter contrast agent dilution. Peak CNR was found in a range between 1 and 5 mmol/liter dilutions, depending on the strength of the magnetic field.

MR lymphangiography using dendrimer-based contrast agents: A comparison at 1.5T and 3.0T

Most macromolecular contrast agents (CAs) show lower r1 and higher r2 relaxivities at 3.0T than at 1.5T. MR lymphangiography in mice using a macromolecular G6 dendrimer-based CA was serially performed and compared at both 1.5T and 3.0T. The r1 and r2 relaxivities of the G6 CA were 25 and 78/s/mM at 1.5T and 17 and 82/s/mM at 3.0T, respectively. The lymph node (LN)-to-fat ratios (LN signal intensity (SI)/fat SI) of T1-weighted 3D-fast spoiled gradient-echo (3D-FSPGR) were 3.2+/-0.4 (mean+/-standard deviation (SD)) at 1.5T and 2.7+/-0.3 at 3.0T (P=0.021), and the LN-to-fat ratios of T2/T1-weighted 3D-fast imaging employing steady-state acquisition with phase cycling (3D-FIESTA-C) were 1.8+/-0.2 at 1.5T and 1.2+/-0.4 at 3.0T (P=0.003). Although 3D-FSPGR successfully delineated the LNs at both 1.5T and 3.0T, 3D-FIESTA-C at 3.0T failed to visualize the LNs.

Three-tesla magnetic resonance imaging of the ventrolateral thalamus: a correlative anatomical description

Object

Surgery for tremor targets the ventrolateral nuclei of the thalamus. An initial radiological estimation of this target can be further refined through intraoperative physiological confirmation. Direct visualization of these nuclei has not yet been described. The improved signal-to-noise ratio associated with 3-tesla (3T) magnetic resonance (MR) imaging makes increased spatial resolution possible, which may aid in the identification of subtle morphological features. This study was conducted to describe the anatomy of the nuclei and fiber projections within the ventral thalamus by using 3T MR imaging.

Methods

Using a commercially available 3T MR unit, the authors obtained images of a formalin-fixed, paraffin-embedded brain. Slices with a 2-mm thickness and 0.2-mm gap were obtained parallel to the anterior commissure–posterior commissure (AC–PC) line. The brain was then sectioned through the cerebral hemispheres to obtain tissue slices encompassing the same levels. Adjacent 10-μm paraffin sections from the middle of each level were stained with Luxol fast blue and cresyl violet. The MR image and histological sections at the level of the AC–PC line were then compared in detail. In a separate study, the human thalamus was scanned in vivo using 3T and 1.5T MR imaging for anatomical comparison.

Conclusions

The anatomy of the nuclei and fiber projections within the ventrolateral thalamus in humans can be described using 3T MR imaging. The findings were reproducible in vivo with 3T but not 1.5T MR imaging. Additional studies are needed to confirm the accuracy of this observation for clinical purposes.

MR imaging of the spine at 3T

There are many advantages and challenges associated with 3T imaging of the spine. The increase in SNR allows for optimization of diagnostic quality and improved clinical efficiency. PI techniques merge well with high-field technology, which minimizes many of the challenges that are associated with 3T systems. The increase in chemical shift, pulsatile flow, and susceptibility artifact can be mediated with manipulation of imaging parameters. One major challenge that plagued 3T imaging of the spine was the decrease in fluid contrast that was associated with the lengthened T1 relaxation times. This has been resolved essentially for non-contrast spine imaging by using T1 FLAIR, which delineates soft tissue, CSF, disc, and bone interfaces exquisitely well. The optimal postcontrast T1 sequence may not exist yet. Clinical experience dictates that with a combination of T1 FLAIR with or without fat saturation (in one plane) and T1 FSE(in the other plane) no significant enhancing pathology will be missed. Despite the challenges, 3T imaging of the spine provides many improvements over 1.5T systems. These advances can be maximized by use of still evolving technologies and pulse sequence designs.

MRA of abdominal vessels: technical advances

Magnetic resonance angiography (MRA) in general and MRA of the abdominal vessels in particular have undergone substantial improvements in the past 5 years triggered by the introduction and application of parallel imaging (PI), new sequence techniques such as centric k-space trajectories and undersampling, dedicated contrast agents and clinical high-field scanners. All of these techniques have the potential to improve image quality and resolution or decrease the image acquisition time. However, each of them has its own specific advantages and drawbacks. This review describes the main technical innovations and focuses on the impact these developments may have on abdominal MRA. Special consideration is given to the interaction of these various technical advances. The clinical value of advanced MRA techniques is discussed and illustrated by characteristic cases.

Comparative Evaluation Between External Phased Array Coil at 3 T and Endorectal Coil at 1.5 T

OBJECTIVE

The aim of this study was to compare the image quality and the diagnostic accuracy of endorectal coil 1.5 T MRI (erMRI) and phased-array coil 3 T MRI (3-T MRI) in the pretherapeutic staging of prostate cancer.

METHODS

Twenty-nine consecutive patients, with pathological proven prostate cancer, have been examined in the same week with both erMRI and 3-T MRI. Two radiologists independently evaluated the image quality focusing on the following points: cancer tissue conspicuity, capsular infiltration and tumor involvement of seminal vesicles, neuro-vascular bundles, and apex. The radiologists assigned to each one of the above findings an image-quality score ranging from 1 to 5 (with 1 meaning "not visible," 2 "poorly visible," 3 "fairly visible," 4 "well visible with some artifacts," and 5 "clearly visible without artifacts".) Afterwards a comparative evaluation of the mean score obtained respectively by erMRI and 3 T MRI was done. Twenty-two of these 29 patients underwent radical prostatectomy. Assuming as gold standard the pathological report from the resected specimen, we compared the diagnostic accuracy of 3TMRI and erMRI in differentiating between tumors confined within the prostate gland (stage<or=T2) and tumors extending through the prostatic capsule (stages T3 and T4).

RESULTS

erMRI's image quality was found to be statistically significantly better than 3 T MRI's in evaluating tumor conspicuity, capsular infiltration, and seminal vesicles involvement. On the other hand, considering apex and NVB involvement no statistically significant difference was found between the 2 techniques. On the diagnosis of intracapsular or extracapsular tumor spread 3 T MRI and erMRI showed a comparable performance of sensitivity (75% vs. 83%), specificity (90% vs. 90%), positive predictive value (90% vs. 90%), and negative predictive value (75% vs. 81%).

CONCLUSIONS

During preoperative prostate cancer staging, 3 T MRI, despite a slightly worse image quality, can provide comparable diagnostic information to erMRI.

Contrast-enhanced MR imaging of the breast at 3.0 and 1.5 T in the same patients: initial experience

PURPOSE

To establish a pulse sequence for dynamic contrast material-enhanced magnetic resonance (MR) imaging of the breast at 3.0 T and to prospectively compare MR imaging at 3.0 T with MR imaging at 1.5 T in the same patients.

MATERIALS AND METHODS

A prospective intraindividual internal review board-approved study was performed in 37 women with 53 lesions (25 breast cancers, 28 benign focal lesions) who underwent contrast-enhanced dynamic bilateral subtraction MR imaging twice, once at 1.5 T with a standard technique (voxel size, 1.44 mm3) and once at 3.0 T (voxel size, 0.45-0.72 mm3) with variable repetition time and flip angle settings. Written informed consent was obtained. Sagittal single breast high-spatial-resolution MR imaging was performed with active fat suppression. Image quality, number and features of enhancing lesions, and Breast Imaging Reporting and Data System categories were compared by using the Wilcoxon matched-pairs signed rank test and Student t test for matched pairs. Diagnostic confidence was compared by using a receiver operating characteristic (ROC) analysis.

RESULTS

With repetition time prolonged to account for longer T1 relaxation times at 3.0 T and a flip angle of 60 degrees, enhancement rates at 3.0 T were substantially below those at 1.5 T. In two patients with benign lesions, enhancement was rated as insufficient to establish diagnosis. When parameter settings were kept equivalent, equivalent enhancement rates were observed with both systems. With these settings, 3.0-T MR imaging yielded homogeneous signal intensity over the entire field of view. No dielectric resonance effects were observed. Overall image quality scores for the dynamic series were slightly higher at 3.0 T (P<.01). A total of 49 lesions were prospectively identified with both systems. Owing to substantial patient motion at 1.5 T, two malignant lesions in one patient were visualized at 3.0 T only. At 3.0 T, differential diagnosis of enhancing lesions was possible with higher diagnostic confidence, as reflected by a larger area under the ROC curve (P<.05).

CONCLUSION

Initial experiences indicate that contrast-enhanced MR imaging at 3.0 T is nearing readiness for clinical use.

Head and Neck Imaging at 3T

For the theoretic advantages of 3T units to translate to improved diagnostic quality, careful attention must be paid to optimization of pulse sequences and development of clinically feasible imaging protocols. RARE sequences continue to be the choice for routine clinical imaging of the head and neck; although exquisite T2W images are afforded, T1W imaging is problematic. Short ETLT1W RARE imaging seems to be a good compromise.

New directions in brain imaging research in functional gastrointestinal disorders

Functional brain imaging has greatly enhanced the ability to investigate brain-gut interactions and to assess the central nervous system role on visceral pain perception. The results of studies using brain imaging in irritable bowel syndrome (IBS) have demonstrated differences in brain activation between patients with IBS and healthy controls. In addition, the more recent studies are starting to shed light on pathophysiological mechanisms that underlie the generation of functional gastrointestinal (GI) symptoms as well as the response to treatment. These studies highlight the potential of functional brain imaging to become an important and exciting investigative tool in research of functional GI disorders. However, the multifactorial, multideterminant nature of these disorders, the current limitations in the understanding of the pathophysiology of the disorders, and the heterogeneous patient population make brain imaging research in this field difficult and require caution in the interpretation of the data. The continued development of brain imaging techniques provides not only exciting opportunities but also significant challenges to the field. This article focuses on brain imaging research in functional GI disorders. It describes some of the recent developments in the use of brain imaging in research of the brain-gut axis and provides an overview of the current data.

Parallel MR Imaging: A User’s Guide

Parallel imaging is a recently developed family of techniques that take advantage of the spatial information inherent in phased-array radiofrequency coils to reduce acquisition times in magnetic resonance imaging. In parallel imaging, the number of sampled k-space lines is reduced, often by a factor of two or greater, thereby significantly shortening the acquisition time. Parallel imaging techniques have only recently become commercially available, and the wide range of clinical applications is just beginning to be explored. The potential clinical applications primarily involve reduction in acquisition time, improved spatial resolution, or a combination of the two. Improvements in image quality can be achieved by reducing the echo train lengths of fast spin-echo and single-shot fast spin-echo sequences. Parallel imaging is particularly attractive for cardiac and vascular applications and will likely prove valuable as 3-T body and cardiovascular imaging becomes part of standard clinical practice. Limitations of parallel imaging include reduced signal-to-noise ratio and reconstruction artifacts. It is important to consider these limitations when deciding when to use these techniques.

Optimization of gadodiamide concentration for MR arthrography at 3 T

OBJECTIVE

The purpose of our study was to determine the optimal concentration of a gadolinium-based contrast agent (gadodiamide) for direct MR arthrography at 3 T compared with 1.5 T in an in vitro study.

CONCLUSION

Optimized concentrations of gadolinium-based contrast agents for MR arthrography are similar at 3 and 1.5 T, although a slightly greater dilution may be useful at 3 T. Signal-to-noise ratio peak levels are significantly reduced by adding an iodinated contrast agent, relatively significantly more at 3 T than at 1.5 T.

Whole-body MRI at high field: technical limits and clinical potential

This review seeks to clarify the most important implications of higher magnetic field strength for clinical examinations of the whole body. An overview is provided on the resulting advantages and disadvantages for anatomical, functional and biochemical magnetic resonance examinations in different regions of the body. It is demonstrated that susceptibility-dependent imaging, chemical shift selective (e.g., fat-suppressed) imaging, and spectroscopic techniques clearly gain from higher field strength. Problems due to shorter wavelength and higher radio frequency energy deposition at higher field strength are reported, especially in examinations of the body trunk. Thorax examinations provided sufficient homogeneity of the radio frequency field for common examination techniques in most cases, whereas abdominal and pelvic imaging was often hampered by undesired dielectric effects. Currently available and potential future strategies to overcome related limitations are discussed. Whole-body MRI at higher field strength currently leads to clearly improved image quality using a variety of established sequence types and for examination of many body regions. But some major problems at higher field strength have to be solved before high-field magnetic resonance systems can really replace the well-established and technically developed magnetic resonance systems operating at 1.5 T for each clinical application.

3 Tesla magnetic resonance imaging of the brain in newborns

While it has been hypothesized that brain development is abnormal in schizophrenia and other neurodevelopmental disorders, there have been few attempts to study very early brain development in children. Twenty unsedated healthy newborns underwent 3 Tesla magnetic resonance imaging (MRI), including diffusion tensor imaging (DTI). The left ventricle was significantly larger than the right; females had significantly larger ventricles than males. Fractional anisotropy (FA) increased significantly with gestational age in the genu and splenium of the corpus callosum. It is feasible to study brain development in unsedated newborns using 3 T MRI.