Development of a Combined MR Fingerprinting and Diffusion Examination for Prostate Cancer

High-resolution myelin-water fraction and quantitative relaxation mapping using 3D ViSTa-MR fingerprinting

PURPOSE

This study aims to develop a high-resolution whole-brain multi-parametric quantitative MRI approach for simultaneous mapping of myelin-water fraction (MWF), T1, T2, and proton-density (PD), all within a clinically feasible scan time.

METHODS

We developed 3D visualization of short transverse relaxation time component (ViSTa)-MRF, which combined ViSTa technique with MR fingerprinting (MRF), to achieve high-fidelity whole-brain MWF and T1/T2/PD mapping on a clinical 3T scanner. To achieve fast acquisition and memory-efficient reconstruction, the ViSTa-MRF sequence leverages an optimized 3D tiny-golden-angle-shuffling spiral-projection acquisition and joint spatial-temporal subspace reconstruction with optimized preconditioning algorithm. With the proposed ViSTa-MRF approach, high-fidelity direct MWF mapping was achieved without a need for multicompartment fitting that could introduce bias and/or noise from additional assumptions or priors.

RESULTS

The in vivo results demonstrate the effectiveness of the proposed acquisition and reconstruction framework to provide fast multi-parametric mapping with high SNR and good quality. The in vivo results of 1 mm- and 0.66 mm-isotropic resolution datasets indicate that the MWF values measured by the proposed method are consistent with standard ViSTa results that are 30× slower with lower SNR. Furthermore, we applied the proposed method to enable 5-min whole-brain 1 mm-iso assessment of MWF and T1/T2/PD mappings for infant brain development and for post-mortem brain samples.

CONCLUSIONS

In this work, we have developed a 3D ViSTa-MRF technique that enables the acquisition of whole-brain MWF, quantitative T1, T2, and PD maps at 1 and 0.66 mm isotropic resolution in 5 and 15 min, respectively. This advancement allows for quantitative investigations of myelination changes in the brain.

Advanced MRI techniques in abdominal imaging

Magnetic resonance imaging (MRI) is a crucial modality for abdominal imaging evaluation of focal lesions and tissue properties. However, several obstacles, such as prolonged scan times, limitations in patients' breath-hold capacity, and contrast agent-associated artifacts, remain in abdominal MR images. Recent techniques, including parallel imaging, three-dimensional acquisition, compressed sensing, and deep learning, have been developed to reduce the scan time while ensuring acceptable image quality or to achieve higher resolution without extending the scan duration. Quantitative measurements using MRI techniques enable the noninvasive evaluation of specific materials. A comprehensive understanding of these advanced techniques is essential for accurate interpretation of MRI sequences. Herein, we therefore review advanced abdominal MRI techniques.

Histogram analysis of MR quantitative parameters: are they correlated with prognostic factors in prostate cancer?

PURPOSE

To investigate the correlation between quantitative MR parameters and prognostic factors in prostate cancer (PCa).

METHOD

A total of 186 patients with pathologically confirmed PCa who underwent preoperative multiparametric MRI (mpMRI), including synthetic MRI (SyMRI), were enrolled from two medical centers. The histogram metrics of SyMRI [T1, T2, proton density (PD)] and apparent diffusion coefficient (ADC) values were extracted. The Mann‒Whitney U test or Student's t test was employed to determine the association between these histogram features and the prognostically relevant factors. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the differentiation performance. Spearman's rank correlation coefficients were calculated to determine the correlations between histogram parameters and the International Society of Urological Pathology (ISUP) grade group as well as pathological T stage.

RESULTS

Significant correlations were found between the histogram parameters and the ISUP grade as well as pathological T stage of PCa. Among these histogram parameters, ADC_minimum had the strongest correlation with the ISUP grade (r = - 0.481, p < 0.001), and ADC_Median showed the strongest association with pathological T stage (r = - 0.285, p = 0.008). The ADC_10th percentile exhibited the highest performance in identifying clinically significant prostate cancer (csPCa) (AUC 0.833; 95% CI 0.771-0.883). When discriminating between the status of different prognostically relevant factors, a significant difference was observed between extraprostatic extension-positive and -negative cancers with regard to histogram parameters of the ADC map (10th percentile, 90th percentile, mean, median, minimum) and T1 map (minimum) (p = 0.002-0.032). Moreover, histogram parameters of the ADC map (90th percentile, maximum, mean, median), T2 map (10th percentile, median), and PD map (10th percentile, median) were significantly lower in PCa with perineural invasion (p = 0.009-0.049). The T2 values were significantly lower in patients with seminal vesicle invasion (minimum, p = 0.036) and positive surgical margin (10th percentile, 90th percentile, mean, median, and minimum, p = 0.015-0.025).

CONCLUSION

Quantitative histogram parameters derived from synthetic MRI and ADC maps may have great potential for predicting the prognostic features of PCa.

Short repetition time diffusion-weighted imaging improves visualization of prostate cancer

PURPOSE

This study aimed to assess whether short repetition time (TR) diffusion-weighted imaging (DWI) could improve diffusion contrast in patients with prostate cancer (PCa) compared with long TR (conventional) reference standard DWI.

MATERIALS AND METHODS

Our Institutional Review Board approved this retrospective study and waived the need for informed consent. Twenty-five patients with suspected PCa underwent multiparametric magnetic resonance imaging (mp-MRI) using a 3.0-T system. DWI was performed with TR of 1850 ms (short) and 6000 ms (long) with b-values of 0, 1000, and 2000s/mm2. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), visual score, apparent diffusion coefficient (ADC), and diagnostic performance were compared between short and long TR DWI for both b-values. The statistical tests included paired t-test for SNR and CNR; Wilcoxon signed-rank test for VA; Pearson's correlation and Bland-Altman plot analysis for ADC; and McNemar test and receiver operating characteristic analysis and Delong test for diagnostic performance.

RESULTS

Regarding b1000, CNR and visual score were significantly higher in short TR compared with long TR (P = .003 and P = .002, respectively), without significant difference in SNR (P = .21). Considering b2000, there was no significant difference in visual score between short and long TR (P = .07). However, SNR and CNR in long TR were higher (P = .01 and P = .04, respectively). ADC showed significant correlations, without apparent bias for ADC between short and long TR for both b-values. For diagnostic performance of DWI between short and long TR for both b-values, one out of five readers noted a significant difference, with the short TR for both b-values demonstrating superior performance.

CONCLUSIONS

Our data showed that the short TR DWI1000 may provide better image quality than did the long TR DWI1000 and may improve visualization and diagnostic performance of PCa for readers.

Reducing femoral flow artefacts in radial magnetic resonance fingerprinting of the prostate using region-optimised virtual coils

High acceleration factors in radial magnetic resonance fingerprinting (MRF) of the prostate lead to strong streak-like artefacts from flow in the femoral blood vessels, possibly concealing important anatomical information. Region-optimised virtual (ROVir) coils is a beamforming-based framework to create virtual coils that maximise signal in a region of interest while minimising signal in a region of interference. In this study, the potential of removing femoral flow streak artefacts in prostate MRF using ROVir coils is demonstrated in silico and in vivo. The ROVir framework was applied to radial MRF k-space data in an automated pipeline designed to maximise prostate signal while minimising signal from the femoral vessels. The method was tested in 15 asymptomatic volunteers at 3 T. The presence of streaks was visually assessed and measurements of whole prostate T1, T2 and signal-to-noise ratio (SNR) with and without streak correction were examined. In addition, a purpose-built simulation framework in which blood flow through the femoral vessels can be turned on and off was used to quantitatively evaluate ROVir's ability to suppress streaks in radial prostate MRF. In vivo it was shown that removing selected ROVir coils visibly reduces streak-like artefacts from the femoral blood flow, without increasing the reconstruction time. On average, 80% of the prostate SNR was retained. A similar reduction of streaks was also observed in silico, while the quantitative accuracy of T1 and T2 mapping was retained. In conclusion, ROVir coils efficiently suppress streaking artefacts from blood flow in radial MRF of the prostate, thereby improving the visual clarity of the images, without significant sacrifices to acquisition time, reconstruction time and accuracy of quantitative values. This is expected to help enable T1 and T2 mapping of prostate cancer in clinically viable times, aiding differentiation between prostate cancer from noncancer and healthy prostate tissue.

Fast deep learning reconstruction techniques for preclinical magnetic resonance fingerprinting

We propose a deep learning (DL) model and a hyperparameter optimization strategy to reconstruct T1 and T2 maps acquired with the magnetic resonance fingerprinting (MRF) methodology. We applied two different MRF sequence routines to acquire images of ex vivo rat brain phantoms using a 7-T preclinical scanner. Subsequently, the DL model was trained using experimental data, completely excluding the use of any theoretical MRI signal simulator. The best combination of the DL parameters was implemented by an automatic hyperparameter optimization strategy, whose key aspect is to include all the parameters to the fit, allowing the simultaneous optimization of the neural network architecture, the structure of the DL model, and the supervised learning algorithm. By comparing the reconstruction performances of the DL technique with those achieved from the traditional dictionary-based method on an independent dataset, the DL approach was shown to reduce the mean percentage relative error by a factor of 3 for T1 and by a factor of 2 for T2 , and to improve the computational time by at least a factor of 37. Furthermore, the proposed DL method enables maintaining comparable reconstruction performance, even with a lower number of MRF images and a reduced k-space sampling percentage, with respect to the dictionary-based method. Our results suggest that the proposed DL methodology may offer an improvement in reconstruction accuracy, as well as speeding up MRF for preclinical, and in prospective clinical, investigations.

High-resolution myelin-water fraction and quantitative relaxation mapping using 3D ViSTa-MR fingerprinting

Purpose

This study aims to develop a high-resolution whole-brain multi-parametric quantitative MRI approach for simultaneous mapping of myelin-water fraction (MWF), T1, T2, and proton-density (PD), all within a clinically feasible scan time.

Methods

We developed 3D ViSTa-MRF, which combined Visualization of Short Transverse relaxation time component (ViSTa) technique with MR Fingerprinting (MRF), to achieve high-fidelity whole-brain MWF and T1/T2/PD mapping on a clinical 3T scanner. To achieve fast acquisition and memory-efficient reconstruction, the ViSTa-MRF sequence leverages an optimized 3D tiny-golden-angle-shuffling spiral-projection acquisition and joint spatial-temporal subspace reconstruction with optimized preconditioning algorithm. With the proposed ViSTa-MRF approach, high-fidelity direct MWF mapping was achieved without a need for multi-compartment fitting that could introduce bias and/or noise from additional assumptions or priors.

Results

The in-vivo results demonstrate the effectiveness of the proposed acquisition and reconstruction framework to provide fast multi-parametric mapping with high SNR and good quality. The in-vivo results of 1mm- and 0.66mm-iso datasets indicate that the MWF values measured by the proposed method are consistent with standard ViSTa results that are 30x slower with lower SNR. Furthermore, we applied the proposed method to enable 5-minute whole-brain 1mm-iso assessment of MWF and T1/T2/PD mappings for infant brain development and for post-mortem brain samples.

Conclusions

In this work, we have developed a 3D ViSTa-MRF technique that enables the acquisition of whole-brain MWF, quantitative T1, T2, and PD maps at 1mm and 0.66mm isotropic resolution in 5 and 15 minutes, respectively. This advancement allows for quantitative investigations of myelination changes in the brain.

Quantitative longitudinal mapping of radiation-treated prostate cancer using MR fingerprinting with radial acquisition and subspace reconstruction

MR fingerprinting (MRF) enables fast multiparametric quantitative imaging with a single acquisition and has been shown to improve diagnosis of prostate cancer. However, most prostate MRF studies were performed with spiral acquisitions that are sensitive to B0 inhomogeneities and consequent blurring. In this work, a radial MRF acquisition with a novel subspace reconstruction technique was developed to enable fast T1/T2 mapping in the prostate in under 4 min. The subspace reconstruction exploits the extensive temporal correlations in the MRF dictionary to pre-compute a low dimensional space for the solution and thus reduce the number of radial spokes to accelerate the acquisition. Iterative reconstruction with the subspace model and additional regularization of the signal representation in the subspace is performed to minimize the number of spokes and maintain matching quality and SNR. Reconstruction accuracy was assessed using the ISMRM NIST phantom. In-vivo validation was performed on two healthy subjects and two prostate cancer patients undergoing radiation therapy. The longitudinal repeatability was quantified using the concordance correlation coefficient (CCC) in one of the healthy subjects by repeated scans over 1 year. One prostate cancer patient was scanned at three time points, before initiating therapy and following brachytherapy and external beam radiation. Changes in the T1/T2 maps obtained with the proposed method were quantified. The prostate, peripheral and transitional zones, and visible dominant lesion were delineated for each study, and the statistics and distribution of the quantitative mapping values were analyzed. Significant image quality improvements compared with standard reconstruction methods were obtained with the proposed subspace reconstruction method. A notable decrease in the spread of the T1/T2 values without biasing the estimated mean values was observed with the subspace reconstruction and agreed with reported literature values. The subspace reconstruction enabled visualization of small differences in T1/T2 values in the tumor region within the peripheral zone. Longitudinal imaging of a volunteer subject yielded CCC of 0.89 for MRF T1, and 0.81 for MRF T2 in the prostate gland. Longitudinal imaging of the prostate patient confirmed the feasibility of capturing radiation treatment related changes. This work is a proof-of-concept for a high resolution and fast quantitative mapping using golden-angle radial MRF combined with a subspace reconstruction technique for longitudinal treatment response assessment in subjects undergoing radiation treatment.

Magnetic Resonance Fingerprinting: A Review of Clinical Applications

ABSTRACT

Magnetic resonance fingerprinting (MRF) is an approach to quantitative magnetic resonance imaging that allows for efficient simultaneous measurements of multiple tissue properties, which are then used to create accurate and reproducible quantitative maps of these properties. As the technique has gained popularity, the extent of preclinical and clinical applications has vastly increased. The goal of this review is to provide an overview of currently investigated preclinical and clinical applications of MRF, as well as future directions. Topics covered include MRF in neuroimaging, neurovascular, prostate, liver, kidney, breast, abdominal quantitative imaging, cardiac, and musculoskeletal applications.

Assessment of MRF for simultaneous T1 and T2 quantification and water-fat separation in the liver at 0.55 T

OBJECTIVE

The goal of this work was to assess the feasibility of performing MRF in the liver on a 0.55 T scanner and to examine the feasibility of water-fat separation using rosette MRF at 0.55 T.

MATERIALS AND METHODS

Spiral and rosette MRF sequences were implemented on a commercial 0.55 T scanner. The accuracy of both sequences in T1 and T2 quantification was validated in the ISMRM/NIST system phantom. The efficacy of rosette MRF in water-fat separation was evaluated in simulations and water/oil phantoms. Both spiral and rosette MRF were performed in the liver of healthy subjects.

RESULTS

In the ISMRM/NIST phantom, both spiral and rosette MRF achieved good agreement with reference values in T1 and T2 measurements. In addition, rosette MRF enables water-fat separation and can generate water- and fat- specific T1 maps, T2 maps, and proton density images from the same dataset for a spatial resolution of 1.56 × 1.56 × 5mm3 within the acquisition time of 15 s.

CONCLUSION

It is feasible to measure T1 and T2 simultaneously in the liver using MRF on a 0.55 T system with lower performance gradients compared to state-of-the-art 1.5 T and 3 T systems within an acquisition time of 15 s. In addition, rosette MRF enables water-fat separation along with T1 and T2 quantification with no time penalty.

Comparing Magnetic Resonance Fingerprinting (MRF) and the MAGiC Sequence for Simultaneous T1 and T2 Quantitative Measurements in the Female Pelvis: A Prospective Study

The aim of this study was to explore the potential of magnetic resonance fingerprinting (MRF), an emerging quantitative MRI technique, in measuring relaxation values of female pelvic tissues compared to the conventional magnetic resonance image compilation (MAGiC) sequence. The study included 32 female patients who underwent routine pelvic MRI exams using anterior and posterior array coils on a 3T clinical scanner. Our findings demonstrated significant correlations between MRF and MAGiC measured T1 and T2 values (p < 0.0001) for various pelvic tissues, including ilium, femoral head, gluteus, obturator, iliopsoas, erector spinae, uterus, cervix, and cutaneous fat. The tissue contrasts generated from conventional MRI and synthetic MRF also showed agreement in bone, muscle, and uterus for both T1-weighted and T2-weighted images. This study highlights the strengths of MRF in providing simultaneous T1 and T2 mapping. MRF offers distinct tissue contrast and has the potential for accurate diagnosis of female pelvic diseases, including tumors, fibroids, endometriosis, and pelvic inflammatory disease. Additionally, MRF shows promise in monitoring disease progression or treatment response. Overall, the study demonstrates the potential of MRF in the field of female pelvic organ imaging and suggests that it could be a valuable addition to the clinical practice of pelvic MRI exams. Further research is needed to establish the clinical utility of MRF and to develop standardized protocols for its implementation in clinical practice.

T1 Mapping of the Prostate Using Single-Shot T1FLASH: A Clinical Feasibility Study to Optimize Prostate Cancer Assessment

PURPOSE

The aim of this study was to assess the clinical feasibility of magnetic resonance imaging (MRI) T1 mapping using T1FLASH for assessment of prostate lesions.

METHODS

Participants with clinical suspicion for prostate cancer (PCa) were prospectively enrolled between October 2021 and April 2022 with multiparametric prostate MRI (mpMRI) acquired on a 3 T scanner. In addition, T1 mapping was accomplished using a single-shot T1FLASH technique with inversion recovery, radial undersampling, and iterative reconstruction. Regions of interest (ROIs) were manually placed on radiologically identified prostate lesions and representative reference regions of the transitional zone (TZ), benign prostate hyperplasia nodules, and peripheral zone (PZ). Mean T1 relaxation times and apparent diffusion coefficient (ADC) values (b = 50/b = 1400 s/mm 2 ) were measured for each ROI. Participants were included in the study if they underwent ultrasound/MRI fusion-guided prostate biopsy for radiologically or clinically suspected PCa. Histological evaluation of biopsy cores served as reference standard, with grading of PCa according to the International Society of Urological Pathology (ISUP). ISUP grades 2 and above were considered clinically significant PCa for the scope of this study. Histological results of prostate biopsy cores were anatomically mapped to corresponding mpMRI ROIs using biopsy plans. T1 relaxation times and ADC values were compared across prostate regions and ISUP groups. Across different strata, T1 relaxation time, ADC values, and diagnostic accuracy (area under the curve [AUC]) were compared using statistical methods accounting for clustered data.

RESULTS

Of 67 eligible participants, a total of 40 participants undergoing ultrasound/MRI fusion-guided prostate biopsy were included. Multislice T1 mapping was successfully performed in all participants at a median acquisition time of 2:10 minutes without evident image artifacts. A total of 71 prostate lesions was radiologically identified (TZ 49; PZ 22). Among those, 22 were histologically diagnosed with PCa (ISUP groups 1/2/3/4 in n = 3/15/3/1 cases, respectively). In the TZ, T1 relaxation time was statistically significantly lower for PCa compared with reference regions ( P = 0.029) and benign prostate hyperplasia nodules ( P < 0.001). Similarly, in the PZ, PCa demonstrated shorter T1 relaxation times versus reference regions ( P < 0.001). PCa also showed a trend toward shorter T1 relaxation times (median, 1.40 seconds) compared with radiologically suspicious lesions with benign histology (median, 1.47 seconds), although statistical significance was not reached ( P = 0.066). For discrimination of PCa from reference regions and benign prostate lesions, T1 relaxation times and ADC values demonstrated AUC = 0.80 and AUC = 0.83, respectively ( P = 0.519). Discriminating PCa from radiologically suspicious lesions with benign histology, T1 relaxation times and ADC values showed AUC = 0.69 and AUC = 0.62, respectively ( P = 0.446).

CONCLUSIONS

T1FLASH-based T1 mapping yields robust results for quantification of prostate T1 relaxation time at a short examination time of 2:10 minutes without evident image artifacts. Associated T1 relaxation times could aid in discrimination of significant and nonsignificant PCa. Further studies are warranted to confirm these results in a larger patient cohort, to assess the additional benefit of T1FLASH maps in conjunction with mpMRI sequences in the setting of deep learning, and to evaluate the robustness of T1FLASH maps compared with potentially artifact-prone diffusion-weighted imaging sequences.

Age-Dependent Changes in Knee Cartilage T1 , T2 , and T1p Simultaneously Measured Using MRI Fingerprinting

BACKGROUND

Magnetic resonance fingerprinting (MRF) techniques have been recently described for simultaneous multiparameter cartilage mapping of the knee although investigation of their ability to detect early cartilage degeneration remains limited.

PURPOSE

To investigate age-dependent changes in knee cartilage T1 , T2 , and T1p relaxation times measured using a three-dimensional (3D) MRF sequence in healthy volunteers.

STUDY TYPE

Prospective.

SUBJECTS

The study group consisted of 24 healthy asymptomatic human volunteers (15 males with mean age 34.9 ± 14.4 years and 9 females with mean age 44.5 ± 13.1 years).

FIELD STRENGTH/SEQUENCE

A 3.0 T gradient-echo-based 3D-MRF sequence was used to simultaneously create proton density-weighted images and T1 , T2 , and T1p maps of knee cartilage.

ASSESSMENT

Mean global cartilage and regional cartilage (lateral femur, lateral tibia, medial femur, medial tibia, and patella) T1 , T2 , and T1ρ relaxation times of the knee were measured.

STATISTICAL TESTS

Kruskal-Wallis tests were used to compared cartilage T1 , T2 , and T1ρ relaxation times between different age groups, while Spearman correlation coefficients was used to determine the association between age and cartilage T1 , T2 , and T1ρ relaxation times. The value of P < 0.05 was considered statistically significant.

RESULTS

Higher age groups showed higher global and regional cartilage T1 , T2 , and T1ρ . There was a significant difference between age groups in global cartilage T2 and T1ρ but no significant difference (P = 0.13) in global cartilage T1. Significant difference was also present between age groups in cartilage T2 and T1ρ for medial femur cartilage and medial tibia cartilage. There were significant moderate correlations between age and T2 and T1ρ for global cartilage (R2  = 0.63-0.64), medial femur cartilage (R2  = 0.50-0.56), and medial tibia cartilage (R2  = 0.54-0.66).

CONCLUSION

Cartilage T2 and T1p relaxation times simultaneously measured using a 3D-MRF sequence in healthy volunteers showed age-dependent changes in knee cartilage, primarily within the medial compartment.

Study of iron metabolism based on T2* mapping sequences in PI-RADS 3 prostate lesions

Introduction

Prostate cancer is one of the most common malignant tumors in Chinese men, which is rich in iron metabolic activity and is closely related to all stages of prostate cancer progression. Since the current diagnostic methods are insufficient, we aimed to evaluate the value of quantitative T2 star values from the T2* mapping sequences in multiparametric magnetic resonance imaging (mpMRI) in the diagnosis and grading of PI-RADS 3 prostate cancer (PCa).

Methods

We prospectively enrolled patients with PCa or benign prostatic hyperplasia (BPH) admitted to our hospital from January 2021 to November 2022. Imaging indicators, including the T2* value and apparent diffusion coefficient (ADC) value, were collected, and enzyme-linked immunosorbent assays (ELISAs) were used to measure the levels of proteins involved in iron metabolism in the patients. ROC curves were drawn to explore whether the T2* value could be used for the diagnosis and grading of PCa.

Results

We found that three iron metabolism indexes, ferritin, hepcidin, and the ferric ion (Fe), and the T2* value were significantly different between the PCa group and BPH group and between the low International Society of Urology Pathology (ISUP) group (ISUP ≤ 2) and the high ISUP group (ISUP>2). Additionally, there was a significant correlation between the levels of these three indicators and the T2* value. Further ROC analysis showed that the levels of iron metabolism-related indexes and T2* values performed well in diagnosing and grading PCa.

Discussion

The T2* value has good value in detecting and predicting the grade of prostate cancer and can reflect the iron metabolism of the tumor, which could provide a foundation for the diagnosis and grading of PCa in the future.

Magnetic resonance fingerprinting based comprehensive quantification of T1 and T2 values of the background prostatic peripheral zone: Correlation with clinical and demographic features

PURPOSE

To quantify and assess the distribution of MR fingerprinting (MRF)-derived T1 and T2 values of the whole prostatic peripheral zone (PZ), and perform subgroup analyses according to clinical and demographic features.

METHOD

One hundred and twenty-four patients with prostate MR exams and MRF-based T1 and T2 maps of the prostatic apex, mid gland, and base were identified from our database and included. Regions of interest encompassing the right and left lobes of the PZ were drawn for each axial slice on the T2 map and copied to the T1 map. Clinical data were obtained from medical records. Kruskal-Wallis test was used for assessing differences between subgroups and the Spearman coefficient was used for assessing any correlations.

RESULTS

Mean T1 and T2 values were 1941 and 88 ms, respectively, for the whole-gland, 1884 and 83 ms for the apex, 1974 and 92 ms for the mid-gland, 1966 and 88 ms for the base. T1 values were weakly negatively correlated with PSA values, while T1 and T2 values were weakly positively correlated with prostate weight and moderately positively correlated with PZ width. Finally, patients with PI-RADS 1 scores had higher T1 and T2 values of the whole PZ, compared with those with scores 2-5.

CONCLUSION

Mean T1 and T2 values of the background PZ of the whole gland were 1941 ± 313 and 88 ± 39 ms, respectively. Among clinical and demographic factors, there was a significant positive correlation between T1 and T2 values and PZ width.

T1 Mapping of the Prostate using Single-Shot T1FLASH and MOLLI MRI Techniques: Comparison of Artifact Burden and Image Quality

PURPOSE

To assess artifact burden and image quality of different MRI T1 mapping techniques of the prostate.

METHODS

Participants with suspected prostate cancer (PCa) were prospectively enrolled from June-October 2022 and examined with multiparametric prostate MRI (mpMRI; 3 T scanner; T1wi, T2wi, DWI und DCE). T1 mapping was performed before and after administration of gadolinium-based contrast-agent (GBCA) using (i) a modified Look-Locker inversion (MOLLI) technique and (ii) a novel single-shot T1FLASH inversion recovery technique. T2wi, DWI, T1FLASH and MOLLI sequences were systematically examined regarding prevalence of artifacts and image quality using a 5-point Likert-Scale.

RESULTS

A total of n = 100 patients were included (median age: 68 years). T1FLASH maps (pre-and post-GBCA) showed metal artifacts in 7% of cases and susceptibility artifacts in 1%. For MOLLI maps, pre-GBCA metal and susceptibility artifacts were documented in 6.5% of cases each. MOLLI maps post-GBCA showed artifacts in 59% of cases resulting primarily from urinary GBCA excretion and GBCA accumulation at the bladder base (p < 0.01 versus T1FLASH post-GBCA). Image quality for T1FLASH pre-GBCA was rated at a mean 4.9+/-0.4 and for MOLLI at 4.8+/-0.6 (p = 0.14). Post-GBCA image quality was rated at a mean 4.9+/-0.4 for T1FLASH and at 3.7+/-1.1 for MOLLI (p < 0.001).

CONCLUSIONS

T1FLASH maps provide a fast and robust method for quantification of T1 relaxation times of the prostate. T1FLASH is suitable for T1 mapping of the prostate following administration of contrast agents, while MOLLI T1 mapping is impaired through GBCA accumulation at the bladder base leading to severe image artifacts and reduced image quality.

High-Resolution 3D Magnetic Resonance Fingerprinting With a Graph Convolutional Network

Magnetic resonance fingerprinting (MRF) is a novel quantitative imaging framework for rapid and simultaneous quantification of multiple tissue properties. 3D MRF allows higher through-plane resolution, but the acquisition process is slow when whole-brain coverage is needed. Existing methods for acceleration mainly rely on GRAPPA for k-space interpolation in the partition-encoding direction, limiting the acceleration factor to 2 or 3. In this work, we replace GRAPPA with a deep learning approach for accurate tissue quantification with greater acceleration. Specifically, a graph convolution network (GCN) is developed to cater to the non-Cartesian spiral sampling trajectories typical in MRF acquisition. The GCN maintains high quantification accuracy with up to 6-fold acceleration and allows 1mm isotropic resolution whole-brain 3D MRF data to be acquired in 3min and submillimeter 3D MRF (0.8mm) in 5min, greatly improving the feasibility of MRF in clinical settings.

Joint estimation of relaxation and diffusion tissue parameters for prostate cancer with relaxation-VERDICT MRI

This work presents a biophysical model of diffusion and relaxation MRI for prostate called relaxation vascular, extracellular and restricted diffusion for cytometry in tumours (rVERDICT). The model includes compartment-specific relaxation effects providing T1/T2 estimates and microstructural parameters unbiased by relaxation properties of the tissue. 44 men with suspected prostate cancer (PCa) underwent multiparametric MRI (mp-MRI) and VERDICT-MRI followed by targeted biopsy. We estimate joint diffusion and relaxation prostate tissue parameters with rVERDICT using deep neural networks for fast fitting. We tested the feasibility of rVERDICT estimates for Gleason grade discrimination and compared with classic VERDICT and the apparent diffusion coefficient (ADC) from mp-MRI. The rVERDICT intracellular volume fraction f_ic discriminated between Gleason 3 + 3 and 3 + 4 (p = 0.003) and Gleason 3 + 4 and ≥ 4 + 3 (p = 0.040), outperforming classic VERDICT and the ADC from mp-MRI. To evaluate the relaxation estimates we compare against independent multi-TE acquisitions, showing that the rVERDICT T2 values are not significantly different from those estimated with the independent multi-TE acquisition (p > 0.05). Also, rVERDICT parameters exhibited high repeatability when rescanning five patients (R² = 0.79-0.98; CV = 1-7%; ICC = 92-98%). The rVERDICT model allows for accurate, fast and repeatable estimation of diffusion and relaxation properties of PCa sensitive enough to discriminate Gleason grades 3 + 3, 3 + 4 and ≥ 4 + 3.

Novel 3D magnetic resonance fingerprinting radiomics in adult brain tumors: a feasibility study

OBJECTIVES

To test the feasibility of using 3D MRF maps with radiomics analysis and machine learning in the characterization of adult brain intra-axial neoplasms.

METHODS

3D MRF acquisition was performed on 78 patients with newly diagnosed brain tumors including 33 glioblastomas (grade IV), 6 grade III gliomas, 12 grade II gliomas, and 27 patients with brain metastases. Regions of enhancing tumor, non-enhancing tumor, and peritumoral edema were segmented and radiomics analysis with gray-level co-occurrence matrices and gray-level run-length matrices was performed. Statistical analysis was performed to identify features capable of differentiating tumors based on type, grade, and isocitrate dehydrogenase (IDH1) status. Receiver operating curve analysis was performed and the area under the curve (AUC) was calculated for tumor classification and grading. For gliomas, Kaplan-Meier analysis for overall survival was performed using MRF T1 features from enhancing tumor region.

RESULTS

Multiple MRF T1 and T2 features from enhancing tumor region were capable of differentiating glioblastomas from brain metastases. Although no differences were identified between grade 2 and grade 3 gliomas, differentiation between grade 2 and grade 4 gliomas as well as between grade 3 and grade 4 gliomas was achieved. MRF radiomics features were also able to differentiate IDH1 mutant from the wild-type gliomas. Radiomics T1 features for enhancing tumor region in gliomas correlated to overall survival (p < 0.05).

CONCLUSION

Radiomics analysis of 3D MRF maps allows differentiating glioblastomas from metastases and is capable of differentiating glioblastomas from metastases and characterizing gliomas based on grade, IDH1 status, and survival.

KEY POINTS

• 3D MRF data analysis using radiomics offers novel tissue characterization of brain tumors. • 3D MRF with radiomics offers glioma characterization based on grade, IDH1 status, and overall patient survival.

3D magnetic resonance fingerprinting for rapid simultaneous T1, T2, and T1ρ volumetric mapping of human articular cartilage at 3 T

Quantitative MRI can detect early biochemical changes in cartilage; however, the conventional techniques only measure one parameter (e.g., T1 , T2 , and T1ρ ) at a time while also being comparatively slow. We implemented a 3D magnetic resonance fingerprinting (3D-MRF) technique for simultaneous, volumetric mapping of T1 , T2 , and T1ρ in knee articular cartilage in under 9 min. It is evaluated on 11 healthy volunteers (mean age: 53 ± 9 years), five mild knee osteoarthritis (OA) patients (Kellgren-Lawrence (KL) score: 2, mean age: 60 ± 4 years), and the National Institute of Standards and Technology (NIST)/International Society for Magnetic Resonance in Medicine (ISMRM) system phantom. Proton density image, and T1 , T2, T1ρ relaxation times, and B1 + were estimated in the NIST/ISMRM system phantom as well as in the human knee medial and lateral femur, medial and lateral tibia, and patellar cartilage. The repeatability and reproducibility of the proposed technique were assessed in the phantom using analysis of the Bland-Altman plots. The intrasubject repeatability was assessed with the coefficient of variation (CV) and root mean square CV (rmsCV). The Mann-Whitney U test was used to assess the difference between healthy subjects and mild knee OA patients. The Bland-Altman plots in the NIST/ISMRM phantom demonstrated an average difference of 0.001% ± 015%, 1.2% ± 7.1%, and 0.47% ± 3% between two scans from the same 3-T scanner (repeatability), and 0.002% ± 015%, 0.62% ± 10.5%, and 0.97% ± 14% between the scans acquired on two different 3-T scanners (reproducibility) for T1 , T2 , and T1ρ , respectively. The in vivo knee study showed excellent repeatability with rmsCV less than 1%, 2%, and 1% for T1 , T2 , and T1ρ , respectively. T1ρ relaxation time in the mild knee OA patients was significantly higher (p < 0.05) than in healthy subjects. The proposed 3D-MRF sequence is fast, reproducible, robust to B1 + inhomogeneity, and can simultaneously measure the T1 , T2 , T1ρ , and B1 + volumetric maps of the knee joint in a single scan within a clinically feasible scan time.

Cardiac MR fingerprinting with a short acquisition window in consecutive patients referred for clinical CMR and healthy volunteers

Cardiac Magnetic Resonance Fingerprinting (cMRF) has been demonstrated to enable robust and accurate T₁ and T₂ mapping for the detection of myocardial fibrosis and edema. However, the relatively long acquisition window (250 ms) used in previous cMRF studies might leave it vulnerable to motion artifacts in patients with high heart rates. The goal of this study was therefore to compare cMRF with a short acquisition window (154 ms) and low-rank reconstruction to routine cardiac T₁ and T₂ mapping at 1.5 T. Phantom studies showed that the proposed cMRF had a high T₁ and T₂ accuracy over a wider range than routine mapping techniques. In 9 healthy volunteers, the proposed cMRF showed small but significant myocardial T₁ and T₂ differences compared to routine mapping (ΔT₁ = 1.5%, P = 0.031 and ΔT₂ = - 7.1%, P < 0.001). In 61 consecutive patients referred for CMR, the native T₁ values were slightly lower (ΔT₁ = 1.6%; P = 0.02), while T₂ values did not show statistical difference (ΔT₂ = 4.3%; P = 0.11). However, the difference was higher in post-contrast myocardial T₁ values (ΔT₁ = 12.3%; P < 0.001), which was reflected in the extracellular volume (ΔECV = 2.4%; P < 0.001). Across all subjects, the proposed cMRF had a lower precision when compared to routine techniques, although its higher spatial resolution enabled the visualization of smaller details.

MR Fingerprinting with b-Tensor Encoding for Simultaneous Quantification of Relaxation and Diffusion in a Single Scan

PURPOSE

Although both relaxation and diffusion imaging are sensitive to tissue microstructure, studies have reported limited sensitivity and robustness of using relaxation or conventional diffusion alone to characterize tissue microstructure. Recently, it has been shown that tensor-valued diffusion encoding and joint relaxation-diffusion quantification enable more reliable quantification of compartment-specific microstructural properties. However, scan times to acquire such data can be prohibitive. Here, we aim to simultaneously quantify relaxation and diffusion using MR fingerprinting (MRF) and b-tensor encoding in a clinically feasible time.

METHODS

We developed multidimensional MRF scans (mdMRF) with linear and spherical b-tensor encoding (LTE and STE) to simultaneously quantify T1, T2, and ADC maps from a single scan. The image quality, accuracy, and scan efficiency were compared between the mdMRF using LTE and STE. Moreover, we investigated the robustness of different sequence designs to signal errors and their impact on the maps.

RESULTS

T1 and T2 maps derived from the mdMRF scans have consistently high image quality, while ADC maps are sensitive to different sequence designs. Notably, the fast imaging steady state precession (FISP)-based mdMRF scan with peripheral pulse gating provides the best ADC maps that are free of image distortion and shading artifacts.

CONCLUSION

We demonstrated the feasibility of quantifying T1, T2, and ADC maps simultaneously from a single mdMRF scan in around 24 s/slice. The map quality and quantitative values are consistent with the reference scans.

Multicenter Repeatability and Reproducibility of MR Fingerprinting in Phantoms and in Prostatic Tissue

PURPOSE

To evaluate multicenter repeatability and reproducibility of T1 and T2 maps generated using MR fingerprinting (MRF) in the International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology MRI system phantom and in prostatic tissues.

METHODS

MRF experiments were performed on 5 different 3 Tesla MRI scanners at 3 different institutions: University Hospitals Cleveland Medical Center (Cleveland, OH), Brigham and Women's Hospital (Boston, MA) in the United States, and Diagnosticos da America (Rio de Janeiro, RJ) in Brazil. Raw MRF data were reconstructed using a Gadgetron-based MRF online reconstruction pipeline to yield quantitative T1 and T2 maps. The repeatability of T1 and T2 values over 6 measurements in the International Society for Magnetic Resonance in Medicine/National Institute of Standards and Technology MRI system phantom was assessed to demonstrate intrascanner variation. The reproducibility between the 4 clinical scanners was assessed to demonstrate interscanner variation. The same-day test-retest normal prostate mean T1 and T2 values from peripheral zone and transitional zone were also compared using the intraclass correlation coefficient and Bland-Altman analysis.

RESULTS

The intrascanner variation of values measured using MRF was less than 2% for T1 and 4.7% for T2 for relaxation values, within the range of 307.7 to 2360 ms for T1 and 19.1 to 248.5 ms for T2 . Interscanner measurements showed that the T1 variation was less than 4.9%, and T2 variation was less than 8.1% between multicenter scanners. Both T1 and T2 values in in vivo prostatic tissue demonstrated high test-retest reliability (intraclass correlation coefficient > 0.92) and strong linear correlation (R2  > 0.840).

CONCLUSION

Prostate MRF measurements of T1 and T2 are repeatable and reproducible between MRI scanners at different centers on different continents for the above measurement ranges.

Improving the understanding and performance of clinical MRI using tissue property filters and the central contrast theorem, MASDIR pulse sequences and synergistic contrast MRI

This paper updates and extends three previous papers on tissue property filters (TP-filters), Multiplied, Added, Divided and/or Subtracted Inversion Recovery (MASTIR) pulse sequences and synergistic contrast MRI (scMRI). It does this by firstly adding the central contrast theorem (CCT) to TP-filters, secondly including division with MASTIR sequences to make them Multiplied, Added, Subtracted and/or Divided IR (MASDIR) sequences, and thirdly incorporating division into the image processing needed for scMR to increase synergistic T₁ contrast. These updated concepts are then used to explain and improve contrast at tissue boundaries, as well as to develop imaging regimes to detect and monitor small changes to the brain over time and quantify T₁. The CCT is in two parts: the first part states that contrast produced by each TP is the product of the change in TP multiplied by the TP sequence weighting which is the first partial derivative of the TP-filter. The second part states that the overall fractional contrast is the algebraic sum of the fractional contrasts produced by each of the TPs. Subtraction of two IR sequences alone about doubles contrast relative to a conventional single IR sequence. Division of this subtraction can amplify contrast 5-15 times compared with conventional IR sequences. Dividing sequences can be problematic in areas where the signal is zero but this is avoided by dividing the difference in signal of two magnitude reconstructed IR sequences by the sum of their signals. The basis for the production of high contrast, high spatial resolution boundaries at white-gray matter junctions, between cerebral cortex and cerebrospinal fluid (CSF) and at other sites with subtracted IR (SIR) and divided subtracted IR (dSIR) sequences is explained and examples are shown. A key concept is the tissue fraction f, which is the proportion of a tissue in a mixture of two tissues within a voxel. Contrast at boundaries is a function of the partial derivative of the TP-filter, the partial derivative of the relevant TP with respect to f, and the partial derivative of f with respect to distance, x. Location of tissue boundaries is important for segmentation and is helpful in determining if inversion times have been chosen correctly. In small change regimes, the high sensitivity to small changes in T₁ provided by dSIR images, together with the high definition boundaries, afford mechanisms for detecting small changes due to contrast agents, disease, perfusion and other causes. 3D isotropic rigid body registration provides a technique for following these changes over time in serial studies. Images showing high lesion contrast, high definition tissue and fluid boundaries, and the detection of small changes are included. T1 maps can be created by linearly scaling dSIR images.

Emerging MR methods for improved diagnosis of prostate cancer by multiparametric MRI

Current challenges of using serum prostate-specific antigen (PSA) level-based screening, such as the increased false positive rate, inability to detect clinically significant prostate cancer (PCa) with random biopsy, multifocality in PCa, and the molecular heterogeneity of PCa, can be addressed by integrating advanced multiparametric MR imaging (mpMRI) approaches into the diagnostic workup of PCa. The standard method for diagnosing PCa is a transrectal ultrasonography (TRUS)-guided systematic prostate biopsy, but it suffers from sampling errors and frequently fails to detect clinically significant PCa. mpMRI not only increases the detection of clinically significant PCa, but it also helps to reduce unnecessary biopsies because of its high negative predictive value. Furthermore, non-Cartesian image acquisition and compressed sensing have resulted in faster MR acquisition with improved signal-to-noise ratio, which can be used in quantitative MRI methods such as dynamic contrast-enhanced (DCE)-MRI. With the growing emphasis on the role of pre-biopsy mpMRI in the evaluation of PCa, there is an increased demand for innovative MRI methods that can improve PCa grading, detect clinically significant PCa, and biopsy guidance. To meet these demands, in addition to routine T1-weighted, T2-weighted, DCE-MRI, diffusion MRI, and MR spectroscopy, several new MR methods such as restriction spectrum imaging, vascular, extracellular, and restricted diffusion for cytometry in tumors (VERDICT) method, hybrid multi-dimensional MRI, luminal water imaging, and MR fingerprinting have been developed for a better characterization of the disease. Further, with the increasing interest in combining MR data with clinical and genomic data, there is a growing interest in utilizing radiomics and radiogenomics approaches. These big data can also be utilized in the development of computer-aided diagnostic tools, including automatic segmentation and the detection of clinically significant PCa using machine learning methods.

Pseudo-T2 mapping for normalization of T2-weighted prostate MRI

Objective

Signal intensity normalization is necessary to reduce heterogeneity in T2-weighted (T2W) magnetic resonance imaging (MRI) for quantitative analysis of multicenter data. AutoRef is an automated dual-reference tissue normalization method that normalizes transversal prostate T2W MRI by creating a pseudo-T2 map. The aim of this study was to evaluate the accuracy of pseudo-T2s and multicenter standardization performance for AutoRef with three pairs of reference tissues: fat/muscle (AutoRef_F), femoral head/muscle (AutoRef_FH) and pelvic bone/muscle (AutoRef_PB).

Materials and methods

T2s measured by multi-echo spin echo (MESE) were compared to AutoRef pseudo-T2s in the whole prostate (WP) and zones (PZ and TZ/CZ/AFS) for seven asymptomatic volunteers with a paired Wilcoxon signed-rank test. AutoRef normalization was assessed on T2W images from a multicenter evaluation set of 1186 prostate cancer patients. Performance was measured by inter-patient histogram intersections of voxel intensities in the WP before and after normalization in a selected subset of 80 cases.

Results

AutoRef_FH pseudo-T2s best approached MESE T2s in the volunteer study, with no significant difference shown (WP: p = 0.30, TZ/CZ/AFS: p = 0.22, PZ: p = 0.69). All three AutoRef versions increased inter-patient histogram intersections in the multicenter dataset, with median histogram intersections of 0.505 (original data), 0.738 (AutoRef_FH), 0.739 (AutoRef_F) and 0.726 (AutoRef_PB).

Discussion

All AutoRef versions reduced variation in the multicenter data. AutoRef_FH pseudo-T2s were closest to experimentally measured T2s.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10334-022-01003-9.

MR fingerprinting of the prostate

Multiparametric magnetic resonance imaging (mpMRI) has been adopted as the key tool for detection, localization, characterization, and risk stratification of patients suspected to have prostate cancer. Despite advantages over systematic biopsy, the interpretation of prostate mpMRI has limitations including a steep learning curve, leading to considerable interobserver variation. There is growing interest in clinical translation of quantitative imaging techniques for more objective lesion assessment. However, traditional mapping techniques are slow, precluding their use in the clinic. Magnetic resonance fingerprinting (MRF) is an efficient approach for quantitative maps of multiple tissue properties simultaneously. The T₁ and T₂ values obtained with MRF have been validated with phantom studies as well as in normal volunteers and patients. Studies have shown that MRF-derived T₁ and T₂ along with ADC values are all significant independent predictors in the differentiation between normal prostate tissue and prostate cancer, and hold promise in differentiating low and intermediate/high-grade cancers. This review seeks to introduce the basics of the prostate MRF technique, discuss the potential applications of prostate MRF for the characterization of prostate cancer, and describes ongoing areas of research.

Simultaneous bilateral T1 , T2 , and T1ρ relaxation mapping of the hip joint with magnetic resonance fingerprinting

Quantitative MRI can detect early biochemical changes in cartilage, but its bilateral use in clinical routines is challenging. The aim of this prospective study was to demonstrate the feasibility of magnetic resonance fingerprinting for bilateral simultaneous T₁ , T₂ , and T_1ρ mapping of the hip joint. The study population consisted of six healthy volunteers with no known trauma or pain in the hip. Monoexponential T₁ , T₂ , and T_1ρ relaxation components were assessed in femoral lateral, superolateral, and superomedial, and inferior, as well as acetabular, superolateral, and superomedial subregions in left and right hip cartilage. Aligned ranked nonparametric factorial analysis was used to assess the side's impact on the subregions. Kruskal-Wallis and Wilcoxon tests were used to compare subregions, and coefficient of variation to assess repeatability. Global averages of T₁ (676.0 ± 45.4 and 687.6 ± 44.5 ms), T₂ (22.5 ± 2.6 and 22.1 ± 2.5 ms), and T_1ρ (38.2 ± 5.5 and 38.2 ± 5.5 ms) were measured in the left and right hip, and articular cartilage, respectively. The Kruskal-Wallis test showed a significant difference between different subregions' relaxation times regardless of the hip side (p < 0.001 for T₁ , p = 0.012 for T₂ , and p < 0.001 for T_1ρ ). The Wilcoxon test showed that T₁ of femoral layers was significantly (p < 0.003) higher than that for acetabular cartilage. The experiments showed excellent repeatability with CV_rms of 1%, 2%, and 4% for T₁ , T₂ , and T_1ρ, respectively. It was concluded that bilateral T₁ , T₂ , and T_1ρ relaxation times, as well as B₁⁺ maps, can be acquired simultaneously from hip joints using the proposed MRF sequence.

Low‐rank inversion reconstruction for through‐plane accelerated radial MR fingerprinting applied to relaxometry at 0. 35 T

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.

Magnetic resonance fingerprinting in prostate cancer before and after contrast enhancement

OBJECTIVES

To assess the apparent diffusion coefficient (ADC) values and the T1 and T2 values derived from nonenhanced (NE) and contrast-enhanced (CE) magnetic resonance fingerprinting (MRF) in the prostate gland and to evaluate differences in values among prostate cancer, the normal peripheral zone (PZ) and the normal transition zone (TZ).

METHODS

Fifty-seven patients (median age, 73 years; range, 48-86) with prostate cancer who underwent multiparametric MRI including NE and CE MRF were included in this study. T1 and T2 values were extracted from NE and CE MRF, respectively. Five quantitative values (the ADC, NE T1, NE T2, CE T1 and CE T2 values) were measured in three areas: prostate cancer, PZ and TZ. We compared the values among the three areas and evaluated the differences between NE MRF and CE MRF values.

RESULTS

ADC values and MRF-derived values were significantly higher in PZ than prostate cancer or TZ (p < 0.001). TZ had a significantly lower CE T1 but significantly higher values of the other variables than prostate cancer (p < 0.001). The T1 values in all three areas and the T2 values in prostate cancer and TZ were significantly lower on CE MRF than on NE MRF (p < 0.001).

CONCLUSIONS

Quantitative analysis of NE and CE MRI can be conducted by using the MRF technique. The ADC value and the T1 and T2 values from CE MRF and NE MRF were found to be significantly different between prostate cancer and normal prostate tissue.

ADVANCES IN KNOWLEDGE

The T1 and T2 values from contrast-enhanced MR fingerprinting are significantly different between prostate cancer and normal prostate tissue.

Mapping the Human Connectome using Diffusion MRI at 300 mT/m Gradient Strength: Methodological Advances and Scientific Impact

Tremendous efforts have been made in the last decade to advance cutting-edge MRI technology in pursuit of mapping structural connectivity in the living human brain with unprecedented sensitivity and speed. The first Connectom 3T MRI scanner equipped with a 300 mT/m whole-body gradient system was installed at the Massachusetts General Hospital in 2011 and was specifically constructed as part of the Human Connectome Project. Since that time, numerous technological advances have been made to enable the broader use of the Connectom high gradient system for diffusion tractography and tissue microstructure studies and leverage its unique advantages and sensitivity to resolving macroscopic and microscopic structural information in neural tissue for clinical and neuroscientific studies. The goal of this review article is to summarize the technical developments that have emerged in the last decade to support and promote large-scale and scientific studies of the human brain using the Connectom scanner. We provide a brief historical perspective on the development of Connectom gradient technology and the efforts that led to the installation of three other Connectom 3T MRI scanners worldwide - one in the United Kingdom in Cardiff, Wales, another in Continental Europe in Leipzig, Germany, and the latest in Asia in Shanghai, China. We summarize the key developments in gradient hardware and image acquisition technology that have formed the backbone of Connectom-related research efforts, including the rich array of high-sensitivity receiver coils, pulse sequences, image artifact correction strategies and data preprocessing methods needed to optimize the quality of high-gradient strength dMRI data for subsequent analyses. Finally, we review the scientific impact of the Connectom MRI scanner, including advances in diffusion tractography, tissue microstructural imaging, ex vivo validation, and clinical investigations that have been enabled by Connectom technology. We conclude with brief insights into the unique value of strong gradients for dMRI and where the field is headed in the coming years.

MR Imaging in Real Time Guiding of Therapies in Prostate Cancer

Magnetic resonance imaging (MRI)-guided therapy for prostate cancer (PCa) aims to reduce the treatment-associated comorbidity of existing radical treatment, including radical prostatectomy and radiotherapy. Although active surveillance has been used as a conservative method to reduce overtreatment, there is a growing demand for less morbidity and personalized (focal) treatment. The development of multiparametric MRI was of real importance in improving the detection, localization and staging of PCa. Moreover, MRI has been useful for lesion targeting within the prostate, as it is used in the guidance of prostate biopsies, by means of cognitive registration, MRI-ultrasound fusion guidance or direct in-bore MRI-guidance. With regard to PCa therapies, MRI is used for precise probe placement into the lesion and to accurately monitor the treatment in real-time. Moreover, advances in MR-compatible thermal ablation allow for noninvasive real-time temperature mapping during treatment. In this review, we present an overview of the current status of MRI-guided therapies in PCa, focusing on cryoablation, focal laser ablation, high intensity focused ultrasound and transurethral ultrasound ablation. We explain the important role of MRI in the evaluation of the completeness of the ablation and during follow-up. Finally, we will discuss the challenges and future development inherent to these new technologies.

Rapid In Vivo Quantification of Creatine Kinase Activity by Phosphorous-31 Magnetic Resonance Spectroscopic Fingerprinting (31P-MRSF)

Creatine kinase (CK) plays an important role in tissue metabolism by providing a buffering mechanism for maintaining a constant supply of adenosine triphosphate (ATP) during metabolic perturbations. Phosphorous-31 magnetic resonance spectroscopy (31P-MRS) employing magnetization transfer techniques is the only noninvasive method for measuring the rate of ATP synthesis via creatine kinase. However, due to the low concentrations of phosphate metabolites, current 31P-MRS methods require long acquisition time to achieve adequate measurement accuracy. In this chapter, we present a new framework of data acquisition and parameter estimation, the 31P magnetic resonance spectroscopic fingerprinting (31P-MRSF) method, for rapid quantification of CK reaction rate constant in the hindlimb of small laboratory animals.

Combined diffusion-relaxometry microstructure imaging: Current status and future prospects

Microstructure imaging seeks to noninvasively measure and map microscopic tissue features by pairing mathematical modeling with tailored MRI protocols. This article reviews an emerging paradigm that has the potential to provide a more detailed assessment of tissue microstructure-combined diffusion-relaxometry imaging. Combined diffusion-relaxometry acquisitions vary multiple MR contrast encodings-such as b-value, gradient direction, inversion time, and echo time-in a multidimensional acquisition space. When paired with suitable analysis techniques, this enables quantification of correlations and coupling between multiple MR parameters-such as diffusivity, T 1 , T 2 , and T 2 ∗ . This opens the possibility of disentangling multiple tissue compartments (within voxels) that are indistinguishable with single-contrast scans, enabling a new generation of microstructural maps with improved biological sensitivity and specificity.

1.5 vs 3 Tesla Magnetic Resonance Imaging: A Review of Favorite Clinical Applications for Both Field Strengths-Part 1

ABSTRACT

Whole-body magnetic resonance imaging (MRI) systems with a field strength of 3 T have been offered by all leading manufacturers for approximately 2 decades and are increasingly used in clinical diagnostics despite higher costs. Technologically, MRI systems operating at 3 T have reached a high standard in recent years, as well as the 1.5-T devices that have been in use for a longer time. For modern MRI systems with 3 T, more complexity is required, especially for the magnet and the radiofrequency (RF) system (with multichannel transmission). Many clinical applications benefit greatly from the higher field strength due to the higher signal yield (eg, imaging of the brain or extremities), but there are also applications where the disadvantages of 3 T might outweigh the advantages (eg, lung imaging or examinations in the presence of implants). This review describes some technical features of modern 1.5-T and 3-T whole-body MRI systems, and reports on the experience of using both types of devices in different clinical settings, with all sections written by specialist radiologists in the respective fields.This first part of the review includes an overview of the general physicotechnical aspects of both field strengths and elaborates the special conditions of diffusion imaging. Many relevant aspects in the application areas of musculoskeletal imaging, abdominal imaging, and prostate diagnostics are discussed.

Magnetic Resonance Fingerprinting of the Pediatric Brain

Magnetic resonance fingerprinting (MRF) is increasingly being used to evaluate brain development and differentiate normal and pathologic tissues in children. MRF can provide reliable and accurate intrinsic tissue properties, such as T1 and T2 relaxation times. MRF is a powerful tool in evaluating brain disease in pediatric population. MRF is a new quantitative MR imaging technique for rapid and simultaneous quantification of multiple tissue properties.

3D MR fingerprinting (MRF) for simultaneous T1 and T2 quantification of the bone metastasis: Initial validation in prostate cancer patients

PURPOSE

To investigate the feasibility of using 3-dimensional MRF for bone marrow evaluation in the field of view of prostate MRI for T1 and T2 quantification of prostate cancer bone metastases, as well as comparing it to the ADC value.

METHODS

In this retrospective study, 30 prostate MRIs were included: 14 cases with prostate cancer bone metastasis and 16 cases without prostate cancer (control). MRF was obtained twice before (nonenhanced [NE] MRF) and after contrast injection (contrast-enhanced [CE] MRF), and T1 and T2 maps were generated from each MRF. Two radiologists independently drew regions of interest (ROIs) on the MRF maps and the ADC maps. Mann-Whitney U tests and the area under the receiver operating characteristic curve (AUROC) evaluated the two-reader means of T1, T2 and ADC values between bone metastasis and normal bone.

RESULTS

There were 83 ROIs, including 39 bone metastases and 44 normal bone. The two-reader average ADC, NE T2 and CE T2 values were significantly lower and NE T1 and CE T1 values were significantly higher in metastatic bone compared with normal bone (P < 0.001). The AUROC of the ADC was lowest (0.685), which was significantly lower than those of NE T1 (1.0, P = 0.001), NE T2 (0.932, P = 0.004), and CE T2 (0.876, P = 0.031).

CONCLUSION

MRF to assess the pelvic bone during a prostate gland evaluation provides a reliable parametric map for skeletal work-up. With higher diagnostic performance than the ADC value, NE MRF is a potential alternative for quantifying bone marrow metastases in prostate cancer patients.

Technical overview of magnetic resonance fingerprinting and its applications in radiation therapy

Magnetic resonance fingerprinting (MRF) is an emerging imaging technique for rapid and simultaneous quantification of multiple tissue properties. The technique has been developed for quantitative imaging of different organs. The obtained quantitative measures have the potential to improve multiple steps of a typical radiotherapy workflow and potentially further improve integration of magnetic resonance imaging guided clinical decision making. In this review paper, we first provide a technical overview of the MRF method from data acquisition to postprocessing, along with recent development in advanced reconstruction methods. We further discuss critical aspects that could influence its usage in radiation therapy, such as accuracy and precision, repeatability and reproducibility, geometric distortion, and motion robustness. Finally, future directions for MRF application in radiation therapy are discussed.

Automated design of pulse sequences for magnetic resonance fingerprinting using physics-inspired optimization

Magnetic resonance fingerprinting (MRF) is a method to extract quantitative tissue properties such as [Formula: see text] and [Formula: see text] relaxation rates from arbitrary pulse sequences using conventional MRI hardware. MRF pulse sequences have thousands of tunable parameters, which can be chosen to maximize precision and minimize scan time. Here, we perform de novo automated design of MRF pulse sequences by applying physics-inspired optimization heuristics. Our experimental data suggest that systematic errors dominate over random errors in MRF scans under clinically relevant conditions of high undersampling. Thus, in contrast to prior optimization efforts, which focused on statistical error models, we use a cost function based on explicit first-principles simulation of systematic errors arising from Fourier undersampling and phase variation. The resulting pulse sequences display features qualitatively different from previously used MRF pulse sequences and achieve fourfold shorter scan time than prior human-designed sequences of equivalent precision in [Formula: see text] and [Formula: see text] Furthermore, the optimization algorithm has discovered the existence of MRF pulse sequences with intrinsic robustness against shading artifacts due to phase variation.

Current Applications and Future Development of Magnetic Resonance Fingerprinting in Diagnosis, Characterization, and Response Monitoring in Cancer

Magnetic resonance imaging (MRI) has enabled non-invasive cancer diagnosis, monitoring, and management in common clinical settings. However, inadequate quantitative analyses in MRI continue to limit its full potential and these often have an impact on clinicians' judgments. Magnetic resonance fingerprinting (MRF) has recently been introduced to acquire multiple quantitative parameters simultaneously in a reasonable timeframe. Initial retrospective studies have demonstrated the feasibility of using MRF for various cancer characterizations. Further trials with larger cohorts are still needed to explore the repeatability and reproducibility of the data acquired by MRF. At the moment, technical difficulties such as undesirable processing time or lack of motion robustness are limiting further implementations of MRF in clinical oncology. This review summarises the latest findings and technology developments for the use of MRF in cancer management and suggests possible future implications of MRF in characterizing tumour heterogeneity and response assessment.

Toward magnetic resonance fingerprinting for low-field MR-guided radiation therapy

PURPOSE

The acquisition of multiparametric quantitative magnetic resonance imaging (qMRI) is becoming increasingly important for functional characterization of cancer prior to- and throughout the course of radiation therapy. The feasibility of a qMRI method known as magnetic resonance fingerprinting (MRF) for rapid T₁ and T₂ mapping was assessed on a low-field MR-linac system.

METHODS

A three-dimensional MRF sequence was implemented on a 0.35T MR-guided radiotherapy system. MRF-derived measurements of T₁ and T₂ were compared to those obtained with gold standard single spin echo methods, and the impacts of the radiofrequency field homogeneity and scan times ranging between 6 and 48 min were analyzed by acquiring between 1 and 8 spokes per time point in a standard quantitative system phantom. The short-term repeatability of MRF was assessed over three measurements taken over a 10-h period. To evaluate transferability, MRF measurements were acquired on two additional MR-guided radiotherapy systems. Preliminary human volunteer studies were performed.

RESULTS

The phantom benchmarking studies showed that MRF is capable of mapping T₁ and T₂ values within 8% and 10% of gold standard measures, respectively, at 0.35T. The coefficient of variation of T₁ and T₂ estimates over three repeated scans was < 5% over a broad range of relaxation times. The T₁ and T₂ times derived using a single-spoke MRF acquisition across three scanners were near unity and mean percent errors in T₁ and T₂ estimates using the same phantom were < 3%. The mean percent differences in T₁ and T₂ as a result of truncating the scan time to 6 min over the large range of relaxation times in the system phantom were 0.65% and 4.05%, respectively.

CONCLUSIONS

The technical feasibility and accuracy of MRF on a low-field MR-guided radiation therapy device has been demonstrated. MRF can be used to measure accurate T₁ and T₂ maps in three dimensions from a brief 6-min scan, offering strong potential for efficient and reproducible qMRI for future clinical trials in functional plan adaptation and tumor/normal tissue response assessment.

Repeatability of MR fingerprinting in normal cervix and utility in cervical carcinoma

Background

Magnetic resonance fingerprinting (MRF) is a fast-imaging acquisition technique that generates quantitative and co-registered parametric maps. The aim of this feasibility study was to evaluate the agreement between MRF and phantom reference values, scan-rescan repeatability of MRF in normal cervix, and its ability to distinguish cervical carcinoma (CC) from normal cervical tissues.

Methods

An International Society of Magnetic Resonance in Medicine/National Institute of Standards and Technology (ISMRM/NIST) phantom was scanned using MRF 15 times over 65 days. Agreement between MRF and phantom reference T1 and T2 values was assessed by linear regression. Healthy volunteers and patients with suspected CC were prospectively recruited. MRF was repeated twice for healthy volunteers (MRF1 and MRF2). Volumes of interest of normal cervical tissues and CC were delineated on T1 and T2 maps. MRF scan-rescan repeatability was evaluated by Bland-Altman plots, within-subject coefficients of variation (wCV), and intraclass correlation coefficients (ICC). T1 and T2 values were compared between CC and normal cervical tissues using Mann-Whitney U test. Receiver operating characteristic (ROC) analysis was performed to evaluate diagnostic efficiency.

Results

Strong correlations were observed between MRF and phantom (R²=0.999 for T1, 0.981 for T2). Twelve healthy volunteers (28.7±5.1 years) and 28 patients with CC (54.6±15.2 years) were recruited for the in-vivo experiments. Repeatability of MRF parameters were wCV <3% for T1, <5% for T2 and ICC ≥0.92 for T1, ≥0.94 for T2. T1 value of CC (1,529±112 ms) was higher than normal mucosa [MRF1: 1,430±129 ms, MRF2: 1,440±130 ms; P=0.031, area under the curve (AUC) ≥0.717] and normal stroma (MRF1: 1,258±101 ms, MRF2: 1,276±105 ms; P<0.001, AUC ≥0.946). T2 value of CC (69±9 ms) was lower than normal mucosa (MRF1: 88±16 ms, MRF2: 87±13 ms; P<0.001, AUC ≥0.854), but was not different from normal stroma (P=0.919).

Conclusions

Excellent agreement was observed between MRF and phantom reference values. MRF exhibited excellent scan-rescan repeatability in normal cervix with potential value in differentiating CC from normal cervical tissues.

A multi-inversion-recovery magnetic resonance fingerprinting for multi-compartment water mapping

PURPOSE

This study aimed at introducing short-T1/T2 compartment to MR fingerprinting (MRF) at 3 T. Water that is bound to myelin macromolecules have significantly shorter T1 and T2 than free water and can be distinguished from free water by multi-compartment analysis.

METHODS

We developed a new multi-inversion-recovery (mIR) water mapping-MRF based on an unbalanced steady-state coherent sequence (FISP). mIR pulses with an interval of 400 or 500 repetition times (TRs) were inserted into the conventional FISP MRF sequence. Data from our proposed mIR MRF was used to quantify different compartments, including myelin water, gray matter free water, and white matter free water, of brain water by virtue of the iterative non-negative least square (NNLS) with reweighting. Three healthy volunteers were scanned with mIR MRF on a clinical 3 T MRI.

RESULTS

Using an extended phase graph simulation, we found that our proposed mIR scheme with four IR pulses allowed differentiation between short and long T1/T2 components. For in vivo experiments, we achieved the quantification of myelin water, gray matter water, and white matter water at an image resolution of 1.17 × 1.17 × 5 mm³/pixel. As compared to the conventional MRF technique with single IR, our proposed mIR improved the detection of myelin water content. In addition, mIR MRF using spiral-in/out trajectory provided a higher signal level compared with that with spiral-out trajectory. Myelin water quantification using mIR MRF with 4 IR and 5 IR pulses were qualitatively similar. Meanwhile, 5 IR MRF showed fewer artifacts in myelin water detection.

CONCLUSION

We developed a new mIR MRF sequence for the rapid quantification of brain water compartments.

Test-retest assessment of non-contrast MRI sequences to characterise and quantify the small bowel wall in healthy participants

Objective

Quantitative Magnetic Resonance Imaging sequences have been investigated as objective imaging biomarkers of fibrosis and inflammation in Crohn’s disease.

Aim

To determine the repeatability and inter- and intra-observer agreement of these measures in the prepared small bowel wall.

Methods

Ten healthy participants were scanned at 3 T on 2 separate occasions using T1 and T2 relaxometry, IVIM-DWI and MT sequences. Test–retest repeatability was assessed using the coefficient of variation (CoV) and intra-class correlation coefficients (ICCs) were used to evaluate the intra- and inter-observer agreement

Results

Test–retest repeatability in the bowel wall was excellent for apparent diffusion coefficient (ADC), magnetisation transfer ratio (MTR), T1, and diffusion coefficient D (CoV 5%, 7%, 8%, and 10%, respectively), good for perfusion fraction (PF) (CoV 20%) and acceptable for T2 (CoV 21%). Inter-observer agreement was good for the T2, D and ADC (ICC = 0.89, 0.86, 0.76, respectively) and moderate for T1 (ICC = 0.55). Intra-observer agreement was similar to inter-observer agreement.

Discussion

This study showed variable results between the different parameters measured. Test–retest repeatability was at least acceptable for all parameters except pseudo-diffusion coefficient D*. Good inter- and intra-observer agreement was obtained for T2, ADC and D, with these parameters performing best in this technical validation study.

Magnetic resonance fingerprinting: an overview

Magnetic resonance fingerprinting (MRF) is an evolving quantitative MRI framework consisting of unique data acquisition, processing, visualization, and interpretation steps. MRF is capable of simultaneously producing multiple high-resolution property maps including T1, T2, M0, ADC, and T2* measurements. While a relatively new technology, MRF has undergone rapid development for a variety of clinical applications from brain tumor characterization and epilepsy imaging to characterization of prostate cancer, cardiac imaging, among others. This paper will provide a brief overview of current state of MRF technology including highlights of technical and clinical advances. We will conclude with a brief discussion of the challenges that need to be overcome to establish MRF as a quantitative imaging biomarker.

Feasibility of Novel Three-Dimensional Magnetic Resonance Fingerprinting of the Prostate Gland: Phantom and Clinical Studies

Objective

To evaluate the feasibility of a new three-dimensional (3D) MR fingerprinting (MRF) technique for the prostate gland by conducting phantom and clinical studies.

Materials and Methods

The new 3D MRF technique used in this study enables quick data acquisition and has a high resolution. For the phantom study, the MRF T1 and T2 values in an in-house phantom were compared with those of gold-standard mapping methods using linear regression analysis. For the clinical study, we evaluated 90 patients who underwent prostate imaging with MRF for suspected prostate cancer between September 2019 and February 2020. The mean T1 and T2 values were compared in the peripheral zone, transition zone, and focal lesions using paired t tests. The differences in the T1 and T2 values according to cancer aggressiveness were evaluated using one-way analysis of variance.

Results

In the phantom study, the MRF T1 and T2 values showed a perfect correlation with the gold-standard T1 and T2 values (R > 0.99). In the clinical study, the T1 and T2 values in the peripheral zone were significantly higher than those in the transitional zone (p < 0.001, both). The T1 and T2 values in prostate cancer were significantly lower than those in the peripheral and transitional zones. The higher the grade of cancer, the lower the T2 values.

Conclusion

The T1 and T2 values obtained from the 3D MRF showed a perfect correlation with the gold standard values in the phantom study. Differences in the T1 and T2 values among the different zones of the prostate gland were identified using 3D MRF in patients.

Application of magnetic resonance fingerprinting to differentiate grade I transitional and fibrous meningiomas from meningothelial meningiomas

Background

The choice of surgical treatment for meningiomas is affected by the subtype and clinical characteristics. Therefore, an accurate preoperative diagnosis is essential. Current magnetic resonance imaging (MRI) technology is unable to distinguish between meningioma subtypes. In the present study, we compared and evaluated the utility of conventional MRI, magnetic resonance fingerprinting (MRF), and diffusion-weighted imaging (DWI) in differentiating World Health Organization grade I transitional and fibrous meningiomas from meningothelial meningiomas.

Methods

Forty-six patients with pathologically confirmed meningiomas (15 meningothelial, 18 transitional, and 13 fibrous) were enrolled in the present study. All patients underwent conventional MRI, MRF, and DWI scans before surgery using a 3T scanner. The Jonckheere-Terpstra test was used to analyze differences in the signal and enhancement characteristics of the three groups from T₁-weighted imaging (T1WI) and T₂-weighted imaging (T2WI). To investigate the difference in quantitative T1 and T2 values derived from MRF and apparent diffusion coefficient (ADC) values between the three groups using the Kruskal-Wallis test, regions of interest (ROIs) were manually drawn on the parenchymal portion of the tumors; P<0.017 was considered statistically significant after Bonferroni correction for multiple comparison. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performances of the different parameters.

Results

Meningothelial meningiomas had significantly higher T1 and T2 values than transitional and fibrous meningiomas (all P<0.017). ROC analysis results revealed that the combination of T1 and T2 values had the largest area under the curve (AUC). The AUC for the combination of T1 and T2 values was 0.826 between meningothelial and transitional meningiomas, and the AUC for the combination of T1 and T2 values between meningothelial and fibrous meningiomas was 0.903. No significant differences were found in the T1 and T2 values between transitional and fibrous meningiomas. There were also no statistically significant differences in the conventional MRI (including T1WI, T2WI, and contrast-enhanced T1WI) and ADC values between the three meningioma subtypes (all P>0.05).

Conclusions

MRF may provide more quantitative information than either conventional MRI or DWI for differentiating transitional and fibrous meningiomas from meningothelial meningiomas. T1 and T2 values derived from MRF may distinguish transitional and fibrous meningiomas from meningothelial meningiomas, and the combination of T1 and T2 values provides the highest diagnostic efficacy.