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Ritschl LM, Monika P, Lisa M, Victoria K, Egon B, Florian P, Robl T, Klaus-Dietrich W, Alex G, Fichter AM. Accuracy of magnetic resonance imaging black bone sequence for mandibular fracture diagnosis and dislocation measurement. J Craniomaxillofac Surg 2025; 53:813-818. [PMID: 40038012 DOI: 10.1016/j.jcms.2025.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Revised: 02/19/2025] [Accepted: 02/20/2025] [Indexed: 03/06/2025] Open
Abstract
This study aims to evaluate the quality of diagnostic assessment of three-dimensional (3D) T1-weighted fast field echo (FFE) "black bone" magnetic resonance imaging (MRI) sequences in comparison to the gold standard computed tomography (CT) in patients with mandible fractures. All consecutive patients who presented with mandibular fractures between the mandibular and mental foramen were included and received an MRI in addition to the standard CT (reference). The patient collective's epidemiological data were analyzed, and the images of CT and MRI were assessed regarding the degree of mandibular fracture dislocation in all three planes. In total, 28 patients were included and no statistically significant difference between the measured dislocations between the two modalities were registered. The evaluation of mandibular fracture dislocation using a T1-FFE "black bone" sequence was feasible and comparable to standard CT imaging. Non-ionizing imaging methods might become a useful alternative to conventional CT in the assessment of acute traumatic injury of the mandible, providing a valid option to reduce radiation, particularly in young patients.
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Affiliation(s)
- Lucas M Ritschl
- Department of Oral and Maxillofacial Surgery, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany.
| | - Probst Monika
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany; MRadenT GmbH, Sendlinger Strasse 37, 80331, Munich, Germany
| | - Maier Lisa
- Department of Oral and Maxillofacial Surgery, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Kehl Victoria
- Institute of Medical Informatics, Statistics and Epidemiology, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Burian Egon
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Probst Florian
- MKG Probst, Sendlinger Strasse 37, 80331, Munich, Germany
| | - Teresa Robl
- Department of Diagnostic and Interventional Neuroradiology, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany; Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilians University, 80337, Munich, Germany
| | - Wolff Klaus-Dietrich
- Department of Oral and Maxillofacial Surgery, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Grabenhorst Alex
- Department of Oral and Maxillofacial Surgery, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany
| | - Andreas M Fichter
- Department of Oral and Maxillofacial Surgery, TUM School of Medicine and Health, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Strasse 22, 81675, Munich, Germany
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Carretero-Gómez L, Fung M, Wiesinger F, Carl M, McKinnon G, de Arcos J, Mandava S, Arauz S, Sánchez-Lacalle E, Nagrani S, López-Alcorocho JM, Rodríguez-Íñigo E, Malpica N, Padrón M. Deep learning-enhanced zero echo time MRI for glenohumeral assessment in shoulder instability: a comparative study with CT. Skeletal Radiol 2025; 54:1263-1273. [PMID: 39572485 PMCID: PMC12000158 DOI: 10.1007/s00256-024-04830-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 10/28/2024] [Accepted: 11/01/2024] [Indexed: 04/16/2025]
Abstract
PURPOSE To evaluate image quality and lesion conspicuity of zero echo time (ZTE) MRI reconstructed with deep learning (DL)-based algorithm versus conventional reconstruction and to assess DL ZTE performance against CT for bone loss measurements in shoulder instability. METHODS Forty-four patients (9 females; 33.5 ± 15.65 years) with symptomatic anterior glenohumeral instability and no previous shoulder surgery underwent ZTE MRI and CT on the same day. ZTE images were reconstructed with conventional and DL methods and post-processed for CT-like contrast. Two musculoskeletal radiologists, blinded to the reconstruction method, independently evaluated 20 randomized MR ZTE datasets with and without DL-enhancement for perceived signal-to-noise ratio, resolution, and lesion conspicuity at humerus and glenoid using a 4-point Likert scale. Inter-reader reliability was assessed using weighted Cohen's kappa (K). An ordinal logistic regression model analyzed Likert scores, with the reconstruction method (DL-enhanced vs. conventional) as the predictor. Glenoid track (GT) and Hill-Sachs interval (HSI) measurements were performed by another radiologist on both DL ZTE and CT datasets. Intermodal agreement was assessed through intraclass correlation coefficients (ICCs) and Bland-Altman analysis. RESULTS DL ZTE MR bone images scored higher than conventional ZTE across all items, with significantly improved perceived resolution (odds ratio (OR) = 7.67, p = 0.01) and glenoid lesion conspicuity (OR = 25.12, p = 0.01), with substantial inter-rater agreement (K = 0.61 (0.38-0.83) to 0.77 (0.58-0.95)). Inter-modality assessment showed almost perfect agreement between DL ZTE MR and CT for all bone measurements (overall ICC = 0.99 (0.97-0.99)), with mean differences of 0.08 (- 0.80 to 0.96) mm for GT and - 0.07 (- 1.24 to 1.10) mm for HSI. CONCLUSION DL-based reconstruction enhances ZTE MRI quality for glenohumeral assessment, offering osseous evaluation and quantification equivalent to gold-standard CT, potentially simplifying preoperative workflow, and reducing CT radiation exposure.
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Affiliation(s)
- Laura Carretero-Gómez
- GE HealthCare, Munich, Germany.
- Medical Image Analysis and Biometry Lab, Rey Juan Carlos University, Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | - Norberto Malpica
- Medical Image Analysis and Biometry Lab, Rey Juan Carlos University, Madrid, Spain
| | - Mario Padrón
- Department of Radiology, Clínica CEMTRO, Madrid, Spain
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Cicci MC, Keenihan EK, Bailey K, Graham L, Sommer S, Cohen EB. Short/Ultra-Short TE MRI Sequences Comparable to CT and Superior to Standard MRI Sequences for Canine Skull Imaging. Vet Radiol Ultrasound 2025; 66:e70035. [PMID: 40317775 PMCID: PMC12048040 DOI: 10.1111/vru.70035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 03/26/2025] [Accepted: 04/13/2025] [Indexed: 05/07/2025] Open
Abstract
Magnetic resonance imaging often needs to be complemented with CT for complete assessment of bony structures due to CTs increased spatial resolution and discrimination of cortical bone margins. The aims of this prospective method comparison study were to perform qualitative and quantitative comparisons of standard MR sequences with three short/ultra-short TE MR sequences using CT as the gold standard. Eight healthy research dogs of similar size had CT and MR of the head performed. Three short/ultra-short TE sequences, VIBE, PETRA, and UTE, alongside standard T2W, PD, and T1W TSE sequences of the head were obtained. Slice thickness of CT and short TE MR sequences were matched. A qualitative scale was used to assess the visibility of cortical margins and skull foramina. For the quantitative assessment, predetermined osseous structures and foramina on designated slices were measured. Levene's test and post hoc folded F tests with false discovery rate adjustments were applied to the residuals from these models to compare precision relative to CT across the sequence types. The short/ultra-short TE MR sequences were significantly better than the standard MR sequences for quantitative assessment of bone thickness of smaller structures and overall qualitative assessment. Any of these short/ultra-short TE sequences may be viable to incorporate into a clinical setting as an alternative to CT to help further evaluate the skull and reduce anesthesia time and client cost. VIBE, PETRA, and UTE sequences have diagnostic image quality and provide a consistent quantitative and qualitative assessment of the cortical bone of the skull when compared with CT.
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Affiliation(s)
- Maura C. Cicci
- Red Bank Veterinary HospitalTinton FallsNew JerseyUSA
- Department of Molecular Biomedical Sciences, College of Veterinary MedicineNC State UniversityRaleighNorth CarolinaUSA
| | - Erin K. Keenihan
- Department of Molecular Biomedical Sciences, College of Veterinary MedicineNC State UniversityRaleighNorth CarolinaUSA
| | - Kate Bailey
- Department of Molecular Biomedical Sciences, College of Veterinary MedicineNC State UniversityRaleighNorth CarolinaUSA
| | - Lynelle Graham
- Department of Molecular Biomedical Sciences, College of Veterinary MedicineNC State UniversityRaleighNorth CarolinaUSA
| | - Stefan Sommer
- Siemens Healthcare AGZurichSwitzerland
- Swiss Center for Musculoskeletal Imaging (SCMI)ZurichSwitzerland
- Advanced Clinical Imaging Technology (ACIT)Siemens Healthcare AGLausanneSwitzerland
| | - Eli B. Cohen
- Department of Molecular Biomedical Sciences, College of Veterinary MedicineNC State UniversityRaleighNorth CarolinaUSA
- Dragonfly Imaging, PLLCCaryNorth CarolinaUSA
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Lee C, Lee J, Mandava S, Fung M, Choi YJ, Jeon KJ, Han SS. Deep learning image enhancement for confident diagnosis of TMJ osteoarthritis in zero-TE MR imaging. Dentomaxillofac Radiol 2025; 54:302-306. [PMID: 39989448 PMCID: PMC12038245 DOI: 10.1093/dmfr/twae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 11/07/2024] [Accepted: 11/14/2024] [Indexed: 02/25/2025] Open
Abstract
OBJECTIVES This study aimed to evaluate the effectiveness of deep learning method for denoising and artefact reduction (AR) in zero echo time MRI (ZTE-MRI). Also, clinical applicability was evaluated by comparing image diagnosis to the temporomandibular joint (TMJ) cone-beam CT (CBCT). METHODS CBCT and routine ZTE-MRI data were collected for 30 patients, along with an additional ZTE-MRI obtained with reduced scan time. Scan time-reduced image sets were processed into denoised and AR images based on a deep learning technique. The image quality of the routine sequence, denoised, and AR image sets was compared quantitatively using the signal-to-noise ratio (SNR) and qualitatively using a 3-point grading system (0: poor, 1: good, 2: excellent). The presence of osteoarthritis was assessed in each imaging protocol. Diagnostic accuracy of each protocol was compared against the CBCT results, which served as the reference standard. The SNR and the qualitative scores were compared using analysis of variance test and Kruskal-Wallis test, respectively. The diagnostic accuracy was assessed using Cohen's κ (<0.5 = poor; 0.5 to <0.75 = moderate; 0.75 to <0.9 = good; ≥0.9 = excellent). RESULTS Both the denoised and AR protocols resulted in significantly enhanced SNR compared to the routine protocol, with the AR protocol showing a higher SNR than the denoised one. The qualitative assessment also showed highest grade in AR protocol with statistical significance. The osteoarthritis diagnosis showed enhanced agreement with CBCT in denoised (κ = 0.928) and AR images (κ = 0.929) than routine images (κ = 0.707). CONCLUSIONS A newly developed deep learning technique for both denoising and artefact reduction in ZTE-MRI presented clinical usefulness. Specifically, AR protocol showed significantly improved image quality and comparable diagnostic accuracy comparable to CBCT. It can be expected that this novel technique would help overcome the current limitation of ZTE-MRI for replacing CBCT in bone imaging of TMJ.
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Affiliation(s)
- Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
- Institute for Innovative in Digital Healthcare, Seoul, 03722, Republic of Korea
| | | | | | - Maggie Fung
- GE HealthCare, New York, NY, 10032, United States
| | - Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
- Institute for Innovative in Digital Healthcare, Seoul, 03722, Republic of Korea
- Oral Science Research Center, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
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Teixeira PAG, Kessler H, Morbée L, Douis N, Boubaker F, Gillet R, Blum A. Mineralized tissue visualization with MRI: Practical insights and recommendations for optimized clinical applications. Diagn Interv Imaging 2025; 106:147-156. [PMID: 39667997 DOI: 10.1016/j.diii.2024.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Revised: 11/01/2024] [Accepted: 11/04/2024] [Indexed: 12/14/2024]
Abstract
Magnetic resonance imaging (MRI) techniques that enhance the visualization of mineralized tissues (hereafter referred to as MT-MRI) are increasingly being incorporated into clinical practice, particularly in musculoskeletal imaging. These techniques aim to mimic the contrast provided by computed tomography (CT), while taking advantage of MRI's superior soft tissue contrast and lack of ionizing radiation. However, the variety of MT-MRI techniques, including three-dimensional gradient-echo, ultra-short and zero-echo time, susceptibility-weighted imaging, and artificial intelligence-generated synthetic CT, each offer different technical characteristics, advantages, and limitations. Understanding these differences is critical to optimizing clinical application. This review provides a comprehensive overview of the most commonly used MT-MRI techniques, categorizing them based on their technical principles and clinical utility. The advantages and disadvantages of each approach, including their performance in bone morphology assessment, fracture detection, arthropathy-related findings, and soft tissue calcification evaluation are discussed. Additionally, technical limitations and artifacts that may affect image quality and diagnostic accuracy, such as susceptibility effects, signal-to-noise ratio issues, and motion artifacts are addressed. Despite promising developments, MT-MRI remains inferior to conventional CT for evaluating subtle bone abnormalities and soft tissue calcification due to spatial resolution limitations. However, advances in deep learning and hardware innovations, such as artificial intelligence-generated synthetic CT and ultrahigh-field MRI, may bridge this gap in the future.
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Affiliation(s)
- Pedro Augusto Gondim Teixeira
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy 54035, France; Université de Lorraine, Inserm, IADI, Nancy 54000, France.
| | - Hippolyte Kessler
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy 54035, France
| | - Lieve Morbée
- Department of Radiology, Ghent University Hospital, Ghent 9000, Belgium
| | - Nicolas Douis
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy 54035, France; Université de Lorraine, Inserm, IADI, Nancy 54000, France
| | - Fatma Boubaker
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy 54035, France
| | - Romain Gillet
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy 54035, France; Université de Lorraine, Inserm, IADI, Nancy 54000, France
| | - Alain Blum
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy 54035, France
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Hwang JY, Yun H, Yoon IN, Chang MY, Kang M, Shin SJ, Hwang MJ. ZTE MRI improves detection of calcific deposits and differentiation between resorptive and formative phases in calcific tendinitis of shoulder. Sci Rep 2025; 15:12084. [PMID: 40204836 PMCID: PMC11982395 DOI: 10.1038/s41598-025-91983-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 02/24/2025] [Indexed: 04/11/2025] Open
Abstract
The purpose of study was to evaluate the diagnostic value of the ZTE sequence of shoulder MRI in patients with calcific tendinitis by comparing conventional sequences. Seventy-nine patients (43 patients with calcific tendinitis and 36 control group) who underwent both radiography and MRI including ZTE sequence were enrolled in our study. Two radiologists assessed the SNR, image quality, presence, size, multiplicity, shape, margin, signal intensity, composition, and location of calcific deposits on ZTE image, FSPDWI, and T2WI. The diagnostic performance was calculated with radiography as the standard of reference. The inter-reader agreement and differentiation of the resorptive phase and formative phase on ZTE were compared to that on FSPDWI and T2WI. A total 59 calcific deposits in 43 patients were found on radiography and classified into type 1 resorptive phases (n = 20) and type 2 formative phases (n = 39). ZTE image quality was for diagnostic use with substantial inter-reader agreement. Sensitivity and detection rate of ZTE image was better than those of FSPDWI and T2WI. The inter-reader agreement of ZTE image was equal to FSPDWI and better than T2WI. The features of calcific deposits on ZTE images were significantly different between two phases. In the resorptive phase, a greater percentage of calcific deposits showed irregular shapes, ill-defined margin, heterogeneous compositions on ZTE images. In conclusion, ZTE sequence may provide useful information for the diagnosis of calcific tendinitis of the shoulder.
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Affiliation(s)
- Ji Young Hwang
- Department of Radiology, College of Medicine, Ewha Womans University, Ewha Womans University Seoul Hospital, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea.
| | - Hyein Yun
- Department of Radiology, College of Medicine, Ewha Womans University, Ewha Womans University Seoul Hospital, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea
| | - In Na Yoon
- Department of Radiology, College of Medicine, Ewha Womans University, Ewha Womans University Seoul Hospital, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea
| | - Min-Yung Chang
- Department of Radiology, College of Medicine, Ewha Womans University, Ewha Womans University Seoul Hospital, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea
| | - Minseong Kang
- Department of Radiology, College of Medicine, Ewha Womans University, Ewha Womans University Seoul Hospital, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea
| | - Sang-Jin Shin
- Department of Orthopaedic Surgery, College of Medicine, Ewha Womans University, Ewha Womans University Seoul Hospital, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea
| | - Moon Jung Hwang
- Advanced Medical Imaging Institute, Korea University Anam Hospital, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
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Fujii R, Sugimura M, Kurita M. [Comparison of CT-like Images Using MRI]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2025; 81:n/a. [PMID: 40058843 DOI: 10.6009/jjrt.25-1467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2025]
Abstract
PURPOSE The objective of this study was to quantitatively evaluate and compare the image contrast and image quality of several recently developed CT-like images (oZTEo, LAVA, MERGE). METHODS Using a self-made phantom created with a GE Healthcare (Milwaukee, WI, USA) MRI Pioneer 3.0T and pig leg bone, along with four types of tissue-mimicking phantoms, we compared cortical bone, contrast-to-noise ratio (CNR), signal change ratio of the tissue-simulating phantom, and visual evaluation. RESULTS CR and CNR were lowest in the order of MERGE, LAVA, and oZTEo. The signal change ratio of background signal and visual evaluation were highest in the order of oZTEo, LAVA, and MERGE. CONCLUSION In comparing CT-like images using MRI, the bone cortex could be visualized in white using black-and-white inversion in all CT-like images, and fracture lines could also be visualized. By capturing CT-like images tailored to the characteristics of each imaging sequence, it is expected that the number of examinations that can be completed using MRI alone will increase, further enhancing the usefulness of MRI.
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You SH, Cho Y, Kim B, Kim J, Im GJ, Park E, Kim I, Kim KM, Kim BK. Synthetic temporal bone CT generation from UTE-MRI using a cycleGAN-based deep learning model: advancing beyond CT-MR imaging fusion. Eur Radiol 2025; 35:38-48. [PMID: 39026063 DOI: 10.1007/s00330-024-10967-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 06/11/2024] [Accepted: 07/03/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES The aim of this study is to develop a deep-learning model to create synthetic temporal bone computed tomography (CT) images from ultrashort echo-time magnetic resonance imaging (MRI) scans, thereby addressing the intrinsic limitations of MRI in localizing anatomic landmarks in temporal bone CT. MATERIALS AND METHODS This retrospective study included patients who underwent temporal MRI and temporal bone CT within one month between April 2020 and March 2023. These patients were randomly divided into training and validation datasets. A CycleGAN model for generating synthetic temporal bone CT images was developed using temporal bone CT and pointwise encoding-time reduction with radial acquisition (PETRA). To assess the model's performance, the pixel count in mastoid air cells was measured. Two neuroradiologists evaluated the successful generation rates of 11 anatomical landmarks. RESULTS A total of 102 patients were included in this study (training dataset, n = 54, mean age 58 ± 14, 34 females (63%); validation dataset, n = 48, mean age 61 ± 13, 29 females (60%)). In the pixel count of mastoid air cells, no difference was observed between synthetic and real images (679 ± 342 vs 738 ± 342, p = 0.13). For the six major anatomical sites, the positive generation rates were 97-100%, whereas those of the five major anatomical structures ranged from 24% to 83%. CONCLUSION We developed a model to generate synthetic temporal bone CT images using PETRA MRI. This model can provide information regarding the major anatomic sites of the temporal bone using MRI. CLINICAL RELEVANCE STATEMENT The proposed algorithm addresses the primary limitations of MRI in localizing anatomic sites within the temporal bone. KEY POINTS CT is preferred for imaging the temporal bone, but has limitations in differentiating pathology there. The model achieved a high success rate in generating synthetic images of six anatomic sites. This can overcome the limitations of MRI in visualizing key anatomic sites in the temporal skull.
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Affiliation(s)
- Sung-Hye You
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yongwon Cho
- Biomedical Research Center, Korea University College of Medicine, Seoul, Korea
- Department of Computer Science and Engineering, Soonchunhyang University, Asan-si, Korea
| | - Byungjun Kim
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea.
| | - Jeeho Kim
- Department of Data Science, Korea University College of Informatics, Seoul, Korea
| | - Gi Jung Im
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Euyhyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | | | - Kyung Min Kim
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Bo Kyu Kim
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Aggrawal D, Saint-Martin L, Manwar R, Siegel A, Schonfeld D, Avanaki K. A Deep Learning-Based Approach to Characterize Skull Physical Properties: A Phantom Study. JOURNAL OF BIOPHOTONICS 2025; 18:e202400131. [PMID: 39540545 DOI: 10.1002/jbio.202400131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 09/22/2024] [Accepted: 10/09/2024] [Indexed: 11/16/2024]
Abstract
Transcranial ultrasound imaging is a popular method to study cerebral functionality and diagnose brain injuries. However, the detected ultrasound signal is greatly distorted due to the aberration caused by the skull bone. The aberration mechanism mainly depends on thickness and porosity, two important skull physical characteristics. Although skull bone thickness and porosity can be estimated from CT or MRI scans, there is significant value in developing methods for obtaining thickness and porosity information from ultrasound itself. Here, we extracted various features from ultrasound signals using physical skull-mimicking phantoms of a range of thicknesses with embedded porosity-mimicking acoustic mismatches and analyzed them using machine learning (ML) and deep learning (DL) models. The performance evaluation demonstrated that both ML- and DL-trained models could predict the physical characteristics of a variety of skull phantoms with reasonable accuracy. The proposed approach could be expanded upon and utilized for the development of effective skull aberration correction methods.
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Affiliation(s)
- Deepika Aggrawal
- Department of Electrical and Computer Engineering, University of Illinois, Chicago, Illinois, USA
| | - Loïc Saint-Martin
- Department of Biomedical Engineering, University of Illinois, Chicago, Illinois, USA
| | - Rayyan Manwar
- Department of Biomedical Engineering, University of Illinois, Chicago, Illinois, USA
| | - Amanda Siegel
- Department of Biomedical Engineering, University of Illinois, Chicago, Illinois, USA
| | - Dan Schonfeld
- Department of Electrical and Computer Engineering, University of Illinois, Chicago, Illinois, USA
| | - Kamran Avanaki
- Department of Biomedical Engineering, University of Illinois, Chicago, Illinois, USA
- Department of Dermatology, University of Illinois, Chicago, Illinois, USA
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Vu BTD, Kamona N, Kim Y, Ng JJ, Jones BC, Wehrli FW, Song HK, Bartlett SP, Lee H, Rajapakse CS. Three contrasts in 3 min: Rapid, high-resolution, and bone-selective UTE MRI for craniofacial imaging with automated deep-learning skull segmentation. Magn Reson Med 2025; 93:245-260. [PMID: 39219299 PMCID: PMC11735049 DOI: 10.1002/mrm.30275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/17/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE Ultrashort echo time (UTE) MRI can be a radiation-free alternative to CT for craniofacial imaging of pediatric patients. However, unlike CT, bone-specific MR imaging is limited by long scan times, relatively low spatial resolution, and a time-consuming bone segmentation workflow. METHODS A rapid, high-resolution UTE technique for brain and skull imaging in conjunction with an automatic segmentation pipeline was developed. A dual-RF, dual-echo UTE sequence was optimized for rapid scan time (3 min) and smaller voxel size (0.65 mm3). A weighted least-squares conjugate gradient method for computing the bone-selective image improves bone specificity while retaining bone sensitivity. Additionally, a deep-learning U-Net model was trained to automatically segment the skull from the bone-selective images. Ten healthy adult volunteers (six male, age 31.5 ± 10 years) and three pediatric patients (two male, ages 12 to 15 years) were scanned at 3 T. Clinical CT for the three patients were obtained for validation. Similarities in 3D skull reconstructions relative to clinical standard CT were evaluated based on the Dice similarity coefficient and Hausdorff distance. Craniometric measurements were used to assess geometric accuracy of the 3D skull renderings. RESULTS The weighted least-squares method produces images with enhanced bone specificity, suppression of soft tissue, and separation from air at the sinuses when validated against CT in pediatric patients. Dice similarity coefficient overlap was 0.86 ± 0.05, and the 95th percentile Hausdorff distance was 1.77 ± 0.49 mm between the full-skull binary masks of the optimized UTE and CT in the testing dataset. CONCLUSION An optimized MRI acquisition, reconstruction, and segmentation workflow for craniofacial imaging was developed.
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Affiliation(s)
- Brian-Tinh Duc Vu
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Address: 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, Address: 210 South 33 St, Philadelphia, PA 19104
| | - Nada Kamona
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Address: 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, Address: 210 South 33 St, Philadelphia, PA 19104
| | - Yohan Kim
- Division of Plastic, Reconstructive and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA, Address: 3401 Civic Center Blvd, Philadelphia, PA 19104
| | - Jinggang J. Ng
- Division of Plastic, Reconstructive and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA, Address: 3401 Civic Center Blvd, Philadelphia, PA 19104
| | - Brandon C. Jones
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Address: 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, Address: 210 South 33 St, Philadelphia, PA 19104
| | - Felix W. Wehrli
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Address: 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104
| | - Hee Kwon Song
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Address: 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104
| | - Scott P. Bartlett
- Division of Plastic, Reconstructive and Oral Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, USA, Address: 3401 Civic Center Blvd, Philadelphia, PA 19104
| | - Hyunyeol Lee
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Address: 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104
- School of Electronics Engineering, Kyungpook National University, Daegu, South Korea, Address: 80 Daehakro, Bukgu, Daegu, Republic of Korea 41566
| | - Chamith S. Rajapakse
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Address: 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104
- Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, Address: 3400 Spruce St, Philadelphia, PA 19104
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11
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Chauhan V, Harikishore K, Girdhar S, Kaushik S, Wiesinger F, Cozzini C, Carl M, Fung M, Mehta BB, Thomas B, Kesavadas C. Utility of zero echo time (ZTE) sequence for assessing bony lesions of skull base and calvarium. Clin Radiol 2024; 79:e1504-e1513. [PMID: 39322533 DOI: 10.1016/j.crad.2024.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/09/2024] [Accepted: 08/26/2024] [Indexed: 09/27/2024]
Abstract
BACKGROUND The emergence of zero echo time (ZTE) imaging has transformed bone imaging, overcoming historical limitations in capturing detailed bone structures. By minimizing the time gap between radiofrequency excitation and data acquisition, ZTE generates CT-like images. While ZTE has shown promise in various applications, its potential in assessing skull base and calvarium lesions remains unexplored. Hence we aim to introduce a novel perspective by investigating the utility of inverted ZTE images (iZTE) and pseudoCT (pCT) images for studying lesions in the skull base and calvarium. MATERIALS AND METHODS A total of 35 eligible patients, with an average age of 42 years and a male/female ratio of 1:4, underwent ZTE MRI and images are processed to generate iZTE and pCT images were generated through a series of steps including intensity equalization, thresholding, and deep learning-based pCT generation. These images were then compared to CT scans using a rating scale; inter-rater kappa coefficient evaluated observer consensus while statistical metrics like sensitivity and specificity assessed their performance in capturing bone-related characteristics. RESULTS The study revealed excellent interobserver agreement for lesion assessment using both pCT and iZTE imaging modalities, with kappa coefficient of 0.91 (P < 0.0001) and 0.92 respectively (P < 0.0001). Also, pCT and iZTE accurately predicted various lesion characteristics with sensitivity ranging from 84.3% to 95.1% and 82.6%-94.2% (95% CI) with a diagnostic accuracy of 95.56% and 94.44% respectively. Although both of them encountered challenges with ground glassing, hyperostosis, and intralesional bony fragments, they showed good performance in other bony lesion assessments. CONCLUSIONS The pilot study suggests strong potential for integrating the ZTE imaging into standard care for skull base and calvarial bony lesions assessment. Additionally, larger-scale studies are needed for comprehensive assessment of its efficacy.
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Affiliation(s)
- V Chauhan
- Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India.
| | - K Harikishore
- Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India.
| | - S Girdhar
- Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India.
| | | | | | | | | | | | | | - B Thomas
- Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India.
| | - C Kesavadas
- Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala, India.
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12
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Park JY, Ha SH, Jeong S, Chang JY, Kang DW, Kwon SU, Kim BJ. Association Between Vertebral Arterial Tortuosity and Aneurysm Growth in Intracranial Vertebral Artery Dissection. J Clin Neurol 2024; 20:617-623. [PMID: 39505314 PMCID: PMC11543393 DOI: 10.3988/jcn.2024.0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/09/2024] [Accepted: 06/21/2024] [Indexed: 11/08/2024] Open
Abstract
BACKGROUND AND PURPOSE An intracranial vertebral artery dissecting aneurysm (iVADA) increases the risk of future subarachnoid hemorrhage, which is a severe complication with high rebleeding rates and poor outcomes. Identifying potential risk factors associated with iVADA growth is crucial for their effective management. METHODS This observational study was carried out at a single center and included patients who had been diagnosed with iVADA based on neuroimaging findings. We divided the patients into two groups: with and without iVADA growth. Growth was defined as any enlargement of a dilated region or a morphological change in follow-up imaging. We measured the vertebral artery tortuosity index (VTI) in the contralateral vertebral artery (VA), defined as its actual length divided by its straight length. We investigated the factors associated with iVADA growth. RESULTS This study included 124 patients. The median follow-up period was 7 months. We observed iVADA growth in 54 patients (43.5%), who were more likely to be current smokers (33.3% vs. 14.3%, p=0.012) and have a higher VTI (1.14±0.11 [mean±standard deviation] vs. 1.06±0.12, p=0.035) compared with those without iVADA growth. A multivariate analysis revealed that the VTI (adjusted odds ratio=28.490, 95% confidence interval=1.025-792.046, p=0.048) was independently associated with iVADA growth. CONCLUSIONS This study has identified an independent association between VA tortuosity and iVADA growth.
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Affiliation(s)
- Jae Young Park
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hee Ha
- Department of Neurology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Soo Jeong
- Department of Neurology, Hanyang University College of Medicine, Seoul, Korea
| | - Jun Young Chang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong-Wha Kang
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sun U Kwon
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bum Joon Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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13
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Kamona N, Ng JJ, Kim Y, D Vu BT, Vossough A, Wagner CS, Cordray H, Lee H, Villavisanis DF, Rajapakse CS, Bartlett SP, Wehrli FW. Craniofacial Imaging of Pediatric Patients by Ultrashort Echo-Time Bone-Selective MRI in Comparison to CT. Acad Radiol 2024; 31:4629-4642. [PMID: 39242296 PMCID: PMC11525957 DOI: 10.1016/j.acra.2024.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 08/23/2024] [Accepted: 08/25/2024] [Indexed: 09/09/2024]
Abstract
RATIONALE AND OBJECTIVES The emergence of low-dose protocols for CT imaging has mitigated pediatric radiation exposure, yet ionizing radiation remains a concern for children with complex craniofacial conditions requiring repeated radiologic monitoring. In this work, the clinical feasibility of an ultrashort echo time (UTE) MRI sequence was investigated in pediatric patients. MATERIALS AND METHODS Twelve pediatric patients (6 female, age range 8 to 18 years) with various imaging conditions were scanned at 3T using a dual-radiofrequency, dual-echo UTE MRI sequence. Bright-bone images were generated using a weighted least-squares conjugate gradient method to enhance bone specificity. The overlap of the binary skull masks was quantified using the Dice similarity coefficient (DSC) and the 95th percentile Hausdorff distance (HD95) to evaluate the similarity between MRI and CT. To assess the anatomic accuracy of 3D skull reconstructions, six craniometric distances were recorded and the agreement between MRI- and CT-derived measurements was evaluated using Lin's concordance correlation coefficient (ρc). RESULTS The bright-bone images from UTE MRI demonstrated high bone-contrast, suppression of soft tissue, and separation from air at the sinuses. The DSC and HD95 between MRI and CT had medians of 0.81 ± 0.10 and 1.87 ± 0.32 mm, respectively. There was good agreement between MRI and CT for all craniometric distances (ρc ranging from 0.90 to 0.99) with a mean absolute difference in measurements of < 2 mm. CONCLUSION The clinical feasibility of the UTE MRI sequence for craniofacial imaging was demonstrated in a cohort of pediatric patients, showing good agreement with CT in resolving thin bone structures and craniometry.
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Affiliation(s)
- Nada Kamona
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jinggang J Ng
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Yohan Kim
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Brian-Tinh D Vu
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Arastoo Vossough
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Division of Neuroradiology, Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Connor S Wagner
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Holly Cordray
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Hyunyeol Lee
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
| | - Dillan F Villavisanis
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Chamith S Rajapakse
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Scott P Bartlett
- Division of Plastic, Reconstructive and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Felix W Wehrli
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
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14
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Ensle F, Abel F, Lohezic M, Obermüller C, Guggenberger R. Deep learning reconstruction for optimized bone assessment in zero echo time MR imaging of the knee. Eur J Radiol 2024; 179:111663. [PMID: 39142010 DOI: 10.1016/j.ejrad.2024.111663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/29/2024] [Accepted: 08/02/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE To evaluate the impact of deep learning-based reconstruction (DLRecon) on bone assessment in zero echo-time (ZTE) MRI of the knee at 1.5 Tesla. METHODS This retrospective study included 48 consecutive exams of 46 patients (23 females) who underwent clinically indicated knee MRI at 1.5 Tesla. Standard imaging protocol comprised a sagittal prescribed, isotropic ZTE sequence. ZTE image reconstruction was performed with a standard-of-care (non-DL) and prototype DLRecon method. Exams were divided into subsets with and without osseous pathology based on the radiology report. Using a 4-point scale, two blinded readers qualitatively graded features of bone depiction including artifacts and conspicuity of pathology including diagnostic certainty in the respective subsets. Quantitatively, one reader measured signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of bone. Comparative analyses were conducted to assess the differences between the reconstruction methods. In addition, interreader agreement was calculated for the qualitative gradings. RESULTS DLRecon significantly improved gradings for bone depiction relative to non-DL reconstruction (all, p < 0.05), while there was no significant difference with regards to artifacts (both, median score of 0; p = 0.058). In the subset with pathologies, conspicuity of pathology and diagnostic confidence were also scored significantly higher in DLRecon compared to non-DL (median 3 vs 2; p ≤ 0.03). Interreader agreement ranged from moderate to almost-perfect (κ = 0.54-0.88). Quantitatively, DLRecon demonstrated significantly enhanced CNR and SNR of bone compared to non-DL (p < 0.001). CONCLUSION ZTE MRI with DLRecon improved bone depiction in the knee, compared to non-DL. Additionally, DLRecon increased conspicuity of osseous findings together with diagnostic certainty.
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Affiliation(s)
- Falko Ensle
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Frederik Abel
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Carina Obermüller
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roman Guggenberger
- Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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15
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Zhang Z, Wang J, Li Y, Liang C, Sui H, Huang Z, Zhu X, Nie L, Song L. Bone assessment of the sacroiliac joint in ankylosing spondylitis: Comparison between computed tomography and zero echo time MRI. Eur J Radiol 2024; 181:111743. [PMID: 39341167 DOI: 10.1016/j.ejrad.2024.111743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 09/03/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024]
Abstract
PURPOSE To demonstrate the clinical applicability of zero echo time magnetic resonance imaging (ZTE MRI) in bone assessment of the sacroiliac joint in ankylosing spondylitis. METHOD Between January 2021 and November 2021, twenty-one ankylosing spondylitis patients underwent clinically indicated MRI including ZTE sequence, in addition, all patients underwent a CT scan covering the sacroiliac joints within 6 months of the MRI examination. The sensitivity, specificity, and accuracy of ZTE MRI were calculated using CT as the reference standard. Cohen's κappa tests were applied to assess the agreement of positive imaging findings (including erosions, osteosclerosis, bony cystic changes, and joint space changes) between MRI and CT as well as the inter-reader agreement for the grading of sacroiliitis in AS patients. RESULTS There was no statistical significance between ZTE MRI and CT in detecting of ankylosing spondylitis(p>0.05). The consistency of the diagnosis of positive imaging findings between ZTE MRI and CT was moderate to excellent (ranging from 0.611 to 0.889), and the consistency of the scores of positive imaging was good to excellent (ranging from 0.857 to 0.979). CONCLUSIONS ZTE MRI provides "CT-like" contrast for bony changes of the sacroiliac joint in ankylosing spondylitis and could simplify and reduce costs for some AS patients when both MRI and CT are typically required.
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Affiliation(s)
- Ziwei Zhang
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, PR China
| | - Jiawei Wang
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, PR China
| | - Yu Li
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, PR China
| | - Chen Liang
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, PR China
| | - He Sui
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, PR China
| | - Zhaoshu Huang
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, PR China
| | - Xia Zhu
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, PR China
| | - Lisha Nie
- GE Healthcare, MR Research China, Beijing 100176, PR China
| | - Lingling Song
- Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, PR China.
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Hokamura M, Nakaura T, Yoshida N, Uetani H, Shiraishi K, Kobayashi N, Matsuo K, Morita K, Nagayama Y, Kidoh M, Yamashita Y, Miyamoto T, Hirai T. Super-resolution deep learning reconstruction approach for enhanced visualization in lumbar spine MR bone imaging. Eur J Radiol 2024; 178:111587. [PMID: 39002269 DOI: 10.1016/j.ejrad.2024.111587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/28/2024] [Accepted: 06/24/2024] [Indexed: 07/15/2024]
Abstract
OBJECTIVES This study aims to assess the effectiveness of super-resolution deep-learning-based reconstruction (SR-DLR), which leverages k-space data, on the image quality of lumbar spine magnetic resonance (MR) bone imaging using a 3D multi-echo in-phase sequence. MATERIALS AND METHODS In this retrospective study, 29 patients who underwent lumbar spine MRI, including an MR bone imaging sequence between January and April 2023, were analyzed. Images were reconstructed with and without SR-DLR (Matrix sizes: 960 × 960 and 320 × 320, respectively). The signal-to-noise ratio (SNR) of the vertebral body and spinal canal and the contrast and contrast-to-noise ratio (CNR) between the vertebral body and spinal canal were quantitatively evaluated. Furthermore, the slope at half-peak points of the profile curve drawn across the posterior border of the vertebral body was calculated. Two radiologists independently assessed image noise, contrast, artifacts, sharpness, and overall image quality of both image types using a 4-point scale. Interobserver agreement was evaluated using weighted kappa coefficients, and quantitative and qualitative scores were compared via the Wilcoxon signed-rank test. RESULTS SNRs of the vertebral body and spinal canal were notably improved in images with SR-DLR (p < 0.001). Contrast and CNR were significantly enhanced with SR-DLR compared to those without SR-DLR (p = 0.023 and p = 0.022, respectively). The slope of the profile curve at half-peak points across the posterior border of the vertebral body and spinal canal was markedly higher with SR-DLR (p < 0.001). Qualitative scores (noise: p < 0.001, contrast: p < 0.001, artifact p = 0.042, sharpness: p < 0.001, overall image quality: p < 0.001) were superior in images with SR-DLR compared to those without. Kappa analysis indicated moderate to good agreement (noise: κ = 0.56, contrast: κ = 0.51, artifact: κ = 0.46, sharpness: κ = 0.76, overall image quality: κ = 0.44). CONCLUSION SR-DLR, which is based on k-space data, has the potential to enhance the image quality of lumbar spine MR bone imaging utilizing a 3D gradient echo in-phase sequence. CLINICAL RELEVANCE STATEMENT The application of SR-DLR can lead to improvements in lumbar spine MR bone imaging quality.
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Affiliation(s)
- Masamichi Hokamura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Naofumi Yoshida
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Kaori Shiraishi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Naoki Kobayashi
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Kensei Matsuo
- Department of Central Radiology, Kumamoto University Hospital, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Kosuke Morita
- Department of Central Radiology, Kumamoto University Hospital, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Yasunori Nagayama
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Masafumi Kidoh
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Yuichi Yamashita
- Canon Medical Systems Corporation, 70-1, Yanagi-cho, Saiwai-ku, Kawasaki-shi, Kanagawa 212-0015, Japan.
| | - Takeshi Miyamoto
- Orthopedic Surgery, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
| | - Toshinori Hirai
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo 1-1-1, Kumamoto 860-8556, Japan.
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Whalen RJ, Provencher MT. Editorial Commentary: Both 3-Dimensional Magnetic Resonance Imaging and Computed Tomography Are Valuable for Determination of Glenoid and Humeral Bone Loss in Patients With On- and Off-Track Shoulder Instability. Arthroscopy 2024; 40:1789-1792. [PMID: 38467170 DOI: 10.1016/j.arthro.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 03/13/2024]
Abstract
Improving the modalities for advanced glenohumeral joint imaging has been an important area to address in the field of orthopaedic surgery. The current gold standard for imaging glenoid and humeral bone loss in patients with shoulder instability, 3-dimensional (3D) computed tomography (CT), provides high-quality 3D images of bones but comes with a cost of extra time, additional imaging because of the need for an additional magnetic resonance imaging (MRI) scan, and exposure to radiation. Three-dimensional MRI is a promising solution that can produce high-contrast images depicting both bony structures and soft tissues. Multiple 3D MRI sequences have been studied, with the FRACTURE (fast field echo resembling a CT using restricted echo-spacing) sequence showing high comparability of bony measurements to 3D CT scans, as well as the ability for widespread clinical use. Recent research has shown minimal differences in 3D CT and 3D MRI and has confirmed that 3D imaging does provide clinically relevant data for determination of on- and off-track instability. Finally, the gold standard for determination of bone loss is the measurement of deficiencies in the surface area of the glenoid using the best-fit circle with a diameter line measurement. This is most practical for day-to-day clinical use.
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18
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Kamona N, Jones BC, Lee H, Song HK, Rajapakse CS, Wagner CS, Bartlett SP, Wehrli FW. Cranial bone imaging using ultrashort echo-time bone-selective MRI as an alternative to gradient-echo based "black-bone" techniques. MAGMA (NEW YORK, N.Y.) 2024; 37:83-92. [PMID: 37934295 PMCID: PMC10923077 DOI: 10.1007/s10334-023-01125-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES CT is the clinical standard for surgical planning of craniofacial abnormalities in pediatric patients. This study evaluated three MRI cranial bone imaging techniques for their strengths and limitations as a radiation-free alternative to CT. METHODS Ten healthy adults were scanned at 3 T with three MRI sequences: dual-radiofrequency and dual-echo ultrashort echo time sequence (DURANDE), zero echo time (ZTE), and gradient-echo (GRE). DURANDE bright-bone images were generated by exploiting bone signal intensity dependence on RF pulse duration and echo time, while ZTE bright-bone images were obtained via logarithmic inversion. Three skull segmentations were derived, and the overlap of the binary masks was quantified using dice similarity coefficient. Craniometric distances were measured, and their agreement was quantified. RESULTS There was good overlap of the three masks and excellent agreement among craniometric distances. DURANDE and ZTE showed superior air-bone contrast (i.e., sinuses) and soft-tissue suppression compared to GRE. DISCUSSIONS ZTE has low levels of acoustic noise, however, ZTE images had lower contrast near facial bones (e.g., zygomatic) and require effective bias-field correction to separate bone from air and soft-tissue. DURANDE utilizes a dual-echo subtraction post-processing approach to yield bone-specific images, but the sequence is not currently manufacturer-supported and requires scanner-specific gradient-delay corrections.
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Affiliation(s)
- Nada Kamona
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Brandon C Jones
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | - Hyunyeol Lee
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
| | - Hee Kwon Song
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Chamith S Rajapakse
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Connor S Wagner
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Scott P Bartlett
- Division of Plastic, Reconstructive, and Oral Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Felix W Wehrli
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Fujisaki A, Tsukamoto J, Narimatsu H, Hayashida Y, Todoroki Y, Hirano N, Takeda K, Shin S, Ota S, Anai K, Fukumitsu S, Yoshimatsu Y, Kono Y, Ueno M, Ide S, Murakami Y, Aoki T. Zero Echo Time Magnetic Resonance Imaging; Techniques and Clinical Utility in Musculoskeletal System. J Magn Reson Imaging 2024; 59:32-42. [PMID: 37288953 DOI: 10.1002/jmri.28843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023] Open
Abstract
Zero echo time (ZTE) sequence is recent advanced magnetic resonance technique that utilizes ultrafast readouts to capture signals from short-T2 tissues. This sequence enables T2- and T2* weighted imaging of tissues with short intrinsic relaxation times by using an extremely short TE, and are increasingly used in the musculoskeletal system. We review the imaging physics of these sequences, practical limitations, and image reconstruction, and then discuss the clinical utilities in various disorders of the musculoskeletal system. ZTE can be readily incorporated into the clinical workflow, and is a promising technique to avoid unnecessary radiation exposure, cost, and time-consuming by computed tomography in some cases. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Akitaka Fujisaki
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Jun Tsukamoto
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Hidekuni Narimatsu
- Department of Radiology, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yoshiko Hayashida
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Yo Todoroki
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Natsumi Hirano
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Kazuki Takeda
- Department of Radiology, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Sho Shin
- Department of Radiology, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Satoru Ota
- Department of Radiology, Hospital of University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kenta Anai
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Satoshi Fukumitsu
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Yuta Yoshimatsu
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Yuichiro Kono
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Midori Ueno
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Satoru Ide
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Yu Murakami
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
| | - Takatoshi Aoki
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan
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20
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Thacher RR, Retzky JS, Dekhne MS, Oquendo YA, Greditzer HG. Current Concepts in the Measurement of Glenohumeral Bone Loss. Curr Rev Musculoskelet Med 2023; 16:419-431. [PMID: 37341857 PMCID: PMC10427601 DOI: 10.1007/s12178-023-09852-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE The extent of glenohumeral bone loss seen in anterior shoulder dislocations plays a major role in guiding surgical management of these patients. The need for accurate and reliable preoperative assessment of bone loss on imaging studies is therefore of paramount importance to orthopedic surgeons. This article will focus on the tools that are available to clinicians for quantifying glenoid bone loss with a focus on emerging trends and research in order to describe current practices. RECENT FINDINGS Recent evidence supports the use of 3D CT as the most optimal method for quantifying bone loss on the glenoid and humerus. New trends in the use of 3D and ZTE MRI represent exciting alternatives to CT imaging, although they are not widely used and require further investigation. Contemporary thinking surrounding the glenoid track concept and the symbiotic relationship between glenoid and humeral bone loss on shoulder stability has transformed our understanding of these lesions and has inspired a new focus of study for radiologists and orthopedist alike. Although a number of different advanced imaging modalities are utilized to detect and quantify glenohumeral bone loss in practice, the current literature supports 3D CT imaging to provide the most reliable and accurate assessments. The emergence of the glenoid track concept for glenoid and humeral head bone loss has inspired a new area of study for researchers that presents exciting opportunities for the development of a deeper understanding of glenohumeral instability in the future. Ultimately, however, the heterogeneity of literature, which speaks to the diverse practices that exist across the world, limits any firm conclusions from being drawn.
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Affiliation(s)
- Ryan R Thacher
- Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA.
| | - Julia S Retzky
- Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA
| | - Mihir S Dekhne
- Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA
| | - Yousi A Oquendo
- Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA
| | - Harry G Greditzer
- Department of Radiology, Hospital for Special Surgery, 535 East 70Th Street, New York, NY, 10021, USA
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21
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Vuillemin V, Guerini H, Thévenin F, Sibileau E, Corcos G, Khaled W, Zeitoun F, Morvan G. Bone Tissue in Magnetic Resonance Imaging: Contribution of New Zero Echo Time Sequences. Semin Musculoskelet Radiol 2023; 27:411-420. [PMID: 37748464 DOI: 10.1055/s-0043-1770771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
The introduction of new ultrashort and zero echo time (ZTE) sequences is revolutionizing magnetic resonance imaging (MRI) and optimizing patient management. These sequences acquire signals in tissues with very short T2: mineralized bone, cortical bone, and calcium deposits. They can be added to a classic MRI protocol. ZTE MRI provides computed tomography-like contrast for bone.
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22
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Inoue A, Watanabe H, Suehiro S, Nishida N, Shiraishi Y, Furumochi T, Takimoto Y, Ohnishi T, Shigekawa S, Kunieda T. Clinical utility of new bone imaging using zero-echo-time sequence in neurosurgical procedures: Can zero-echo-time be used in clinical practice in neurosurgery? Neuroradiol J 2023; 36:289-296. [PMID: 37259240 PMCID: PMC10268098 DOI: 10.1177/19714009221114447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024] Open
Abstract
PURPOSE The purpose of this study was to evaluate the clinical usefulness of zero-echo-time (ZTE)-based magnetic resonance imaging (MRI) in planning the optimum surgical approach and applying ZTE for anatomical guidance during transcranial surgery. METHODS Eleven of 26 patients who underwent transcranial surgery and carotid endarterectomy and in whom ZTE-based MRI and magnetic resonance angiography (MRA) data were obtained were analyzed by creating ZTE/MRA fusion images and 3D ZTE-based MRI models. We examined whether these images and models can be substituted for computed tomography imaging for neurosurgical procedures. Furthermore, the clinical usability of the 3D ZTE-based MRI models was evaluated by comparing them with actual surgical views. RESULTS Zero-echo-time/MRA fusion images and 3D ZTE-based MRI models clearly illustrated the cranial and intracranial morphology without radiation exposure or the use of iodinated contrast medium. The models allowed determination of the optimum surgical approach to cerebral aneurysms, brain tumors near the brain surface, and cervical internal carotid artery stenosis by visualizing the relationship of lesions with adjacent bone structures. However, ZTE-based MRI did not provide useful information for surgery for skull base lesions such as vestibular schwannoma because bone structures of the skull base often include air components, which cause signal disturbance in MRI. CONCLUSIONS Zero-echo-time sequences on MRI allowed distinct visualization of not only bone but also vital structures around the lesion. This technology has low invasiveness for patients and was useful for preoperative planning and guidance of the optimum approach during surgery in a subset of neurosurgical diseases.
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Affiliation(s)
- Akihiro Inoue
- Department of Neurosurgery, Ehime University School of
Medicine, Japan
| | - Hideaki Watanabe
- Department of Neurosurgery, Ehime University School of
Medicine, Japan
| | - Satoshi Suehiro
- Department of Neurosurgery, Ehime University School of
Medicine, Japan
| | - Naoya Nishida
- Department of Otolaryngology, Ehime University School of
Medicine, Japan
| | | | | | | | | | - Seiji Shigekawa
- Department of Neurosurgery, Ehime University School of
Medicine, Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Ehime University School of
Medicine, Japan
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23
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Branson HM, Martinez-Rios C. Conventional MR Imaging in Trauma Management in Pediatrics. Neuroimaging Clin N Am 2023; 33:251-260. [PMID: 36965943 DOI: 10.1016/j.nic.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Traumatic brain injury (TBI) is a major cause of death and disability in children across the world. The aim of initial brain trauma management of pediatric patients is to diagnose the extent of TBI and to determine if immediate neurosurgical intervention is required. A noncontrast computed tomography is the recommended diagnostic imaging choice for all patients with acute moderate to severe TBI. This article outlines the current use of conventional MR imaging in the management of pediatric head trauma and discusses potential future recommendations.
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Affiliation(s)
- Helen M Branson
- Department of Diagnostic Imaging, SickKids, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada.
| | - Claudia Martinez-Rios
- Department of Diagnostic Imaging, SickKids, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, CHEO, University of Ottawa, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada
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24
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Kumar H, Green R, Cornfeld DM, Condron P, Emsden T, Elsayed A, Zhao D, Gilbert K, Nash MP, Clark AR, Tawhai MH, Burrowes K, Murphy R, Tayebi M, McGeown J, Kwon E, Shim V, Wang A, Choisne J, Carman L, Besier T, Handsfield G, Babarenda Gamage TP, Shen J, Maso Talou G, Safaei S, Maller JJ, Taylor D, Potter L, Holdsworth SJ, Wilson GA. Roadmap for an imaging and modelling paediatric study in rural NZ. Front Physiol 2023; 14:1104838. [PMID: 36969588 PMCID: PMC10036853 DOI: 10.3389/fphys.2023.1104838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/30/2023] [Indexed: 03/12/2023] Open
Abstract
Our study methodology is motivated from three disparate needs: one, imaging studies have existed in silo and study organs but not across organ systems; two, there are gaps in our understanding of paediatric structure and function; three, lack of representative data in New Zealand. Our research aims to address these issues in part, through the combination of magnetic resonance imaging, advanced image processing algorithms and computational modelling. Our study demonstrated the need to take an organ-system approach and scan multiple organs on the same child. We have pilot tested an imaging protocol to be minimally disruptive to the children and demonstrated state-of-the-art image processing and personalized computational models using the imaging data. Our imaging protocol spans brain, lungs, heart, muscle, bones, abdominal and vascular systems. Our initial set of results demonstrated child-specific measurements on one dataset. This work is novel and interesting as we have run multiple computational physiology workflows to generate personalized computational models. Our proposed work is the first step towards achieving the integration of imaging and modelling improving our understanding of the human body in paediatric health and disease.
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Affiliation(s)
- Haribalan Kumar
- Mātai Medical Research Institute, Gisborne, New Zealand
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- GE Healthcare (Australia & New Zealand), Auckland, New Zealand
| | - Robby Green
- Mātai Medical Research Institute, Gisborne, New Zealand
| | - Daniel M. Cornfeld
- Mātai Medical Research Institute, Gisborne, New Zealand
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Paul Condron
- Mātai Medical Research Institute, Gisborne, New Zealand
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Taylor Emsden
- Mātai Medical Research Institute, Gisborne, New Zealand
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Ayah Elsayed
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Auckland University of Technology, Auckland, New Zealand
| | - Debbie Zhao
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Kat Gilbert
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Martyn P. Nash
- Mātai Medical Research Institute, Gisborne, New Zealand
- Department of Engineering Science, University of Auckland, Auckland, New Zealand
| | - Alys R. Clark
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Merryn H. Tawhai
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Kelly Burrowes
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Rinki Murphy
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Maryam Tayebi
- Mātai Medical Research Institute, Gisborne, New Zealand
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Josh McGeown
- Mātai Medical Research Institute, Gisborne, New Zealand
| | - Eryn Kwon
- Mātai Medical Research Institute, Gisborne, New Zealand
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Alan Wang
- Mātai Medical Research Institute, Gisborne, New Zealand
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
| | - Julie Choisne
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Laura Carman
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Thor Besier
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Geoffrey Handsfield
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | | | - Jiantao Shen
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Gonzalo Maso Talou
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Soroush Safaei
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Jerome J. Maller
- GE Healthcare (Australia & New Zealand), Auckland, New Zealand
- Monash Alfred Psychiatry Research Centre, Melbourne, VIC, Australia
| | | | - Leigh Potter
- Mātai Medical Research Institute, Gisborne, New Zealand
| | - Samantha J. Holdsworth
- Mātai Medical Research Institute, Gisborne, New Zealand
- Faculty of Medical and Health Sciences, Centre for Brain Research, University of Auckland, Auckland, New Zealand
- *Correspondence: Samantha J. Holdsworth,
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25
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Kim JH, Ko YS, Kwon SM, Kim CH, Lee CY. Predictive Factors of Recurrence after Endovascular Treatment of Unruptured Vertebrobasilar Fusiform Aneurysms. Clin Neuroradiol 2023; 33:73-86. [PMID: 35763061 DOI: 10.1007/s00062-022-01184-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/01/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to investigate the predictive factors of recurrence after endovascular treatment (EVT) for unruptured vertebrobasilar fusiform aneurysms (VBFA). METHODS This single-center retrospective study evaluated 36 patients who underwent EVT of unruptured VBFA between 2008 and 2020. Variables influencing recurrence, such as size, type, thrombus, preoperative symptoms, and treatment methods, were analyzed. All patients were followed up using vessel imaging. RESULTS In total, 7 of 36 patients (19.4%) developed recurrence. The mean time from EVT to recurrence was 9.2 months (range 2-26.9 months). Maximum aneurysmal diameter on magnetic resonance imaging was decreased, increased, and remained unchanged in 1, 7, and 28 patients, respectively. Transitional type VBFA, brain compression symptoms, large aneurysmal diameter and length, preoperative modified Rankin Scale (mRS) score ≥ 2, sole stenting technique, and intra-aneurysmal thrombus significantly influenced the risk of recurrence. Post-EVT, 7 (19.4%) patients showed complete occlusion of the aneurysm on the immediate postoperative angiogram, and 22 (61.1%) patients showed complete occlusion on the 1‑year follow-up imaging. Good outcomes were observed in 32 patients (88.9%) at the last follow-up, with a mRS score of 0-1 after EVT. CONCLUSION EVT achieves good outcomes in unruptured VBFA. Transitional type VBFA, brain compression symptoms, large aneurysmal diameter and length, preoperative mRS score ≥ 2, sole stenting technique, and intra-aneurysmal thrombus are risk factors for aneurysm recurrence after EVT.
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Affiliation(s)
- Jae Hyun Kim
- Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, 1035, Dalgubeol-daero, 42601, Dalseo-gu, Daegu, Korea (Republic of)
| | - Young San Ko
- Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, 1035, Dalgubeol-daero, 42601, Dalseo-gu, Daegu, Korea (Republic of)
| | - Sae Min Kwon
- Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, 1035, Dalgubeol-daero, 42601, Dalseo-gu, Daegu, Korea (Republic of)
| | - Chang Hyun Kim
- Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, 1035, Dalgubeol-daero, 42601, Dalseo-gu, Daegu, Korea (Republic of)
| | - Chang Young Lee
- Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, 1035, Dalgubeol-daero, 42601, Dalseo-gu, Daegu, Korea (Republic of).
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26
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Bharadwaj UU, Coy A, Motamedi D, Sun D, Joseph GB, Krug R, Link TM. CT-like MRI: a qualitative assessment of ZTE sequences for knee osseous abnormalities. Skeletal Radiol 2022; 51:1585-1594. [PMID: 35088162 PMCID: PMC9198000 DOI: 10.1007/s00256-021-03987-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 12/15/2021] [Accepted: 12/29/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To qualitatively evaluate the utility of zero echo-time (ZTE) MRI sequences in identifying osseous findings and to compare ZTE with optimized spoiled gradient echo (SPGR) sequences in detecting knee osseous abnormalities. MATERIALS AND METHODS ZTE and standard knee MRI sequences were acquired at 3T in 100 consecutive patients. Three radiologists rated confidence in evaluating osseous abnormalities and image quality on a 5-grade Likert scale in ZTE compared to standard sequences. In a subset of knees (n = 57) SPGR sequences were also obtained, and diagnostic confidence in identifying osseous structures was assessed, comparing ZTE and SPGR sequences. Statistical significance of using ZTE over SPGR was characterized with a paired t-test. RESULTS Image quality of the ZTE sequences was rated high by all reviewers with 278 out of 299 (100 studies, 3 radiologists) scores ≥ 4 on the Likert scale. Diagnostic confidence in using ZTE sequences was rated "very high confidence" in 97%, 85%, 71%, and 73% of the cases for osteophytosis, subchondral cysts, fractures, and soft tissue calcifications/ossifications, respectively. In 74% of cases with osseous findings, reviewer scores indicated confidence levels (score ≥ 3) that ZTE sequences improved diagnostic certainty over standard sequences. The diagnostic confidence in using ZTE over SPGR sequences for osseous structures as well as abnormalities was favorable and statistically significant (p < 0.01). CONCLUSION Incorporating ZTE sequences in the standard knee MRI protocol was technically feasible and improved diagnostic confidence for osseous findings in relation to standard MR sequences. In comparison to SPGR sequences, ZTE improved assessment of osseous abnormalities.
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Affiliation(s)
- Upasana Upadhyay Bharadwaj
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA.
| | - Adam Coy
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
- Musculoskeletal Radiology, Vision Radiology, Dallas, TX, USA
| | - Daria Motamedi
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
| | - Dong Sun
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gabby B Joseph
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
| | - Roland Krug
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
| | - Thomas M Link
- Musculoskeletal Imaging, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA
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27
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Bambach S, Ho ML. Deep Learning for Synthetic CT from Bone MRI in the Head and Neck. AJNR Am J Neuroradiol 2022; 43:1172-1179. [PMID: 36920777 PMCID: PMC9575432 DOI: 10.3174/ajnr.a7588] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/13/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Bone MR imaging techniques enable visualization of cortical bone without the need for ionizing radiation. Automated conversion of bone MR imaging to synthetic CT is highly desirable for downstream image processing and eventual clinical adoption. Given the complex anatomy and pathology of the head and neck, deep learning models are ideally suited for learning such mapping. MATERIALS AND METHODS This was a retrospective study of 39 pediatric and adult patients with bone MR imaging and CT examinations of the head and neck. For each patient, MR imaging and CT data sets were spatially coregistered using multiple-point affine transformation. Paired MR imaging and CT slices were generated for model training, using 4-fold cross-validation. We trained 3 different encoder-decoder models: Light_U-Net (2 million parameters) and VGG-16 U-Net (29 million parameters) without and with transfer learning. Loss functions included mean absolute error, mean squared error, and a weighted average. Performance metrics included Pearson R, mean absolute error, mean squared error, bone precision, and bone recall. We investigated model generalizability by training and validating across different conditions. RESULTS The Light_U-Net architecture quantitatively outperformed VGG-16 models. Mean absolute error loss resulted in higher bone precision, while mean squared error yielded higher bone recall. Performance metrics decreased when using training data captured only in a different environment but increased when local training data were augmented with those from different hospitals, vendors, or MR imaging techniques. CONCLUSIONS We have optimized a robust deep learning model for conversion of bone MR imaging to synthetic CT, which shows good performance and generalizability when trained on different hospitals, vendors, and MR imaging techniques. This approach shows promise for facilitating downstream image processing and adoption into clinical practice.
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Affiliation(s)
- S Bambach
- From the Abigail Wexner Research Institute at Nationwide Children's Hospital (S.B.), Columbus, Ohio
| | - M-L Ho
- Department of Radiology (M.-L.H.), Nationwide Children's Hospital, Columbus, Ohio.
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28
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Wiesinger F, Ho ML. Zero-TE MRI: principles and applications in the head and neck. Br J Radiol 2022; 95:20220059. [PMID: 35616709 PMCID: PMC10162052 DOI: 10.1259/bjr.20220059] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/21/2022] [Accepted: 05/12/2022] [Indexed: 12/17/2022] Open
Abstract
Zero echo-time (ZTE) MRI is a novel imaging technique that utilizes ultrafast readouts to capture signal from short-T2 tissues. Additional sequence advantages include rapid imaging times, silent scanning, and artifact resistance. A robust application of this technology is imaging of cortical bone without the use of ionizing radiation, thus representing a viable alternative to CT for both rapid screening and "one-stop-shop" MRI. Although ZTE is increasingly used in musculoskeletal and body imaging, neuroimaging applications have historically been limited by complex anatomy and pathology. In this article, we review the imaging physics of ZTE including pulse sequence options, practical limitations, and image reconstruction. We then discuss optimization of settings for ZTE bone neuroimaging including acquisition, processing, segmentation, synthetic CT generation, and artifacts. Finally, we examine clinical utility of ZTE in the head and neck with imaging examples including malformations, trauma, tumors, and interventional procedures.
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Affiliation(s)
| | - Mai-Lan Ho
- Nationwide Children’s Hospital and The Ohio State University, Columbus, USA
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29
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Yıldız AE, Yaraşır Y, Huri G, Aydıngöz Ü. Optimization of the Grashey View Radiograph for Critical Shoulder Angle Measurement: A Reliability Assessment With Zero Echo Time MRI. Orthop J Sports Med 2022; 10:23259671221109522. [PMID: 35982832 PMCID: PMC9380228 DOI: 10.1177/23259671221109522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/11/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Suboptimal positioning on Grashey view radiographs may limit the
prognosticating potential of the critical shoulder angle (CSA) for shoulder
disorders. Purpose: To investigate whether radiography optimized according to the latest research
is reliable for measuring CSA in comparison with magnetic resonance imaging
(MRI) featuring 3-dimensional (3D) zero echo time (ZTE) sequencing, which
accentuates the contrast between cortical bone and surrounding soft tissue
with high fidelity. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Patients with shoulder pain were prospectively and consecutively enrolled.
All patients had Grashey view radiographs as well as 3.0-T MRI scans with
isotropic 3D ZTE sequencing. Acceptable positioning on the radiographs was
determined using the ratio of the transverse to longitudinal (RTL) diameter
of the lateral glenoid outline; radiographs with an RTL ≥0.25 were repeated.
Two observers independently measured the CSA on the radiographs and the
coronal oblique reformatted ZTE images, the latter including verification of
measurement points by cross-referencing against images from other planes.
Reliability of measurements between observers and modalities was analyzed
with the intraclass correlation coefficient (ICC). The paired-samples
t test was used to compare the differences between
imaging modalities. Results: Enrolled were 65 patients (35 female and 30 male; mean age, 40.2 years;
range, 25-49 years). Radiographs with optimal positioning (RTL < 0.25)
were attained after a mean of 1.6 exposures (range, 1-4); the mean RTL was
0.09 (range, 0-0.20). Interobserver agreement of CSA was excellent for
radiographs (ICC = 0.91; 95% CI, 0.84-0.94) and good for ZTE MRI scans (ICC
= 0.85; 95% CI, 0.71-0.92). Intermodality agreement of CSA between
radiographs and ZTE MRI scans was moderate (ICC = 0.66; 95% CI, 0.48-0.73).
The CSA was significantly different between an optimal radiograph (30.7° ±
4.3°) and ZTE MRI scan (31.8° ± 3.8) (P = .005). Subgroup
analysis revealed no significant differences in CSA measurement between ZTE
MRI scans and Grashey view radiographs with an RTL of <0.1
(P = .08). Conclusion: CSA measurement on ZTE MRI scans with anatomic point cross-referencing was
significantly different from that on Grashey view radiographs, even with
optimal positioning, and radiography may necessitate more than 1 exposure.
An RTL of <0.1 ensured reliability of radiographs when other standards of
sufficient x-ray exposure were met.
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Affiliation(s)
- Adalet Elçin Yıldız
- Department of Radiology, Hacettepe University School of Medicine,
Ankara, Turkey
- Adalet Elçin Yıldız, MD, Department of Radiology, Hacettepe
University School of Medicine, Sihhiye, 06230 Ankara, Turkey (
)
| | - Yasin Yaraşır
- Department of Radiology, Hacettepe University School of Medicine,
Ankara, Turkey
| | - Gazi Huri
- Department of Orthopedics and Traumatology, Hacettepe University
School of Medicine, Ankara, Turkey
| | - Üstün Aydıngöz
- Department of Radiology, Hacettepe University School of Medicine,
Ankara, Turkey
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Aydıngöz Ü, Yıldız AE, Ergen FB. Zero Echo Time Musculoskeletal MRI: Technique, Optimization, Applications, and Pitfalls. Radiographics 2022; 42:1398-1414. [PMID: 35904982 DOI: 10.1148/rg.220029] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Zero echo time (ZTE) imaging is an MRI technique that produces images similar to those obtained with radiography or CT. In ZTE MRI, the very short T2 signal from the mineralized trabecular bone matrix and especially cortical bone-both of which have a low proton density (PD)-is sampled in a unique sequence setup. Additionally, the PD weighting of the ZTE sequence results in less contrast between soft tissues. Therefore, along with gray-scale inversion from black to white and vice versa, ZTE imaging provides excellent contrast between cortical bone and soft tissues similar to that of radiography and CT. However, despite isotropic or near-isotropic three-dimensional (3D) imaging capabilities of the ZTE sequence, spatial resolution in this technique is still inferior to that of radiography and CT, and 3D volume renderings are currently time-consuming and require postprocessing software that features segmentation and manual contouring. Optimization of ZTE MRI mostly entails adjustments of bandwidth, flip angle, field of view, and image matrix. A wide range of structural abnormalities and disease or healing processes in the musculoskeletal system are well delineated with ZTE MRI, including conditions that involve bone-based morphometric analyses (which aid diagnosis, help prognostication, and guide surgery), impaction, avulsion and stress fractures, loose bodies or erosions in and around joints, soft-tissue calcifications and ossifications, and bone tumors (including treatment response). The pitfalls of ZTE imaging include mimics of foci of calcification or ossification such as intra-articular gas and susceptibility artifacts from surgical materials and hemosiderin deposition, which can be avoided in many instances by cross-referencing images obtained with other MRI sequences. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Üstün Aydıngöz
- From the Department of Radiology, Hacettepe University School of Medicine, 06230 Ankara, Turkey
| | - Adalet Elçin Yıldız
- From the Department of Radiology, Hacettepe University School of Medicine, 06230 Ankara, Turkey
| | - F Bilge Ergen
- From the Department of Radiology, Hacettepe University School of Medicine, 06230 Ankara, Turkey
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Lee W, Han HJ, Kim J, Park KY, Kim YB, Jang CK, Chung J. Flow diverter for the treatment of large (> 10 mm) vertebral artery dissecting aneurysms. Acta Neurochir (Wien) 2022; 164:1247-1254. [PMID: 34383115 DOI: 10.1007/s00701-021-04965-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/05/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the outcomes of flow-diverting device (FDD) treatment for large vertebral artery dissecting aneurysms (VADAs). METHODS This retrospective study evaluated 12 patients with 12 VADAs who were treated using FDD between 2013 and 2020. Clinical and radiographic data, including procedure-related complications and clinical outcomes assessed using the modified Rankin Scale (mRS) at the time of the last follow-up, were collected and reviewed. RESULTS All 12 patients had unruptured aneurysms. There were 3 (25%) female and 9 (75%) male patients, and the mean patient age was 54.6 years. The mean size of the aneurysm was 15.9 ± 4.8 mm. The mean follow-up duration was 15.8 months. Single FDD without additional coils was used in all patients. One patient underwent second-line treatment with FDD for recurrence of large VADA after stent-assisted coiling. Immediate follow-up angiography after placement of the FDD demonstrated intra-aneurysmal contrast stasis. There were 2 (17%) patients who had peri-procedural stroke. Angiography at the 6-month follow-up in 10 patients showed favorable occlusion (OKM grade C3 + D). A total of 11 (92%) patients had good clinical outcome (modified Rankin Scale ≤ 2) at the last follow-up. No re-treatment or delayed aneurysm rupture occurred during the follow-up period. CONCLUSIONS Reconstructive technique with FDD is a feasible and effective modality for the treatment of large VADAs, showing favorable occlusion rate and clinical outcome.
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Eley KA, Delso G. Imaging of Bone in the Head and Neck Region, is There More Than CT? CURRENT RADIOLOGY REPORTS 2022; 10:69-82. [PMID: 35463479 PMCID: PMC9013214 DOI: 10.1007/s40134-022-00396-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 01/22/2023]
Abstract
Purpose of Review The objective of this review is to document the advances in non-ionising imaging alternatives to CT for the head and neck. Recent Findings The main alternative to CT for imaging bone of the head and neck region is MRI, particularly techniques which incorporate gradient echo imaging (Black Bone technique) and ultra-short or zero-echo time imaging. Since these techniques can provide high resolution isometric voxels, they can be used to provide multi-planar reformats and, following post processing, 3D reconstructed images of the craniofacial skeleton. As expected, the greatest advancements in recent years have been focused on enhanced image processing techniques and attempts to address the difficulties encountered at air-bone interfaces. Summary This article will review the imaging techniques and recent advancements which are bringing non-ionising alternatives to CT imaging of the bone of the head and neck region into the realm of routine clinical application.
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Affiliation(s)
- Karen A. Eley
- Department of Radiology, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ UK
| | - Gaspar Delso
- MR Applications & Workflow, GE Healthcare, Barcelona, Spain
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Kim YN, Choi JW, Lim YC, Song J, Park JH, Jung WS. Usefulness of Silent MRA for Evaluation of Aneurysm after Stent-Assisted Coil Embolization. Korean J Radiol 2022; 23:246-255. [PMID: 35029075 PMCID: PMC8814699 DOI: 10.3348/kjr.2021.0332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the usefulness of Silent MR angiography (MRA) for evaluating intracranial aneurysms treated with stent-assisted coil embolization. MATERIALS AND METHODS Ninety-nine patients (101 aneurysms) treated with stent-assisted coil embolization (Neuroform atlas, 71 cases; Enterprise, 17; LVIS Jr, 9; and Solitaire AB, 4 cases) underwent time-of-flight (TOF) MRA and Silent MRA in the same session using a 3T MRI system within 24 hours of embolization. Two radiologists independently interpreted both MRA images retrospectively and rated the image quality using a 5-point Likert scale. The image quality and diagnostic accuracy of the two modalities in the detection of aneurysm occlusion were further compared based on the stent design and the site of aneurysm. RESULTS The average image quality scores of the Silent MRA and TOF MRA were 4.38 ± 0.83 and 2.78 ± 1.04, respectively (p < 0.001), with an almost perfect interobserver agreement. Silent MRA had a significantly higher image quality score than TOF MRA at the distal internal carotid artery (n = 57, 4.25 ± 0.91 vs. 3.05 ± 1.16, p < 0.001), middle cerebral artery (n = 21, 4.57 ± 0.75 vs. 2.19 ± 0.68, p < 0.001), anterior cerebral artery (n = 13, 4.54 ± 0.66 vs. 2.46 ± 0.66, p < 0.001), and posterior circulation artery (n = 10, 4.50 ± 0.71 vs. 2.90 ± 0.74, p = 0.013). Silent MRA had superior image quality score to TOF MRA in the stented arteries when using Neuroform atlas (4.66 ± 0.53 vs. 3.21 ± 0.84, p < 0.001), Enterprise (3.29 ± 1.59 vs. 1.59 ± 0.51, p = 0.003), LVIS Jr (4.33 ± 1.89 vs. 1.89 ± 0.78, p = 0.033), and Solitaire AB stents (4.00 ± 2.25 vs. 2.25 ± 0.96, p = 0.356). The interpretation of the status of aneurysm occlusion exhibited significantly higher sensitivity with Silent MRA than with TOF MRA when using the Neuroform Atlas stent (96.4% vs. 14.3%, respectively, p < 0.001) and LVIS Jr stent (100% vs. 20%, respectively, p = 0.046). CONCLUSION Silent MRA can be useful to evaluate aneurysms treated with stent-assisted coil embolization, regardless of the aneurysm location and type of stent used.
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Affiliation(s)
- You Na Kim
- Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea
| | - Jin Wook Choi
- Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea
| | - Yong Cheol Lim
- Department of Neurosurgery, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea
| | - Jihye Song
- Department of Neurosurgery, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea
| | - Ji Hyun Park
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Korea
| | - Woo Sang Jung
- Department of Radiology, Ajou University School of Medicine, Ajou University Medical Center, Suwon, Korea.,Department of Radiology, Kangwon National University College of Medicine, Chuncheon, Korea.
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Sandberg JK, Young VA, Yuan J, Hargreaves BA, Wishah F, Vasanawala SS. Zero echo time pediatric musculoskeletal magnetic resonance imaging: initial experience. Pediatr Radiol 2021; 51:2549-2560. [PMID: 34156504 DOI: 10.1007/s00247-021-05125-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/24/2021] [Accepted: 06/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Projection radiography (XR) is often supplemented by both CT (to evaluate osseous structures with ionizing radiation) and MRI (for marrow and soft-tissue assessment). Zero echo time (ZTE) MR imaging produces a "CT-like" osseous contrast that might obviate CT. OBJECTIVE This study investigated our institution's initial experience in implementing an isotropic ZTE MR imaging sequence for pediatric musculoskeletal examinations. MATERIALS AND METHODS Pediatric patients referred for extremity MRI at 3 tesla (T) underwent ZTE MR imaging to yield images with contrast similar to that of CT. A radiograph-like image was also created with ray-sum image processing. We assessed ZTE-CT/XR anatomical image quality (Sanat) from 0 (nondiagnostic) to 5 (outstanding). Further, we made image comparisons on a 5-point scale (Scomp) (range of -2 = conventional CT/XR greater anatomical delineation to +2 = ZTE-CT/XR greater anatomical delineation; 0=same) for three cohorts: (1) ZTE-XR to conventional radiography, (2) ZTE-CT to conventional CT and (3) pathological lesion assessment on ZTE-XR to conventional radiography. We measured cortical thickness of ZTE-XR and ZTE-CT and compared these with conventional imaging. We calculated confidence interval of proportions, Wilcoxon rank sum test and intraclass correlation coefficients for inter-reader agreement. RESULTS Cohorts 1, 2 and 3 consisted of 40, 20 and 35 cases, respectively (age range 0.6-23.0 years). ZTE-CT versus CT and ZTE-XR versus radiography of cortical thicknesses were not significantly different (P=0.55 and P=0.31, respectively). Cortical delineation was rated diagnostic or better (score of 3, 4 or 5) in all cases (confidence interval of proportions = 100%) for ZTE-CT/XR. Similarly, intramedullary cavity delineation was rated diagnostic or better in all cases for ZTE-CT, and ZTE-XR was at least diagnostic in 58-63% of cases. For cohort 2, cortex and intramedullary cavity Scomp for ZTE-CT was comparable to those of conventional CT, with confidence interval of proportion (sum of score of -1 to +2) of 93-100% and 95%, respectively. Pathology visualized on ZTE-CT/XR was comparable; Scomp confidence interval of proportions was 95%/97-100%, with improved delineation of non-displaced fractures on ZTE-XR. Readers had moderate to near-perfect intraclass correlation coefficient (range=0.60-0.93). CONCLUSION Implementation of a diagnostic-quality ZTE MRI sequence in the pediatric population is feasible and can be performed as a complementary pulse sequence to enhance musculoskeletal MRI studies. Compared to conventional CT, ZTE has comparable cortical delineation, intramedullary cavity and pathology visualization. While not intended as a replacement for conventional radiography, ZTE-XR provides similar visualization of pathology.
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Affiliation(s)
- Jesse K Sandberg
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA.
| | - Victoria A Young
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
| | - Jianmin Yuan
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
| | - Brian A Hargreaves
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
| | - Fidaa Wishah
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
| | - Shreyas S Vasanawala
- Department of Radiology, Stanford University School of Medicine, 725 Welch Road, Room 1844, Stanford, CA, 94305, USA
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Deininger-Czermak E, Euler A, Franckenberg S, Finkenstaedt T, Villefort C, Gascho D, Guggenberger R. Evaluation of ultrashort echo-time (UTE) and fast-field-echo (FRACTURE) sequences for skull bone visualization and fracture detection - A postmortem study. J Neuroradiol 2021; 49:237-243. [PMID: 34758365 DOI: 10.1016/j.neurad.2021.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 10/11/2021] [Accepted: 11/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE CT is considered the modality of choice in the assessment of the skull due to the fast and accurate depiction of bone structures. Nevertheless, MRI has evolved into a possible alternative due to optimal soft tissue contrast and recent advances with the ability to visualize tissues with shortest T2 times, such as osseous structures. In this study we compare skull bone visualization and fracture detection across two MRI sequences to CT as reference standard. MATERIAL AND METHODS Twenty subjects underwent CT and MRI with less than 72 h between examination. The MRI protocol included a 2D ultrashort echo time (UTE) and a 3D multi-echo in-phase fast-field-echo (FRACTURE) sequence. Independent raters evaluated qualitative characteristics and fracture detectability in different skull subregions (skull vault, skull base and viscerocranium). Interrater and intermodality agreement was evaluated by calculating intraclass coefficients (ICC). RESULTS FRACTURE ICC indicated a good agreement in all subregions (ICC = 0.83 - 0.88), whereas UTE had excellent results calculated in the skull vault and viscerocranium (ICC = 0.91 - 0.94). At the skull vault, both MRI sequences received an overall good rating (UTE: 2.63 ± 0.42 FRACTURE. 2.81 ± 0.32). Fracture detection using MRI sequences for the skull vault, was highest compared to other subregions. CONCLUSIONS Both MRI sequences may provide an alternative e.g. for surgical planning or follow up exams of the osseous neurocranium; although, at the skull base and viscerocranium bone visualization with MRI bone imaging sequences perform inferior to CT standard imaging.
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Affiliation(s)
- Eva Deininger-Czermak
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Andre Euler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Sabine Franckenberg
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Tim Finkenstaedt
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Dominic Gascho
- Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
| | - Roman Guggenberger
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
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36
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Kobayashi N, Bambach S, Ho ML. Ultrashort Echo-Time MR Imaging of the Pediatric Head and Neck. Magn Reson Imaging Clin N Am 2021; 29:583-593. [PMID: 34717846 DOI: 10.1016/j.mric.2021.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Bone MR imaging techniques use extremely rapid echo times to maximize detection of short-T2 tissues with low water concentrations. The major approaches used in clinical practice are ultrashort echo-time and zero echo-time. Synthetic CT generation is feasible using atlas-based, voxel-based, and deep learning approaches. Major clinical applications in the pediatric head and neck include evaluation for craniosynostosis, sinonasal and jaw imaging, trauma, interventional planning, and postoperative follow-up. In this article, we review the technical background and practical usefulness of bone MR imaging with key imaging examples.
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Affiliation(s)
- Naoharu Kobayashi
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, 2021 6th Street SE, Minneapolis, MN 55455, USA
| | - Sven Bambach
- Abigail Wexner Research Institute at Nationwide Children's Hospital, 575 Children's Crossroad, Columbus, OH 43215, USA
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Dr - ED4, Columbus, OH 43205, USA.
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Chong LR, Lee K, Sim FY. 3D MRI with CT-like bone contrast - An overview of current approaches and practical clinical implementation. Eur J Radiol 2021; 143:109915. [PMID: 34461599 DOI: 10.1016/j.ejrad.2021.109915] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 12/24/2022]
Abstract
CT is the imaging modality of choice for assessment of 3D bony morphology but incurs the penalty of ionizing radiation. Improving the ability of 3D MRI to provide high-resolution images of cortical bone with CT-like bone contrast has been a focus of recent research. The ability of 3D MRI to deliver cortical bone information with similar diagnostic performance to CT would complement assessment of soft tissues and medullary bone from a single MRI examination, simplifying evaluation and obviating radiation exposure from additional CT. This article presents an overview of current 3D MRI approaches for imaging cortical bone with CT-like bone contrast including ultrashort echo time, zero echo time, T1-weighted gradient recalled echo, susceptibility-weighted imaging and deep learning techniques. We also discuss clinical implementation of an optimized stack-of-stars 3D gradient recalled echo pulse sequence (3D-Bone) on commercially available MRI scanners for rendering 3D MRI with CT-like bone contrast in our institutional practice.
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Affiliation(s)
- Le Roy Chong
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Republic of Singapore.
| | - Kathy Lee
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Republic of Singapore.
| | - Fang Yang Sim
- Department of Radiology, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Republic of Singapore.
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38
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Johnson B, Alizai H, Dempsey M. Fast field echo resembling a CT using restricted echo-spacing (FRACTURE): a novel MRI technique with superior bone contrast. Skeletal Radiol 2021; 50:1705-1713. [PMID: 33175183 DOI: 10.1007/s00256-020-03659-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Computerized tomography (CT) is the modality of choice for imaging bone; however, it utilizes ionizing radiation and suffers from poor soft-tissue contrast. Unlike CT, magnetic resonance imaging (MRI) provides excellent soft-tissue contrast but is limited in its ability to image bone. The objective of this study is to describe a new technical innovation which provides superior cortical and trabecular bone contrast on MRI. METHODS FRACTURE (fast field echo resembling a CT using restricted echo-spacing), a 3D gradient echo pulse sequence with restricted echo-spacing combined with an automated post-processing, is described. RESULTS Cases demonstrating the application and utility of this technique in diagnostic MRI performed for traumatic, inflammatory, neoplastic, and developmental conditions in pediatric patients are presented. CONCLUSION The cortical and trabecular bone contrast generated by FRACTURE yields clinically relevant information for diagnosis and management of a subset of patients in whom it may potentially obviate the need for a preoperative CT scan.
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Affiliation(s)
- Brian Johnson
- Advanced Clinical Solutions, Philips Healthcare, Dallas, TX, USA
| | - Hamza Alizai
- Department of Radiology, Scottish Rite Hospital for Children, 2222 Welborn St, Dallas, TX, 75219, USA.
| | - Molly Dempsey
- Department of Radiology, Scottish Rite Hospital for Children, 2222 Welborn St, Dallas, TX, 75219, USA
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Lawson M, Tully J, Ditchfield M, Metcalfe P, Qi Y, Kuganesan A, Badawy MK. A review of current imaging techniques used for the detection of occult bony fractures in young children suspected of sustaining non-accidental injury. J Med Imaging Radiat Oncol 2021; 66:68-78. [PMID: 34176229 DOI: 10.1111/1754-9485.13270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/01/2021] [Indexed: 11/30/2022]
Abstract
Non-accidental injuries remain a leading cause of preventable morbidity and mortality in young children. The accurate identification of the full spectrum of injuries in children presenting with suspected abuse is essential to ensure the appropriate protective intervention is taken. The identification of occult bone fractures in this cohort is important as it raises the level of concern about the mechanism of injury and maintaining the child's safety. Radiographic imaging remains the modality of choice for skeletal assessment; however, current studies report concerns regarding the ability of radiographs to detect certain fractures in the acute stage. As such, alternative modalities for the detection of fractures have been proposed. This article reviews the current literature regarding fracture detectability and radiation dose burden of imaging modalities currently used for the assessment of occult bony injury in young children in whom non-accidental injury is suspected.
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Affiliation(s)
- Michael Lawson
- Monash Imaging, Monash Health, Melbourne, Victoria, Australia.,Centre for Medical and Radiation Physics, School of Physics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Joanna Tully
- Victorian Forensic Paediatric Medical Service, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Michael Ditchfield
- Monash Imaging, Monash Health, Melbourne, Victoria, Australia.,Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Metcalfe
- Centre for Medical and Radiation Physics, School of Physics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Yujin Qi
- Centre for Medical and Radiation Physics, School of Physics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Mohamed K Badawy
- Monash Imaging, Monash Health, Melbourne, Victoria, Australia.,Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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40
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Jeong HS, Park C, Kim KS, Kim JH, Jeon CH. Clinical feasibility of MR-generated synthetic CT images of the cervical spine: Diagnostic performance for detection of OPLL and comparison of CT number. Medicine (Baltimore) 2021; 100:e25800. [PMID: 33950980 PMCID: PMC8104225 DOI: 10.1097/md.0000000000025800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/13/2021] [Indexed: 01/04/2023] Open
Abstract
We aimed to determine the incremental value of magnetic resonance generated synthetic computed tomography (MRCT), evaluate cervical ossification of the posterior longitudinal ligament (OPLL), and compare the computed tomography (CT) numbers between MRCT and conventional CT.Twenty-two patients who underwent magnetic resonance imaging (MRI) with MRCT protocols and CT were enrolled. MRCT images were generated from 3D-T2-weighted imaging, 3D-pointwise-encoding time reduction with radial acquisition, 3D-T1-Dixon, and 3D-time-of-flight sequences. Two radiologists independently evaluated the presence of OPLL at each cervical spine level during sessions 1 (MRI alone) and 2 (MRI + MRCT). CT was the reference standard for the presence of OPLL. One reader measured the mean CT number of the vertebral body and spinous process at each cervical spine level in the MRCT and CT images.Sensitivity for the detection of OPLL was markedly higher in session 2 (MRI + MRCT) than in session 1 (MRI alone), as measured by both readers (47% vs. 90%, reader 1; 63% vs. 93%, reader 2). The mean CT number of MRCT and CT showed a moderate to strong positive correlation (ρ = .42-.72, P < .001).The combined use of MRCT and MRI showed improved sensitivity for the evaluation of cervical OPLL. The mean CT number of MRCT and CT showed a positive correlation.
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Affiliation(s)
- Hee Seok Jeong
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan
| | - Chankue Park
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan
| | | | - Jin Hyeok Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan
| | - Chang Ho Jeon
- Department of Radiology, Pusan National University Hospital, Pusan, Korea
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41
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Probst M, Burian E, Robl T, Weidlich D, Karampinos D, Brunner T, Zimmer C, Probst FA, Folwaczny M. Magnetic resonance imaging as a diagnostic tool for periodontal disease: A prospective study with correlation to standard clinical findings-Is there added value? J Clin Periodontol 2021; 48:929-948. [PMID: 33745132 DOI: 10.1111/jcpe.13458] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/25/2021] [Accepted: 02/28/2021] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the correlation between standard clinical findings, radiographic (OPT) and magnetic resonance imaging (MRI) as well as to assess whether MRI is capable of providing additional information related to the severity and extent of periodontal disease. METHODS 42 patients with generalized periodontitis received pre-interventional MRI scans. These were compared to MR images of a periodontal healthy control group (n = 34). The extent of the osseous oedema, detected by MRI, was set in correlation with clinical periodontitis-associated findings. RESULTS A highly significant correlation between bone oedema and clinical testings such as probing depth (p < 0.0001) and bleeding on probing (p < 0.0001) was revealed. The oedema exceeded the extent of demineralized bone. Patients with a positive BOP test showed a 2.51-fold increase in risk of already having a bone oedema around the respective tooth even if probing depth was ≤3 mm (logistic binary regression analysis, OR 2.51; 95% CI: 1.54-4.11; p < 0.0001). CONCLUSION MRI findings correlated with standard clinical findings, and MRI was able to depict intraosseous changes before any osseous defect had occurred.
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Affiliation(s)
- Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Teresa Robl
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Dimitrios Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Teresa Brunner
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University, Munich, Germany
| | - Florian Andreas Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Munich, Germany
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Hecht S, Anderson KM, Castel A, Griffin JF, Hespel AM, Nelson N, Sun X. Agreement of Magnetic Resonance Imaging With Computed Tomography in the Assessment for Acute Skull Fractures in a Canine and Feline Cadaver Model. Front Vet Sci 2021; 8:603775. [PMID: 33969028 PMCID: PMC8100023 DOI: 10.3389/fvets.2021.603775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 03/26/2021] [Indexed: 12/05/2022] Open
Abstract
Computed tomography (CT) is the imaging modality of choice to evaluate patients with acute head trauma. However, magnetic resonance imaging (MRI) may be chosen in select cases. The objectives of this study were to evaluate the agreement of MRI with CT in the assessment for presence or absence of acute skull fractures in a canine and feline cadaver model, compare seven different MRI sequences (T1-W, T2-W, T2-FLAIR, PD-W, T2*-W, “SPACE” and “VIBE”), and determine agreement of four different MRI readers with CT data. Pre- and post-trauma CT and MRI studies were performed on 10 canine and 10 feline cadaver heads. Agreement of MRI with CT as to presence or absence of a fracture was determined for 26 individual osseous structures and four anatomic regions (cranium, face, skull base, temporomandibular joint). Overall, there was 93.5% agreement in assessing a fracture as present or absent between MRI and CT, with a significant difference between the pre and post trauma studies (99.4 vs. 87.6%; p < 0.0001; OR 0.042; 95% CI 0.034–0.052). There was no significant difference between dogs and cats. The agreement for the different MRI sequences with CT ranged from 92.6% (T2*-W) to 94.4% (PD-W). There was higher agreement of MRI with CT in the evaluation for fractures of the face than other anatomic regions. Agreement with CT for individual MRI readers ranged from 92.6 to 94.7%. A PD-W sequence should be added to the MR protocol when evaluating the small animal head trauma patient.
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Affiliation(s)
- Silke Hecht
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, United States
| | - Kimberly M Anderson
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, United States
| | - Aude Castel
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, United States
| | - John F Griffin
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, United States
| | - Adrien-Maxence Hespel
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, United States
| | - Nathan Nelson
- Department of Molecular and Biomedical Sciences, North Carolina State University, Raleigh, NC, United States
| | - Xiaocun Sun
- Office of Information Technology, University of Tennessee, Knoxville, TN, United States
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Park H, Nam IC, Baek HJ, Ryu KH, Cho E, Kim SS, An HJ. Chronic Intradiploic Organizing Hematoma of the Skull Mimicking Calvarial Tumor Diagnosed Using Zero TE MRI: A Case Report and Review of Literature. ACTA ACUST UNITED AC 2020; 57:medicina57010018. [PMID: 33379265 PMCID: PMC7824157 DOI: 10.3390/medicina57010018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/22/2020] [Accepted: 12/24/2020] [Indexed: 11/16/2022]
Abstract
Chronic intradiploic organizing hematoma of the skull is a rare lesion that usually presents as a progressively growing mass after head trauma, thus making it difficult to diagnose. To date, only nine cases that have been histopathologically confirmed as organizing hematoma of the skull have been reported in the literature. Herein, we describe a case of a chronic organizing hematoma involving the right parietal bone, presenting as a slowly growing mass in a 54-year-old man. The lesion was also visualized on magnetic resonance imaging (MRI) with a zero echo time sequence. In this case report, we emphasize that chronic intradiploic organizing hematoma should be considered in the differential diagnosis of a palpable scalp mass. We also highlight the importance of meticulous radiological review in the context of appropriate clinical suspicion and the usefulness of the zero TE sequence in evaluating calvarial lesions.
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Affiliation(s)
- Hyun Park
- Department of Neurosurgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea; (H.P.); (S.S.K.)
| | - In Chul Nam
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea;
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea; (K.H.R.); (E.C.)
- Department of Radiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, 816-15 Jinju-daero, Jinju 52727, Korea
- Correspondence: ; Tel.: +82-55-214-3140
| | - Kyeong Hwa Ryu
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea; (K.H.R.); (E.C.)
| | - Eun Cho
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea; (K.H.R.); (E.C.)
| | - Seung Soo Kim
- Department of Neurosurgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea; (H.P.); (S.S.K.)
| | - Hyo Jung An
- Department of Pathology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea;
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Saat R, Kurdo G, Laulajainen-Hongisto A, Markkola A, Jero J. Detection of Coalescent Acute Mastoiditis on MRI in Comparison with CT. Clin Neuroradiol 2020; 31:589-597. [PMID: 32696283 PMCID: PMC8463380 DOI: 10.1007/s00062-020-00931-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 06/22/2020] [Indexed: 11/26/2022]
Abstract
Purpose Current imaging standard for acute mastoiditis (AM) is contrast-enhanced computed tomography (CT), revealing inflammation-induced bone destruction, whereas magnetic resonance imaging (MRI) outperforms CT in detecting intracranial infection. Our aim was to compare the diagnostic performance of MRI with CT in detecting coalescent AM and see to which extent MRI alone would suffice to diagnose or rule out this condition. Methods The MR images of 32 patients with AM were retrospectively analyzed. Bone destruction was evaluated from T2 turbo spin echo (TSE) and T1 Gd magnetization-prepared rapid acquisition with gradient echo (MPRAGE) images. Intramastoid enhancement and diffusion restriction were evaluated subjectively and intramastoid apparent diffusion coefficient (ADC) values were measured. The MRI findings were compared with contrast-enhanced CT findings of the same patients within 48 h of the MR scan. Results Depending on the anatomical subsite, MRI detected definite bone defects with a sensitivity of 100% and a specificity of 54–82%. Exception was the inner cortical table where sensitivity was only 14% and specificity was 76%. Sensitivity for general coalescent mastoiditis remained 100% due to multiple coexisting lesions. The absence of intense enhancement and non-restricted diffusion had a high negative predictive value for coalescent mastoiditis: an intramastoid ADC above 1.2 × 10−3 mm2/s excluded coalescent mastoiditis with a negative predictive value of 92%. Conclusion The MRI did not miss coalescent mastoiditis but was inferior to CT in direct estimation of bone defects. When enhancement and diffusion characteristics are also considered, MRI enables dividing patients into low, intermediate and high-risk categories with respect to coalescent mastoiditis, where only the intermediate risk group is likely to benefit from additional CT.
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Affiliation(s)
- R Saat
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, POB 340 Haartmaninkatu 4, HUS 00029, Helsinki, Finland.
- Radiology, East Tallinn Central Hospital, Ravi tn. 18, 10138, Tallinn, Estonia.
| | - G Kurdo
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, POB 340 Haartmaninkatu 4, HUS 00029, Helsinki, Finland
| | - A Laulajainen-Hongisto
- Otorhinolaryngology and Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, POB 263 Kasarmikatu 11-13, HUS 00029, Helsinki, Finland
| | - A Markkola
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, POB 340 Haartmaninkatu 4, HUS 00029, Helsinki, Finland
| | - J Jero
- Otorhinolaryngology and Head and Neck Surgery, University of Turku and Turku University Hospital, POB 52 Kiinamyllynkatu 4-8, 20521, Turku, Finland
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Clinical utility of new three-dimensional model using a zero-echo-time sequence in endoscopic endonasal transsphenoidal surgery. Clin Neurol Neurosurg 2020; 190:105743. [PMID: 32113079 DOI: 10.1016/j.clineuro.2020.105743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Recognizing the anatomical orientation surrounding the sellar floor is crucial in endoscopic endonasal transsphenoidal surgery (ETSS). Zero-echo-time (ZTE) sequences were recently suggested for a new bone identification technique on magnetic resonance imaging (MRI). This study aimed to evaluate the clinical usefulness of three-dimensional (3D)-ZTE-based MRI models in providing anatomical guidance for ETSS. PATIENTS AND METHODS ZTE-based MRI and magnetic resonance angiography (MRA) data from 15 consecutive patients with pituitary tumor treated between September 2018 and May 2019 were used to create 3D-MRI models. From these, the architecture surrounding the sellar floor, particularly anatomical relationships between tumors and internal carotid arteries (ICAs), was visualized to preoperatively plan surgical procedures. In addition, 3D-ZTE-based MRI models were compared to actual surgical views during ETSS to evaluate model applicability. RESULTS These 3D-ZTE-based MRI models clearly demonstrated the morphology of the sellar floor and matched well with intraoperative views, including pituitary tumor, by successively eliminating sphenoidal structures. The models also permitted determination of the maximum marginal line of the opening of the sellar floor by presenting vital structures such as ICAs and tumors. With such 3D-MRI models, the surgeon could access the intracranial area through the sellar floor more safely, and resect the pituitary tumor maximally without complications. CONCLUSION Our 3D-MRI models based on ZTE sequences allowed distinct visualization of vital structures and pituitary tumor around the sellar floor. This new method using 3D-ZTE-based MRI models showed low invasiveness for patients and was useful in preoperative planning for ETSS, facilitating maximum tumor resection without complications.
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Lee C, Jeon KJ, Han SS, Kim YH, Choi YJ, Lee A, Choi JH. CT-like MRI using the zero-TE technique for osseous changes of the TMJ. Dentomaxillofac Radiol 2019; 49:20190272. [PMID: 31670578 DOI: 10.1259/dmfr.20190272] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE This study was conducted to assess the clinical usability of the zero-echo time (ZTE) technique of MRI for evaluating bone changes of the temporomandibular joint (TMJ) in comparison with CBCT. METHODS Twenty patients with TMJ disorder who underwent both CBCT and MRI were randomly selected. CBCT images were obtained with an Alphard 3030 device (Asahi Roentgen Ind., Co. Ltd, Kyoto, Japan). MRIs were obtained using a 3.0 T scanner (Pioneer; GE Healthcare, Waukesha, WI, USA) and a 21-channel head coil. An isotropic three-dimensional proton-density-weighted ZTE sequence was acquired. Two radiologists evaluated 40 joints of 20 patients for the presence of the following osseous changes: flattening, erosion, osteophyte and sclerosis of the condyle; and flattening, erosion and sclerosis of the articular fossa. CBCT and ZTE-MRI assessments were performed at a 2-month interval. The prevalence-adjusted and bias-adjusted κ statistic was used to analyse interexaminer and intraexaminer agreement and the agreement between ZTE-MRI and CBCT. RESULTS Intraexaminer and interexaminer agreement analyses of ZTE-MRI showed high reproducibility (κ>0.80), which was comparable to that of CBCT. Flattening, osteophyte and sclerosis of the condyle and all types of bone changes in the mandibular fossa showed nearly perfect agreement between CBCT and ZTE-MRI (κ = 0.80-0.90). Erosion of the condyle showed substantial agreement between both sets of images (κ = 0.65-0.70). CONCLUSIONS It is suggested that ZTE-MRI provides clinically reliable images for bone assessment in TMJ disorder. MRI may become a beneficial diagnostic tool for patients with both TMJ disc and bone pathology, with advantages involving medical costs and radiation dose.
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Affiliation(s)
- Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Young Hyun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Ari Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jong Hoon Choi
- Department of Orofacial Pain and Oral Medicine, Yonsei Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
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Ryu KH, Baek HJ, Moon JI, Choi BH, Park SE, Ha JY, Park H, Kim SS, Kim JS, Cho SB, Carl M. Usefulness of Noncontrast-Enhanced Silent Magnetic Resonance Angiography (MRA) for Treated Intracranial Aneurysm Follow-up in Comparison with Time-of-Flight MRA. Neurosurgery 2019; 87:220-228. [DOI: 10.1093/neuros/nyz421] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 07/29/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Flow visualization in time-of-flight magnetic resonance angiography (TOF MRA) is limited for treated intracranial aneurysms owing to magnetic susceptibility and radiofrequency shielding.
OBJECTIVE
To assess the clinical usefulness of noncontrast-enhanced magnetic resonance angiography (MRA) using a silent scan (silent MRA) as a follow-up imaging modality in patients with treated intracranial aneurysms.
METHODS
A total of 119 patients with 126 treated aneurysms underwent silent MRA and TOF MRA during the same scan session. Two neuroradiologists independently assessed overall image quality and visualization of the treated site using a 5-point Likert scale to compare the 2 image sets. We used receiver operating characteristic (ROC) curve analysis to investigate the diagnostic performance of the 2 MRA methods in evaluating aneurysm occlusion. Interobserver reliability was also assessed using weighted kappa statistics.
RESULTS
The overall image quality scores of silent MRA and TOF MRA were 4.04 ± 0.22 and 4.64 ± 0.48, respectively (P < .001), and interobserver agreement was substantial (P < .001). For the treated site, the score of flow visualization on silent MRA was higher than that on TOF MRA, 3.94 ± 0.94 vs 2.59 ± 1.37 (P < .001), with substantial interobserver agreement (P < .001). ROC curve analysis showed that silent MRA was superior to TOF MRA in diagnostic performance (area under the curve [AUC] = 0.962; 95% CI: 0.931-0.982 vs AUC = 0.843; 95% CI: 0.792-0.886; P < .001).
CONCLUSION
Silent MRA can be useful to evaluate treated intracranial aneurysms during follow-up without radiation exposure and use of contrast material. It is characterized by higher diagnostic performance and superior visualization for the treated site.
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Affiliation(s)
- Kyeong Hwa Ryu
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Jin Il Moon
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Bo Hwa Choi
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
- Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Sung Eun Park
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Ji Young Ha
- Department of Radiology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Hyun Park
- Department of Neurosurgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
- Department of Neurosurgery, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Seung Soo Kim
- Department of Neurosurgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jung-Soo Kim
- Department of Neurosurgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Soo Buem Cho
- Department of Radiology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Michael Carl
- Applied Science Lab, GE Healthcare, San Diego, CA, United States
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Engström M, McKinnon G, Cozzini C, Wiesinger F. In‐phase zero TE musculoskeletal imaging. Magn Reson Med 2019; 83:195-202. [DOI: 10.1002/mrm.27928] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 07/13/2019] [Accepted: 07/15/2019] [Indexed: 12/15/2022]
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