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Gassert FT, Kufner A, Renz M, Gassert FG, Bollwein C, Kronthaler S, Feuerriegel GC, Kirschke JS, Ganter C, Makowski MR, Braun C, Schwaiger BJ, Woertler K, Karampinos DC, Gersing AS. Comparing CT-Like Images Based on Ultra-Short Echo Time and Gradient Echo T1-Weighted MRI Sequences for the Assessment of Vertebral Disorders Using Histology and True CT as the Reference Standard. J Magn Reson Imaging 2024; 59:1542-1552. [PMID: 37501387 DOI: 10.1002/jmri.28927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Several magnetic resonance (MR) techniques have been suggested for radiation-free imaging of osseous structures. PURPOSE To compare the diagnostic value of ultra-short echo time and gradient echo T1-weighted MRI for the assessment of vertebral pathologies using histology and computed tomography (CT) as the reference standard. STUDY TYPE Prospective. SUBJECTS Fifty-nine lumbar vertebral bodies harvested from 20 human cadavers (donor age 73 ± 13 years; 9 male). FIELD STRENGTH/SEQUENCE Ultra-short echo time sequence optimized for both bone (UTEb) and cartilage (UTEc) imaging and 3D T1-weighted gradient-echo sequence (T1GRE) at 3 T; susceptibility-weighted imaging (SWI) gradient echo sequence at 1.5 T. CT was performed on a dual-layer dual-energy CT scanner using a routine clinical protocol. ASSESSMENT Histopathology and conventional CT were acquired as standard of reference. Semi-quantitative and quantitative morphological features of degenerative changes of the spines were evaluated by four radiologists independently on CT and MR images independently and blinded to all other information. Features assessed were osteophytes, endplate sclerosis, visualization of cartilaginous endplate, facet joint degeneration, presence of Schmorl's nodes, and vertebral dimensions. Vertebral disorders were assessed by a pathologist on histology. STATISTICAL TESTS Agreement between T1GRE, SWI, UTEc, and UTEb sequences and CT imaging and histology as standard of reference were assessed using Fleiss' κ and intra-class correlation coefficients, respectively. RESULTS For the morphological assessment of osteophytes and endplate sclerosis, the overall agreement between SWI, T1GRE, UTEb, and UTEc with the reference standard (histology combined with CT) was moderate to almost perfect for all readers (osteophytes: SWI, κ range: 0.68-0.76; T1GRE: 0.92-1.00; UTEb: 0.92-1.00; UTEc: 0.77-0.85; sclerosis: SWI, κ range: 0.60-0.70; T1GRE: 0.77-0.82; UTEb: 0.81-0.92; UTEc: 0.61-0.71). For the visualization of the cartilaginous endplate, UTEc showed the overall best agreement with the reference standard (histology) for all readers (κ range: 0.85-0.93). DATA CONCLUSIONS Morphological assessment of vertebral pathologies was feasible and accurate using the MR-based bone imaging sequences compared to CT and histopathology. T1GRE showed the overall best performance for osseous changes and UTEc for the visualization of the cartilaginous endplate. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Florian T Gassert
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Kufner
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Martin Renz
- Department of Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Felix G Gassert
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christine Bollwein
- Department of Pathology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sophia Kronthaler
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Georg C Feuerriegel
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jan S Kirschke
- Department of Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Carl Ganter
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marcus R Makowski
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christian Braun
- Institute of Forensic Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - Benedikt J Schwaiger
- Department of Neuroradiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Klaus Woertler
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Musculoskeletal Radiology Section, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Radiology, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexandra S Gersing
- Department of Neuroradiology, University Hospital of Munich, LMU Munich, Munich, Germany
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Jerban S, Moazamian D, Mohammadi HS, Ma Y, Jang H, Namiranian B, Shin SH, Alenezi S, Shah SB, Chung CB, Chang EY, Du J. More accurate trabecular bone imaging using UTE MRI at the resonance frequency of fat. Bone 2024; 184:117096. [PMID: 38631596 DOI: 10.1016/j.bone.2024.117096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/18/2024] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
High-resolution magnetic resonance imaging (HR-MRI) has been increasingly used to assess the trabecular bone structure. High susceptibility at the marrow/bone interface may significantly reduce the marrow's apparent transverse relaxation time (T2*), overestimating trabecular bone thickness. Ultrashort echo time MRI (UTE-MRI) can minimize the signal loss caused by susceptibility-induced T2* shortening. However, UTE-MRI is sensitive to chemical shift artifacts, which manifest as spatial blurring and ringing artifacts partially due to non-Cartesian sampling. In this study, we proposed UTE-MRI at the resonance frequency of fat to minimize marrow-related chemical shift artifacts and the overestimation of trabecular thickness. Cubes of trabecular bone from six donors (75 ± 4 years old) were scanned using a 3 T clinical scanner at the resonance frequencies of fat and water, respectively, using 3D UTE sequences with five TEs (0.032, 1.1, 2.2, 3.3, and 4.4 ms) and a clinical 3D gradient echo (GRE) sequence at 0.2 × 0.2 × 0.4 mm3 voxel size. Trabecular bone thickness was measured in 30 regions of interest (ROIs) per sample. MRI results were compared with thicknesses obtained from micro-computed tomography (μCT) at 50 μm3 voxel size. Linear regression models were used to calculate the coefficient of determination between MRI- and μCT-based trabecular thickness. All MRI-based trabecular thicknesses showed significant correlations with μCT measurements. The correlations were higher (examined with paired Student's t-test, P < 0.01) for 3D UTE images performed at the fat frequency (R2 = 0.59-0.74, P < 0.01) than those at the water frequency (R2 = 0.18-0.52, P < 0.01) and clinical GRE images (R2 = 0.39-0.47, P < 0.01). Significantly reduced correlations were observed with longer TEs. This study highlighted the feasibility of UTE-MRI at the fat frequency for a more accurate assessment of trabecular bone thickness.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA.
| | - Dina Moazamian
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | | | - Yajun Ma
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Behnam Namiranian
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Soo Hyun Shin
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Salem Alenezi
- Research and Laboratories Sector, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | - Sameer B Shah
- Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA; Orthopaedic Research, University of California, San Diego, La Jolla, CA, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA.
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Li YX, Liang XL, Liu J, Ma YJ. Assessment of Osteoporosis at the Lumbar Spine Using Ultrashort Echo Time Magnetization Transfer (UTE-MT) MRI. J Magn Reson Imaging 2024; 59:1285-1298. [PMID: 37470693 PMCID: PMC10799192 DOI: 10.1002/jmri.28910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Bone collagen-matrix contributes to the mechanical properties of bone by imparting tensile strength and elasticity, which can be indirectly quantified by ultrashort echo time magnetization transfer ratio (UTE-MTR) to assess osteoporosis. PURPOSE To evaluate osteoporosis at the human lumbar spine using UTE-MTR. STUDY TYPE Prospective. POPULATION One hundred forty-eight-volunteers (age-range, 50-85; females, N = 90), including 81-normal bone density, 35-osteopenic, and 32-osteoporotic subjects. Ten additional healthy volunteers were recruited to study the intrasession reproducibility of the UTE-MT. FIELD STRENGTH/SEQUENCE 3T/UTE-MT, short repetition-time adiabatic inversion recovery prepared UTE (STAIR-UTE), and iterative decomposition of water-and-fat with echo-asymmetry and least-squares estimation (IDEAL-IQ). ASSESSMENT Fracture risk was calculated using Fracture-Risk-Assessment-Tool (FRAX). Region-of-interests (ROIs) were delineated on the trabecular area in the maps of bone-mineral-density, UTE-MTR, collagen-bound water proton-fraction (CBWPF), and bone-marrow fat fraction (BMFF). STATISTICAL TESTS Linear-regression and Bland-Altman analysis were performed to assess the reproducibility of UTE-MTR measurements in the different scans. UTE-MTR and BMFF were correlated with bone-mineral-density using Pearson's regression and with FRAX scores using nonlinear regression. The abilities of UTE-MTR, CBWPF, and BMFF to discriminate between the three patient subgroups were evaluated using receiver-operator-characteristic (ROC) analysis and area-under-the-curve (AUC). Decision-curve-analysis (DCA) and clinical-impact curves were used to evaluate the value of UTE-MTR in clinical diagnosis. The DeLong test was used to compare the ROC curves. P-value <0.05 was considered statistically significant. RESULTS Excellent reproducibility was obtained for the UTE-MT measurements. UTE-MTR strongly correlated with bone-mineral-density (r = 0.76) and FRAX scores (r = -0.77). UTE-MTR exhibited higher AUCs (≥0.723) than BMFF, indicating its superior ability to distinguish between the three patient subgroups. The DCA and clinical-impact curves confirmed the diagnostic value of UTE-MTR. UTE-MTR and CBWPF showed similar performance in correlation with bone-mineral-density and cohort classification. DATA CONCLUSION UTE-MTR strongly correlates with bone-mineral-density and FRAX and shows great potential in distinguishing between normal, osteopenic, and osteoporotic subjects. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yu-Xuan Li
- Shanxi Medical University, Taiyuan, China
| | - Xiao-Ling Liang
- Department of Radiology, University of California San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA
| | - Jin Liu
- Department of Radiology, University of California San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA
| | - Ya-Jun Ma
- Department of Radiology, University of California San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA
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Ma Y, Carl M, Tang Q, Moazamian D, Athertya JS, Jang H, Bukata SV, Chung CB, Chang EY, Du J. Whole knee joint mapping using a phase modulated UTE adiabatic T 1ρ (PM-UTE-AdiabT 1ρ ) sequence. Magn Reson Med 2024; 91:896-910. [PMID: 37755319 PMCID: PMC10843531 DOI: 10.1002/mrm.29871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/14/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE To develop a 3D phase modulated UTE adiabatic T1ρ (PM-UTE-AdiabT1ρ ) sequence for whole knee joint mapping on a clinical 3 T scanner. METHODS This new sequence includes six major features: (1) a magnetization reset module, (2) a train of adiabatic full passage pulses for spin locking, (3) a phase modulation scheme (i.e., RF cycling pair), (4) a fat saturation module, (5) a variable flip angle scheme, and (6) a 3D UTE Cones sequence for data acquisition. A simple exponential fitting was used for T1ρ quantification. Phantom studies were performed to investigate PM-UTE-AdiabT1ρ 's sensitivity to compositional changes and reproducibility as well as its correlation with continuous wave-T1ρ measurement. The PM-UTE-AdiabT1ρ technique was then applied to five ex vivo and five in vivo normal knees to measure T1ρ values of femoral cartilage, meniscus, posterior cruciate ligament, anterior cruciate ligament, patellar tendon, and muscle. RESULTS The phantom study demonstrated PM-UTE-AdiabT1ρ 's high sensitivity to compositional changes, its high reproducibility, and its strong linear correlation with continuous wave-T1ρ measurement. The ex vivo and in vivo knee studies demonstrated average T1ρ values of 105.6 ± 8.4 and 77.9 ± 3.9 ms for the femoral cartilage, 39.2 ± 5.1 and 30.1 ± 2.2 ms for the meniscus, 51.6 ± 5.3 and 29.2 ± 2.4 ms for the posterior cruciate ligament, 79.0 ± 9.3 and 52.0 ± 3.1 ms for the anterior cruciate ligament, 19.8 ± 4.5 and 17.0 ± 1.8 ms for the patellar tendon, and 91.1 ± 8.8 and 57.6 ± 2.8 ms for the muscle, respectively. CONCLUSION The 3D PM-UTE-AdiabT1ρ sequence allows volumetric T1ρ assessment for both short and long T2 tissues in the knee joint on a clinical 3 T scanner.
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Affiliation(s)
- Yajun Ma
- Department of Radiology, University of California San Diego, CA, USA
| | | | - Qingbo Tang
- Department of Radiology, University of California San Diego, CA, USA
- Radiology Service, Veterans Affairs San Diego Healthcare System, CA, USA
| | - Dina Moazamian
- Department of Radiology, University of California San Diego, CA, USA
| | - Jiyo S Athertya
- Department of Radiology, University of California San Diego, CA, USA
| | - Hyungseok Jang
- Department of Radiology, University of California San Diego, CA, USA
| | - Susan V Bukata
- Department of Orthopaedic Surgery, University of California San Diego, CA, USA
| | - Christine B Chung
- Department of Radiology, University of California San Diego, CA, USA
- Radiology Service, Veterans Affairs San Diego Healthcare System, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California San Diego, CA, USA
- Radiology Service, Veterans Affairs San Diego Healthcare System, CA, USA
| | - Jiang Du
- Department of Radiology, University of California San Diego, CA, USA
- Radiology Service, Veterans Affairs San Diego Healthcare System, CA, USA
- Department of Bioengineering, University of California San Diego, CA, USA
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Jerban S, Jang H, Chang EY, Bukata S, Du J, Chung CB. Bone Biomarkers Based on Magnetic Resonance Imaging. Semin Musculoskelet Radiol 2024; 28:62-77. [PMID: 38330971 DOI: 10.1055/s-0043-1776431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Magnetic resonance imaging (MRI) is increasingly used to evaluate the microstructural and compositional properties of bone. MRI-based biomarkers can characterize all major compartments of bone: organic, water, fat, and mineral components. However, with a short apparent spin-spin relaxation time (T2*), bone is invisible to conventional MRI sequences that use long echo times. To address this shortcoming, ultrashort echo time MRI sequences have been developed to provide direct imaging of bone and establish a set of MRI-based biomarkers sensitive to the structural and compositional changes of bone. This review article describes the MRI-based bone biomarkers representing total water, pore water, bound water, fat fraction, macromolecular fraction in the organic matrix, and surrogates for mineral density. MRI-based morphological bone imaging techniques are also briefly described.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, La Jolla, California
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, La Jolla, California
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, La Jolla, California
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Susan Bukata
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, California
| | - Jiang Du
- Department of Radiology, University of California, San Diego, La Jolla, California
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Bioengineering, University of California, San Diego, La Jolla, California
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, La Jolla, California
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
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Zhang X, Zhou B, Chen Y, Cai Z, Guo Y, Wei Z, Li S, Feng Y, Sedaghat S, Jang H. Evaluation of gadolinium deposition in cortical bone using three-dimensional ultrashort echo time quantitative susceptibility mapping: A preliminary study. NMR Biomed 2024; 37:e5035. [PMID: 37721094 PMCID: PMC10726698 DOI: 10.1002/nbm.5035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 09/19/2023]
Abstract
The aim of the current study was to investigate the feasibility of three-dimensional ultrashort echo time quantitative susceptibility mapping (3D UTE-QSM) for the assessment of gadolinium (Gd) deposition in cortical bone. To this end, 40 tibial bovine cortical bone specimens were divided into five groups then soaked in phosphate-buffered saline (PBS) solutions with five different Gd concentrations of 0, 0.4, 0.8, 1.2, and 1.6 mmol/L for 48 h. Additionally, eight rabbits were randomly allocated into three groups, consisting of a normal-dose macrocyclic gadolinium-based contrast agent (GBCA) group (n = 3), a high-dose macrocyclic GBCA group (n = 3), and a control group (n = 2). All bovine and rabbit tibial bone samples underwent magnetic resonance imaging (MRI) on a 3-T clinical MR system. A 3D UTE-Cones sequence was utilized to acquire images with five different echo times (i.e., 0.032, 0.2, 0.4, 0.8, and 1.2 ms). The UTE images were subsequently processed with the morphology-enabled dipole inversion algorithm to yield a susceptibility map. The average susceptibility was calculated in three regions of interest in the middle of each specimen, and the Pearson's correlation between the estimated susceptibility and Gd concentration was calculated. The bone samples soaked in PBS with higher Gd concentrations exhibited elevated susceptibility values. A mean susceptibility value of -2.47 ± 0.23 ppm was observed for bovine bone soaked in regular PBS, while the mean QSM value increased to -1.75 ± 0.24 ppm for bone soaked in PBS with the highest Gd concentration of 1.6 mmol/L. A strong positive correlation was observed between Gd concentrations and QSM values. The mean susceptibility values of rabbit tibial specimens in the control group, normal-dose GBCA group, and high-dose GBCA group were -4.11 ± 1.52, -3.85 ± 1.33, and -3.39 ± 1.35 ppm, respectively. In conclusion, a significant linear correlation between Gd in cortical bone and QSM values was observed. The preliminary results suggest that 3D UTE-QSM may provide sensitive noninvasive assessment of Gd deposition in cortical bone.
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Affiliation(s)
- Xiaodong Zhang
- Department of Radiology, Third Affiliated Hospital of Southern Medical University, Guangzhou, China
- University of California, San Diego, San Diego, CA, United States
| | - Beibei Zhou
- The Third School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Yanjun Chen
- Department of Radiology, Third Affiliated Hospital of Southern Medical University, Guangzhou, China
- University of California, San Diego, San Diego, CA, United States
| | - Zhenyu Cai
- University of California, San Diego, San Diego, CA, United States
| | - Yihao Guo
- School of Biomedical Engineering, Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
| | - Zhao Wei
- University of California, San Diego, San Diego, CA, United States
| | - Shisi Li
- Department of Radiology, Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Yanqiu Feng
- School of Biomedical Engineering, Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, China
| | - Sam Sedaghat
- University of California, San Diego, San Diego, CA, United States
| | - Hyungseok Jang
- University of California, San Diego, San Diego, CA, United States
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Jerban S, Ma Y, Alenezi S, Moazamian D, Athertya J, Jang H, Dorthe E, Dlima D, Woods G, Chung CB, Chang EY, Du J. Ultrashort Echo Time (UTE) MRI porosity index (PI) and suppression ratio (SR) correlate with the cortical bone microstructural and mechanical properties: Ex vivo study. Bone 2023; 169:116676. [PMID: 36657630 PMCID: PMC9987215 DOI: 10.1016/j.bone.2023.116676] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/19/2022] [Accepted: 01/08/2023] [Indexed: 01/18/2023]
Abstract
Ultrashort echo time (UTE) MRI can image and consequently enable quantitative assessment of cortical bone. UTE-MRI-based evaluation of bone is largely underutilized due to the high cost and time demands of MRI in general. The signal ratio in dual-echo UTE imaging, known as porosity index (PI), as well as the signal ratio between UTE and inversion recovery UTE (IR-UTE) imaging, known as the suppression ratio (SR), are two rapid UTE-based bone evaluation techniques (∼ 5 mins scan time each), which can potentially reduce the time demand and cost in future clinical studies. This study aimed to investigate the correlations of PI and SR measures with cortical bone microstructural and mechanical properties. Cortical bone strips (n = 135) from tibial and femoral midshafts of 37 donors (61 ± 24 years old) were scanned using a dual-echo 3D Cones UTE sequence and a 3D Cones IR-UTE sequence for PI and SR calculations, respectively. Average bone mineral density, porosity, and pore size were measured using microcomputed tomography (μCT). Bone mechanical properties were measured using 4-point bending tests. The μCT measures showed significant correlations with PI (moderate to strong, R = 0.68-0.71) and SR (moderate, R = 0.58-0.68). Young's modulus, yield stress, and ultimate stress demonstrated significant moderate correlations with PI and SR (R = 0.52-0.62) while significant strong correlations with μCT measures (R > 0.7). PI and SR can potentially serve as fast and noninvasive (non-ionizing radiation) biomarkers for evaluating cortical bone in various bone diseases.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA; Department of Orthopedic Surgery, University of California, San Diego, La Jolla, CA, USA.
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Salem Alenezi
- Research and Laboratories Sector, Saudi Food and Drug Authority, Riyadh, Kingdom of Saudi Arabia
| | - Dina Moazamian
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Jiyo Athertya
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Erik Dorthe
- Shiley Center for Orthopedic Research and Education at Scripps Clinic, La Jolla, CA, USA
| | - Darryl Dlima
- Shiley Center for Orthopedic Research and Education at Scripps Clinic, La Jolla, CA, USA
| | - Gina Woods
- Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA.
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Jones BC, Wehrli FW, Kamona N, Deshpande RS, Vu BTD, Song HK, Lee H, Grewal RK, Chan TJ, Witschey WR, MacLean MT, Josselyn NJ, Iyer SK, Al Mukaddam M, Snyder PJ, Rajapakse CS. Automated, calibration-free quantification of cortical bone porosity and geometry in postmenopausal osteoporosis from ultrashort echo time MRI and deep learning. Bone 2023; 171:116743. [PMID: 36958542 PMCID: PMC10121925 DOI: 10.1016/j.bone.2023.116743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/01/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Assessment of cortical bone porosity and geometry by imaging in vivo can provide useful information about bone quality that is independent of bone mineral density (BMD). Ultrashort echo time (UTE) MRI techniques of measuring cortical bone porosity and geometry have been extensively validated in preclinical studies and have recently been shown to detect impaired bone quality in vivo in patients with osteoporosis. However, these techniques rely on laborious image segmentation, which is clinically impractical. Additionally, UTE MRI porosity techniques typically require long scan times or external calibration samples and elaborate physics processing, which limit their translatability. To this end, the UTE MRI-derived Suppression Ratio has been proposed as a simple-to-calculate, reference-free biomarker of porosity which can be acquired in clinically feasible acquisition times. PURPOSE To explore whether a deep learning method can automate cortical bone segmentation and the corresponding analysis of cortical bone imaging biomarkers, and to investigate the Suppression Ratio as a fast, simple, and reference-free biomarker of cortical bone porosity. METHODS In this retrospective study, a deep learning 2D U-Net was trained to segment the tibial cortex from 48 individual image sets comprised of 46 slices each, corresponding to 2208 training slices. Network performance was validated through an external test dataset comprised of 28 scans from 3 groups: (1) 10 healthy, young participants, (2) 9 postmenopausal, non-osteoporotic women, and (3) 9 postmenopausal, osteoporotic women. The accuracy of automated porosity and geometry quantifications were assessed with the coefficient of determination and the intraclass correlation coefficient (ICC). Furthermore, automated MRI biomarkers were compared between groups and to dual energy X-ray absorptiometry (DXA)- and peripheral quantitative CT (pQCT)-derived BMD. Additionally, the Suppression Ratio was compared to UTE porosity techniques based on calibration samples. RESULTS The deep learning model provided accurate labeling (Dice score 0.93, intersection-over-union 0.88) and similar results to manual segmentation in quantifying cortical porosity (R2 ≥ 0.97, ICC ≥ 0.98) and geometry (R2 ≥ 0.82, ICC ≥ 0.75) parameters in vivo. Furthermore, the Suppression Ratio was validated compared to established porosity protocols (R2 ≥ 0.78). Automated parameters detected age- and osteoporosis-related impairments in cortical bone porosity (P ≤ .002) and geometry (P values ranging from <0.001 to 0.08). Finally, automated porosity markers showed strong, inverse Pearson's correlations with BMD measured by pQCT (|R| ≥ 0.88) and DXA (|R| ≥ 0.76) in postmenopausal women, confirming that lower mineral density corresponds to greater porosity. CONCLUSION This study demonstrated feasibility of a simple, automated, and ionizing-radiation-free protocol for quantifying cortical bone porosity and geometry in vivo from UTE MRI and deep learning.
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Affiliation(s)
- Brandon C Jones
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Felix W Wehrli
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Nada Kamona
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Rajiv S Deshpande
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Brian-Tinh Duc Vu
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Hee Kwon Song
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Hyunyeol Lee
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; School of Electronics Engineering, Kyungpook National University, 80 Daehakro, Bukgu, Daegu 41566, Republic of Korea.
| | - Rasleen Kaur Grewal
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Trevor Jackson Chan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, 210 South 33(rd) St, Philadelphia, PA 19104, United States of America.
| | - Walter R Witschey
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Matthew T MacLean
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
| | - Nicholas J Josselyn
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America; Department of Data Science, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609, United States of America.
| | - Srikant Kamesh Iyer
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America
| | - Mona Al Mukaddam
- Department of Medicine, Division of Endocrinology, Perelman School of Medicine, University of Pennsylvania, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States of America.
| | - Peter J Snyder
- Department of Medicine, Division of Endocrinology, Perelman School of Medicine, University of Pennsylvania, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, Philadelphia, PA 19104, United States of America.
| | - Chamith S Rajapakse
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 1 Founders Building, 3400 Spruce St, Philadelphia, PA 19104, United States of America.
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9
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Liu J, Chen JD, Li P, Liao JW, Feng JX, Chen ZY, Cai ZY, Li W, Chen XJ, Su ZH, Lu H, Li SL, Ma YJ. Comprehensive assessment of osteoporosis in lumbar spine using compositional MR imaging of trabecular bone. Eur Radiol 2022; 33:3995-4006. [PMID: 36571604 DOI: 10.1007/s00330-022-09368-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To comprehensively assess osteoporosis in the lumbar spine, a compositional MR imaging technique is proposed to quantify proton fractions for all the water components as well as fat in lumbar vertebrae measured by a combination of a 3D short repetition time adiabatic inversion recovery prepared ultrashort echo time (STAIR-UTE) MRI and IDEAL-IQ. METHODS A total of 182 participants underwent MRI, quantitative CT, and DXA. Lumbar collagen-bound water proton fraction (CBWPF), free water proton fraction (FWPF), total water proton fraction (TWPF), bone mineral density (BMD), and T-score were calculated in three vertebrae (L2-L4) for each subject. The correlations of the CBWPF, FWPF, and TWPF with BMD and T-score were investigated respectively. A comprehensive diagnostic model combining all the water components and clinical characteristics was established. The performances of all the water components and the comprehensive diagnostic model to discriminate between normal, osteopenia, and osteoporosis cohorts were also evaluated using receiver operator characteristic (ROC). RESULTS The CBWPF showed strong correlations with BMD (r = 0.85, p < 0.001) and T-score (r = 0.72, p < 0.001), while the FWPF and TWPF showed moderate correlations with BMD (r = 0.65 and 0.68, p < 0.001) and T-score (r = 0.47 and 0.49, p < 0.001). The high area under the curve values obtained from ROC analysis demonstrated that CBWPF, FWPF, and TWPF have the potential to differentiate the normal, osteopenia, and osteoporosis cohorts. At the same time, the comprehensive diagnostic model shows the best performance. CONCLUSIONS The compositional MRI technique, which quantifies CBWPF, FWPF, and TWPF in trabecular bone, is promising in the assessment of bone quality. KEY POINTS • Compositional MR imaging technique is able to quantify proton fractions for all the water components (i.e., collagen-bound water proton fraction (CBWPF), free water proton fraction (FWPF), and total water proton fraction (TWPF)) in the human lumbar spine. • The biomarkers derived from the compositional MR imaging technique showed moderate to high correlations with bone mineral density (BMD) and T-score and showed good performance in distinguishing people with different bone mass. • The comprehensive diagnostic model incorporating CBWPF, FWPF, TWPF, and clinical characteristics showed the highest clinical diagnostic capability for the assessment of osteoporosis.
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Affiliation(s)
- Jin Liu
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Jian-Di Chen
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Ping Li
- Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Jian-Wei Liao
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Jia-Xin Feng
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Zi-Yang Chen
- Department of Spinal Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, China
| | - Zhi-Yuan Cai
- Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Wei Li
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Xiao-Jun Chen
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China
| | - Zhi-Hai Su
- Department of Spinal Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, China
| | - Hai Lu
- Department of Spinal Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, China
| | - Shao-Lin Li
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong Province, China. .,Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China.
| | - Ya-Jun Ma
- Department of Radiology, University of California San Diego, 9452 Medical Center Drive, La Jolla, CA, 92037, USA
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10
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Ma Y, Jang H, Jerban S, Chang EY, Chung CB, Bydder GM, Du J. Making the invisible visible-ultrashort echo time magnetic resonance imaging: Technical developments and applications. Appl Phys Rev 2022; 9:041303. [PMID: 36467869 PMCID: PMC9677812 DOI: 10.1063/5.0086459] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/12/2022] [Indexed: 05/25/2023]
Abstract
Magnetic resonance imaging (MRI) uses a large magnetic field and radio waves to generate images of tissues in the body. Conventional MRI techniques have been developed to image and quantify tissues and fluids with long transverse relaxation times (T2s), such as muscle, cartilage, liver, white matter, gray matter, spinal cord, and cerebrospinal fluid. However, the body also contains many tissues and tissue components such as the osteochondral junction, menisci, ligaments, tendons, bone, lung parenchyma, and myelin, which have short or ultrashort T2s. After radio frequency excitation, their transverse magnetizations typically decay to zero or near zero before the receiving mode is enabled for spatial encoding with conventional MR imaging. As a result, these tissues appear dark, and their MR properties are inaccessible. However, when ultrashort echo times (UTEs) are used, signals can be detected from these tissues before they decay to zero. This review summarizes recent technical developments in UTE MRI of tissues with short and ultrashort T2 relaxation times. A series of UTE MRI techniques for high-resolution morphological and quantitative imaging of these short-T2 tissues are discussed. Applications of UTE imaging in the musculoskeletal, nervous, respiratory, gastrointestinal, and cardiovascular systems of the body are included.
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Affiliation(s)
- Yajun Ma
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, California 92037, USA
| | | | | | - Graeme M Bydder
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Jiang Du
- Author to whom correspondence should be addressed:. Tel.: (858) 246-2248, Fax: (858) 246-2221
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11
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Ma YJ, Jang H, Lombardi AF, Corey-Bloom J, Bydder GM. Myelin water imaging using a short-TR adiabatic inversion-recovery (STAIR) sequence. Magn Reson Med 2022; 88:1156-1169. [PMID: 35613378 PMCID: PMC9867567 DOI: 10.1002/mrm.29287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/21/2022] [Accepted: 04/13/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE To develop a new myelin water imaging (MWI) technique using a short-TR adiabatic inversion-recovery (STAIR) sequence on a clinical 3T MR scanner. METHODS Myelin water (MW) in the brain has both a much shorter T1 and a much shorter T2 * than intracellular/extracellular water. A STAIR sequence with a short TR was designed to efficiently suppress long T1 signals from intracellular/extracellular water, and therefore allow selective imaging of MW, which has a much shorter T1 . Numerical simulation and phantom studies were performed to investigate the effectiveness of long T1 signal suppression. TheT2 * in white matter (WM) was measured with STAIR and compared with T2 * measured with a conventional gradient recall echo in in vivo study. Four healthy volunteers and 4 patients with multiple sclerosis were recruited for qualitative and quantitative MWI. Apparent MW fraction was generated to compare MW in normal WM in volunteers to MW in lesions in patients with multiple sclerosis. RESULTS Both simulation and phantom studies showed that when TR was sufficiently short (eg, 250 ms), the STAIR sequence effectively suppressed long T1 signals from tissues with a broad range of T1 s using a single TR/TI combination. The volunteer study showed a short T2 * of 9.5 ± 1.7 ms in WM, which is similar to reported values for MW. Lesions in patients with multiple sclerosis showed a significantly lower apparent MW fraction (4.5% ± 1.0%) compared with that of normal WM (9.2% ± 1.5%) in healthy volunteers (p < 0.05). CONCLUSIONS The STAIR sequence provides selective MWI in brain and can quantify reductions in MW content in patients with multiple sclerosis.
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Affiliation(s)
- Ya-Jun Ma
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Hyungseok Jang
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Alecio F. Lombardi
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Jody Corey-Bloom
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - Graeme M. Bydder
- Department of Radiology, University of California San Diego, San Diego, CA, USA
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12
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Sollmann N, Kirschke JS, Kronthaler S, Boehm C, Dieckmeyer M, Vogele D, Kloth C, Lisson CG, Carballido-Gamio J, Link TM, Karampinos DC, Karupppasamy S, Beer M, Krug R, Baum T. Imaging of the Osteoporotic Spine - Quantitative Approaches in Diagnostics and for the Prediction of the Individual Fracture Risk. ROFO-FORTSCHR RONTG 2022; 194:1088-1099. [PMID: 35545103 DOI: 10.1055/a-1770-4626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Osteoporosis is a highly prevalent systemic skeletal disease that is characterized by low bone mass and microarchitectural bone deterioration. It predisposes to fragility fractures that can occur at various sites of the skeleton, but vertebral fractures (VFs) have been shown to be particularly common. Prevention strategies and timely intervention depend on reliable diagnosis and prediction of the individual fracture risk, and dual-energy X-ray absorptiometry (DXA) has been the reference standard for decades. Yet, DXA has its inherent limitations, and other techniques have shown potential as viable add-on or even stand-alone options. Specifically, three-dimensional (3 D) imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), are playing an increasing role. For CT, recent advances in medical image analysis now allow automatic vertebral segmentation and value extraction from single vertebral bodies using a deep-learning-based architecture that can be implemented in clinical practice. Regarding MRI, a variety of methods have been developed over recent years, including magnetic resonance spectroscopy (MRS) and chemical shift encoding-based water-fat MRI (CSE-MRI) that enable the extraction of a vertebral body's proton density fat fraction (PDFF) as a promising surrogate biomarker of bone health. Yet, imaging data from CT or MRI may be more efficiently used when combined with advanced analysis techniques such as texture analysis (TA; to provide spatially resolved assessments of vertebral body composition) or finite element analysis (FEA; to provide estimates of bone strength) to further improve fracture prediction. However, distinct and experimentally validated diagnostic criteria for osteoporosis based on CT- and MRI-derived measures have not yet been achieved, limiting broad transfer to clinical practice for these novel approaches. KEY POINTS:: · DXA is the reference standard for diagnosis and fracture prediction in osteoporosis, but it has important limitations.. · CT- and MRI-based methods are increasingly used as (opportunistic) approaches.. · For CT, particularly deep-learning-based automatic vertebral segmentation and value extraction seem promising.. · For MRI, multiple techniques including spectroscopy and chemical shift imaging are available to extract fat fractions.. · Texture and finite element analyses can provide additional measures for vertebral body composition and bone strength.. CITATION FORMAT: · Sollmann N, Kirschke JS, Kronthaler S et al. Imaging of the Osteoporotic Spine - Quantitative Approaches in Diagnostics and for the Prediction of the Individual Fracture Risk. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1770-4626.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.,Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States.,Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Stefan Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christof Boehm
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Daniel Vogele
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Christopher Kloth
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | | | - Julio Carballido-Gamio
- Department of Radiology, University of Colorado - Anschutz Medical Campus, Aurora, CO, United States
| | - Thomas Marc Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Dimitrios Charalampos Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Subburaj Karupppasamy
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design, Singapore.,Sobey School of Business, Saint Mary's University, Halifax, NS, Canada
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Roland Krug
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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13
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Kronthaler S, Diefenbach MN, Boehm C, Zamskiy M, Makowski MR, Baum T, Sollmann N, Karampinos DC. On quantification errors of R 2 * $$ {R}_2^{\ast } $$ and proton density fat fraction mapping in trabecularized bone marrow in the static dephasing regime. Magn Reson Med 2022; 88:1126-1139. [PMID: 35481686 DOI: 10.1002/mrm.29279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To study the effect of field inhomogeneity distributions in trabecularized bone regions on the gradient echo (GRE) signal with short TEs and to characterize quantification errors on R 2 * $$ {R}_2^{\ast } $$ and proton density fat fraction (PDFF) maps when using a water-fat model with an exponential R 2 * $$ {R}_2^{\ast } $$ decay model at short TEs. METHODS Field distortions were simulated based on a trabecular bone micro CT dataset. Simulations were performed for different bone volume fractions (BV/TV) and for different bone-fat composition values. A multi-TE UTE acquisition was developed to acquire multiple UTEs with random order to minimize eddy currents. The acquisition was validated in phantoms and applied in vivo in a volunteer's ankle and knee. Chemical shift encoded MRI (CSE-MRI) based on a Cartesian multi-TE GRE scan was acquired in the spine of patients with metastatic bone disease. RESULTS Simulations showed that signal deviations from the exponential signal decay at short TEs were more prominent for a higher BV/TV. UTE multi-TE measurements reproduced in vivo the simulation-based predicted behavior. In regions with high BV/TV, the presence of field inhomogeneities induced an R 2 * $$ {R}_2^{\ast } $$ underestimation in trabecularized bone marrow when using CSE-MRI at 3T with a short TE. CONCLUSION R 2 * $$ {R}_2^{\ast } $$ can be underestimated when using short TEs (<2 ms at 3 T) and a water-fat model with an exponential R 2 * $$ {R}_2^{\ast } $$ decay model in multi-echo GRE acquisitions of trabecularized bone marrow.
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Affiliation(s)
- Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Maximilian N Diefenbach
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christof Boehm
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Mark Zamskiy
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Jerban S, Alenezi S, Afsahi AM, Ma Y, Du J, Chung CB, Chang E. MRI-based mechanical competence assessment of bone using micro finite element analysis (micro-FEA): Review. Magn Reson Imaging 2022; 88:9-19. [DOI: 10.1016/j.mri.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 12/09/2021] [Accepted: 01/20/2022] [Indexed: 12/18/2022]
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15
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Liu J, Liao JW, Li W, Chen XJ, Feng JX, Yao L, Huang PH, Su ZH, Lu H, Liao YT, Li SL, Ma YJ. Assessment of Osteoporosis in Lumbar Spine: In Vivo Quantitative MR Imaging of Collagen Bound Water in Trabecular Bone. Front Endocrinol (Lausanne) 2022; 13:801930. [PMID: 35250862 PMCID: PMC8888676 DOI: 10.3389/fendo.2022.801930] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/21/2022] [Indexed: 11/17/2022] Open
Abstract
AIM Bone collagen matrix makes a crucial contribution to the mechanical properties of bone by imparting tensile strength and elasticity. The collagen content of bone is accessible via quantification of collagen bound water (CBW) indirectly. We prospectively study the performance of the CBW proton density (CBWPD) measured by a 3D short repetition time adiabatic inversion recovery prepared ultrashort echo time (STAIR-UTE) magnetic resonance imaging (MRI) sequence in the diagnosis of osteoporosis in human lumbar spine. METHODS A total of 189 participants with a mean age of 56 (ranged from 50 to 86) years old were underwent MRI, quantitative computed tomography (QCT), and dual-energy X-ray absorptiometry (DXA) in lumbar spine. Major fracture risk was also evaluated for all participants using Fracture Risk Assessment Tool (FRAX). Lumbar CBWPD, bone marrow fat fraction (BMFF), bone mineral density (BMD) and T score values were calculated in three vertebrae (L2-L4) for each subject. Both the CBWPD and BMFF were correlated with BMD, T score, and FRAX score for comparison. The abilities of the CBWPD and BMFF to discriminate between three different cohorts, which included normal subjects, patients with osteopenia, and patients with osteoporosis, were also evaluated and compared using receiver operator characteristic (ROC) analysis. RESULTS The CBWPD showed strong correlation with standard BMD (R2 = 0.75, P < 0.001) and T score (R2 = 0.59, P < 0.001), as well as a moderate correlation with FRAX score (R2 = 0.48, P < 0.001). High area under the curve (AUC) values (≥ 0.84 using QCT as reference; ≥ 0.76 using DXA as reference) obtained from ROC analysis demonstrated that the CBWPD was capable of well differentiating between the three different subject cohorts. Moreover, the CBWPD had better correlations with BMD, T score, and FRAX score than BMFF, and also performed better in cohort discrimination. CONCLUSION The STAIR-UTE-measured CBWPD is a promising biomarker in the assessment of bone quality and fracture risk.
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Affiliation(s)
- Jin Liu
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Jian-Wei Liao
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Wei Li
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Xiao-Jun Chen
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Jia-Xin Feng
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Lin Yao
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Pan-Hui Huang
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Zhi-Hai Su
- Department of Spinal Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Hai Lu
- Department of Spinal Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | | | - Shao-Lin Li
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
- *Correspondence: Shao-Lin Li,
| | - Ya-Jun Ma
- Department of Radiology, University of California San Diego, La Jolla, CA, United States
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16
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Afsahi AM, Ma Y, Jang H, Jerban S, Chung CB, Chang EY, Du J. Ultrashort Echo Time Magnetic Resonance Imaging Techniques: Met and Unmet Needs in Musculoskeletal Imaging. J Magn Reson Imaging 2021; 55:1597-1612. [PMID: 34962335 DOI: 10.1002/jmri.28032] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 12/14/2022] Open
Abstract
This review article summarizes recent technical developments in ultrashort echo time (UTE) magnetic resonance imaging of musculoskeletal (MSK) tissues with short-T2 relaxation times. A series of contrast mechanisms are discussed for high-contrast morphological imaging of short-T2 MSK tissues including the osteochondral junction, menisci, ligaments, tendons, and bone. Quantitative UTE mapping of T1, T2*, T1ρ, adiabatic T1ρ, magnetization transfer ratio, MT modeling of macromolecular proton fraction, quantitative susceptibility mapping, and water content is also introduced. Met and unmet needs in MSK imaging are discussed. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Amir Masoud Afsahi
- Department of Radiology, University of California, San Diego, California, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, California, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, California, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
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17
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Kronthaler S, Boehm C, Feuerriegel G, Börnert P, Katscher U, Weiss K, Makowski MR, Schwaiger BJ, Gersing AS, Karampinos DC. Assessment of vertebral fractures and edema of the thoracolumbar spine based on water-fat and susceptibility-weighted images derived from a single ultra-short echo time scan. Magn Reson Med 2021; 87:1771-1783. [PMID: 34752650 DOI: 10.1002/mrm.29078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE To develop a methodology to simultaneously perform single echo Dixon water-fat imaging and susceptibility-weighted imaging (SWI) based on a single echo time (TE) ultra-short echo time (UTE) (sUTE) scan to assess vertebral fractures and degenerative bone changes in the thoracolumbar spine. METHODS A methodology was developed to solve the smoothness-constrained inverse water-fat problem to separate water and fat while removing unwanted low-frequency phase terms. Additionally, the corrected UTE phase was used for SWI. UTE imaging (TE: 0.14 ms, 3T MRI) was performed in the lumbar spine of nine patients with vertebral fractures and bone marrow edema (BME). All images were reviewed by two radiologists. Water- and fat-separated images were analyzed in comparison with short-tau inversion recovery (STIR) and with respect to BME visibility. The visibility of fracture lines and cortical outlining of the UTE magnitude images were analyzed in comparison with computed tomography. RESULTS Unwanted phase components, dominated by the B1 phase, were removed from the UTE phase images. The rating of the diagnostic quality of BME visualization showed a high preference for the sUTE-Dixon water- and fat-separated images in comparison with STIR. The UTE magnitude images enabled better visualizing fracture lines compared with STIR and slightly better visibility of cortical outlining. With increasing SWI weighting osseous structures and fatty tissues were enhanced. CONCLUSION The proposed sUTE-Dixon-SWI methodology allows the removal of unwanted low-frequency phases and enables water-fat separation and SWI processing from a single complex UTE image. The methodology can be used for the simultaneous assessment of vertebral fractures and BME of the thoracolumbar spine.
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Affiliation(s)
- Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Christof Boehm
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Georg Feuerriegel
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | | | | | | | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Benedikt J Schwaiger
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexandra S Gersing
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
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18
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Abstract
PURPOSE OF REVIEW The purpose of this review is to inform researchers and clinicians with the most recent imaging techniques that are employed (1) to opportunistically screen for osteoporosis and (2) to provide a better understanding into the disease etiology of osteoporosis. RECENT FINDINGS Phantomless calibration techniques for computed tomography (CT) may pave the way for better opportunistic osteoporosis screening and the retroactive analysis of imaging data. Additionally, hardware advances are enabling new applications of dual-energy CT and cone-beam CT to the study of bone. Advances in MRI sequences are also improving imaging evaluation of bone properties. Finally, the application of image registration techniques is enabling new uses of imaging to investigate soft tissue-bone interactions as well as bone turnover. While DXA remains the most prominent imaging tool for osteoporosis diagnosis, new imaging techniques are becoming more widely available and providing additional information to inform clinical decision-making.
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Affiliation(s)
- Justin J Tse
- Department of Radiology, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ainsley C J Smith
- Department of Radiology, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Biomedical Engineering Graduate Program, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Michael T Kuczynski
- Department of Radiology, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Biomedical Engineering Graduate Program, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Daphne A Kaketsis
- Department of Radiology, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Biomedical Engineering Graduate Program, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Sarah L Manske
- Department of Radiology, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada.
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Biomedical Engineering Graduate Program, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada.
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19
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Jang H, Ma Y, Carl M, Jerban S, Chang EY, Du J. Ultrashort echo time Cones double echo steady state (UTE-Cones-DESS) for rapid morphological imaging of short T 2 tissues. Magn Reson Med 2021; 86:881-892. [PMID: 33755258 DOI: 10.1002/mrm.28769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE In this study, we aimed to develop a new technique, ultrashort echo time Cones double echo steady state (UTE-Cones-DESS), for highly efficient morphological imaging of musculoskeletal tissues with short T2 s. We also proposed a novel, single-point Dixon (spDixon)-based approach for fat suppression. METHODS The UTE-Cones-DESS sequence was implemented on a 3T MR system. It uses a short radiofrequency (RF) pulse followed by a pair of balanced spiral-out and spiral-in readout gradients separated by an unbalanced spoiling gradient in-between. The readout gradients are applied immediately before or after the RF pulses to achieve a UTE image (S+ ) and a spin/stimulated echo image (S- ). Weighted echo subtraction between S+ and S- was performed to achieve high contrast specific to short T2 tissues, and spDixon was applied to suppress fat by using the intrinsic complex signal of S+ and S- . Six healthy volunteers and five patients with osteoarthritis were recruited for whole-knee imaging. Additionally, two healthy volunteers were recruited for lower leg imaging. RESULTS The UTE-Cones-DESS sequence allows fast volumetric imaging of musculoskeletal tissues with excellent image contrast for the osteochondral junction, tendons, menisci, and ligaments in the knee joint as well as cortical bone and aponeurosis in the lower leg within 5 min. spDixon yields efficient fat suppression in both S+ and S- images without requiring any additional acquisitions or preparation pulses. CONCLUSION The rapid UTE-Cones-DESS sequence can be used for high contrast morphological imaging of short T2 tissues, providing a new tool to assess their association with musculoskeletal disorders.
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Affiliation(s)
- Hyungseok Jang
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | | | - Saeed Jerban
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, San Diego, CA, USA.,Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
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20
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Ma YJ, Jang H, Wei Z, Wu M, Chang EY, Corey-Bloom J, Bydder GM, Du J. Brain ultrashort T 2 component imaging using a short TR adiabatic inversion recovery prepared dual-echo ultrashort TE sequence with complex echo subtraction (STAIR-dUTE-ES). J Magn Reson 2021; 323:106898. [PMID: 33429170 PMCID: PMC7855631 DOI: 10.1016/j.jmr.2020.106898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 12/13/2020] [Accepted: 12/21/2020] [Indexed: 05/15/2023]
Abstract
Long T2 water contamination is a major challenge with direct in vivo UTE imaging of ultrashort T2 components in the brain since water contributes most of the signal detected from white and gray matter. The Short TR Adiabatic Inversion Recovery prepared Ultrashort TE (STAIR-UTE) sequence can significantly suppress water signals and simultaneously image ultrashort T2 components. However, the TR used may not be sufficiently short to allow the STAIR preparation to completely suppress all the water signals in the brain due to specific absorption rate (SAR) limitations on clinical MR scanners. In this study, we describe a STAIR prepared dual-echo UTE sequence with complex Echo Subtraction (STAIR-dUTE-ES) which improves water suppression for selective ultrashort T2 imaging compared with that achieved with the STAIR-UTE sequence. Numerical simulations showed that the STAIR-dUTE-ES technique can effectively suppress water signals and allow accurate quantification of ultrashort T2 protons. Volunteer and Multiple Sclerosis (MS) patient studies demonstrated the feasibility of the STAIR-dUTE-ES technique for selective imaging and quantification of ultrashort T2 components in vivo. A significantly lower mean UltraShort T2 Proton Fraction (USPF) was found in lesions in MS patients (5.7 ± 0.7%) compared with that in normal white matter of healthy volunteers (8.9 ± 0.6%). The STAIR-dUTE-ES sequence provides robust water suppression for volumetric imaging and quantitation of ultrashort T2 component. The reduced USPF in MS lesions shows the clinical potential of the sequence for diagnosis and monitoring treatment in MS.
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Affiliation(s)
- Ya-Jun Ma
- Department of Radiology, University of California San Diego, San Diego, CA, USA.
| | - Hyungseok Jang
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Zhao Wei
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Mei Wu
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California San Diego, San Diego, CA, USA; Radiology Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Jody Corey-Bloom
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | - Graeme M Bydder
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California San Diego, San Diego, CA, USA.
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21
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Schwaiger BJ, Schneider C, Kronthaler S, Gassert FT, Böhm C, Pfeiffer D, Baum T, Kirschke JS, Karampinos DC, Makowski MR, Woertler K, Wurm M, Gersing AS. CT-like images based on T1 spoiled gradient-echo and ultra-short echo time MRI sequences for the assessment of vertebral fractures and degenerative bone changes of the spine. Eur Radiol 2021; 31:4680-4689. [PMID: 33443599 PMCID: PMC8213670 DOI: 10.1007/s00330-020-07597-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/28/2020] [Accepted: 12/03/2020] [Indexed: 12/24/2022]
Abstract
Objectives To evaluate the performance of 3D T1w spoiled gradient-echo (T1SGRE) and ultra-short echo time (UTE) MRI sequences for the detection and assessment of vertebral fractures and degenerative bone changes compared with conventional CT. Methods Fractures (n = 44) and degenerative changes (n = 60 spinal segments) were evaluated in 30 patients (65 ± 14 years, 18 women) on CT and 3-T MRI, including CT-like images derived from T1SGRE and UTE. Two radiologists evaluated morphological features on both modalities: Genant and AO/Magerl classifications, anterior/posterior vertebral height, fracture age; disc height, neuroforaminal diameter, grades of spondylolisthesis, osteophytes, sclerosis, and facet joint degeneration. Diagnostic accuracy and agreement between MRI and CT and between radiologists were assessed using crosstabs, weighted κ, and intraclass correlation coefficients. Image quality was graded on a Likert scale. Results For fracture detection, sensitivity, specificity, and accuracy were 0.95, 0.98, and 0.97 for T1SGRE and 0.91, 0.96, and 0.95 for UTE. Agreement between T1SGRE and CT was substantial to excellent (e.g., Genant: κ, 0.92 [95% confidence interval, 0.83–1.00]; AO/Magerl: κ, 0.90 [0.76–1.00]; osteophytes: κ, 0.91 [0.82–1.00]; sclerosis: κ, 0.68 [0.48–0.88]; spondylolisthesis: ICCs, 0.99 [0.99–1.00]). Agreement between UTE and CT was lower, ranging from moderate (e.g., sclerosis: κ, 0.43 [0.26–0.60]) to excellent (spondylolisthesis: ICC, 0.99 [0.99–1.00]). Inter-reader agreement was substantial to excellent (0.52–1.00), respectively, for all parameters. Median image quality of T1SGRE was rated significantly higher than that of UTE (p < 0.001). Conclusions Morphologic assessment of bone pathologies of the spine using MRI was feasible and comparable to CT, with T1SGRE being more robust than UTE. Key Points • Vertebral fractures and degenerative bone changes can be assessed on CT-like MR images, with 3D T1w spoiled gradient-echo–based images showing a high diagnostic accuracy and agreement with CT. • This could enable MRI to precisely assess bone morphology, and 3D T1SGRE MRI sequences may substitute additional spinal CT examinations in the future. • Image quality and robustness of T1SGRE sequences are higher than those of UTE MRI for the assessment of bone structures.
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Affiliation(s)
- Benedikt J Schwaiger
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany. .,Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
| | - Charlotte Schneider
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian T Gassert
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christof Böhm
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Daniela Pfeiffer
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Klaus Woertler
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Markus Wurm
- Department of Trauma Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexandra S Gersing
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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22
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Shaikh S. Editorial for "Comparison of MR Ultrashort Echo Time and Optimized 3D-Multiecho In-Phase Sequence to Computed Tomography for Assessment of the Osseous Craniocervical Junction". J Magn Reson Imaging 2021; 53:1040-1041. [PMID: 33386769 DOI: 10.1002/jmri.27477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sikandar Shaikh
- Department of Radiology, Shadan Institute of Medical Sciences, Hyderabad, India.,Department of Biomedical Engineering, Indian Institute of Technology, Hyderabad, India
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23
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Sollmann N, Becherucci EA, Boehm C, Husseini ME, Ruschke S, Burian E, Kirschke JS, Link TM, Subburaj K, Karampinos DC, Krug R, Baum T, Dieckmeyer M. Texture Analysis Using CT and Chemical Shift Encoding-Based Water-Fat MRI Can Improve Differentiation Between Patients With and Without Osteoporotic Vertebral Fractures. Front Endocrinol (Lausanne) 2021; 12:778537. [PMID: 35058878 PMCID: PMC8763669 DOI: 10.3389/fendo.2021.778537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Osteoporosis is a highly prevalent skeletal disease that frequently entails vertebral fractures. Areal bone mineral density (BMD) derived from dual-energy X-ray absorptiometry (DXA) is the reference standard, but has well-known limitations. Texture analysis can provide surrogate markers of tissue microstructure based on computed tomography (CT) or magnetic resonance imaging (MRI) data of the spine, thus potentially improving fracture risk estimation beyond areal BMD. However, it is largely unknown whether MRI-derived texture analysis can predict volumetric BMD (vBMD), or whether a model incorporating texture analysis based on CT and MRI may be capable of differentiating between patients with and without osteoporotic vertebral fractures. MATERIALS AND METHODS Twenty-six patients (15 females, median age: 73 years, 11 patients showing at least one osteoporotic vertebral fracture) who had CT and 3-Tesla chemical shift encoding-based water-fat MRI (CSE-MRI) available were analyzed. In total, 171 vertebral bodies of the thoracolumbar spine were segmented using an automatic convolutional neural network (CNN)-based framework, followed by extraction of integral and trabecular vBMD using CT data. For CSE-MRI, manual segmentation of vertebral bodies and consecutive extraction of the mean proton density fat fraction (PDFF) and T2* was performed. First-order, second-order, and higher-order texture features were derived from texture analysis using CT and CSE-MRI data. Stepwise multivariate linear regression models were computed using integral vBMD and fracture status as dependent variables. RESULTS Patients with osteoporotic vertebral fractures showed significantly lower integral and trabecular vBMD when compared to patients without fractures (p<0.001). For the model with integral vBMD as the dependent variable, T2* combined with three PDFF-based texture features explained 40% of the variance (adjusted R2[Ra2] = 0.40; p<0.001). Furthermore, regarding the differentiation between patients with and without osteoporotic vertebral fractures, a model including texture features from CT and CSE-MRI data showed better performance than a model based on integral vBMD and PDFF only ( Ra2 = 0.47 vs. Ra2 = 0.81; included texture features in the final model: integral vBMD, CT_Short-run_emphasis, CT_Varianceglobal, and PDFF_Variance). CONCLUSION Using texture analysis for spine CT and CSE-MRI can facilitate the differentiation between patients with and without osteoporotic vertebral fractures, implicating that future fracture prediction in osteoporosis may be improved.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- *Correspondence: Nico Sollmann,
| | - Edoardo A. Becherucci
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christof Boehm
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Malek El Husseini
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Karupppasamy Subburaj
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore, Singapore
- Changi General Hospital, Singapore, Singapore
| | - Dimitrios C. Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Roland Krug
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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24
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Kronthaler S, Rahmer J, Börnert P, Makowski MR, Schwaiger BJ, Gersing AS, Karampinos DC. Trajectory correction based on the gradient impulse response function improves high-resolution UTE imaging of the musculoskeletal system. Magn Reson Med 2020; 85:2001-2015. [PMID: 33251655 DOI: 10.1002/mrm.28566] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE UTE sequences typically acquire data during the ramping up of the gradient fields, which makes UTE imaging prone to eddy current and system delay effects. The purpose of this work was to use a simple gradient impulse response function (GIRF) measurement to estimate the real readout gradient waveform and to demonstrate that precise knowledge of the gradient waveform is important in the context of high-resolution UTE musculoskeletal imaging. METHODS The GIRF was measured using the standard hardware of a 3 Tesla scanner and applied on 3D radial UTE data (TE: 0.14 ms). Experiments were performed on a phantom, in vivo on a healthy knee, and in vivo on patients with spine fractures. UTE images were reconstructed twice, first using the GIRF-corrected gradient waveforms and second using nominal-corrected waveforms, correcting for the low-pass filter characteristic of the gradient chain. RESULTS Images reconstructed with the nominal-corrected gradient waveforms exhibited blurring and showed edge artifacts. The blurring and the edge artifacts were reduced when the GIRF-corrected gradient waveforms were used, as shown in single-UTE phantom scans and in vivo dual-UTE gradient-echo scans in the knee. Further, the importance of the GIRF-based correction was indicated in UTE images of the lumbar spine, where thin bone structures disappeared when the nominal correction was employed. CONCLUSION The presented GIRF-based trajectory correction method using standard scanner hardware can improve the quality of high-resolution UTE musculoskeletal imaging.
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Affiliation(s)
- Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | | | | | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Benedikt J Schwaiger
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Alexandra S Gersing
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
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Ma YJ, Shao H, Fan S, Lu X, Du J, Young IR, Bydder GM. New options for increasing the sensitivity, specificity and scope of synergistic contrast magnetic resonance imaging (scMRI) using Multiplied, Added, Subtracted and/or FiTted (MASTIR) pulse sequences. Quant Imaging Med Surg 2020; 10:2030-2065. [PMID: 33014733 PMCID: PMC7495319 DOI: 10.21037/qims-20-795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/23/2020] [Indexed: 11/06/2022]
Abstract
This paper reviews magnetic resonance (MR) pulse sequences in which the same or different tissue properties (TPs) such as T1 and T2 are used to contribute synergistically to lesion contrast. It also shows how synergistic contrast can be created with Multiplied, Added, Subtracted and/or fiTted Inversion Recovery (MASTIR) sequences, and be used to improve the sensitivity, specificity and scope of clinical magnetic resonance imaging (MRI) protocols. Synergistic contrast can be created from: (i) the same TP, e.g., T1 used twice or more in a pulse sequence; (ii) different TPs such as ρm, T1, T2, and D* used once or more within a sequence, and (iii) additional suppression or reduction of signals from tissues and/or fluids such as fat, long T2 tissues and cerebrospinal fluid (CSF). The short inversion time (TI) inversion recovery (IR) (STIR) and double IR (DIR) sequences usually show synergistic positive contrast for lesions which have increases in both T1 and T2. The diffusion weighted pulsed gradient spin echo (PGSE) sequence shows synergistic contrast for lesions which have an increase in T2 and a decrease in D*; the sequence is both positively weighted for T2 and negatively weighted for D*. In the brain, when an IR sequence nulling white matter has subtracted from it an IR sequence nulling gray matter to form the subtracted IR (SIR) sequence, increases in the single TP T1 between the two nulling points of the original two sequences generate high synergistic positive contrast. In addition, the subtraction to produce the SIR sequence reduces fat and CSF signals. To provide high sensitivity to changes in TPs in disease the SIR sequence can be used (i) alone to provide synergistic T1 contrast as above; (ii) with T2-weighting to provide synergistic T1 and T2 contrast, and (iii) with T2- and D*-weighting to provide synergistic T1, T2, and D* contrast. The SIR sequence can also be used in reversed form (longer TI form minus shorter TI form) to produce very high positive synergistic T1 contrast for reductions in T1, and so increase the positive contrast enhancement produced by clinical gadolinium-based contrast agents (GBCAs) when they reduce T1. The specificity of MRI examinations can be improved by using the reversed SIR sequence with a long echo time (TE) gradient echo as well as echo subtraction to show synergistic high contrast from T1 and T2* shortening produced by organic iron. Other added and subtracted forms of the MASTIR sequence can be used synergistically to selectively show myelin, myelin water and fluids including blood and CSF. Protocols using MASTIR sequences to provide synergistic contrast in MRI of the brain, prostate and articular cartilage are included as illustrative examples, and the features of synergistic contrast MRI (scMRI) are compared to those of multiparametric MRI (mpMRI) and functional MRI (fMRI).
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Affiliation(s)
- Ya-Jun Ma
- Department of Radiology, University of California, San Diego, CA, USA
| | - Hongda Shao
- Department of Radiology, University of California, San Diego, CA, USA
| | - Shujuan Fan
- Department of Radiology, University of California, San Diego, CA, USA
| | - Xing Lu
- Department of Radiology, University of California, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, USA
| | - Ian R. Young
- Formerly Department of Electrical Engineering, Imperial College, London, UK
| | - Graeme M. Bydder
- Department of Radiology, University of California, San Diego, CA, USA
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Ma YJ, Jerban S, Jang H, Chang D, Chang EY, Du J. Quantitative Ultrashort Echo Time (UTE) Magnetic Resonance Imaging of Bone: An Update. Front Endocrinol (Lausanne) 2020; 11:567417. [PMID: 33071975 PMCID: PMC7531487 DOI: 10.3389/fendo.2020.567417] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/17/2020] [Indexed: 12/24/2022] Open
Abstract
Bone possesses a highly complex hierarchical structure comprised of mineral (~45% by volume), organic matrix (~35%) and water (~20%). Water exists in bone in two forms: as bound water (BW), which is bound to bone mineral and organic matrix, or as pore water (PW), which resides in Haversian canals as well as in lacunae and canaliculi. Magnetic resonance (MR) imaging has been increasingly used for assessment of cortical and trabecular bone. However, bone appears as a signal void on conventional MR sequences because of its short T2*. Ultrashort echo time (UTE) sequences with echo times (TEs) 100-1,000 times shorter than those of conventional sequences allow direct imaging of BW and PW in bone. A series of quantitative UTE MRI techniques has been developed for bone evaluation. UTE and adiabatic inversion recovery prepared UTE (IR-UTE) sequences have been developed to quantify BW and PW. UTE magnetization transfer (UTE-MT) sequences have been developed to quantify collagen backbone protons, and UTE quantitative susceptibility mapping (UTE-QSM) sequences have been developed to assess bone mineral.
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Affiliation(s)
- Ya-Jun Ma
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Douglas Chang
- Department of Orthopedic Surgery, University of California, San Diego, San Diego, CA, United States
| | - Eric Y. Chang
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Jiang Du
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
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Ma YJ, Jang H, Wei Z, Cai Z, Xue Y, Lee RR, Chang EY, Bydder GM, Corey-Bloom J, Du J. Myelin Imaging in Human Brain Using a Short Repetition Time Adiabatic Inversion Recovery Prepared Ultrashort Echo Time (STAIR-UTE) MRI Sequence in Multiple Sclerosis. Radiology 2020; 297:392-404. [PMID: 32779970 DOI: 10.1148/radiol.2020200425] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background Water signal contamination is a major challenge for direct ultrashort echo time (UTE) imaging of myelin in vivo because water contributes most of the signals detected in white matter. Purpose To validate a new short repetition time (TR) adiabatic inversion recovery (STAIR) prepared UTE (STAIR-UTE) sequence designed to suppress water signals and to allow imaging of ultrashort T2 protons of myelin in white matter using a clinical 3-T scanner. Materials and Methods In this prospective study, an optimization framework was used to obtain the optimal inversion time for nulling water signals using STAIR-UTE imaging at different TRs. Numeric simulation and phantom studies were performed. Healthy volunteers and participants with multiple sclerosis (MS) underwent MRI between November 2018 and October 2019 to compare STAIR-UTE and a clinical T2-weighted fluid-attenuated inversion recovery sequence for assessment of MS lesions. UTE measures of myelin were also performed to allow comparison of signals in lesions and with those in normal-appearing white matter (NAWM) in patients with MS and in normal white matter (NWM) in healthy volunteers. Results Simulation and phantom studies both suggest that the proposed STAIR-UTE technique can effectively suppress long T2 tissues with a broad range of T1s. Ten healthy volunteers (mean age, 33 years ± 8 [standard deviation]; six women) and 10 patients with MS (mean age, 51 years ± 16; seven women) were evaluated. The three-dimensional STAIR-UTE sequence effectively suppressed water components in white matter and selectively imaged myelin, which had a measured T2* value of 0.21 msec ± 0.04 in the volunteer study. A much lower mean UTE measure of myelin proton density was found in MS lesions (3.8 mol/L ± 1.5), and a slightly lower mean UTE measure was found in NAWM (7.2 mol/L ± 0.8) compared with that in NWM (8.0 mol/L ± 0.8) in the healthy volunteers (P < .001 for both comparisons). Conclusion The short repetition time adiabatic inversion recovery-prepared ultrashort echo time sequence provided efficient water signal suppression for volumetric imaging of myelin in the brain and showed excellent myelin signal contrast as well as marked ultrashort echo time signal reduction in multiple sclerosis lesions and a smaller reduction in normal-appearing white matter compared with normal white matter in volunteers. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Messina and Port in this issue.
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Affiliation(s)
- Ya-Jun Ma
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
| | - Hyungseok Jang
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
| | - Zhao Wei
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
| | - Zhenyu Cai
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
| | - Yanping Xue
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
| | - Roland R Lee
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
| | - Eric Y Chang
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
| | - Graeme M Bydder
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
| | - Jody Corey-Bloom
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
| | - Jiang Du
- From the Departments of Radiology (Y.J.M., H.J., Z.W., Z.C., Y.X., R.R.L., E.Y.C., G.M.B., J.D.) and Neurosciences (J.C.B.) University of California San Diego, 9452 Medical Center Dr, La Jolla, CA 92037; and Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, Calif (E.Y.C.)
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Abstract
Bone is a composite material consisting of mineral, organic matrix, and water. Water in bone can be categorized as bound water (BW), which is bound to bone mineral and organic matrix, or as pore water (PW), which resides in Haversian canals as well as in lacunae and canaliculi. Bone is generally classified into two types: cortical bone and trabecular bone. Cortical bone is much denser than trabecular bone that is surrounded by marrow and fat. Magnetic resonance (MR) imaging has been increasingly used for noninvasive assessment of both cortical bone and trabecular bone. Bone typically appears as a signal void with conventional MR sequences because of its short T2*. Ultrashort echo time (UTE) sequences with echo times 100 to 1,000 times shorter than those of conventional sequences allow direct imaging of BW and PW in bone. This article summarizes several quantitative MR techniques recently developed for bone evaluation. Specifically, we discuss the use of UTE and adiabatic inversion recovery prepared UTE sequences to quantify BW and PW, UTE magnetization transfer sequences to quantify collagen backbone protons, UTE quantitative susceptibility mapping sequences to assess bone mineral, and conventional sequences for high-resolution imaging of PW as well as the evaluation of trabecular bone architecture.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, California
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, California
| | - Zhao Wei
- Department of Radiology, University of California, San Diego, California
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, California.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Jiang Du
- Department of Radiology, University of California, San Diego, California
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Sollmann N, Löffler MT, Kronthaler S, Böhm C, Dieckmeyer M, Ruschke S, Kirschke JS, Carballido-Gamio J, Karampinos DC, Krug R, Baum T. MRI-Based Quantitative Osteoporosis Imaging at the Spine and Femur. J Magn Reson Imaging 2020; 54:12-35. [PMID: 32584496 DOI: 10.1002/jmri.27260] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/31/2020] [Accepted: 06/01/2020] [Indexed: 12/27/2022] Open
Abstract
Osteoporosis is a systemic skeletal disease with a high prevalence worldwide, characterized by low bone mass and microarchitectural deterioration, predisposing an individual to fragility fractures. Dual-energy X-ray absorptiometry (DXA) has been the clinical reference standard for diagnosing osteoporosis and for assessing fracture risk for decades. However, other imaging modalities are of increasing importance to investigate the etiology, treatment, and fracture risk. The purpose of this work is to review the available literature on quantitative magnetic resonance imaging (MRI) methods and related findings in osteoporosis at the spine and proximal femur as the clinically most important fracture sites. Trabecular bone microstructure analysis at the proximal femur based on high-resolution MRI allows for a better prediction of osteoporotic fracture risk than DXA-based bone mineral density (BMD) alone. In the 1990s, T2 * mapping was shown to correlate with the density and orientation of the trabecular bone. Recently, quantitative susceptibility mapping (QSM), which overcomes some of the limitations of T2 * mapping, has been applied for trabecular bone quantifications at the spine, whereas ultrashort echo time (UTE) imaging provides valuable surrogate markers of cortical bone quantity and quality. Magnetic resonance spectroscopy (MRS) and chemical shift encoding-based water-fat MRI (CSE-MRI) enable the quantitative assessment of the nonmineralized bone compartment through extraction of the bone marrow fat fraction (BMFF). Furthermore, CSE-MRI allows for the differentiation of osteoporotic vs. pathologic fractures, which is of high clinical relevance. Lastly, advanced postprocessing and image analysis tools, particularly considering statistical parametric mapping and region-specific BMFF distributions, have high potential to further improve MRI-based fracture risk assessments at the spine and hip. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Maximilian T Löffler
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Sophia Kronthaler
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Christof Böhm
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jan S Kirschke
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Julio Carballido-Gamio
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Roland Krug
- Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
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Wei Z, Ma YJ, Jang H, Yang W, Du J. To measure T 1 of short T 2 species using an inversion recovery prepared three-dimensional ultrashort echo time (3D IR-UTE) method: A phantom study. J Magn Reson 2020; 314:106725. [PMID: 32320926 PMCID: PMC7307614 DOI: 10.1016/j.jmr.2020.106725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/20/2020] [Accepted: 04/02/2020] [Indexed: 05/04/2023]
Abstract
PURPOSE To demonstrate the feasibility of a new method for measuring T1 of short T2 species based on an adiabatic inversion recovery-prepared three-dimensional ultrashort echo time Cones (3D IR-UTE-Cones) sequence. METHODS T1 values for short T2 species were quantified using 3D IR-UTE-Cones data acquired with different repetition times (TRs) and inversion times (TIs). An inversion efficiency factor Q was introduced into the fitting model to accurately calculate T1 values for short T2 species. Experiments were performed on twelve MnCl2 aqueous solution phantoms with a wide range of T1 values and T2* values on a 3 T clinical MR system to verify the efficacy of the proposed method. For comparison, a variable flip angle UTE (VFA-UTE) sequence, a variable TR UTE (VTR-UTE) sequence, and a conventional 2D IR fast spin echo (IR-FSE) sequence were also used to quantify T1 values of those phantoms. T1 values were compared between all performed sequences. RESULTS The proposed 3D IR-UTE-Cones method provided higher contrast images of short T2 phantoms and measured much shorter T1 values than the VFA-UTE, VTR-UTE and 2D IR-FSE methods. T1 values as short as 2.95 ms could be measured by the 3D IR-UTE-Cones sequence. The 3D IR-UTE-Cones methods with different TRs were applied to different ranges of T1 measurement, and the scan time was significantly decreased by using 5 TIs along the recovery curves to perform fitting with comparable accuracy. CONCLUSION The 3D IR-UTE-Cones sequence could accurately measure short T1 values while providing high contrast images of short T2 species.
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Affiliation(s)
- Zhao Wei
- Department of Radiology, University of California San Diego, CA, United States; University of Chinese Academy of Sciences, Beijing, China; Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.
| | - Ya-Jun Ma
- Department of Radiology, University of California San Diego, CA, United States.
| | - Hyungseok Jang
- Department of Radiology, University of California San Diego, CA, United States.
| | - Wenhui Yang
- University of Chinese Academy of Sciences, Beijing, China; Institute of Electrical Engineering, Chinese Academy of Sciences, Beijing, China.
| | - Jiang Du
- Department of Radiology, University of California San Diego, CA, United States.
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Jerban S, Chang DG, Ma Y, Jang H, Chang EY, Du J. An Update in Qualitative Imaging of Bone Using Ultrashort Echo Time Magnetic Resonance. Front Endocrinol (Lausanne) 2020; 11:555756. [PMID: 33117275 PMCID: PMC7551122 DOI: 10.3389/fendo.2020.555756] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 09/11/2020] [Indexed: 12/31/2022] Open
Abstract
Bone is comprised of mineral, collagenous organic matrix, and water. X-ray-based techniques are the standard approach for bone evaluation in clinics, but they are unable to detect the organic matrix and water components in bone. Magnetic resonance imaging (MRI) is being used increasingly for bone evaluation. While MRI can non-invasively assess the proton pools in soft tissues, cortical bone typically appears as a signal void with clinical MR techniques because of its short T2*. New MRI techniques have been recently developed to image bone while avoiding the ionizing radiation present in x-ray-based methods. Qualitative bone imaging can be achieved using ultrashort echo time (UTE), single inversion recovery UTE (IR-UTE), dual-inversion recovery UTE (Dual-IR-UTE), double-inversion recovery UTE (Double-IR-UTE), and zero echo time (ZTE) sequences. The contrast mechanisms as well as the advantages and disadvantages of each technique are discussed.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Douglas G. Chang
- Departments of Orthopaedic Surgery, University of California, San Diego, San Diego, CA, United States
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
| | - Eric Y. Chang
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
| | - Jiang Du
- Department of Radiology, University of California, San Diego, San Diego, CA, United States
- *Correspondence: Jiang Du,
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Guo T, Ma Y, Jerban S, Jang H, Zhao W, Chang EY, Chen M, Bydder GM, Du J. T 1 measurement of bound water in cortical bone using 3D adiabatic inversion recovery ultrashort echo time (3D IR-UTE) Cones imaging. Magn Reson Med 2019; 84:634-645. [PMID: 31863519 DOI: 10.1002/mrm.28140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/04/2019] [Accepted: 11/30/2019] [Indexed: 11/11/2022]
Abstract
PURPOSE We describe the measurement of bound water T1 ( T 1 BW ) of cortical bone in vitro and in vivo with a 3D adiabatic inversion recovery ultrashort echo time (IR-UTE) Cones sequence using a clinical 3T scanner. METHODS A series IR-UTE data from 6 repetition times (TRs) with 5 inversion times (TIs) at each TR were acquired from 12 human tibial bone specimens, and data from 4 TRs with 5 TIs at each TR were acquired from the tibial midshafts of 8 healthy volunteers. The pore water nulling point was calculated from exponential fitting of the inversion recovery curve at each TR. Bone specimens and volunteers were then scanned again with the calculated nulling point at each TR. T 1 BW was derived through exponential fitting of data from IR-UTE images acquired at different TRs using the calculated pore water nulling point for each TR. RESULTS In vitro pore water nulling TIs were 141.3 ± 11.6, 123.4 ± 8.9, 101.3 ± 6.2, 88.9 ± 5.3, 74.8 ± 4.2, and 59.2 ± 3.9 ms for the 6 TRs of 500, 400, 300, 250, 200, and 150 ms, respectively. In vivo pore water nulling TIs were 132.8 ± 12.8, 110.3 ± 10.0, 80.0 ± 7.2, and 63.9 ± 5.4 ms for the 4 TRs of 400, 300, 200, and 150 ms, respectively. Excellent exponential fitting was achieved for IR-UTE imaging of bound water with pore water nulled at each TR. The mean T 1 BW was 106.9 ± 6.3 ms in vitro and 112.3 ± 16.4 ms in vivo. CONCLUSION Using the 3D IR-UTE Cones with a variable TR/TI approach, T 1 BW of cortical bone was calculated after complete nulling of pore water signals.
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Affiliation(s)
- Tan Guo
- Department of Radiology, Beijing Hospital, Beijing, China.,Department of Radiology, University of California, San Diego, California
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, California
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, California
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California
| | - Wei Zhao
- Department of Radiology, University of California, San Diego, California
| | - Eric Y Chang
- Research Service, VA San Diego Healthcare System, San Diego, California
| | - Min Chen
- Department of Radiology, Beijing Hospital, Beijing, China
| | - Graeme M Bydder
- Department of Radiology, University of California, San Diego, California
| | - Jiang Du
- Department of Radiology, University of California, San Diego, California
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