Multipoint mapping for imaging of semi-solid materials

Zero echo time pediatric musculoskeletal magnetic resonance imaging: initial experience

BACKGROUND

Projection radiography (XR) is often supplemented by both CT (to evaluate osseous structures with ionizing radiation) and MRI (for marrow and soft-tissue assessment). Zero echo time (ZTE) MR imaging produces a "CT-like" osseous contrast that might obviate CT.

OBJECTIVE

This study investigated our institution's initial experience in implementing an isotropic ZTE MR imaging sequence for pediatric musculoskeletal examinations.

MATERIALS AND METHODS

Pediatric patients referred for extremity MRI at 3 tesla (T) underwent ZTE MR imaging to yield images with contrast similar to that of CT. A radiograph-like image was also created with ray-sum image processing. We assessed ZTE-CT/XR anatomical image quality (S_anat) from 0 (nondiagnostic) to 5 (outstanding). Further, we made image comparisons on a 5-point scale (S_comp) (range of -2 = conventional CT/XR greater anatomical delineation to +2 = ZTE-CT/XR greater anatomical delineation; 0=same) for three cohorts: (1) ZTE-XR to conventional radiography, (2) ZTE-CT to conventional CT and (3) pathological lesion assessment on ZTE-XR to conventional radiography. We measured cortical thickness of ZTE-XR and ZTE-CT and compared these with conventional imaging. We calculated confidence interval of proportions, Wilcoxon rank sum test and intraclass correlation coefficients for inter-reader agreement.

RESULTS

Cohorts 1, 2 and 3 consisted of 40, 20 and 35 cases, respectively (age range 0.6-23.0 years). ZTE-CT versus CT and ZTE-XR versus radiography of cortical thicknesses were not significantly different (P=0.55 and P=0.31, respectively). Cortical delineation was rated diagnostic or better (score of 3, 4 or 5) in all cases (confidence interval of proportions = 100%) for ZTE-CT/XR. Similarly, intramedullary cavity delineation was rated diagnostic or better in all cases for ZTE-CT, and ZTE-XR was at least diagnostic in 58-63% of cases. For cohort 2, cortex and intramedullary cavity S_comp for ZTE-CT was comparable to those of conventional CT, with confidence interval of proportion (sum of score of -1 to +2) of 93-100% and 95%, respectively. Pathology visualized on ZTE-CT/XR was comparable; S_comp confidence interval of proportions was 95%/97-100%, with improved delineation of non-displaced fractures on ZTE-XR. Readers had moderate to near-perfect intraclass correlation coefficient (range=0.60-0.93).

CONCLUSION

Implementation of a diagnostic-quality ZTE MRI sequence in the pediatric population is feasible and can be performed as a complementary pulse sequence to enhance musculoskeletal MRI studies. Compared to conventional CT, ZTE has comparable cortical delineation, intramedullary cavity and pathology visualization. While not intended as a replacement for conventional radiography, ZTE-XR provides similar visualization of pathology.

Short-T2 MRI: Principles and recent advances

Among current modalities of biomedical and diagnostic imaging, MRI stands out by virtue of its versatile contrast obtained without ionizing radiation. However, in various cases, e.g., water protons in tissues such as bone, tendon, and lung, MRI performance is limited by the rapid decay of resonance signals associated with short transverse relaxation times T₂ or T₂*. Efforts to address this shortcoming have led to a variety of specialized short-T₂ techniques. Recent progress in this field expands the choice of methods and prompts fresh considerations with regard to instrumentation, data acquisition, and signal processing. In this review, the current status of short-T₂ MRI is surveyed. In an attempt to structure the growing range of techniques, the presentation highlights overarching concepts and basic methodological options. The most frequently used approaches are described in detail, including acquisition strategies, image reconstruction, hardware requirements, means of introducing contrast, sources of artifacts, limitations, and applications.

Ultrashort echo time magnetic resonance fingerprinting (UTE-MRF) for simultaneous quantification of long and ultrashort T2 tissues

PURPOSE

To demonstrate an ultrashort echo time magnetic resonance fingerprinting (UTE-MRF) method that allows quantifying relaxation times for muscle and bone in the musculoskeletal system and generating bone enhanced images that mimic CT scans.

METHODS

A fast imaging steady-state free precession MRF sequence with half pulse excitation and half projection readout was designed to sample fast T₂ decay signals. Varying echo time (TE) of a sinusoidal pattern was applied to enhance sensitivity for tissues with short and ultrashort T₂ values. The performance of UTE-MRF was evaluated via simulations, phantom, and in vivo experiments.

RESULTS

A minimal TE of 0.05 ms was achieved. Simulations indicated the sinusoidal TE sampling increased T₂ quantification accuracy in the cortical bone and tendon but had little impact on long T₂ muscle quantifications. For the rubber phantom, the averaged relaxometries from UTE-MRF (T₁ = 162 ms and T₂ = 1.07 ms) compared well with the gold standard (T₁ = 190 ms and T 2 ∗ = 1.03 ms). For the long T₂ agarose phantom, the linear regression slope between UTE-MRF and gold standard was 1.07 (R² = 0.991) for T₁ and 1.04 (R² = 0.994) for T₂ . In vivo experiments showed the detection of the cortical bone (averaged T₂ = 1.0 ms) and Achilles tendon (averaged T₂ = 15 ms). Scalp structures from the bone enhanced image show high similarity with CT.

CONCLUSION

The UTE-MRF with sinusoidal TEs can simultaneously quantify T₁ , T₂ , proton density, and B₀ in long, short, even ultrashort T₂ musculoskeletal structures. Bone enhanced images can be achieved in the brain with UTE-MRF.

Rapid ex vivo imaging of PAIII prostate to bone tumor with SWIFT-MRI

PURPOSE

The limiting factor for MRI of skeletal/mineralized tissue is fast transverse relaxation. A recent advancement in MRI technology, SWIFT (Sweep Imaging with Fourier Transform), is emerging as a new approach to overcome this difficulty. Among other techniques like UTE, ZTE, and WASPI, the application of SWIFT technology has the strong potential to impact preclinical and clinical imaging, particularly in the context of primary or metastatic bone cancers because it has the added advantage of imaging water in mineralized tissues of bone allowing MRI images to be obtained of tissues previously visible only with modalities such as computed tomography (CT). The goal of the current study is to examine the feasibility of SWIFT for the assessment of the prostate cancer induced changes in bone formation (osteogenesis) and destruction (osteolysis) in ex vivo specimens.

METHODS

A luciferase expressing prostate cancer cell line (PAIII) or saline control was inoculated directly into the tibia of 6-week-old immunocompromised male mice. Tumor growth was assessed weekly for 3 weeks before euthanasia and dissection of the tumor bearing and sham tibias. The ex vivo mouse tibia specimens were imaged with a 9.4 Tesla (T) and 7T MRI systems. SWIFT images are compared with traditional gradient-echo and spin-echo MRI images as well as CT and histological sections.

RESULTS

SWIFT images with nominal resolution of 78 μm are obtained with the tumor and different bone structures identified. Prostate cancer induced changes in the bone microstructure are visible in SWIFT images, which is supported by spin-echo, high resolution CT and histological analysis.

CONCLUSION

SWIFT MRI is capable of high-quality high-resolution ex vivo imaging of bone tumor and surrounding bone and soft tissues. Furthermore, SWIFT MRI shows promise for in vivo bone tumor imaging, with the added benefits of nonexposure to ionizing radiation, quietness, and speed.

Hybrid-SPRITE MRI

In a FID based frequency encoding MRI experiment the central part of k-space is not generally accessible due to the probe dead time. This portion of k-space is however crucial for image reconstruction. SPRITE (Single Point Ramped Imaging with T1 Enhancement), SPI with a linearly ramped phase encode gradient, has been employed to image short relaxation time systems for many years with great success. It is a robust imaging method in significant measure because it provides acquisition of high quality k-space origin data. We propose a new sampling scheme, termed hybrid-SPRITE, combining phase and frequency encoding to ensure high quality images with reduced acquisition times, reduced gradient duty cycle and increased sensitivity. In hybrid-SPRITE, numerous time domain points are collected to assist image reconstruction. An Inverse Non-uniform Discrete Fourier Transform (INDFT) is employed in 1D applications. A pseudo-polar grid is exploited in 2D hybrid-SPRITE for rapid and accurate image reconstruction.

Direct depiction of bone microstructure using MRI with zero echo time

This paper reports a proof of principle of direct depiction of trabecular bone microstructure in vitro by means of magnetic resonance imaging (MRI). Such depiction is achieved by (1)H imaging of water embedded in the bone matrix. The fast transverse relaxation of this compartment with T2(⁎) on the order of a few hundreds of microseconds is addressed by a three-dimensional MRI technique with zero echo time (ZTE). ZTE imaging at an isotropic spatial resolution of 56 μm is demonstrated in a trabecular bone specimen extracted from a bovine bone. In the MR images, the trabecular bone structure is clearly depicted and a high level of robustness against off-resonance artefacts is observed. The structural accuracy of the MR data is investigated by comparison with x-ray micro-computed tomography.

Preliminary use of a double-echo pulse sequence with 3D ultrashort echo time in the MRI of bones and joints

The aim of the present study was to investigate the application of a double-echo pulse sequence with 3D ultrashort echo time (UTE) in the magnetic resonance imaging (MRI) of bones and joints. In total, 7 healthy volunteers and 1 volunteer with a suspected tear of the lateral meniscus of the left knee joint underwent MRI with a double-echo pulse sequence and 3D UTE. The imaging was performed on the tibial diaphysis, knee joint and ankle of the volunteers and on a segment of porcine fibula in vitro. The echo time of echo 1 (TE1) of the UTE images for the achilles tendon of the ankle joint were set as 0.08, 0.16, 0.24 and 0.35 msec. The maximum intensity projection (MIP) of the difference images created from the primary double-echo images with a TE1 of 0.08 msec were performed on the tendons of the ankle to display their 3D structure. The data were analyzed with a one-way ANOVA and paired-sample t-test. The 3D distribution of the tendons was displayed through MIPs of the difference images created from the primary double-echo images. The cortical bones, periosteum, tendons and menisci of the 8 volunteers appeared as high signal intensities in the UTE pulse sequence. Multiplanar reconstruction followed by subtraction of the primary double-echo images raised the image signal-to-noise (S/N) ratio from 2.80±0.75 to 3.76±0.88 (t=−4.851, P<0.01). The artifacts appeared more marked as the TE1 was prolonged. A double pulse sequence MRI with 3D UTE may display the short T₂ components which are not displayed with a conventional clinical MRI sequence, therefore creating a basis for the further quantification of these tissues.

On the utility of spectroscopic imaging as a tool for generating geometrically accurate MR images and parameter maps in the presence of field inhomogeneities and chemical shift effects

Lack of spatial accuracy is a recognized problem in magnetic resonance imaging (MRI) which severely detracts from its value as a stand-alone modality for applications that put high demands on geometric fidelity, such as radiotherapy treatment planning and stereotactic neurosurgery. In this paper, we illustrate the potential and discuss the limitations of spectroscopic imaging as a tool for generating purely phase-encoded MR images and parameter maps that preserve the geometry of an object and allow localization of object features in world coordinates. Experiments were done on a clinical system with standard facilities for imaging and spectroscopy. Images were acquired with a regular spin echo sequence and a corresponding spectroscopic imaging sequence. In the latter, successive samples of the acquired echo were used for the reconstruction of a series of evenly spaced images in the time and frequency domain. Experiments were done with a spatial linearity phantom and a series of test objects representing a wide range of susceptibility- and chemical-shift-induced off-resonance conditions. In contrast to regular spin echo imaging, spectroscopic imaging was shown to be immune to off-resonance effects, such as those caused by field inhomogeneity, susceptibility, chemical shift, f(0) offset and field drift, and to yield geometrically accurate images and parameter maps that allowed object structures to be localized in world coordinates. From these illustrative examples and a discussion of the limitations of purely phase-encoded imaging techniques, it is concluded that spectroscopic imaging offers a fundamental solution to the geometric deficiencies of MRI which may evolve toward a practical solution when full advantage will be taken of current developments with regard to scan time reduction. This perspective is backed up by a demonstration of the significant scan time reduction that may be achieved by the use of compressed sensing for a simple phantom.

Review. The Agfa Mayneord lecture: MRI of short and ultrashort T₂ and T₂* components of tissues, fluids and materials using clinical systems

A variety of techniques are now available to directly or indirectly detect signal from tissues, fluids and materials that have short, ultrashort or supershort T₂ or T₂* components. There are also methods of developing image contrast between tissues and fluids in the short T₂ or T₂* range that can provide visualisation of anatomy, which has not been previously seen with MRI. Magnetisation transfer methods can now be applied to previously invisible tissues, providing indirect access to supershort T₂ components. Particular methods have been developed to target susceptibility effects and quantify them after correcting for anatomical distortion. Specific methods have also been developed to image the effects of magnetic iron oxide particles with positive contrast. Major advances have been made in techniques designed to correct for loss of signal and gross image distortion near metal. These methods are likely to substantially increase the range of application for MRI.

Qualitative and quantitative ultrashort echo time (UTE) imaging of cortical bone

We describe the use of two-dimensional ultrashort echo time (2D UTE) sequences with minimum TEs of 8 μs to image and quantify cortical bone on a clinical 3T scanner. An adiabatic inversion pulse was used for long T(2) water and fat signal suppression. Adiabatic inversion prepared UTE acquisitions with varying TEs were used for T(2) measurement. Saturation recovery UTE acquisitions were used for T(1) measurement. Bone water concentration was measured with the aid of an external reference phantom. UTE techniques were evaluated on cadaveric specimens and healthy volunteers. A signal-to-noise ratio of around 30, contrast-to-noise ratio of around 27/20 between bone and muscle/fat were achieved in tibia in vivo with a nominal voxel size of 0.23 × 0.23 × 6.0 mm(3) in a scan time of 5 min. A mean T(1) of 223 ± 11 ms and mean T(2) of 390 ± 19 μs were found. Mean bone water concentrations of 23.3 ± 1.6% with UTE and 21.7 ± 1.3% with adiabatic inversion prepared UTE sequences were found in tibia in five normal volunteers. The results show that in vivo qualitative and quantitative evaluation of cortical bone is feasible with 2D UTE sequences.

In vivo ultra-high-field magnetic resonance imaging of trabecular bone microarchitecture at 7 T

PURPOSE

To investigate the feasibility of 7 T magnetic resonance imaging (MRI) to visualize and quantify trabecular bone structure in vivo by comparison with 3T MRI and in vivo three-dimensional (3D) high-resolution peripheral quantitative computed tomography (HR-pQCT).

MATERIALS AND METHODS

The distal tibiae of 10 healthy volunteers were imaged. Therefore, fully balanced steady state free precession (bSSFP) and spin-echo (bSSSE) pulse sequences were implemented and optimized for 7 T. Structural bone parameters, such as apparent bone-volume over total-volume fraction (app.BV/TV), apparent trabecular plate separation (app.TbSp), apparent trabecular plate thickness (app.TbTh), and apparent trabecular plate number (app.TbN), were derived.

RESULTS

All structural trabecular bone parameters correlated well (r > 0.6) between 7T and 3T, and between 7 T and HR-pQCT (r > 0.69), with the exception of app.TbTh, which correlated modestly (r = 0.41) between field strengths and very low with HR-pQCT (r < 0.16). Regarding absolute values, app.TbN varied only 4% between field strengths, and only 0.6% between 7 T and HR-pQCT. App.TbSp correlated best between 7 T and HR-pQCT (r = 0.89). Using bSSSE, significant smaller trabecular thickness and significant higher trabecular number were found compared to bSSFP.

CONCLUSION

We concluded that imaging and quantification of the trabecular bone architecture at 7 T is feasible and preferably done using bSSSE. There exists great potential for ultra-high-field (UHF) MRI applied to trabecular bone measurements.

Magnetic resonance imaging of entheses. Part 1

Entheses are the sites of attachment of a tendon, ligament, or joint capsule to bone. Many features of entheses are adapted to disperse stress and accommodate compressive and shear forces at, or near, boundaries between tendons or ligaments and bone. Of particular interest is calcified and uncalcified fibrocartilage, which has mechanical properties that differ from those of tensile regions of tendons or ligaments, and from bone. Ultrashort echo time (UTE) pulse sequences can identify the specific tissue components of entheses and differentiate cortical bone, calcified fibrocartilage, uncalcified fibrocartilage, and fibrous connective tissue. Magic angle imaging can also differentiate tissues, such as fibrocartilage and tendon, which have different fibre orientations. Understanding the magnetic resonance (MR) appearance of entheses involves consideration of tissue properties, fibre-to-field angle, magic angle effects, pulse sequences, and geometrical factors including fibre-to-section orientation and partial volume effects. New approaches using MR imaging, allow entheses to be visualised with much greater detail than previously possible, and this may help in biomechanical studies, diagnosis of disease including overuse syndromes and spondyloarthropathies, as well as monitoring tissue repair and healing.

Multi-modality study of the compositional and mechanical implications of hypomineralization in a rabbit model of osteomalacia

Osteomalacia is characterized by hypomineralization of the bone associated with increased water content. In this work we evaluate the hypotheses that 1) 3D solid-state magnetic resonance imaging (MRI) of (31)P (SSI-PH) and (1)H (SSI-WATER) of cortical bone can quantify the key characteristics of osteomalacia induced by low-phosphate diet; and 2) return to normophosphatemic diet (NO) results in recovery of these indices to normal levels. Twenty female five-week old rabbits were divided into four groups. Five animals were fed a normal diet for 8 weeks (NOI); five a hypophosphatemic diet (0.09%) for the same period to induce osteomalacia (HYI). To examine the effect of recovery from hypophosphatemia an additional five animals received a hypophosphatemic diet for 8 weeks, after which they were returned to a normal diet for 6 weeks (HYII). Finally, five animals received a normal diet for the entire 14 weeks (NOII). The NOI and HYI animals were sacrificed after 8 weeks, the NOII and HYII groups after 14 weeks. Cortical bone was extracted from the left and right tibiae of all the animals. Water content was measured by SSI-WATER and by a previously reported spectroscopic proton-deuteron nuclear magnetic resonance (NMR) exchange technique (NMR-WATER), phosphorus content by SSI-PH. All MRI and NMR experiments were performed on a 9.4 T spectroscopy/micro-imaging system. Degree of mineralization of bone (DMB) was measured by micro-CT and elastic modulus and ultimate strength by 3-point bending. The following parameters were lower in the hypophosphatemic group: phosphorus content measured by SSI-PH (9.5+/-0.4 versus 11.1+/-0.3 wt.%, p<0.0001), ash content (63.9+/-1.7 versus 65.4+/-1.1 wt.%, p=0.05), ultimate strength, (96.3+/-16.0 versus 130.7+/-6.4 N/mm(2), p=0.001), and DMB (1115+/-28 versus 1176+/-24 mg/cm(3), p=0.003); SSI-WATER: 16.1+/-1.5 versus 14.4+/-1.1 wt.%, p=0.04; NMR-WATER: 19.0+/-0.6 versus 17.4+/-1.2 wt.%, p=0.01. Return to a normophosphatemic diet reduced or eliminated these differences (SSI-PH: 9.5+/-0.9 versus 10.6+/-0.8 wt.%, p=0.04; DMB: 1124+/-31 versus 1137+/-10 mg/cm(3), p=0.2; US: 95.6+/-18.6 versus 103.9+/-7.5 N/mm(2), p=0.2; SSI-WATER: 12.4+/-0.6 versus 12.2+/-0.3 wt.%, p=0.3) indicating recovery of the mineral density close to normal levels. Phosphorus content measured by SSI-PH was significantly correlated with DMB measured by micro-CT (r(2)=0.47, p=0.001) as well as with ultimate strength (r(2)=0.54, p=0.0004). The results show that the methods presented have potential for in situ assessment of mineralization and water, both critical to the bone's mechanical behavior.

In vivo MRI of submillisecond T(2) species with two-dimensional and three-dimensional radial sequences and applications to the measurement of cortical bone water

Water in dense collagenous tissues such as tendons and ligaments, as well as water in cortical bone that occupies the spaces of the lacuno-canicular system or is tightly bound to collagen, is not ordinarily detectable by MRI. Water proton T(2) in these structures is generally less than 1 ms. Recent advances in instrumentation in conjunction with non-Cartesian imaging strategies now allow center of k-space to be scanned 100 micros or less after excitation. We examined the performance of two radial pulse sequences, a 2D sequence with half-pulse excitation and a new 3D hybrid sequence with variable-echo Cartesian encoding in the third dimension, on a whole-body 3 T scanner. Both pulse sequences used long-T(2) soft-tissue suppression pulses. The half-pulse slice profiles observed experimentally agreed well with those computed on the basis of a numerical solution of Bloch equations. The techniques yielded a signal-to-noise ratio of the order of 25 in 9 min scan time at a nominal voxel size of 0.58 x 0.58 x 8 mm(3) and 50-90 micros 'echo time' in the cortex of the tibial mid-shaft. With the use of an external reference, the water volume fraction of cortical bone in four subjects (mean +/- SD age 32.25 +/- 5.3 years) was found to be 22.5 +/- 2.7%, in good agreement with literature values.

Water- and fat-suppressed proton projection MRI (WASPI) of rat femur bone

Investigators often study rats by microCT to investigate the pathogenesis and treatment of skeletal disorders in humans. However, microCT measurements provide information only on bone mineral content and not the solid matrix. CT scans are often carried out on cancellous bone, which contains a significant volume of marrow cells, stroma, water, and fat, and thus the apparent bone mineral density (BMD) does not reflect the mineral density within the matrix, where the mineral crystals are localized. Water- and fat-suppressed solid-state proton projection imaging (WASPI) was utilized in this study to image the solid matrix content (collagen, tightly bound water, and other immobile molecules) of rat femur specimens, and meet the challenges of small sample size and demanding submillimeter resolution. A method is introduced to recover the central region of k-space, which is always lost in the receiver dead time when free induction decays (FIDs) are acquired. With this approach, points near the k-space origin are sampled under a small number of radial projections at reduced gradient strength. The typical scan time for the current WASPI experiments was 2 hr. Proton solid-matrix images of rat femurs with 0.4-mm resolution and 12-mm field of view (FOV) were obtained. This method provides a noninvasive means of studying bone matrix in small animals.

Evaluation of bioreactor-cultivated bone by magnetic resonance microscopy and FTIR microspectroscopy

We present a three-dimensional mineralizing model based on a hollow fiber bioreactor (HFBR) inoculated with primary osteoblasts isolated from embryonic chick calvaria. Using non-invasive magnetic resonance microscopy (MRM), the growth and development of the mineralized tissue around the individual fibers were monitored over a period of 9 weeks. Spatial maps of the water proton MRM properties of the intact tissue, with 78 microm resolution, were used to determine changes in tissue composition with development. Unique changes in the mineral and collagen content of the tissue were detected with high specificity by proton density (PD) and magnetization transfer ratio (MTR) maps, respectively. At the end of the growth period, the presence of a bone-like tissue was verified by histology and the formation of poorly crystalline apatite was verified by selected area electron diffraction and electron probe X-ray microanalysis. FTIR microspectroscopy confirmed the heterogeneous nature of the bone-like tissue formed. FTIR-derived phosphate maps confirmed that those locations with the lowest PD values contained the most mineral, and FTIR-derived collagen maps confirmed that bright pixels on MTR maps corresponded to regions of high collagen content. In conclusion, the spatial mapping of tissue constituents by FTIR microspectroscopy corroborated the findings of non-invasive MRM measurements and supported the role of MRM in monitoring the bone formation process in vitro.

Structural and functional assessment of trabecular and cortical bone by micro magnetic resonance imaging

Osteoporosis is a multifactorial disorder of bone mineral homeostasis affecting the elderly. It is a major public health issue with significant socioeconomic consequences. Recent findings suggest that bone loss-the key manifestation of the disease-is accompanied by architectural deterioration, both affecting the bone's mechanical competence and susceptibility to fracture. This article reviews the potential of quantitative micro MRI (mu-MRI), including a discussion of the technical requirements for image acquisition, processing, and analysis for assessing the architectural implications of osteoporosis and as a means to monitor the response to treatment. With current technology, the resolution achievable in clinically acceptable scan times and necessary signal-to-noise ratio (SNR) is comparable to trabecular thickness. This limited spatial resolution regime demands processing and analysis algorithms designed to operate under such limiting conditions. It is shown that three different classes of structural parameters can be distinguished, characterizing scale, topology, and orientation. There is considerable evidence that osteoporotic bone loss affects all three classes but that topological changes, resulting from conversion of trabecular plates to rods, with the latter's eventual disconnection, are particularly prominent. Clinical applications discussed can be divided into those dealing with assessment of osteoporotic fracture risk as opposed to the study of the effect of disease progression and regression in response to treatment. Current data suggest that noninvasive assessment of cortical and trabecular bone (TB) architecture by mu-MRI may provide new surrogate endpoints to assess the efficacy of intervention in osteoporosis treatment and prevention.

Ex vivo identification of atherosclerotic plaque calcification by a 31P solid-state magnetic resonance imaging technique

Calcified tissue is a common component of atherosclerotic plaques, and occurs most often in mature plaques. The process of calcification is a poorly understood risk factor that may contribute to a plaque's vulnerability to sudden rupture. In this study a solid-state imaging sequence, termed single-point imaging (SPI), was used to observe calcification directly in ex vivo atherosclerotic plaques. Standards were used to validate the ability of (31)P SPI to detect and differentiate calcification from crystalline cholesterol, phospholipids, and other plaque components. After suitable experimental parameters were found, human carotid specimens obtained by endarterectomy were imaged ex vivo by (31)P solid-state imaging and standard (1)H methods. In contrast to (1)H imaging methods, (31)P imaging detected only the calcification in the plaque.

Magnetic resonance imaging with ultrashort TE (UTE) PULSE sequences: Technical considerations

It is now possible to detect signals from tissues and tissue components with short T(2)s, such as cortical bone, using ultrashort TE (UTE) pulse sequences. The background to the use of these sequences is reviewed with particular emphasis on MR system issues. Tissue properties are discussed, and tissues are divided into those with a majority and those with a minority of short T(2) components. UTE pulse sequences and their variants are described and clinical applications are illustrated. System design requirements for sequences of this type, including gradient performance, RF switching, and data-processing issues, are outlined.

Designing long-T2 suppression pulses for ultrashort echo time imaging

Ultrashort echo time (UTE) imaging has shown promise as a technique for imaging tissues with T2 values of a few milliseconds or less. These tissues, such as tendons, menisci, and cortical bone, are normally invisible in conventional magnetic resonance imaging techniques but have signal in UTE imaging. They are difficult to visualize because they are often obscured by tissues with longer T2 values. In this article, new long-T2 suppression RF pulses that improve the contrast of short-T2 species are introduced. These pulses are improvements over previous long-T2 suppression pulses that suffered from poor off-resonance characteristics or T1 sensitivity. Short-T2 tissue contrast can also be improved by suppressing fat in some applications. Dual-band long-T2 suppression pulses that additionally suppress fat are also introduced. Simulations, along with phantom and in vivo experiments using 2D and 3D UTE imaging, demonstrate the feasibility, improved contrast, and improved sensitivity of these new long-T2 suppression pulses. The resulting images show predominantly short-T2 species, while most long-T2 species are suppressed.

Clinical ultrashort echo time imaging of bone and other connective tissues

The background underpinning the clinical use of ultrashort echo time, SPRITE and other pulse sequences for imaging bone and other connective tissues with short T2 is reviewed. Features of the basic physics relevant to UTE imaging are described, including the consequences when the radiofrequency pulse duration is of the order of T2 so that rotation of tissue magnetization into the transverse plane is incomplete. Consequences of the broad linewidth of short T2 components are also discussed, including partial saturation by off-resonance fat suppression pulses as well as those used in multislice and multiecho imaging. The need for rapid data acquisition of the order of T2 is explained. The basic two-dimensional UTE pulse sequence with its half excitation pulse and radial imaging from the centre of k-space is described, together with options that suppress fat and/or reduce the signal from long T2 components. The basic features of SPRITE and other sequences with very short TE are described. Image interpretation is discussed. Clinical features of the imaging of cortical bone, tendons, ligaments, menisci, periosteum and the spine are illustrated. The source of the short T2 signal in these tissues is predominantly collagen and water tightly bound to collagen. Short T2 components in all of these tissues are detectible and may show high signals. Possible future developments are outlined, as are technical limitations of clinical magnetic resonance systems.

Quantitative MRI for the assessment of bone structure and function

Osteoporosis is the most common degenerative disease in the elderly. It is characterized by low bone mass and structural deterioration of bone tissue, leading to morbidity and increased fracture risk in the hip, spine and wrist-all sites of predominantly trabecular bone. Bone densitometry, currently the standard methodology for diagnosis and treatment monitoring, has significant limitations in that it cannot provide information on the structural manifestations of the disease. Recent advances in imaging, in particular MRI, can now provide detailed insight into the architectural consequences of disease progression and regression in response to treatment. The focus of this review is on the emerging methodology of quantitative MRI for the assessment of structure and function of trabecular bone. During the past 10 years, various approaches have been explored for obtaining image-based quantitative information on trabecular architecture. Indirect methods that do not require resolution on the scale of individual trabeculae and therefore can be practiced at any skeletal location, make use of the induced magnetic fields in the intertrabecular space. These fields, which have their origin in the greater diamagnetism of bone relative to surrounding marrow, can be measured in various ways, most typically in the form of R2', the recoverable component of the total transverse relaxation rate. Alternatively, the trabecular network can be quantified by high-resolution MRI (micro-MRI), which requires resolution adequate to at least partially resolve individual trabeculae. Micro-MRI-based structure analysis is therefore technically demanding in terms of image acquisition and algorithms needed to extract the structural information under conditions of limited signal-to-noise ratio and resolution. Other requirements that must be met include motion correction and image registration, both critical for achieving the reproducibility needed in repeat studies. Key clinical applications targeted involve fracture risk prediction and evaluation of the effect of therapeutic intervention.

Fully balanced steady-state 3D-spin-echo (bSSSE) imaging at 3 Tesla

In this work a 3D fully balanced steady-state spin-echo sequence (bSSSE) was designed and implemented on a 3-Tesla whole-body MR scanner. In contrast to previously introduced nonbalanced SSSE (nbSSSE) sequences, bSSSE features fully rewound imaging gradients. Additionally, all phase encodings and the readout prephasing are performed after the refocusing pulse. Its performance was compared with previously used gradient-echo (GE) and nbSSSE sequences. The signal response of each sequence was simulated by numerical solution of the Bloch equation. All sequences were then optimized based on these simulations for high-resolution (HR) imaging of tissues with short relaxation times and applied to in vivo HR-MRI of trabecular bone. bSSSE outperformed nbSSSE sequences in terms of SNR and SNR efficiency. Measurements of structural bone parameters revealed thinner trabeculae and a lower bone/bone-marrow fraction for the bSSSE sequence compared to the nbSSSE sequence. By applying a parallel imaging technique based on generalized autocalibrating partially parallel acquisition (GRAPPA) with a reduction factor of 2, we were able to maintain a clinically feasible scan time using bSSSE. Comparisons of structural bone parameters revealed a difference of less than 3% for all structural parameters between parallel and conventional imaging.

Magnetic resonance imaging of objects with dipolar-broadened spectra using soft excitation pulses

Feasibility of acquiring high-resolution 3D NMR images of objects with dipolar-broadened spectra by using soft excitation pulses is experimentally demonstrated. The models are liquid-crystalline phantoms and a pencil eraser. The pulse sequence is a standard 3D gradient-echo sequence.

Nuclear magnetic resonance studies of bone water

Mineralized bone tissue has a significant water component. Bone water is associated with the collagen fibers or mineral fraction or occurring as pore water of the Haversian and lacunocanalicular system. Among the multiple physiologic functions that include signaling and providing to bone its viscoelastic properties, bone water enables the transport of ions and nutrients to and waste products from the cells. In addition, it plays a key role during mineralization whereby collagen-bound water is gradually replaced by calcium apatite-like mineral. In this review it is shown how nuclear magnetic resonance (NMR) allows the study of various physiologically relevant properties of bone water nondestructively. Isotope exchange experiments are described from which the apparent water diffusion coefficient can be calculated. The method is based on monitoring the migration of H2O into the D2O after immersion of the specimen in heavy water. Data obtained from rabbit cortical bone in the normal and mineral-depleted skeleton provide evidence for the hypothesized reciprocal relationship between bone water and mineral. Further, from the diffusion coefficient (Da = (7.8+/-1.5) x 10(-7) cm2/s) measured at 40 degrees C it can be inferred that diffusive transport of small molecules from the bone's microvascular system to the osteocytes occurs within minutes. Finally, whereas isotope exchange is not feasible in vivo, it is shown that bone water can be imaged by proton MRI.

Magnetic resonance imaging of cortical bone with ultrashort TE pulse sequences

PURPOSE

Normal adult cortical bone has a very short T(2) and characteristically produces no signal with pulse sequence echo times (TEs) routinely used in clinical practice. We wished to determine whether it was possible to use ultrashort TE (UTE) pulse sequences to detect signal from cortical bone in human subjects and use this signal to characterise this tissue.

SUBJECTS AND METHODS

Seven volunteers and 10 patients were examined using ultrashort TE pulse sequences (TE=0.07 or 0.08 ms). Short and long inversion as well as fat suppression pulses were used as preparation pulses. Later echo images were also obtained as well as difference images produced by subtracting a later echo image from a first echo image. Saturation pulses were used for T(1) measurement and sequences with progressively increasing TEs for T(2)* measurement. Intravenous gadodiamide was administered to four subjects.

RESULTS

Signal in cortical bone was detected with UTE sequences in children, normal adults and patients. This signal was usually made more obvious by subtracting a later echo image from the first provided that the signal-to-noise ratio was sufficiently high. Normal mean adult T(1)s ranged from 140 to 260 ms, and mean T(2)*s ranged from 0.42 to 0.50 ms. T(1) increased significantly with age (P<.01). Increased signal was observed after contrast enhancement in the normal volunteer and the three patients to whom it was administered. Reduction in signal from short T(2) components was seen in acute fractures, and increase in signal in these components was seen with new bone formation after fracture malunion. In a case of osteoporosis, bone cross-sectional area and signal level appeared reduced.

CONCLUSION

Signal can be detected from normal and abnormal cortical bone with UTE pulse sequences, and this can be used to measure its T(1) and T(2)* as well as observe contrast enhancement. Difference images are of value in increasing the conspicuity of cortical bone and observing abnormalities in disease.

MRI of hip prostheses using single-point methods: in vitro studies towards the artifact-free imaging of individuals with metal implants

Use of magnetic resonance imaging (MRI) in individuals with orthopedic implants is limited because of the large distortions caused by metallic components. As a possible solution for this problem, we suggest the use of single-point imaging (SPI) methods, which are immune to the susceptibility artifacts observed with conventional MRI methods. A further advantage of SPI, based on the fact that signal encoding is achieved in ultra-short times (as short as tens of microseconds), is that they enable the direct visualization of the polymeric elements of the implants, allowing the detection of possible implant failures. We present in vitro SPI images of polymeric sockets of two hip prostheses together with artifact-free images of gelatin phantoms containing their respective metallic stems. These data underscore the great potential of the SPI technique for obtaining artifact-free images of individuals with large metal implants.

Single point imaging with suppressed sound pressure levels through gradient-shape adjustment

Acoustic noise produced during single point imaging (SPI) experiments was modulated by changes in the spatial encoding gradients. Parameters of both linear and sine-shaped gradient ramps were modified to minimize the acoustic noise levels. Acoustic noise measurements during SPI were measured on three different gradient systems and revealed that for small gradient-bore systems a considerable acoustic noise reduction of more than 20 dB can easily be achieved. SPI in conjunction with an optimized gradient waveform can be a superb alternative to the previously introduced single point ramped imaging with T(1) enhancement (SPRITE) method when sound levels and overheating of gradients are a concern.

Water content measured by proton-deuteron exchange NMR predicts bone mineral density and mechanical properties

NMR was used to measure matrix water content in normal and hypomineralized cortical bone. Water content showed an inverse relationship with mineral content, suggesting it could serve as a surrogate measure for the bone's degree of mineralization.

INTRODUCTION

So far, true bone mineral density (DMB; degree of mineralization of bone) can not be measured nondestructively.

MATERIALS AND METHODS

Here, a new technique combining 1H nuclear magnetic resonance (NMR) spectroscopy and deuterium isotope exchange was used to measure water content in cortical bone from two groups of rabbits: a control group and a group fed a low-phosphorus (P) diet to induce hypomineralization of the bone matrix.

RESULTS

NMR-derived water content was higher in the P-depleted group and showed an inverse relationship with mineral content (measured gravimetrically and by 31p NMR). Hypomineralized bone was found to be weaker than normal bone as demonstrated by mechanical testing. More importantly, the data showed a strong inverse correlation between water content and bone mechanical properties, which indicates that water content could be predictive of the bone's mechanical competence.

CONCLUSIONS

Water content could potentially serve as a surrogate measure for the bone's degree of mineralization, and this technique could be used to study other disorders of mineral homeostasis known to alter the mineralization state of the matrix. Although the method presented here is not suitable for in vivo measurements of bone water content, the authors have previously shown that 1H NMR images of bone can be acquired; thus, noninvasive quantification of bone water may be feasible.

Density of organic matrix of native mineralized bone measured by water- and fat-suppressed proton projection MRI

Water- and fat-suppressed projection MR imaging (WASPI) utilizes the large difference between the proton T(2) (*)s of the solid organic matrix and the fluid constituents of bone to suppress the fluid signals while preserving solid matrix signals. The solid constituents include collagen and some molecularly immobile water and exhibit very short T(2) (*). The fluid constituents include mobile water and fat, with long T(2) (*). In WASPI, chemical shift selective low-power pi/2 pulses excite mobile water and fat magnetization which is subsequently dephased by gradient pulses, while the magnetization of collagen and immobile water remains mostly in the z-direction. Additional selective pi pulses in alternate scans further cancel the residual water and fat magnetization. Following water and fat suppression, the matrix signal is excited by a short hard pulse and the free induction decay acquired in the presence of a gradient in a 3D projection method. WASPI was implemented on a 4.7 T MR imaging system and tested on phantoms and bone specimens, enabling excellent visualization of bone matrix. The bone matrix signal per unit volume of bovine trabecular specimens was measured by this MR technique and compared with that determined by chemical analysis. This method could be used in combination with bone mineral density measurement by solid state (31)P projection MRI to determine the degree of bone mineralization.