Citizen science approach to assessing patient perception of MRI with flexible radiofrequency coils

Magnetic Resonance Imaging (MRI) is a major medical imaging modality, which is non-invasive and provides unique soft tissue contrast without ionizing radiation. The successful completion of MRI exams critically depends on patient compliance, and, thus patient comfort. The design, appearance and usability of local MRI radiofrequency (RF) coils potentially influences the patients' perception of the exam. However, systematic investigations and empirical evidence for these aspects are missing. A questionnaire specifically evaluating the impact of RF coils on patient comfort in MRI would be a valuable addition to clinical studies comparing the performance of novel flexible RF coils with standard rigid coils. This paper describes the development of such a questionnaire in the scope of a citizen science (CS) initiative conducted with a group of students at the upper secondary school level. In this work, the CS initiative is presented in the format of a case report and its impact on scientific projects and the students' education is outlined. The resulting questionnaire is made available in German and English so as to be directly applicable by researchers working on the clinical evaluation of novel RF coils or the comfort evaluation of specific hardware setups in general.

Panoramic Magnetic Resonance Imaging of the Breast With a Wearable Coil Vest

BACKGROUND

Breast cancer, the most common malignant cancer in women worldwide, is typically diagnosed by x-ray mammography, which is an unpleasant procedure, has low sensitivity in women with dense breasts, and involves ionizing radiation. Breast magnetic resonance imaging (MRI) is the most sensitive imaging modality and works without ionizing radiation, but is currently constrained to the prone imaging position due to suboptimal hardware, therefore hampering the clinical workflow.

OBJECTIVES

The aim of this work is to improve image quality in breast MRI, to simplify the clinical workflow, shorten measurement time, and achieve consistency in breast shape with other procedures such as ultrasound, surgery, and radiation therapy.

MATERIALS AND METHODS

To this end, we propose "panoramic breast MRI"-an approach combining a wearable radiofrequency coil for 3 T breast MRI (the "BraCoil"), acquisition in the supine position, and a panoramic visualization of the images. We demonstrate the potential of panoramic breast MRI in a pilot study on 12 healthy volunteers and 1 patient, and compare it to the state of the art.

RESULTS

With the BraCoil, we demonstrate up to 3-fold signal-to-noise ratio compared with clinical standard coils and acceleration factors up to 6 × 4. Panoramic visualization of supine breast images reduces the number of slices to be viewed by a factor of 2-4.

CONCLUSIONS

Panoramic breast MRI allows for high-quality diagnostic imaging and facilitated correlation to other diagnostic and interventional procedures. The developed wearable radiofrequency coil in combination with dedicated image processing has the potential to improve patient comfort while enabling more time-efficient breast MRI compared with clinical coils.

A modular system of flexible receive-only coil arrays for 3 T Magnetic Resonance Imaging

Flexible form-fitting radiofrequency coils provide high signal-to-noise ratio (SNR) for magnetic resonance imaging (MRI), and in array configuration large anatomical areas of interest can be covered. We propose a modular system - "ModFlex"- of flexible lightweight 4-channel coaxial coil arrays for 3 T MRI. We investigated the performance difference between commercial reference coils and 8- and 16-channel ModFlex receive-only array systems. In vivo, six anatomical targets in four regions of interest - the neck, the ankle, the spine and the hip - were imaged with the novel coil array system. The versatility of ModFlex and the robustness of the coil characteristics for different use cases is demonstrated. We measured an SNR gain for 4 out of 6 and similar SNR for 2 out of 6 anatomical target regions as compared to commercial reference coils. Parallel imaging capabilities are comparable to standard coils in hip and neck imaging, but ModFlex outperforms standard coils in ankle and spine imaging. High SNR combined with high acceleration possibilities enables faster imaging workflows and/or high-resolution MR acquisitions. The coil's versatility is beneficial for use cases with varying subject sizes and could improve patient comfort.

Flexible Multi-Turn Multi-Gap Coaxial RF Coils: Design Concept and Implementation for Magnetic Resonance Imaging at 3 and 7 Tesla

Magnetic resonance has become a backbone of medical imaging but suffers from inherently low sensitivity. This can be alleviated by improved radio frequency (RF) coils. Multi-turn multi-gap coaxial coils (MTMG-CCs) introduced in this work are flexible, form-fitting RF coils extending the concept of the single-turn single-gap CC by introducing multiple cable turns and/or gaps. It is demonstrated that this enables free choice of the coil diameter, and thus, optimizing it for the application to a certain anatomical site, while operating at the self-resonance frequency. An equivalent circuit for MTMG-CCs is modeled to predict their resonance frequency. Possible configurations regarding size, number of turns and gaps, and cable types for different B ₀ field strengths are calculated. Standard copper wire loop coils (SCs) and flexible CCs made from commercial coaxial cable were fabricated as receive-only coils for 3 T and transmit/receive coils at 7 T with diameters between 4 and 15 cm. Electromagnetic simulations are used to investigate the currents on MTMG-CCs, and demonstrate comparable specific absorption rate of 7 T CCs and SCs. Signal-to-noise ratio (SNR), transmit efficiency, and active detuning performance of CCs were compared in bench tests and MR experiments. For the form-fitted receive-only CCs at 3 T no significant SNR degradation was found as compared to flat SCs on a balloon phantom. Form-fitted transmit/receive CCs at 7 T showed higher transmit efficiency and SNR. MTMG-CCs can be sized to optimize sensitivity, are flexible and lightweight, and could therefore enable the fabrication of wearable coils with improved patient comfort.

Design, Implementation, and Evaluation of a Head and Neck MRI RF Array Integrated with a 511 keV Transmission Source for Attenuation Correction in PET/MR

The goal of this work is to further improve positron emission tomography (PET) attenuation correction and magnetic resonance (MR) sensitivity for head and neck applications of PET/MR. A dedicated 24-channel receive-only array, fully-integrated with a hydraulic system to move a transmission source helically around the patient and radiofrequency (RF) coil array, is designed, implemented, and evaluated. The device enables the calculation of attenuation coefficients from PET measurements at 511 keV including the RF coil and the particular patient. The RF coil design is PET-optimized by minimizing photon attenuation from coil components and housing. The functionality of the presented device is successfully demonstrated by calculating the attenuation map of a water bottle based on PET transmission measurements; results are in excellent agreement with reference values. It is shown that the device itself has marginal influence on the static magnetic field B₀ and the radiofrequency transmit field B₁ of the 3T PET/MR system. Furthermore, the developed RF array is shown to outperform a standard commercial 16-channel head and neck coil in terms of signal-to-noise ratio (SNR) and parallel imaging performance. In conclusion, the presented hardware enables accurate calculation of attenuation maps for PET/MR systems while improving the SNR of corresponding MR images in a single device without degrading the B₀ and B₁ homogeneity of the scanner.

A head coil system with an integrated orbiting transmission point source mechanism for attenuation correction in PET/MRI

The combination of positron emission tomography (PET) and magnetic resonance imaging (MRI) provides a benefit for diagnostic imaging. Still, attenuation correction (AC) is a challenge in PET/MRI compared to stand-alone PET and PET-computed tomography (PET/CT). In the absence of photonic transmission sources, AC in PET/MRI is usually based on retrospective segmentation of MR images or complex additional MR-sequences. However, most methods available today are still challenged by either the incorporation of cortical bone or substantial anatomical variations of subjects. This leads to a bias in quantification of tracer concentration in PET. Therefore, we have developed a fully integrated transmission source system for PET/MRI of the head to enable direct measurement of attenuation coefficients using external positron emitters, which is the reference standard in AC. Based on a setup called the 'liquid drive' presented by Jones et al (1995) two decades ago, we built a head coil system consisting of an MR-compatible hydraulic system driving a point source on a helical path around a 24-channel MR-receiver coil to perform a transmission scan. Sinogram windowing of the moving source allows for post-injection measurements. The prototype was tested in the Siemens Biograph mMR using a homogeneous water phantom and a phantom with air cavities and a Teflon (PTFE) cylinder. The second phantom was measured both with and without emission activity. For both measurements air, water and Teflon were clearly distinguishable and homogeneous regions of the phantom were successfully reproduced in the AC map. For water the linear attenuation coefficient was measured as (0.096  ±  0.005) cm^-1 in accordance with the true physical value. This combined MR head coil and transmission source system is, to our knowledge, the first working example to use an orbiting point source in PET/MRI and may be helpful in providing fully-quantitative PET data in neuro-PET/MRI.

A flexible 12-channel transceiver array of transmission line resonators for 7 T MRI

A flexible transceiver array based on transmission line resonators (TLRs) combining the advantages of coil arrays with the possibility of form-fitting targeting cardiac MRI at 7 T is presented. The design contains 12 elements which are fabricated on a flexible substrate with rigid PCBs attached on the center of each element to place the interface components, i.e. transmit/receive (T/R) switch, power splitter, pre-amplifier and capacitive tuning/matching circuitry. The mutual coupling between elements is cancelled using a decoupling ring-based technique. The performance of the developed array is evaluated by 3D electromagnetic simulations, bench tests, and MR measurements using phantoms. Efficient inter-element decoupling is demonstrated in flat configuration on a box-shaped phantom (S_ij < -19 dB), and bent on a human torso phantom (S_ij < -16 dB). Acceleration factors up to 3 can be employed in bent configuration with reasonable g-factors (<1.7) in an ROI at the position of the heart. The array enables geometrical conformity to bodies within a large range of size and shape and is compatible with parallel imaging and parallel transmission techniques.

Flexible 23-channel coil array for high-resolution magnetic resonance imaging at 3 Tesla

PURPOSE

The purpose of this work is the design, implementation and evaluation of a mechanically flexible receive-only coil array for magnetic resonance imaging (MRI) at 3 T that can be applied to various target organs and provides high parallel imaging performance.

METHODS

A 23-channel array was designed based on a rigid-flex printed circuit board (PCB). The flexible multi-layer part contains the copper traces forming the coil elements. The rigid part of the PCB houses the solder joints and lumped elements. The coil housing consists of rigid caps mounted above the rigid parts. Adhesive PTFE sheets cover all flexible parts. The developed array was tested on the bench as well as in phantom and in vivo MRI experiments employing parallel imaging acceleration factors up to six.

RESULTS

Efficient mutual decoupling between receive elements and detuning between receive array and body coil was achieved. An increased signal-to-noise ratio in comparison to commercial reference coils is demonstrated, especially in regions close to the developed array and for high parallel imaging acceleration factors. Exemplary in vivo images of head, ankle, knee, shoulder and hand are presented.

CONCLUSION

Based on high sensitivity close to the array and low g-factors, this flexible coil is well suited for studies of occipital and temporal cortex, as well as musculoskeletal targets like knee, ankle, elbow and wrist.

In vivo MRI of the human finger at 7 T

Purpose

To demonstrate a dedicated setup for ultrahigh resolution MR imaging of the human finger in vivo.

Methods

A radiofrequency coil was designed for optimized signal homogeneity and sensitivity in the finger at ultrahigh magnetic field strength (7 T), providing high measurement sensitivity. Imaging sequences (2D turbo‐spin echo (TSE) and 3D magnetization‐prepared rapid acquisition gradient echo (MPRAGE)) were adapted for high spatial resolution and good contrast of different tissues in the finger, while keeping acquisition time below 10 minutes. Data was postprocessed to display finger structures in three dimensions.

Results

3D MPRAGE data with isotropic resolution of 200 µm, along with 2D TSE images with in‐plane resolutions of 58 × 78 µm² and 100 × 97 µm², allowed clear identification of various anatomical features such as bone and bone marrow, tendons and annular ligaments, cartilage, arteries and veins, nerves, and Pacinian corpuscles.

Conclusion

Using this dedicated finger coil at 7 T, together with adapted acquisition sequences, it is possible to depict the internal structures of the human finger in vivo within patient‐compatible measurement time. It may serve as a tool for diagnosis and treatment monitoring in pathologies ranging from inflammatory or erosive joint diseases to injuries of tendons and ligaments to nervous or vascular disorders in the finger. Magn Reson Med 79:588–592, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

High-sensitivity TMS/fMRI of the Human Motor Cortex Using a Dedicated Multichannel MR Coil

PURPOSE

To validate a novel setup for concurrent TMS/fMRI in the human motor cortex based on a dedicated, ultra-thin, multichannel receive MR coil positioned between scalp and TMS system providing greatly enhanced sensitivity compared to the standard birdcage coil setting.

METHODS

A combined TMS/fMRI design was applied over the primary motor cortex based on 1Hz stimulation with stimulation levels of 80%, 90%, 100%, and 110% of the individual active motor threshold, respectively. Due to the use of a multichannel receive coil we were able to use multiband-accelerated (MB=2) EPI sequences for the acquisition of functional images. Data were analysed with SPM12 and BOLD-weighted signal intensity time courses were extracted in each subject from two local maxima (individual functional finger tapping localiser, fixed MNI coordinate of the hand knob) next to the hand area of the primary motor cortex (M1) and from the global maximum.

RESULTS

We report excellent image quality without noticeable signal dropouts or image distortions. Parameter estimates in the three peak voxels showed monotonically ascending activation levels over increasing stimulation intensities. Across all subjects, mean BOLD signal changes for 80%, 90%, 100%, 110% of the individual active motor threshold were 0.43%, 0.63%, 1.01%, 2.01% next to the individual functional finger tapping maximum, 0.73%, 0.91%, 1.34%, 2.21% next to the MNI-defined hand knob and 0.88%, 1.09%, 1.65%, 2.77% for the global maximum, respectively.

CONCLUSION

Our results show that the new setup for concurrent TMS/fMRI experiments using a dedicated MR coil array allows for high-sensitivity fMRI particularly at the site of stimulation. Contrary to the standard birdcage approach, the results also demonstrate that the new coil can be successfully used for multiband-accelerated EPI acquisition. The gain in flexibility due to the new coil can be easily combined with neuronavigation within the MR scanner to allow for accurate targeting in TMS/fMRI experiments.

Multi-turn multi-gap transmission line resonators - Concept, design and first implementation at 4.7T and 7T

A novel design scheme for monolithic transmission line resonators (TLRs) is presented - the multi-turn multi-gap TLR (MTMG-TLR) design. The MTMG-TLR design enables the construction of TLRs with multiple turns and multiple gaps. This presents an additional degree of freedom in tuning self-resonant TLRs, as their resonance frequency is fully determined by the coil geometry (e.g. diameter, number of turns, conductor width, etc.). The novel design is evaluated at 4.7T and 7T by simulations and experiments, where it is demonstrated that MTMG-TLRs can be used for MRI, and that the B1 distribution of MTMG-TLRs strongly depends on the number and distribution of turns. A comparison to conventional loop coils revealed that the B1 performance of MTMG-TLRs is comparable to a loop coil with the same mean diameter; however, lower 10g SAR values were found for MTMG-TLRs. The MTMG-TLR design is expected to bring most benefits at high static field, where it allows for independent size and frequency selection, which cannot be achieved with standard TLR design. However, it also enables more accurate geometric optimization at low static field. Thereby, the MTMG-TLR design preserves the intrinsic advantages of TLRs, i.e. mechanical flexibility, high SAR efficiency, mass production, and coil miniaturization.