Jingfei Ma

Imaging bone metastases in breast cancer: techniques and recommendations for diagnosis

Bone is the most common site of distant metastases from breast carcinoma. The presence of bone metastases affects a patients prognosis, quality of life, and the planning of their treatment. We discuss recent innovations in bone imaging and present algorithms, based on the strengths and weaknesses of each technique, to facilitate the most successful and cost-effective choice of imaging studies for the detection of osseous metastases. Skeletal scintigraphy (bone scan) is very sensitive in the detection of osseous metastases and is recommended as the first imaging study in patients who are asymptomatic. Radiographs are recommended for the assessment of abnormal radionuclide uptake or the risk of pathological fracture and as initial imaging studies in patients with bone pain. MRI or PET-CT can be considered for cases of abnormal radionuclide uptake that are not addressed by radiography. Osseous metastases can lead to emergent situations, such as spinal-cord compression or impending fracture of a weight-bearing bone, and imaging guidelines are essential for early detection and initiation of appropriate therapy. The imaging method used in non-emergent situations, such as assessment of the ribs, sternum, pelvis, hips, and joints, should be guided by the strengths and limitations of each technique.

Fat-suppressed three-dimensional dual echo Dixon technique for contrast agent enhanced MRI.

To develop a fast T1‐weighted, fat‐suppressed three‐dimensional dual echo Dixon technique and to demonstrate its use in contrast agent enhanced MRI.

Fast spin‐echo triple‐echo dixon (fTED) technique for efficient T2‐weighted water and fat imaging

Previously published fast spin‐echo (FSE) implementations of a Dixon method for water and fat separation all require multiple scans and thus a relatively long scan time. Further, the minimum echo spacing (esp), a time critical for FSE image quality and scan efficiency, often needs to be increased in order to bring about the required phase shift between the water and fat signals. This work proposes and implements a novel FSE triple‐echo Dixon (fTED) technique that can address these limitations. In the new technique, three raw images are acquired in a single FSE scan by replacing each frequency‐encoding gradient in a conventional FSE with three consecutive gradients of alternating polarity. The timing of the three gradients is adjusted by selecting an appropriate receiver bandwidth (RBW) so that the water and fat signals for the three corresponding echoes have a relative phase shift of −180°, 0°, and 180°, respectively. A fully automated postprocessing algorithm is then used to generate separate water‐only and fat‐only images for each slice. The technique was implemented with and without parallel imaging. We demonstrate that the new fTED technique enables both uniform water/fat separation and fast scanning with uncompromised scan parameters, including applications such as T2‐weighted separate water and fat imaging of the abdomen during breath‐holding. Magn Reson Med 58:103–109, 2007.

Fast three-dimensional dual echo Dixon technique improves fat suppression in breast MRI

To compare qualitative and quantitative measures of the contrast‐enhanced dual‐echo Dixon technique with the commonly used standard three‐dimensional (3D) gradient echo (spectrally selective fat suppression) technique (SS‐FS) in breast MRI exams (bMRI).

Fast dixon-based multisequence and multiplanar MRI for whole-body detection of cancer metastases

To develop and demonstrate the feasibility of multisequence and multiplanar MRI for whole‐body cancer detection.

Fast Dixon Whole-Body MRI for Detecting Distant Cancer Metastasis: A Preliminary Clinical Study

To evaluate the feasibility of fast Dixon whole‐body (WB) magnetic resonance imaging (MRI) for detecting bone and liver metastasis in clinical patients and to compare its performance with skeletal scintigraphy (SS) for detecting bone metastases using reference imaging with >1 year follow‐up as the gold standard.

Three-dimensional fast spoiled gradient-echo dual echo (3D-FSPGR-DE) with water reconstruction: Preliminary experience with a novel pulse sequence for gadolinium-enhanced abdominal MR imaging

To compare three‐dimensional fast spoiled gradient‐echo dual‐echo (3D‐FSPGR‐DE) with water reconstruction to conventional 3D‐FSPGR for gadolinium‐enhanced abdominal imaging.

Fast spin-echo triple echo dixon: Initial clinical experience with a novel pulse sequence for simultaneous fat-suppressed and nonfat-suppressed T2-weighted spine magnetic resonance imaging

To evaluate a prototype fast spin‐echo (FSE) triple‐echo Dixon (FTED) technique for T2‐weighted spine imaging with and without fat suppression compared to conventional T2‐weighted fast recovery (FR) FSE and short‐tau inversion recovery (STIR) imaging.

Fast spin‐echo triple‐echo Dixon: Initial clinical experience with a novel pulse sequence for fat‐suppressed T2‐weighted abdominal MR imaging

To evaluate a prototype fast spin echo (FSE) triple‐echo‐Dixon (fTED) technique for breath‐hold, fat‐suppressed, T2‐weighted abdominal imaging.

Conspicuity of bone metastases on fast Dixon-based multisequence whole-body MRI: clinical utility per sequence.

PURPOSE The purpose of the study was to evaluate the conspicuity of bone metastases on each of the numerous sequences produced by fast Dixon-based multisequence whole-body (WB) magnetic resonance imaging (MRI) scanning in order to determine the most clinically useful sequences overall and per anatomic region. MATERIALS AND METHODS Twenty-seven breast cancer patients with bone metastases were prospectively studied with fast Dixon-based WB MRI including head/neck, chest, abdominal, pelvic, thigh, calf/feet and either cervical, thoracic and lumbar or cervical/thoracic and thoracic/lumbar regions. Sequences included coronal T2, axial T1 without and with intravenous gadolinium (+C), sagittal T1 spine+C, each associated fat-only (FO) and fat-saturated (FS) sequence, axial diffusion-weighted imaging (DWI) and short tau inversion recovery (STIR). Blinded reviewers evaluated lesion conspicuity, a surrogate of clinical utility, on a five-point scale per anatomic region. Sequences were compared using analysis of variance, differences were detected with Tukeys honestly significant difference test, and the four sequences with highest mean conspicuity were compared to the remainder overall and per anatomic region. RESULTS Overall, a significant lesion conspicuity difference was found (P<.0001), and lesion conspicuity was significantly higher on FS T1+C, FO T1+C, T1+C sagittal and FS T1+C axial sequences (P<.0001). Per-region results were the same in the head/neck. Other sequences overlapped with these and included the following: chest/abdomen - FO T2, DWI; pelvis - DWI, FO T2; thigh - FS T2, FO T2, FO T1+C; calf/feet - FS T2, DWI, FO T2, STIR. CONCLUSION Overall, bone lesions were most conspicuous on FS T1+C sagittal, FO T1+C sagittal, T1+C sagittal and FS T1+C axial fast Dixon WB MRI sequences.