Michael A. Boss

Development of a temperature‐controlled phantom for magnetic resonance quality assurance of diffusion, dynamic, and relaxometry measurements

PURPOSE Diffusion-weighted (DW) and dynamic contrast-enhanced magnetic resonance imaging (MRI) are increasingly applied for the assessment of functional tissue biomarkers for diagnosis, lesion characterization, or for monitoring of treatment response. However, these techniques are vulnerable to the influence of various factors, so there is a necessity for a standardized MR quality assurance procedure utilizing a phantom to facilitate the reliable estimation of repeatability of these quantitative biomarkers arising from technical factors (e.g., B1 variation) affecting acquisition on scanners of different vendors and field strengths. The purpose of this study is to present a novel phantom designed for use in quality assurance for multicenter trials, and the associated repeatability measurements of functional and quantitative imaging protocols across different MR vendors and field strengths. METHODS A cylindrical acrylic phantom was manufactured containing 7 vials of polyvinylpyrrolidone (PVP) solutions of different concentrations, ranging from 0% (distilled water) to 25% w/w, to create a range of different MR contrast parameters. Temperature control was achieved by equilibration with ice-water. Repeated MR imaging measurements of the phantom were performed on four clinical scanners (two at 1.5 T, two at 3.0 T; two vendors) using the same scanning protocol to assess the long-term and short-term repeatability. The scanning protocol consisted of DW measurements, inversion recovery (IR) T1 measurements, multiecho T2 measurement, and dynamic T1-weighted sequence allowing multiple variable flip angle (VFA) estimation of T1 values over time. For each measurement, the corresponding calculated parameter maps were produced. On each calculated map, regions of interest (ROIs) were drawn within each vial and the median value of these voxels was assessed. For the dynamic data, the autocorrelation function and their variance were calculated; for the assessment of the repeatability, the coefficients of variation (CoV) were calculated. RESULTS For both field strengths across the available vendors, the apparent diffusion coefficient (ADC) at 0 °C ranged from (1.12 ± 0.01) × 10(-3) mm(2)/s for pure water to (0.48 ± 0.02) × 10(-3) mm(2)/s for the 25% w/w PVP concentration, presenting a minor variability between the vendors and the field strengths. T2 and IR-T1 relaxation time results demonstrated variability between the field strengths and the vendors across the different acquisitions. Moreover, the T1 values derived from the VFA method exhibited a large variation compared with the IR-T1 values across all the scanners for all repeated measurements, although the calculation of the standard deviation of the VFA-T1 estimate across each ROI and the autocorrelation showed a stability of the signal for three scanners, with autocorrelation of the signal over the dynamic series revealing a periodic variation in one scanner. Finally, the ADC, the T2, and the IR-T1 values exhibited an excellent repeatability across the scanners, whereas for the dynamic data, the CoVs were higher. CONCLUSIONS The combination of a novel PVP phantom, with multiple compartments to give a physiologically relevant range of ADC and T1 values, together with ice-water as a temperature-controlled medium, allows reliable quality assurance measurements that can be used to measure agreement between MRI scanners, critical in multicenter functional and quantitative imaging studies.

Implementing diffusion-weighted MRI for body imaging in prospective multicentre trials: current considerations and future perspectives

For body imaging, diffusion-weighted MRI may be used for tumour detection, staging, prognostic information, assessing response and follow-up. Disease detection and staging involve qualitative, subjective assessment of images, whereas for prognosis, progression or response, quantitative evaluation of the apparent diffusion coefficient (ADC) is required. Validation and qualification of ADC in multicentre trials involves examination of i) technical performance to determine biomarker bias and reproducibility and ii) biological performance to interrogate a specific aspect of biology or to forecast outcome. Unfortunately, the variety of acquisition and analysis methodologies employed at different centres make ADC values non-comparable between them. This invalidates implementation in multicentre trials and limits utility of ADC as a biomarker. This article reviews the factors contributing to ADC variability in terms of data acquisition and analysis. Hardware and software considerations are discussed when implementing standardised protocols across multi-vendor platforms together with methods for quality assurance and quality control. Processes of data collection, archiving, curation, analysis, central reading and handling incidental findings are considered in the conduct of multicentre trials. Data protection and good clinical practice are essential prerequisites. Developing international consensus of procedures is critical to successful validation if ADC is to become a useful biomarker in oncology.Key Points• Standardised acquisition/analysis allows quantification of imaging biomarkers in multicentre trials.• Establishing “precision” of the measurement in the multicentre context is essential.• A repository with traceable data of known provenance promotes further research.

Quantitative magnetic resonance imaging phantoms: A review and the need for a system phantom

The MRI community is using quantitative mapping techniques to complement qualitative imaging. For quantitative imaging to reach its full potential, it is necessary to analyze measurements across systems and longitudinally. Clinical use of quantitative imaging can be facilitated through adoption and use of a standard system phantom, a calibration/standard reference object, to assess the performance of an MRI machine. The International Society of Magnetic Resonance in Medicine AdHoc Committee on Standards for Quantitative Magnetic Resonance was established in February 2007 to facilitate the expansion of MRI as a mainstream modality for multi‐institutional measurements, including, among other things, multicenter trials. The goal of the Standards for Quantitative Magnetic Resonance committee was to provide a framework to ensure that quantitative measures derived from MR data are comparable over time, between subjects, between sites, and between vendors. This paper, written by members of the Standards for Quantitative Magnetic Resonance committee, reviews standardization attempts and then details the need, requirements, and implementation plan for a standard system phantom for quantitative MRI. In addition, application‐specific phantoms and implementation of quantitative MRI are reviewed. Magn Reson Med 79:48–61, 2018.

Design of a breast phantom for quantitative MRI.

We present a breast phantom designed to enable quantitative assessment of measurements of T1 relaxation time, apparent diffusion coefficient (ADC), and other attributes of breast tissue, with long‐term support from a national metrology institute.

Single bead detection with an NMR microcapillary probe.

We have developed a nuclear magnetic resonance (NMR) microcapillary probe for the detection of single magnetic microbeads. The geometry of the probe has been optimized so that the signal from the background water has a similar magnitude compared to the signal from the dephased water nearby a single magnetic bead within the probe detector coil. In addition, the RF field of the coil must be uniform within the effective range of the magnetic bead. Three different RF probes were tested in a 7 T (300 MHz) pulsed NMR spectrometer with sample volumes ranging from 5 nL down to 1 nL. The 1 nL probe had a single-shot signal-to-noise ratio (SNR) for pure water of 27 and a volume resolution that exhibits a 600-fold improvement over a conventional (5 mm tube) NMR probe with a sample volume of 18 μL. This allowed for the detection of a 1 μm magnetite/polystyrene bead (m=2×10(-14)Am(2)) with an estimated experimental SNR of 30. Simulations of the NMR spectra for the different coil geometries and positions of the bead within the coil were developed that include the B(0) shift near a single bead, the inhomogeneity of the coils, the local coil sensitivity, the skin effect of the coil conductor, and quantitated estimates of the proximity effect between coil windings.

Accuracy, repeatability, and interplatform reproducibility of T1 quantification methods used for DCE‐MRI: Results from a multicenter phantom study

To determine the in vitro accuracy, test‐retest repeatability, and interplatform reproducibility of T1 quantification protocols used for dynamic contrast‐enhanced MRI at 1.5 and 3 T.

Standardized phantoms for quantitative cardiac MRI

Background Quantitative MR relaxometry techniques are increasingly used in cardiac MR applications, e.g. MOLLI for high resolution T1 mapping. To use these techniques in the clinic, we must understand how to make comparable measurements across vendor systems and software versions and compare results across sites. A standardized phantom used for regular quality control is one approach. The Biomagnetic Imaging program at the National Institute for Standards and Technology (NIST) has created phantoms for measuring T1, T2, proton density in collaboration with ISMRM (Fig. 1) and diffusion in collaboration with RSNA-QIBA. In addition, a breast phantom including T1 and diffusion components is in development with UCSF. We propose a cardiac phantom focused on quantitative measurements of the myocardium preand post-contrast and the blood pool. To test quantitative cardiac MR sequences, the phantom must mimic both the T1 and T2 relaxation properties in the same sample. The phantom must be stable, preferably for five years, and be reliably produced. Agarose gel is difficult to produce free of air bubbles and has a limited shelf life.

Multisite concordance of apparent diffusion coefficient measurements across the NCI quantitative imaging network

Abstract. Diffusion weighted MRI has become ubiquitous in many areas of medicine, including cancer diagnosis and treatment response monitoring. Reproducibility of diffusion metrics is essential for their acceptance as quantitative biomarkers in these areas. We examined the variability in the apparent diffusion coefficient (ADC) obtained from both postprocessing software implementations utilized by the NCI Quantitative Imaging Network and online scan time-generated ADC maps. Phantom and in vivo breast studies were evaluated for two (ADC2) and four (ADC4) b-value diffusion metrics. Concordance of the majority of implementations was excellent for both phantom ADC measures and in vivo ADC2, with relative biases <0.1% (ADC2) and <0.5% (phantom ADC4) but with higher deviations in ADC at the lowest phantom ADC values. In vivo ADC4 concordance was good, with typical biases of ±2% to 3% but higher for online maps. Multiple b-value ADC implementations were separated into two groups determined by the fitting algorithm. Intergroup mean ADC differences ranged from negligible for phantom data to 2.8% for ADC4 in vivo data. Some higher deviations were found for individual implementations and online parametric maps. Despite generally good concordance, implementation biases in ADC measures are sometimes significant and may be large enough to be of concern in multisite studies.

TU‐C‐12A‐08: Thermally‐Stabilized Isotropic Diffusion Phantom for Multisite Assessment of Apparent Diffusion Coefficient Reproducibilty

PURPOSE To construct an appropriate phantom for quality control use in diffusion-weighted imaging (DWI), to establish ground truth for measurement of apparent diffusion coefficient (ADC) and to characterize measurement linearity across a relevant physiological range of ADC. METHODS Aqueous solutions containing the polymer polyvinylpyrrolidone (PVP) were mixed at concentrations of 0, 10, 20, 30, 40 and 50% by mass PVP. These solutions were placed in 20 mL vials, arranged in concentric inner and outer circles, with a central water vial, and were fixed in a spherical phantom with a diameter of 194 mm, designed to fit into commercially-available MRI head coils. Two prototype phantoms were constructed, and underwent inter-site comparison in the US and EU. The phantoms were filled with an ice-water bath to ensure stable temperature; 0 °C temperature was verified by use of a thermocouple before and after scans. The phantoms were scanned using b-values of 0, 500 and 900 s/mm2 at several sites, using coronal and/or axial orientations and scan planes. RESULTS ADC values ranged from 0.12 to 1.12 × 10-3 mm2 /s, and exhibited a high degree of reproducibility across different scanners and imaging sites (coefficient of variations (CoV) ranged from 1.1 to 2.2% for 0 to 40% PVP, with 50% PVP at 11.3%). Little difference in ADCs was seen between inner and outer ring vials of the same PVP concentration (average CoV< 5% across vials, 10.3% for 50% PVP). CONCLUSION The range of ADCs covers a relevant physiological range, most notably in brain white matter. The ADCs of water vials were in excellent agreement with literature values of the diffusion coefficient of water at 0 °C (1.1 × 10-3 mm2 /s). The phantom provides a much needed quality control tool for DWI, and provides ground truth with the diffusion coefficient of water at 0 °C.

Prototype phantoms for characterization of ultralow field magnetic resonance imaging.

Prototype phantoms were designed, constructed, and characterized for the purpose of calibrating ultralow field magnetic resonance imaging (ULF MRI) systems. The phantoms were designed to measure spatial resolution and to quantify sensitivity to systematic variation of proton density and relaxation time, T1.