Peter Speier

3D Radial Projection Technique With Ultrashort Echo Times for Sodium MRI: Clinical Applications in Human Brain and Skeletal Muscle

23Na MRI has the potential to noninvasively detect sodium (Na) content changes in vivo. The goal of this study was to implement 23Na MRI in a clinical setting for neurooncological and muscular imaging. Due to the biexponential T2 decay of the tissue Na signal with a short component, which ranges between 0.5–8 ms, the measurement of total Na content requires imaging techniques with echo times (TEs) below 0.5 ms. A 3D radial pulse sequence with a TE of 0.2 ms at a spatial resolution of 4 × 4 × 4 mm3 was developed that allows the acquisition and presentation of Na images on the scanner. This sequence was evaluated in patients with low‐ and high‐grade gliomas, and higher 23Na MR signals corresponding to an increased Na content were found in the tumor regions. The contrast‐to‐noise ratio (CNR) between tumor and white matter increased from 0.8 ± 0.2 to 1.3 ± 0.3 with tumor grade. In patients with an identified muscular 23Na channelopathy (Paramyotonia congenita (PC)), induced muscle weakness led to a signal increase of ∼18% in the 23Na MR images, which was attributed to intracellular Na+ accumulation in this region. Magn Reson Med 57:74–81, 2007.

Acquisition and reconstruction of undersampled radial data for myocardial perfusion magnetic resonance imaging

To improve myocardial perfusion magnetic resonance imaging (MRI) by reconstructing undersampled radial data with a spatiotemporal constrained reconstruction method (STCR).

In vivo diffusion tensor MRI of the human heart: reproducibility of breath-hold and navigator-based approaches.

The aim of this study was to implement a quantitative in vivo cardiac diffusion tensor imaging (DTI) technique that was robust, reproducible, and feasible to perform in patients with cardiovascular disease. A stimulated‐echo single‐shot echo‐planar imaging (EPI) sequence with zonal excitation and parallel imaging was implemented, together with a novel modification of the prospective navigator (NAV) technique combined with a biofeedback mechanism. Ten volunteers were scanned on two different days, each time with both multiple breath‐hold (MBH) and NAV multislice protocols. Fractional anisotropy (FA), mean diffusivity (MD), and helix angle (HA) fiber maps were created. Comparison of initial and repeat scans showed good reproducibility for both MBH and NAV techniques for FA (P > 0.22), MD (P > 0.15), and HA (P > 0.28). Comparison of MBH and NAV FA (FAMBHday1 = 0.60 ± 0.04, FANAVday1 = 0.60 ± 0.03, P = 0.57) and MD (MDMBHday1 = 0.8 ± 0.2 × 10−3 mm2/s, MDNAVday1 = 0.9 ± 0.2 × 10−3 mm2/s, P = 0.07) values showed no significant differences, while HA values (HAMBHday1Endo = 22 ± 10°, HAMBHday1Mid‐Endo = 20 ± 6°, HAMBHday1Mid‐Epi = −1 ± 6°, HAMBHday1Epi = −17 ± 6°, HANAVday1Endo = 7 ± 7°, HANAVday1Mid‐Endo = 13 ± 8°, HANAVday1Mid‐Epi = −2 ± 7°, HANAVday1Epi = −14 ± 6°) were significantly different. The scan duration was 20% longer with the NAV approach. Currently, the MBH approach is the more robust in normal volunteers. While the NAV technique still requires resolution of some bulk motion sensitivity issues, these preliminary experiments show its potential for in vivo clinical cardiac diffusion tensor imaging and for delivering high‐resolution in vivo 3D DTI tractography of the heart. Magn Reson Med 70:454–465, 2013.

Reproducibility of in-vivo diffusion tensor cardiovascular magnetic resonance in hypertrophic cardiomyopathy

BackgroundMyocardial disarray is an important histological feature of hypertrophic cardiomyopathy (HCM) which has been studied post-mortem, but its in-vivo prevalence and extent is unknown. Cardiac Diffusion Tensor Imaging (cDTI) provides information on mean intravoxel myocyte orientation and potentially myocardial disarray. Recent technical advances have improved in-vivo cDTI, and the aim of this study was to assess the interstudy reproducibility of quantitative in-vivo cDTI in patients with HCM.Methods and resultsA stimulated-echo single-shot-EPI sequence with zonal excitation and parallel imaging was implemented. Ten patients with HCM were each scanned on 2 different days. For each scan 3 short axis mid-ventricular slices were acquired with cDTI at end systole. Fractional anisotropy (FA), mean diffusivity (MD), and helix angle (HA) maps were created using a cDTI post-processing platform developed in-house. The mean ± SD global FA was 0.613 ± 0.044, MD was 0.750 ± 0.154 × 10-3 mm2/s and HA was epicardium −34.3 ± 7.6°, mesocardium 3.5 ± 6.9° and endocardium 38.9 ± 8.1°. Comparison of initial and repeat studies showed global interstudy reproducibility for FA (SD = ± 0.045, Coefficient of Variation (CoV) = 7.2%), MD (SD = ± 0.135 × 10-3 mm2/s, CoV = 18.6%) and HA (epicardium SD = ± 4.8°; mesocardium SD = ± 3.4°; endocardium SD = ± 2.9°). Reproducibility of FA was superior to MD (p = 0.003). Global MD was significantly higher in the septum than the reference lateral wall (0.784 ± 0.188 vs 0.750 ± 0.154 x10-3 mm2/s, p < 0.001). Septal HA was significantly lower than the reference lateral wall in all 3 transmural layers (from −8.3° to −10.4°, all p < 0.001).ConclusionsTo the best of our knowledge, this is the first study to assess the interstudy reproducibility of DTI in the human HCM heart in-vivo and the largest cDTI study in HCM to date. Our results show good reproducibility of FA, MD and HA which indicates that current technology yields robust in-vivo measurements that have potential clinical value. The interpretation of regional differences in the septum requires further investigation.

Active catheter tracking using parallel MRI and real-time image reconstruction.

In this work active MR catheter tracking with automatic slice alignment was combined with an autocalibrated parallel imaging technique. Using an optimized generalized autocalibrating partially parallel acquisitions (GRAPPA) algorithm with an acceleration factor of 2, we were able to reduce the acquisition time per image by 34%. To accelerate real‐time GRAPPA image reconstruction, the coil sensitivities were updated only after slice reorientation. For a 2D trueFISP acquisition (160 × 256 matrix, 80% phase matrix, half Fourier acquisition, TR = 3.7 ms, GRAPPA factor = 2) real‐time image reconstruction was achieved with up to six imaging coils. In a single animal experiment the method was used to steer a catheter from the vena cava through the beating heart into the pulmonary vasculature at an image update rate of about five images per second. Under all slice orientations, parallel image reconstruction was accomplished with only minor image artifacts, and the increased temporal resolution provided a sharp delineation of intracardial structures, such as the papillary muscle. Magn Reson Med, 2006.

Assessment of magnetization transfer effects in myocardial tissue using balanced steady-state free precession (bSSFP) cine MRI.

Magnetization transfer imaging (MTI) by means of MRI exploits the mobility of water molecules in tissue and offers an alternative contrast mechanism beyond the more commonly used mechanisms based on relaxation times. A cardiac MTI method was implemented on a commercially available 1.5 T MR imager. It is based on the acquisition of two sets of cardiac‐triggered cine balanced steady‐state free precession (bSSFP) images with different levels of RF power deposition. Reduction of RF power was achieved by lengthening the RF excitation pulses of a cine bSSFP sequence from 0.24 ms to 1.7 ms, while keeping the flip angle constant. Normal volunteers and patients with acute myocardial infarcts were imaged in short and long axis views. Normal myocardium showed an MT ratio (MTR) of 33.0 ± 3.3%. In acute myocardial infarct, MTR was reduced to 24.5 ± 9.2% (P < 0.04), most likely caused by an increase in water content due to edema. The method thus allows detection of acute myocardial infarct without the administration of contrast agents. Magn Reson Med, 2009.

A novel method for quantitative monitoring of transplanted islets of langerhans by positive contrast magnetic resonance imaging

The Automatic Quantitative Ultrashort Echo Time imaging (AQUTE) protocol for serial MRI allows quantitative in vivo monitoring of iron labeled pancreatic islets of Langerhans transplanted into the liver, quantifying graft implantation and persistence in a rodent model. Rats (n = 14), transplanted with iron oxide loaded cells (0–4000 islet equivalents, IEQ), were imaged using a 3D radial ultrashort echo time difference technique (dUTE) on a Siemens MAGNETOM 3T clinical scanner up to 5 months postsurgery. In vivo 3D dUTE images gave positive contrast from labeled cells, suppressing liver signal and small vessels, allowing automatic quantification. Position of labeled islet clusters was consistent over time and quantification of hyperintense pixels correlated with the number of injected IEQs (R2= 0.898, p < 0.0001), and showed persistence over time (5 months posttransplantation). Automatic quantification was superior to standard imaging and manual counting methods, due to the uniform suppressed background and high contrast, resulting in significant timesavings, reproducibility and ease of quantification. Three‐dimensional coverage of the whole liver in the absence of cardiac/respiratory artifact provided further improvement over conventional imaging. This imaging protocol reliably quantifies transplanted islet mass and has high translational potential to clinical studies of transplanted pancreatic islets.

Scenes from the Past: MR Imaging versus CT of Ancient Peruvian and Egyptian Mummified Tissues

Ancient Egyptian and Peruvian mummies are extremely valuable historical remains, and noninvasive methods for their examination are desirable. The current standard of reference for radiologic imaging of mummies is computed tomography (CT), with tissue having a homogeneous appearance on all CT images. It was long believed that ancient mummified tissue could not be studied with magnetic resonance (MR) imaging because of the low water content in mummies. Recently, however, the usefulness of MR imaging in the evaluation of mummified tissue was demonstrated for the first time, with use of a special ultrashort echo time technique. The authors of the present study acquired and analyzed MR imaging and CT data from the left hands of two ancient Egyptian mummies and the head of a third Egyptian mummy (ca 1500-1100 bce), as well as data from an ancient Peruvian mummy (ca 1100 ce). CT was found to provide superior detail of the anatomic structures, mainly because of its higher spatial resolution. The signal intensity of mummified tissue varied greatly on MR images; thus, the quality of these images is not yet comparable to that of clinical MR images, and further research will be needed to determine the full capacity of MR imaging in this setting. Nevertheless, additional information may theoretically be obtained with MR imaging, which should be viewed as complementary to, rather than a replacement for, CT.

Automatic view planning for cardiac MRI acquisition

Conventional cardiac MRI acquisition involves a multi-step approach, requiring a few double-oblique localizers in order to locate the heart and prescribe long- and short-axis views of the heart. This approach is operator-dependent and time-consuming. We propose a new approach to automating and accelerating the acquisition process to improve the clinical workflow. We capture a highly accelerated static 3D full-chest volume through parallel imaging within one breath-hold. The left ventricle is localized and segmented, including left ventricle outflow tract. A number of cardiac landmarks are then detected to anchor the cardiac chambers and calculate standard 2-, 3-, and 4-chamber long-axis views along with a short-axis stack. Learning-based algorithms are applied to anatomy segmentation and anchor detection. The proposed algorithm is evaluated on 173 localizer acquisitions. The entire view planning is fully automatic and takes less than 10 seconds in our experiments.

Ungated radial quiescent-inflow single-shot (UnQISS) magnetic resonance angiography using optimized azimuthal equidistant projections

We hypothesized that non–contrast‐enhanced MR angiography (NEMRA) could be performed without cardiac gating by using a variant of the quiescent‐inflow single‐shot (QISS) technique.