Saifeng Liu

Quantitative susceptibility mapping: current status and future directions

Quantitative susceptibility mapping (QSM) is a new technique for quantifying magnetic susceptibility. It has already found various applications in quantifying in vivo iron content, calcifications and changes in venous oxygen saturation. The accuracy of susceptibility mapping is dependent on several factors. In this review, we evaluate the entire process of QSM from data acquisition to individual data processing steps. We also show preliminary results of several new concepts introduced in this review in an attempt to improve the quality and accuracy for certain steps. The uncertainties in estimating susceptibility differences using susceptibility maps, phase images, and T2* maps are analyzed and compared. Finally, example clinical applications are presented. We conclude that QSM holds great promise in quantifying iron and becoming a standard clinical tool.

Measuring iron in the brain using quantitative susceptibility mapping and X-ray fluorescence imaging

Measuring iron content in the brain has important implications for a number of neurodegenerative diseases. Quantitative susceptibility mapping (QSM), derived from magnetic resonance images, has been used to measure total iron content in vivo and in post mortem brain. In this paper, we show how magnetic susceptibility from QSM correlates with total iron content measured by X-ray fluorescence (XRF) imaging and by inductively coupled plasma mass spectrometry (ICPMS). The relationship between susceptibility and ferritin iron was estimated at 1.10±0.08 ppb susceptibility per μg iron/g wet tissue, similar to that of iron in fixed (frozen/thawed) cadaveric brain and previously published data from unfixed brains. We conclude that magnetic susceptibility can provide a direct and reliable quantitative measurement of iron content and that it can be used clinically at least in regions with high iron content.

Improving Susceptibility Mapping Using a Threshold-Based K-Space/Image Domain Iterative Reconstruction Approach

To improve susceptibility quantification, a threshold‐based k‐space/image domain iterative approach that uses geometric information from the susceptibility map itself as a constraint to overcome the ill‐posed nature of the inverse filter is introduced. Simulations were used to study the accuracy of the method and its robustness in the presence of noise. In vivo data were processed and analyzed using this method. Both simulations and in vivo results show that most streaking artifacts inside the susceptibility map caused by the ill‐defined inverse filter were suppressed by the iterative approach. In simulated data, the bias toward lower mean susceptibility values inside vessels has been shown to decrease from around 10% to 2% when choosing an appropriate threshold value for the proposed iterative method. Typically, three iterations are sufficient for this approach to converge and this process takes less than 30 s to process a 512 × 512 × 256 dataset. This iterative method improves quantification of susceptibility inside vessels and reduces streaking artifacts throughout the brain for data collected from a single‐orientation acquisition. This approach has been applied to vessels alone as well as to vessels and other structures with lower susceptibility to generate whole brain susceptibility maps with significantly reduced streaking artifacts. Magn Reson Med, 2013.

Susceptibility mapping of air, bone, and calcium in the head.

To demonstrate the mapping of structures with high susceptibility values, such as the sinuses, bones and teeth, using short echo times.

Susceptibility-weighted imaging: current status and future directions

Susceptibility‐weighted imaging (SWI) is a method that uses the intrinsic nature of local magnetic fields to enhance image contrast in order to improve the visibility of various susceptibility sources and to facilitate diagnostic interpretation. It is also the precursor to the concept of the use of phase for quantitative susceptibility mapping (QSM). Nowadays, SWI has become a widely used clinical tool to image deoxyhemoglobin in veins, iron deposition in the brain, hemorrhages, microbleeds and calcification. In this article, we review the basics of SWI, including data acquisition, data reconstruction and post‐processing. In particular, the source of cusp artifacts in phase images is investigated in detail and an improved multi‐channel phase data combination algorithm is provided. In addition, we show a few clinical applications of SWI for the imaging of stroke, traumatic brain injury, carotid vessel wall, siderotic nodules in cirrhotic liver, prostate cancer, prostatic calcification, spinal cord injury and intervertebral disc degeneration. As the clinical applications of SWI continue to expand both in and outside the brain, the improvement of SWI in conjunction with QSM is an important future direction of this technology. Copyright

Improved MR venography using quantitative susceptibility-weighted imaging

To remove the geometry dependence of phase‐based susceptibility weighting masks in susceptibility‐weighted imaging (SWI) and to improve the visualization of the veins and microbleeds.

Quantitative susceptibility mapping of small objects using volume constraints.

Microbleeds have been implicated to play a role in many neurovascular and neurodegenerative diseases. The diameter of each microbleed has been used previously as a possible quantitative measure for grading microbleeds. We propose that magnetic susceptibility provides a new quantitative measure of extravasated blood. Recently, a Fourier‐based method has been used that allows susceptibility quantification from phase images for any arbitrarily shaped structures. However, when very small objects, such as microbleeds, are considered, the accuracy of this susceptibility mapping method still remains to be evaluated. In this article, air bubbles and glass beads are taken as microbleed surrogates to evaluate the quantitative accuracy of the susceptibility mapping method. We show that when an object occupies only a few voxels, an estimate of the true volume of the object is necessary for accurate susceptibility quantification. Remnant errors in the quantified susceptibilities and their sources are evaluated. We show that quantifying magnetic moment, rather than the susceptibility of these small structures, may be a better and more robust alternative. Magn Reson Med, 2013.

Quantitative measurements of brain iron deposition in cirrhotic patients using susceptibility mapping

Background Susceptibility-weighted imaging (SWI) has been used to detect micro-bleeds and iron deposits in the brain. However, no reports have been published on the application of SWI in studying iron changes in the brain of cirrhotic patients. Purpose To compare the susceptibility of different brain structures in cirrhotic patients with that in healthy controls and to evaluate susceptibility as a potential biomarker and correlate the measured susceptibility and cadaveric brain iron concentration for a variety of brain structures. Material and Methods Forty-three cirrhotic patients (27 men, 16 women; mean age, 50 ± 9 years) and 34 age- and sex-matched healthy controls (22 men, 12 women; mean age, 47 ± 7 years) were included in this retrospective study. Susceptibility was measured in the frontal white matter, basal ganglia, midbrain, and dentate nucleus and compared with results gathered from two postmortem brain studies. Correlation between susceptibility and clinical biomarkers and neuropsychiatric tests scores was calculated. Results In cirrhotic patients, the susceptibility of left frontal white matter, bilateral caudate head, and right substantia nigra was higher than that in healthy controls (P < 0.05). There was a positive correlation between susceptibility and iron concentration from one postmortem brain study (r = 0.835, P = 0.01) in eight deep grey matter structures and another in five brain structures (r = 0.900, P = 0.03). The susceptibility of right caudate head (r = 0.402) and left caudate head (r = 0.408) correlated with neuropsychological test scores (both P < 0.05). Conclusion Abnormal iron deposits occur in cirrhotic patients and abnormal susceptibility of some brain regions appears to reflect neurocognitive changes.

Determination of detection sensitivity for cerebral microbleeds using susceptibility-weighted imaging

Cerebral microbleeds (CMBs) are small brain hemorrhages caused by the break down or structural abnormalities of small vessels of the brain. Owing to the paramagnetic properties of blood degradation products, CMBs can be detected in vivo using susceptibility‐weighted imaging (SWI). SWI can be used not only to detect iron changes and CMBs, but also to differentiate them from calcifications, both of which may be important MR‐based biomarkers for neurodegenerative diseases. Moreover, SWI can be used to quantify the iron in CMBs. SWI and gradient echo (GE) imaging are the two most common methods for the detection of iron deposition and CMBs. This study provides a comprehensive analysis of the number of voxels detected in the presence of a CMB on GE magnitude, phase and SWI composite images as a function of resolution, signal‐to‐noise ratio (SNR), TE, field strength and susceptibility using in silico experiments. Susceptibility maps were used to quantify the bias in the effective susceptibility value and to determine the optimal TE for CMB quantification. We observed a non‐linear trend with susceptibility for CMB detection from the magnitude images, but a linear trend with susceptibility for CMB detection from the phase and SWI composite images. The optimal TE values for CMB quantification were found to be 3 ms at 7 T, 7 ms at 3 T and 14 ms at 1.5 T for a CMB of one voxel in diameter with an SNR of 20: 1. The simulations of signal loss and detectability were used to generate theoretical formulae for predictions. Copyright

A fully flow-compensated multiecho susceptibility-weighted imaging sequence: The effects of acceleration and background field on flow compensation

To present a fully flow‐compensated multiecho gradient echo sequence that can be used for MR angiography (MRA), susceptibility weighted imaging (SWI), and quantitative susceptibility mapping (QSM) and to study the effects of flow acceleration and background field gradients on flow compensation.