Samantha J. Holdsworth

Real-time optical motion correction for diffusion tensor imaging†

Head motion is a fundamental problem in brain MRI. The problem is further compounded in diffusion tensor imaging because of long acquisition times, and the sensitivity of the tensor computation to even small misregistration. To combat motion artifacts in diffusion tensor imaging, a novel real‐time prospective motion correction method was introduced using an in‐bore monovision system. The system consists of a camera mounted on the head coil and a self‐encoded checkerboard marker that is attached to the patients forehead. Our experiments showed that optical prospective motion correction is more effective at removing motion artifacts compared to image‐based retrospective motion correction. Statistical analysis revealed a significant improvement in similarity between diffusion data acquired at different time points when prospective correction was used compared to retrospective correction (P < 0.001). Magn Reson Med, 2010.

Robust GRAPPA-Accelerated Diffusion-Weighted Readout-Segmented (RS)-EPI

Readout segmentation (RS‐EPI) has been suggested as a promising variant to echo‐planar imaging (EPI) for high‐resolution imaging, particularly when combined with parallel imaging. This work details some of the technical aspects of diffusion‐weighted (DW)‐RS‐EPI, outlining a set of reconstruction methods and imaging parameters that can both minimize the scan time and afford high‐resolution diffusion imaging with reduced distortions. These methods include an efficient generalized autocalibrating partially parallel acquisition (GRAPPA) calibration for DW‐RS‐EPI data without scan time penalty, together with a variant for the phase correction of partial Fourier RS‐EPI data. In addition, the role of pulsatile and rigid‐body brain motion in DW‐RS‐EPI was assessed. Corrupt DW‐RS‐EPI data arising from pulsatile nonlinear brain motion had a prevalence of ∼7% and were robustly identified via k‐space entropy metrics. For DW‐RS‐EPI data corrupted by rigid‐body motion, we showed that no blind overlap was required. The robustness of RS‐EPI toward phase errors and motion, together with its minimized distortions compared with EPI, enables the acquisition of exquisite 3 T DW images with matrix sizes close to 5122. Magn Reson Med, 2009.

Clinical Application of Readout-Segmented− Echo-Planar Imaging for Diffusion-Weighted Imaging in Pediatric Brain

BACKGROUND AND PURPOSE: RS-EPI has been suggested as an alternative approach to EPI for high-resolution DWI with reduced distortions. To determine whether RS-EPI is a useful approach for routine clinical use, we implemented GRAPPA-accelerated RS-EPI DWI at our pediatric hospital and graded the images alongside standard accelerated (ASSET) EPI DWI used routinely for clinical studies. MATERIALS AND METHODS: GRAPPA-accelerated RS-EPI DWIs and ASSET EPI DWIs were acquired on 35 pediatric patients using a 3T system in 35 pediatric patients. The images were graded alongside each other by using a 7-point Likert scale as follows: 1, nondiagnostic; 2, poor; 3, acceptable; 4, standard; 5, above average; 6, good; and 7, outstanding. RESULTS: The following were the average scores for EPI and RS-EPI, respectively: resolution, 3.5/5.2; distortion level, 2.9/6.0; SNR, 3.4/4.1; lesion conspicuity, 3.3/5.9; and diagnostic confidence, 3.2/6.0. Overall, the RS-EPI had significantly improved diagnostic confidence and more reliably defined the extent and structure of several lesions. Although ASSET EPI scans had better SNR per scanning time, the higher spatial resolution as well as reduced blurring and distortions on RS-EPI scans helped to better reveal important anatomic details at the cortical-subcortical levels, brain stem, temporal and inferior frontal lobes, skull base, sinonasal cavity, cranial nerves, and orbits. CONCLUSIONS: This work shows the importance of both resolution and decreased distortions in the clinics, which can be accomplished by a combination of parallel imaging and alternative k-space trajectories such as RS-EPI.

New Methods in Diffusion-Weighted and Diffusion Tensor Imaging

Considerable strides have been made by countless individual researchers in diffusion-weighted imaging (DWI) to push DWI from an experimental tool, limited to a few institutions with specialized instrumentation, to a powerful tool used routinely for diagnostic imaging. The field of DWI constantly evolves, and progress has been made on several fronts. These developments are primarily composed of improved robustness against patient and physiologic motion, increased spatial resolution, new biophysical and tissue models, and new clinical applications for DWI. This article aims to provide a succinct overview of some of these new developments and a description of some of the major challenges associated with DWI.

In vivo investigation of restricted diffusion in the human brain with optimized oscillating diffusion gradient encoding

Previous studies in phantoms and animals using animal MR systems have shown promising results in using oscillating gradient spin echo (OGSE) diffusion acquisition to depict microstructure information. The OGSE approach has also been shown to be a sensitive biomarker of tumor treatment response and white matter‐related diseases. Translating these studies to a human MR scanner faces multiple challenges due to the much weaker gradient system. The goals of this study are to optimize the OGSE acquisition for a human MR system and investigate its applicability in the in vivo human brain.

Clinical applications of iron oxide nanoparticles for magnetic resonance imaging of brain tumors

Current neuroimaging provides detailed anatomic and functional evaluation of brain tumors, allowing for improved diagnostic and prognostic capabilities. Some challenges persist even with todays advanced imaging techniques, including accurate delineation of tumor margins and distinguishing treatment effects from residual or recurrent tumor. Ultrasmall superparamagnetic iron oxide nanoparticles are an emerging tool that can add clinically useful information due to their distinct physiochemical features and biodistribution, while having a good safety profile. Nanoparticles can be used as a platform for theranostic drugs, which have shown great promise for the treatment of CNS malignancies. This review will provide an overview of clinical ultrasmall superparamagnetic iron oxides and how they can be applied to the diagnostic and therapeutic neuro-oncologic setting.

Ultra-high resolution diffusion tensor imaging of the microscopic pathways of the medial temporal lobe ☆

Diseases involving the medial temporal lobes (MTL) such as Alzheimers disease and mesial temporal sclerosis pose an ongoing diagnostic challenge because of the difficulty in identifying conclusive imaging features, particularly in pre-clinical states. Abnormal neuronal connectivity may be present in the circuitry of the MTL, but current techniques cannot reliably detect those abnormalities. Diffusion tensor imaging (DTI) has shown promise in defining putative abnormalities in connectivity, but DTI studies of the MTL performed to date have shown neither dramatic nor consistent differences across patient populations. Conventional DTI methodology provides an inadequate depiction of the complex microanatomy present in the medial temporal lobe because of a typically employed low isotropic resolution of 2.0-2.5 mm, a low signal-to-noise ratio (SNR), and echo-planar imaging (EPI) geometric distortions that are exacerbated by the inhomogeneous magnetic environment at the skull base. In this study, we pushed the resolving power of DTI to near-mm isotropic voxel size to achieve a detailed depiction of mesial temporal microstructure at 3 T. High image fidelity and SNR at this resolution are achieved through several mechanisms: (1) acquiring multiple repetitions of the minimum field of view required for hippocampal coverage to boost SNR; (2) utilizing a single-refocused diffusion preparation to enhance SNR further; (3) performing a phase correction to reduce Rician noise; (4) minimizing distortion and maintaining left-right distortion symmetry with axial-plane parallel imaging; and (5) retaining anatomical and quantitative accuracy through the use of motion correction coupled with a higher-order eddy-current correction scheme. We combined this high-resolution methodology with a detailed segmentation of the MTL to identify tracks in all subjects that may represent the major pathways of the MTL, including the perforant pathway. Tractography performed on a subset of the data identified similar tracks, although they were lesser in number. This detailed analysis of MTL substructure may have applications to clinical populations.

Comparison of Readout-Segmented Echo-Planar Imaging (EPI) and Single-Shot EPI in Clinical Application of Diffusion-Weighted Imaging of the Pediatric Brain

OBJECTIVE Readout-segmented echo-planar imaging (EPI) has been suggested as an alternative to single-shot EPI for diffusion-weighted imaging (DWI) with reduced distortion. However, clinical comparisons of readout-segmented EPI and EPI DWI are limited by unmatched imaging parameters and reconstruction procedures. Our goal was to compare the clinical utility of generalized autocalibrating partial parallel acquisition (GRAPPA)-accelerated readout-segmented EPI DWI with GRAPPA-accelerated EPI DWI for visualization of the pediatric brain in regions prone to distortion, such as the orbit, skull base, and posterior fossa. SUBJECTS AND METHODS Thirty consecutive patients (mean age, 7.8 years) presenting with orbital, skull base, and posterior fossa neuropathologic abnormalities were scanned at 3 T. Images were obtained using GRAPPA-accelerated readout-segmented EPI and GRAPPA-accelerated EPI with an identical scanning time, acceleration factor, target resolution, and image postprocessing procedure. The two datasets were independently reviewed by two blinded neuroradiologists. Imaging studies were evaluated for resolution, signal-to-noise ratio (SNR), contrast, distortion, lesion conspicuity, and diagnostic confidence and graded using a 7-point Likert scale (1, nondiagnostic; 7, outstanding). RESULTS There was good reader agreement in the scores (κ = 0.66; 95% CI, 0.54-0.78). The mean scores for EPI and readout-segmented EPI, respectively, were as follows: resolution, 5.0 and 6.0; SNR, 5.5 and 3.0; contrast, 3.7 and 3.2; distortion, 4.8 and 6.0; lesion conspicuity, 4.6 and 5.1; and diagnostic confidence, 4.7 and 5.4. Readout-segmented EPI was superior in resolution, distortion reduction, lesion conspicuity, and diagnostic confidence, whereas EPI scored better in SNR and contrast. Readout-segmented EPI was considered the better sequence overall in 85% of the cases. CONCLUSION This study shows the benefits of improved resolution and reduced distortion of readout-segmented EPI in evaluating the orbit, skull base, and posterior fossa, sites of common neuropathologic abnormalities in children.

Magnetic Resonance Imaging Techniques: fMRI, DWI, and PWI

Magnetic resonance imaging (MRI) is a noninvasive technique which can acquire important quantitative and anatomical information from an individual in any plane or volume at comparatively high resolution. Over the past several years, developments in scanner hardware and software have enabled the acquisition of fast MRI imaging, proving extremely useful in various clinical and research applications such as in brain mapping or functional MRI (fMRI), perfusion-weighted imaging (PWI), and diffusion-weighted imaging (DWI). These techniques have revolutionized the use of MRI in the clinics, providing great insight into physiologic mechanisms and pathologic conditions. Since these relatively new areas of MRI have relied on fast scanning techniques, they have only recently been widely introduced to clinical sites. As such, this review article is devoted to the technological aspects of these techniques, as well as their roles and limitations in neuroimaging applications.

Comparison of cerebral blood flow measurement with [15O]-water positron emission tomography and arterial spin labeling magnetic resonance imaging: A systematic review

Noninvasive imaging of cerebral blood flow provides critical information to understand normal brain physiology as well as to identify and manage patients with neurological disorders. To date, the reference standard for cerebral blood flow measurements is considered to be positron emission tomography using injection of the [15O]-water radiotracer. Although [15O]-water has been used to study brain perfusion under normal and pathological conditions, it is not widely used in clinical settings due to the need for an on-site cyclotron, the invasive nature of arterial blood sampling, and experimental complexity. As an alternative, arterial spin labeling is a promising magnetic resonance imaging technique that magnetically labels arterial blood as it flows into the brain to map cerebral blood flow. As arterial spin labeling becomes more widely adopted in research and clinical settings, efforts have sought to standardize the method and validate its cerebral blood flow values against positron emission tomography-based cerebral blood flow measurements. The purpose of this work is to critically review studies that performed both [15O]-water positron emission tomography and arterial spin labeling to measure brain perfusion, with the aim of better understanding the accuracy and reproducibility of arterial spin labeling relative to the positron emission tomography reference standard.