[Show abstract][Hide abstract] ABSTRACT: To compare the image quality of three techniques and diagnostic performance in detecting implant rupture.
The study included 161 implants for the evaluation of image quality, composed of water-saturated short TI inversion recovery (herein called "water-sat STIR"), three-point Dixon techniques (herein called "Dixon"), and short TI inversion recovery fast spin-echo with iterative decomposition of silicone and water using least-squares approximation (herein called "STIR IDEAL") and included 41 implants for the evaluation of diagnostic performance in detecting rupture, composed of water-sat STIR and STIR IDEAL. Six image quality categories were evaluated and three classifications were used: normal implant, possible rupture, and definite rupture.
Statistically significant differences were noted for the image quality categories (p<0.001). STIR IDEAL was superior or equal to water-sat STIR in all image quality categories except artifact effects and superior to Dixon in all categories. Water-sat STIR performed the poorest for water suppression uniformity. The sensitivity and specificity in detecting implant rupture of STIR-IDEAL were 81.8 % and 77.8 % and the difference between two techniques was not statistically significant.
STIR-IDEAL is a useful silicone-specific imaging technique demonstrating more robust water suppression and equivalent diagnostic accuracy for detecting implant rupture, than water-sat STIR, at the cost of longer scan time and an increase in minor motion artifacts.
Magnetic Resonance Imaging 07/2013; · 2.06 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To develop a robust T(2) -weighted volumetric imaging technique with uniform water-silicone separation and simultaneous fat suppression for rapid assessment of breast implants in a single acquisition.
A three-dimensional (3D) fast spin echo sequence that uses variable refocusing flip angles was combined with a three-point chemical-shift technique (IDEAL) and short tau inversion recovery (STIR). Phase shifts of -π/6, +π/2, and +7π/6 between water and silicone were used for IDEAL processing. For comparison, two-dimensional images using 2D-FSE-IDEAL with STIR were also acquired in axial, coronal, and sagittal orientations.
Near-isotropic (true spatial resolution-0.9 × 1.3 × 2.0 mm(3) ) volumetric breast images with uniform water-silicone separation and simultaneous fat suppression were acquired successfully in clinically feasible scan times (7:00-10:00 min). The 2D images were acquired with the same in-plane resolution (0.9 × 1.3 mm(2) ), but the slice thickness was increased to 6 mm with a slice gap of 1 mm for complete coverage of the implants in a reasonable scan time, which varied between 18:00 and 22:30 min.
The single volumetric acquisition with uniform water and silicone separation enables images to be reformatted into any orientation. This allows comprehensive assessment of breast implant integrity in less than 10 min of total examination time.
Journal of Magnetic Resonance Imaging 01/2012; 35(5):1216-21. · 2.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: R₂ mapping has important applications in MRI, including functional imaging, tracking of super-paramagnetic particles, and measurement of tissue iron levels. However, R₂ measurements can be confounded by several effects, particularly the presence of fat and macroscopic B₀ field variations. Fat introduces additional modulations in the signal. Macroscopic field variations introduce additional dephasing that results in accelerated signal decay. These effects produce systematic errors in the resulting R₂ maps and make the estimated R₂ values dependent on the acquisition parameters. In this study, we develop a complex-reconstruction, confounder-corrected R₂ mapping technique, which addresses the presence of fat and macroscopic field variations for both 2D and 3D acquisitions. This technique extends previous chemical shift-encoded methods for R₂, fat and water mapping by measuring and correcting for the effect of macroscopic field variations in the acquired signal. The proposed method is tested on several 2D and 3D phantom and in vivo liver, cardiac, and brain datasets.
Magnetic Resonance in Medicine 12/2011; 68(3):830-40. · 3.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To show the feasibility of assessing the spatial distribution of skeletal muscle adipose tissue using chemical shift-based water/fat separation and to characterize differences in calf intermuscular adipose tissue (IMAT) compartmentalization in patients with type 2 diabetes mellitus (T2DM) compared to healthy age-matched controls.
A chemical shift-based water/fat separation approach using a multiecho 3D spoiled gradient echo sequence was applied in a study of 64 patients, including 35 healthy controls and 29 subjects with T2DM. Masks were defined based on manual segmentations to compute fat volume within different compartments, including regions of subcutaneous adipose tissue (SAT) and six muscular regions. IMAT was divided into two compartments representing fat within the muscular regions (intraMF) and fat between the muscular regions (interMF). Two-sample Student's t-tests were used to compare fat volumes between the two groups.
The subjects with T2DM had a lower volume of SAT compared to the healthy controls (P = 4 × 10(-5) ). There was no statistically significant difference in the IMAT volume between the two groups. However, the intraMF volume normalized by the IMAT volume was higher in the diabetics compared to the controls (P = 0.006).
Chemical shift-based water/fat separation enables the quantification of fat volume within localized muscle regions, showing that the IMAT regional distribution is significantly different in T2DM compared to normal controls.
Journal of Magnetic Resonance Imaging 11/2011; 35(4):899-907. · 2.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To validate the utility and performance of a T 2 correction method for hepatic fat quantification in an animal model of both steatosis and iron overload.
Mice with low (n = 6), medium (n = 6), and high (n = 8) levels of steatosis were sedated and imaged using a chemical shift-based fat-water separation method to obtain magnetic resonance imaging (MRI) fat-fraction measurements. Imaging was performed before and after each of two superparamagnetic iron oxide (SPIO) injections to create hepatic iron overload. Fat-fraction maps were reconstructed with and without T 2 correction. Fat-fraction with and without T 2 correction and T 2 measurements were compared after each injection. Liver tissue was harvested and imaging results were compared to triglyceride extraction and histology grading.
Excellent correlation was seen between MRI fat-fraction and tissue-based fat quantification. Injections of SPIOs led to increases in R 2 (=1/T 2). Measured fat-fraction was unaffected by the presence of iron when T 2 correction was used, whereas measured fat-fraction dramatically increased without T 2 correction.
Hepatic fat-fraction measured using a T 2-corrected chemical shift-based fat-water separation method was validated in an animal model of steatosis and iron overload. T 2 correction enables robust fat-fraction estimation in both the presence and absence of iron, and is necessary for accurate hepatic fat quantification.
Journal of Magnetic Resonance Imaging 11/2011; 35(4):844-51. · 2.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Fat suppression is an essential part of routine MRI scanning. Multiecho chemical-shift based water-fat separation methods estimate and correct for Bo field inhomogeneity. However, they must contend with the intrinsic challenge of water-fat ambiguity that can result in water-fat swapping. This problem arises because the signals from two chemical species, when both are modeled as a single discrete spectral peak, may appear indistinguishable in the presence of Bo off-resonance. In conventional methods, the water-fat ambiguity is typically removed by enforcing field map smoothness using region growing based algorithms. In reality, the fat spectrum has multiple spectral peaks. Using this spectral complexity, we introduce a novel concept that identifies water and fat for multiecho acquisitions by exploiting the spectral differences between water and fat. A fat likelihood map is produced to indicate if a pixel is likely to be water-dominant or fat-dominant by comparing the fitting residuals of two different signal models. The fat likelihood analysis and field map smoothness provide complementary information, and we designed an algorithm (Fat Likelihood Analysis for Multiecho Signals) to exploit both mechanisms. It is demonstrated in a wide variety of data that the Fat Likelihood Analysis for Multiecho Signals algorithm offers highly robust water-fat separation for 6-echo acquisitions, particularly in some previously challenging applications.
Magnetic Resonance in Medicine 08/2011; 67(4):1065-76. · 3.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Multipoint water-fat separation techniques rely on different water-fat phase shifts generated at multiple echo times to decompose water and fat. Therefore, these methods require complex source images and allow unambiguous separation of water and fat signals. However, complex-based water-fat separation methods are sensitive to phase errors in the source images, which may lead to clinically important errors. An alternative approach to quantify fat is through "magnitude-based" methods that acquire multiecho magnitude images. Magnitude-based methods are insensitive to phase errors, but cannot estimate fat-fraction greater than 50%. In this work, we introduce a water-fat separation approach that combines the strengths of both complex and magnitude reconstruction algorithms. A magnitude-based reconstruction is applied after complex-based water-fat separation to removes the effect of phase errors. The results from the two reconstructions are then combined. We demonstrate that using this hybrid method, 0-100% fat-fraction can be estimated with improved accuracy at low fat-fractions.
Magnetic Resonance in Medicine 07/2011; 66(1):199-206. · 3.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: MRI imaging of hepatic iron overload can be achieved by estimating T(2) values using multiple-echo sequences. The purpose of this work is to develop and clinically evaluate a weighted least squares algorithm based on T(2) Iterative Decomposition of water and fat with Echo Asymmetry and Least-squares estimation (IDEAL) technique for volumetric estimation of hepatic T(2) in the setting of iron overload. The weighted least squares T(2) IDEAL technique improves T(2) estimation by automatically decreasing the impact of later, noise-dominated echoes. The technique was evaluated in 37 patients with iron overload. Each patient underwent (i) a standard 2D multiple-echo gradient echo sequence for T(2) assessment with nonlinear exponential fitting, and (ii) a 3D T(2) IDEAL technique, with and without a weighted least squares fit. Regression and Bland-Altman analysis demonstrated strong correlation between conventional 2D and T(2) IDEAL estimation. In cases of severe iron overload, T(2) IDEAL without weighted least squares reconstruction resulted in a relative overestimation of T(2) compared with weighted least squares.
Magnetic Resonance in Medicine 05/2011; 67(1):183-90. · 3.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To propose a new noncontrast-enhanced flow-independent angiography sequence based on balanced steady-state free precession (bSSFP) that produces reliable vessel contrast despite the reduced blood flow in the extremities.
The proposed technique addresses a variety of factors that can compromise the exam success including insufficient background suppression, field inhomogeneity, and large volumetric coverage requirements. A bSSFP sequence yields reduced signal from venous blood when long repetition times are used. Complex-sum bSSFP acquisitions decrease the sensitivity to field inhomogeneity but retain phase information, so that data can be processed with the Iterative Decomposition of Water and Fat with Echo Asymmetry and Least-Squares Estimation (IDEAL) method for robust fat suppression. Meanwhile, frequent magnetization preparation coupled with parallel imaging reduces the muscle and long-T(1) fluid signals without compromising scan efficiency.
In vivo flow-independent peripheral angiograms with reliable background suppression and high spatial resolution are produced. Comparisons with phase-sensitive bSSFP angiograms (that yield out-of-phase fat and water signals, and exploit this phase difference to suppress fat) demonstrate enhanced vessel depiction with the proposed technique due to reduced partial-volume effects and improved venous suppression.
Magnetization-prepared complex-sum bSSFP with IDEAL fat/water separation can create reliable flow-independent angiographic contrast in the lower extremities.
Journal of Magnetic Resonance Imaging 04/2011; 33(4):931-9. · 2.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Chemical shift-based water/fat separation, like iterative decomposition of water and fat with echo asymmetry and least-squares estimation, has been proposed for quantifying intermuscular adipose tissue. An important confounding factor in iterative decomposition of water and fat with echo asymmetry and least-squares estimation-based intermuscular adipose tissue quantification is the large difference in T(1) between muscle and fat, which can cause significant overestimation in the fat fraction. This T(1) bias effect is usually reduced by using small flip angles. T(1) -correction can be performed by using at least two different flip angles and fitting for T(1) of water and fat. In this work, a novel approach for the water/fat separation problem in a dual flip angle experiment is introduced and a new approach for the selection of the two flip angles, labeled as the unequal small flip angle approach, is developed, aiming to improve the noise efficiency of the T(1) -correction step relative to existing approaches. It is shown that the use of flip angles, selected such the muscle water signal is assumed to be T(1) -independent for the first flip angle and the fat signal is assumed to be T(1) -independent for the second flip angle, has superior noise performance to the use of equal small flip angles (no T(1) estimation required) and the use of large flip angles (T(1) estimation required).
Magnetic Resonance in Medicine 03/2011; 66(5):1312-26. · 3.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To address phase and amplitude errors for multi-point water-fat separation with "bipolar" acquisitions, which efficiently collect all echoes with alternating read-out gradient polarities in one repetition.
With the bipolar acquisitions, eddy currents and other system nonidealities can induce inconsistent phase errors between echoes, disrupting water-fat separation. Previous studies have addressed phase correction in the read-out direction. However, the bipolar acquisitions may be subject to spatially high order phase errors as well as an amplitude modulation in the read-out direction. A method to correct for the 2D phase and amplitude errors is introduced. Low resolution reference data with reversed gradient polarities are collected. From the pair of low-resolution data collected with opposite gradient polarities, the two-dimensional phase errors are estimated and corrected. The pair of data are then combined for water-fat separation.
We demonstrate that the proposed method can effectively remove the high order errors with phantom and in vivo experiments, including obliquely oriented scans.
For bipolar multi-echo acquisitions, uniform water-fat separation can be achieved by removing high order phase errors with the proposed method.
Journal of Magnetic Resonance Imaging 05/2010; 31(5):1264-71. · 2.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Noninvasive biomarkers of intracellular accumulation of fat within the liver (hepatic steatosis) are urgently needed for detection and quantitative grading of nonalcoholic fatty liver disease, the most common cause of chronic liver disease in the United States. Accurate quantification of fat with MRI is challenging due the presence of several confounding factors, including T*(2) decay. The specific purpose of this work is to quantify the impact of T*(2) decay and develop a multiexponential T*(2) correction method for improved accuracy of fat quantification, relaxing assumptions made by previous T*(2) correction methods. A modified Gauss-Newton algorithm is used to estimate the T*(2) for water and fat independently. Improved quantification of fat is demonstrated, with independent estimation of T*(2) for water and fat using phantom experiments. The tradeoffs in algorithm stability and accuracy between multiexponential and single exponential techniques are discussed.
Magnetic Resonance in Medicine 04/2010; 63(4):849-57. · 3.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To validate quantitative imaging techniques used to detect and measure steatosis with magnetic resonance (MR) imaging in an ob/ob mouse model of hepatic steatosis.
The internal research animal and resource center approved this study. Twenty-eight male ob/ob mice in progressively increasing age groups underwent imaging and were subsequently sacrificed. Six ob/+ mice served as control animals. Fat fraction imaging was performed with a chemical shift-based water-fat separation method. The following three methods of conventional fat quantification were compared with imaging: lipid extraction and qualitative and quantitative histologic analysis. Fat fraction images were reconstructed with single- and multiple-peak spectral models of fat and with and without correction for T2* effects. Fat fraction measurements obtained with the different reconstruction methods were compared with the three methods of fat quantification, and linear regression analysis and two-sided and two-sample t tests were performed.
Lipid extraction and qualitative and quantitative histologic analysis were highly correlated with the results of fat fraction imaging (r(2) = 0.92, 0.87, 0.82, respectively). No significant differences were found between imaging measurements and lipid extraction (P = .06) or quantitative histologic (P = .07) measurements when multiple peaks of fat and T2* correction were included in image reconstruction. Reconstructions in which T2* correction, accurate spectral modeling, or both were excluded yielded lower agreement when compared with the results yielded by other techniques. Imaging measurements correlated particularly well with histologic grades in mice with low fat fractions (intercept, -1.0% +/-1.2 [standard deviation]).
MR imaging can be used to accurately quantify fat in vivo in an animal model of hepatic steatosis and may serve as a quantitative biomarker of hepatic steatosis.
[Show abstract][Hide abstract] ABSTRACT: Coronary wall cardiovascular magnetic resonance (CMR) is a promising noninvasive approach to assess subclinical atherosclerosis, but data are limited in subjects over 60 years old, who are at increased risk. The purpose of the study was to evaluate coronary wall CMR in an asymptomatic older cohort.
Cross-sectional images of the proximal right coronary artery (RCA) were acquired using spiral black-blood coronary CMR (0.7 mm resolution) in 223 older, community-based patients without a history of cardiovascular disease (age 60-72 years old, 38% female). Coronary measurements (total vessel area, lumen area, wall area, and wall thickness) had small intra- and inter-observer variabilities (r = 0.93~0.99, all p < 0.0001), though one-third of these older subjects had suboptimal image quality. Increased coronary wall thickness correlated with increased coronary vessel area (p < 0.0001), consistent with positive remodeling. On multivariate analysis, type 2 diabetes was the only risk factor associated with increased coronary wall area and thickness (p = 0.03 and p = 0.007, respectively). Coronary wall CMR measures were also associated with coronary calcification (p = 0.01-0.03).
Right coronary wall CMR in asymptomatic older subjects showed increased coronary atherosclerosis in subjects with type 2 diabetes as well as coronary calcification. Coronary wall CMR may contribute to the noninvasive assessment of subclinical coronary atherosclerosis in older, at-risk patient groups.
Journal of Cardiovascular Magnetic Resonance 01/2010; 12:75. · 4.44 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To validate a T(1)-independent, T(2)*-corrected fat quantification technique that uses accurate spectral modeling of fat using a homogeneous fat-water-SPIO phantom over physiologically expected ranges of fat percentage and T(2)* decay in the presence of iron overload.
A homogeneous gel phantom consisting of vials with known fat-fractions and iron concentrations is described. Fat-fraction imaging was performed using a multiecho chemical shift-based fat-water separation method (IDEAL), and various reconstructions were performed to determine the impact of T(2)* correction and accurate spectral modeling. Conventional two-point Dixon (in-phase/out-of-phase) imaging and MR spectroscopy were performed for comparison with known fat-fractions.
The best agreement with known fat-fractions over the full range of iron concentrations was found when T(2)* correction and accurate spectral modeling were used. Conventional two-point Dixon imaging grossly underestimated fat-fraction for all T(2)* values, but particularly at higher iron concentrations.
This work demonstrates the necessity of T(2)* correction and accurate spectral modeling of fat to accurately quantify fat using MRI.
Journal of Magnetic Resonance Imaging 11/2009; 30(5):1215-22. · 2.57 Impact Factor