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Oscillating-gradient spin-echo sequences enable the measurement of diffusion weighting with a short diffusion time and can provide indications of internal structures. We report two cases of brain abscess in which the apparent diffusion coefficient (ADC) values appear higher at short diffusion times in comparison with those at long diffusion times. Diffusion time dependence of the ADC in brain abscesses suggests not only substrate viscosity but also restricted diffusion due to the structure within the lesions.

Purpose To characterize the diffusion time-dependence in muscle in healthy adult volunteers, boys with Duchenne's muscular dystrophy (DMD), and age-matched controls in a clinically feasible acquisition time for pediatric applications. Methods Diffusion data were acquired using a pulsed gradient stimulated echo diffusion preparation at 5 different diffusion times (70, 130, 190, 250, and 330 ms), at 4 different b-values (0, 200, 400, 600, and 800 s/mm2 ) and 6 directions (orthogonal x, y, and z and diagonal xy, xz, and yz) and processed to obtain standard diffusion indices (mean diffusivity [MD] and fractional anisotropy [FA]) at each diffusion time. Results Time-dependent diffusion was seen in muscle in healthy adult volunteers, boys with DMD, and age-matched controls. Boys with DMD showed reduced MD and increased FA values in comparison to age matched controls across a range of diffusion times. A diffusion time of Δ = 190 ms had the largest effect size. Conclusions These results could be used to optimize diffusion imaging in this disease further and imply that these diffusion indices may become an important biomarker in monitoring progression in DMD in the future.

Introduction Oscillating gradient spin-echo (OGSE) sequences enable acquisitions with shorter diffusion times. There is growing interest in the effect of diffusion time on apparent diffusion coefficient (ADC) values in patients with cancer. However, little evidence exists regarding its usefulness for differentiating between high-grade and low-grade brain tumors. The purpose of this study is to investigate the utility of changes in the ADC value between short and long diffusion times in distinguishing low-grade and high-grade brain tumors. Material and methods Eleven patients with high-grade brain tumors and ten patients with low-grade brain tumors were scanned using a 3 T magnetic resonance imaging with diffusion-weighted imaging (DWI) using OGSE and PGSE (effective diffusion time [Δeff]: 6.5 ms and 35.2 ms) and b-values of 0 and 1000 s/mm2. Using a region of interest (ROI) analysis of the brain tumors, we measured the ADC for two Δeff (ADCΔeff) values and computed the subtraction ADC (ΔADC = ADC6.5 ms − ADC35.2 ms) and the relative ADC (ΔADC = (ADC6.5 ms − ADC35.2 ms) / ADC35.2 ms × 100). The maximum values for the subtraction ADC (ΔADCmax) and the relative ADC (rADCmax) on the ROI were compared between low-grade and high-grade tumors using the Wilcoxon rank-sum test. A P-value Results High-grade tumors had significantly higher ΔADCmax and rADCmax than low-grade tumors. The ΔADCmax values of the normal white matter were lower than the ΔADCmax of high- and low-grade brain tumors. Conclusion The dependence of ADC values on diffusion time between 6.5 ms and 35.2 ms was stronger in high-grade tumors than in low-grade tumors, suggesting differences in internal tissue structure. This finding highlights the importance of reporting diffusion times in ADC evaluations and might contribute to the grading of brain tumors using DWI.

Objectives To assess the ability of quantitative T2, diffusion tensor imaging (DTI) and radiologist’s scores to detect muscle changes following acute muscle tear in soccer and rugby players. To assess the ability of these parameters to predict return to play times. Methods In this prospective, longitudinal study, 13 male athletes (age 19 to 34 years; mean 25 years) underwent MRI within 1 week of suffering acute muscle tear. Imaging included measurements of T2 and DTI parameters. Images were also assessed using modified Peetrons and British athletics muscle injury classification (BAMIC) scores. Participants returned for a second scan within 1 week of being determined fit to return to play. MRI measurements were compared between visits. Pearson’s correlation between visit 1 measurements and return to play times was assessed. Results There were significant differences between visits in BAMIC scores (Z = − 2.088; p = 0.037), modified Peetrons (Z = − 2.530; p = 0.011) and quantitative MRI measurements; T2, 13.12 ms (95% CI, 4.82 ms, 21.42 ms; p = 0.01); mean diffusivity (0.22 (0.04, 0.39); p = 0.02) and fractional anisotropy (0.07 (0.01, 0.14); p = 0.03). BAMIC scores showed a significant correlation with return to play time (Rs = 0.64; p = 0.02), but modified Peetrons scores and quantitative parameters did not. Conclusions T2 and DTI measurements in muscle can detect changes due to healing following muscle tear. Although BAMIC scores correlated well with return to play times, in this small study, quantitative MRI values did not, suggesting that T2 and DTI measurements are inferior predictors of return to play time compared with visual scoring. Key Points • Muscle changes following acute muscle tear can be measured using T2 and diffusion measurements on MRI. • Measurements of T2 and diffusion using MRI are not as good as a radiologist’s visual report at predicting return to play time after acute muscle tear.

BACKGROUND Evaluation of prostate MRI relies on diffusion-weighted imaging (DWI), commonly distorted by susceptibility artifacts, thereby creating a need for approaches to correct such distortion. PURPOSE To compare geometric distortion on prostate MRI between standard DWI and a geometric distortion correction method for DWI described as static distortion correction DWI (SDC DWI). STUDY TYPE Retrospective case study. POPULATION Thirty patients (ages 31-81 years) undergoing prostate MRI. SEQUENCE Geometric distortions from echo planar imaging were corrected with the SDC DWI protocol, which first acquires a B0 -field map to estimate geometric distortions. ASSESSMENT Contours of the prostate were placed on axial T2 -weighted imaging (T2 WI) as an anatomic standard. Pixel shifts and apparent diffusion coefficient (ADC) values were compared between prostate contours applied to the SDC DWI and standard DWI sequences. Detailed characterization of the impact of SDC DWI was performed in three representative patients. STATISTICAL TESTS One-way analysis of variance (ANOVA) test, Spearman correlation test, and Bland-Altman plots were calculated. RESULTS There was significantly greater overlap of the SDC DWI prostate region of interest (ROI) with T2 WI than standard DWI with T2 WI (10.56 cm2 ± 3.14, P < 0.05). R2 of ADC values from standard DWI vs. SDC DWI in the 30 patients ranged from 0.02-0.94 (mean 0.60). A patient without susceptibility artifact demonstrated minimal pixel shift ranging from 0.6-1.3 mm and high correlation of ADC values (R2 = 0.89) between SDC DWI and standard DWI. A patient with rectal gas showed greater pixel shift (range: -2.5 to -0.5 mm) and less ADC value correlation (R2 = 0.69). A patient with a pelvic phlebolith adjacent to the prostate showed an even greater pixel shift (range: 10-16 mm) and decreased ADC correlation (R2 = 0.21). DATA CONCLUSION SDC DWI appears to correct for susceptibility-related pixel shifts in the prostate compared with standard DWI, which may have value for assessing prostate lesions obscured by geometric warping. Level of Evidence 4 Technical Efficacy Stage 1 J. Magn. Reson. Imaging 2019;50:1614-1619.

The aim of this study was to assess and compare the overall performance, reliability, variability, as well as the accuracy of diffusion tensor imaging (DTI) and fiber tracking metrics, for the muscles of the calf at 3 T and 7 T.Ten volunteers (5 males; mean age, 29.1 ± 4.7 years), with no history of muscle disease, were examined twice at 3 T and 7 T, using a stimulated-echo acquisition mode DTI sequence. Signal-to-noise ratio (SNR) and DTI metrics (track numbers [trn], length [trl], volume [trv], fractional anisotropy [FA], mean [MD], axial [AD], and radial diffusivity [RD]) of the whole-calf muscles, the tibialis anterior, the gastrocnemius medialis, the gastrocnemius lateralis, and the soleus were collected. The Student t test was used to compare SNR and DTI metrics obtained at 3 T and 7 T. The coefficients of variation and the intraclass correlation coefficients were derived to assess the variability and the reliability of the DTI measurements at 3 T and 7 T. To further assess the accuracy of the measurements, the absolute difference was computed for each DTI metric at 3 T and 7 T and then compared (Student t test). The applied level of significance for all the statistical analyses was P0.05.As expected, the SNR was higher at 7 T than at 3 T (+111%; P0.001). At 7 T, the tracked fibers of the whole calf muscles, the gastrocnemii, and the soleus were more numerous (trn +5.5%, +3.1%, +8.5%, and +15.1%, respectively), longer (trl +13.1%, +18.8%, +19.3%, and +33.3%, respectively), and showed a greater volume (trv +12.1%, +12.2%, +14.7%, and +15.7%, respectively) than at 3 T (P0.05 each). The soleus demonstrated higher FA (+14.3%), lower MD (-1.7%), AD (-1.9%), and RD (-2%) at 7 T than at 3 T (P0.05 each), whereas the other muscles showed more heterogeneous results. The coefficients of variation were good (ie,10%) for all DTI metrics at both 3 T and 7 T. The intraclass correlation coefficient was excellent (0.750) at 7 T and 3 T for several DTI metrics, such as the trn of the gastrocnemii and the soleus, the trv of the gastrocnemii, the FA of the whole-calf muscles, gastrocnemius medialis, tibialis anterior, and soleus, and the RD of all investigated muscles (ie, whole-calf muscles, gastrocnemii, tibialis anterior, and soleus). There were no significant differences between the 2 consecutive measurements with each device, except for the trn of the whole-calf muscles and the FA of the gastrocnemius lateralis (higher mean absolute difference at 3 T and 7 T, respectively; P0.05 each).Despite the numerous challenges associated with DTI of the muscles, both 3 T and 7 T demonstrated reliable and precise results.

BACKGROUND There is growing interest in the effect of diffusion time on apparent diffusion coefficient (ADC) values in cancers; however, little evidence exists regarding its utility to differentiate malignant from benign head and neck tumors. PURPOSE To investigate the utility of ADC value changes in distinguishing between malignant and benign head and neck tumors using the different diffusion times obtained from oscillating gradient spin-echo (OGSE) and pulsed gradient spin-echo (PGSE) MRI sequences. STUDY TYPE Prospective. SUBJECTS Thirty-one consecutive patients with suspected head and neck tumors and a phantom. FIELD STRENGTH/SEQUENCE 3T MRI with diffusion-weighted imaging (DWI) using OGSE (effective diffusion time: 4.3 msec) and PGSE (effective diffusion time: 82.6 msec) sequences and b-values of 0 and 700 s/mm2 . ASSESSMENT ADC values using OGSE (ADCOGSE ) and PGSE (ADCPGSE ) and relative ADC value changes between ADCOGSE and ADCPGSE . STATISTICAL TESTS Wilcoxon test, Mann-Whitney test, and McNemar test. RESULTS Relative ADC changes for each polyvinylpyrrolidone (PVP) and water in the phantom between OGSE and PGSE sequences were small (relative ADC change within 0.6%). Malignant tumors had significantly smaller ADCOGSE and ADCPGSE values than benign tumors (P < 0.001 and < 0.0001, respectively). Significantly larger relative ADC changes were observed in malignant compared with benign head and neck tumors (P < 0.0001). ADCPGSE values were significantly lower than ADCOGSE values in both malignant and benign head and neck tumors (0.97 vs. 1.28 × 10-3 mm2 /s: P < 0.0001 and 1.93 vs. 1.99 × 10-3 mm2 /s: P = 0.0056, respectively). Relative ADC change and ADCPGSE tended to have higher diagnostic performance than ADCOGSE , with area under the curve (AUC) values of 0.97, 0.96, and 0.89, respectively. DATA CONCLUSION ADC values obtained using the PGSE sequence were lower than those obtained with OGSE. This difference was larger for malignant than benign tumors, suggesting differences in tissue structure (diffusion hindrance) or cell permeability, revealed by changes in diffusion time. The results underline the potential importance of reporting diffusion time for interpretation of head and neck diffusion MRI. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:88-95.

RATIONALE AND OBJECTIVES: The purpose of this study was to investigate the use of multiparametric, whole-body, diffusion-weighted imaging (WB-DWI) and Apparent Diffusion Coefficient (ADC) maps with T(2)-weighted MRI at 3T for the detection and monitoring of metastatic disease in patients. MATERIALS AND METHODS: Fifty-four participants (32 healthy subjects and 22 patients) were scanned with WB-DWI methods using a 3T MRI scanner. Axial, sagittal, or coronal fat-suppressed T(2)-weighted (T(2)WI), T(1)-weighted(T(1)WI), and DWI images were acquired. Total MRI acquisition and set up time was approximately 45 minutes. Metastatic disease on MRI was confirmed based on T(2)WI characteristics. The number of lesions were established on Computed Tomography (CT) or PET/CT. Whole-body ADC maps and T(2)WI were constructed and region-of-interests (ROIs) were drawn in normal and abnormal-appearing tissue for quantitative analysis. Statistical analysis was performed using a paired t-tests and p

Current clinical MRI evaluation of musculature largely focuses on nonquantitative assessments (including T1-, T2- and PD-weighted images), which may vary greatly between imaging systems and readers. This work aims to determine the efficacy of a quantitative approach to study the microstructure of muscles at the cellular level with the random permeable barrier model (RPBM) applied to time-dependent diffusion tensor imaging (DTI) for varying diffusion time. Patients (N = 15, eight males and seven females) with atrophied calf muscles due to immobilization of one leg in a nonweight-bearing cast, were enrolled after providing informed consent. Their calf muscles were imaged with stimulated echo diffusion for DTI, T1-mapping and RPBM modeling. Specifically, After cast removal, both calf muscles (atrophied and contralateral control leg) were imaged with MRI for all patients, with follow-up scans to monitor recovery of the atrophied leg for six patients after 4 and 8 weeks. We compare RPBM-derived microstructural metrics: myofiber diameter, a, and sarcolemma permeability, κ, along with macroscopic anatomical parameters (muscle cross-sectional area, fiber orientation, , and T1 relaxation). ROC analysis was used to compare parameters between control and atrophied muscle, while the Friedman test was used to evaluate the atrophied muscle longitudinally. We found that the RPBM framework enables measurement of microstructural parameters from diffusion time-dependent DTI, of which the myofiber diameter is a stronger predictor of intramuscular morphological changes than either macroscopic (anatomical) measurements or empirical diffusion parameters. This work demonstrates the potential of RPBM to assess pathological changes in musculature that seem undetectable with standard diffusion and anatomical MRI.

Introduction The aim of this study was to investigate the variation of apparent diffusion coefficient (ADC) values with diffusion time according to breast tumor type and prognostic biomarkers expression. Materials and methods A total of 201 patients with known or suspected breast tumors were prospectively enrolled in this study, and 132 breast tumors (86 malignant and 46 benign) were analyzed. Diffusion-weighted imaging scans with 2 diffusion times were acquired on a clinical 3-T magnetic resonance imaging scanner using oscillating and pulsed diffusion-encoding gradients (effective diffusion times, 4.7 and 96.6 milliseconds) and b values of 0 and 700 s/mm2. Diagnostic performances to differentiate malignant and benign breast tumors for ADC values at short and long diffusion times (ADCshort and ADClong), ΔADC (the rate of change in ADC values with diffusion time), ADC0-1000 (ADC value from a standard protocol), and standard reading including dynamic contrast-enhanced magnetic resonance imaging (BI-RADS) were investigated. The correlations of ADCshort, ADClong, and ΔADC values with hormone receptor expression and breast cancer subtypes were also analyzed. Results The ADC values were lower, and ΔADC was higher in malignant tumors compared with benign tumors. The specificity of ADC values at all diffusion times and ΔADC values for differentiating malignant and benign breast tumors was superior to that of BI-RADS (87.0%-95.7% vs 73.9%), whereas the sensitivity was inferior (87.2%-90.7% vs 100%). Lower ADCshort and ADC0-1000 in ER-positive compared with ER-negative cancers (false discovery rate [FDR]-adjusted P = 0.037 and 0.018, respectively) and lower ADCshort, ADClong, and ADC0-1000 in progesterone receptor-positive compared with progesterone receptor-negative cancers (FDR-adjusted P = 0.037, 0.036, and 0.018, respectively) were found. Ki-67-positive cancers had larger ΔADCs than Ki-67-negative cancers (FDR-adjusted P = 0.018). Conclusions The ADC values vary with different diffusion time and vary in correlation with molecular biomarkers, especially Ki-67. Those results suggest that the diffusion time, which should be reported, might be a useful parameter to consider for breast cancer management.

The feasibility of detecting mild exercise-related muscle fatigue via stimulated echo (STE) and q-space imaging (qsi) was evaluated. The right calves of seven healthy volunteers were subjected to mild exercise loading, and qsi was generated using spin echo (Δ: 45.6 ms) and three different STE (Δ: 114, 214, and 414 ms) acquisitions. We concluded that qsi with an increased STE diffusion time can detect mild fatigue in the gastrocnemius muscle.

PURPOSE To evaluate the sensitivity of stimulated-echo acquisition mode (STEAM) and pulsed-gradient spin-echo (PGSE) diffusion tensor imaging (DTI) acquisitions with different diffusion times for measuring renal tissue anisotropy. METHODS Twelve healthy volunteers underwent an MRI examination at a 3T scanner including STEAM and PGSE DTI with variable diffusion times Δ (20.3, 37 and 125 ms). Three volunteers were scanned twice to test the reproducibility for repeated examinations. Diffusion parameters fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in the automatically segmented cortical and medullary regions of interests in both kidneys were calculated and averaged over all subjects for further analysis. Moreover, 5-grade qualitative evaluation of the FA and ADC maps from each sequence was conducted by two experienced radiologists in a consensus. RESULTS The cortex-medulla difference in the STEAM sequence was significantly higher than that in PGSE with short ∆ = 20.3 ms (P

Objectives To assess acute muscle tears in professional football players by diffusion tensor imaging (DTI) and evaluate the impact of normalization of data. Methods Eight football players with acute lower limb muscle tears were examined. DTI metrics of the injured muscle and corresponding healthy contralateral muscle and of ROIs drawn in muscle tears (ROItear) in the corresponding healthy contralateral muscle (ROIhc_t) in a healthy area ipsilateral to the injury (ROIhi) and in a corresponding contralateral area (ROIhc_i) were compared. The same comparison was performed for ratios of the injured (ROItear/ROIhi) and contralateral sides (ROIhc_t/ROIhc_i). ANOVA, Bonferroni-corrected post-hoc and Student’s t-tests were used. Results Analyses of the entire muscle did not show any differences (p>0.05 each) except for axial diffusivity (AD; p=0.048). ROItear showed higher mean diffusivity (MD) and AD than ROIhc_t (p

BACKGROUND Diffusion-weighted imaging (DWI) provides insight into the pathophysiology underlying renal dysfunction. Variants of DWI include intravoxel incoherent motion (IVIM), which differentiates between microstructural diffusion and vascular or tubular flow, and diffusion tensor imaging (DTI), which quantifies diffusion directionality. PURPOSE To investigate the reproducibility of joint IVIM-DTI and compare controls to presurgical renal mass patients. STUDY TYPE Prospective cross-sectional. SUBJECTS Thirteen healthy controls and ten presurgical renal mass patients were scanned. Ten controls were scanned twice to investigate reproducibility. FIELD STRENGTH/SEQUENCE Subjects were scanned on a 3T system using 10 b-values and 20 diffusion directions for IVIM-DTI in a study approved by the local Institutional Review Board. ASSESSMENT Retrospective coregistration and measurement of joint IVIM-DTI parameters were performed. STATISTICAL ANALYSIS Parameter reproducibility was defined as intraclass correlation coefficient (ICC) >0.7 and coefficient of variation (CV)

We report two cases of pathologically proven intracranial epidermoid cysts. Both cases were scanned with diffusion-weighted imaging using pulsed gradient spin-echo (PGSE) and oscillating gradient spin-echo (OGSE; 50 Hz) prototype sequences with diffusion times of 47.3 ms and 8.5 ms, respectively. The apparent diffusion coefficient measured by OGSE was higher than that measured by PGSE, indicating the spatial restriction of water diffusion in the laminated keratin layers within the cyst as demonstrated by histopathology.

PURPOSE Water exchange exists between different neuronal compartments of brain tissue but is often ignored in most diffusion models. The goal of the current study was to demonstrate the dependence of diffusion measurements on echo time (TE) in the human brain and to investigate the underlying effects of myelin water exchange. METHODS Five healthy subjects were examined with single-shot pulsed-gradient spin-echo echo-planar imaging with fixed duration (δ) and separation (Δ) of diffusion gradient pulses and a set of varying TEs. The effects of water exchange and intrinsic T2 difference in cellular environments were investigated with Monte Carlo simulations. RESULTS Both in vivo measurements and simulations showed that fractional anisotropy (FA) and axial diffusivity (AD) had positive correlations with TE, while radial diffusivity (RD) showed a negative correlation, which is consistent with a previous study. The simulation results further indicated the sensitivity of TE dependence to the change of g-ratio. CONCLUSION The exchange between myelin and intra/extra-axonal water pools often plays a non-negligible role in the observed TE dependence of diffusion parameters, which may accompany or alter the effect of intrinsic T2 in causing such dependence. The TE dependence may potentially serve as a biomarker for demyelination processes (e.g., in multiple sclerosis and Alzheimer's disease). Magn Reson Med 79:1650-1660, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

PurposeTo introduce T2-adjusted computed DWI (T2-cDWI), a method that provides synthetic images at arbitrary b-values and echo times (TEs) that improve tissue contrast by removing or increasing T2 contrast in diffusion-weighted images. Materials and methodsIn addition to the standard DWI acquisition protocol T2-weighted echo-planar images at multiple (2) echo times were acquired. This allows voxelwise estimation of apparent diffusion coefficient (ADC) and T2 values, permitting synthetic images to be generated at any chosen b-value and echo time. An analytical model is derived for the noise properties in T2-cDWI, and validated using a diffusion test-object. Furthermore, we present T2-cDWI in two example clinical case studies: (i) a patient with mesothelioma demonstrating multiple disease tissue compartments and (ii) a patient with primary ovarian cancer demonstrating solid and cystic disease compartments. ResultsMeasured image noise in T2-cDWI from phantom experiments conformed to the analytical model and demonstrated that T2-cDWI at high computed b-value/TE combinations achieves lower noise compared with conventional DWI. In patients, T2-cDWI with low b-value and long TE enhanced fluid signal while suppressing solid tumour components. Conversely, large b-values and short TEs overcome T2 shine-through effects and increase the contrast between tumour and fluid compared with conventional high-b-value DW images. ConclusionT2-cDWI is a promising clinical tool for improving image signal-to-noise, image contrast, and tumour detection through suppression of T2 shine-through effects. T2-cDWI provides a promising tool for improved image tissue-contrast in oncology.T2-cDWI synthesizes images at arbitrary b-value and/or echo-time.T2-cDWI may improve signal-to-noise over conventional diffusion-weighted imaging.With T2-cDWI it is possible to overcome/enhance T2 shine-through effects.

Objectives: To assess the test–retest variability of both diffusion parameters and fat fraction (FF) estimates in normal muscle, and to assess differences in normal values between muscles in the thigh. Methods: 29 healthy volunteers (mean age 37 years, range 20–60 years, 17/29 males) completed the study. Magnetic resonance images of the mid-thigh were acquired using a stimulated echo acquisition mode-echoplanar imaging (STEAM-EPI) imaging sequence, to assess diffusion, and 2-point Dixon imaging, to assess FF. Imaging was repeated in 19 participants after a 30 min interval in order to assess test–retest variability of the measurements. Results: Intraclass correlation coefficients (ICCs) for test–retest variability were 0.99 [95% confidence interval, (CI): 0.98, 1] for FF, 0.94 (95% CI: 0.84, 0.97) for mean diffusivity and 0.89 (95% CI: 0.74, 0.96) for fractional anisotropy (FA). FF was higher in the hamstrings than the quadriceps by a mean difference of 1.81% (95% CI:1.63, 2.00)%, p < 0.001. Mean diffusivity was significantly lower in the hamstrings than the quadriceps (0.26 (0.13, 0.39) x10-3 mm2s−1, p < 0.001) whereas fractional anisotropy was significantly higher in the hamstrings relative to the quadriceps with a mean difference of 0.063 (0.05, 0.07), p < 0.001. Conclusions: This study has shown excellent test-retest, variability in MR-based FF and diffusion measurements and demonstrated significant differences in these measures between hamstrings and quadriceps in the healthy thigh. Advances in knowledge: Test–retest variability is excellent for STEAM-EPI diffusion and 2-point Dixon-based FF measurements in the healthy muscle. Inter- and intraobserver variability were excellent for region of interest placement for STEAM-EPI diffusion and 2-point Dixon-based FF measurements in the healthy muscle. There are significant differences in FF and diffusion measurements between the hamstrings and quadriceps in the normal muscle.

Introduction Oscillating gradient spin-echo (OGSE) sequences can shorten diffusion times by replacing the long-lasting diffusion-sensitizing gradients used in pulsed gradient spin-echo (PGSE) methods with rapidly oscillating gradients. To obtain information regarding the internal structure of choroid plexus cysts that appear hyperintense on diffusion-weighted imaging (DWI), we investigated the apparent diffusion coefficient (ADC) values acquired with a shorter diffusion time using an OGSE sequence. Material and methods Twenty-seven patients with choroid plexus cysts were scanned using a 3 T magnetic resonance scanner. DWI was performed with both OGSE and PGSE, with effective diffusion times (Δeff) of 6.5 and 35.2 ms, respectively. ADC values for choroid plexus cysts, white matter (WM), and cerebrospinal fluid (CSF) were measured. The ADC values obtained with the shorter and longer diffusion times were compared using the Wilcoxon signed-rank test. P Results The ADC values of choroid plexus cysts and WM were significantly higher at the Δeff of 6.5 ms on OGSE than with the Δeff of 35.2 ms on PGSE. The ADC values of CSF were significantly lower at the Δeff of 6.5 ms on OGSE than with the Δeff of 35.2 ms on PGSE. The ADC values of choroid plexus cysts were lower than the ADC values of CSF with Δeff of 35.2 and 6.5 ms. Conclusions The dependence of ADC values on the diffusion time in choroid plexus cysts suggested spatially restricted diffusion. In measurements obtained with short diffusion times, the lower ADC values for choroid plexus cysts in comparison with the CSF indicated the presence of spatially restricted diffusion and increased cyst viscosity.

Being able to finely characterize the spinal cord (SC) microstructure and its alterations is a key point when investigating neural damage mechanisms encountered in different central nervous system (CNS) pathologies, such as multiple sclerosis, amyotrophic lateral sclerosis or myelopathy. Based on novel methods, including inhomogeneous magnetization transfer (ihMT) and dedicated SC probabilistic atlas post-processing, the present study focuses on the in vivo characterization of the healthy SC tissue in terms of regional microstructure differences between (i) upper and lower cervical vertebral levels and (ii) sensory and motor tracts, as well as differences attributed to normal aging. Forty-eight healthy volunteers aged from 20 to 70 years old were included in the study and scanned at 3 T using axial high-resolution T2 *-w imaging, diffusion tensor imaging (DTI) and ihMT, at two vertebral levels (C2 and C5). A processing pipeline with minimal user intervention, SC segmentation and spatial normalization into a reference space was implemented in order to assess quantitative morphological and structural parameters (cross-sectional areas, scalar DTI and MT/ihMT metrics) in specific white and gray matter regions of interest. The multi-parametric MRI metrics collected allowed upper and lower cervical levels to be distinguished, with higher ihMT ratio (ihMTR), higher axial diffusivity (λ∥ ) and lower radial diffusivity (λ⊥ ) at C2 compared with C5. Significant differences were also observed between white matter fascicles, with higher ihMTR and lower λ∥ in motor tracts compared with posterior sensory tracts. Finally, aging was found to be associated with significant metric alterations (decreased ihMTR and λ∥ ). The methodology proposed here, which can be easily transferred to the clinic, provides new insights for SC characterization. It bears great potential to study focal and diffuse SC damage in neurodegenerative and demyelinating diseases. Copyright © 2016 John Wiley & Sons, Ltd.

Compared with the conventional pulsed gradient spin-echo (PGSE) sequence, diffusion-weighted imaging (DWI) with the oscillating gradient spin-echo (OGSE) sequence can shorten the diffusion time by changing the frequency. The purpose was to investigate whether n-alkanes are suitable as isotropic phantoms for estimating the diffusion coefficient with the OGSE sequence. We investigated changes in the apparent diffusion coefficient (ADC) due to differences in the viscosities of nine n-alkane phantoms with different numbers of carbon atoms from C8H18 to C16H34 using OGSE and PGSE sequences at 21 °C. Effective diffusion times of 4.3, 5.1, 6.5, 9.3, 20, 40, and 60 ms were used. The T2 relaxation times of each n-alkane phantom were measured using quantitative synthetic magnetic resonance imaging (MRI). Circular regions of interest were placed manually within the alkane phantoms on ADC and T2 maps. In each alkane phantom, changes in mean ADC values were almost constant with changes in diffusion times. Viscosities and ADC values showed inverse proportionality, as expected theoretically. The ADC values of alkanes do not depend on diffusion times. The n-alkanes can be useful phantoms for assessing the accuracy of clinical protocols of DWI with the OGSE sequence.

Purpose To demonstrate the reproducibility of the diffusion properties and three-dimensional structural organization measurements of the lower leg muscles by using diffusion-tensor imaging (DTI) assessed with ultra-high-field-strength (7.0-T) magnetic resonance (MR) imaging and tractography of skeletal muscle fibers. On the basis of robust statistical mapping analyses, this study also aimed at determining the sensitivity of the measurements to sex difference and intramuscular variability. Materials and Methods All examinations were performed with ethical review board approval; written informed consent was obtained from all volunteers. Reproducibility of diffusion tensor indexes assessment including eigenvalues, mean diffusivity, and fractional anisotropy (FA) as well as muscle volume and architecture (ie, fiber length and pennation angle) were characterized in lower leg muscles (n = 8). Intramuscular variability and sex differences were characterized in young healthy men and women (n = 10 in each group). Student t test, statistical parametric mapping, correlation coefficients (Spearman rho and Pearson product-moment) and coefficient of variation (CV) were used for statistical data analysis. Results High reproducibility of measurements (mean CV ± standard deviation, 4.6% ± 3.8) was determined in diffusion properties and architectural parameters. Significant sex differences were detected in FA (4.2% in women for the entire lower leg; P = .001) and muscle volume (21.7% in men for the entire lower leg; P = .008), whereas architecture parameters were almost identical across sex. Additional differences were found independently of sex in diffusion properties and architecture along several muscles of the lower leg. Conclusion The high-spatial-resolution DTI assessed with 7.0-T MR imaging allows a reproducible assessment of structural organization of superficial and deep muscles, giving indirect information on muscle function.

OBJECTIVES: We assessed the use of high-resolution ultra-high-field diffusion magnetic resonance imaging (dMRI) to determine neuronal fiber orientation density functions (fODFs) throughout the human brain, including gray matter (GM), white matter (WM), and small intertwined structures in the cerebellopontine region. MATERIALS AND METHODS: We acquired 7-T whole-brain dMRI data of 23 volunteers with 1.4-mm isotropic resolution; fODFs were estimated using constrained spherical deconvolution. RESULTS:High-resolution fODFs enabled a detailed view of the intravoxel distributions of fiber populations in the whole brain. In the brainstem region, the fODF of the extra- and intrapontine parts of the trigeminus could be resolved. Intrapontine trigeminal fiber populations were crossed in a network-like fashion by fiber populations of the surrounding cerebellopontine tracts. In cortical GM, additional evidence was found that in parts of primary somatosensory cortex, fODFs seem to be oriented less perpendicular to the cortical surface than in GM of motor, premotor, and secondary somatosensory cortices. CONCLUSION: With 7-T MRI being introduced into clinical routine, high-resolution dMRI and derived measures such as fODFs can serve to characterize fine-scale anatomic structures as a prerequisite to detecting pathologies in GM and small or intertwined WM tracts.

Purpose To examine the usefulness of rich diffusion protocols with high b-values and varying diffusion time for probing microstructure in bone metastases. Analysis techniques including biophysical and mathematical models were compared with the clinical apparent diffusion coefficient (ADC). Methods Four patients were scanned using 13 b-values up to 3,000 s/mm2 and diffusion times ranging 18–52 ms. Data were fitted to mono-exponential ADC, intravoxel incoherent motion (IVIM), Kurtosis and Vascular, extracellular, and restricted diffusion for cytometry in tumors (VERDICT) models. Parameters from the models were compared using correlation plots. Results ADC and IVIM did not fit the data well, failing to capture the signal at high b-values. The Kurtosis model best explained the data in many voxels, but in voxels exhibiting a more time-dependent signal, the VERDICT model explained the data best. The ADC correlated significantly (p

Purpose We used a combined intravoxel incoherent motion–diffusion tensor imaging (IVIM-DTI) methodology to distinguish structural from flow effects on renal diffusion anisotropy. Methods Eight volunteers were examined with IVIM-DTI at 3T with 20 diffusion directions and 10 b-values. Mean diffusivity (MD) and fractional anisotropy (FA) from DTI analysis were calculated for low (b ≤ 200 s/mm2), high (b > 200 s/mm2), and full b-value ranges. IVIM-parameters perfusion-fraction fP, pseudo-diffusivity Dp, and tissue-diffusivity Dt were first calculated independently on a voxelwise basis for all directions. After estimating a fixed isotropic fp from these data, global anisotropies of Dt and Dp in the cortex and medulla were determined in a constrained cylindrical description and visualized using polar plots and cosine scatterplots. Results For all b-value ranges, medullary FA was significantly higher than that of the cortex. The corticomedullary difference was smaller for the high b-value range. Significantly higher fp and Dt were determined for the cortex and showed a significantly higher directional variance in the medulla. Polar plot analysis displayed nearly isotropic Dp and Dt in the cortex and anisotropy in the medulla. Conclusion Both flow and microstructure apparently contribute to the medullary diffusion anisotropy. The described novel method may be useful in separating decreased tubular flow from irreversible structural tubular damage, for example, in diabetic nephropathy or during allograft rejection. Magn Reson Med 73:1526–1532, 2015. © 2014 Wiley Periodicals, Inc.

The purpose of this work was to carry out diffusion tensor imaging (DTI) at multiple diffusion times Td in skeletal muscle in normal subjects and chronic exertional compartment syndrome (CECS) patients and analyze the data with the random permeable barrier model (RPBM) for biophysical specificity. Using an institutional review board approved HIPAA-compliant protocol, seven patients with clinical suspicion of CECS and eight healthy volunteers underwent DTI of the calf muscle in a Siemens MAGNETOM Verio 3 T scanner at rest and after treadmill exertion at four different T(d) values. Radial diffusion values λ(rad) were computed for each of seven different muscle compartments and analyzed with RPBM to produce estimates of free diffusivity D(0), fiber diameter a, and permeability κ. Fiber diameter estimates were compared with measurements from literature autopsy reference for several compartments. Response factors (post/pre-exercise ratios) were computed and compared between normal controls and CECS patients using a mixed-model two-way analysis of variance. All subjects and muscle compartments showed nearly time-independent diffusion along and strongly time-dependent diffusion transverse to the muscle fibers. RPBM estimates of fiber diameter correlated well with corresponding autopsy reference. D(0) showed significant (p

Diffusion tensor imaging (DTI) has been used extensively both clinically [1] and for research [2] to map white matter fiber tracts in the central nervous system (CNS). In this application DTI takes advantage of the anisotropic structure of axons, which permits faster diffusion of water molecules parallel to and slower diffusion perpendicular to the axon. DTI has also been applied, although to a much lesser extent, for defining the micro structure of other tissues which also have an inherent structural anisotropy [3]. For example, skeletal muscles consist of bundles of individual muscle fibers, which are in turn comprised of multiple parallel protein bands called myofibrils. This protein configuration and the overall cellular geometry give muscle fibers a highly anisotropic structure. Consequently, DTI can be used to reveal the orientation of muscle fibers [4, 5]. The value of these analyses is derived partly from the observation that the spatial arrangement of muscle fibers with respect to the muscle's line of action is directly related to the muscle's ability to produce force [6, 7]. In particular, two structural phenomena, the pennation angle and muscle fiber length, are integral for assessing the ability of a muscle to generate force. Estimating muscle fiber structure through DTI in fact may be easier than deriving aspects of axonal structure because the muscle fiber diameters, which are approximately 10-90 μm, match the diffusion length within the typical diffusion time of between 10- 50 ms [8, 9]. This could be particularly helpful when assessing changes in muscle fibers as a result of injury or training, where measurements cannot currently be readily made non-invasively over the whole muscle. While there is growing interest in applying these techniques to muscle, data are still lacking regarding the effect of different DTI pulse sequences on the derived muscle fiber length and pennation angle. The application of DTI to muscle presents a number of unique challenges that require adaptation of the twice refocused spin echo (TRSE) MR pulse sequences commonly used in the brain. One factor is the smaller T2 to T1 ratio in muscle versus the white matter in the CNS [10]. One consequence of this is that the signal-to-noise ratio (SNR) in diffusion weighted images is poorer in muscle compared to the brain [11]. An additional challenge, more important to imaging muscle than the CNS, is minimizing the contribution to the image of adipose tissue that surrounds and infiltrates the muscle. Because diffusion weighted images are typically acquired with echo planar imaging (EPI) techniques, the off-resonance protons in fat lead to displacement of the fat in the image so that it overlaps the muscle of interest [5]. The result will be a bias in the estimates of the diffusion coefficients and added variability to the estimates of the eigenvector directions [12, 13]. Because of the much smaller amount of fat in the scalp, this problem is not nearly as significant for imaging the brain. Lastly, localized eddy current-induced fields which result from the prolonged high gradient pulses to encode diffusion can further degrade the geometric fidelity and general image quality [11, 14]. These well recognized challenges have encouraged the exploration of alternative diffusion encoding strategies from the more commonly used TRSE, echo planar acquisitions typically used with DTI. To deal with these challenges some investigators have explored using a single-echo spin echo acquisition similar to the original Stejskal-Tanner technique but with a modified gradient design to reduce eddy current generation [14-16]. Within a TRSE technique alternative bipolar gradient encoding schemes have been investigated to minimize the compromise in image quality and SNR [17]. Bipolar gradient schemes have reduced geometric distortion but at the expense of slightly longer TE than monopolar encoding schemes [18] [14]. A few groups have used a Stimulated Echo Acquisition Mode (STEAM) sequence, wherein the diffusion encoding occurs during the mixing time (TM) [8, 19]. As only T1 recovery occurs during TM, it is possible to increase TM to achieve an adequate b value while simultaneously reducing TE. The lengthened diffusion encoding time also reduces the need for high amplitude gradients, thus reducing the induced eddy currents that spatially distort the images. While in limited studies both techniques have been shown to work in muscle, a comparison between the two pulse sequences, particularly for quantitative fiber tracking applications, is lacking in the literature. Such a comparison will be of value to clinicians and researchers alike to help them optimize or choose the sequence that would work best for their particular application. Previous studies that have evaluated either a STEAM or a TRSE sequence for imaging muscle have used different field strengths (1.5 T and 3.0T), have compared the sequences in-vivo in human muscle, run simulations, or used excised brain tissue [5, 11, 14]. Thus, the purpose of this study was to compare a TRSE DTI sequence to a STEAM DTI sequence on the Vastus Lateralis (VL) of healthy human participants.

Background Diffusion-weighted imaging (DWI) magnetic resonance imaging (MRI) is most commonly performed utilizing a single-shot echo-planar imaging technique (ss-EPI). Susceptibility artifact and image blur are severe when this sequence is utilized at 3 T. Purpose To evaluate a readout-segmented approach to DWI MR in comparison with single-shot echo planar imaging for brain MRI. Material and Methods Eleven healthy volunteers and 14 patients with acute and early subacute infarctions underwent DWI MR examinations at 1.5 and 3T with ss-EPI and readout-segmented echo-planar (rs-EPI) DWI at equal nominal spatial resolutions. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) calculations were made, and two blinded readers ranked the scans in terms of high signal intensity bulk susceptibility artifact, spatial distortions, image blur, overall preference, and motion artifact. Results SNR and CNR were greatest with rs-EPI (8.1±0.2 SNR vs. 6.0±0.2; P -4 at 3T).Spatial distortions were greater with single-shot (0.23±0.03 at 3T; P Conclusion Substantial image quality improvements are possible with readout-segmented vs. single-shot EPI - the current clinical standard for DWI - regardless of field strength (1.5 or 3 T). This results in improved image quality secondary to greater real spatial resolution and reduced artifacts from susceptibility in MR imaging of the brain.

To optimize intravoxel incoherent motion (IVIM) diffusion-weighted (DW) imaging by estimating the effects of diffusion gradient polarity and breathing acquisition scheme on image quality, signal-to-noise ratio (SNR), IVIM parameters, and parameter reproducibility, as well as to investigate the potential of IVIM in the detection of hepatic fibrosis.In this institutional review board-approved prospective study, 20 subjects (seven healthy volunteers, 13 patients with hepatitis C virus infection; 14 men, six women; mean age, 46 years) underwent IVIM DW imaging with four sequences: (a) respiratory-triggered (RT) bipolar (BP) sequence, (b) RT monopolar (MP) sequence, (c) free-breathing (FB) BP sequence, and (d) FB MP sequence. Image quality scores were assessed for all sequences. A biexponential analysis with the Bayesian method yielded true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (PF) in liver parenchyma. Mixed-model analysis of variance was used to compare image quality, SNR, IVIM parameters, and interexamination variability between the four sequences, as well as the ability to differentiate areas of liver fibrosis from normal liver tissue.Image quality with RT sequences was superior to that with FB acquisitions (P = .02) and was not affected by gradient polarity. SNR did not vary significantly between sequences. IVIM parameter reproducibility was moderate to excellent for PF and D, while it was less reproducible for D*. PF and D were both significantly lower in patients with hepatitis C virus than in healthy volunteers with the RT BP sequence (PF = 13.5% ± 5.3 [standard deviation] vs 9.2% ± 2.5, P = .038; D = [1.16 ± 0.07] × 10(-3) mm(2)/sec vs [1.03 ± 0.1] × 10(-3) mm(2)/sec, P = .006).The RT BP DW imaging sequence had the best results in terms of image quality, reproducibility, and ability to discriminate between healthy and fibrotic liver with biexponential fitting.

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) mm(2) /s, MDNAVday1 = 0.9 ± 0.2 × 10(-3) mm(2) /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.

There is ongoing debate whether using a higher spatial resolution (sampling k-space) or a higher angular resolution (sampling q-space angles) is the better way to improve diffusion MRI (dMRI) based tractography results in living humans. In both cases, the limiting factor is the signal-to-noise ratio (SNR), due to the restricted acquisition time. One possible way to increase the spatial resolution without sacrificing either SNR or angular resolution is to move to a higher magnetic field strength. Nevertheless, dMRI has not been the preferred application for ultra-high field strength (7 T). This is because single-shot echo-planar imaging (EPI) has been the method of choice for human in vivo dMRI. EPI faces several challenges related to the use of a high resolution at high field strength, for example, distortions and image blurring. These problems can easily compromise the expected SNR gain with field strength. In the current study, we introduce an adapted EPI sequence in conjunction with a combination of ZOOmed imaging and Partially Parallel Acquisition (ZOOPPA). We demonstrate that the method can produce high quality diffusion-weighted images with high spatial and angular resolution at 7 T. We provide examples of in vivo human dMRI with isotropic resolutions of 1 mm and 800 μm. These data sets are particularly suitable for resolving complex and subtle fiber architectures, including fiber crossings in the white matter, anisotropy in the cortex and fibers entering the cortex.

Anatomical MRI studies at 7T have demonstrated the ability to provide high-quality images of human tissue in vivo. However, diffusion-weighted imaging at 7T is limited by the increased level of artifact associated with standard, single-shot, echo-planar imaging, even when parallel imaging techniques such as generalized autocalibrating partially parallel acquisitions (GRAPPA) are used to reduce the effective echo spacing. Readout-segmented echo-planar imaging in conjunction with parallel imaging has the potential to reduce these artifacts by allowing a further reduction in effective echo spacing during the echo-planar imaging readout. This study demonstrates that this approach does indeed provide a substantial improvement in image quality by reducing image blurring and susceptibility-based distortions, as well as by allowing the acquisition of diffusion-weighted images with a high spatial resolution. A preliminary application of the technique to high-resolution diffusion tensor imaging provided a high level of neuroanatomical detail, which should prove valuable in a wide range of applications. Magn Reson Med 64:9–14, 2010. © 2010 Wiley-Liss, Inc.

Purpose: To evaluate a modified Stejskal-Tanner diffusion gradient pulsing scheme that applies diffusion encoding during the entire time between the 2 requisite radiofrequency pulses, shortening TE. Materials and Methods: Seventeen healthy volunteers and 15 patients with acute and early subacute infarcts were evaluated at 3 T utilizing: a conventional bipolar gradient double spin echo planar imaging diffusion weighted imaging with a parallel imaging factor of 2 (p2) and a modified Stejskal-Tanner short TE (sTE) SE echo planar imaging diffusion weighted imaging with parallel imaging factors of 2, 3, and 4. Signal-to-noise ratio (SNR) and susceptibility-induced spatial distortions were quantified, and a blinded reader ranked scans in terms of susceptibility artifact and overall preference. Results: The sTE sequence allowed a shortening in TE of 18 to 28 milliseconds versus the standard bipolar gradient sequence. SNRs were generally not significantly different among the sTE scans because of compensation by number of scan averages. By using twice the number of averages, the SNR with the bipolar gradient sequence was not significantly different from that of the sTE sequences in patients. sTE scans with higher parallel imaging factors demonstrated less susceptibility-related artifact. The blinded reader ranked the p3 or p4 sTE scans most preferred and the bipolar gradient scans least or tied for least preferred in every case. Conclusions: Utilization of the sTE modified Stejskal-Tanner sequence markedly improves SNR—an increase that may be used with parallel imaging to improve overall scan quality whereas maintaining reasonable scan times and SNR.

Purpose To explore the application of diffusion tensor imaging (DTI) for breast tissue and breast pathologies using a stimulated-echo acquisition mode (STEAM) with variable diffusion times. Materials and Methods In this Health Insurance Portability and Accountability Act-compliant study, approved by the local institutional review board, eight patients and six healthy volunteers underwent an MRI examination at 3 Tesla including STEAM-DTI with several diffusion times ranging from 68.5 to 902.5 ms. A DTI model was fitted to the data for each diffusion time, and parametric maps of mean diffusivity, fractional anisotropy, axial diffusivity, and radial diffusivity were computed for healthy fibroglandular tissue (FGT) and lesions. The median value of radial diffusivity for FGT was fitted to a linear decay to obtain an estimation of the surface-to-volume ratio, from which the radial diameter was calculated. Results For healthy FGT, radial diffusivity presented a linear decay with the square root of the diffusion time resulting in a range of estimated radial diameters from 202 to 496 µm, while axial diffusivity presented a nearly time-independent diffusion. Residual fat signal was reduced at longer diffusion times due to the shorter T1 of fat. Residual fat signal to the overall signal in the healthy volunteers' FGT was found to range from 2.39% to 2.55% (shortest mixing time), and from 0.40% to 0.51% (longest mixing time) for the b500 images. Conclusion The use of variable diffusion times may provide an in vivo noninvasive tool to probe diffusion lengths in breast tissue and breast pathology, and might aid by improving fat suppression at longer diffusion times. Level of Evidence: 2 J. Magn. Reson. Imaging 2017;45:84–93.

To compare image quality of monopolar and bipolar diffusion-weighted imaging (DWI) sequences of the liver at 3T.32 healthy volunteers (mean 27 ± 8 years; 27 M/5F) and 11 patients (mean age 58 ± 14 years; 8 M/3F) underwent liver MRI using a 3T system incorporating 2-channel parallel transmission for B1-shimming and reduced B1-inhomogeneity. Scans included free-breathing DWI sequences (b-value 0, 400, 800 s/mm(2)) acquired using both monopolar and bipolar techniques. Estimated signal-to-noise ratio (eSNR), apparent diffusion coefficient (ADC), and measures of subjective image quality on b-800 images, scored on a 1-5 scale by two independent radiologists, were compared between sequences.Monopolar sequence demonstrated significantly higher eSNR (volunteers: 12.7 ± 4.0 vs. 11.3 ± 3.5, patients: 11.4 ± 4.0 vs. 10.2 ± 3.3; p ≤ 0.013) compared with the bipolar sequence. Monopolar sequence also achieved significantly higher scores for reader 1 in volunteers and patients in terms of clarity of right lobe edge, clarity of intra-hepatic vessels, conspicuity of the left lobe, and overall diagnostic quality (p ≤ 0.031), as well as significantly higher scores for reader 2 in volunteers in terms of clarity of intra-hepatic vessels, conspicuity of the left lobe, and overall diagnostic quality (p ≤ 0.035). Respiratory motion artifact was not significantly different between sequences in patients or volunteers for either reader (p ≥ 0.191). Hepatic ADC was significantly lower using monopolar technique only in volunteers (1.28 ± 0.12 vs. 1.43 ± 0.15, p 0.001).In comparison with past studies performed at 1.5T, when using a modern 3T system, we observed improved image quality of liver DWI using a monopolar, rather than a bipolar, acquisition scheme, largely attributed to higher eSNR.

Diffusion tensor imaging (DTI) provides information about the microstructure in the brain and spinal cord. While new neuroimaging techniques have significantly advanced the accuracy and sensitivity of DTI of the brain, the quality of spinal cord DTI data has improved less. This is in part due to the small size of the spinal cord (ca. 1 cm diameter) and more severe instrumental (e.g. eddy current) and physiological (e.g. cardiac pulsation) artefacts present in spinal cord DTI. So far, the improvements in image quality and resolution have resulted from cardiac gating and new acquisition approaches (e.g. reduced field-of-view techniques). The use of retrospective correction methods is not well established for spinal cord DTI. The aim of this paper is to develop an improved post-processing pipeline tailored for DTI data of the spinal cord with increased quality. For this purpose, we compared two eddy current and motion correction approaches using three-dimensional affine (3D-affine) and slice-wise registrations. We also introduced a new robust-tensor-fitting method that controls for whole-volume outliers. Although in general 3D-affine registration improves data quality, occasionally it can lead to misregistrations and biassed tensor estimates. The proposed robust tensor fitting reduced misregistration-related bias and yielded more reliable tensor estimates. Overall, the combination of slice-wise motion correction, eddy current correction, and robust tensor fitting yielded the best results. It increased the contrast-to-noise ratio (CNR) in FA maps by about 30% and reduced intra-subject variation in fractional anisotropy (FA) maps by 18%. The higher quality of FA maps allows for a better distinction between grey and white matter without increasing scan time and is compatible with any multi-directional DTI acquisition scheme., Graphical abstract Highlights ► Goal: Reliable definition of grey and white matter in spinal cord DTI. ► Un-processed fractional anisotropy (FA) map is blurry and biassed. ► Processed FA is crisp, unbiased, and contrast-to-noise ratio is improved. ► Retrospective processing of data improves spinal cord DTI.

Background In vivo Cardiac Diffusion Tensor Imaging (cDTI) remains extremely challenging due to a mixture of cardiac and respiratory motion. In previous work a prospective navigator technique (NAV) has been implemented and compared to breath-hold (BH) acquisitions. Statistically significant differences were found between BH and NAV techniques for helix-angle (HA) values. Further interrogation of the data suggested that the inconsistent HA patterns were found in NAV data sets in which a small fraction (up to 10%) of the diffusion-weighted frames had signal voids in some part of the LV. The purpose of this work was to improve the robustness of the NAV technique.

Background Myocardial 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 results A 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 Conclusions To 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.

Summary The purpose of this work was to implement prospective navigators to allow free breathing in vivo DTI of the heart to be performed and, thereby, allow the technique to be broadly applied in patients with cardiovascular disease. Background Diffusion tensor MRI (DTI) provides a non-invasive approach for the depiction of the myocardial fibre architecture [1-5]. In vivo DTI remains extremely challenging due to the need for motion correction. Several techniques have been used to compensate for respiratory motion: multiple breath-holds (>36 per patient), synchronised breathing and retrospective navigators based on image cross-correlation [2-5]. The purpose of this work was to implement prospective navigators to allow free breathing in vivo DTI of the heart to be performed and, thereby, allow the technique to be broadly applied in patients with cardiovascular disease.

Background In vivo Cardiac Diffusion Tensor Imaging (cDTI) has great potential to depict the microstructure of the myocardium, with Mean Diffusivity (MD), Fractional Anisotropy (FA), and Helix Angle (HA) maps. Quantitative analysis of these parameters might help disease diagnosis, however HA is particularly difficult to quantify as it varies across the myocardial wall. To overcome this, we developed a method to quantify HA deviation from an average healthy map. This technique, together with quantitative FA and MD analysis, have been applied to healthy volunteer data by varying the number of averages to analyse the improvement of the measurements.

Clinical use of the Stejskal-Tanner diffusion weighted images is hampered by the geometric distortions that result from the large residual 3D eddy current field induced. In this work we aimed to predict, using linear response theory, the residual 3D eddy current field required for geometric distortion correction based on phantom eddy current field measurements. The predicted 3D eddy current field induced by the diffusion-weighting gradients was able to reduce the root mean square error of the residual eddy current field to ~1Hz. The model’s performance was tested on diffusion weighted images of 4 normal volunteers, following distortion correction, the image quality of the Stejskal-Tanner diffusion-weighted images was found to have comparable image quality to image registration based corrections (FSL) at low b-values. Unlike registration techniques the correction was not hindered by low SNR at high b-values, and results in improved image quality relative to FSL. Characterization of the 3D eddy current field with linear response theory enables the prediction of the 3D eddy current field required to correct eddy current induced geometric distortions for a wide range of clinical and high b-value protocols.