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Magnetic resonance-guided focused ultrasound (MRgFUS) ablation of the ventral intermediate (Vim) thalamic nucleus is an incisionless treatment for essential tremor (ET). The standard initial targeting method uses an approximate, atlas-based stereotactic approach. We developed a new patient-specific targeting method to identify an individual's Vim and the optimal MRgFUS target region therein for suppression of tremor. In this retrospective study of 14 ET patients treated with MRgFUS, we investigated the ability of WMnMPRAGE, a highly sensitive and robust sequence for imaging gray matter-white matter contrast, to identify the Vim, FUS ablation, and a clinically efficacious region within the Vim in individual patients. We found that WMnMPRAGE can directly visualize the Vim in ET patients, segmenting this nucleus using manual or automated segmentation capabilities developed by our group. WMnMPRAGE also delineated the ablation's core and penumbra, and showed that all patients' ablation cores lay primarily within their Vim segmentations. We found no significant correlations between standard ablation features (e.g., ablation volume, Vim-ablation overlap) and 1-month post-treatment clinical outcome. We then defined a group-based probabilistic target, which was nonlinearly warped to individual brains; this target was located within the Vim for all patients. The overlaps between this target and patient ablation cores correlated significantly with 1-month clinical outcome (r = -.57, p = .03), in contrast to the standard target (r = -.23, p = .44). We conclude that WMnMPRAGE is a highly sensitive sequence for segmenting Vim and ablation boundaries in individual patients, allowing us to find a novel tremor-associated center within Vim and potentially improving MRgFUS treatment for ET., (© 2020 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.)

A pedagogical review of fluid-attenuated inversion recovery (FLAIR) and double inversion recovery (DIR) imaging is conducted in this article. The basics of the two pulse sequences are first described, including the details of the inversion preparation and imaging sequences with accompanying mathematical formulae for choosing the inversion time in a variety of scenarios for use on clinical MRI scanners. Magnetization preparation (or T2prep), a strategy for improving image signal-to-noise ratio and contrast and reducing T 1 weighting at high field strengths, is also described. Lastly, image artifacts commonly associated with FLAIR and DIR are described with clinical examples, to help avoid misdiagnosis., Level of Evidence: 5 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1590-1600., (© 2017 International Society for Magnetic Resonance in Medicine.)

Purpose: To introduce a respiratory-gated high-spatiotemporal-resolution dynamic-contrast-enhanced MRI technique and a high-temporal-resolution aortic input function (HTR-AIF) estimation method for glomerular filtration rate (GFR) assessment in children., Methods: A high-spatiotemporal-resolution DCE-MRI method with view-shared reconstruction was modified to incorporate respiratory gating, and an AIF estimation method that uses a fraction of the k-space data from each respiratory period was developed (HTR-AIF). The method was validated using realistic digital phantom simulations and demonstrated on clinical subjects. The GFR estimates using HTR-AIF were compared with estimates obtained by using an AIF derived directly from the view-shared images., Results: Digital phantom simulations showed that using the HTR-AIF technique gives more accurate AIF estimates (RMSE = 0.0932) compared with the existing estimation method (RMSE = 0.2059) that used view-sharing (VS). For simulated GFR > 27 mL/min, GFR estimation error was between 32% and 17% using view-shared AIF, whereas estimation error was less than 10% using HTR-AIF. In all clinical subjects, the HTR-AIF method resulted in higher GFR estimations than the view-shared method., Conclusion: The HTR-AIF method improves the accuracy of both the AIF and GFR estimates derived from the respiratory-gated acquisitions, and makes GFR estimation feasible in free-breathing pediatric subjects., (© 2015 Wiley Periodicals, Inc.)

Purpose: To develop and validate clinically a single-shot fast spin echo (SSFSE) sequence utilizing variable flip angle refocusing pulses to shorten acquisition times via reductions in specific absorption rate (SAR) and improve image quality., Materials and Methods: A variable refocusing flip angle SSFSE sequence (vrfSSFSE) was designed and implemented, with simulations and volunteer scans performed to determine suitable flip angle modulation parameters. With Institutional Review Board (IRB) approval/informed consent, patients referred for 3T abdominal magnetic resonance imaging (MRI) were scanned with conventional SSFSE and either half-Fourier (n = 25) or full-Fourier vrfSSFSE (n = 50). Two blinded radiologists semiquantitatively scored images on a scale from -2 to 2 for contrast, noise, sharpness, artifacts, cardiac motion-related signal loss, and the ability to evaluate the pancreas and kidneys., Results: vrfSSFSE demonstrated significantly increased speed (∼2-fold, P < 0.0001). Significant improvements in image quality parameters with full-Fourier vrfSSFSE included increased contrast, sharpness, and visualization of pancreatic and renal structures with higher bandwidth technique (mean scores 0.37, 0.83, 0.62, and 0.31, respectively, P ≤ 0.001), and decreased image noise and improved visualization of renal structures when used with an equal bandwidth technique (mean scores 0.96 and 0.35, respectively, P < 0.001). Increased cardiac motion-related signal loss with full-Fourier vrfSSFSE was seen in the pancreas but not the kidney., Conclusion: vrfSSFSE increases speed at 3T over conventional SSFSE via reduced SAR, and when combined with full-Fourier acquisition can improve image quality, although with some increased sensitivity to cardiac motion-related signal loss., (© 2015 Wiley Periodicals, Inc.)

Purpose: To investigate a new variable spatiotemporal resolution dynamic contrast-enhanced (DCE) MRI method termed DIfferential Subsampling with Cartesian Ordering (DISCO), for imaging of breast cancer., Materials and Methods: DISCO combines variable density, pseudorandom k-space segmentation and two-point Dixon fat-water separation for high spatiotemporal resolution breast DCE MRI. During the contrast wash-in phase, view sharing is used to achieve high temporal resolution. Forty patients referred for breast MRI were imaged, 26 using the proposed DISCO sequence and 14 using a conventional low-spatial-resolution dynamic sequence (VIBRANT-FLEX) on a 3 Tesla scanner. DISCO dynamic images from 14 patients were compared with VIBRANT-FLEX images from 14 other patients. The image quality assessed by radiologist image ranking in a blinded manner, and the temporal characteristics of the two sequences were compared., Results: A spatial resolution of 1.1 × 1.1 × 1.2 mm(3) (160 slices, 28 cm field of view) was achieved with axial bilateral coverage in 120 s. Dynamic images with ∼ 9 s effective temporal resolution were generated during the 2-min contrast wash-in phase. The image quality of DISCO dynamic images ranked significantly higher than low spatial resolution VIBRANT-FLEX images (19.5 versus 9.5, Mann-Whitney U-test P = 0.00914), with no significant differences in the maximum slope of aortic enhancement., Conclusion: DISCO is a promising variable-spatiotemporal-resolution imaging sequence for capturing the dynamics of rapidly enhancing tumors as well as structural features postcontrast. A near 1-mm isotropic spatial resolution was achieved with postcontrast static phase images in 120 s and dynamic phase images acquired in 9 s per phase., (© 2013 Wiley Periodicals, Inc.)

Purpose: To evaluate the performance of 2D versus 3D T2-weighted spin echo imaging in the breast., Materials and Methods: 2D and 3D T2-weighted images were acquired in 25 patients as part of a clinically indicated breast magnetic resonance imaging (MRI) exam. Lesion-to-fibroglandular tissue signal ratio was measured in 16 identified lesions. Clarity of lesion morphology was assessed through a blinded review by three radiologists. Instances demonstrating the potential diagnostic contribution of 3D versus 2D T2-weighted imaging in the breast were noted through unblinded review by a fourth radiologist., Results: The lesion-to-fibroglandular tissue signal ratio was well correlated between 2D and 3D T2-weighted images (R(2)  = 0.93). Clarity of lesion morphology was significantly better with 3D T2-weighted imaging for all observers based on a McNemar test (P ≤ 0.02, P ≤ 0.01, P ≤ 0.03). Instances indicating the potential diagnostic contribution of 3D T2-weighted imaging included improved depiction of signal intensity and improved alignment between DCE and T2-weighted findings., Conclusion: In this pilot study, 3D T2-weighted imaging provided comparable contrast and improved depiction of lesion morphology in the breast in comparison to 2D T2-weighted imaging. Based on these results further investigation to determine the diagnostic impact of 3D T2-weighted imaging in breast MRI is warranted., (Copyright © 2013 Wiley Periodicals, Inc.)

Novel MR image acquisition strategies have been investigated to elicit contrast within the thalamus, but direct visualization of individual thalamic nuclei remains a challenge because of their small size and the low intrinsic contrast between adjacent nuclei. We present a step-by-step specific optimization of the 3D MPRAGE pulse sequence at 7T to visualize the intra-thalamic nuclei. We first measured T1 values within different sub-regions of the thalamus at 7T in 5 individuals. We used these to perform simulations and sequential experimental measurements (n=17) to tune the parameters of the MPRAGE sequence. The optimal set of parameters was used to collect high-quality data in 6 additional volunteers. Delineation of thalamic nuclei was performed twice by one rater and MR-defined nuclei were compared to the classic Morel histological atlas. T1 values within the thalamus ranged from 1400ms to 1800ms for adjacent nuclei. Using these values for theoretical evaluations combined with in vivo measurements, we showed that a short inversion time (TI) close to the white matter null regime (TI=670ms) enhanced the contrast between the thalamus and the surrounding tissues, and best revealed intra-thalamic contrast. At this particular nulling regime, lengthening the time between successive inversion pulses (TS=6000ms) increased the thalamic signal and contrast and lengthening the α pulse train time (N*TR) further increased the thalamic signal. Finally, a low flip angle during the gradient echo acquisition (α=4°) was observed to mitigate the blur induced by the evolution of the magnetization along the α pulse train. This optimized set of parameters enabled the 3D delineation of 15 substructures in all 6 individuals; these substructures corresponded well with the known anatomical structures of the thalamus based on the classic Morel atlas. The mean Euclidean distance between the centers of mass of MR- and Morel atlas-defined nuclei was 2.67mm (±1.02mm). The reproducibility of the MR-defined nuclei was excellent with intraclass correlation coefficient measured at 0.997 and a mean Euclidean distance between corresponding centers of mass found at first versus second readings of 0.69mm (±0.38mm). This 7T strategy paves the way to better identification of thalamic nuclei for neurosurgical planning and investigation of regional changes in neurological disorders., (© 2013.)

The Bloch-Siegert (B-S) B1 (+) mapping technique is a fast, phase-based method that is highly SAR limited especially at 7T, necessitating the use of long repetition times. Spiral and echo-planar readouts were incorporated in a gradient-echo based B-S sequence to reduce specific absoprtion rate (SAR) and improve its scan efficiency. A novel, numerically optimized 4 ms B-S off-resonant pulse at + 1960 Hz was used to increase sensitivity and further reduce SAR compared with the conventional 6 ms Fermi B-S pulse. Using echo-planar and spiral readouts, scan time reductions of 8-16 were achieved. By reducing the B-S pulse width by a factor of 1.5, SAR was reduced by a factor of 1.5 and overall sensitivity was increased by a factor of 1.33 due to the nearly halved resonance offset of the new B-S pulse. This was validated on phantoms and volunteers at 7 T., (Copyright © 2013 Wiley Periodicals, Inc.)

A novel 3D breath-held Dixon fat-water separated balanced steady state free precession (b-SSFP) sequence for MR cholangiopancreatography (MRCP) is described and its potential clinical utility assessed in a series of patients. The main motivation is to develop a robust breath-held alternative to the respiratory gated 3D Fast Spin Echo (FSE) sequence, the current clinical sequence of choice for MRCP. Respiratory gated acquisitions are susceptible to motion artifacts and blurring in patients with significant diaphragmatic drift, erratic respiratory rhythms or sleep apnea. A two point Dixon fat-water separation scheme was developed which eliminates signal loss arising from B0 inhomogeneity effects and minimizes artifacts from perturbation of the b-SSFP steady state. Preliminary results from qualitative analysis of 49 patients demonstrate robust performance of the 3D Dixon b-SSFP sequence with diagnostic image quality acquired in a 20-24s breath-hold., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Purpose: To present a new method that can simultaneously and efficiently measure T1 and B1 (+) maps using reference region variable flip angle (RR-VFA) imaging., Methods: Assuming T1 relaxation time in a reference region such as fat is well characterized, and the reference region sufficiently covers smoothly varying B1 (+) field inhomogeneity, B1 (+) maps can be measured from VFA images, conventionally used for T1 measurements. Fat-only images from two-point Dixon acquisitions were used to compute B1 (+) maps, and the B1 (+) maps were compared with ones using the double-angle method (DAM) in 22 breast MRI patients at 3T. Additionally, high spatial resolution VFA images were acquired to show T1 measurements with and without the RR-VFA B1 (+) correction in six patients., Results: RR-VFA is able to generate reliable B1 (+) maps, similar to those using the conventional DAM. This simultaneous T1 and B1 (+) mapping can also be used to reduce T1 estimation errors, where T1 maps have more uniform fibroglandular tissue T1 and better depiction of heterogeneous T1 of breast masses., Conclusion: A new method that can measure both T1 and B1 (+) maps based on Dixon VFA images is described, offering improved T1 quantification with no scan time penalty., (Copyright © 2013 Wiley Periodicals, Inc.)

Objective: The purpose of this study was to measure and compare the relaxation times of musculoskeletal tissues at 3.0 T and 7.0 T, and to use these measurements to select appropriate parameters for musculoskeletal protocols at 7.0 T., Materials and Methods: We measured the T₁ and T₂ relaxation times of cartilage, muscle, synovial fluid, bone marrow and subcutaneous fat at both 3.0 T and 7.0 T in the knees of five healthy volunteers. The T₁ relaxation times were measured using a spin-echo inversion recovery sequence with six inversion times. The T₂ relaxation times were measured using a spin-echo sequence with seven echo times. The accuracy of both the T₁ and T₂ measurement techniques was verified in phantoms at both magnetic field strengths. We used the measured relaxation times to help design 7.0 T musculoskeletal protocols that preserve the favorable contrast characteristics of our 3.0 T protocols, while achieving significantly higher resolution at higher SNR efficiency., Results: The T₁ relaxation times in all tissues at 7.0 T were consistently higher than those measured at 3.0 T, while the T₂ relaxation times at 7.0 T were consistently lower than those measured at 3.0 T. The measured relaxation times were used to help develop high resolution 7.0 T protocols that had similar fluid-to-cartilage contrast to that of the standard clinical 3.0 T protocols for the following sequences: proton-density-weighted fast spin-echo (FSE), T₂-weighted FSE, and 3D-FSE-Cube., Conclusion: The T₁ and T₂ changes were within the expected ranges. Parameters for musculoskeletal protocols at 7.0 T can be optimized based on these values, yielding improved resolution in musculoskeletal imaging with similar contrast to that of standard 3.0 T clinical protocols., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Purpose: To develop and evaluate a multiphasic contrast-enhanced MRI method called DIfferential Sub-sampling with Cartesian Ordering (DISCO) for abdominal imaging., Materials and Methods: A three-dimensional, variable density pseudo-random k-space segmentation scheme was developed and combined with a Dixon-based fat-water separation algorithm to generate high temporal resolution images with robust fat suppression and without compromise in spatial resolution or coverage. With institutional review board approval and informed consent, 11 consecutive patients referred for abdominal MRI at 3 Tesla (T) were imaged with both DISCO and a routine clinical three-dimensional SPGR-Dixon (LAVA FLEX) sequence. All images were graded by two radiologists using quality of fat suppression, severity of artifacts, and overall image quality as scoring criteria. For assessment of arterial phase capture efficiency, the number of temporal phases with angiographic phase and hepatic arterial phase was recorded., Results: There were no significant differences in quality of fat suppression, artifact severity or overall image quality between DISCO and LAVA FLEX images (P > 0.05, Wilcoxon signed rank test). The angiographic and arterial phases were captured in all 11 patients scanned using the DISCO acquisition (mean number of phases were two and three, respectively)., Conclusion: DISCO effectively captures the fast dynamics of abdominal pathology such as hyperenhancing hepatic lesions with a high spatio-temporal resolution. Typically, 1.1 × 1.5 × 3 mm spatial resolution over 60 slices was achieved with a temporal resolution of 4-5 s., (Copyright © 2012 Wiley Periodicals, Inc.)

Purpose: To evaluate the capability of a new breathhold non-contrast-enhanced MRA method (Non-contrast Outer Radial Inner Square k-space Scheme, NORISKS) to visualize renal arteries by comparing the method with a routine clinical but significantly longer non-contrast-enhanced (non-CE) MRA technique., Materials and Methods: Eighteen subjects referred for abdominal MRI were examined with NORISKS and a routine non-contrast-enhanced MRA technique. Two versions of NORISKS were evaluated: with and without ECG gating. The images were then scored independently and in blinded manner by two radiologists on 5-point scales for visualization of the proximal and distal renal arteries and quality of fat suppression., Results: No statistically significant difference was detected between NORISKS and routine clinical non-CE MRA in all categories except for visualization of the distal renal arteries where ungated NORISKS performed poorer than the routine non-CE MRA (P < 10(-4) )., Conclusion: We have demonstrated a promising non-CE MRA method for acquiring renal angiograms within a breathhold without any compromise in spatial resolution or coverage. ECG-gated NORISKS is able to acquire renal angiograms that are comparable to a routine clinical non-CE MRA method (Inhance IFIR, GE Healthcare), which requires approximately seven times the scan time of NORISKS., (Copyright © 2011 Wiley Periodicals, Inc.)

A three-dimensional balanced steady-state free precession (b-SSFP)-Dixon technique with a novel group-encoded k-space segmentation scheme called GUINNESS (Group-encoded Ungated Inversion Nulling for Non-contrast Enhancement in the Steady State) was developed. GUINNESS was evaluated for breath-held non-contrast-enhanced MR angiography of the renal arteries on 18 subjects (6 healthy volunteers, 12 patients) at 3.0 T. The method provided high signal-to-noise and contrast renal angiograms with homogeneous fat and background suppression in short breath-holds on the order of 20 s with high spatial resolution and coverage. GUINNESS has potential as a short breath-hold alternative to conventional respiratory-gated methods, which are often suboptimal in pediatric subjects and patients with significant diaphragmatic drift/sleep apnea., (Copyright © 2012 Elsevier Inc. All rights reserved.)

In rapid parallel magnetic resonance imaging, the problem of image reconstruction is challenging. Here, a novel image reconstruction technique for data acquired along any general trajectory in neural network framework, called "Composite Reconstruction And Unaliasing using Neural Networks" (CRAUNN), is proposed. CRAUNN is based on the observation that the nature of aliasing remains unchanged whether the undersampled acquisition contains only low frequencies or includes high frequencies too. Here, the transformation needed to reconstruct the alias-free image from the aliased coil images is learnt, using acquisitions consisting of densely sampled low frequencies. Neural networks are made use of as machine learning tools to learn the transformation, in order to obtain the desired alias-free image for actual acquisitions containing sparsely sampled low as well as high frequencies. CRAUNN operates in the image domain and does not require explicit coil sensitivity estimation. It is also independent of the sampling trajectory used, and could be applied to arbitrary trajectories as well. As a pilot trial, the technique is first applied to Cartesian trajectory-sampled data. Experiments performed using radial and spiral trajectories on real and synthetic data, illustrate the performance of the method. The reconstruction errors depend on the acceleration factor as well as the sampling trajectory. It is found that higher acceleration factors can be obtained when radial trajectories are used. Comparisons against existing techniques are presented. CRAUNN has been found to perform on par with the state-of-the-art techniques. Acceleration factors of up to 4, 6 and 4 are achieved in Cartesian, radial and spiral cases, respectively., (Copyright © 2010 Elsevier Inc. All rights reserved.)

A popular dynamic imaging technique, k-t BLAST (ktB) is studied here for fMR imaging. ktB utilizes correlations in k-space and time, to reconstruct the image time series with only a fraction of the data. The algorithm works by unwrapping the aliased Fourier conjugate space of k-t (y-f-space). The unwrapping process utilizes the estimate of the true y-f-space, by acquiring densely sampled low k-space data. The drawbacks of this method include separate training scan, blurred training estimates and aliased phase maps. The proposed changes are incorporation of phase information from the training map and using generalized-series-extrapolated training map. The proposed technique is compared with ktB on real fMRI data. The proposed changes allow for ktB to operate at an acceleration factor of 6. Performance is evaluated by comparing activation maps obtained using reconstructed images. An improvement of up to 10 dB is observed in the PSNR of activation maps. Besides, a 10% reduction in RMSE is obtained over the entire time series of fMRI images. Peak improvement of the proposed method over ktB is 35%, averaged over five data sets., ((c) 2010 Elsevier Inc. All rights reserved.)