Search

Purpose: We propose a quantitative framework for motion-corrected T2 fetal brain measurements in vivo and validate the single-shot fast spin echo (SS-FSE) sequence to perform these measurements., Methods: Stacks of two-dimensional SS-FSE slices are acquired with different echo times (TE) and motion-corrected with slice-to-volume reconstruction (SVR). The quantitative T2 maps are obtained by a fit to a dictionary of simulated signals. The sequence is selected using simulated experiments on a numerical phantom and validated on a physical phantom scanned on a 1.5T system. In vivo quantitative T2 maps are obtained for five fetuses with gestational ages (GA) 21-35 weeks on the same 1.5T system., Results: The simulated experiments suggested that a TE of 400 ms combined with the clinically utilized TEs of 80 and 180 ms were most suitable for T2 measurements in the fetal brain. The validation on the physical phantom confirmed that the SS-FSE T2 measurements match the gold standard multi-echo spin echo measurements. We measured average T2s of around 200 and 280 ms in the fetal brain grey and white matter, respectively. This was slightly higher than fetal T2* and the neonatal T2 obtained from previous studies., Conclusion: The motion-corrected SS-FSE acquisitions with varying TEs offer a promising practical framework for quantitative T2 measurements of the moving fetus., (© 2024 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: This study leverages externally generated Pilot Tone (PT) signals to perform motion-corrected brain MRI for sequences with arbitrary k-space sampling and image contrast., Theory and Methods: PT signals are promising external motion sensors due to their cost-effectiveness, easy workflow, and consistent performance across contrasts and sampling patterns. However, they lack robust calibration pipelines. This work calibrates PT signal to rigid motion parameters acquired during short blocks (˜4 s) of motion calibration (MC) acquisitions, which are short enough to unobstructively fit between acquisitions. MC acquisitions leverage self-navigated trajectories that enable state-of-the-art motion estimation methods for efficient calibration. To capture the range of patient motion occurring throughout the examination, distributed motion calibration (DMC) uses data acquired from MC scans distributed across the entire examination. After calibration, PT is used to retrospectively motion-correct sequences with arbitrary k-space sampling and image contrast. Additionally, a data-driven calibration refinement is proposed to tailor calibration models to individual acquisitions. In vivo experiments involving 12 healthy volunteers tested the DMC protocol's ability to robustly correct subject motion., Results: The proposed calibration pipeline produces pose parameters consistent with reference values, even when distributing only six of these approximately 4-s MC blocks, resulting in a total acquisition time of 22 s. In vivo motion experiments reveal significant ( p < 0.05 $$ p<0.05 $$ ) improved motion correction with increased signal to residual ratio for both MPRAGE and SPACE sequences with standard k-space acquisition, especially when motion is large. Additionally, results highlight the benefits of using a distributed calibration approach., Conclusions: This study presents a framework for performing motion-corrected brain MRI in sequences with arbitrary k-space encoding and contrast, using externally generated PT signals. The DMC protocol is introduced, promoting observation of patient motion occurring throughout the examination and providing a calibration pipeline suitable for clinical deployment. The method's application is demonstrated in standard volumetric MPRAGE and SPACE sequences., (© 2024 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: T1 mapping and T1-weighted contrasts have a complimentary but currently under utilized role in fetal MRI. Emerging clinical low field scanners are ideally suited for fetal T1 mapping. The advantages are lower T1 values which results in higher efficiency and reduced field inhomogeneities resulting in a decreased requirement for specialist tools. In addition the increased bore size associated with low field scanners provides improved patient comfort and accessibility. This study aims to demonstrate the feasibility of fetal brain T1 mapping at 0.55T., Methods: An efficient slice-shuffling inversion-recovery echo-planar imaging (EPI)-based T1-mapping and postprocessing was demonstrated for the fetal brain at 0.55T in a cohort of 38 fetal MRI scans. Robustness analysis was performed and placental measurements were taken for validation., Results: High-quality T1 maps allowing the investigation of subregions in the brain were obtained and significant correlation with gestational age was demonstrated for fetal brain T1 maps ( p < 0 . 05 $$ p<0.05 $$ ) as well as regions-of-interest in the deep gray matter and white matter., Conclusions: Efficient, quantitative T1 mapping in the fetal brain was demonstrated on a clinical 0.55T MRI scanner, providing foundations for both future research and clinical applications including low-field specific T1-weighted acquisitions., (© 2024 The Author(s). Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Introduction: Ultra-high field MR imaging offers marked gains in signal-to-noise ratio, spatial resolution, and contrast which translate to improved pathological and anatomical sensitivity. These benefits are particularly relevant for the neonatal brain which is rapidly developing and sensitive to injury. However, experience of imaging neonates at 7T has been limited due to regulatory, safety, and practical considerations. We aimed to establish a program for safely acquiring high resolution and contrast brain images from neonates on a 7T system., Methods: Images were acquired from 35 neonates on 44 occasions (median age 39 + 6 postmenstrual weeks, range 33 + 4 to 52 + 6; median body weight 2.93 kg, range 1.57 to 5.3 kg) over a median time of 49 mins 30 s. Peripheral body temperature and physiological measures were recorded throughout scanning. Acquired sequences included T2 weighted (TSE), Actual Flip angle Imaging (AFI), functional MRI (BOLD EPI), susceptibility weighted imaging (SWI), and MR spectroscopy (STEAM)., Results: There was no significant difference between temperature before and after scanning ( p = 0.76) and image quality assessment compared favorably to state-of-the-art 3T acquisitions. Anatomical imaging demonstrated excellent sensitivity to structures which are typically hard to visualize at lower field strengths including the hippocampus, cerebellum, and vasculature. Images were also acquired with contrast mechanisms which are enhanced at ultra-high field including susceptibility weighted imaging, functional MRI, and MR spectroscopy., Discussion: We demonstrate safety and feasibility of imaging vulnerable neonates at ultra-high field and highlight the untapped potential for providing important new insights into brain development and pathological processes during this critical phase of early life., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Bridgen, Tomi-Tricot, Uus, Cromb, Quirke, Almalbis, Bonse, De la Fuente Botella, Maggioni, Cio, Cawley, Casella, Dokumaci, Thomson, Willers Moore, Bridglal, Saravia, Finck, Price, Pickles, Cordero-Grande, Egloff, O'Muircheartaigh, Counsell, Giles, Deprez, De Vita, Rutherford, Edwards, Hajnal, Malik and Arichi.)

Background The benefits of using low-field-strength fetal MRI to evaluate antenatal development include reduced image artifacts, increased comfort, larger bore size, and potentially reduced costs, but studies about fetal low-field-strength MRI are lacking. Purpose To evaluate the reliability and feasibility of low-field-strength fetal MRI to assess anatomic and functional measures in pregnant participants using a commercially available 0.55-T MRI scanner and a comprehensive 20-minute protocol. Materials and Methods This prospective study was performed at a large teaching hospital (St Thomas' Hospital; London, England) from May to November 2022 in healthy pregnant participants and participants with pregnancy-related abnormalities using a commercially available 0.55-T MRI scanner. A 20-minute protocol was acquired including anatomic T2-weighted fast-spin-echo, quantitative T2*, and diffusion sequences. Key measures like biparietal diameter, transcerebellar diameter, lung volume, and cervical length were evaluated by two radiologists and an MRI-experienced obstetrician. Functional organ-specific mean values were given. Comparison was performed with existing published values and higher-field MRI using linear regression, interobserver correlation, and Bland-Altman plots. Results A total of 79 fetal MRI examinations were performed (mean gestational age, 29.4 weeks ± 5.5 [SD] [age range, 17.6-39.3 weeks]; maternal age, 34.4 years ± 5.3 [age range, 18.4-45.5 years]) in 47 healthy pregnant participants (control participants) and in 32 participants with pregnancy-related abnormalities. The key anatomic two-dimensional measures for the 47 healthy participants agreed with large cross-sectional 1.5-T and 3-T control studies. The interobserver correlations for the biparietal diameter in the first 40 consecutive scans were 0.96 (95% CI: 0.7, 0.99; P = .002) for abnormalities and 0.93 (95% CI: 0.86, 0.97; P < .001) for control participants. Functional features, including placental and brain T2* and placental apparent diffusion coefficient values, strongly correlated with gestational age (mean placental T2* in the control participants: 5.2 msec of decay per week; R 2 = 0.66; mean T2* at 30 weeks, 176.6 msec; P < .001). Conclusion The 20-minute low-field-strength fetal MRI examination protocol was capable of producing reliable structural and functional measures of the fetus and placenta in pregnancy. Clinical trial registration no. REC 21/LO/0742 © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Gowland in this issue.

Purpose: The MP2RAGE sequence is typically optimized for either T 1 -weighted uniform image (UNI) or gray matter-dominant fluid and white matter suppression (FLAWS) contrast images. Here, the purpose was to optimize an MP2RAGE protocol at 7 Tesla to provide UNI and FLAWS images simultaneously in a clinically applicable acquisition time at <0.7 mm isotropic resolution., Methods: Using the extended phase graph formalism, the signal evolution of the MP2RAGE sequence was simulated incorporating T 2 relaxation, diffusion, RF spoiling, and B 1 + variability. Flip angles and TI were optimized at different TRs (TR MP2RAGE ) to produce an optimal contrast-to-noise ratio for UNI and FLAWS images. Simulation results were validated by comparison to MP2RAGE brain scans of 5 healthy subjects, and a final protocol at TR MP2RAGE  = 4000 ms was applied in 19 subjects aged 8-62 years with and without epilepsy., Results: FLAWS contrast images could be obtained while maintaining >85% of the optimal UNI contrast-to-noise ratio. Using TI 1 /TI 2 /TR MP2RAGE of 650/2280/4000 ms, 6/8 partial Fourier in the inner phase-encoding direction, and GRAPPA factor = 4 in the other, images with 0.65 mm isotropic resolution were produced in <7.5 min. The contrast-to-noise ratio was around 20% smaller at TR MP2RAGE  = 4000 ms compared to that at TR MP2RAGE  = 5000 ms; however, the 20% shorter duration makes TR MP2RAGE  = 4000 ms a good candidate for clinical applications example, pediatrics., Conclusion: FLAWS and UNI images could be obtained in a single scan with 0.65 mm isotropic resolution, providing a set of high-contrast images and full brain coverage in a clinically applicable scan time. Images with excellent anatomical detail were demonstrated over a wide age range using the optimized parameter set., (© 2022 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: Universal Pulses (UPs) are excitation pulses that reduce the flip angle inhomogeneity in high field MRI systems without subject-specific optimization, originally developed for parallel transmit (PTX) systems at 7 T. We investigated the potential benefits of UPs for single channel (SC) transmit systems at 3 T, which are widely used for clinical and research imaging, and for which flip angle inhomogeneity can still be problematic., Methods: SC-UPs were designed using a spiral nonselective k-space trajectory for brain imaging at 3 T using transmit field maps (B 1 + ) and off-resonance maps (B 0 ) acquired on two different scanner types: a 'standard' single channel transmit system and a system with a PTX body coil. The effect of training group size was investigated using data (200 subjects) from the standard system. The PTX system was used to compare SC-UPs to PTX-UPs (15 subjects). In two additional subjects, prospective imaging using SC-UP was studied., Results: Average flip angle homogeneity error fell from 9.5 ± 0.5 % for 'default' excitation to 3.0 ± 0.6 % using SC-UPs trained over 50 subjects. Performance of the UPs was found to steadily improve as training group size increased, but stabilized after ~15 subjects. On the PTX-enabled system, SC-UPs again outperformed default excitation in simulations (4.8 ± 0.6 % error versus 10.6 ± 0.8 % respectively) though greater homogenization could be achieved with PTX-UPs (3.9 ± 0.6 %) and personalized pulses (SC-PP 3.6 ± 1.0 %, PTX-PP 2.9 ± 0.6 %). MP-RAGE imaging using SC-UP resulted in greater separation between grey and white matter signal intensities than default excitation., Conclusions: SC-UPs can improve excitation homogeneity in standard 3 T systems without further calibration and could be used instead of a default excitation pulse for nonselective neuroimaging at 3 T., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: Neonatal brain and cardiac imaging would benefit from the increased signal-to-noise ratio levels at 7 T compared to lower field. Optimal performance might be achieved using purpose designed RF coil arrays. In this study, we introduce an 8-channel dipole array and investigate, using simulations, its RF performances for neonatal applications at 7 T., Methods: The 8-channel dipole array was designed and evaluated for neonatal brain/cardiac configurations in terms of SAR efficiency (ratio between transmit-field and maximum specific-absorption-rate level) using adjusted dielectric properties for neonate. A birdcage coil operating in circularly polarized mode was simulated for comparison. Validation of the simulation model was performed on phantom for the coil array., Results: The 8-channel dipole array demonstrated up to 46% higher SAR efficiency levels compared to the birdcage coil in neonatal configurations, as the specific-absorption-rate levels were alleviated. An averaged normalized root-mean-square-error of 6.7% was found between measured and simulated transmit field maps on phantom., Conclusion: The 8-channel dipole array design integrated for neonatal brain and cardiac MR was successfully demonstrated, in simulation with coverage of the baby and increased SAR efficiency levels compared to the birdcage. We conclude that the 8Tx-dipole array promises safe operating procedures for MR imaging of neonatal brain and heart at 7 T., (© 2022. The Author(s).)

Purpose: To develop a fully data-driven retrospective intrascan motion-correction framework for volumetric brain MRI at ultrahigh field (7 Tesla) that includes modeling of pose-dependent changes in polarizing magnetic (B 0 ) fields., Theory and Methods: Tissue susceptibility induces spatially varying B 0 distributions in the head, which change with pose. A physics-inspired B 0 model has been deployed to model the B 0 variations in the head and was validated in vivo. This model is integrated into a forward parallel imaging model for imaging in the presence of motion. Our proposal minimizes the number of added parameters, enabling the developed framework to estimate dynamic B 0 variations from appropriately acquired data without requiring navigators. The effect on data-driven motion correction is validated in simulations and in vivo., Results: The applicability of the physics-inspired B 0 model was confirmed in vivo. Simulations show the need to include the pose-dependent B 0 fields in the reconstruction to improve motion-correction performance and the feasibility of estimating B 0 evolution from the acquired data. The proposed motion and B 0 correction showed improved image quality for strongly corrupted data at 7 Tesla in simulations and in vivo., Conclusion: We have developed a motion-correction framework that accounts for and estimates pose-dependent B 0 fields. The method improves current state-of-the-art data-driven motion-correction techniques when B 0 dependencies cannot be neglected. The use of a compact physics-inspired B 0 model together with leveraging the parallel imaging encoding redundancy and previously proposed optimized sampling patterns enables a purely data-driven approach., (© 2022 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: This work proposes a novel RF pulse design for parallel transmit (pTx) systems to obtain uniform saturation of semisolid magnetization for magnetization transfer (MT) contrast in the presence of transmit field B 1 + inhomogeneities. The semisolid magnetization is usually modeled as being purely longitudinal, with the applied B 1 + field saturating but not rotating its magnetization; thus, standard pTx pulse design methods do not apply., Theory and Methods: Pulse design for saturation homogeneity (PUSH) optimizes pTx RF pulses by considering uniformity of root-mean squared B 1 + , B 1 rms , which relates to the rate of semisolid saturation. Here we considered designs consisting of a small number of spatially non-selective sub-pulses optimized over either a single 2D plane or 3D. Simulations and in vivo experiments on a 7T Terra system with an 8-TX Nova head coil in five subjects were carried out to study the homogenization of B 1 rms and of the MT contrast by acquiring MT ratio maps., Results: Simulations and in vivo experiments showed up to six and two times more uniform B 1 rms compared to circular polarized (CP) mode for 2D and 3D optimizations, respectively. This translated into 4 and 1.25 times more uniform MT contrast, consistently for all subjects, where two sub-pulses were enough for the implementation and coil used., Conclusion: The proposed PUSH method obtains more uniform and higher MT contrast than CP mode within the same specific absorption rate (SAR) budget., (© 2022 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: Magnetization transfer (MT) and inhomogeneous MT (ihMT) contrasts are used in MRI to provide information about macromolecular tissue content. In particular, MT is sensitive to macromolecules, and ihMT appears to be specific to myelinated tissue. This study proposes a technique to characterize MT and ihMT properties from a single acquisition, producing both semiquantitative contrast ratios and quantitative parameter maps., Theory and Methods: Building on previous work that uses multiband RF pulses to efficiently generate ihMT contrast, we propose a cyclic steady-state approach that cycles between multiband and single-band pulses to boost the achieved contrast. Resultant time-variable signals are reminiscent of an MR fingerprinting acquisition, except that the signal fluctuations are entirely mediated by MT effects. A dictionary-based low-rank inversion method is used to reconstruct the resulting images and to produce both semiquantitative MT ratio and ihMT ratio maps, as well as quantitative parameter estimates corresponding to an ihMT tissue model., Results: Phantom and in vivo brain data acquired at 1.5 Tesla demonstrate the expected contrast trends, with ihMT ratio maps showing contrast more specific to white matter, as has been reported by others. Quantitative estimation of semisolid fraction and dipolar T 1 was also possible and yielded measurements consistent with literature values in the brain., Conclusion: By cycling between multiband and single-band pulses, an entirely MT-mediated fingerprinting method was demonstrated. This proof-of-concept approach can be used to generate semiquantitative maps and quantitatively estimate some macromolecular-specific tissue parameters., (© 2021 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: We present in vivo testing of a parallel transmit system intended for interventional MR-guided cardiac procedures., Methods: The parallel transmit system was connected in-line with a conventional 1.5 Tesla MRI system to transmit and receive on an 8-coil array. The system used a current sensor for real-time feedback to achieve real-time current control by determining coupling and null modes. Experiments were conducted on 4 Charmoise sheep weighing 33.9-45.0 kg with nitinol guidewires placed under X-ray fluoroscopy in the atrium or ventricle of the heart via the femoral vein. Heating tests were done in vivo and post-mortem with a high RF power imaging sequence using the coupling mode. Anatomical imaging was done using a combination of null modes optimized to produce a useable B 1 field in the heart., Results: Anatomical imaging produced cine images of the heart comparable in quality to imaging with the quad mode (all channels with the same amplitude and phase). Maximum observed temperature increases occurred when insulation was stripped from the wire tip. These were 4.1℃ and 0.4℃ for the coupling mode and null modes, respectively for the in vivo case; increasing to 6.0℃ and 1.3℃, respectively for the ex vivo case, because cooling from blood flow is removed. Heating < 0.1℃ was observed when insulation was not stripped from guidewire tips. In all tests, the parallel transmit system managed to reduce the temperature at the guidewire tip., Conclusion: We have demonstrated the first in vivo usage of an auxiliary parallel transmit system employing active feedback-based current control for interventional MRI with a conventional MRI scanner., (© 2021 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: To investigate safe limits for neonatal imaging using a 7T head coil, including both specific absorption rate (SAR) and temperature predictions., Methods: Head-centered neonate models were simulated using finite-difference time domain-based electromagnetic and thermal solvers. The effects of higher water content of neonatal tissues compared with adults, position shifts, and thermal insulation were also considered. An adult model was simulated for comparison., Results: Maximum and average SAR are both elevated in the neonate when compared with an adult model. When normalized to B 1 + , the SAR experienced by a neonate is greater than an adult by approximately a factor of 2; when normalized to net forward power (forward-reflected), this increases to a factor of 2.5-3.0; and when normalized to absorbed power, approximately a factor of 4. Use of age-adjusted dielectric properties significantly increases the predicted SAR, compared with using adult tissue properties for the neonates. Thermal simulations predict that change in core temperature/maximum temperature remain compliant with International Electrotechnical Commission limits when a thermally insulated neonate is exposed at the SAR limit for up to an hour., Conclusion: This study of two neonate models cannot quantify the variability expected within a larger population. Likewise, the use of age-adjusted dielectric properties have a significant effect, but while their use is well motivated by literature, there is uncertainty in the true dielectric properties of neonatal tissue. Nevertheless, the main finding is that unlike at lower field strengths, operational limits for 7T neonatal MRI using an adult head coil should be more conservative than limits for use on adults., (© 2021 International Society for Magnetic Resonance in Medicine.)

This study presents a comparison of quantitative MRI methods based on an efficiency metric that quantifies their intrinsic ability to extract information about tissue parameters. Under a regime of unbiased parameter estimates, an intrinsic efficiency metricηwas derived for fully-sampled experiments which can be used to both optimize and compare sequences. Here we optimize and compare several steady-state and transient gradient-echo based qMRI methods, such as magnetic resonance fingerprinting (MRF), for jointT1andT2mapping. The impact of undersampling was also evaluated, assuming incoherent aliasing that is treated as noise by parameter estimation. In vivo validation of the efficiency metric was also performed. Transient methods such as MRF can be up to 3.5 times more efficient than steady-state methods, when spatial undersampling is ignored. If incoherent aliasing is treated as noise during least-squares parameter estimation, the efficiency is reduced in proportion to the SNR of the data, with reduction factors of 5 often seen for practical SNR levels. In vivo validation showed a very good agreement between the theoretical and experimentally predicted efficiency. This work presents and validates an efficiency metric to optimize and compare the performance of qMRI methods. Transient methods were found to be intrinsically more efficient than steady-state methods, however the effect of spatial undersampling can significantly erode this advantage., (Creative Commons Attribution license.)

Purpose: A framework to design radiofrequency (RF) pulses specifically to minimize the TR of gradient echo sequences is presented, subject to hardware and physiological constraints., Methods: Single-band and multiband (MB) RF pulses can be reduced in duration using variable-rate selective excitation (VERSE) VERSE for a range of flip angles; however, minimum-duration pulses do not guarantee minimum TR because these can lead to a high specific absorption rate (SAR). The optimal RF pulse is found by meeting spatial encoding, peripheral nerve stimulation (PNS) and SAR constraints. A TR reduction for a range of designs is achieved and an application of this in an MB cardiac balanced steady-state free-precession (bSSFP) experiment is presented. Gradient imperfections and their imaging effects are also considered., Results: Sequence TR with low-time bandwidth product (TBP) pulses, as used in bSSFP, was reduced up to 14%, and the TR when using high TBP pulses, as used in slab-selective imaging, was reduced by up to 72%. A breath-hold cardiac exam was reduced by 46% using both MB and the TR-optimal framework. The importance of RF-based correction of gradient imperfections is demonstrated. PNS was not a practical limitation., Conclusion: The TR-optimal framework designs RF pulses for a range of pulse parameters, specifically to minimize sequence TR., (© 2021 International Society for Magnetic Resonance in Medicine.)

Purpose: To develop a novel gadolinium-free model-based quantitative magnetization transfer (qMT) technique to assess macromolecular changes associated with myocardial fibrosis., Methods: The proposed sequence consists of a two-dimensional breath-held dual shot interleaved acquisition of five MT-weighted (MTw) spoiled gradient echo images, with variable MT flip angles (FAs) and off-resonance frequencies. A two-pool exchange model and dictionary matching were used to quantify the pool size ratio (PSR) and bound pool T2 relaxation ( T 2 B ). The signal model was developed and validated using 25 MTw images on a bovine serum albumin (BSA) phantom and in vivo human thigh muscle. A protocol with five MTw images was optimized for single breath-hold cardiac qMT imaging. The proposed sequence was tested in 10 healthy subjects and 5 patients with myocardial fibrosis and compared to late gadolinium enhancement (LGE)., Results: PSR values in the BSA phantom were within the confidence interval of previously reported values (concentration 10% BSA = 5.9 ± 0.1%, 15% BSA = 9.4 ± 0.2%). PSR and T 2 B in thigh muscle were also in agreement with literature (PSR = 10.9 ± 0.3%, T 2 B = 6.4 ± 0.4 us). In 10 healthy subjects, global left ventricular PSR was 4.30 ± 0.65%. In patients, PSR was reduced in areas associated with LGE (remote: 4.68 ± 0.70% vs. fibrotic: 3.12 ± 0.78 %, n = 5, P < .002)., Conclusion: In vivo model-based qMT mapping of the heart was performed for the first time, with promising results for non-contrast enhanced assessment of myocardial fibrosis., (© 2020 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

Objective An inguinal hernia is a common condition associated with advanced age, male gender, smoking, connective tissue disorder, and factors responsible for increased intra-abdominal pressure. This study aimed to observe the relationship of body mass index with the development of inguinal hernia in males and females. Methodology This cross-sectional descriptive study using a non-probability convenient sampling technique was carried out at Al-Tibri medical college and hospital, Karachi, Pakistan. A total of 82 patients were selected: 78 males and four females. The ethical approval for the study was taken from Institutional Research and Ethical Committee. Inclusion criteria based on the patient age above 40 of either gender with complaints of pain in the groin region with clinical findings like swelling and tenderness. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM Inc., Armonk, USA). Results The mean age of 82 patients diagnosed with an inguinal hernia on a clinical basis was 47.41 ± 15.49 years. The mean height was 67.09 ± 3.95 inches. The mean weight was 63.5 ± 6.77 kg. The mean BMI was 22.07 ± 2.17 kg/m 2 . Seventy-eight (96.06%) were males, and four (5.9%) were females. Thirty-four (41.5%) patients were diagnosed with right inguinal hernia, 34 (41.5%) - with a left inguinal hernia, and 14 (17.1%) - with a bilateral inguinal hernia. BMI was normal in 68 (86.3%) and low in 14 (20.55%) patients. Our study indicated that patients with normal BMI were more likely to suffer from inguinal hernia than patients with low BMI. Conclusion This study concluded that the normal body mass index was associated with a high occurrence of inguinal hernia among the genders. The normal body mass index in males exhibits more inguinal hernia chances than a low body mass index. It was observed that the frequency of unilateral right inguinal hernia is higher than bilateral. Similarly, males are more affected than females., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Melwani et al.)

Prenatal detection of congenital heart disease facilitates the opportunity for potentially life-saving care immediately after the baby is born. Echocardiography is routinely used for screening of morphological malformations, but functional measurements of blood flow are scarcely used in fetal echocardiography due to technical assumptions and issues of reliability. Magnetic resonance imaging (MRI) is readily used for quantification of abnormal blood flow in adult hearts, however, existing in utero approaches are compromised by spontaneous fetal motion. Here, we present and validate a novel method of MRI velocity-encoding combined with a motion-robust reconstruction framework for four-dimensional visualization and quantification of blood flow in the human fetal heart and major vessels. We demonstrate simultaneous 4D visualization of the anatomy and circulation, which we use to quantify flow rates through various major vessels. The framework introduced here could enable new clinical opportunities for assessment of the fetal cardiovascular system in both health and disease.

Purpose: To demonstrate that quantitative magnetization transfer (qMT) parameters can be extracted from steady-state free-precession (SSFP) data with no external T 1 map or banding artifacts., Methods: SSFP images with multiple MT weightings were acquired and qMT parameters fitted with a two-stage elliptical signal model., Results: Monte Carlo simulations and data from a 3T scanner indicated that most qMT parameters could be recovered with reasonable accuracy. Systematic deviations from theory were observed in white matter, consistent with previous literature on frequency distribution effects., Conclusions: qMT parameters can be extracted from SSFP data alone, in a manner robust to banding artifacts, despite several confounds., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Objective The aim of this study is to determine the frequency and risk factors for hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus (Anti-HCV) in a preoperative screening of patients admitted at the surgical unit of Al-Tibri Medical College and Hospital and Lyari General Hospital, Karachi. Materials and methods This study was conducted at the surgical units of Al-Tibri Medical College Hospital and Lyari General Hospital, Karachi. This study was conducted for six months from 30th June 2017 to 31st December 2017. This observational study was performed using a non-probability convenient sampling technique. All patients who were undergoing elective and emergency surgical procedure were selected for the study and screened for HBsAg and anti-HCV by immunochromatographic test (ICT) method at the hospital laboratory. The risk factors identified as parenteral injections, past surgical procedure, blood transfusion, etc. along with demographic data as age, gender, and district residential status were recorded on a specially designed proforma. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Descriptive statistics were applied, and the qualitative data were expressed as the mean and standard deviation. Results Among a total of 360 patients included in the study, 63 (21.38%) were found with anti-HCV positive, and 14 (3.88%) were HBsAg positive with none of the patients found to have co-infection. The male-to-female ratio was 2.3:1. The mean age of patients was 32.34±4.3 years. The age range affected commonly in the study population was 21-30 years, 24(31%). The commonest risk factor for transmission of viral infection was parenteral injection abuser 31(40.2%), followed by surgical procedure 13(18.1%), blood transfusion 10(12.9%), and barber shave 7(9.1%). Conclusion It was predicted in our study that hepatitis C was more common in patients screened preoperatively for surgery. However, the most frequent risk factor in these patients was parenteral abuse history. The preoperative screening is an important investigative tool for the identification of silent cases in the community for preventive measures adoption and treatment for silent carriers., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Malik et al.)

Purpose: The widespread clinical application of quantitative MRI has been hindered by a lack of reproducibility across sites and vendors. Previous work has attributed this to incorrect B 1 mapping or insufficient spoiling conditions. We recently proposed the controlled saturation magnetization transfer (CSMT) framework and hypothesized that the lack of reproducibility can also be attributed to magnetization transfer effects. This work seeks to validate this hypothesis and demonstrate that reproducible multivendor single-pool relaxometry can be achieved with the CSMT approach., Methods: Three healthy volunteers were scanned on scanners from 3 vendors (GE Healthcare, Philips, Siemens). An extensive set of images necessary for joint T 1 and T 2 estimation were acquired with (1) each vendor default RF pulses and spoiling conditions; (2) harmonized RF spoiling; and (3) harmonized RF spoiling and CSMT pulses. Different subsets of images were used to generate 6 different T 1 and T 2 maps for each subject's data from each vendor. Cross-protocol, cross-vendor, and test/retest variability were estimated., Results: Harmonized RF spoiling conditions are insufficient to ensure good cross-vendor reproducibility. Controlled saturation magnetization transfer allows cross-protocol variability to be reduced from 18.3% to 4.0%. Whole-brain variability using the same protocol was reduced from a maximum of 19% to 4.5% across sites. Both CSMT and native vendor RF conditions have a reported variability of less than 5% for repeat measures on the same vendor., Conclusion: Magnetization transfer effects are a major contributor to intersite/intrasite variability of T 1 and T 2 estimation. Controlled saturation magnetization transfer stabilizes these effects, paving the way for the use of single-pool T 1 and T 2 as a reliable source for clinical diagnosis across sites., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: MRI-guided cardiovascular intervention using standard metal guidewires can produce focal tissue heating caused by induced radiofrequency guidewire currents. It has been shown that safe operation is made possible by using parallel transmit radiofrequency coils driven in the null current mode, which does not induce radiofrequency currents and hence allows safe tissue visualization. We propose that the maximum current modes, usually considered unsafe, be used at very low power levels to visualize conductive wires, and we investigate pulse sequences best suited for this application., Methods: Spoiled gradient echo, balanced steady-state free precession, and turbo spin echo sequences were evaluated for their ability to visualize a conductive guidewire embedded in a gel phantom when run in maximum current modes at very low power level. Temperature at the guidewire tip was monitored for safety assessment., Results: Excellent guidewire visualization could be achieved using maximum current modes excitation, with the turbo spin echo sequence giving the best image quality. Although turbo spin echo is usually considered to be a high-power sequence, our method reduced all pulses to 1% amplitude (0.01% power), and heating was not detected. In addition, visualization of background tissue can be achieved using null current mode, also with no recorded heating at the guidewire tip even when running at 100% (reported) specific absorption rate., Conclusion: Parallel transmit is a promising approach for both guidewire and tissue visualization using maximum and null current modes, respectively, for interventional cardiac MRI. Such systems can switch excitation mode instantaneously, allowing for flexible integration into interactive sequences., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: In this work, we explore the use of multiband (MB) balanced steady-state free precession (bSSFP) with blipped-controlled aliasing in parallel imaging (CAIPI), which avoids the issues of altered frequency response associated with RF phase cycling, and show its application to accelerating cardiac cine imaging., Methods: Blipped and RF-cycled CAIPI were implemented into a retrospective-gated segmented cine multiband bSSFP sequence. The 2 methods were compared at 3T using MB2 to demonstrate the effect on frequency response. Further data (4 subjects) were acquired at both 1.5T and 3T collecting 12-slice short axis stacks using blipped-CAIPI with MB acceleration factors of 1-4. The impact on SNR and contrast was evaluated along with g-factors at different accelerations., Results: Data acquired with blipped-CAIPI multiband bSSFP up to factor 4 yielded functional cine data with good SNR and contrast, while reliably keeping dark-band artefacts clear of the heart at 1.5T. SAR limits the maximum MB acceleration, particularly at 3T, where minimum TR increase is problematic and leakage artefacts are more prevalent. Mean g-factors across the heart were measured at 1.00, 1.06, and 1.12 for MB2-MB4, whereas blood-pool SNR measures (end-diastole) decreased by 11.8, 21.5, and 36.9%; ultimately LV-myocardium CNR remained sufficient at 1.5T with values ranging: 15.6, 13.4, 11.9, and 9.6 (MB1-MB4)., Conclusion: Blipped-CAIPI multiband bSSFP can be used in cardiovascular applications without affecting the frequency response because of controlled aliasing and can be readily incorporated into segmented cine acquisitions without adding any additional constraints because of phase cycling requirements. The method was used to collect full ventricular coverage within a single breath-hold., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: Inhomogeneous magnetization transfer (ihMT) is an emerging form of MRI contrast that may offer high specificity for myelinated tissue. Existing ihMT and pulsed MT sequences often use separate radiofrequency pulses for saturation and signal excitation. This study investigates the use of nonselective multiband radiofrequency pulses for simultaneous off-resonance saturation and on-resonance excitation specifically for generation of ihMT contrast within rapid steady-state pulse sequences., Theory and Methods: A matrix-based signal modeling approach was developed and applied for both balanced steady state free precession and spoiled gradient echo sequences, accounting specifically for multiband pulses. Phantom experiments were performed using a combination of balanced steady state free precession and spoiled gradient echo sequences, and compared with model fits. A human brain imaging exam was performed using balanced steady state free precession sequences to demonstrate the achieved contrast., Results: A simple signal model derived assuming instantaneous radiofrequency pulses was shown to agree well with full integration of the governing equations and provided fits to phantom data for materials with strong ihMT contrast (PL161 root mean square error = 0.9%, and hair conditioner root mean square error = 2.4%). In vivo ihMT ratio images showed the expected white matter contrast that has been seen by other ihMT investigations, and the observed ihMT ratios corresponded well with predictions., Conclusions: ihMT contrast can be generated by integrating multiband radiofrequency pulses directly into both spoiled gradient echo and balanced steady state free precession sequences, and the presented signal modeling approach can be used to understand the acquired signals., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: This study incorporates a gradient system imperfection model into an optimal control framework for radio frequency (RF) pulse design., Theory and Methods: The joint design of minimum-time RF and slice selective gradient shapes is posed as an optimal control problem. Hardware limitations such as maximal amplitudes for RF and slice selective gradient or its slew rate are included as hard constraints to assure practical applicability of the optimized waveforms. In order to guarantee the performance of the optimized waveform with possible gradient system disturbances such as limited system bandwidth and eddy currents, a measured gradient impulse response function (GIRF) for a specific system is integrated into the optimization., Results: The method generates optimized RF and pre-distorted slice selective gradient shapes for refocusing that are able to fully compensate the modeled imperfections of the gradient system under investigation. The results nearly regenerate the optimal results of an idealized gradient system. The numerical Bloch simulations are validated by phantom and in-vivo experiments on 2 3T scanners., Conclusions: The presented design approach demonstrates the successful correction of gradient system imperfections within an optimal control framework for RF pulse design., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Objective: To produce a strategic roadmap for supporting the development of dementia research in Pakistan., Background: While global research strategies for dementia research already exist, none is tailored to the specific needs and challenges of low- and middle-income countries (LMIC) like Pakistan., Methods: We undertook an iterative consensus process with lay and professional experts to develop a Theory of Change-based strategy for dementia research in Pakistan. This included Expert Reference Groups (ERGs), strategic planning techniques, a "research question" priority survey, and consultations with Key Opinion Leaders., Results: We agreed on ten principles to guide dementia research in Pakistan, emphasizing pragmatic, resource sparing, real-world approaches to support people with dementia, both locally and internationally. Goals included capacity/capability building. Priority research topics included raising awareness and understanding of dementia, and improving quality of life., Conclusion: This roadmap may be a model for other LMIC health ecosystems with emerging dementia research cultures., (© 2019 The Authors.)

Purpose: Quantitative MRI applications, such as mapping the T 1 time of tissue, puts high demands on the accuracy and precision of transmit field ( B 1 + ) estimation. A candidate approach to satisfy these requirements exploits the difference in phase induced by the Bloch-Siegert frequency shift (BSS) of 2 acquisitions with opposite off-resonance frequency radiofrequency pulses. Interleaving these radiofrequency pulses ensures robustness to motion and scanner drifts; however, here we demonstrate that doing so also introduces a bias in the B 1 + estimates., Theory and Methods: It is shown here by means of simulation and experiments that the amplitude of the error depends on MR pulse sequence parameters, such as repetition time and radiofrequency spoiling increment, but more problematically, on the intrinsic properties, T 1 and T 2 , of the investigated tissue. To solve these problems, a new approach to BSS-based B 1 + estimation that uses a multi-echo acquisition and a general linear model to estimate the correct BSS-induced phase is presented., Results: In line with simulations, phantom and in vivo experiments confirmed that the general linear model-based method removed the dependency on tissue properties and pulse sequence settings., Conclusion: The general linear model-based method is recommended as a more accurate approach to BSS-based B 1 + mapping., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: To investigate the potential of continuous radiofrequency (RF) shifting (SWEEP) as a technique for creating densely sampled data while maintaining a stable signal state for dynamic imaging., Methods: We present a method where a continuous stable state of magnetization is swept smoothly across the anatomy of interest, creating an efficient approach to dense multiple 2D slice imaging. This is achieved by introducing a linear frequency offset to successive RF pulses shifting the excited slice by a fraction of the slice thickness with each successive repeat times (TR). Simulations and in vivo imaging were performed to assess how this affects the measured signal. Free breathing, respiration resolved 4D volumes in fetal/placental imaging is explored as potential application of this method., Results: The SWEEP method maintained a stable signal state over a full acquisition reducing artifacts from unstable magnetization. Simulations demonstrated that the effects of SWEEP on slice profiles was of the same order as that produced by physiological motion observed with conventional methods. Respiration resolved 4D data acquired with this method shows reduced respiration artifacts and resilience to non-rigid and non-cyclic motion., Conclusions: The SWEEP method is presented as a technique for improved acquisition efficiency of densely sampled short-TR 2D sequences. Using conventional slice excitation the number of RF pulses required to enter a true steady state is excessively high when using short-TR 2D acquisitions, SWEEP circumvents this limitation by creating a stable signal state that is preserved between slices., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: To develop an MRI acquisition and reconstruction framework for volumetric cine visualization of the fetal heart and great vessels in the presence of maternal and fetal motion., Methods: Four-dimensional (4D) depiction was achieved using a highly-accelerated multi-planar real-time balanced steady-state free precession acquisition combined with retrospective image-domain techniques for motion correction, cardiac synchronization and outlier rejection. The framework was validated using a numerical phantom and evaluated in a study of 20 mid- to late-gestational age human fetal subjects (23-33 weeks gestational age). Reconstructed MR data were compared with matched ultrasound. A preliminary assessment of flow-sensitive reconstruction using the velocity information encoded in the phase of real-time images is included., Results: Reconstructed 4D data could be visualized in any two-dimensional plane without the need for highly specific scan plane prescription prior to acquisition or for maternal breath hold to minimize motion. Reconstruction was fully automated aside from user-specified masks of the fetal heart and chest. The framework proved robust when applied to fetal data and simulations confirmed that spatial and temporal features could be reliably recovered. Evaluation suggested the reconstructed framework has the potential to be used for comprehensive assessment of the fetal heart, either as an adjunct to ultrasound or in combination with other MRI techniques., Conclusions: The proposed methods show promise as a framework for motion-compensated 4D assessment of the fetal heart and great vessels., (© 2019 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Multicomponent driven equilibrium steady-state observation of T 1 and T 2 (mcDESPOT) aims to quantify the Myelin Water Fraction (MWF) using a two-pool microstructural model. The MWF has been used to track neurodevelopment and neurodegeneration and has been histologically correlated to myelin content. mcDESPOT has a clinically feasible acquisition time and high signal-to-noise ratio (SNR) relative to other MWF techniques. However, disagreement exists in the literature between experimental studies that show MWF maps with plausible grey matter-white matter (GM-WM) contrast and theoretical work that questions the accuracy and precision of mcDESPOT. We demonstrate that mcDESPOT parameter estimation is inaccurate and imprecise if intercompartmental exchange is included in the microstructural model, but that significant bias results if exchange is neglected. The source of apparent MWF contrast is likely due to the complex convergence behaviour of the Stochastic Region Contraction (SRC) method commonly used to fit the mcDESPOT model. mcDESPOT-derived parameter estimates are hence not directly relatable to the underlying microstructural model and are only comparable to others using similar acquisition schemes and fitting constraints., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: This study demonstrates magnetization transfer (MT) effects directly affect relaxometry measurements and develops a framework that allows single-pool models to be valid in 2-pool MT systems., Methods: A theoretical framework is developed in which a 2-pool MT system effectively behaves as a single-pool if the RMS RF magnetic field ( B 1 rms {\text{B}}&#95;{1}^{{{\text{rms}}}}) is kept fixed across all measurements. A practical method for achieving controlled saturation magnetization transfer (CSMT) using multiband RF pulses is proposed. Numerical, Phantom, and in vivo validations were performed directly comparing steady state (SS) estimation approaches that under correct single-pool assumptions would be expected to vary in precision but not accuracy., Results: Numerical simulations predict single-pool estimates obtained from MT model generated data are not consistent for different SS estimation methods, and a systematic underestimation of T 2 is expected. Neither effect occurs under the proposed CSMT approach. Both phantom and in vivo experiments corroborate the numerical predictions. Experimental data highlights that even when using the same relaxometry method, different estimates are obtained depending on which combination of flip angles (FAs) and TRs are used if the CSMT approach is not used. Using CSMT, stable measurements of both T 1 and T 2 are obtained. The measured T 1 ( T 1 CSMT ) ) depends on B 1 rms {\text{B}}&#95;{1}^{{{\text{rms}}}}, which is therefore an important parameter to specify., Conclusion: This work demonstrates that conventional single pool relaxometry, which is highly efficient for human studies, results in unreliable parameter estimates in biological tissues because of MT effects. The proposed CSMT framework is shown to allow single-pool assumptions to be valid, enabling reliable and efficient quantitative imaging to be performed., (© 2018 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: Echo planar imaging (EPI) is the primary sequence for functional and diffusion MRI. In fetal applications, the large field of view needed to encode the maternal abdomen leads to prolonged EPI readouts, which may be further extended due to safety considerations that limit gradient performance. The resulting images become very sensitive to water-fat shift and susceptibility artefacts. The purpose of this study was to reduce artefacts and increase stability of EPI in fetal brain imaging, balancing local field homogeneity across the fetal brain with longer range variations to ensure compatibility with fat suppression of the maternal abdomen., Methods: Spectral Pre-saturation with Inversion-Recovery (SPIR) fat suppression was optimized by investigating SPIR pulse frequency offsets. Subsequently, fetal brain EPI data were acquired using image-based (IB) shimming on 6 pregnant women by (1) minimizing B 0 field variations within the fetal brain (localized IB shimming) and (2) with added constraint to limit B 0 variation in maternal fat (fat constrained IB shimming)., Results: The optimal offset for the SPIR pulse at 3 Tesla was 550 Hz. Both shimming approaches had similar performances in terms of B 0 homogeneity within the brain, but constrained IB shimming enabled higher fat suppression efficiency., Conclusion: Optimized SPIR in combination with constrained IB shimming can improve maternal fat suppression while minimizing EPI distortions in the fetal brain., (© 2018 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: Simultaneous multi-slice techniques are reliant on multiband RF pulses, for which conventional design strategies result in long pulse durations, lengthening echo-times so lowering SNR for spin-echo imaging, and lengthening repetition times for gradient echo sequences. Pulse durations can be reduced with advanced RF pulse design methods that use time-variable selection gradients. However, the ability of gradient systems to reproduce fast switching pulses is often limited and can lead to image artifacts when ignored. We propose a time-efficient pulse design method that inherently produces gradient waveforms with lower temporal bandwidth., Methods: Efficient multiband RF pulses with time-variable gradients were designed using time-optimal VERSE. Using VERSE directly on multiband pulses leads to gradient waveforms with high temporal bandwidth, whereas VERSE applied first to singleband RF pulses and then modulated to make them multiband, significantly reduces this. The relative performance of these approaches was compared using simulation and experimental measurements., Results: Applying VERSE before multiband modulation was successful at removing out-of-band slice distortion. This effectively removes the need for high frequency modulation in the gradient waveform while preserving the benefit of time-efficiency inherited from VERSE., Conclusion: We propose a time-efficient RF pulse design that produces gradient pulses with lower temporal bandwidth, reducing image artifacts associated with finite temporal bandwidth of gradient systems., (© International Society for Magnetic Resonance in Medicine.)

Purpose: Image quality obtained for brain imaging at 7T can be hampered by inhomogeneities in the static magnetic field, B 0 , and the RF electromagnetic field, B 1 . In imaging sequences such as fluid-attenuated inversion recovery (FLAIR), which is used to assess neurological disorders, these inhomogeneities cause spatial variations in signal that can reduce clinical efficacy. In this work, we aim to correct for signal inhomogeneities to ensure whole-brain coverage with 3D FLAIR at 7T., Methods: The direct signal control (DSC) framework was used to optimize channel weightings applied to the 8 transmit channels used in this work on a pulse-by-pulse basis through the echo train in the FLAIR sequences. 3D FLAIR brain images were acquired on 5 different subjects and compared with imaging using a quadrature-like mode of the transmit array. Precomputed "universal" DSC solutions calculated from a separate set of 5 subjects were also explored., Results: DSC consistently enabled improved imaging across all subjects, with no dropouts in signal seen over the entire brain volume, which contrasted with imaging in quadrature mode. Further, the universal DSC solutions also consistently improved imaging despite not being optimized specifically for the subject being imaged., Conclusion: 3D FLAIR brain imaging at 7T is substantially improved using DSC and is able to recover regions of low signal without increasing imaging time or interecho spacing., (© 2018 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: An extended phase graph framework (EPG-X) for modeling systems with exchange or magnetization transfer (MT) is proposed., Theory: EPG-X models coupled two-compartment systems by describing each compartment with separate phase graphs that exchange during evolution periods. There are two variants: EPG-X(BM) for systems governed by the Bloch-McConnell equations, and EPG-X(MT) for the pulsed MT formalism. For the MT case, the "bound" protons have no transverse components, so their phase graph consists of only longitudinal states., Methods: The EPG-X model was validated against steady-state solutions and isochromat-based simulation of gradient-echo sequences. Three additional test cases were investigated: (i) MT effects in multislice turbo spin-echo; (ii) variable flip angle gradient-echo imaging of the type used for MR fingerprinting; and (iii) water exchange in multi-echo spin-echo T 2 relaxometry., Results: EPG-X was validated successfully against isochromat based transient simulations and known steady-state solutions. EPG-X(MT) simulations matched in-vivo measurements of signal attenuation in white matter in multislice turbo spin-echo images. Magnetic resonance fingerprinting-style experiments with a bovine serum albumin (MT) phantom showed that the data were not consistent with a single-pool model, but EPG-X(MT) could be used to fit the data well. The EPG-X(BM) simulations of multi-echo spin-echo T 2 relaxometry suggest that exchange could lead to an underestimation of the myelin-water fraction., Conclusions: The EPG-X framework can be used for modeling both steady-state and transient signal response of systems exhibiting exchange or MT. This may be particularly beneficial for relaxometry approaches that rely on characterizing transient rather than steady-state sequences. Magn Reson Med 80:767-779, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited., (© 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: This study aims to increase the precision of single-compartment DESPOT relaxometry by two means: (i) a joint system relaxometry (JSR) approach that estimates parameters in a single step using all available data; and (ii) optimizing acquisition parameters by deploying a robust design tool based on the Crámer-Rao lower bound (CRLB)., Methods: Following the development of the analysis and design capabilities, phantom and four in vivo subject experiments were performed to compare directly the precision achieved with DESPOT and JSR estimation using published protocols and protocols designed using a proposed CRLB framework., Results: Experimental data demonstrate JSR's ability to decrease relaxometry estimation variance. Phantom results show 72 to 77% improvement using the same data as conventional DESPOT. This is further improved to 81 to 87% using optimal parameters. Both experiments show systematic bias depending on the acquisition parameters used, which are shown to be highly reproducible and to vary with different magnetization transfer conditions., Conclusions: Compared with DESPOT, JSR produces reproducible relaxation maps with improved precision. Further improvement was achieved using CRLB as a protocol design tool. With this combined approach, it is possible to achieve submillimeter maps of ρ,T1,T2, and B0 in an 11-min examination, making the approach appealing for potential clinical use. Magn Reson Med 79:234-245, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited., (© 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: Development of a MRI acquisition and reconstruction strategy to depict fetal cardiac anatomy in the presence of maternal and fetal motion., Methods: The proposed strategy involves i) acquisition and reconstruction of highly accelerated dynamic MRI, followed by image-based ii) cardiac synchronization, iii) motion correction, iv) outlier rejection, and finally v) cardiac cine reconstruction. Postprocessing entirely was automated, aside from a user-defined region of interest delineating the fetal heart. The method was evaluated in 30 mid- to late gestational age singleton pregnancies scanned without maternal breath-hold., Results: The combination of complementary acquisition/reconstruction and correction/rejection steps in the pipeline served to improve the quality of the reconstructed 2D cine images, resulting in increased visibility of small, dynamic anatomical features. Artifact-free cine images successfully were produced in 36 of 39 acquired data sets; prolonged general fetal movements precluded processing of the remaining three data sets., Conclusions: The proposed method shows promise as a motion-tolerant framework to enable further detail in MRI studies of the fetal heart and great vessels. Processing data in image-space allowed for spatial and temporal operations to be applied to the fetal heart in isolation, separate from extraneous changes elsewhere in the field of view. Magn Reson Med 79:327-338, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited., (2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Geometric distortion induced by the main B0 field disrupts the consistency of fetal echo planar imaging (EPI) data, on which diffusion and functional magnetic resonance imaging is based. In this paper, we present a novel data-driven method for simultaneous motion and distortion correction of fetal EPI. A motion-corrected and reconstructed T2 weighted single shot fast spin echo (ssFSE) volume is used as a model of undistorted fetal brain anatomy. Our algorithm interleaves two registration steps: estimation of fetal motion parameters by aligning EPI slices to the model; and deformable registration of EPI slices to slices simulated from the undistorted model to estimate the distortion field. The deformable registration is regularized by a physically inspired Laplacian constraint, to model distortion induced by a source-free background B0 field. Our experiments show that distortion correction significantly improves consistency of reconstructed EPI volumes with ssFSE volumes. In addition, the estimated distortion fields are consistent with fields calculated from acquired field maps, and the Laplacian constraint is essential for estimation of plausible distortion fields. The EPI volumes reconstructed from different scans of the same subject were more consistent when the proposed method was used in comparison with EPI volumes reconstructed from data distortion corrected using a separately acquired B0 field map.

Purpose: Multiband pulses are characterized by highly temporally modulated waveforms. Rapid phase or frequency modulation can be extremely demanding on the performance of radiofrequency (RF) pulse generation, which can lead to errors that can be avoided if pulses are restricted to amplitude modulation (AM) only. In this work, three existing multiband pulse design techniques are modified to produce AM waveforms., Theory and Methods: Multiband refocusing pulses were designed using phase-optimization, time-shifting, and root-flipping. Each technique was constrained to produce AM pulses by exploiting conjugate symmetry in their respective frequency domain representations. Pulses were designed using the AM and unconstrained techniques for a range of multiband factors (ie, number of simultaneously excited slices), time-bandwidth products, and slice separations. Performance was compared by examining the resulting effective pulse durations. Phantom and in vivo experiments were conducted for validation., Results: Acquired data confirmed that AM pulses can produce precise results when unconstrained designs may produce artifacts. The average duration of AM pulses is longer than the unconstrained versions. Averaged across a range of parameters, the duration cost for AM pulses was 26, 38, and 20% for phase-optimizing, time-shifting and root-flipping, respectively., Conclusions: Amplitude modulation multiband pulses can be produced for a relatively small increase in pulse duration. Magn Reson Med 78:2185-2193, 2017. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited., (© 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Cardiac magnetic resonance imaging (MRI) at high field presents challenges because of the high specific absorption rate and significant transmit field (B 1 + ) inhomogeneities. Parallel transmission MRI offers the ability to correct for both issues at the level of individual radiofrequency (RF) pulses, but must operate within strict hardware and safety constraints. The constraints are themselves affected by sequence parameters, such as the RF pulse duration and TR, meaning that an overall optimal operating point exists for a given sequence. This work seeks to obtain optimal performance by performing a 'sequence-level' optimization in which pulse sequence parameters are included as part of an RF shimming calculation. The method is applied to balanced steady-state free precession cardiac MRI with the objective of minimizing TR, hence reducing the imaging duration. Results are demonstrated using an eight-channel parallel transmit system operating at 3 T, with an in vivo study carried out on seven male subjects of varying body mass index (BMI). Compared with single-channel operation, a mean-squared-error shimming approach leads to reduced imaging durations of 32 ± 3% with simultaneous improvement in flip angle homogeneity of 32 ± 8% within the myocardium., (© 2017 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)

In parallel RF pulse design, peak RF magnitudes and specific absorption rate levels are critical concerns in the hardware and safety limits. The variable rate selective excitation (VERSE) method is an efficient technique to limit the peak RF power by applying a local-only RF and gradient waveform reshaping while retaining the on-resonance profile. The accuracy of the excitation performed by the VERSEd RF and gradient waveforms strictly depends on the performance of the employed hardware. Any deviation from the nominal gradient fields as a result of frequency dependent system imperfections violates the VERSE condition similarly to off-resonance effects, leading to significant excitation errors and the RF pulse not converging to the targeted peak RF power. Moreover, for iterative VERSE-guided RF pulse design (i.e. reVERSE), the k-space trajectory actually changes at every iteration, which is assumed to be constant. In this work, we show both theoretically and experimentally the effect of gradient system imperfections on iteratively VERSEd parallel RF excitations. In order to improve the excitation accuracy besides limiting the RF power below certain thresholds, we propose to integrate gradient field monitoring or gradient impulse response function (GIRF) estimations of the actual gradient fields into the RF pulse design problem. A third-order dynamic field camera comprising a set of NMR field sensors and GIRFs was used to measure or estimate the actual gradient waveforms that are involved in the VERSE algorithm respectively. The deviating and variable k-space is counteracted at each iteration of the VERSE-guided iterative RF pulse design. The proposed approaches are demonstrated for accelerated multiple-channel spatially selective RF pulses, and highly improved experimental performance was achieved at both 3 T and 7 T., (© 2017 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)

Purpose: The design of turbo spin-echo sequences is modeled as a dynamic optimization problem which includes the case of inhomogeneous transmit radiofrequency fields. This problem is efficiently solved by optimal control techniques making it possible to design patient-specific sequences online., Theory and Methods: The extended phase graph formalism is employed to model the signal evolution. The design problem is cast as an optimal control problem and an efficient numerical procedure for its solution is given. The numerical and experimental tests address standard multiecho sequences and pTx configurations., Results: Standard, analytically derived flip angle trains are recovered by the numerical optimal control approach. New sequences are designed where constraints on radiofrequency total and peak power are included. In the case of parallel transmit application, the method is able to calculate the optimal echo train for two-dimensional and three-dimensional turbo spin echo sequences in the order of 10 s with a single central processing unit (CPU) implementation. The image contrast is maintained through the whole field of view despite inhomogeneities of the radiofrequency fields., Conclusion: The optimal control design sheds new light on the sequence design process and makes it possible to design sequences in an online, patient-specific fashion. Magn Reson Med 77:361-373, 2017. © 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine., (© 2016 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

The development of MRI systems operating at or above 7 T has provided researchers with a new window into the human body, yielding improved imaging speed, resolution and signal-to-noise ratio. In order to fully realise the potential of ultrahigh-field MRI, a range of technical hurdles must be overcome. The non-uniformity of the transmit field is one of such issues, as it leads to non-uniform images with spatially varying contrast. Parallel transmission (i.e. the use of multiple independent transmission channels) provides previously unavailable degrees of freedom that allow full spatial and temporal control of the radiofrequency (RF) fields. This review discusses the many ways in which these degrees of freedom can be used, ranging from making more uniform transmit fields to the design of subject-tailored RF pulses for both uniform excitation and spatial selection, and also the control of the specific absorption rate. © 2015 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd., (© 2015 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.)

Purpose: To design multidimensional spatially selective radiofrequency (RF) pulses for inner volume imaging (IVI) with three-dimensional (3D) fast spin echo (FSE) sequences. Enhanced background suppression is achieved by exploiting particular signal properties of FSE sequences., Theory and Methods: The CPMG condition dictates that echo amplitudes will rapidly decrease if a 90° phase difference between excitation and refocusing pulses is not present, and refocusing flip angles are not precisely 180°. This mechanism is proposed as a means for generating additional background suppression for spatially selective excitation, by biasing residual excitation errors toward violating the CPMG condition. 3D RF pulses were designed using this method with a 3D spherical spiral trajectory, under-sampled by factor 5.6 for an eight-channel PTx system, at 3 Tesla., Results: 3D-FSE IVI with pulse durations of approximately 12 ms was demonstrated in phantoms and for T2 -weighted brain imaging in vivo. Good image quality was obtained, with mean background suppression factors of 103 and 82 ± 6 in phantoms and in vivo, respectively., Conclusion: Inner Volume Imaging with 3D-FSE has been demonstrated in vivo with tailored 3D-RF pulses. The proposed design methods are also applicable to 2D pulses. Magn Reson Med 76:848-861, 2016. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine., (© 2015 The Authors. Magnetic Resonance in Medicine Published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

Purpose: Parallel transmission (PTx) requires knowledge of the B1+ produced by each element. However, B1+ mapping can be challenging when transmit fields exhibit large dynamic range. This study presents a method to produce high quality relative B1+ maps when this is the case., Theory and Methods: The proposed technique involves the acquisition of spoiled gradient echo (SPGR) images at multiple radiofrequency drive levels for each transmitter. The images are combined using knowledge of the SPGR signal equation using maximum likelihood estimation, yielding an image for each channel whose signal is proportional to the B1+ field strength. Relative B1+ maps are then obtained by taking image ratios. The method was tested using numerical simulations, phantom imaging, and through in vivo experiments., Results: The numerical simulations demonstrated that the proposed method can reconstruct relative transmit sensitivities over a wide range of B1+ amplitudes and at several SNR levels. The method was validated at 3 Tesla (T) by comparing it with an alternative B1+ mapping method, and demonstrated in vivo at 7T., Conclusion: Relative B1+ mapping in the presence of large dynamic range has been demonstrated through numerical simulations, phantom imaging at 3T and experimentally at 7T. The method will enable PTx to be applied in challenging imaging scenarios at ultrahigh field. Magn Reson Med 76:490-499, 2016. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited., (© 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.)

The use of multiple transmission channels (known as Parallel Transmission, or PTx) provides increased control of the MRI signal formation process. This extra flexibility comes at a cost of uncertainty of the power deposited in the patient under examination: the electric fields produced by each transmitter can interfere in such a way to lead to excessively high heating. Although it is not possible to determine local heating, the global Q matrix (which allows the whole-body Specific Absorption Rate (SAR) to be known for any PTx pulse) can be measured in-situ by monitoring the power incident upon and reflected by each transmit element during transmission. Recent observations have shown that measured global Q matrices can be corrupted by losses between the coil array and location of power measurement. In this work we demonstrate that these losses can be accounted for, allowing accurate global Q matrix measurement independent of the location of the power measurement devices., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: The use of electromagnetic (EM) modeling is critical for specific absorption rate (SAR) characterization in parallel transmission MRI. Radiofrequency arrays that include decoupling networks can be difficult to characterize accurately in simulation. A practical method of simplifying modeling is to exclude the decoupling networks and model each transmit element in isolation. Results from this type of model can be related to a real device by applying "active decoupling" to the real device to suppress residual coupling when in use. Here, we compare this approach with a full model that includes decoupling networks., Methods: EM simulations for a variety of adult male voxel models placed within an eight-channel transverse electromagnetic (TEM) array tuned for 3 Tesla operation were run with and without decoupling networks included. The resulting EM fields and SAR estimates were compared using basic normalization, and simulated active decoupling., Results: Modeling the transmit elements independently leads to variations which have significantly different SAR estimates of ∼20% on average compared with the full model if not normalized appropriately. After "active decoupling," SAR was still generally seen to be overestimated by ∼7% with independent channel modeling; despite having similar B1(+) field distributions., Conclusion: Modeling transmission elements independently may lead to substantially incorrect SAR estimates if the corresponding MRI system is not run in an analogous manner., (© 2014 Wiley Periodicals, Inc.)