Antonio Napolitano1, Martina Lucignani1, Francesca Bottino1, Anna Nigri2, Domenico Aquino2, Fulvia Palesi3, Maria Grazia Bruzzone2, Michela Tosetti4,5, Claudia A. M. Gandini Wheeler-Kingshott6,7,8, and the Italian IRCCS advanced neuroimaging network9
1Medical Physics Department, Bambino Gesù Children's Hospital, Rome, Italy, 2Neuroradiology Department, Carlo Besta Neurological Institute, Milan, Italy, 3Brain MRI 3T Center, Mondino National Neurological Institute, Pavia, Italy, 4IRCCS Stella Maris Foundation, Pisa, Italy, 5Imago7 Foundation, Pisa, Italy, 6Brain MRI 3T Research Center, Mondino National Neurological Institute, Pavia, Italy, 7Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy, 8Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom, 9Advanced Neuroimaging Network of Italian Research Neurological Institutes (IRCCS), Italy, Italy
Synopsis
A multicenter network of Italian
Neurological Research Hospital was recently started. Its first aim was to
establish quality assessment protocols for future quantitative imaging studies.
In this context, we report the outcome of the first 6 months of data collection
using a dedicated phantom and processing pipeline. Scanner performance was
assessed in terms of several stability indicators, grouped by manufacturer. The
preliminary results represent the initial step towards a large-scale scanner
stability assessment in clinical settings. We expected to gather regular data
from all the sites in order to broaden data analysis and assess the multi-site
temporal stability.
INTRODUCTION.
An advanced Neuroimaging Network of Italian Research Neurological Institutes (IRCCS) was recently approved. It comprises 22 sites (20 sites with clinical scanners) with different
scanner manufacturers (Philips, Siemens and GE). The first aim of the network was to establish
quality assessment protocols for future quantitative imaging studies. In this
context, monitoring temporal signal stability during fMRI acquisition was
considered an important aspect for scanner performance assessment. The aim of
the current work is to report the outcome of the first 6 months of data
collection using a dedicated phantom and processing pipeline. MATERIALS AND METHODS.
The study included 20 italian Research Neurological Institutes (IRCCS), equipped with
different MR hardware (Table 1). The
network decided to acquire the Functional Stability Reference (FUNSTAR) Phantom (Gold Standard Phantoms ltd., https://www.goldstandardphantoms.com)
at each centres for its homogeneity characteristics (Fig 2). The FBIRN protocol1
for temporal stability was acquired over the past 6 months at 9 sites (4
Philips 3T, 3 Siemens 3T and 2 GE (1.5T and 3T)) with the following unified parameters
: TR = 2000 msec, TE = 30 msec, FA = 90 degree, FOV = 220 mm, matrix = 64x64,
slices = 32 interleaved with 4-mm thickness and 5-mm spacing, volumes = 200,
readout direction = RL, phase-encoding direction = PA, bandwidth = 1595 Hz/px @
Siemens, 1857 Hz/px @ Philips, 7812 Hz/px @ GE. The FUNSTAR phantom is made of two semi-spheres with a plastic septum
at the joining plane. The acquisition protocol was optimised by defining the
position of the FUNSTAR phantom in the receiver coil that reduced artefacts from
the plastic septum (Fig 2A). The analysis was performed by automatically
placing Region of Interest (ROI) in the central section of the phantom center
(Central ROI), at the periphery of the phantom (Peripheral ROIs) and in the
background (Fig 2D). Since artefacts occurred in proximity of the central
slice, we set the Central slice analysis 4 slices away from the center. The following parameters were computed: Signal-to-noise
ratio (SNR), signal-to-fluctuation-noise ratio (SFNR), Static Spatial Noise
(SSN), drift, presence of spikes, Weisskoff analysis and mean intensity
fluctuation in Peripheral ROIs. All the QA analyses were automated and performed in Python 2.7.RESULTS.
Data were
grouped by manufacturer. Boxplots of SNR, SFNR and drift percentage from Central and
Peripheral ROIs are displayed in Fig 3, while SSN and Weisskoff RDC are reported
in Fig 4. Mean intensity fluctuation within Peripheral ROIs produces high
variability values, ranging from 20% (GE) up to 90% (Siemens). None of the
centres presented data with spikes.DISCUSSION.
These preliminary results represent the
initial step towards a large-scale scanner stability assessment in clinical
settings. The high variability of the peripheral intensity fluctuation measurements
could be related to the head coil used by each sites and by the lack of a
standardised support structure for the phantom to reduce positioning
differences. CONCLUSION.
The data presented here are the initial
outcome of a network of research hospitals in its early phase. We expected to gather
regular data (monthly) from all the sites in order to broaden data analysis and
assess the multi-site temporal stability. We aim to be able to define parameter
values that will be useful to identify the minimum stability requirements necessary
for good quality multi-centre data. Acknowledgements
The
Italian IRCCS advanced neuroimaging network is constituted by the following
centers: IRCCS Istituto Auxologico Italiano (Milan); IRCCS Ospedale pediatrico
Bambino Gesù (Rome); Fondazione IRCCS Istituto neurologico “Carlo Besta”
(Milan); IRCCS Centro Neurolesi “Bonino Pulejo” (Messina); Centro IRCCS “Santa
Maria nascente” - Don Gnocchi (Milan); IRCCS Centro San Giovanni di Dio –
Fatebenefratelli (Brescia); IRCCS Ospedale pediatrico “Giannina Gaslini”
(Genoa); IRCCS Istituto Clinico Humanitas (Milan); Istituto di Ricerche
Farmacologiche “Mario Negri” IRCCS (Milan); Istituti Clinici Scientifici
Maugeri, IRCCS (Pavia); IRCCS Eugenio Medea (Bosisio Parini); Fondazione IRCCS
Istituto Neurologico “Casimiro Mondino” (Pavia); IRCCS NEUROMED – Istituto
Neurologico Mediterraneo (Pozzilli); IRCCS Associazione Oasi Maria SS Onlus –
Troina (Enna); Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico (Milan);
IRCCS Fondazione Ospedale San Camillo (Venice); IRCCS Ospedale San Raffaele
(Milan); IRCCS Fondazione Santa Lucia (Rome); IRCCS Istituto di Scienze
Neurologiche (Bologna); IRCCS SDN Istituto di ricerca diagnostica e nucleare
(Naples); IRCCS Fondazione Stella Maris (Pisa)References
[1] Friedman, L., Glover, G.H. (2006).
Report on a Multicenter fMRI Quality Assurance Protocol. Journal of Magnetic Resonance Imaging 23:827-839