Gradient echo (GRE) is more sensitive than CT for detecting intracerebral hemorrhage (1). However, T2* weighted hypointensity in GRE suffers from blooming artifacts that are highly dependent on imaging parameters. Conversely, quantitative susceptibility mapping (QSM) based on GRE phase data can provide an accurate measurement of the hemorrhage volumes by removing blooming artifacts inherent in traditional T2* weighted imaging (2). Further, during blood degradation in hemorrhage, susceptibility progressively increases from oxyhemoglobin (diamagentic) to dexyhemoglobin (paramagentic), methemoglobin (strongly paramagnetic), and hemosiderin (super paramagentic). Therefore, QSM may be used to precisely measure the susceptibility changes between pre- and post-treatment and provide useful quantitative information in hemorrhage patient management.In this study, five cerebral hematoma patients were scanned twice, with one week apart, using a GE Signa HDxt 3 T scanner (GE Healthcare, Waukesha, WI) equipped with an 8-channel head coil. Phase images with whole-brain coverage were acquired using a standard flow-compensated 3D SPGR sequence with the following parameters: TE₁/ΔTE/TE₁₆ = 3.16/2.42/39.46 ms, TR = 43 ms, FA = 12º, FOV = 220×220×132 mm³, matrix size = 256×256×66. The raw phase was processed by Laplacian-based phase unwrapping and V_SHARP background phase removal (3). Estimating susceptibility maps with a wide range of values remains challenging. In cases such as large veins and intracranial hemorrhages, extreme susceptibility values in focal areas tend to generate severe streaking artifacts, which unfortunately reduces image contrast and detail. Previously, one technique called streaking artifact reduced quantitative susceptibility mapping (STAR-QSM), is a promising tool that can characterize local tissue susceptibility and can reduce the strong susceptibility effects that exist in the hematoma patients (3).An example of T2* weighted magnitude, QSM maps for a cerebral hematoma patient were shown in Fig. 1. The diameter of the hematoma volume exhibited substantial enlargement as blooming artifacts with increasing echo time on T2* weighted magnitude images. Tissue susceptibility values near the hematoma were severely affected by artifacts (hypo-intense pixels) in the iLSQR-computed QSM map, with some surrounding regions completely obscured. STAR-QSM, on the other hand, highly suppressed streaking artifacts created not only by the hematoma itself but also by the strong susceptibility sources (i.e., veins) near the brain edges (red arrows in Fig. 1A) , resulting in cleaner and sharper boundaries between hematoma lesions and surrounding tissues. In addition, the geometric shape of the hematoma revealed by susuceptiblity maps at the longest TE=40 ms still remain highly consisent with that on magnitude magnitude at TE = 8ms, which means QSM is more reiable for measuring hemorrhage volume than magntude. The similar results have been reported by previous studies (2). Fig. 2 shows the QSM as a means to evalute the susceptilbity values before and after treatment. The hemorrhage size can be obtianed by manually segmentation by MIPAV (Medical Image Processing, Analysis, and Visualization, NIH). For example, the hemorrhage size is 3.2 cm³ and 2.62 cm³ for patient #1 pre- and post-treastment, respectively On average, the mean susceptilibty values are 0.92 ± 0.15 ppm and 0.70 ± 0.12 ppm for pre- and post-treastment, respectively. Moreover, the hemotoma regions exhibit a heterogeneity pattern with more papramagnetic susceptiblity in the center than the boudaries as shown by color QSM in Fig. 2. Results from all five patients are reported in Table 1 with hemotoma volume and mean susceptibility values. It can be seen that both hemorrhage volume and susceptiblity vlaue are reduced post-treatment.Hemorrhages contain paramagnetic components that generate magnetic fields. Fields extending beyond their source locations cause blooming artifacts in GRE magnitude images. Blooming artifacts depend on phase accumulation, which is proportional to TE and local fields. QSM, on the other hand, measuring from GRE phase images, is determined by deconvolving paramagnetic sources with the dipole kernel and can eliminate such blooming artifacts. It is shown here that STAR-QSM can effctively remove the streaking artifact and provide more reiable measure for hematoma volume and suceptibility quantification, e.g., for evaluating the patients per- and post-treatment. By taking the avantage of high quality susceptibility maps, susceptibility information can help to provide furhter classification of the hemorrhage stage. In conclusion, the susceptilbity of a cerebral hemorrhage is an intrinsic physical property. It can provide reiable volume measuement, offering an imaging parameter-indepent means to characterize the cerebral hemorrhage, e.g., managment of hematoma patient treatment.