Katharina Paul1, Helmar Waiczies2, André Kuehne2, Till Huelnhagen1, Eva Oberacker1, Oliver Stachs3, and Thoralf Niendorf1,2,4
1Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany, 2MRI.TOOLS GmbH, Berlin, Germany, 3Department of Ophthalmology, University of Rostock, Rostock, Germany, 4Experimental and Clinical Research Center (ECRC), a joint cooperation between the Charité Medical Faculty and the Max Delbrueck Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
Synopsis
Diffusion-weighted imaging of the
eye and orbit is an emerging MRI application to provide guidance during
diagnostic assessment and treatment of ophthalmological diseases. RARE based
diffusion-sensitized imaging (ms-RARE) provides images free of geometric
distortions. Yet imaging speed, RF power deposition and artifacts by
involuntary eye motion remain a concern. Combined acquisition techniques (CAT)
merging RARE and EPI within one echo train offer the possibility to shorten
acquisition times and relax specific absorption rate constraints. This study
examines the applicability of RARE-EPI CAT for diffusion-sensitized imaging of
the eye and orbit free of geometric distortions at 3.0 T and 7.0 T.
Purpose
MRI of the spatial arrangements
of the eye segments and their masses is an emerging application increasingly
used in (pre-)clinical imaging and diagnostic radiology1-5.
Diffusion weighted MRI (DWI) probes self-diffusion of water in tissue on a
microscopic level and holds the promise to enhance the diagnostic accuracy over
anatomic ophthalmic imaging6. Diffusion-sensitized
segmented split-echo rapid acquisition with relaxation enhancement imaging (RARE)
provides high-spatial resolution images of the eye, orbit and nervus opticus at
3.0T and 7.0T7. Geometric distortions that
are observed for EPI-DWI approaches are offset by
DWI using RARE, but radiofrequency (RF) power deposition, scan time constraints
and sensitivity to involuntary eye motion remain a legitimate concern.
Previously proposed combined acquisition techniques (CAT)8 merging RARE and EPI9,10
within one acquisition hold the promise to maintain the anatomic fidelity of
RARE based diffusion-weighted imaging while simultaneously relaxing specific
absorption rate (SAR) and imaging speed constraints. This study examines the
applicability of diffusion-sensitized RARE-EPI CAT for ophthalmic imaging.Methods
Conventional
RARE11 was modified (according to 8) by replacing [(1-λ)×ETL] RARE echoes by EPI echoes (Figure 1, ETL=echo
train length). The factor λ (0≤λ≤1) defines the fraction of echoes within the
echo train covered by the RARE module. Data were acquired center-out in k-space
together with a minimal TE for diffusion-weighted acquisitions while a linear phase
encoding scheme in conjunction with partial Fourier sampling was applied for
T2-weighted images. Split echo acquisition and 1D navigator based phase
correction were incorporated as illustrated in Figure 1 to facilitate robust diffusion
sensitization (details in 7). To examine the geometric fidelity of RARE-EPI
CAT, FLASH (anatomic reference), traditional RARE, single-shot-EPI (ss-EPI) and
readout-segmented-EPI (rs-EPI)12,13 phantom imaging was performed at 3.0T (Verio,
Siemens, Erlangen, Germany). Quantification of geometric distortion was
performed using center of gravity analysis. In-vivo anatomical brain images
were acquired to demonstrate the comparability of RARE-EPI CAT to conventional
RARE images. To elucidate the propensity of diffusion-sensitized RARE-EPI CAT,
ss-EPI and rs-EPI to geometric distortions ADC mapping of the eyes was
conducted at 3.0T. To demonstrate the applicability of RARE-EPI CAT at
ultrahigh magnetic field strengths ADC mapping of the eyes was performed at 7.0T (Magnetom, Siemens, Erlangen, Germany) using RARE and RARE-EPI CAT. A
dedicated six-element transceiver coil array consisting of loop elements was
employed at 7.0T5 (MRI.TOOLS GmbH, Berlin, Germany).Results
For RARE minor distortions were
observed in the phantom images with respect to the FLASH reference that can be
attributed to differences in the point spread function of the two pulse
sequences (Figure 2).
The deviations were severely increased for ss-EPI and rs-EPI. Using a factor λ=0.5 for RARE-EPI CAT increased the mean displacement by 15% versus the value
obtained for traditional RARE. For ETL=16 plus 3 dummy
pulses the administered RF power deposition is reduced by 36% for λ=0.5 based
on calculations using the integral of the RF pulses as a measure. Figure 3 shows anatomical
data of two exemplary volunteers for brain slices including the eyes comparing
conventional RARE with RARE-EPI CAT. Image quality and contrast are maintained
for RARE-EPI CAT which manifests itself in the visibility of subtle anatomical
structures as demonstrated in the zoomed views of Figure 3. To illustrate the immunity of
diffusion-sensitized RARE-EPI CAT to geometric distortions in comparison to
RARE, ss-EPI and rs-EPI, ADC maps acquired at 3.0T are presented in Figure 4. Severe
geometric distortions were observed for ss-EPI while rs-EPI showed moderate
distortions. RARE-EPI CAT exhibits anatomical integrity comparable to
RARE based ADC mapping. No distortions and no other imaging artifacts were
detected as indicated by the match between the ADC maps superimposed to
reference images. Figure
5 demonstrates the applicability of diffusion-sensitized RARE-EPI CAT at
7.0T which is underscored by the qualitative match between the ADC maps acquired
using RARE and RARE-EPI CAT.Discussion
Our data demonstrate that
RARE-EPI CAT meets the requirement of high anatomic fidelity and enables
diffusion-weighted imaging of the eye and orbit free of geometric distortion. This
offers means to accelerate data acquisition by increasing the number of slices
or lowering TR and helps to reduce the propensity to involuntary eye motion.
The relaxed SAR constraints of combined RARE-EPI CAT facilitates the
incorporation of multiband RF pulses14 into the pulse sequence to further enhance anatomic coverage.Conclusion
This study showed that
diffusion-sensitized RARE-EPI CAT provides images of the eye and orbit free of
geometric distortions. The results underline the challenges of ocular EPI at 3.0T and 7.0T and demonstrate that these issues can be offset by using a combined
RARE-EPI CAT imaging technique.Acknowledgements
No acknowledgement found.References
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