To improve signal-to-noise ratio (SNR) in cardiac QSM (cQSM), we introduce here 3D acquisition that is more SNR efficient than previous 2D acquisition. Respiratory motion artifacts during the long 3D acquisition are compensated using navigator gating. We also investigated potential SNR gain at 3T over previous 1.5T. Our initial results seem to suggest possible issues at 3T that prevent the realization of potential cQSM improvement at from 1.5T to 3T in terms of SNR and contrast.
We developed an ECG-triggered navigator gated multi-echo 3D FGRE sequence for cardiac QSM on both 1.5T and 3T scanner (GE Healthcare), along with a graphical user display for displaying acquisition information in real time, as shown in figure 1. A pencil beam navigator echo was used to detect the diaphragm position, and an efficient 2-bin phase-ordered automatic window selection (PAWS) gating algorithm1 was used to control the data acquisition based on the diaphragm position in real time.
QSM sequences generally require long TR, resulting in long acquisition window, which makes the sequence more susceptible to motion artifacts. To address for large motion during acquisition in each heartbeat, a navigator echo was played out both before and after each acquisition within a given heartbeat. If the displacement between the two detected diaphragm positions within a single heartbeat was greater than 2mm, then the data from this heartbeat are rejected.
Scan parameters on 1.5T were: 5 echoes, first TE≈1.7ms, DTE≈2.3ms, TR≈15ms, bandwidth is ±62.5kHz, acquisition resolution = 192x192, 24 slices, 5mm slice thickness, 10 views per heartbeat,75% phase FOV, 75% partial readout, and 80% partial slice encoding. The scan parameter on 3T is the same as 1.5T except that the readout resolution was 256, the bandwidth was ±50kHz, and DTE≈3.5ms. We chose 3.5ms DTE such that water and fat signals can be differential for accurate water-fat separation.
A graph cut based phase unwrapping and fat-water separation method2 combined with a chemical shift update method3 was used to compute the total field from the complex data. A Total Field Inversion method4 was used to obtain the final susceptibility map from the total field. Four healthy volunteers, each consented with IRB approved protocol, were scanned with the proposed free-breath cardiac QSM sequence on both 1.5T and 3T GE scanner. To demonstrate the benefit of playing a second navigator echo after acquisition in each heartbeat to avoid large motion, a third scan was done on one volunteer on 3T without the second navigator echo.
As shown in figure 2, when all data are accepted regardless of motion during each acquisition, the resulting image quality was degraded by ghosting artifacts, with score of 3.5 (0=very minimal ghosting, 1=minimal ghosting, 2=moderate ghosting, 3=severe ghosting, 4=excess ghosting). Using the dual navigator protocol, the resulting image quality was significantly improved, with a score of 2.6 on 1.5T and 2.5 on 3T.
As shown in figure 3, the image qualities of the magnitude images are similar on both 1.5T and 3T. However, the QSM from 1.5T has better contrast between LV and RV than the QSM from 3T does. The average susceptibility difference between right ventricular and left ventricular blood pool on the four volunteers was 255±3ppb on 1.5T and 230±4ppb on 3T, which translate to an 80.6±.2% SvO2 on 1.5T and 82.2±.3% SvO2 on 3T.
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