Quantitative susceptibility mapping (QSM) with joint background field removal and dipole inversion is applied in the spine of osteoporosis patients and healthy volunteers. Preliminary multi-MR-parametric patient results are compared to low-dose CT scans to investigate the feasibility of QSM to qualitatively and quantitatively detect features of diseased tissues and differentiate positive and negative susceptibility sources in comparison to R2*-mapping.
With informed written consent and internal review board ethics approval, a time-interleaved multi-gradient-echo (TIMGRE) sequence [11] with six echoes in two interleaves was applied in six patients (75.8 ± 10years), for whom a low-dose CT was part of the normal radiological care, and three healthy volunteers (27.3 ± 2 years). Sequence parameters involved TR/TEmin/∆TEeff = (9.9/1.33/1.1) ms, FOV = (220 × 220 × 80) mm3 , voxel size = (1.8 mm)3 , flip angle = 3°, scan time = 4:30 min, BWpix = 1504.4 Hz. The TIMGRE sequence allowed to decouple the achievable resolution from the selection of SNR-optimal echo-times for the field mapping [11], which was performed by a graph cut algorithm [12] resulting in unwrapped field maps. The field mapping accounted for the presence of fat, modeled with a 10-peak spectrum specific to bone marrow [13], and a common R2∗-decay for water and fat. For the joint BFR and dipole inversion step the following $$$\ell_2$$$ total-variation regularized optimization problem similar to [5,9] was solved:
$$\chi=\underset{\chi'}{\text{argmin}}\,||W\Delta(f_B-\frac{\gamma}{2\pi}B_0d\ast\chi')||_2+\lambda ||M\nabla\chi'||_2, (1)$$
where fB is the estimated field map, the center frequency $$$\frac{\gamma}{2\pi}B_0$$$, dipole kernel d, magnitude weighting W, and a MEDI-like edge regularization damping M [5]. The first (data-fidelity) term in Equation (1) incorporates the background field removal by exploiting the harmonic properties of the background field. The operator ∆ was implemented as a spherical mean operator with a kernel size of 6 voxels [10]. The regularization parameter λ was heuristically chosen by visual comparison. The resulting susceptibility map χ was not subject to any referencing.
Figure 1 illustrates the differences in signal amplitude problematic for a foreground–background definition. The flowchart in Figure 2 displays the proposed method in performing BFR and dipole inversion jointly to bypass the foreground–background definition. The multi-parametric results of a representative data set from a 76-year-old patient are shown in Figure 3. The QSM maps in Figure 4 show opposite susceptibility of intradiscal air and aortic calcification in a data set of a 81-year-old patient suffering from osteoporosis. In Figure 5 another patient data set (60-year-old) shows susceptibility differences of degenerative changes through bone calcification next to intradiscal air, where both features cannot be detected by the similarly increased intra-voxel dephasing indicated in the R2*-map.
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