Gabriele Bonanno1,2,3, Tom Hilbert4,5,6, Arun Joseph1,2,3, Emilie Mussard4,5,6, Christoph Forman7, Gian Franco Piredda4,5,6, and Tobias Kober4,5,6
1Advanced Clinical Imaging Technology, Siemens Healthcare AG, Bern, Switzerland, 2Translational Imaging Center, sitem-insel AG, Bern, Switzerland, 3Departments of Radiology and Biomedical Research, University of Berne, Bern, Switzerland, 4Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland, 5Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland, 6LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland, 7Magnetic Resonance, Siemens Healthcare GmbH, Erlangen, Germany
Synopsis
Magnetization Transfer Ratio (MTR)
imaging may be a valuable tool for the diagnosis and follow-up of demyelinating
diseases. However, MTR maps require long scan times for whole-brain coverage
and high isotropic resolution. We present a novel MTR imaging method based on a
spiral-phyllotaxis Cartesian FLASH sequence and compressed sensing, called MTRSparse,
and compare it to fully sampled and parallel-imaging-accelerated acquisitions
in healthy volunteers. MTRSparse showed good contrast and similar MTR values in
comparison to the reference method with up to 87% reduction in acquisition time.
This can help facilitate implementation of MTR imaging in the clinical practice.
Introduction
In demyelinating diseases, the body’s immune system
attacks the myelin sheath that surrounds the
nerves’ axons causing progressive pain, and physical and
cognitive dysfunction [1]. Early diagnosis of demyelination
is crucial for guiding targeted treatment and
reducing symptoms. The contrast mechanism of magnetization transfer (MT) originates
from water bound to macromolecules such as proteins within the myelin sheath.
Therefore, MT can be linked to myelin content as well as inflammation and edema
[2].
In MT imaging, off-resonance pulses saturate the macromolecular
proton pool (i.e. the semi-solid pool), which indirectly reduces the signal intensity
of the free proton pool via magnetization transfer between these two pools [3].
A ratio of image intensities from saturated and unsaturated acquisitions (MTR)
allows for a qualitative visualization of areas with MT effect. The proteins in
the myelin sheath are potentially the main cause for MT effects in white matter;
hence MTR might be considered an indirect measure of myelination [4]. However, long
acquisition times are required to obtain three-dimensional MTR images with
full-brain coverage and isotropic resolution. Therefore, these acquisitions are
prone to bulk motion and their use in clinical practice is hindered.
Here, we present a novel MT imaging method based on
a FLASH sequence [5] and compressed sensing (called MTRSparse hereafter)
and investigate its feasibility to obtain 3D MTR maps with 1-mm isotropic
resolution in less than 5 min. MTRSparse was validated in healthy subjects and in
comparison to fully sampled and parallel-imaging reference MTR acquisitions.Methods
IRB-approved experiments were performed in 5 healthy subjects (3
females, 29±1.6 yo) at 3 T (MAGNETOM Prisma, Siemens
Healthcare, Erlangen, Germany) using a commercially available 64-channel head
coil. In each subject, whole-brain images were acquired
with the following 3D Cartesian FLASH prototype sequences:
- Reference: Fully sampled acquisition;
- GRAPPA [6]: Acquisition with a 2-fold acceleration
factor in the phase encoding direction;
- MTRSparse: Acquisitions that were
undersampled with a variable-density spiral-phyllotaxis pattern [7] employing an additional random
perturbation of each encoding location, at different acceleration factors
(Figure 1).
Each of these was acquired twice, with and without MT saturation pulses.
Other scan parameters were identical across acquisitions (Table 1). The MT pulse was implemented with a Gaussian pulse shape, 500° RF
excitation angle at 2 kHz off-resonance frequency. Additionally, an MP-RAGE [8]
sequence was acquired as anatomical reference for automatic volumes-of-interest (VOI) segmentation.
Reconstructions of all scans were performed inline on the
scanner. Reference and GRAPPA scans used product reconstructions. For MTRSparse
acquisitions, coil sensitivity maps were estimated from in-sequence calibration scans using the ESPIRiT algorithm [9] and the final image was
obtained with a prototype compressed sensing algorithm as previously described [10]
which used Haar wavelet regularization with 15 iterations.
Offline
Analysis: MTR maps were
computed in MATLAB (MathWorks, Natick, MA) as (MT
off-MT
on)/MT
off,
where MT
on/off denotes scans with/without MT preparation. To account
for potential subject motion, MT
on images were rigidly registered [11]
onto the MToff images prior to MTR calculation. Masks were obtained
from MP-RAGE scans using the prototype segmentation software MorphoBox [12] in 9
bilateral VOIs (frontal, parietal, and occipital white and gray matter,
corpus-callosum, thalamus, and putamen). Subsequently, the MP-RAGE images were
rigidly registered [11] to each MTR image and the same transformation was
applied to the masks to perform a VOI analysis in the native space of the MTR images.
Median MTR values were extracted in each VOI, and the mean and standard
deviation of the medians were computed across subjects. Additionally, average
percentage-change of the medians with respect to reference scans was computed
across subjects.
Results
All MTRSparse scans were
reconstructed directly on the scanner hardware with a computation time of around
two minutes per image.
Qualitatively, similar image
quality of MToff, MTon, and MTR images was observed when
comparing MTRSparse methods to reference and GRAPPA scans. Figure 2 shows all
contrasts across scans and methods acquired in an example subject. Motion
artifacts can be observed in reference images that may be attributed to the
lengthy acquisition time, whereas aliasing artifacts become apparent in
MTRSparse images with the highest acceleration factor of 10 (Figure 2).
Figure 3 shows 3D views of another
subject, where 5- and 8-fold accelerated MTRSparse compare well with conventional
methods. The MTR images show similar contrast despite the reduction in
acquisition time.
Mean MTR values across subjects of VOI medians were comparable
across methods and the absolute mean percentage-change was lower than 2%
(Figure 4). The large variation in standard deviation may be due to the limited
number of subjects.Discussion
This study suggests that 10-fold accelerated MTRSparse may be
affected by aliasing artifacts, whereas 5-
and 8-fold acceleration can provide similar contrast to reference
methods and <2% change in MTR values, with reduced total scan times for MTR
maps of 6:22 (2x3:11) min and 4:12 (2x2:06) min, respectively. For
comparison, the conventional parallel-imaging protocol tested here required
17:42 (2x8:51) min total scan time. MTRSparse promises
to yield whole-brain MTR maps with 1-mm isotropic resolution and adequate
contrast in less than 5 min and with ~2-min inline reconstruction. This may help facilitate future use of MTR
imaging in clinical practice. Further investigation in larger
cohorts of healthy subjects and patients is warranted.Acknowledgements
No acknowledgement found.References
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