Satomu Hanamatsu1, Kazuhiro Murayama2, Yoshiharu Ohno3, Kaori Yamamoto4, Yuki Obama1, Hirotaka Ikeda1, Hiroyuki Nagata1, Masato Ikedo4, Masao Yui4, Akiyoshi Iwase5, and Hiroshi Toyama1
1Radiology, Fujita Health University, School of Medicine, Toyoake, Japan, 2Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University, School of Medicine, Toyoake, Japan, 3Radiology, Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University, School of Medicine, Toyoake, Japan, 4Canon Medical Systems Corporation, Otawara, Japan, 5Radiology, Fujita Health University, Hospital, Toyoake, Japan
Synopsis
To the best of our knowledges, there are
no major papers that assess the influence of Fast 3D wheel to cerebral MR
angiography in patients with cerebrovascular diseases. We hypothesize that “Fast 3D wheel (Fast
3Dw)” has a potential to reduce examination time without degradation of image
quality and aneurysm or vascular evaluations, when compared with PI. The purpose of this study was to directly
compare the efficacy of Fast 3Dw for cerebral MR angiography with conventional
PI in patients with cerebral aneurysm.
Introduction
Cerebral
MR angiography has been one of the fundamental imaging tools for screening or
evaluation of cerebrovascular diseases in routine clinical practice. Since 2004, conventional parallel imaging
(PI) techniques has been widely applied in not only neuro, but also other MR
imaging in routine clinical practice. The
two parallel imaging methods are most commonly used on clinical scanners today,
sensitivity encoding (SENSE) and generalized auto-calibrating partially
parallel acquisitions (GRAPPA) in all MR vendors1, 2. In addition, compressed sensing is clinically
utilized by several MR vendors and tested for its’ utility as compared with PI3-6. One of the drawbacks of CS is reduced
quantitative and qualitative image qualities3-6, and deep learning
reconstruction (DLR) would be better to be applied as well as CS in routine
clinical practice6. In this
situation, “Fast 3D
mode” is recently introduced from Canon Medical Systems as new methods for
k-space data acquisition. In contrast to
conventional 3D MRI, which mainly obtains k-space data with a slice encoding in
k-space for each TR, “Fast 3D multiple”, which is one of the Fast 3D acquisitions,
obtains k space data with multiple slices encoding in each TR. In addition, another Fast 3D acquisition named
as “Fast 3D wheel” obtains reduced k-space data as segmented radial scan from
low frequency data at k-space center to the high frequency data at the
periphery of k-space. When applied these techniques, we can reduce examination
time without degradation of image quality and obtain good image quality without
DLR in routine clinical practice. To the
best of our knowledges, there are no major papers that assess the influence of
Fast 3D wheel to cerebral MR angiography in patients with cerebrovascular
diseases. We hypothesize that “Fast 3D
wheel (Fast 3Dw)” has a potential to reduce examination time without
degradation of image quality and aneurysm or vascular evaluations, when
compared with PI. The purpose of this
study was to directly compare the efficacy of Fast 3Dw for cerebral MR
angiography with conventional PI in patients with cerebral aneurysm. Materials and Methods
50 consecutive candidates with unruptured cerebral
aneurysm underwent conventional MRA by PI and Fast 3Dw methods at a 3T scanner
(Vantage Centurian: Canon Medical Systems Corporation). For quantitative vascular clarity assessment,
signal-to-noise ratios (SNRs) of internal carotid artery (ICA), middle cerebral
artery (MCA) and white matter (WM) and contrast noise ratios (CNRs) between
white matter and ICA or MCA were assessed by ROI measurements as following
formula.
- SNR = SIICA/SDWM; SIMCA/SDWM [1]
- CNR = (SIICA-SIWM)
/ {(SDICA + SDWM) / 2} or (SIMCA-SIWM)
/ {(SDMCA + SDWM) / 2} [2]
To evaluate the diameters of each aneurysm, diameters
of ICA and MCA on each MRA data were semi-automatically measured by using
ImageJ application (https://imagej.nih.gov/ij/). For
qualitative assessment, vascular clarity, artifact and diagnostic confidence
level were also evaluated by visual scoring systems by a 5-point scale by two
investigators, and final score of each index was determined as consensus of two
readers. To compare examination time
reduction capability, mean examination time was compared between Fast 3Dw and
PI by t-test. For comparison of
quantitative vascular clarity between two methods, SNRs at internal carotid
artery (ICA), middle cerebral artery (MCA) and white matter and CNRs between
white matter and ICA or MCA were compared between Fast 3Dw and PI by
t-test. To compare quantitative aneurysm
evaluation capability between two methods, diameters of each aneurysm, ICA and
MCA were compared between Fast 3Dw and PI by t-test. To evaluate interobserver agreement for all
qualitative vascular clarity evaluations on each method, kappa statistics were
performed followed by χ2 test.
To compare all qualitative image quality indexes between two methods,
vascular clarity, artifact and diagnostic confidence level were compared by
Wilcoxon’s signed rank test.
Results
Representative
cases are shown in Figure 1. Comparison
of mean examination times, SNRs and CNRs between PI and Fast 3Dw are shown in
Figure 2. Mean examination time of Fast
3Dw was significantly shorter than that of PI (p<0.05). SNR of Fast 3Dw was significantly higher than that
of PI (p<0.05). Compared results of
size of aneurysms and diameters of ICA and MCA between PI and Fast 3Dw are
shown in Figure 3. There were no
significant differences of between PI and Fast 3Dw (p>0.05). Figure 4 shows interobserver agreements of
vascular clarity, artifacts and diagnostic confidence level of PI and Fast 3Dw
and compared results of each qualitative index between PI and Fast 3Dw. Interobserver agreement of each qualitative
index on Fast 3Dw was significant and substantial or excellent (0.78≤κ≤0.81, p<0.001),
although that on PI was significant and substantial (0.66≤κ≤0.79, p<0.001). When compared each qualitative index between
PI and Fast 3Dw, there were no significant differences (p>0.05). Conclusion
Fast 3Dw has a superior potential to conventional PI for examination
time reduction with keeping image quality and accuracies for aneurysm size and
vascular diameter measurements in patients with cerebral aneurysm. Acknowledgements
This work was technically and financially supported by Canon Medical Sytstems Corporation.References
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