James Lo1,2, Eric Y. Chang1,3, Jiang Du1,2,3, Graeme M Bydder1, and Yajun Ma1
1Department of Radiology, University of California San Diego, San Diego, CA, United States, 2Department of Bioengineering, University of California San Diego, San Diego, CA, United States, 3Radiology Service, Veteran Affairs San Diego Healthcare System, San Diego, CA, United States
Synopsis
Keywords: Neurodegeneration, Quantitative Imaging, Myelin
In this study, we developed a comprehensive MR imaging
protocol to quantify all the major components of the brain. This protocol
includes four different kinds of sequences: a magnetization transfer prepared
Cones (MT-Cones) for two-pool MT modeling, a short-TR adiabatic
inversion-recovery prepared Cones (STAIR-Cones) for myelin water imaging, a
proton-density weighted Cones (PDw-Cones) for total water imaging, and a highly
T
2 weighted Cones (T
2w-Cones) for extracellular water
imaging. Using a combination of these techniques, we successfully quantified the
proton fractions of brain macromolecules, myelin water, intracellular water,
and extracellular water components in three healthy volunteers with a 3T
clinical scanner.
Introduction
There are four main compartments in the brain, namely macromolecules
(e.g., myelin lipid, protein, and axonal membranes), myelin water (trapped in
the myelin lipid layers) (MW), intracellular water (IW), and extracellular
water (e.g., cerebrospinal-fluid) (EW) (1–6). Volume or content changes of these
components may be important in neuroinflammatory and neurodegenerative diseases
(1–6). Recently, many MR imaging techniques
have been developed to independently image or quantify these specific brain
compartments. For example, quantitative two-pool magnetization transfer (MT)
modeling techniques have been utilized to evaluate semisolid tissue changes in
the brain (1,2). MW imaging techniques have been
developed to assess myelin content changes (3,4). T2-FLAIR is a widely
used clinical sequence to evaluate neuropathological changes related to IW
changes (7). Highly T1rho- and T2-weighted
sequences have been developed for selective EW imaging (5,6).
In this study, we developed a comprehensive protocol for
brain multicompartment imaging using a 3D Cones sequence with a short echo time
(i.e., 0.8ms) for data acquisition (8,9). This protocol includes four
different sequences: a MT prepared Cones (MT-Cones) for two-pool MT modeling (10), a short-TR adiabatic inversion recovery
prepared Cones (STAIR-Cones) for myelin water imaging (11), a proton density-weighted Cones
(PDw-Cones) for total water (TW) imaging (11), and a highly T2-weighted
Cones (T2w-Cones) for extracellular water imaging (6). By combining these four
techniques, we aim to quantify the proton fractions (PFs) of macromolecules, MW,
IW, and EW components using a 3T clinical scanner.
Methods
Three healthy male volunteers (aged 28
5-years-old)
were recruited and scanned in this study. Informed consent was obtained from each
volunteer.
Figure 1 shows the sequence diagrams. In the
MT-Cones sequence, a Fermi-shaped MT pulse is employed to generate MT contrast
(Figure 1A) (10). In the STAIR-Cones sequence, an Adiabatic
Full Passage (AFP) pulse is utilized to suppress long-T2 water
(i.e., intra/extracellular water) signals (Figure 1B) (11). The TR of the STAIR-Cones sequence
is relatively short (i.e., 250 ms) to enable robust long-T2 water
signal suppression. A multispoke acquisition strategy is applied to both
sequences to reduce scan time. The highly T2w-Cones sequence includes
four major features (Figure 1C): (i) a magnetization reset module to generate a
constant magnetization recovery, (ii) a T2 preparation module with a
long free decay time (e.g., 350 ms), (iii) an RF cycling or phase modulation
scheme (i.e., the RF phase of the second 90º pulse alternates by 180º in
adjacent TRs), and (iv) a Variable Flip Angle (VFA) technique to reduce signal
variation along the multiple data acquisition spokes and improve the Signal-to-Noise
Ratio performance. In each acquisition spoke (Figure 1D), a slab-selective RF
pulse is utilized for signal excitation followed by center-out spiral encoding.
This spiral encoding forms a 3D Cones trajectory to cover the whole k-space
efficiently (Figure 1E). The PDw-Cones uses the sequence shown in Figure 1D. A
relatively low flip angle (e.g., 1º) is used with this sequence to mitigate the
T1 contrast (11). In addition, brain T1 values are
measured using a VFA-Cones technique with B1 correction (12). The B1 maps are measured
by an actual flip angle Cones (AFI-Cones) sequence (12,13). The detailed sequence parameters
in this study are listed in Table 1.
Figure 2 shows the
workflow to quantify brain PFs of macromolecules, MW, IW, and EW using
the proposed protocol. Macromolecular proton fraction (MMPF) and TW fraction
are first estimated by two-pool MT modeling. The ratios of MW, IW, and EW to TW
are calculated from STAIR-Cones, PDw-Cones, and T2w-Cones images. With
known TW fraction estimated by the MT modeling, the MW PF (MWPF), IW PF (IWPF),
and EW PF (EWPF) are easily obtained.Results and Discussion
Figure 3 shows the representative images
acquired with MT-Cones, PDw-Cones, STAIR-Cones and T2w-Cones sequences
in a 22-year-old volunteer. Images with a higher MT FA and a smaller frequency
offset show a stronger MT effect. As seen in the STAIR-Cones images, the white
matter region has a much higher myelin water content than the gray matter
region. Extracellular water is selectively imaged with the
highly T2w-Cones sequence, when signals of all the other water
compartments are completely decayed.
Figure 4 shows the brain multicompartment
mapping results, including MMPF, MWPF, IWPF, and EWPF maps. The MMPF, MWPF, and
IWPF in white matter range from 10 to 18%, 5 to 12%, and 65 to 75%,
respectively. The MMPF, MWPF, and IWPF in gray matter range from 4 to 7%, 1.5
to 3%, and 81 to 88%, respectively. The EWPF ranges from 0 to 100%. As can be
seen in these maps, the white matter shows much higher values of MMPF and MWPF than
the gray matter. The gray matter has a higher IWPF than the white matter. Extracellular
water mainly exists in non-white and gray matter regions, such as the ventricles
and subarachnoid space.
Conclusion
The brain multicompartment imaging protocol can quantify the
PFs of the major tissue components including macromolecules, myelin water,
intracellular water, and extracellular water components in the brain, and has considerable
potential in clinical practice for assessment of neuroinflammatory and neurodegenerative
diseases.Acknowledgements
The authors acknowledge grant support from the National
Institutes of Health (R01AR062581, R01AR068987, R01AR075825, R01AR079484, and
RF1AG075717 and R21AR075851), VA Clinical Science and Rehabilitation Research
and Development Services (Merit Awards I01CX001388, I01CX002211, and
I01RX002604), and GE Healthcare. References
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