Zhiyuan Zhang1,2,3, Jeehun Kim1,3,4, Richard Lartey1,3, Carl Scherman Winalski1,3,5, and Xiaojuan Li1,3,5
1Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, United States, 2Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States, 3Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States, 4Electrical, Computer, and Systems Engineering, Case Western Reserve University, Cleveland, OH, United States, 5Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, United States
Synopsis
Keywords: Cartilage, Quantitative Susceptibility mapping
Quantitative MR T1ρ and
T2 imaging are promising methods to detect osteoarthritis at its early stage. Current
T1ρ and T2 mapping in human subjects is limited to a relatively
low resolution which has limited sensitivity to focal lesions due to partial-volume
effects. One of the hurdles to achieving high resolution is the increase in
fitting bias when using a conventional nonlinear least-squares fitting with low
SNR images. In this study, we evaluated T1ρ quantification with in-vivo high-resolution imaging
with different fitting methods.
Introduction
Osteoarthritis
(OA) is a worldwide healthcare challenge causing the loss of mobility and tremendous
pain in its late stage. OA affects multiple tissues in the joint and can cause
irreversible loss of tissues such as cartilage while the disease progresses.
Researchers have focused on detecting OA at its early stage to allow potential
early interventions before irreversible damage to the joint. Quantitative MRI
techniques including T1ρ and T2 mapping have been suggested as promising
methods to detect OA at the early stage1,2. However, current T1ρ and
T2 mapping techniques in human subjects are primarily limited with relatively
low spatial resolution, which is prone to partial-volume effects and may limit
the sensitivity of probing small focal lesions. There are potential two
challenges to implementing high-resolution mapping techniques in human
subjects: one is the long acquisition time, which can be addressed by MR
acceleration techniques with novel reconstruction methods; the other is the
lower signal-to-noise (SNR) ratio, especially in images in later echoes. Our
group and others have shown that the conventional nonlinear least-square fitting
method can introduce significant bias of T1ρ/T2 estimates with low SNR. This
study was focused on addressing the second challenge, aiming to demonstrate the
feasibility and potential benefit of high-resolution T1ρ imaging in human
knees and to evaluate high-resolution T1ρ quantifications with different
fitting methods. The results were compared to T1ρ imaging with standard-resolution. Method
Acquisition
parameters:
Four volunteers (3 females, age:
32.2±13.7 years) were scanned at a 3T Prisma MRI scanner (Siemens Healthcare
AG, Erlangen, Germany) with a knee coil (1Tx/15Rx, QED, Mayfield, OH). The MRI protocol
included DESS and MAPSS T1ρ imaging with standard- and high-resolutions (Table
1).
Imaging
reconstruction and analysis:
The T1ρ echo images were
reconstructed with two methods: 1) sum-of-squares (SOS)3. 2) complex-combined magnitude image (CPX)4.
Four fitting methods were applied afterwards:
(1) Nonlinear least-squares
fitting to SOS images (SOS-NLS)
(2)
NLS fitting to CPX images (CPX-NLS)
(3)
Maximum-likelihood estimation using SOS images (MLE)5,6
(4) Noise-corrected
nonlinear least-square using SOS images (NCNLS)5,7,8
The
high-resolution DESS images were registered to the first echo T1ρ image and
cartilage was automatically segmented in the registered DESS into six
compartments using in-house developed deep learning-based methods: medial and
lateral femur cartilage (MFC/LFC), medial and lateral tibia cartilage (MT/LT),
trochlear, and patella cartilage (TRO/PAT).
SNRs of standard- and high-resolution T1ρ echo images in each
defined compartment were measured as the ratio of signal intensity within segmented
cartilage over background noise standard deviation. T1ρ estimates were compared
between different fitting methods, and between standard- and high-resolution
T1ρ imaging using ANOVA, paired t-tests, and coefficients of variation (CVs). Result
Table
2 shows the SNR of each cartilage compartment for standard- and high-resolution
T1ρ echo images. Lower SNRs were observed with high-resolution T1ρ imaging, as
expected. Among compartments, PAT and TRO showed the highest SNR.
For
both standard- and high-resolution T1ρ imaging, SOS-NLS, and CPX-NLS
over-estimated T1ρ compared to MLE and NCNLS, Figure 1. For both resolutions,
T1ρ values of PAT and TRO showed the smallest differences between fitting
methods, Table 3(a).
Between
standard- and high-resolution T1ρ imaging, estimated T1ρ values from
high-resolution were significantly higher than standard-resolution when using
SOS-NLS and CPX-NLS fitting methods. No significant differences between the two
resolutions were observed when using MLE and NCNLS methods with CV < 3%, Table
3(b).
Figure
2 shows a case with clear partial-volume effects in standard-resolution T1ρ
imaging, which is minimal in high-resolution imaging. Discussion
Previous
work from our group and others suggested that the NLS on SOS images will
overestimate T1ρ (or T2) due to noise floors, while MLE and NCNLS methods can
provide a reliable estimate even with low SNR. The results from our study are
consistent with our previous findings. First, the differences between different
fitting methods were smallest in PAT and TRO due to the highest SNR in these
compartments. Second, the differences between different fitting methods became
larger with high-resolution imaging due to decreased SNR. SOS-NLS showed the
largest differences between the two resolutions because this method was the
most sensitive to SNR. MLE and NCNLS provided robust estimates even with
decreased SNR in high-resolution T1ρ imaging. CPX-NLS also provides bias
compared to NCNLS and MLE due to the complexity of measuring accurate coil sensitivity
maps. Our preliminary work suggests clear benefits of minimizing partial-volume
effects with high-resolution T1ρ imaging, as shown in Figure 2. Further work is
warranted to explore this benefit in more subjects including patients with
osteoarthritis. Conclusion
The
high-resolution T1ρ imaging has the benefits of less partial-volume effects and
provides more details that cannot be obtained using current standard-resolution
T1ρ imaging. Advanced fitting methods, including maximum-likelihood estimate and
noise-corrected nonlinear least-square fitting, shall be used for
high-resolution T1ρ imaging due to the lower SNR, which will provide a robust
estimate.Acknowledgements
The study was supported by NIH/NIAMS R01 AR077452References
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