Sajith Rajamani1, Ashok Kumar Reddy1, Nitin Jain1, Rajdeep Das1, Rajagopalan Sundaresan1, Jeremy Heinlein2, Harsh Kumar Agarwal1, Arnaud Guidon2, Sudhir Ramanna1, and Ramesh Venkatesan1
1GE Healthcare, Bangalore, India, 2GE Healthcare, Milwauke, WI, United States
Synopsis
DWI is an important sequence for
the diagnosis of liver lesions and to monitor the treatment response in
patients undergoing therapies for hepatic malignancies [1]. But it is difficult
to place the anterior abdomen coil for obese patients in non-wide bore MRI
systems because of a potential chance of pinching the coil between patient and
the bore. This is a limiting factor for the adoption of liver DWI MRI in
clinical practice [2]. As a solution, we are proposing Dual Shots DWI with
under-sampling across shots using volume coil located inside the magnet.
Purpose
Acquisition of abdomen mri protocol including DWI in a non-wide bore scanner using volume coil located inside the magnet bore without blurring and distortion in obese patients for whom positioning of dedicated anterior array abdomen coil is not possible because of very less space between the patient’s abdomen region and bore.Introduction
Diffusion weighted imaging is an
increasingly used and proven technique in diagnosis and characterization of
liver lesions [3]. Current clinical DWI protocol utilizes single shot spin-echo
based echo planar imaging with ASSET (GE)/ GRAPPA (Siemens)/ SENSE (Philips) or multi shot DWI with sensitivity-encoding using dedicated multichannel receiver coil positioned over the anterior aspect
of the patient to reduce blurring and distortion [4,5].
According to WHO, it is estimated
that more than 1 billion people worldwide are obese. In a non-wide bore MRI
scanner, it is difficult to position an obese patient with a dedicated
multichannel anterior array coil. Such patients are referred to centers having
a wide bore MRI. In this abstract, we propose the use of single channel volume
coil located inside the magnet bore instead of dedicated multi-channel abdomen
anterior array coil. Major challenge in using single channel volume coil is the
incompatibility of conventional parallel imaging methods because,
it needs sensitivity information from individual coil elements of a
multi-channel receiver coil to correct the phase information and estimation of
missing k-space lines [6]. DWI is susceptible to distortion and blurring if
parallel imaging under sampling is not used [7]. whereas other sequences don’t result
in these artifacts with full K-Space sampling (Figure1). To mitigate these
artifacts, we have proposed Dual Shot DWI with peripheral sub-sampling of
k-space across shots to reduce the echo-spacing between the phase encoding
lines.Materials & Methods
A healthy volunteer scan was
performed after obtaining informed consent approved by IRB on a 60cm bore 1.5T
GE Signa HDXT scanner. An abdomen protocol was scanned using volume coil.
Sequences used were, Axial T2 weighted image with fat sat, axial 2D Fiesta, 3D
LAVA, single shot DWI and Dual shot DWI with sub-sampling across shots. The Dual
Shot DWI Parameters are b values b0, b50 and b-500, field of View: 36cm TR/TE:
2000ms/59ms, No. of shots:2 breath hold duration: 18 seconds. Number of averages
1 for b0 and 2 for b0 and b500. ADC processing was done on an AW workstation
using Ready view application.
Data sampling and
reconstruction of Dual shot DWI: the central portion of k-space is
fully sampled which we call as ‘Cal data’. Peripheral part is sub-sampled across
both shots to decrease the echo spacing between phase encoding lines to reduce
blurring due to T2* decay. The Cal data from each shot is used to correct for
the phase difference across the shots which are sub sampled (Figure2).
Reconstruction was done using customized MATLAB scripts.Results
Figure 3 shows single shot DWI
and dual shot DWI with b500 sub-sampled across shots and their ADC maps. Single
shot DWI image shows reduced signal to noise ratio and blurring because of long
read out and T2* decay whereas dual shot Dwi with sub sampling has improved
signal to noise ratio and reduced blurring.Conclusion and Discussion
High quality DWI with ADC map is
required for the diagnosis and characterization of liver lesions. To generate diffusion
weighted images using spin echo EPI without blurring and distortion without the
use of dedicated abdomen coil, Dual shot DWI with sub-sampling across shots
were used. Initial results show reduction in blurring and improved signal to
noise ratio. However, further studies are required to evaluate more. This
technique can be used in obese patients where low resolution is suffice for the
characterization of abnormality. But in case of smaller pathologies and
whenever high-resolution diffusion weighted imaging is required, then should be
referred to a wide bore scanner using dedicated multichannel abdomen coil.Acknowledgements
No acknowledgement found.References
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