Ultrafast imaging: Principles,pitfalls, solutions,and applications

Ultrafast MRI refers to efficient scan techniques that use a high percentage of the scan time for data acquisition. Often, they are used to achieve short scan duration ranging from sub‐second to several seconds. Alternatively, they may form basic components of longer scans that may be more robust or have higher image quality. Several important applications use ultrafast imaging, including real‐time dynamic imaging, myocardial perfusion imaging, high‐resolution coronary imaging, functional neuroimaging, diffusion imaging, and whole‐body scanning. Over the years, echo‐planar imaging (EPI) and spiral imaging have been the main ultrafast techniques, and they will be the focus of the review. In practice, there are important challenges with these techniques, as it is easy to push imaging speed too far, resulting in images of a nondiagnostic quality. Thus, it is important to understand and balance the trade‐off between speed and image quality. The purpose of this review is to describe how ultrafast imaging works, the potential pitfalls, current solutions to overcome the challenges, and the key applications. J. Magn. Reson. Imaging 2010;32:252–266. © 2010 Wiley‐Liss, Inc.     

High-resolution steady-state free precession coronary magnetic resonance angiography within a breath-hold: parallel imaging with extended cardiac data acquisition.

Coronary artery imaging data are conventionally acquired in a single imaging frame during mid-diastole. The data acquisition window must be sufficiently short to avoid cardiac motion artifacts. A short data acquisition window results in decreased imaging efficiency and limited spatial resolution. Parallel imaging may lessen these limitations, but requires highly accurate coil sensitivity. The purpose of this work was to increase the imaging efficiency and spatial resolution in coronary artery imaging using parallel imaging with an extended acquisition window. External coil calibration data were acquired before and after a short mid-diastolic period of accelerated imaging data acquisition. It was assumed that residual cardiac motion in the extended acquisition window would not impede accurate estimation of coil sensitivity since only low spatial frequency signals were acquired for coil calibration. Experimental studies were performed in five healthy volunteers at 3 T using steady-state free precession sequence. Statistical comparison was made between the proposed method and conventional data acquisition for visual quality of image and vessel sharpness. The proposed technique demonstrated higher visual grading and improved vessel sharpness. The proposed method is a new approach to enhance the imaging efficiency and spatial resolution in coronary artery imaging.     

Ultra-high-speed MR imaging

Conventional magnetic resonance imaging (MRI) has been shown to provide excellent morphological images of the body organs, particularly structures undergoing little physiologic motion. Nevertheless, the clinical usefulness of MRI has been hampered by long acquisition times, high cost of scanning because of limited patient throughput, and image artifacts due to patient motion. With recent technical developments, several ultrafast scanning techniques capable of acquiring images in a breath-hold now find their introduction into clinical use. The system improvements are potentially useful for a vast range of applications hitherto not accessible to MR imaging. Among these are functional brain imaging, realtime imaging of cardiac motion and perfusion, fast abdominal imaging, improved MR angiography, and potentially real-time monitoring of interventional procedures. Whereas some ultrafast techniques can be performed on conventional scanners, echo-planar imaging, the fastest currently available data acquisition strategy, requires specially designed hardware. This article provides on overview of the technical advances in the ultrafast MRI and discusses potential applications and the possible future impact on body scanning.Correspondence to: G. K. von Schulthess     

Ultrafast MR imaging in pediatric neuroradiology

Purpose: 
To compare the diagnostic information obtained from ultrafast MR imaging with standard MR imaging techniques in pediatric neuroradiology. The goal was to judge whether ultrafast methods can be used to replace standard methods and reduce the need for sedation or general anesthesia as a result of the considerably shorter scan times. Material and Methods: 
Our prospective study involved 125 patients. Routine clinical imaging was performed along with two ultrafast methods. Single shot fast spin echo (SSFSE) was used to give T2-weighted images and an echo planar imaging (EPI) sequence to provide a T1-weighted images.
The ultrafast images were presented to an experienced neuroradiologist who was also given the information present on the initial referral card. These reports based on the ultrafast images were then compared with the formal radiologic report made solely on the basis of the standard imaging. Results: 
The overall sensitivity and specificity for ultrafast imaging when compared to the reference standard were 78% and 98% with positive and negative predictive values of 98% and 76%. Pathologies characterized by small areas of subtle T2 prolongation were difficult or impossible to see on the ultrafast images but otherwise they provided reliable information. Conclusions: 
This paper demonstrates that ultrafast MR imaging can diagnose many pediatric intracranial abnormalities as well as standard methods. Anatomic resolution limits its capacity to define subtle developmental anomalies and contrast resolution limitations of the ultrafast methods reduce the detection of pathology characterized by subtle T2 prolongation.     

Fast interleaved echo-planar imaging with navigator: High resolution anatomic and functional images at 4 tesla

Echo-planar Imaging (EPI) Is sensitive to magnetic field inhomogeneities, which lead to signal loss and geometric distortions of the image. Magnetic field inhomogeneities induced by susceptibility differences, as encountered in the human body, increase with the magnetic field strength, thus, complicating implementation of high resolution EPI techniques on high magnetic field systems. These problems were overcome by using a fast multishot high resolution EPI method that uses variable flip angles, center-out k-space sampling, and navigator echoes. This approach maximizes signal-to-noise ratio, reduces flow artifacts, and permits correction of intersegment amplitude and phase variations, providing high spatial and temporal resolution. This scheme can be implemented with a single magnetization preparation for contrast that precedes the segments. The utility of this ultrafast segmented EPI technique with navigator is demonstrated for anatomic and functional imaging studies on the human brain at 4 T.     

Sensitivity-encoded (SENSE) proton echo-planar spectroscopic imaging (PEPSI) in the human brain.

Magnetic resonance spectroscopic imaging (MRSI) provides spatially resolved metabolite information that is invaluable for both neuroscience studies and clinical applications. However, lengthy data acquisition times, which are a result of time-consuming phase encoding, represent a major challenge for MRSI. Fast MRSI pulse sequences that use echo-planar readout gradients, such as proton echo-planar spectroscopic imaging (PEPSI), are capable of fast spectral-spatial encoding and thus enable acceleration of image acquisition times. Combining PEPSI with recent advances in parallel MRI utilizing RF coil arrays can further accelerate MRSI data acquisition. Here we investigate the feasibility of ultrafast spectroscopic imaging at high field (3T and 4T) by combining PEPSI with sensitivity-encoded (SENSE) MRI using eight-channel head coil arrays. We show that the acquisition of single-average SENSE-PEPSI data at a short TE (15 ms) can be accelerated to 32 s or less, depending on the field strength, to obtain metabolic images of choline (Cho), creatine (Cre), N-acetyl-aspartate (NAA), and J-coupled metabolites (e.g., glutamate (Glu) and inositol (Ino)) with acceptable spectral quality and localization. The experimentally measured reductions in signal-to-noise ratio (SNR) and Cramer-Rao lower bounds (CRLBs) of metabolite resonances were well explained by both the g-factor and reduced measurement times. Thus, this technology is a promising means of reducing the scan times of 3D acquisitions and time-resolved 2D measurements.     

Dynamic study of the upper airway with ultrafast spoiled GRASS MR imaging.

Dynamic magnetic resonance (MR) imaging of the upper airway was not possible previously because of poor temporal resolution. Recently, a rapid technique has been developed that provides the means to obtain multiple images at different section locations with sufficient image quality and temporal resolution to allow a comprehensive, dynamic study of the upper airway. The authors describe an ultrafast spoiled GRASS (gradient-recalled acquisition in the steady state) pulse sequence for dynamic studies of the upper airway. The authors believe that this procedure has potential for identifying and characterizing upper airway abnormalities such as nonfixed occlusions and/or narrowings that may exist in patients with obstructive sleep apnea.     

Novel reconstruction method for three‐dimensional axial continuously moving table whole‐body magnetic resonance imaging featuring autocalibrated parallel imaging GRAPPA

Continuously moving table MR imaging has been successfully evaluated for whole‐body tumor staging and metastasis screening. In previous studies it was demonstrated that three‐dimensional (3D) slab‐selective excitation with lateral readout can provide very efficient k‐space coverage when the longitudinal field of view (FOV) is limited. To reduce respiratory artifacts, data acquisition in the thoracoabdominal region of the patient typically must be performed during one single breath hold. This consequently restricts acquisition time and thus spatial resolution. In this work, a novel reconstruction method is introduced for axial 3D moving table data acquisition with lateral readout. The method features table position correction completely in k‐space and is compatible with autocalibrated parallel imaging (GRAPPA). Parallel imaging can be applied to increase spatial resolution while maintaining the breath‐holding time. A sophisticated protocol for whole‐body moving table MRI was developed. The impact of gradient nonlinearity on the featured imaging method was evaluated in phantom and volunteer experiments. Finally, the protocol was optimized toward minimizing residual artifacts. Moving table whole‐body MRI with lateral readout was performed in 5 healthy volunteers and was compared with lateral readout data acquired with a GRAPPA accelerated protocol providing increased spatial resolution. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Strategies to improve contrast in turboFLASH imaging: reordered phase encoding and k-space segmentation.

TurboFLASH (fast low-angle shot) sequences enable the acquisition of an image in a fraction of a second. However, unique to T1-weighted ultrafast imaging, the magnetization variation during image acquisition can produce artifacts along the phase-encoding direction. In this study, the signal behavior and nature of these artifacts were analyzed with various acquisition schemes to improve image contrast. The magnetization variation during image acquisition and its filtering effect on the image were simulated for three different approaches to T1-weighted turboFLASH imaging: standard turboFLASH with (a) monotonically ascending phase-encoding steps, (b) reordered phase encoding, and (c) k-space segmentation. Each of the modified data acquisition schemes has advantages. However, for subsecond imaging, reordered phase encoding produced improved image contrast over that of standard turboFLASH, and segmented k-space imaging gave superior tissue contrast compared with that of both standard and reordered turboFLASH, with imaging time that permits breath-hold studies.     

High temporal resolution functional MRI using parallel echo volumar imaging

PURPOSE: To combine parallel imaging with 3D single-shot acquisition (echo volumar imaging, EVI) in order to acquire high temporal resolution volumar functional MRI (fMRI) data. MATERIALS AND METHODS: An improved EVI sequence was associated with parallel acquisition and field of view reduction in order to acquire a large brain volume in 200 msec. Temporal stability and functional sensitivity were increased through optimization of all imaging parameters and Tikhonov regularization of parallel reconstruction. Two human volunteers were scanned with parallel EVI in a 1.5T whole-body MR system, while submitted to a slow event-related auditory paradigm. RESULTS: Thanks to parallel acquisition, the EVI volumes display a low level of geometric distortions and signal losses. After removal of low-frequency drifts and physiological artifacts, activations were detected in the temporal lobes of both volunteers and voxelwise hemodynamic response functions (HRF) could be computed. On these HRF different habituation behaviors in response to sentence repetition could be identified. CONCLUSION: This work demonstrates the feasibility of high temporal resolution 3D fMRI with parallel EVI. Combined with advanced estimation tools, this acquisition method should prove useful to measure neural activity timing differences or study the nonlinearities and nonstationarities of the BOLD response.     

Auto-SENSE perfusion imaging of the whole human heart

PURPOSE: To show the application of auto-sensitivity encoding (SENSE)-a self-calibrating parallel imaging technique-to first pass perfusion imaging of the whole human heart. MATERIALS AND METHODS: The self-calibrating parallel imaging method auto-SENSE was implemented for a saturation recovery turbo-fast low-angle shot (FLASH) sequence on a 1.5-T scanner using a standard four-element body phased array coil. By reducing the acquisition time per slice by a factor of two compared to conventional turbo FLASH imaging, the number of imaged slices could be doubled to six to ten with an unchanged temporal resolution of one image per heartbeat. This technique has been tested in eight healthy volunteers for contrast-enhanced heart perfusion imaging. RESULTS: Auto-SENSE heart perfusion imaging with improved coverage of the human heart could be performed successfully in all volunteers. A first quantitative comparison of perfusion values between the auto-SENSE and the non-SENSE techniques shows good agreement. CONCLUSION: Auto-SENSE allows perfusion imaging of the whole human heart without gaps.     

Comparison of ultrafast half-Fourier single-shot turbo spin-echo sequence with turbo spin-echo sequences for T2-weighted imaging of the female pelvis

So that we might evaluate the ultrafast half-Fourier single-shot turbo spin-echo (HASTE) sequence in T2-weighted MRI of the female pelvis and compare it with the turbo spin-echo (TSE) sequence, we prospectively studied 60 consecutive females with suspected abnormalities of the pelvis. For all MR examinations, we used a 1.5-T superconductive magnet with a phased array coil. The HASTE sequence was applied with TR/effective TE/echo train = ∞/90/64 and a 128 × 256 matri× (acquisition time: .3 sec/slice), conventional TSE imaging with 3,400 to 5,000/132/15 and a 128 × 256 matri× (mean acquisition time: 2 min 4 sec), and high-resolution TSE imaging with 3,400 to 5,000/132/15 and a 300 × 512 matri× (6 min 4 sec). Although the lesion conspicuity for the HASTE sequence was less than that for the high-resolution TSE sequences, artifacts (including ghosting, bowel motion, susceptibility difference, and chemical shift) were negligible on HASTE images of all patients. The lesion conspicuity for the HASTE sequence was significantly better than for the conventional TSE sequence. In spite of the very short acquisition time, the subjective scoring of the overall image quality for the HASTE sequence was significantly higher than for the conventional TSE sequence (P < .01) and were slightly lower than for the high-resolution TSE sequence. Compared with high-resolution TSE, HASTE provided clearer visualization of large leiomyomas and ovarian tumors but slightly poorer visualization of uterine cancer. In occlusion, HASTE sequence generates higher contrast and is free from motion and chemical shift artifact with much higher time efficacy. Because of limited image resolution, the HASTE sequence should be used when the high-resolution TSE imaging is suboptimal.     

Single-shot versus interleaved echo-planar MR -imaging: Application to visualization of cardiac valve leaflets

Visualization of the cardiac valves with standard magnetic resonance (MR) imaging is not adequate because of long acquisition times. Echo-planar imaging (PI) can, however, be performed with a temporal resolution (30–50 msec) comparable to that of echocardiography. The authors evaluated the feasibility of real-time imaging of cardiac valve motion with ultrafast MR techniques. Eight healthy volunteers and three patients with mitral stenosis and re- gurgitation were studied with a 1.5-T whole-body im- ager. Two different EPI sequences were assessed: a standard single-shot gradient-echo EPI (GEPI) SCquence and a fast imaging technique based on multiple-shot EPI with interleaved k-space acquisition (IGEPI). Fat-suppressed images with an in-plane resolution of 3.7 × 3.7 mm were obtained equally spaced through the cardiac cycle. Half-k-space acquisition was used. Morphologic evaluation was superior with IGEPI, owing to the better intracavitary signal homogeneity (P ≤ 0.01). and the mitral valve leaflets were easier to identify on systolic images. IGEPI provided adequate valve visibility in all three patients.     

Correlation imaging for multiscan MRI with parallel data acquisition

A new approach to high‐speed magnetic resonance imaging (MRI) that uses all the data acquired in a multiscan imaging session is presented. This approach accelerates MRI data acquisition by statistically estimating correlation functions from images with different contrast and/or resolution. In multiscan MRI with parallel data acquisition, the estimation of correlation functions is dynamically improved as imaging proceeds. This allows imaging acceleration factors to be increased in subsequent scans, thereby reducing the total time of a multiscan MRI protocol. Furthermore, the correlation function estimates bring information about both coil sensitivity and anatomical structure into image reconstruction, thereby offering the ability to speed up MRI beyond the parallel imaging acceleration limit posed by a coil array alone. In this study, the feasibility of correlation imaging is demonstrated experimentally using brain and spine imaging protocols. The ability of correlation imaging to achieve an aggregate acceleration factor in excess of the number of coil elements in the phase encoding direction is also demonstrated. Magn Reson Med, 2012. © 2012 Wiley Periodicals, Inc.     

Application of sensitivity-encoded echo-planar imaging for blood oxygen level-dependent functional brain imaging.

The benefits of sensitivity-encoded (SENSE) echo-planar imaging (EPI) for functional MRI (fMRI) based on blood oxygen level-dependent (BOLD) contrast were quantitatively investigated at 1.5 T. For experiments with 3.4 x 3.4 x 4.0 mm(3) resolution, SENSE allowed the single-shot EPI image acquisition duration to be shortened from 24.1 to 12.4 ms, resulting in a reduced sensitivity to geometric distortions and T(*)(2) blurring. Finger-tapping fMRI experiments, performed on eight normal volunteers, showed an overall 18% loss in t-score in the activated area, which was substantially smaller than expected based on the image signal-to-noise ratio (SNR) and g-factor, but similar to the loss predicted by a model that takes physiologic noise into account.     

Faster dynamic imaging of speech with field inhomogeneity corrected spiral fast low angle shot (FLASH) at 3 T

Purpose

To evaluate the impact of magnetic field inhomogeneity correction on achievable imaging speeds for magnetic resonance imaging (MRI) of articulating oropharyngeal structures during speech and to determine if sufficient acquisition speed is available for visualizing speech structures with real‐time MRI.

Materials and Methods

We designed a spiral fast low angle shot (FLASH) sequence that combines several acquisition techniques with an advanced image reconstruction approach that includes magnetic field inhomogeneity correction. A simulation study was performed to examine the interaction between imaging speed, image quality, number of spiral shots, and field inhomogeneity correction. Six volunteer subjects were scanned to demonstrate adequate visualization of articulating structures during simple speech samples.

Results

The simulation study confirmed that magnetic field inhomogeneity correction improves the available tradeoff between image quality and speed. Our optimized sequence co‐acquires magnetic field maps for image correction and achieves a dynamic imaging rate of 21.4 frames per second, significantly faster than previous studies. Improved visualization of anatomical structures, such as the soft palate, was also seen from the field‐corrected reconstructions in data acquired on volunteer subjects producing simple speech samples.

Conclusion

Adequate temporal resolution of articulating oropharyngeal structures during speech can be obtained by combining outer volume suppression, multishot spiral imaging, and magnetic field corrected image reconstruction. Correcting for the large, dynamic magnetic field variation in the oropharyngeal cavity improves image quality and allows for higher temporal resolution. J. Magn. Reson. Imaging 2010;32:1228–1237. © 2010 Wiley‐Liss, Inc.     

Multislice dark-blood carotid artery wall imaging: a 1.5 T and 3.0 T comparison

PURPOSE: To compare two multislice turbo spin-echo (TSE) carotid artery wall imaging techniques at 1.5 T and 3.0 T, and to investigate the feasibility of higher spatial resolution carotid artery wall imaging at 3.0 T. MATERIALS AND METHODS: Multislice proton density-weighted (PDW), T2-weighted (T2W), and T1-weighted (T1W) inflow/outflow saturation band (IOSB) and rapid extended coverage double inversion-recovery (REX-DIR) TSE carotid artery wall imaging was performed on six healthy volunteers at 1.5 T and 3.0 T using time-, coverage-, and spatial resolution-matched (0.47 x 0.47 x 3 mm3) imaging protocols. To investigate whether improved signal-to-noise ratio (SNR) at 3.0 T could allow for improved spatial resolution, higher spatial resolution imaging (0.31 x 0.31 x 3 mm3) was performed at 3.0 T. Carotid artery wall SNR, carotid lumen SNR, and wall-lumen contrast-to-noise ratio (CNR) were measured. RESULTS: Signal gain at 3.0 T relative to 1.5 T was observed for carotid artery wall SNR (223%) and wall-lumen CNR (255%) in all acquisitions (P < 0.025). IOSB and REX-DIR images were found to have different levels of SNR and CNR (P < 0.05) with IOSB values observed to be larger. Normalized to a common imaging time, the higher spatial resolution imaging at 3.0 T and the lower spatial resolution imaging at 1.5 T provided similar levels of wall-lumen CNR (P = NS). CONCLUSION: Multislice carotid wall imaging at 3.0 T with IOSB and REX-DIR benefits from improved SNR and CNR relative to 1.5 T, and allows for higher spatial resolution carotid artery wall imaging.     

Characterization and reduction of saturation banding in multiplanar coherent and incoherent steady‐state imaging

Hypointense band artifacts occur at intersections of nonparallel imaging planes in rapidly acquired MR images; quantitative or numerical analysis of these bands and strategies to mitigate their appearance have largely gone unexplored. The magnetization evolution in the different regions of multiplanar images was simulated for three common rapid steady‐state techniques (spoiled gradient echo, steady state free precession, balanced steady state free precession). Saturation banding was found to be highly dependent on the pulse sequence, acquisition time, and phase‐encoding order. Encoding the center of k‐space at the end of the acquisition of each slice (i.e., reverse centric phase encoding) is demonstrated to be a simple and robust method for significantly reducing the relative saturation in all imaging planes. View ordering and resolution dependence were confirmed in multiplanar abdominal images. The added importance of reducing the artifact in accelerated acquisition techniques (e.g., parallel imaging) is particularly notable in multiplanar balanced steady state free precession images in the brain. Magn Reson Med 63:1415–1421, 2010. © 2010 Wiley‐Liss, Inc.     

Highly accelerated cardiovascular MR imaging using many channel technology: concepts and clinical applications

Cardiovascular magnetic resonance imaging (CVMRI) is of proven clinical value in the non-invasive imaging of cardiovascular diseases. CVMRI requires rapid image acquisition, but acquisition speed is fundamentally limited in conventional MRI. Parallel imaging provides a means for increasing acquisition speed and efficiency. However, signal-to-noise (SNR) limitations and the limited number of receiver channels available on most MR systems have in the past imposed practical constraints, which dictated the use of moderate accelerations in CVMRI. High levels of acceleration, which were unattainable previously, have become possible with many-receiver MR systems and many-element, cardiac-optimized RF-coil arrays. The resulting imaging speed improvements can be exploited in a number of ways, ranging from enhancement of spatial and temporal resolution to efficient whole heart coverage to streamlining of CVMRI work flow. In this review, examples of these strategies are provided, following an outline of the fundamentals of the highly accelerated imaging approaches employed in CVMRI. Topics discussed include basic principles of parallel imaging; key requirements for MR systems and RF-coil design; practical considerations of SNR management, supported by multi-dimensional accelerations, 3D noise averaging and high field imaging; highly accelerated clinical state-of-the art cardiovascular imaging applications spanning the range from SNR-rich to SNR-limited; and current trends and future directions.     

4D radial coronary artery imaging within a single breath-hold: cine angiography with phase-sensitive fat suppression (CAPS).

Coronary artery data acquisition with steady-state free precession (SSFP) is typically performed in a single frame in mid-diastole with a spectrally selective pulse to suppress epicardial fat signal. Data are acquired while the signal approaches steady state, which may lead to artifacts from the SSFP transient response. To avoid sensitivity to cardiac motion, an accurate trigger delay and data acquisition window must be determined. Cine data acquisition is an alternative approach for resolving these limitations. However, it is challenging to use conventional fat saturation with cine imaging because it interrupts the steady-state condition. The purpose of this study was to develop a 4D coronary artery imaging technique, termed "cine angiography with phase-sensitive fat suppression" (CAPS), that would result in high temporal and spatial resolution simultaneously. A 3D radial stacked k-space was acquired over the entire cardiac cycle and then interleaved with a sliding window. Sensitivity-encoded (SENSE) reconstruction with rescaling was developed to reduce streak artifact and noise. Phase-sensitive SSFP was employed for fat suppression using phase detection. Experimental studies were performed on volunteers. The proposed technique provides high-resolution coronary artery imaging for all cardiac phases, and allows multiple images at mid-diastole to be averaged, thus enhancing the signal-to-noise ratio (SNR) and vessel delineation.