Assessment of mediastinal tumors with diffusion‐weighted single‐shot echo‐planar MRI

Purpose

To assess the role of diffusion‐weighted single‐shot echo‐planar magnetic resonance imaging (MRI) in patients with mediastinal tumors.

Methods

Prospective study was conducted on 45 consecutive patients (29 male, 16 female, age 22–66 years, mean 41 years) with mediastinal tumor. They underwent diffusion‐weighted single‐shot echo‐planar MRI of the mediastinum with a b‐factor of 0, 300, and 600 sec/mm². The apparent diffusion coefficient (ADC) value of the mediastinal tumor was correlated with the histopathological findings.

Results

The mean ADC value of malignant mediastinal tumors was 1.09 ± 0.25 × 10^?3 mm²/sec, and of benign tumors was 2.38 ± 0.56 × 10^?3 mm²/sec. There was a significant difference in the mean ADC value between malignant and benign tumors (P = 0.001) and within different grades of malignancy (0.001). When an ADC value of 1.56 × 10^?3 mm²/sec was used as a threshold value for differentiating malignant from benign tumor, the best results were obtained with an accuracy of 95%, sensitivity of 96%, specificity of 94%, positive predictive value of 94%, negative predictive value of 96%, and area under the curve of 0.938.

Conclusion

The ADC value is a noninvasive parameter that can be used for differentiation of malignant from benign mediastinal tumors and grading of mediastinal malignancy. J. Magn. Reson. Imaging 2009. © 2009 Wiley‐Liss, Inc.

     

Optimizing signal‐to‐noise ratio of high‐resolution parallel single‐shot diffusion‐weighted echo‐planar imaging at ultrahigh field strengths

The potential signal‐to‐noise ratio (SNR) gain at ultrahigh field strengths offers the promise of higher image resolution in single‐shot diffusion‐weighted echo‐planar imaging the challenge being reduced T₂ and T₂* relaxation times and increased B₀ inhomogeneity which lead to geometric distortions and image blurring. These can be addressed using parallel imaging (PI) methods for which a greater range of feasible reduction factors has been predicted at ultrahigh field strengths—the tradeoff being an associated SNR loss. Using comprehensive simulations, the SNR of high‐resolution diffusion‐weighted echo‐planar imaging in combination with spin‐echo and stimulated‐echo acquisition is explored at 7 T and compared to 3 T. To this end, PI performance is simulated for coil arrays with a variable number of circular coil elements. Beyond that, simulations of the point spread function are performed to investigate the actual image resolution. When higher PI reduction factors are applied at 7 T to address increased image distortions, high‐resolution imaging benefits SNR‐wise only at relatively low PI reduction factors. On the contrary, it features generally higher image resolutions than at 3 T due to smaller point spread functions. The SNR simulations are confirmed by phantom experiments. Finally, high‐resolution in vivo images of a healthy volunteer are presented which demonstrate the feasibility of higher PI reduction factors at 7 T in practice. Magn Reson Med, 2012. © 2011 Wiley Periodicals, Inc.     

Effect of shot number on the calculated apparent diffusion coefficient in phantoms and in human liver in diffusion‐weighted echo‐planar imaging

Purpose

To show the signal intensity varies with shot number in diffusion‐weighted (DW) echo‐planar imaging (EPI) and affects apparent diffusion coefficient (ADC) calculation.

Materials and Methods

This prospective study was performed on 35 adult patients and 20 volunteers. Measurements were made on a 3T scanner using a breathhold DW spin‐echo EPI (SE EPI) sequence. Three protocols were used: A) eight consecutive shots at a fixed b‐value of 0 seconds/mm² with TR = 1000 and 3000 msec; B) seven consecutive shots at b‐values = 0, 1000, 750, 500, 250, 100, 0 seconds/mm² (in that order) with TR = 3500 msec; and C) seven consecutive shots (as in B) with TR = 1000, 1750, and 7000 msec.

Results

For protocol A, signal intensity decreased significantly from the first to second shot (P<0.0001) and thereafter remained constant. For protocol B, the ADC depended on which b = 0 seconds/mm² image was used. Using the first b = 0 seconds/mm², the mean ADC was 15% higher than using the second b = 0 seconds/mm² (P<0.0001). For protocol C, the difference between ADC using the first b = 0 seconds/mm² and the second b = 0 seconds/mm² decreased as the TR increased.

Conclusion

The signal intensity can vary with shot number in SE EPI. For TR ≥ 3000 msec, steady‐state is attained after one shot. Using data acquired prior to steady‐state confounds the calculation of ADC values. J. Magn. Reson. Imaging 2009;30:547–553. © 2009 Wiley‐Liss, Inc.     

Correction for eddy current induced Bo shifts in diffusion‐weighted echo‐planar imaging

The importance of diffusion‐weighted MRI in the assessment of acute stroke is well‐recognized, and quantitative maps of the apparent diffusion coefficient (ADC) are now widely used. Echo‐planar imaging provides a robust method of acquiring diffusion‐weighted images free of motion artifact. However, initial experience with clinical MRI systems indicates that calculation of artifact‐free ADC maps from a series of echo‐planar diffusion‐weighted images is not necessarily straight‐forward. One of the problems is that frequency shifts resulting from eddy currents can cause misregistration of base diffusion‐weighted images. In this study, an on‐line correction method that overcomes this problem is described, and phantom and human images that demonstrate the validity of the technique are presented. The method uses a non‐phase‐encoded reference scan to correct the phase of each echo in the echo train, and can provide ADC maps that are free of misregistration artifacts, without the need for off‐line postprocessing. Magn Reson Med 41:95‐102, 1999. © 1999 Wiley‐Liss, Inc.     

Diffusion‐weighted imaging of human carotid artery using 2D single‐shot interleaved multislice inner volume diffusion‐weighted echo planar imaging (2D ss‐IMIV‐DWEPI) at 3T: Diffusion measurement in atherosclerotic plaque

Purpose:

To determine if 2D single‐shot interleaved multislice inner volume diffusion‐weighted echo planar imaging (ss‐IMIV‐DWEPI) can be used to obtain quantitative diffusion measurements that can assist in the identification of plaque components in the cervical carotid artery.

Materials and Methods:

The 2D ss‐DWEPI sequence was combined with interleaved multislice inner volume region localization to obtain diffusion weighted images with 1 mm in‐plane resolution and 2 mm slice thickness. Eleven subjects, six of whom have carotid plaque, were studied with this technique. The apparent diffusion coefficient (ADC) images were calculated using DW images with b = 10 s/mm² and b = 300 s/mm².

Results:

The mean ADC measurement in normal vessel wall of the 11 subjects was 1.28 ± 0.09 × 10^?3 mm²/s. Six of the 11 subjects had carotid plaque and ADC measurements in plaque ranged from 0.29 to 0.87 × 10^?3 mm²/s. Of the 11 common carotid artery walls studied (33 images), at least partial visualization of the wall was obtained in all ADC images, more than 50% visualization in 82% (27/33 images), and full visualization in 18% (6/33 images).

Conclusion:

2D ss‐IMIV‐DWEPI can perform diffusion‐weighted carotid magnetic resonance imaging (MRI) in vivo with reasonably high spatial resolution (1 × 1 × 2 mm³). ADC values of the carotid wall and plaque are consistent with similar values obtained from ex vivo endarterectomy specimens. The spread in ADC values obtained from plaque indicate that this technique could form a basis for plaque component identification in conjunction with other MRI/MRA techniques. J. Magn. Reson. Imaging 2009;30:1068–1077. © 2009 Wiley‐Liss, Inc.

     

High resolution diffusion‐weighted imaging using readout‐segmented echo‐planar imaging,parallel imaging and a two‐dimensional navigator‐based reacquisition

Single‐shot echo‐planar imaging (EPI) is well established as the method of choice for clinical, diffusion‐weighted imaging with MRI because of its low sensitivity to the motion‐induced phase errors that occur during diffusion sensitization of the MR signal. However, the method is prone to artifacts due to susceptibility changes at tissue interfaces and has a limited spatial resolution. The introduction of parallel imaging techniques, such as GRAPPA (GeneRalized Autocalibrating Partially Parallel Acquisitions), has reduced these problems, but there are still significant limitations, particularly at higher field strengths, such as 3 Tesla (T), which are increasingly being used for routine clinical imaging. This study describes how the combination of readout‐segmented EPI and parallel imaging can be used to address these issues by generating high‐resolution, diffusion‐weighted images at 1.5T and 3T with a significant reduction in susceptibility artifact compared with the single‐shot case. The technique uses data from a 2D navigator acquisition to perform a nonlinear phase correction and to control the real‐time reacquisition of unusable data that cannot be corrected. Measurements on healthy volunteers demonstrate that this approach provides a robust correction for motion‐induced phase artifact and allows scan times that are suitable for routine clinical application. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

Efficient fat suppression by slice‐selection gradient reversal in twice‐refocused diffusion encoding

Most diffusion imaging sequences rely on single‐shot echo‐planar imaging (EPI) for spatial encoding since it is the fastest acquisition available. However, it is sensitive to chemical‐shift artifacts due to the low bandwidth in the phase‐encoding direction, making fat suppression necessary. Often, spectral‐selective RF pulses followed by gradient spoiling are used to selectively saturate the fat signal. This lengthens the acquisition time and increases the specific absorption rate (SAR). However, in pulse sequences that contain two slice‐selective 180° refocusing pulses, the slice‐selection gradient reversal (SSGR) method of fat suppression can be implemented; i.e., using slice‐selection gradients of opposing polarity for the two refocusing pulses. We combined this method with the twice‐refocused spin‐echo sequence for diffusion encoding and tested its performance in both phantoms and in vivo. Unwanted fat signal was entirely suppressed with this method without affecting the water signal intensity or the slice profile. Magn Reson Med 60:1256–1260, 2008. © 2008 Wiley‐Liss, Inc.