Comparison of diffusion‐weighted MRI and 2‐[fluorine‐18]‐fluoro‐2‐deoxy‐D‐glucose positron emission tomography (FDG‐PET) for detecting primary colorectal cancer and regional lymph node metastases

Purpose

To examine the usefulness of diffusion‐weighted MRI (DW‐MRI) for the detection of both primary colorectal cancer and regional lymph node metastases, and compare its performance with 2‐[fluorine‐18]‐fluoro‐2‐deoxy‐D‐glucose positron emission tomography (FDG‐PET) in the same patients.

Materials and Methods

We studied 25 patients with known colorectal cancer. All underwent both DW‐MRI and FDG‐PET studies. The images were retrospectively assessed by visual inspection and the imaging findings were compared with histopathological findings on surgical specimens.

Results

Of the 27 primary colorectal lesions surgically excised in 25 patients, 23 (85.2%) were true‐positive on both DW‐MRI and FDG‐PET. Two cancers were false‐negative on DW‐MRI but true‐positive on FDG‐PET, and two were false‐negative on both DW‐MRI and FDG‐PET. With respect to the detectability of metastatic lymph nodes, DW‐MRI and FDG‐PET manifested a sensitivity of 80% (8/10) and 30.0% (3/10), a specificity of 76.9% (10/13) and 100% (13/13), and an accuracy of 78.3% (18/23) and 69.6% (16/23), respectively.

Conclusion

DW‐MRI is inferior to FDG‐PET for the detection of primary lesions, but superior for the detection of lymph node metastases. J. Magn. Reson. Imaging 2009;29:336–340. © 2009 Wiley‐Liss, Inc.     

Tumor volume and subvolume concordance between FDG‐PET/CT and diffusion‐weighted MRI for squamous cell carcinoma of the cervix

Purpose:

To compare [¹⁸F]fluorodeoxyglucose (FDG) / positron emission tomography (PET) / computed tomography (CT) and magnetic resonance imaging (MRI) for evaluating patients with cervical cancer. We compared tumor characteristics on FDG‐PET and apparent diffusion coefficient (ADC) maps on diffusion‐weighted MRI (DWI) to evaluate concordance of two functional imaging techniques.

Materials and Methods:

Twenty women with cervical cancer underwent pretreatment FDG‐PET/CT and pelvic MRI. Images were rigidly fused by pelvic anatomy using coregistration software. Tumor contours on PET images were generated by autosegmentation of the region containing at least 40% of the maximum standardized uptake value (SUV). DWI contours were generated by manual segmentation. Tumor volume similarity was evaluated using the [PET]/[ADC] volume proportion, Dice's coefficient, and the mean SUV isothreshold at the surface of each ADC contour. Tumor subvolume similarity was evaluated with analysis of variance (ANOVA).

Results:

The [PET]/[ADC] volume proportion was 0.88 ± 0.14. Dice's coefficient between PET and ADC tumor contours was 0.76 ± 0.06. The mean SUV isothreshold at the ADC‐delineated tumor surface was 34 ± 4%. Subvolumes with increased metabolic activity on FDG‐PET also had more restricted diffusion on DWI (P < 0.0001, ANOVA).

Conclusion:

Concordance of functional imaging was observed between FDG‐PET and DWI for cervical cancer. Tumor subvolumes with increased metabolic activity on FDG‐PET also have greater cell density by DWI. J. Magn. Reson. Imaging 2013;37:431–434. © 2012 Wiley Periodicals, Inc.     

Magnetization transfer‐based 3D visualization of foot peripheral nerves

Purpose:

To investigate magnetization transfer (MT) effects as a new source of contrast for imaging and tracking of peripheral foot nerves.

Materials and Methods:

Two sets of 3D spoiled gradient‐echo images acquired with and without a saturation pulse were used to generate MT ratio (MTR) maps of 260 μm in‐plane resolution for eight volunteers at 3T. Scan parameters were adjusted to minimize signal loss due to T2 dephasing, and a dedicated coil was used to improve the inherently low signal‐to‐noise ratio of small voxels. Resulting MTR values in foot nerves were compared with those in surrounding muscle tissue.

Results:

Average MTR values for muscle (45.5 ± 1.4%) and nerve (21.4 ± 3.1%) were significantly different (P < 0.0001). In general, the difference in MTR values was sufficiently large to allow for intensity‐based segmentation and tracking of foot nerves in individual subjects. This procedure was termed MT‐based 3D visualization.

Conclusion:

The MTR serves as a new source of contrast for imaging of peripheral foot nerves and provides a means for high spatial resolution tracking of these structures. The proposed methodology is directly applicable on standard clinical MR scanners and could be applied to systemic pathologies, such as diabetes. J. Magn. Reson. Imaging 2013;37:1234–1237. © 2012 Wiley Periodicals, Inc.     

Differentiation of malignant and benign breast lesions using magnetization transfer imaging and dynamic contrast‐enhanced MRI

Purpose:

To evaluate feasibility of using magnetization transfer ratio (MTR) in conjunction with dynamic contrast‐enhanced MRI (DCE‐MRI) for differentiation of benign and malignant breast lesions at 3 Tesla.

Materials and Methods:

This prospective study was IRB and HIPAA compliant. DCE‐MRI scans followed by MT imaging were performed on 41 patients. Regions of interest (ROIs) were drawn on co‐registered MTR and DCE postcontrast images for breast structures, including benign lesions (BL) and malignant lesions (ML). Initial enhancement ratio (IER) and delayed enhancement ratio (DER) were calculated, as were normalized MTR, DER, and IER (NMTR, NDER, NIER) values. Diagnostic accuracy analysis was performed.

Results:

Mean MTR in ML was lower than in BL (P < 0.05); mean DER and mean IER in ML were significantly higher than in BL (P < 0.01, P < 0.001). NMTR, NDER, and NIER were significantly lower in ML versus BL (P < 0.007, P < 0.001, P < 0.001). IER had highest diagnostic accuracy (77.6%), sensitivity (86.2%), and area under the ROC curve (.879). MTR specificity was 100%. Logistic regression modeling with NMTR and NIER yielded best results for BL versus ML (sensitivity 93.1%, specificity 80%, AUC 0.884, accuracy 83.7%).

Conclusion:

Isolated quantitative DCE analysis may increase specificity of breast MR for differentiating BL and ML. DCE‐MRI with NMTR may produce a robust means of evaluating breast lesions. J. Magn. Reson. Imaging 2013;37:138–145. © 2012 Wiley Periodicals, Inc.     

Preoperative detection of prostate cancer: A comparison with 11C‐choline PET, 18F‐fluorodeoxyglucose PET and MR imaging

Purpose:

To compare ¹¹C‐choline positron emission tomography (C‐PET), ¹⁸F‐fluorodeoxyglucose PET (FDG‐PET), and MR imaging in the preoperative detection of prostate cancer.

Materials and Methods:

C‐PET, FDG‐PET, and MR images were obtained in 43 consecutive patients with suspected prostate cancer, and prostate cancers were histopathologically confirmed in 26 patients. Unenhanced T1‐weighted, T2‐weighted, and gadolinium‐enhanced MR images were obtained. C‐PET and FDG‐PET were conducted 1.5 and 60 minutes after injection of 5.5 and 5.0 MBq/kg tracers, respectively. A nuclear and a genitourinary radiologist retrospectively reviewed PET and MR images at random, respectively, and assigned a confidence level for the presence of prostate cancer using a four‐point scale. Diagnostic performance was tested using the McNemar test and receiver operating characteristic curve analysis.

Results:

The sensitivity was greater (P < 0.05) with MR (88%) and C‐PET (73%) images than with FDG‐PET images (31%). The accuracy was greater (P < 0.05) with MR images (88%) than with C‐PET (67%) and FDG‐PET (53%) images. The area‐under‐curve value with MR (0.90) was greater than those with C‐PET (0.53) and FDG‐PET (0.54) images (P < 0.01).

Conclusion:

MR imaging should be primarily performed in the preoperative detection of prostate cancer. C‐PET and FDG‐PET did not improve the detection. J. Magn. Reson. Imaging 2010;31:1151–1156. © 2010 Wiley‐Liss, Inc.     

Half‐fourier‐acquisition single‐shot turbo spin‐echo (HASTE) MRI of the lung at 3 Tesla using parallel imaging with 32‐receiver channel technology

Purpose

To assess the feasibility of half‐Fourier‐acquisition single‐shot turbo spin‐echo (HASTE) of the lung at 3 Tesla (T) using parallel imaging with a prototype of a 32‐channel torso array coil, and to determine the optimum acceleration factor for the delineation of intrapulmonary anatomy.

Materials and Methods

Nine volunteers were examined on a 32‐channel 3T MRI system using a prototype 32‐channel‐torso‐array‐coil. HASTE‐MRI of the lung was acquired at both, end‐inspiratory and end‐expiratory breathhold with parallel imaging (Generalized autocalibrating partially parallel acquisitions = GRAPPA) using acceleration factors ranging between R = 1 (TE = 42 ms) and R = 6 (TE = 16 ms). The image quality of intrapulmonary anatomy and subjectively perceived noise level was analyzed by two radiologists in consensus. In addition quantitative measurements of the signal‐to‐noise ratio (SNR) of HASTE with different acceleration factors were assessed in phantom measurements.

Results

Using an acceleration factor of R = 4 image blurring was substantially reduced compared with lower acceleration factors resulting in sharp delineation of intrapulmonary structures in expiratory scans. For inspiratory scans an acceleration factor of 2 provided the best image quality. Expiratory scans had a higher subjectively perceived SNR than inspiratory scans.

Conclusion

Using optimized multi‐element coil geometry HASTE‐MRI of the lung is feasible at 3T with acceleration factors up to 4. Compared with nonaccelerated acquisitions, shorter echo times and reduced image blurring are achieved. Expiratory scanning may be favorable to compensate for susceptibility associated signal loss at 3T. J. Magn. Reson. Imaging 2009;30:541–546. © 2009 Wiley‐Liss, Inc.     

Breathhold‐regulated blood oxygenation level‐dependent (BOLD) MRI of human brain at 3 tesla

Purpose:

To investigate the cerebrovascular response to repeated breathhold challenges using blood oxygenation level‐dependent (BOLD) MRI at 3T and compare the results with previous data at 1.5T.

Materials and Methods:

Six normal volunteers and six patients with brain tumors were recruited for this 3T study. For the normal group, BOLD MRI during repeated breathholds of different durations (five to 30 seconds) were acquired. Maximum signal change, full‐width at half‐maximum (FWHM) and onset time (defined as the time to the first half‐maximum) were determined by curve fitting. The fractional activation volume was also calculated. Patients performed a 10‐ or 15‐second breathhold paradigm according to individual capability.

Results:

Significant BOLD signal increases in the gray matter for a breathhold period as short as 5 seconds at 3T, instead of 10 seconds at 1.5T. The fractional activation volume vs. breathhold duration reached a plateau of 49.54 ± 7.26% at 15 seconds at 3T, which was higher and shorter than that at 1.5T. The maximum signal changes were significantly larger (a 69% increase) at 3T than at 1.5T. In the patient group, there were BOLD signal increases in gray matter but not in tumor bulk or perifocal edema, which agreed with the results previously found at 1.5T.

Conclusion:

BOLD MRI at 3T is more sensitive for detecting breathhold‐regulated signal changes than at 1.5T, which allows a shorter and more feasible breathhold paradigm for clinical applications in patients with brain tumors. J. Magn. Reson. Imaging 2010;31:78–84. © 2009 Wiley‐Liss, Inc.     

Optimized high‐resolution mapping of magnetization transfer (MT) at 3 Tesla for direct visualization of substructures of the human thalamus in clinically feasible measurement time

Purpose

To optimize contrast‐to‐noise and spatial resolution of a FLASH‐based magnetization transfer (MT) protocol for visualization of substructures in human thalamus.

Materials and Methods

Healthy adults were examined at 3 Tesla with a three‐dimensional (3D) spoiled gradient‐echo sequence. The signal‐to‐noise ratio (SNR) was increased by averaging eight bipolar echo acquisitions (mean echo time = 12.3 ms; bandwidth = 370 Hz/pixel). Three isotropic datasets with different weighting (proton density: flip angle/repetition time = 7°/30 ms; T₁: 20°/30 ms and MT: 10°/48 ms, Gaussian MT prepulse) yielded maps of T₁, signal amplitude, MT ratio and MT saturation for comparison to MP‐RAGE images. Measuring time was 23 min using partial k‐space acquisition. First, the SNR of MT saturation maps in thalamus was optimized by means of the excitation flip angle. Then, noise and partial volume effects were traded off by means of the resolution. Finally, the contrast within the thalamus and to adjacent structures was compared between different maps.

Results

The optimized MT saturation maps at 0.95 mm isotropic resolution provided the highest contrast. It was most prominent between structures of high axonal content (internal medullary lamina, ventral nuclei) and those containing predominantly neuronal somata (pulvinar, mediodorsal thalamus, geniculate bodies).

Conclusion

Semiquantitative MT saturation maps provide an enhanced intra‐thalamic contrast. The borders and nuclear groups of the thalamus are reliably delineated; individual assignment of singular nuclei seems feasible. J. Magn. Reson. Imaging 2009;29:1285–1292. © 2009 Wiley‐Liss, Inc.     

MTR variations in normal adult brain structures using balanced steady-state free precession

Introduction  

Magnetization transfer (MT) is sensitive to the macromolecular environment of water protons and thereby provides information not obtainable from conventional magnetic resonance imaging (MRI). Compared to standard methods, MT-sensitized balanced steady-state free precession (bSSFP) offers high-resolution images with significantly reduced acquisition times. In this study, high-resolution magnetization transfer ratio (MTR) images from normal appearing brain structures were acquired with bSSFP.     

Added value of breathhold diffusion‐weighted MRI in detection of small hepatocellular carcinoma lesions compared with dynamic contrast‐enhanced MRI alone using receiver operating characteristic curve analysis

Purpose

To evaluate the added value of single‐breathhold diffusion‐weighted MRI (DWI) in detection of small hepatocellular carcinoma (HCC) lesions (≤2 cm) in patients with chronic liver disease, by comparing the detection sensitivity of combined DWI/conventional dynamic contrast‐enhanced (DCE)‐MRI to that of conventional DCE‐MRI alone.

Materials and Methods

A total of 37 patients with chronic liver diseases underwent abdominal MRI at 1.5T, including T1‐weighted imaging (T1WI), T2‐weighted imaging (T2WI), and 2D conventional DCE. For each patient study, axial DWI was performed with a single‐shot echo‐planar imaging (EPI) sequence using a modified sensitivity‐encoding (mSENSE) technique with b‐value of 500 seconds/mm². A total of 20–24 slices were obtained during a 15–17‐second breathhold. Two observers independently interpreted the combined DWI/conventional DCE‐MRI images and the conventional DCE‐MRI images alone in random order. For all small HCC lesions, the diagnostic performance using each imaging set was evaluated by receiver operating characteristic (ROC) curve analysis. Sensitivity and positive predictive values were also calculated and analyzed.

Results

A total of 47 small HCCs were confirmed as final result. The area under the ROC curve (Az) of combined DWI/conventional DCE‐MRI images (observer 1, 0.922; observer 2, 0.918) were statistically higher than those of conventional DCE‐MRI alone (observer 1, 0.809; observer 2, 0.778) for all small HCC lesions (P < 0.01). The lesion detection sensitivities using the combined technique for both observers were significantly higher than those using conventional DCE‐MRI alone (P < 0.01). The sensitivity values for two observers using the combined technique were 97.87% and those using conventional DCE‐MRI alone were 85.11% to 82.98%. The positive predictive values for two observers using the combined imaging technique (97.87%) were slightly higher than those using conventional DCE‐MRI alone (92.86–93.02%), but there was no significant difference between the two imaging sets.

Conclusion

Combined use of breathhold DWI with conventional DCE‐MRI helped to provide higher sensitivities than conventional DCE‐MRI alone in the detection of small HCC lesions in patients with chronic liver disease. J. Magn. Reson. Imaging 2009;29:341–349. © 2009 Wiley‐Liss, Inc.     

Imaging age‐related cognitive decline: A comparison of diffusion tensor and magnetization transfer MRI

Purpose

To determine which MR technique was the most sensitive to age‐related white matter damage. We compared both diffusion tensor imaging (DTI) and magnetization transfer (MT) maps to determine which technique correlated most strongly with cognitive function in a middle‐aged and elderly community population.

Materials and Methods

In all, 64 healthy subjects (aged 50–90) underwent MRI and neuropsychology. Histograms were generated for white matter mean diffusivity (MD), fractional anisotropy (FA), and MT ratio (MTR). White matter hyperintensity volume (WMH) and brain volume were also determined. Composite neuropsychological scores were derived for 4 cognitive domains (executive function, working memory, episodic memory, and information processing speed).

Results

All MRI parameters correlated with age (FA r = 0.726, P < 0.001; MD r = ?0.619 P < 0.001, MTR r = ?0.566, P < 0.001, WMH r = 0.511, P < 0.001). All MRI parameters correlated with cognition, but DTI, and particularly FA, correlated most strongly. Adding DTI parameters explained more variance in cognition than WMH alone; the increase was greatest with FA, which alone explained 45%, 33%, and 25% of the variance in cognition for information processing speed, episodic memory, and executive function, respectively.

Conclusion

DTI appears the most sensitive imaging parameter to determine age‐related white matter damage. The stronger relationship with FA suggests that axonal damage is important in age‐related cognitive decline. J. Magn. Reson. Imaging 2009;29:23–30. © 2008 Wiley‐Liss, Inc.

     

Simultaneous temperature and magnetization transfer (MT) monitoring during high‐intensity focused ultrasound (HIFU) treatment: Preliminary investigation on ex vivo porcine muscle

Purpose

To measure temperature change and magnetization transfer ratio (MTR) simultaneously during high‐intensity focused ultrasound (HIFU) treatment.

Materials and Methods

This study proposed an interleaved dual gradient‐echo technique to monitor the heat and tissue damage brought to the heated tissue. The technique was applied to tissue samples to test its efficacy.

Results

Ex vivo experiments on the porcine muscle demonstrated that both temperature changes and MTR exhibited high consistency in localizing the heated regions. As the heat dissipated after the treatment, the temperature of the heated regions decreased rapidly but MTR continued to be elevated. Moreover, thermal dose (TD) maps derived from the temperature curves demonstrated a sharp margin in the heated regions, but MTR maps may show a spatial gradient of tissue damage, suggesting complimentary information provided by these two measures.

Conclusion

In a protocol of spot‐by‐spot heating over a large volume of tissue, MTR provides additional values to mark the locations of previously heated regions. By continuously recording the locations of heated spots, MTR maps could help plan the next target spots appropriately, potentially improving the efficiency of HIFU treatment and reducing undesirable damage to the normal tissue. J. Magn. Reson. Imaging 2009. © 2009 Wiley‐Liss, Inc.     

Single breathhold cardiac CINE imaging with multi‐echo three‐dimensional hybrid radial SSFP acquisition

Purpose:

To achieve single breathhold whole heart cardiac CINE imaging with improved spatial resolution and temporal resolution by using a multi‐echo three‐dimensional (3D) hybrid radial SSFP acquisition.

Materials and Methods:

Multi‐echo 3D hybrid radial SSFP acquisitions were used to acquire cardiac CINE imaging within a single breathhold. An optimized interleaving scheme was developed for view ordering throughout the cardiac cycle.

Results:

Whole heart short axis views were acquired with a spatial resolution of 1.3 × 1.3 × 8.0 mm³ and temporal resolution of 45 ms, within a single 17 s breathhold. The technique was validated on eight healthy volunteers by measuring the left ventricular volume throughout the cardiac cycle and comparing with the conventional 2D multiple breathhold technique. The left ventricle functional measurement bias of our proposed 3D technique from the conventional 2D technique: end diastolic volume ?3.3 mL ± 13.7 mL, end systolic volume 1.4 mL ± 6.1 mL, and ejection fraction ?1.7% ± 4.3%, with high correlations 0.94, 0.97, and 0.91, accordingly.

Conclusion:

A multi‐echo 3D hybrid radial SSFP acquisition was developed to allow for a whole heart cardiac CINE exam in a single breathhold. Cardiac function measurements in volunteers compared favorably with the standard multiple breathhold exams. J. Magn. Reson. Imaging 2010;32:434–440. © 2010 Wiley‐Liss, Inc.

     

Conversion of arterial input functions for dual pharmacokinetic modeling using Gd‐DTPA/MRI and 18F‐FDG/PET

Reaching the full potential of magnetic resonance imaging (MRI)‐positron emission tomography (PET) dual modality systems requires new methodologies in quantitative image analyses. In this study, methods are proposed to convert an arterial input function (AIF) derived from gadolinium‐diethylenetriaminepentaacetic acid (Gd‐DTPA) in MRI, into a ¹⁸F‐fluorodeoxyglucose (¹⁸F‐FDG) AIF in PET, and vice versa. The AIFs from both modalities were obtained from manual blood sampling in a F98‐Fisher glioblastoma rat model. They were well fitted by a convolution of a rectangular function with a biexponential clearance function. The parameters of the biexponential AIF model were found statistically different between MRI and PET. Pharmacokinetic MRI parameters such as the volume transfer constant (K^trans), the extravascular–extracellular volume fraction (ν_e), and the blood volume fraction (ν_p) calculated with the Gd‐DTPA AIF and the Gd‐DTPA AIF converted from ¹⁸F‐FDG AIF normalized with or without blood sample were not statistically different. Similarly, the tumor metabolic rates of glucose (TMRGlc) calculated with ¹⁸F‐FDG AIF and with ¹⁸F‐FDG AIF obtained from Gd‐DTPA AIF were also found not statistically different. In conclusion, only one accurate AIF would be needed for dual MRI‐PET pharmacokinetic modeling in small animal models. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.     

[<Superscript>68</Superscript>Ga]DOTATATE PET/MRI and [<Superscript>18</Superscript>F]FDG PET/CT are complementary and superior to diffusion-weighted MR imaging for radioactive-iodine-refractory differentiated thyroid cancer

Purpose

The purpose of this study was to determine whether [⁶⁸Ga]DOTATATE PET/MRI with diffusion-weighted imaging (DWI) can replace or complement [¹⁸F]FDG PET/CT in patients with radioactive-iodine (RAI)-refractory differentiated thyroid cancer (DTC).

Methods

The study population comprised 12 patients with elevated thyroglobulin and a negative RAI scan after thyroidectomy and RAI remnant ablation who underwent both [¹⁸F]FDG PET/CT and [⁶⁸Ga]DOTATATE PET/MRI within 8 weeks of each other. The presence of recurrent cancer was evaluated on a per-patient, per-organ and per-lesion basis. Histology, and prior and follow-up examinations served as the standard of reference.

Results

Recurrent or metastatic tumour was confirmed in 11 of the 12 patients. [⁶⁸Ga]DOTATATE PET(/MRI) correctly identified the tumour burden in all 11 patients, whereas in one patient local relapse was missed by [¹⁸F]FDG PET/CT. In the lesion-based analysis, overall lesion detection rates were 79/85 (93 %), 69/85 (81 %) and 27/82 (33 %) for [¹⁸F]FDG PET/CT, [⁶⁸Ga]DOTATATE PET/MRI and DWI, respectively. [¹⁸F]FDG PET(/CT) was superior to [⁶⁸Ga]DOTATATE PET(/MRI) in the overall evaluation and in the detection of pulmonary metastases. In the detection of extrapulmonary metastases, [⁶⁸Ga]DOTATATE PET(/MRI) showed a higher sensitivity than [¹⁸F]FDG PET(/CT), at the cost of lower specificity. DWI achieved only poor sensitivity and was significantly inferior to [¹⁸F]FDG PET in the lesion-based evaluation in the detection of both extrapulmonary and pulmonary metastases.

Conclusion

[¹⁸F]FDG PET/CT was more sensitive than [⁶⁸Ga]DOTATATE PET/MRI in the evaluation of RAI-refractory DTC, mostly because of its excellent ability to detect lung metastases. In the evaluation of extrapulmonary lesions, [⁶⁸Ga]DOTATATE PET(/MRI) was more sensitive and [¹⁸F]FDG PET(/CT) more specific. Furthermore, DWI did not provide additional information and cannot replace [¹⁸F]FDG PET for postoperative monitoring of patients with suspected RAI-refractory DTC.

     

Magnetisation transfer MR imaging of the kidney: evaluation at 3.0 T in association with renal function

Objective

To evaluate the feasibility of using magnetisation transfer (MT) MRI of the kidney at 3.0 T to assess renal function.

Methods

Forty-four patients who underwent abdominal MRI on a 3.0-T system including gradient-echo (GRE) sequences with and without MT pulse were included. In each patient, MT ratio (MTR) of the renal cortex and medulla was measured by using regions of interest (ROIs) placed on the MTR map image.

Results

Regression analysis showed good correlation between estimated glomerular filtration rate (eGFR) and MTR of the renal cortex (r?=??0.645, P?<?0.0001). Among 44 patients, 22 were categorised as the normal renal function group and 22 were classified as the decreased eGFR group. The mean MTR of the renal cortex in patients with decreased eGFR (mean MTR, 30.7?±?3.2 %) was significantly higher (P?<?0.0001) than that in patients with normal renal function (mean MTR, 25.3?±?2.2 %), although the mean MTRs of the renal medulla in the two groups were not significantly different.

Conclusion

There was good correlation between eGFR and MTR of the renal cortex derived from MT MRI at 3.0 T. This technique may have the potential to evaluate the degree of renal function non-invasively in patients with renal impairment.

Key Points

? Magnetisation transfer techniques can provide new information about renal disease. ? MTR values of the renal cortex correlate well with estimated glomerular filtration. ? Higher MTR of the renal cortex exists in patients with renal dysfunction. ? MT MRI at 3.0 T may be useful for evaluating renal function.     

Breathheld autocalibrated phase‐contrast imaging

Purpose:

To compare generalized autocalibrating partially parallel acquisitions (GRAPPA), modified sensitivity encoding (mSENSE), and SENSE in phase‐contrast magnetic resonance imaging (PC‐MRI) applications.

Materials and Methods:

Aliasing of the torso can occur in PC‐MRI applications. If the data are further undersampled for parallel imaging, SENSE can be problematic in correctly unaliasing signals due to coil sensitivity maps that do not match that of the aliased volume. Here, a method for estimating coil sensitivities in flow applications is described. Normal volunteers (n = 5) were scanned on a 1.5 T MRI scanner and underwent PC‐MRI scans using GRAPPA, mSENSE, SENSE, and conventional PC‐MRI acquisitions. Peak velocity and flow through the aorta and pulmonary artery were evaluated.

Results:

Bland–Altman statistics for flow in the aorta and pulmonary artery acquired with mSENSE and GRAPPA methods (R = 2 and R = 3 cases) have comparable mean differences to flow acquired with conventional PC‐MRI. GRAPPA and mSENSE PC‐MRI have more robust measurements than SENSE when there is aliasing artifact caused by insufficient coil sensitivity maps. For peak velocity, there are no considerable differences among the mSENSE, GRAPPA, and SENSE reconstructions and are comparable to conventional PC‐MRI.

Conclusion:

Flow measurements of images reconstructed with autocalibration techniques have comparable agreement with conventional PC‐MRI and provide robust measurements in the presence of wraparound. J. Magn. Reson. Imaging 2010;31:1004–1014. ©2010 Wiley‐Liss, Inc.     

Diagnostic Value of <Superscript>18</Superscript>F-FDG PET/CT and MRI in the Preoperative Evaluation of Uterine Carcinosarcoma

Purpose

This study aimed to compare the diagnostic value of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) and magnetic resonance imaging (MRI) in the preoperative evaluation of uterine carcinosarcoma.

Methods

Fifty-four women with pathologically confirmed uterine carcinosarcoma who underwent preoperative FDG PET/CT and MRI from June 2006 to November 2016 were included. Pathologic findings from primary tumor lesions, para-aortic and pelvic lymph node (LN) areas, and peritoneal seeding lesions were compared with the FDG PET/CT and MRI findings. The maximum standardized uptake value (SUVmax) of the primary tumor and LN was obtained. The tumor-to-liver ratio (TLR) was calculated by dividing the SUVmax of the primary tumor or LN by the mean SUV of the liver.

Results

For detecting primary tumor lesions (n?=?54), the sensitivity and accuracy of FDG PET/CT (53/54) and MRI (53/54) were 98.2%. The sensitivity, specificity, and accuracy of FDG PET/CT versus MRI were as follows: 63.2% (12/19) versus 26.3% (5/19), 100% (35/35) versus 100% (35/35), and 87.0% versus 74.0%, respectively, for pelvic LN areas (p?=?0.016); 85.7% (12/14) versus 42.9% (6/14), 90% (36/40) versus 97.5% (39/40), and 88.9% versus 83.3%, respectively, for para-aortic LN areas (p?=?0.004); and 59.4% (19/32) versus 50% (16/32), 100% (22/22) versus 100% (22/22), and 75.9% versus 70.4%, respectively, for peritoneal seeding lesions (p?=?0.250). For distant metastasis, the sensitivity, specificity, and accuracy of FDG PET/CT were 100 (8/8), 97.8 (45/46), and 98.2%, respectively.

Conclusions

FDG PET/CT showed superior diagnostic accuracy compared to MRI in detecting pelvic and para-aortic LN metastasis in patients with uterine carcinosarcoma. Moreover, FDG PET/CT facilitated the identification of distant metastasis.

     

Whole heart magnetization‐prepared steady‐state free precession coronary vein MRI

Purpose

To compare two coronary vein imaging techniques using whole‐heart balanced steady‐state free precession (SSFP) and a targeted double‐oblique spoiled gradient‐echo (GRE) sequences in combination with magnetization transfer (MT) preparation sequence for tissue contrast improvement.

Materials and Methods

Nine healthy subjects were imaged with the proposed technique. The results are compared with optimized targeted MT prepared GRE acquisitions. Both quantitative and qualitative analyses were performed to evaluate each imaging method.

Results

Whole‐heart images were successfully acquired with no visible image artifact in the vicinity of the coronary veins. The anatomical features and visual grading of both techniques were comparable. However, the targeted small slab acquisition of the left ventricular lateral wall was superior to whole‐heart acquisition for visualization of relevant information for cardiac resynchronization therapy (CRT) lead implantation.

Conclusion

We demonstrated the feasibility of whole‐heart coronary vein MRI using a 3D MT‐SSFP imaging sequence. A targeted acquisition along the lateral left ventricular wall is preferred for visualization of branches commonly used in CRT lead implantation. J. Magn. Reson. Imaging 2009;29:1293–1299. © 2009 Wiley‐Liss, Inc.     

PET/CT for staging and follow-up of pediatric nasopharyngeal carcinoma

Purpose

While FDG PET/CT for the evaluation of nasopharyngeal carcinoma (NPC) in adult patients has documented advantages and disadvantages compared with conventional imaging, to our knowledge, no studies of FDG PET/CT for the evaluation of NPC in pediatric patients have been performed. In this investigation, we studied the utility of FDG PET/CT in children with NPC.

Methods

The study group comprised 18 children with biopsy-proven NPC who underwent FDG PET/CT and MRI (total 38 pairs of images). All baseline and follow-up FDG PET/CT and MRI studies were independently reviewed for restaging of disease.

Results

The concordance between FDG PET/CT and MRI in T, N, and overall staging was 29%, 64%, and 43%, respectively. Compared with MRI, FDG PET/CT yielded lower T and overall staging and showed less cervical and retropharyngeal lymphadenopathy. The concordance between follow-up FDG PET/CT and MRI was 79% overall and 100% 9?months after therapy. In patients who achieved complete remission, FDG PET/CT showed disease clearance 3–6?months earlier than MRI. There were no false-positive or false-negative FDG PET/CT scans during follow-up.

Conclusion

FDG PET/CT may underestimate tumor extent and regional lymphadenopathy compared with MRI at the time of diagnosis, but it helps to detect metastases and clarify ambiguous findings. FDG PET/CT is sensitive and specific for follow-up and enables earlier determination of disease remission. FDG PET/CT is a valuable imaging modality for the evaluation and monitoring of NPC in pediatric patients.