Faculty Bibliography

PURPOSE: The purpose of this study was to estimate perfusion metrics in healthy and cirrhotic liver with pharmacokinetic modeling of high-temporal resolution reconstruction of continuously acquired free-breathing gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced acquisition in patients undergoing clinically indicated liver magnetic resonance imaging. SUBJECTS AND METHODS: In this Health Insurance Portability and Accountability Act-compliant prospective study, 9 cirrhotic and 10 noncirrhotic patients underwent clinical magnetic resonance imaging, which included continuously acquired radial stack-of-stars 3-dimensional gradient recalled echo sequence with golden-angle ordering scheme in free breathing during contrast injection. A total of 1904 radial spokes were acquired continuously in 318 to 340 seconds. High-temporal resolution data sets were formed by grouping 13 spokes per frame for temporal resolution of 2.2 to 2.4 seconds, which were reconstructed using the golden-angle radial sparse parallel technique that combines compressed sensing and parallel imaging. High-temporal resolution reconstructions were evaluated by a board-certified radiologist to generate gadolinium concentration-time curves in the aorta (arterial input function), portal vein (venous input function), and liver, which were fitted to dual-input dual-compartment model to estimate liver perfusion metrics that were compared between cirrhotic and noncirrhotic livers. RESULTS: The cirrhotic livers had significantly lower total plasma flow (70.1 +/- 10.1 versus 103.1 +/- 24.3 mL/min per 100 mL; P < 0.05), lower portal venous flow (33.4 +/- 17.7 versus 89.9 +/- 20.8 mL/min per 100 mL; P < 0.05), and higher arterial perfusion fraction (52.0% +/- 23.4% versus 12.4% +/- 7.1%; P < 0.05). The mean transit time was higher in the cirrhotic livers (24.4 +/- 4.7 versus 15.7 +/- 3.4 seconds; P < 0.05), and the hepatocellular uptake rate was lower (3.03 +/- 2.1 versus 6.53 +/- 2.4 100/min; P < 0.05). CONCLUSIONS: Liver perfusion metrics can be estimated from free-breathing dynamic acquisition performed for every clinical examination without additional contrast injection or time. This is a novel paradigm for dynamic liver imaging.

PURPOSE: To demonstrate dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of the prostate with both high spatial and temporal resolution via a combination of golden-angle radial k-space sampling, compressed sensing, and parallel-imaging reconstruction (GRASP), and to compare image quality and lesion depiction between GRASP and conventional DCE in prostate cancer patients. MATERIALS AND METHODS: Twenty prostate cancer patients underwent two 3T prostate MRI examinations on separate dates, one using standard DCE (spatial resolution 3.0 x 1.9 x 1.9 mm, temporal resolution 5.5 sec) and the other using GRASP (spatial resolution 3.0 x 1.1 x 1.1 mm, temporal resolution 2.3 sec). Two radiologists assessed measures of image quality and dominant lesion size. The experienced reader recorded differences in contrast arrival times between the dominant lesion and benign prostate. RESULTS: Compared with standard DCE, GRASP demonstrated significantly better clarity of the capsule, peripheral/transition zone boundary, urethra, and periprostatic vessels; image sharpness; and lesion conspicuity for both readers (P < 0.001-0.020). GRASP showed improved interreader correlation for lesion size (GRASP: r = 0.691-0.824, standard: r = 0.495-0.542). In 8/20 cases, only GRASP showed earlier contrast arrival in tumor than benign; in no case did only standard DCE show earlier contrast arrival in tumor. CONCLUSION: High spatiotemporal resolution prostate DCE is possible with GRASP, which has the potential to improve image quality and lesion depiction as compared with standard DCE.J. Magn. Reson. Imaging 2014. (c) 2014 Wiley Periodicals, Inc.

PURPOSE: To apply the low-rank plus sparse (L+S) matrix decomposition model to reconstruct undersampled dynamic MRI as a superposition of background and dynamic components in various problems of clinical interest. THEORY AND METHODS: The L+S model is natural to represent dynamic MRI data. Incoherence between k-t space (acquisition) and the singular vectors of L and the sparse domain of S is required to reconstruct undersampled data. Incoherence between L and S is required for robust separation of background and dynamic components. Multicoil L+S reconstruction is formulated using a convex optimization approach, where the nuclear norm is used to enforce low rank in L and the l1 norm is used to enforce sparsity in S. Feasibility of the L+S reconstruction was tested in several dynamic MRI experiments with true acceleration, including cardiac perfusion, cardiac cine, time-resolved angiography, and abdominal and breast perfusion using Cartesian and radial sampling. RESULTS: The L+S model increased compressibility of dynamic MRI data and thus enabled high-acceleration factors. The inherent background separation improved background suppression performance compared to conventional data subtraction, which is sensitive to motion. CONCLUSION: The high acceleration and background separation enabled by L+S promises to enhance spatial and temporal resolution and to enable background suppression without the need of subtraction or modeling. Magn Reson Med, 2014. (c) 2014 Wiley Periodicals, Inc.

Background: Evaluation of myocardial function with MRI is challenging on patients with impaired breath-hold (BH) capabilities or arrhythmias due to the difficulty of respiratory motion suspension and synchronization of cardiac cycles. Compressed sensing (CS) enables free breathing (FB) real-time cine imaging with improved spatiotemporal resolution, but conventional temporal sparsifying transforms do not account for respiratory motion, which limits its performance. In this work, we propose to acquire data continuously in FB using a golden-angle radial sampling scheme and reconstruct images with separated but synchronized cardiac and respiratory motion dimensions using self-detected motion signals. For patients with arrhythmias, both "normal" and "ectopic" cycles are reconstructed by sorting out cardiac cycles with different lengths. The performance of the proposed method was compared to Cartesian BH approach using retrospective ECG-gating in 9 patients. Methods: Both BH and FB cine sequences (b-SSFP) were implemented on a 1.5T MRI scanner (Avanto, Siemens). Imaging parameters for BH cine were: spatial resolution = 1.8 x 1.8 mm², slice thickness = 8 mm, TR/TE = 2.5/1.25 ms, FA = 55degree. Imaging parameters for FB cine were: spatial resolution = 2 x 2 mm², slice thickness = 8 mm, TR/TE2.8/1.4 ms, FA = 70degree. Both sequences achieved temporal resolution ~30-40 ms. Cardiac imaging was performed on 9 patients (mean age = 56; 4 had normal sinus rhythm, 4 had arrhythmias including bigeminy PVCs, atrial fibrillation and Mobitz I, 1 was incapable of prolonged BH). One short axis and one 4 chamber cine image set were acquired on each patient at ~12-15s per slice. In FB cine imaging, central k-space positions (green dots, Figure 1a) were used to extract cardiac and respiratory signals from coils near the heart and diaphragm respectively (Figure 1b). Data were sorted and synchronized to separately reconstruct cardiac cycles of different lengths at different respiratory states. A mul!

Background: For patients with impaired breath-hold capacity or arrhythmias, free breathing real-time cine MRI is preferred at the expense of compromised spatiotemporal resolution. Compressed sensing (CS) has been used to achieve higher spatiotemporal resolutions in real-time cine MRI, but the superposition of respiratory and cardiac motion limits temporal sparsity. In this work, we propose a novel approach that sorts out cardiac and respiratory motion into separated but synchronized dimensions and performs a joint multicoil CS reconstruction with different sparsity constraints on cardiac and respiratory dimensions. Golden-angle radial sampling was employed for flexible data sorting. In arrhythmias cases, data are also sorted according to cardiac cycles with different length to reconstruct both "normal" and "ectopic" cycles. Methods: Cardiac imaging was performed on one volunteer (male age = 27) and one patient (female age = 49) with Mobitz I arrhythmia during free breathing without external gating on a 1.5T MRI scanner (Avanto, Siemens). Data were continuously acquired for 15 s in a short axis plane using a 2D golden-angle radial b-SSFP sequence. Imaging parameters were: spatial resolution = 2 x 2 mm², TR/TE = 2.8/1.4 ms, FA = 70degree and slice thickness = 8 mm. Temporal evolution of the central k-space positions (green dots, Figure 1a) was used to estimate cardiac contraction and respiration from coil-elements close to the heart and diaphragm respectively (Figure 1b). Raw data were then sorted into an expanded dataset of images containing two dynamic dimensions, one for cardiac and the other for respiratory motion. As shown in Figure 1b, each colored rectangular block represents an individual cardiac phase from a short "snapshot" period (e.g. 13 adjacent spokes). Data were sorted first into a higher dimensional matrix using the cardiac motion signal (Figure 1c left) followed by a second sorting along the respiratory dimension from expiration to inspiration using the respiratory mot!

PURPOSE: To develop a fast and flexible free-breathing dynamic volumetric MRI technique, iterative Golden-angle RAdial Sparse Parallel MRI (iGRASP), that combines compressed sensing, parallel imaging, and golden-angle radial sampling. METHODS: Radial k-space data are acquired continuously using the golden-angle scheme and sorted into time series by grouping an arbitrary number of consecutive spokes into temporal frames. An iterative reconstruction procedure is then performed on the undersampled time series where joint multicoil sparsity is enforced by applying a total-variation constraint along the temporal dimension. Required coil-sensitivity profiles are obtained from the time-averaged data. RESULTS: iGRASP achieved higher acceleration capability than either parallel imaging or coil-by-coil compressed sensing alone. It enabled dynamic volumetric imaging with high spatial and temporal resolution for various clinical applications, including free-breathing dynamic contrast-enhanced imaging in the abdomen of both adult and pediatric patients, and in the breast and neck of adult patients. CONCLUSION: The high performance and flexibility provided by iGRASP can improve clinical studies that require robustness to motion and simultaneous high spatial and temporal resolution. Magn Reson Med, 2013. (c) 2013 Wiley Periodicals, Inc.

For patients with impaired breath-hold capacity and/or arrhythmias, real-time cine MRI may be more clinically useful than breath-hold cine MRI. However, commercially available real-time cine MRI methods using parallel imaging typically yield relatively poor spatio-temporal resolution due to their low image acquisition speed. We sought to achieve relatively high spatial resolution ( approximately 2.5 x 2.5 mm(2) ) and temporal resolution ( approximately 40 ms), to produce high-quality real-time cine MR images that could be applied clinically for wall motion assessment and measurement of left ventricular function. In this work, we present an eightfold accelerated real-time cardiac cine MRI pulse sequence using a combination of compressed sensing and parallel imaging (k-t SPARSE-SENSE). Compared with reference, breath-hold cine MRI, our eightfold accelerated real-time cine MRI produced significantly worse qualitative grades (1-5 scale), but its image quality and temporal fidelity scores were above 3.0 (adequate) and artifacts and noise scores were below 3.0 (moderate), suggesting that acceptable diagnostic image quality can be achieved. Additionally, both eightfold accelerated real-time cine and breath-hold cine MRI yielded comparable left ventricular function measurements, with coefficient of variation <10% for left ventricular volumes. Our proposed eightfold accelerated real-time cine MRI with k-t SPARSE-SENSE is a promising modality for rapid imaging of myocardial function. J. Magn. Reson. Imaging 2012;. (c) 2012 Wiley Periodicals, Inc.