Magnetic Resonance in Medical Sciences
Online ISSN : 1880-2206
Print ISSN : 1347-3182
ISSN-L : 1347-3182
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Displaying 1-50 of 51 articles from this issue
  • Noriko Nishioka, Yukie Shimizu, Toru Shirai, Hisaaki Ochi, Yoshitaka B ...
    Article ID: mp.2023-0146
    Published: 2024
    Advance online publication: March 15, 2024
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    Supplementary material

    Purpose: We present a novel algorithm for the automated detection of cerebral microbleeds (CMBs) on 2D gradient-recalled echo T2* weighted images (T2*WIs). This approach combines a morphology filter bank with a convolutional neural network (CNN) to improve the efficiency of CMB detection. A technical evaluation was performed to ascertain the algorithm’s accuracy.

    Methods: In this retrospective study, 60 patients with CMBs on T2*WIs were included. The gold standard was set by three neuroradiologists based on the Microbleed Anatomic Rating Scale guidelines. Images with CMBs were extracted from the training dataset comprising 30 cases using a morphology filter bank, and false positives (FPs) were removed based on the threshold of size and signal intensity. The extracted images were used to train the CNN (Vgg16). To determine the effectiveness of the morphology filter bank, the outcomes of the following two methods for detecting CMBs from the 30-case test dataset were compared: (a) employing the morphology filter bank and additional FP removal and (b) comprehensive detection without filters. The trained CNN processed both sets of initial CMB candidates, and the final CMB candidates were compared with the gold standard. The sensitivity and FPs per patient of both methods were compared.

    Results: After CNN processing, the morphology-filter-bank-based method had a 95.0% sensitivity with 4.37 FPs per patient. In contrast, the comprehensive method had a 97.5% sensitivity with 25.87 FPs per patient.

    Conclusion: Through effective CMB candidate refinement with a morphology filter bank and FP removal with a CNN, we achieved a high CMB detection rate and low FP count. Combining a CNN and morphology filter bank may facilitate the accurate automated detection of CMBs on T2*WIs.

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  • Hiroyuki Kameda, Yumi Nakada, Yuta Urushibata, Hiroyuki Sugimori, Taka ...
    Article ID: tn.2023-0152
    Published: 2024
    Advance online publication: March 15, 2024
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    17O-labeled water is a T2-shortening contrast agent used in proton MRI and is a promising method for visualizing cerebrospinal fluid (CSF) dynamics because it provides long-term tracking of water molecules. However, various external factors reduce the accuracy of 17O-concentration measurements using conventional signal-intensity-based methods. In addition, T2 mapping, which is expected to provide a stable assessment, is generally limited to temporal–spatial resolution. We developed the T2-prepared based on T2 mapping used in cardiac imaging to adapt to long T2 values and tested whether it could accurately measure 17O-concentration in the CSF using a phantom. The results showed that 17O-concentration in a fluid mimicking CSF could be evaluated with an accuracy comparable to conventional T2-mapping (Carr–Purcell–Meiboom–Gill multi-echo spin-echo method). This method allows 17O-imaging with a high temporal resolution and stability in proton MRI. This imaging technique may be promising for visualizing CSF dynamics using 17O-labeled water.

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  • Jan Valošek, Julien Cohen-Adad
    Article ID: rev.2023-0159
    Published: 2024
    Advance online publication: March 12, 2024
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    The spinal cord plays a pivotal role in the central nervous system, providing communication between the brain and the body and containing critical motor and sensory networks. Recent advancements in spinal cord MRI data acquisition and image analysis have shown a potential to improve the diagnostics, prognosis, and management of a variety of pathological conditions. In this review, we first discuss the significance of standardized spinal cord MRI acquisition protocol in multi-center and multi-manufacturer studies. Then, we cover open-access spinal cord MRI datasets, which are important for reproducible science and validation of new methods. Finally, we elaborate on the recent advances in spinal cord MRI data analysis techniques implemented in the open-source software package Spinal Cord Toolbox (SCT).

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  • Hiroki Tanaka, Sho Koyasu, Masahiro Kikuchi, Mami Iima, Koichi Omori, ...
    Article ID: mp.2023-0137
    Published: 2024
    Advance online publication: March 07, 2024
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    Supplementary material

    Purpose: The 8th edition of the American Joint Committee on Cancer staging system included the depth of invasion (DOI) for the T classification of oral cancer. However, no standardized method has been established to clinically measure the DOI. This study aimed to investigate the accuracy of MRI-based DOI for oral tongue squamous cell carcinoma (OTSCC) in each MRI sequence.

    Methods: We enrolled 49 patients with histologically proven OTSCC, treated surgically between April 2017 and February 2021. We divided the DOI into three groups using 5 and 10 mm, the thresholds for determining the T stage, and retrospectively evaluated the agreement between MRI-based DOI and pathological DOI (pDOI) for each MRI sequence, axial T1-weighted imaging (T1WI), T2-weighted imaging with fat suppression (FS-T2WI), contrast-enhanced T1WI with fat suppression (CE-T1WI), diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) maps. We also divided the DOI into two groups using 3 mm, the threshold for considering elective neck dissection, and evaluated the overestimation rate of MRI-based DOI in lesions with pDOI ≤ 3 mm.

    Results: With 5-mm and 10-mm divisions, the accuracy of the DOI assessment was highest on DWI (0.82, weighted kappa = 0.85). With a 3-mm division, the accuracy was also highest on DWI (0.87, kappa = 0.73). The overestimation rate of the MRI-based DOI in lesions with pDOI ≤ 3 mm was lowest on DWI (27.8%).

    Conclusion: DOI on DWI exhibits a comparatively higher rate of concordance with pDOI. DWI may be more useful than other MRI sequences in evaluating the DOI of OTSCC.

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  • Atsushi Higaki, Akira Yamamoto, Toshimasa Okada, Tomio Ueno, Yasuyuki ...
    Article ID: ici.2023-0161
    Published: 2024
    Advance online publication: February 29, 2024
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    Supplementary material

    A woman in her sixties with portosystemic shunt and hepatic encephalopathy underwent open mesenteric vein ligation, resulting in improved portal flow and blood ammonia. In this case, 4D flow MRI was a valuable diagnostic and follow-up tool, visualizing and quantifying physiological portal hemodynamics with features distinct from those of contrast-enhanced CT and digital subtraction angiography. Our case study highlights the value of 4D flow MRI for managing portosystemic shunts.

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  • Toru Shirai, Yasuhiko Terada, Katsumi Kose, Shigehito Yamada
    Article ID: tn.2023-0149
    Published: 2024
    Advance online publication: February 27, 2024
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    A chemically fixed Carnegie stage 23 (approximately 56 days of gestation) human embryo specimen was imaged using 3D spin-echo and gradient-echo sequences in a static magnetic field strength of 4.74T, and a quantitative susceptibility map was calculated using the 3D gradient-echo image. The acquired 3D microscopic images (90 μm cube voxel size) clarified the relationship between R2 (transverse relaxation rate), R2* (apparent transverse relaxation rate), and magnetic susceptibility in the heart, liver, kidney, and spinal cord. The results suggested that the R2* and magnetic susceptibility in each tissue were probably due to paramagnetic iron ions originating from erythrocytes. The large R2* (~130 s-1) and magnetic susceptibility (~0.122 ppm) in the liver were attributed to its hemopoietic function. A large magnetic susceptibility (~0.116 ppm) was also observed in the spinal cord, but we conclude that more detailed future studies are needed.

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  • Midori Kusama, Yukio Kimura, Masami Yoneyama, Takashi Namiki, Takeshi ...
    Article ID: mp.2023-0095
    Published: 2024
    Advance online publication: February 21, 2024
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    Purpose: Neuromelanin is visualized by optimizing the conditions of longitudinal relaxation (T1)-weighted imaging (T1WI). Although it was originally developed in 2D imaging, 3D imaging has been also reported, and T1WI sequences with magnetization transfer (MT) pulses are now widely used in 3D gradient echo (GRE) sequences. In this study, we assert that the use of spectral presaturation with inversion recovery (SPIR) may also be useful as an alternative to MT pulses, and we optimize SPIR and compare it with MT.

    Methods: Neuromelanin images with MT pulse and SPIR (flip angles [FAs] = 19º, 22º, and 25º) were acquired from 30 healthy volunteers. To achieve the same acquisition time of 5 min, the slab thickness of the MT images was less than 1/3 of those of the SPIR images; the acquisition areas for MT and SPIR were the brainstem and the whole brain, respectively. Visual and quantitative evaluation was performed and compared on the four sequences acquired for the substantia nigra pars compacta (SNc) and the locus coeruleus (LC). For visual assessment, we used the mean score from a 3-point scale by two evaluators. For quantitative evaluation, the contrast ratios of SNc and LC were calculated in comparison with the background tissue signal.

    Results: In visual assessments, the mean scores of the SPIR FA19º and FA22º images were better than others in the SNc. Regarding LC, the SPIR FA22º image yielded the best mean score. In quantitative evaluations, the MT image was significantly lower than the other three images in SNc. Regarding LC, there were no significant differences among the four acquired images (MT and SPIR FA19º, FA22º, and FA25º).

    Conclusions: Detection of neuromelanin in SNc and LC was improved by the use of SPIR compared to MT pulse in 3D neuromelanin imaging.

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  • Kazuki Kunieda, Kazuyuki Makihara, Shigehito Yamada, Masayuki Yamaguch ...
    Article ID: mp.2023-0110
    Published: 2024
    Advance online publication: February 16, 2024
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    Purpose: To delineate brain microstructures in human embryos during the formation of the various major primordia by MR microscopy, with different contrasts appropriate for each target.

    Methods: We focused mainly on the internal structures in the cerebral cortex and the accessory nerves of the brain. To find appropriate sequence parameters, we measured nuclear magnetic resonance (NMR) parameters and created kernel density plots of T1 and T2 values. We performed T1-weighted gradient echo imaging with parameters similar to those used in the previous studies. We performed T2*-weighted gradient echo imaging to delineate the target structures with the appropriate sequence parameters according to the NMR parameter and flip angle measurements. We also performed high-resolution imaging with both T1- and T2*-weighted sequences.

    Results: T1, T2, and T2* values of the target tissues were positively correlated and shorter than those of the surrounding tissues. In T1-weighted images with a voxel size of (30 µm)3 and (20 µm)3, various organs and tissues and the agarose gel were differentiated as in previous studies, and the structure of approximately 40 µm in size was depicted, but the detailed structures within the cerebral cortex and the accessory nerves were not delineated. In T2*-weighted images with a voxel size of (30 µm)3, the layered structure within the cerebral cortex and the accessory nerves were clearly visualized. Overall, T1-weighted images provided more information than T2*-weighted images, but important internal brain structures of interest were visible only in T2*-weighted images. Therefore, it is essential to perform MR microscopy with different contrasts.

    Conclusion: We have visualized brain structures in a human embryo that had not previously been delineated by MR microscopy. We discussed pulse sequences appropriate for the structures of interest. This methodology would provide a way to visualize crucial embryological information about the anatomical structure of human embryos.

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  • Koichi Ito, Kazuyuki Ohgi, Koichiro Kimura, Koichi Ishitaki, Akiyoshi ...
    Article ID: mp.2023-0114
    Published: 2024
    Advance online publication: February 16, 2024
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    Purpose: The kidney iron deposition can cause kidney damage and renal insufficiency in paroxysmal nocturnal hemoglobinuria (PNH) patients. Assessment of iron deposition in the kidney is essential for the early diagnosis of renal damage in PNH patients. The purpose of this study was to evaluate kidney R2* (T2* reciprocals) values in PNH patients using the iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ).

    Methods: Two radiologists measured the R2* values of the renal cortex in 14 PNH patients and 13 healthy volunteers using IDEAL-IQ. Lactate dehydrogenase (LDH), a reliable marker of intravascular hemolysis, was also measured in all participants.

    Results: The kidney R2* values were significantly higher in PNH patients compared with those in healthy volunteers (P < 0.001). High inter-operator reproducibility of the measurements was also acquired using IDEAL-IQ. LDH levels were also significantly higher in PNH patients compared with those in healthy volunteers (P < 0.001). Kidney R2* values strongly correlated with LDH levels in PNH patients.

    Conclusion: IDEAL-IQ has a possibility of becoming a useful method for the noninvasive evaluation of renal iron overload in PNH patients.

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  • Naoko Mori
    Article ID: lte.2023-0173
    Published: 2024
    Advance online publication: February 14, 2024
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  • Shunrou Fujiwara, Kuniaki Ogasawara, Kohei Chida, Yasushi Ogasawara, J ...
    Article ID: mp.2022-0152
    Published: 2024
    Advance online publication: February 14, 2024
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    Supplementary material

    Purpose: The present study aimed to investigate whether diffusion-weighted imaging (DWI) can qualify and quantify cerebrospinal fluid (CSF) dynamics in the brains of healthy subjects. For this purpose, we developed new DWI-based fluidography and compared the CSF dynamics seen on the fluidography with two apparent diffusion coefficients obtained with different DWI signal models at anatomical spaces filled by CSF.

    Methods: DWI with multiple b values was performed for 10 subjects using a 7T MRI scanner. DWI-fluidography based on the DWI signal variations in different motion probing gradient directions was developed for visualizing the CSF dynamics voxel-by-voxel. DWI signals were measured using an ROI in the representative CSF-filled anatomical spaces in the brain. For the multiple DWI signals, the mono-exponential and kurtosis models were fitted and two kinds of apparent diffusion coefficients (ADCC and ADCK) were estimated in each space using the Gaussian and non-Gaussian diffusion models, respectively.

    Results: DWI-fluidography could qualitatively represent the features of CSF dynamics in each anatomical space. ADCs indicated that the motions at the foramen of Monro, the cistern of the velum interpositum, the quadrigeminal cistern, the Sylvian cisterns, and the fourth ventricle were more drastic than those at the subarachnoid space and anterior horns of the lateral ventricle. Those results seen in ADCs were identical to the findings on DWI-fluidography.

    Conclusion: DWI-fluidography based on the features of DWI signals could show differences of CSF dynamics among anatomical spaces.

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  • Md Shahadat Hossain Akram, Masaki Fukunaga, Fumihiko Nishikido, Sodai ...
    Article ID: mp.2023-0061
    Published: 2024
    Advance online publication: February 09, 2024
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    Purpose: The purpose of this study was to do a feasibility study on a microstrip transmission line (MS) RF coil for a positron emission tomography (PET) insert in a 7 Tesla human MRI system. The proposed MS coil integrated the RF shield of the PET detector as the ground conductor of the coil. We called the integrated module “MS PET coil.”

    Methods: A single-channel MS PET coil was developed with an integrated RF-shielded PET detector module. For comparison, we also studied a conventional MS coil with a single-layer ground conductor. A lutetium fine silicate (LFS) scintillation crystal block (14 × 14 × 4-layer) with a silicon photomultiplier (Hamamatsu Photonics K.K., Shizuoka, Japan) and a front-end readout circuit board were mounted inside the shield cage of the MS PET coil. The MS PET coil was studied with and without PET detectors. All three coil configurations were studied with a homogeneous phantom in a 7T MRI system (Siemens Healthineers, Erlangen, Germany). PET data measurements were conducted using a Cesium-137 radiation point source.

    Results: The MR images were similar for the MS coil and the empty MS PET coil, as well as for the cases of MS PET coil with and without PET measurements. Compared to the empty MS PET coil (without PET detector and cable RF shield), decreases in SNR, increases in image noise and RF power, and a slight decrease in resonance frequency were seen for the case of the MS PET coil with the detector and cable shield. Differences in the PET energy histograms or in the crystal identification maps with and without MRI measurements were negligible.

    Conclusions: Both the MRI and PET performances of the MS PET coil showed responses that matched the MS coil responses. The performance variations of MRI data with and without PET measurement and PET data with and without MR imaging were negligible.

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  • Natsumi Hirano Tani, Yuki Koreeda, Aya Nawata, Akitaka Fujisaki, Yoshi ...
    Article ID: mp.2023-0127
    Published: 2024
    Advance online publication: February 07, 2024
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    Purpose: Adipocytes around aggressive breast cancer (BC) are less lipid different from naive adipocytes (cancer-associated adipocytes, CAAs), and peritumoral edema caused by the release of cytokines from CAAs can conduce to decrease the peritumoral fat proportion. The purpose of this study was to correlate peritumoral fat content identified by using iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) with lymph node metastasis (LNM) and recurrence-free survival (RFS) in BC patients and to compare with T2-weighted (T2WI) and diffusion-weighted images (DWI) analyses.

    Methods: This retrospective study consisted of 85 patients who were diagnosed with invasive carcinoma of breast and underwent breast MRI, including IDEAL before surgery. The scan time of fat fraction (FF) map imaging using IDEAL was 33s. Four regions of interest (ROIs), which are 5 mm from the tumor edge, and one ROI in the mammary fat of the healthy side were set on the FF map. Then average peritumoral FF values (TFF), average FF values on the healthy side (HFF), and peritumoral fat ratio (PTFR, which is defined as TFF/HFF) were calculated. Tumor apparent diffusion coefficient (ADC) values were measured on ADC map obtained by DWI. Peritumoral edema was classified into three grades based on the degree of signal intensity around the tumor on T2WI (T2 edema).

    Results: The results of stepwise logistic regression analysis for four variables (TFF, PTFR, T2 edema, and ADC value) indicated that TFF and T2 edema were significant factors of LNM (p < 0.01). RFS was significantly associated with TFF (p = 0.016), and 47 of 49 (95.9%) patients with TFF more than 85.5% were alive without recurrence.

    Conclusion: Peritumoral fat content identified by using IDEAL is associated with LNM and RFS and may therefore be a useful prognostic biomarker for BC.

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  • Noriko Kanemaru, Takeharu Yoshikawa, Soichiro Miki, Takahiro Nakao, Yu ...
    Article ID: mp.2023-0147
    Published: 2024
    Advance online publication: February 07, 2024
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    Purpose: The purpose of this study was to investigate the longitudinal MRI characteristic of COVID-19-vaccination-related axillary lymphadenopathy by evaluating the size, T2-weighted signal intensity, and apparent diffusion coefficient (ADC) values.

    Methods: COVID-19-vaccination-related axillary lymphadenopathy was observed in 90 of 433 health screening program participants on the chest region of whole-body axial MRIs in 2021, as reported in our previous study. Follow-up MRI was performed at an interval of approximately 1 year after the second vaccination dose from 2022 to 2023. The diameter, signal intensity on T2-weighted images, and ADC of the largest enlarged lymph nodes were measured on chest MRI. The values were compared between the post-vaccination MRI and the follow-up MRI, and statistically analyzed.

    Results: Out of the 90 participants who had enlarged lymph nodes of 5 mm or larger in short axis after the second vaccination dose, 76 participants (45 men and 31 women, mean age: 61 years) were enrolled in the present study. The median short- and long-axis diameter of the enlarged lymph nodes was 7 mm and 9 mm for post-vaccination MRI and 4 mm and 6 mm for follow-up MRI, respectively. The median signal intensity relative to the muscle on T2-weighted images decreased (5.1 for the initial post-vaccination MRI and 3.6 for the follow-up MRI, P < .0001). The ADC values did not show a notable change and remained in a normal range.

    Conclusion: The enlarged axillary lymph nodes decreased both in size and in signal intensity on T2-weighted images of follow-up MRI. The ADC remained unchanged. Our findings may provide important information to establish evidence-based guidelines for conducting proper assessment and management of post-vaccination lymphadenopathy.

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  • Takashi Nishihara, Yuko Nakamura, Nobuyuki Yoshizawa, Masahiro Takizaw ...
    Article ID: tn.2023-0104
    Published: 2024
    Advance online publication: February 02, 2024
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    Gadoxetic acid is both an extracellular- and hepatocyte-specific contrast agent. Signals from the extracellular space may lower the contrast between lesions and the surrounding hepatic parenchyma. To improve hepatocyte-specific enhancement, we developed an intracellular contrast-enhancing fat-saturated T1-weighted gradient-echo nature of the sequence (ICE-TIGRE). It incorporates the motion-sensitized driven-equilibrium (MSDE) pulse to suppress signals from the blood flow. We investigated the optimal ICE-TIGRE scanning parameters, i.e., the order of the MSDE and the fat saturation pulses, the duration time, and the b value of the MSDE pulse, using a phantom and three volunteers without applying gadoxetic acid. ICE-TIGRE successfully increased the contrast between the liver parenchyma and the portal vein. To maintain fat saturation, the preparation pulse order should be MSDE–fat saturation. A duration time of 21 ms should be applied to minimize the effect of the T2 factor on the T1 contrast, and a b value of 60 s/mm2 should be applied to maximize the diffusion contrast for ICE-TIGRE with the imaging system used in this study.

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  • Kouhei Kamiya, Sayori Hanashiro, Osamu Kano, Wataru Uchida, Koji Kamag ...
    Article ID: mp.2023-0138
    Published: 2024
    Advance online publication: January 30, 2024
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    Supplementary material

    Purpose: Here, we aimed to characterize the cortical and subcortical microstructural alterations in the brains of patients with amyotrophic lateral sclerosis (ALS). In particular, we compared these features between bulbar-onset ALS (b-ALS) and limb-onset ALS (l-ALS).

    Methods: Diffusion MRI data (b = 0, 700, 2000 ms/mm2, 1.7-mm isotropic voxel) from 28 patients with ALS (9 b-ALS and 19 l-ALS) and 17 healthy control subjects (HCs) were analyzed. Diffusional kurtosis imaging (DKI) metrics were sampled at the mid-cortical and subcortical surfaces. We used permutation testing with a nonparametric combination of mean diffusivity (MD), fractional anisotropy (FA), and mean kurtosis (MK) to assess intergroup differences over the cerebrum. We also carried out an atlas-based analysis focusing on Brodmann Area 4 and 6 (primary motor and premotor areas) and investigated the correlation between MRI metrics and clinical parameters.

    Results: At both the mid-cortical and subcortical surfaces, b-ALS was associated with significantly greater MD, smaller FA, and smaller MK in the motor and premotor areas than HC. In contrast, the patients with l-ALS showed relatively moderate differences relative to HCs. The ALS Functional Rating Scale-Revised bulbar subscore was significantly correlated with the diffusion metrics in Brodmann Area 4.

    Conclusion: The distribution of abnormalities over the cerebral hemispheres and the more severe microstructural alteration in b-ALS compared to l-ALS were in good agreement with findings from postmortem histology. Our results suggest the feasibility of surface-based DKI analyses for exploring brain microstructural pathologies in ALS. The observed differences between b-ALS and l-ALS and their correlations with functional bulbar impairment support the clinical relevance of DKI measurement in the cortical and juxtacortical regions of patients with ALS.

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  • Tsutomu Inaoka, Masayuki Sugeta, Tomoya Nakatsuka, Shusuke Kasuya, Rum ...
    Article ID: mp.2023-0028
    Published: 2024
    Advance online publication: January 16, 2024
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    Purpose: To evaluate the significant findings of hip periprosthetic joint infection (PJI) using metal-artifact-reduction (MAR) MRI and to compare the MRI results to other clinical markers.

    Methods: The results of MRI, including two-dimensional fast-spin echo sequences with increased bandwidth and multi-acquisition variable-resonance image combination selective for hips with orthopedic implants at 1.5T (from April 2014 to November 2021), were retrospectively assessed for imaging findings and diagnostic impressions by two radiologists. Clinical data and courses were also investigated. Univariate and multivariate analyses were performed to identify the significant MRI findings in patients with hip PJI and those who underwent surgical intervention. The MRI impressions were compared with other clinical markers in diagnosing hip PJI.

    Results: Thirty-seven hip joints in 24 Asian patients (age = 73.9 ± 10.8 years; 18 females) were included. Twelve hip joints (32%) had PJI; seven underwent a surgical intervention. The significant findings for hip PJI included periosteal edema of the acetabulum, intermuscular edema, intramuscular fluid collection, and lymphadenopathy (P < 0.05). In the cases with surgical intervention, the significant findings included capsular distension, capsular thickening, an osteolysis-like pattern of the femur, subcutaneous fluid collection, and lymphadenopathy (P < 0.05). The MRI impressions had high diagnostic significance for both hip PJI cases and those with surgical intervention (P < 0.001). The MRI impression was more significant for hip PJI than the other clinical markers (P < 0.05), while the other clinical markers were more significant in the cases with surgical intervention (P < 0.05).

    Conclusion: The significant findings in the hip PJI cases included acetabular periosteal edema, intermuscular edema, intramuscular fluid collection, and lymphadenopathy. The significant findings in the cases with surgical intervention included capsular distention, capsular thickening, a femoral osteolysis-like pattern, subcutaneous fluid collection, and lymphadenopathy. The utilization of MAR MRI demonstrated great diagnostic significance for hip PJI.

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  • Shohei Inui, Daita Kaneda, Keita Sakurai, Yuto Uchida, Osamu Abe, Yosh ...
    Article ID: mp.2023-0093
    Published: 2024
    Advance online publication: January 16, 2024
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    Purpose: Magnetization prepared rapid acquisition with gradient echo (MPRAGE) sequence is a gold-standard technique for voxel-based morphometry (VBM) because of high spatial resolution and excellent tissue contrast, especially between gray matter (GM) and white matter (WM). Despite its benefits, MPRAGE exhibits distinct challenge for VBM in some patients with neurological disease because of long scan time and motion artifacts. Speedily acquired localizer images may alleviate this problem. This study aimed to evaluate the feasibility of VBM using 3D Fast Low Angle Shot image captured for localizer (L3DFLASH).

    Methods: Consecutive 13 patients with pathologically confirmed Alzheimer’s disease (AD) (82 ± 9 years) and 21 healthy controls (HC) (79 ± 4 years) were included in this study. Whole-brain L3DFLASH and MPRAGE were captured and preprocessed using the Computational Anatomy Toolbox 12 (CAT12). Agreement with MPRAGE was evaluated for L3DFLASH using regional normalized volume for segmented brain areas. In addition to brain volume difference on VBM and Bland-Altman analysis, atrophic pattern of AD on VBM was evaluated using L3DFLASH and MPRAGE.

    Results: Acquisition time was 18 s for L3DFLASH and 288 s for MPRAGE. There was a slight systematic difference in all regional normalized volumes from L3DFLASH and MPRAGE. For the whole cohort, GM volume measured from MPRAGE was greater than that from L3DFLASH in most of the region on VBM. When AD and HC were compared, AD-related atrophic pattern was demonstrated in both L3DFLASH and MPRAGE on VBM, although the difference was noted in significant clusters between them.

    Conclusion: Although systematic difference was noted in regional brain volume measured from L3DFLASH and MPRAGE, AD-related atrophic pattern was preserved in L3DFLASH on VBM. VBM, using speedily acquired localizer image, may provide limited but useful information for evaluating brain atrophy.

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  • Shunsuke Tajima, Haruo Isoda, Masaki Fukunaga, Yoshiaki Komori, Shinji ...
    Article ID: mp.2023-0016
    Published: 2023
    Advance online publication: December 20, 2023
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    Purpose: Hemodynamics is important in the initiation, growth, and rupture of intracranial aneurysms. Since intracranial aneurysms are small, a high-field MR system with high spatial resolution and high SNR is desirable for this hemodynamic analysis. The purpose of this study was to investigate whether the accuracy of MR fluid dynamic (MRFD) results based on 3D phase-contrast MR (3D PC MR, non-electrocardiogram[ECG]-gated 4D Flow MRI) data from a human cerebrovascular phantom and human healthy subjects obtained by a 7T MR system was superior to those by a 3T MR system.

    Methods: 3D PC MR and 3D time of flight MR angiography (3D TOF MRA) imaging were performed on a 3T MR system and a 7T MR system for a human cerebrovascular phantom and 10 healthy human subjects, and MRFD analysis was performed using these data. The MRFD results from each MR system were then compared with the following items based on the computational fluid dynamics (CFD) results: 3D velocity vector field; correlation coefficient (R), angular similarity index (ASI), and magnitude similarity index (MSI) of blood flow velocity vectors.

    Results: In the MRFD results of 3D velocity vectors of the cerebrovascular phantom, noise-like vectors were observed near the vascular wall on the 3T MR system, but no noise was observed on the 7T MR system, showing results similar to those of CFD. In the MRFD results of the cerebrovascular phantom and healthy subjects, the correlation coefficients R, ASI, and MSI of the 7T MR system were higher than those of the 3T MR system, and ASI and MSI of healthy human subjects were significantly different between the two systems.

    Conclusions: The accuracy of high spatial resolution MRFD using the 7T MR system exceeded that of the 3T MR system.

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  • Wei Mao, Yuqin Ding, Xiaoqiang Ding, Caixia Fu, Bohong Cao, Dominik Ni ...
    Article ID: mp.2023-0027
    Published: 2023
    Advance online publication: December 22, 2023
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    Purpose: The objective of this study was to evaluate renal function and pathologic injury in chronic kidney disease (CKD) using T1 mapping.

    Methods: We recruited fifteen healthy volunteers (HV) and seventy-five CKD patients to undergo T1 mapping examination, and renal parenchymal T1 values were measured. Spearman correlation analysis was used to evaluate the relevance between the pathologic injury score, estimated glomerular filtration rate (eGFR), and renal parenchymal T1 values. The diagnostic efficiency of T1 value in evaluating renal pathologic impairment was assessed.

    Results: In all subjects, renal cortical T1 value was remarkably lower than renal medullary T1 value (P < 0.01). The renal medullary T1 value of HV was considerably lower than that of CKD patients in all stages (P < 0.05). The T1 values were negatively correlated with eGFR (cortex, r = –0.718; medulla, r = –0.645). The T1 values were positively correlated with glomerular injury score (cortex, r = 0.692; medulla, r = 0.632), tubulointerstitial injury score (cortex, r = 0.758; medulla, r = 0.690) (all P < 0.01). The area under the curve (AUC) of renal cortical and medullary T1 values were 0.914 and 0.880 to distinguish moderate–severe from mild renal injury groups. To differentiate mild renal injury group from control group, the AUC values of renal cortical and medullary T1 values were 0.879 and 0.856.

    Conclusion: T1 mapping has potential application value in non-invasively assessing renal pathologic injury in CKD.

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  • Shinji Naganawa, Rintaro Ito, Mariko Kawamura, Toshiaki Taoka
    Article ID: bc.2023-0122
    Published: 2023
    Advance online publication: November 10, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Postsurgery intracranial air usually diminishes, presumably merging with cerebrospinal fluid (CSF) and venous circulation. Our study presents two transsphenoidal surgery cases, highlighting potential air absorption by arachnoid granulation (AG)—an underexplored phenomenon. AG has long been deemed pivotal for CSF absorption, but recent perspectives suggest a significant role in waste clearance, neuroinflammation, and neuroimmunity. These cases may stimulate renewed research on the multifaceted role of AG in neurofluid dynamics and potentially elucidate further AG functions.

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  • Hitomi Numamoto, Koji Fujimoto, Kanae Kawai Miyake, Yasutaka Fushimi, ...
    Article ID: mp.2023-0102
    Published: 2023
    Advance online publication: November 10, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    Purpose: To compare image distortion and reproducibility of quantitative values between reverse encoding distortion correction (RDC) diffusion-weighted imaging (DWI) and conventional DWI techniques in a phantom study and in healthy volunteers.

    Methods: This prospective study was conducted with the approval of our institutional review board. Written informed consent was obtained from each participant. RDC-DWIs were created from images obtained at 3T in three orthogonal directions in a phantom and in 10 participants (mean age, 70.9 years; age range, 63–83 years). Images without distortion correction (noDC-DWI) and those corrected with B0 (B0c-DWI) were also created. To evaluate distortion, coefficients of variation were calculated for each voxel and ROIs were placed at four levels of the brain. To evaluate the reproducibility of apparent diffusion coefficient (ADC) measurements, intra- and inter-scan variability (%CVADC) were calculated from repeated scans of the phantom. Analysis was performed using Wilcoxon signed-rank test with Bonferroni correction, and P < 0.05 was considered statistically significant.

    Results: In the phantom, distortion was less in RDC-DWI than in B0c-DWI (P < 0.006), and was less in B0c-DWI than in noDC-DWI (P < 0.006). Intra-scan %CVADC was within 1.30%, and inter-scan %CVADC was within 2.99%. In the volunteers, distortion was less in RDC-DWI than in B0c-DWI in three of four locations (P < 0.006), and was less in B0c-DWI than in noDC-DWI (P < 0.006). At the middle cerebellar peduncle, distortion was less in RDC-DWI than in noDC-DWI (P < 0.006), and was less in noDC-DWI than in B0c-DWI (P < 0.0177).

    Conclusion: In both the phantom and in volunteers, distortion was the least in RDC-DWI than in B0c-DWI and noDC-DWI.

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  • Nobuyasu Ichinose, Kentaro Haraoka, Takaya Mori, Masanori Ozaki, Akira ...
    Article ID: mp.2023-0074
    Published: 2023
    Advance online publication: November 02, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Recently, the utility of non-contrast MR endolymphatic hydrops imaging was reported, but the pitfall was indicated based on T2 preparation pulse sensitiveness to local static magnetic field (B0) inhomogeneity. The purpose of this study is to clarify the effects of surrounding magnetic environment of temporal bone to lymphatic fluid signal intensity on the T2 preparation and fluid attenuated inversion recovery pulse combination (T2prep 3D-FLAIR) technique in human inner ear study.

    Methods: We prepared a custom-made phantom comprising a chicken leg bone submersed in saline. To evaluate signal characteristics of saline close to bone, multiple TE gradient echoes, T2 relaxation time measurement, and T2prep 3D-FLAIR image were acquired. In the vicinity of the vestibule of a healthy volunteer, similar examinations were executed. Additionally, to investigate the influence of the magnetic environment from B0, the evaluation was performed in five head position settings relative to B0.

    Results: In both the phantom case and volunteer case, together with T2 star signal intensity attenuation, T2 relaxation time shortening was observed on fluid around bone. Specifically, at the outer edge in the vestibule and cochlea of the volunteer, T2 relaxation time was shorter than that of center of vestibule and that of cochlea. In the T2prep 3D-FLAIR image, higher signal intensity was observed at the same location on the outer edge of them. These results showed that bone affects surrounding fluid magnetic environment. Also, for B0 influence, despite a large area variation ratio, there is no statistically significant difference correlated to orientation within B0.

    Conclusion: The surrounding magnetic environment of the temporal bone affects lymphatic fluid signals of the peripheral part of the human inner ear on T2prep 3D-FLAIR technique.

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  • Atsushi Nakamoto, Hiromitsu Onishi, Takahiro Tsuboyama, Hideyuki Fukui ...
    Article ID: mp.2023-0039
    Published: 2023
    Advance online publication: October 28, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: To compare objective and subjective image quality, lesion conspicuity, and apparent diffusion coefficient (ADC) of high-resolution multiplexed sensitivity-encoding diffusion-weighted imaging (MUSE-DWI) with conventional DWI (c-DWI) and reduced FOV DWI (rFOV-DWI) in prostate MRI.

    Methods: Forty-seven patients who underwent prostate MRI, including c-DWI, rFOV-DWI, and MUSE-DWI, were retrospectively evaluated. SNR and ADC of normal prostate tissue and contrast-to-noise ratio (CNR) and ADC of prostate cancer (PCa) were measured and compared between the three sequences. Image quality and lesion conspicuity were independently graded by two radiologists using a 5-point scale and compared between the three sequences.

    Results: The SNR of normal prostate tissue was significantly higher with rFOV-DWI than with the other two DWI techniques (P ≤ 0.01). The CNR of the PCa was significantly higher with rFOV-DWI than with MUSE-DWI (P < 0.05). The ADC of normal prostate tissue measured by rFOV-DWI was lower than that measured by MUSE-DWI and c-DWI (P < 0.01), while there was no difference in the ADC of cancers. In the qualitative analysis, MUSE-DWI showed significantly higher scores than rFOV-DWI and c-DWI for visibility of anatomy and overall image quality in both readers, and significantly higher scores for distortion in one of the two readers (P < 0.001). There was no difference in lesion conspicuity between the three sequences.

    Conclusion: High-resolution MUSE-DWI showed higher image quality and reduced distortion compared to c-DWI, while maintaining a wide FOV and similar ADC quantification, although no difference in lesion conspicuity was observed.

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  • Yoshitaka Bito, Hisaaki Ochi, Ryuji Shirase, Wataru Yokohama, Kuniaki ...
    Article ID: mp.2023-0081
    Published: 2023
    Advance online publication: October 27, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Analysis of cerebrospinal fluid (CSF) dynamics may be beneficial for understanding the mechanisms and diagnosis of several neurological diseases. Low b-value diffusion tensor imaging (low-b DTI) is useful for observing the slow and complex motion of the CSF. Theoretically, a mathematical framework suggests that low-b DTI provides the variance of the pseudorandom motion of the CSF. Furthermore, low-b DTI could provide comprehensive information on fluid dynamics. Accordingly, we proposed an analysis technique that resolves intravoxel pseudorandom motion into ordered (linear) and disordered (random) motions based on the mathematical framework.

    Methods: The proposed analysis technique helps measure low-b DTI with multiple diffusion times and linearly fits its mean diffusivity (MD) with the diffusion time to obtain two parameters, double-slope Vv and y-intersect Dr, which represent the variance of the velocity distribution of linear motion and the diffusion coefficient of random motion, respectively. Seven healthy subjects were scanned to evaluate the proposed technique and investigate fluid dynamics in several representative ROIs.

    Results: The obtained data showed the validity of the technique, repeatability, and consistency across the subjects in ROIs, such as the lateral ventricle (LV), third ventricle (3V), fourth ventricle (4V), and Sylvian fissure (SF). The obtained parameters Vv and Dr highlighted different characteristics of fluid dynamics in the representative ROIs: low Vv and low Dr in the LV, high Vv and moderate Dr in the 3V, and moderate Vv and moderate Dr in the 4V and SF.

    Conclusion: The proposed analysis technique will facilitate a comprehensive investigation of the complex dynamics of the CSF using resolved parameters representing ordered and disordered motions.

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  • Masafumi Takafuji, Masaki Ishida, Satoshi Nakamura, Kei Nakata, Haruno ...
    Article ID: mp.2023-0018
    Published: 2023
    Advance online publication: September 28, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: The purposes of this study were to compare global coronary flow reserve (CFR) between patients with idiopathic dilated cardiomyopathy (DCM) and risk-matched controls using cardiac MRI (CMR), and to evaluate the relationship between global CFR and CMR left ventricular (LV) parameters.

    Methods: Twenty-six patients with DCM and 26 risk-matched controls who underwent comprehensive CMR examination, including stress-rest coronary sinus flow measurement by phase contrast (PC) cine CMR were retrospectively studied. LV peak global longitudinal, radial, and circumferential strains (GLS, GRS, and GCS) were determined by feature tracking.

    Results: Patients with DCM had significantly lower global CFR compared with the risk-matched controls (2.87 ± 0.86 vs. 4.03 ± 1.47, P = 0.001). Among the parameters, univariate linear regression analyses revealed significant correlation of global CFR with LV end-diastolic volume index (r = –0.396, P = 0.045), LV mass index (r = –0.461, P = 0.018), GLS (r = –0.558, P = 0.003), and GRS (r = 0.392, P = 0.047). Multiple linear regression analysis revealed GLS as the only independent predictor of global CFR (standardized β = –0.558, P = 0.003).

    Conclusion: Global CFR was significantly impaired in patients with idiopathic DCM and independently associated with LV GLS, suggesting that microvascular dysfunction may contribute to deterioration of LV function in patients with idiopathic DCM.

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  • Ryoichi Kose, Katsumi Kose, Koji Fujimoto, Tomohisa Okada, Daiki Tamad ...
    Article ID: tn.2023-0063
    Published: 2023
    Advance online publication: September 09, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Recent high-performance gradient coils are fabricated mainly at the expense of spatial linearity. In this study, we measured the spatial nonlinearity of the magnetic field generated by the gradient coils of two MRI systems with high-performance gradient coils. The nonlinearity of the gradient fields was measured using 3D gradient echo sequences and a spherical phantom with a built-in lattice structure. The spatial variation of the gradient field was approximated to the 3rd order polynomials. The coefficients of the polynomials were calculated using the steepest descent method. The geometric distortion of the acquired 3D MR images was corrected using the polynomials and compared with the 3D images corrected using the harmonic functions provided by the MRI venders. As a result, it was found that the nonlinearity correction formulae provided by the vendors were insufficient and needed to be verified or corrected using a geometric phantom such as used in this study.

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  • Zuofeng Zheng, Yawen Liu, Hongxia Yin, Pengling Ren, Tingting Zhang, J ...
    Article ID: tn.2022-0161
    Published: 2023
    Advance online publication: September 08, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Synthetic MRI is being increasingly used for the quantification of brain longitudinal relaxation time (T1), transverse relaxation time (T2), and proton density (PD) values. However, the effect of fast imaging protocols on these quantitative values has not been fully estimated. The purpose of this study was to investigate the effect of fast scan parameters on T1, T2, and PD measured with a multi-dynamic multi-echo (MDME) sequence of normal brain at 3.0T. Thirty-four volunteers were scanned using 3 MDME sequences with different scan times (named Fast, 2 min, 29 sec; Routine, 4 min, 07 sec; and Research, 7 min, 46 sec, respectively). The measured T1, T2, and PD in 18 volumes of interest (VOI) of brain were compared between the 3 sequences using rank sum test, t test, coefficients of variation (CVs) analysis, correlation analysis, and Bland-Altman analysis. We found that even though T1, T2, and PD were significantly different between the 3 sequences in most of the brain regions, the intersequence CVs were relatively low and linear correlation were high. Bland-Altman plots showed that most of the values fall within the 95% prediction limits. We concluded that fast imaging protocols of MDME sequence used in our study can potentially be used for quantitative evaluation of brain tissues. Since changing scan parameters can affect the measured T1, T2, and PD values, it is necessary to use consistent scan parameter for comparing or following up cases quantitatively.

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  • Yuta Endo, Sanae Takahashi, Haruna Shibo, Makoto Amanuma, Kuninori Kob ...
    Article ID: mp.2023-0029
    Published: 2023
    Advance online publication: September 04, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Polarity-corrected inversion time preparation (PCTIP), a myocardial T1 mapping technique, is expected to reduce measurement underestimation in the modified Look-Locker inversion recover method. However, measurement precision is reduced, especially for heart rate variability. We devised an analysis using a recurrence formula to overcome this problem and showed that it improved the measurement accuracy, especially at high heart rates. Therefore, this study aimed to determine the effect of this analysis on the accuracy and precision of T1 measurements for irregular heart rate variability.

    Methods: A PCTIP scan using a 3T MRI scanner was performed in phantom experiment. We generated the simulated R-waves required for electrocardiogram (ECG)-gated acquisition using a signal generator set to 30 combinations. T1 map was generated using the signal train of the PCTIP images by nonlinear curve fitting using conventional and recurrence formulas. Accuracy against reference T1 and precision of heart rate variability were evaluated. To evaluate the fitting accuracy of both analyses, the relative fitting error was calculated.

    Results: For the longer T1, the fitting error was larger than the short T1, with the conventional analysis showing 10.1±2.0%. The recurrence formula analysis showed a small fitting error less than 1%, which was consistent for all heart rate variability patterns. In the conventional analysis, the accuracy, especially for longer T1, showed a large underestimation of the measurements and poor linearity. However, in the recurrence formula analysis, the accuracy improved at a long T1, and linearity also improved. The Bland–Altman plot showed that it varied greatly depending on the heart rate variability pattern for the longer T1 in the conventional analysis, whereas the recurrence formula analysis suppressed this variation.

    Conclusion: T1 analysis of PCTIP using the recurrence formula analysis achieved accurate and precise T1 measurements, even for irregular heart rate variability.

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  • Daisuke Takenaka, Yoshiyuki Ozawa, Kaori Yamamoto, Maiko Shinohara, Ma ...
    Subject Area: MAJOR PAPERS
    Article ID: mp.2023-0068
    Published: 2023
    Advance online publication: September 01, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Deep learning reconstruction (DLR) has been recommended as useful for improving image quality. Moreover, compressed sensing (CS) or DLR has been proposed as useful for improving temporal resolution and image quality on MR sequences in different body fields. However, there have been no reports regarding the utility of DLR for image quality and T-factor assessment improvements on T2-weighted imaging (T2WI), short inversion time (TI) inversion recovery (STIR) imaging, and unenhanced- and contrast-enhanced (CE) 3D fast spoiled gradient echo (GRE) imaging with and without CS in comparison with thin-section multidetector-row CT (MDCT) for non-small cell lung cancer (NSCLC) patients. The purpose of this study was to determine the utility of DLR for improving image quality and the appropriate sequence for T-category assessment for NSCLC patients.

    Methods: As subjects for this study, 213 pathologically diagnosed NSCLC patients who underwent thin-section MDCT and MR imaging as well as T-factor diagnosis were retrospectively enrolled. SNR of each tumor was calculated and compared by paired t-test for each sequence with and without DLR. T-factor for each patient was assessed with thin-section MDCT and all MR sequences, and the accuracy for T-factor diagnosis was compared among all sequences and thin-section CT by means of McNemar’s test.

    Results: SNRs of T2WI, STIR imaging, unenhanced thin-section Quick 3D imaging, and CE-thin-section Quick 3D imaging with DLR were significantly higher than SNRs of those without DLR (P < 0.05). Diagnostic accuracy of STIR imaging and CE-thick- or thin-section Quick 3D imaging was significantly higher than that of thin-section CT, T2WI, and unenhanced thick- or thin-section Quick 3D imaging (P < 0.05).

    Conclusion: DLR is thus considered useful for image quality improvement on MR imaging. STIR imaging and CE-Quick 3D imaging with or without CS were validated as appropriate MR sequences for T-factor evaluation in NSCLC patients.

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  • Barış Genç, Kerim Aslan, Ali Özçağlayan, Lütfi İncesu
    Article ID: mp.2023-0054
    Published: 2023
    Advance online publication: August 01, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Glioblastoma patients develop recurrence in the opposite hemisphere far from the primary tumor site even after complete resection. This is one of the main reasons for short disease survival. Our aim in this study is to detect microstructural changes in the contralateral hemisphere of glioblastoma patients using different diffusion models with the fully automated tract-based spatial statistics (TBSS) method.

    Methods: Fourteen right-sided and eleven left-sided glioblastoma patients without any treatment and eighteen age- and gender-matched controls were included in the study. Multi-shell diffusion weighted images were created with a 3T MRI device. After various preprocessing steps, images of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), axial kurtosis (AK), mean kurtosis (MK), radial kurtosis (RK), intracellular volume fraction (ICVF), orientation dispersion index (ODI), and isotropic water fraction (ISO) were obtained. TBSS was used to compare diffusion tensor imaging, diffusion kurtosis imaging, and neurite orientation dispersion and density imaging parameters of right- and left-sided glioblastoma patients with the control group for the contralateral hemisphere.

    Results: Both right-sided and left-sided glioblastoma patients have shown an increase in MD and ODI in the contralateral hemisphere. While right-sided glioblastoma patients showed an increase in RD, AD, and ISO in a more limited area in the contralateral hemisphere, left-sided glioblastoma patients showed an increase in MK and AK. FA, ICVF, and RK did not show any difference in both groups.

    Conclusion: There are microstructural changes in the contralateral hemisphere in glioblastoma patients, and these changes differ between right-sided and left-sided glioblastoma patients.

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  • Naoto Fujita, Suguru Yokosawa, Toru Shirai, Yasuhiko Terada
    Article ID: mp.2023-0031
    Published: 2023
    Advance online publication: July 28, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    Purpose: Deep neural networks (DNNs) for MRI reconstruction often require large datasets for training. Still, in clinical settings, the domains of datasets are diverse, and how robust DNNs are to domain differences between training and testing datasets has been an open question. Here, we numerically and clinically evaluate the generalization of the reconstruction networks across various domains under clinically practical conditions and provide practical guidance on what points to consider when selecting models for clinical application.

    Methods: We compare the reconstruction performance between four network models: U-Net, the deep cascade of convolutional neural networks (DC-CNNs), Hybrid Cascade, and variational network (VarNet). We used the public multicoil dataset fastMRI for training and testing and performed a single-domain test, where the domains of the dataset used for training and testing were the same, and cross-domain tests, where the source and target domains were different. We conducted a single-domain test (Experiment 1) and cross-domain tests (Experiments 2–4), focusing on six factors (the number of images, sampling pattern, acceleration factor, noise level, contrast, and anatomical structure) both numerically and clinically.

    Results: U-Net had lower performance than the three model-based networks and was less robust to domain shifts between training and testing datasets. VarNet had the highest performance and robustness among the three model-based networks, followed by Hybrid Cascade and DC-CNN. Especially, VarNet showed high performance even with a limited number of training images (200 images/10 cases). U-Net was more robust to domain shifts concerning noise level than the other model-based networks. Hybrid Cascade showed slightly better performance and robustness than DC-CNN, except for robustness to noise-level domain shifts. The results of the clinical evaluations generally agreed with the results of the quantitative metrics.

    Conclusion: In this study, we numerically and clinically evaluated the robustness of the publicly available networks using the multicoil data. Therefore, this study provided practical guidance for clinical applications.

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  • Hideki Hoshi, Reiji Sugita, Yoshio Machida
    Article ID: tn.2022-0132
    Published: 2023
    Advance online publication: June 21, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    The usefulness of a highly targeted pencil beam (PB) label was compared with the commonly used slab label for direct visualization of pancreaticobiliary reflux using the time-spatial labeling inversion pulse (time-SLIP) technique. Signal profiles of flow phantom images obtained with a 1.5T MRI were analyzed. Both labels had similar labeling capabilities, but the edge characteristics of the PB label were blunt. Next, sixty-eight patients were classified into two groups according to the angle of the pancreaticobiliary ducts, and the displacement of the pancreatic ducts in respiratory fluctuation was measured. The results were approximately 7 mm in both groups. The blunt edge characteristics of the PB label suggest that it is robust to respiratory fluctuations. The overall labeling ability of the PB is comparable to that of the slab. In the larger angle of pancreaticobiliary ducts, the PB label may be able to label the pancreatic duct more selectively.

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  • Naoya Kinota, Hiroyuki Kameda, Bai Xiawei, Takaaki Fujii, Daisuke Kato ...
    Article ID: mp.2023-0023
    Published: 2023
    Advance online publication: May 30, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: To investigate whether deep cervical lymph node (DCLN) ligation alters intracranial cerebrospinal fluid (CSF) tracer dynamics and outflow using a rat model with intrathecal dynamic contrast-enhanced (DCE) MRI.

    Methods: Six bilateral DCLN-ligated and six sham-operated rats were subjected to DCE MRI with Gd-BTDO3A, and dynamic T1-weighted images were acquired. ROIs were collected from the CSF at the C1 level (CSF_C1), CSF between the olfactory bulbs (CSF_OB), CSF at the pituitary recess (CSF_PitR), and CSF at the pineal recess (CSF_PinR), upper nasal turbinate (UNT), olfactory bulbs, cerebrum, and the jugular region. Time-intensity curves were evaluated, and the maximum slope, peak timing, peak signal ratio, and elimination half-life for the four CSF ROIs and UNT were calculated and compared.

    Results: Delayed tracer arrival in the rostral CSF space and the nasal cavity with tracer retention in the ventral CSF space were observed in the ligation group. The maximum slopes were smaller in the ligation group at UNT (sham: 0.075 ± 0.0061, ligation: 0.044 ± 0.0086/min, P = 0.011). A significant difference was not detected in peak timings. The peak signal ratio values were lower in the ligation group at UNT (sham: 2.12 ± 0.19, ligation: 1.72 ± 0.11, P = 0.011). The elimination half-life was delayed in the ligation group at CSF_C1 (sham: 30.5 ± 2.70, ligation: 44.4 ± 12.6 min, P = 0.043), CSF_OB (sham: 30.2 ± 2.67, ligation: 44.8 ± 7.47 min, P = 0.021), and CSF_PitR (sham: 30.2 ± 2.49, ligation: 41.3 ± 7.57 min, P = 0.021).

    Conclusion: The DCLN ligation in rats blocked CSF outflow into the nasal cavity and caused CSF retention.

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  • Aika Okazawa, Mami Iima, Masako Kataoka, Ryosuke Okumura, Sachiko Taka ...
    Article ID: mp.2022-0056
    Published: 2023
    Advance online publication: May 26, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: We aimed to investigate the diagnostic feasibility of an adjusted diffusion-weighted imaging (DWI) lexicon using multiple b values to assess breast lesions according to DWI-based breast imaging reporting and data system (BI-RADS).

    Methods: This Institutional Review Board (IRB)-approved prospective study included 127 patients with suspected breast cancer. Breast MRI was performed using a 3T scanner. Breast DW images were acquired using five b-values of 0, 200, 800, 1000, and 1500 s/mm2 (5b-value DWI) on 3T MRI. Two readers independently assessed lesion characteristics and normal breast tissue using DWI alone (5b-value DWI and 2b-value DWI with b = 0 and 800 s/mm2) according to DWI-based BI-RADS and in combination with the standard dynamic contrast-enhanced images (combined MRI). Interobserver and intermethod agreements were assessed using kappa statistics. The specificity and sensitivity of lesion classification were evaluated.

    Results: Ninety-five breast lesions (39 malignant and 56 benign) were evaluated. Interobserver agreement for lesion assessment on 5b-value DWI was very good (k ≥ 0.82) for DWI-based BI-RADS categories, lesion type, and mass characteristics; good (k = 0.75) in breast composition; and moderate (k ≥ 0.44) in background parenchymal signal (BPS) and non-mass distribution. Intermethod agreement between assessments performed using either 5b-value DWI or combined MRI was good-to-moderate (k = 0.52–0.67) for lesion type; moderate (k = 0.49–0.59) for DWI-based BI-RADS category and mass characteristics; and fair (k = 0.25–0.40) for mass shape, BPS, and breast composition. The sensitivity and positive predictive values (PPVs) for 5b-value DWI were 79.5%, 84.6% and 60.8%, 61.1% for each reader, respectively; 74.4%, 74.4% and 63.0%, 61.7% for 2b-value DWI; and 97.4%, 97.4% and 73.1%, 76.0% for combined MRI. The specificity and negative predictive values (NPVs) were 64.3%, 62.5% and 81.8%, 85.4% for 5b-value DWI; 69.6%, 67.9% and 79.6%, 79.2% for 2b-value DWI; and 75.0%, 78.6% and 97.7%, 97.8% for combined MRI.

    Conclusion: Good observer agreement was observed in the 5b-value DWI. The 5b-value DWI based on multiple b-values might have the potential to complement the 2b-value DWI; however, their diagnostic performance tended to be inferior to that of combined MRI for the characterization of breast tumors.

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  • Minkyeong Kim, Tae Young Lee, Byeong Seong Kang, Woon Jung Kwon, Soyeo ...
    Article ID: mp.2022-0144
    Published: 2023
    Advance online publication: May 13, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Although diffusion-weighted imaging (DWI) with ultra-high b-values is reported to be advantageous in the detection of some tumors, its applicability is not yet known in biliary malignancy. Therefore, this study aimed to evaluate the impact of measured b = 1400 s/mm2 (M1400) and calculated b = 1400 s/mm2 (C1400) DWI on image quality and quality of lesion discernibility using a modern 3T MR system compared to conventional b = 800 s/mm2 DWI (M800).

    Methods: We evaluated 56 patients who had pathologically proven biliary malignancy. All the patients underwent preoperative or baseline 3T MRI using DWI (b = 50, 400, 800, and 1400 s/mm2). The calculated DWI was obtained using a conventional DWI set (b = 50, 400, and 800). The tumor-to-bile contrast ratio (CR) and tumor SNR were compared between the different DWI images. Likert scores were given on a 5-point scale to assess the overall image quality, overall artifacts, ghost artifacts, misregistration artifacts, margin sharpness, and lesion discernibility. Repeated-measures analysis of variance with post hoc analyses was used for statistical evaluations.

    Results: The CR of the tumor-to-bile was significantly higher in both M1400 and C1400 than in M800 (Pa < 0.01). SNRs were significantly higher in M800, followed by C1400 and M1400 (Pa < 0.01). Lesion discernibility was significantly improved for M1400, followed by C1400 and M800 for both readers (Pa < 0.01).

    Conclusion: Using a 3T MRI, both measured and calculated DWI with an ultra-high b-value offer superior lesion discernibility for biliary malignancy compared to the conventional DWI.

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  • Shoko Hara, Masaaki Hori, Koji Kamagata, Christina Andica, Motoki Inaj ...
    Article ID: mp.2022-0146
    Published: 2023
    Advance online publication: April 18, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    Purpose: Moyamoya disease (MMD) is a cerebrovascular disease associated with steno-occlusive changes in the arteries of the circle of Willis and with hemodynamic impairment. Previous studies have reported that parenchymal extracellular free water levels may be increased and the number of neurites may be decreased in patients with MMD. The aim of the present study was to investigate the postoperative changes in parenchymal free water and neurites and their relationship with cognitive improvement.

    Methods: Multi-shell diffusion MRI (neurite orientation dispersion and density imaging and free water imaging using a bi-tensor model) was performed in 15 hemispheres of 13 adult patients with MMD (11 female, mean age 37.9 years) who had undergone revascularization surgery as well as age- and sex-matched normal controls. Parameter maps of free water and free-water-eliminated neurites were created, and the regional parameter values were compared among controls, patients before surgery, and patients after surgery.

    Results: The anterior and middle cerebral artery territories of patients showed higher preoperative free water levels (P ≤ 0.007) and lower postoperative free water levels (P ≤ 0.001) than those of normal controls. The change in the dispersion of the white matter in the anterior cerebral artery territory correlated with cognitive improvement (r = –0.75; P = 0.004).

    Conclusion: Our study suggests that increased parenchymal free water levels decreased after surgery and that postoperative changes in neurite parameters are related to postoperative cognitive improvement in adult patients with MMD. Diffusion analytical methods separately calculating free water and neurites may be useful for unraveling the pathophysiology of chronic ischemia and the postoperative changes that occur after revascularization surgery in this disease population.

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  • Daiki Ito, Tetsushi Habe, Tomokazu Numano, Shigeo Okuda, Shigeyoshi So ...
    Article ID: mp.2022-0149
    Published: 2023
    Advance online publication: April 12, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: This study aimed to facilitate research progress in MR elastography (MRE) by providing a versatile and convenient application for MRE reconstruction, namely the MRE research tool (MRE-rTool). It can be used for a series of MRE image analyses, including phase unwrapping, arbitrary bandpass and directional filtering, noise assessment of the wave propagation image (motion SNR), and reconstruction of the elastogram in both 2D and 3D MRE acquisitions. To reinforce the versatility of MRE-rTool, the conventional method of motion SNR was modified into a new method that reflects the effects of image filtering.

    Methods: MRE tests of the phantom and liver were performed using different estimation algorithms for stiffness value (algebraic inversion of the differential equation [AIDE], local frequency estimation [LFE] in MRE-rTool, and multimodel direct inversion [MMDI] in clinical reconstruction) and acquiring dimensions (2D and 3D acquisitions). This study also tested the accuracy of masking low SNR regions using modified and conventional motion SNR under various mechanical vibration powers.

    Results: The stiffness values estimated using AIDE/LFE in MRE-rTool were comparable to that of MMDI (phantom, 3.71 ± 0.74, 3.60 ± 0.32, and 3.60 ± 0.54 kPa in AIDE, LFE, and MMDI; liver, 2.26 ± 0.31, 2.74 ± 0.16, and 2.21 ± 0.26 kPa in AIDE, LFE, and MMDI). The stiffness value in 3D acquisition was independent of the direction of the motion-encoding gradient and was more accurate than that of 2D acquisition. The masking of low SNR regions using the modified motion SNR worked better than that in the conventional motion SNR for each vibration power, especially when using a directional filter.

    Conclusion: The performance of MRE-rTool on test data reached the level required in clinical MRE studies. MRE-rTool has the potential to facilitate MRE research, contribute to the future development of MRE, and has been freely released online.

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  • Shimpei Kato, Ryo Kurokawa, Fumio Suzuki, Shiori Amemiya, Takahiro Shi ...
    Article ID: mp.2022-0099
    Published: 2023
    Advance online publication: March 29, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Burning mouth syndrome (BMS) is defined by a burning sensation or pain in the tongue or other oral sites despite the presence of normal mucosa on inspection. Both psychiatric and neuroimaging investigations have examined BMS; however, there have been no analyses using the neurite orientation dispersion and density imaging (NODDI) model, which provides detailed information of intra- and extracellular microstructures. Therefore, we performed voxel-wise analyses using both NODDI and diffusion tensor imaging (DTI) models and compared the results to better comprehend the pathology of BMS.

    Methods: Fourteen patients with BMS and 11 age- and sex-matched healthy control subjects were prospectively scanned using a 3T-MRI machine using 2-shell diffusion imaging. Diffusion tensor metrics (fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity [AD], and radial diffusivity [RD]) and neurite orientation and dispersion index metrics (intracellular volume fraction [ICVF], isotropic volume fraction [ISO], and orientation dispersion index [ODI]) were retrieved from diffusion MRI data. These data were analyzed using tract-based spatial statistics (TBSS) and gray matter-based spatial statistics (GBSS).

    Results: TBSS analysis showed that patients with BMS had significantly higher FA and ICVF and lower MD and RD than the healthy control subjects (family-wise error [FWE] corrected P < 0.05). Changes in ICVF, MD, and RD were observed in widespread white matter areas. Fairly small areas with different FA were included. GBSS analysis showed that patients with BMS had significantly higher ISO and lower MD and RD than the healthy control subjects (FWE-corrected P < 0.05), mainly limited to the amygdala.

    Conclusion: The increased ICVF in the BMS group may represent myelination and/or astrocytic hypertrophy, and microstructural changes in the amygdala in GBSS analysis indicate the emotional-affective profile of BMS.

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  • Kengo Kiso, Takahiro Tsuboyama, Hiromitsu Onishi, Kazuya Ogawa, Atsush ...
    Article ID: mp.2022-0111
    Published: 2023
    Advance online publication: March 29, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: To compare the effects of deep learning reconstruction (DLR) on respiratory-triggered T2-weighted MRI of the liver between single-shot fast spin-echo (SSFSE) and fast spin-echo (FSE) sequences.

    Methods: Respiratory-triggered fat-suppressed liver T2-weighted MRI was obtained with the FSE and SSFSE sequences at the same spatial resolution in 55 patients. Conventional reconstruction (CR) and DLR were applied to each sequence, and the SNR and liver-to-lesion contrast were measured on FSE-CR, FSE-DLR, SSFSE-CR, and SSFSE-DLR images. Image quality was independently assessed by three radiologists. The results of the qualitative and quantitative analyses were compared among the four types of images using repeated-measures analysis of variance or Friedman’s test for normally and non-normally distributed data, respectively, and a visual grading characteristics (VGC) analysis was performed to evaluate the image quality improvement by DLR on the FSE and SSFSE sequences.

    Results: The liver SNR was lowest on SSFSE-CR and highest on FSE-DLR and SSFSE-DLR (P < 0.01). The liver-to-lesion contrast did not differ significantly among the four types of images. Qualitatively, noise scores were worst on SSFSE-CR but best on SSFSE-DLR because DLR significantly reduced noise (P < 0.01). In contrast, artifact scores were worst both on FSE-CR and FSE-DLR (P < 0.01) because DLR did not reduce the artifacts. Lesion conspicuity was significantly improved by DLR compared with CR in the SSFSE (P < 0.01) but not in FSE sequences for all readers. Overall image quality was significantly improved by DLR compared with CR for all readers in the SSFSE (P < 0.01) but only one reader in the FSE (P < 0.01). The mean area under the VGC curve values for the FSE-DLR and SSFSE-DLR sequences were 0.65 and 0.94, respectively.

    Conclusion: In liver T2-weighted MRI, DLR produced more marked improvements in image quality in SSFSE than in FSE.

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  • Vadim Malis, Won C. Bae, Asako Yamamoto, Yoshimori Kassai, Marin A McD ...
    Article ID: mp.2022-0073
    Published: 2023
    Advance online publication: March 23, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    Purpose: Fatty acid composition of the orbit makes it challenging to achieve complete fat suppression during orbit MR imaging. Implementation of a fat suppression technique capable of suppressing signals from saturated (aliphatic) and unsaturated (olefinic or protons at double-bonded carbon sites) fat would improve the visualization of an optical nerve. Furthermore, the ability to semi-quantify the fractions of aliphatic and olefinic fat may potentially provide valuable information in assessing orbit pathology.

    Methods: A phantom study was conducted on various oil samples on a clinical 3 Tesla scanner. The imaging protocol included three 2D fast spin echo (FSE) sequences: in-phase, polarity-altered spectral and spatial selective acquisition (PASTA), and a combination of PASTA with opposed phase in olefinic and aliphatic chemical shift. The results were validated against high-resolution 11.7T NMR and compared with images acquired with spectral attenuated inversion recovery (SPAIR) and chemical shift selective (CHESS) fat suppression techniques. In-vivo data were acquired on eight healthy subjects and were compared with the prior histological studies.

    Results: PASTA with opposed phase achieved complete suppression of fat signals in the orbits and provided images of well-delineated optical nerves and muscles in all subjects. The olefinic fat fraction in the olive, walnut, and fish oil phantoms at 3T was found to be 5.0%, 11.2%, and 12.8%, respectively, whereas 11.7T NMR provides the following olefinic fat fractions: 6.0% for olive, 11.5% for walnut, and 12.6% for fish oils. For the in-vivo study, on average, olefinic fat accounted for 9.9% ± 3.8% of total fat while the aliphatic fat fraction was 90.1% ± 3.8%, in the normal orbits.

    Conclusion: We have introduced a new fat suppression technique using PASTA with opposed phase and applied it to human orbits. The purposed method achieves an excellent orbital fat suppression and the quantification of aliphatic and olefinic fat signals.

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  • Masatoshi Iwamura, Satoru Ide, Kenya Sato, Akihisa Kakuta, Soichiro Ta ...
    Article ID: mp.2022-0112
    Published: 2023
    Advance online publication: March 16, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Brain MRI with high spatial resolution allows for a more detailed delineation of multiple sclerosis (MS) lesions. The recently developed deep learning-based reconstruction (DLR) technique enables image denoising with sharp edges and reduced artifacts, which improves the image quality of thin-slice 2D MRI. We, therefore, assessed the diagnostic value of 1 mm-slice-thickness 2D T2-weighted imaging (T2WI) with DLR (1 mm T2WI with DLR) compared with conventional MRI for identifying MS lesions.

    Methods: Conventional MRI (5 mm T2WI, 2D and 3D fluid-attenuated inversion recovery) and 1 mm T2WI with DLR (imaging time: 7 minutes) were performed in 42 MS patients. For lesion detection, two neuroradiologists counted the MS lesions in two reading sessions (conventional MRI interpretation with 5 mm T2WI and MRI interpretations with 1 mm T2WI with DLR). The numbers of lesions per region category (cerebral hemisphere, basal ganglia, brain stem, cerebellar hemisphere) were then compared between the two reading sessions.

    Results: For the detection of MS lesions by 2 neuroradiologists, the total number of detected MS lesions was significantly higher for MRI interpretation with 1 mm T2WI with DLR than for conventional MRI interpretation with 5 mm T2WI (765 lesions vs. 870 lesions at radiologist A, < 0.05). In particular, of the 33 lesions in the brain stem, radiologist A detected 21 (63.6%) additional lesions by 1 mm T2WI with DLR.

    Conclusion: Using the DLR technique, whole-brain 1 mm T2WI can be performed in about 7 minutes, which is feasible for routine clinical practice. MRI with 1 mm T2WI with DLR enabled increased MS lesion detection, particularly in the brain stem.

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  • Mitsue Miyazaki, Vadim Malis, Asako Yamamoto, Jirach Kungsamutr, Linda ...
    Article ID: mp.2023-0005
    Published: 2023
    Advance online publication: March 11, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Cerebrospinal fluid (CSF) clearance is essential for maintaining a healthy brain and cognition by removal of metabolic waste from the central nervous system. Physical exercise has been shown to improve human health; however, the effect of physical exercise on intrinsic CSF outflow in humans remains unexplored. The purpose of this study was to investigate intrinsic CSF outflow pathways and quantitative metrics of healthy individuals with active and sedentary lifestyles. In addition, the effect of exercise was investigated among the sedentary subjects before and after 3 weeks of physical activity.

    Methods: This study was performed on 18 healthy adults with informed consent, using a clinical 3-Tesla MRI scanner. We classified participants into two groups based on reported time spent sitting per day (active group: < 7 hours sitting per day and sedentary group: ≥ 7 hours sitting per day). To elucidate the effect of exercise, sedentary individuals increased their activity to 3.5 hours for 3 weeks.

    Results: We show that there are two intrinsic CSF egress pathways of the dura mater and lower parasagittal dura (PSD). The adults with an active lifestyle had greater intrinsic CSF outflow metrics than adults with a more sedentary lifestyle. However, after increased physical activity, the sedentary group showed improved CSF outflow metrics. This improvement was particularly notable at the lower PSD, where outflow metrics were highest among the active group.

    Conclusion: Our findings describe the relationship between physical activity and intrinsic CSF outflow and show a potential selective outflow pathway with increasing physical activity in the lower PSD pathway, potentially from the perivascular space or cortical venous subpial space.

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  • Hiroaki Shimizu, Naoko Mori, Shunji Mugikura, Yui Maekawa, Minoru Miya ...
    Article ID: mp.2022-0091
    Published: 2023
    Advance online publication: March 01, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    Purpose: To evaluate the effectiveness of the texture analysis of axillary high-resolution 3D T2-weighted imaging (T2WI) in distinguishing positive and negative lymph node (LN) metastasis in patients with clinically node-negative breast cancer.

    Methods: Between December 2017 and May 2021, 242 consecutive patients underwent high-resolution 3D T2WI and were classified into the training (n = 160) and validation cohorts (n = 82). We performed manual 3D segmentation of all visible LNs in axillary level I to extract the texture features. As the additional parameters, the number of the LNs and the total volume of all LNs for each case were calculated. The least absolute shrinkage and selection operator algorithm and Random Forest were used to construct the models. We constructed the texture model using the features from the LN with the largest least axis length in the training cohort. Furthermore, we constructed the 3 models combining the selected texture features of the LN with the largest least axis length, the number of LNs, and the total volume of all LNs: texture-number model, texture-volume model, and texture-number-volume model. As a conventional method, we manually measured the largest cortical diameter. Moreover, we performed the receiver operating curve analysis in the validation cohort and compared area under the curves (AUCs) of the models.

    Results: The AUCs of the texture model, texture-number model, texture-volume model, texture-number-volume model, and conventional method in the validation cohort were 0.7677, 0.7403, 0.8129, 0.7448, and 0.6851, respectively. The AUC of the texture-volume model was higher than those of other models and conventional method. The sensitivity, specificity, positive predictive value, and negative predictive value of the texture-volume model were 90%, 69%, 49%, and 96%, respectively.

    Conclusion: The texture-volume model of high-resolution 3D T2WI effectively distinguished positive and negative LN metastasis for patients with clinically node-negative breast cancer.

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  • Shoto Ikegami, Dai Ishiyama, Yoshiki Oda, Kinuko Niihara, Masafumi Yos ...
    Article ID: bc.2022-0070
    Published: 2023
    Advance online publication: February 08, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Metamorphosis in the pupae of the Trypoxylus dichotomus was continuously observed at 9.4T until their emergence. A large liquid-like mass occupied most of the volume in the trunk, while the surrounding tissue already existed at the beginning of the observation period. As the mass shrunk, tissues such as flight muscle formed, whereas the reservoir became prolonged to form the intestinal tract. This implies that the liquid-like mass worked as the raw material for creating adult tissues.

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  • Hinako Oshiro, Junichi Hata, Daisuke Nakashima, Naoya Hayashi, Yawara ...
    Article ID: mp.2022-0103
    Published: 2023
    Advance online publication: February 08, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION
    Supplementary material

    Purpose: Diffusion MRI is a physical measurement method that quantitatively indicates the displacement of water molecules diffusing in voxels. However, there are insufficient data to characterize the diffusion process physically in a uniform structure such as a phantom. This study investigated the transitional relationship between structure scale, temperature, and diffusion time for simple restricted diffusion using a capillary phantom.

    Methods: We performed diffusion-weighted pulsed-gradient stimulated-echo acquisition mode (STEAM) MRI with a 9.4 Tesla MRI system (Bruker BioSpin, Ettlingen, Germany) and a quadrature coil with an inner diameter of 86 mm (Bruker BioSpin). We measured the diffusion coefficients (radial diffusivity [RD]) of capillary plates (pore sizes 6, 12, 25, 50, and 100 μm) with uniformly restricted structures at various temperatures (10ºC, 20ºC, 30ºC, and 40ºC) and multiple diffusion times (12–800 ms). We evaluated the characteristics of scale, temperature, and diffusion time for restricted diffusion.

    Results: The RD decayed and became constant depending on the structural scale. Diffusion coefficient fluctuations with temperature occurred mostly under conditions of a large structural scale and short diffusion time. We obtained data suggesting that temperature-dependent changes in the diffusion coefficients follow physical laws.

    Conclusion: No water molecules were observed outside the glass tubes in the capillary plates, and the capillary plates only reflected a restricted diffusion process within the structure.

    We experimentally evaluated the characteristics of simple restricted diffusion to reveal the transitional relationship of the diffusion coefficient with diffusion time, structure scale, and temperature through composite measurement.

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  • Tomohiko Nishino, Kazuhiro Takahashi, Sayaka Ono, Masakazu Mimaki
    Article ID: mp.2022-0140
    Published: 2023
    Advance online publication: February 07, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Despite the usefulness of blood oxygenation level-dependent (BOLD) MRI in assessing glomerulonephritis activity, its relationship with histological findings remains unclear. Because glomerulonephritis presents multiple complex injury patterns, analysis of each pattern is essential. We aimed to elucidate the relationship between the histological findings of the kidney and BOLD MRI findings in mesangial proliferative glomerulonephritis.

    Methods: Children under 16 years of age diagnosed with mesangial proliferative glomerulonephritis by kidney biopsy at our university hospital between January 2013 and September 2022 were included in this study. Cortical and medullary spin relaxation rate (R2*) values were measured using BOLD MRI at 3T within two weeks before and after the kidney biopsy. The R2* values, including the fluctuations with low-dose oxygen administration, were retrospectively examined in relation to the cortical (mesangial proliferation, endothelial cell proliferation, crescent, sclerosis, and fibrosis) and medullary findings (fibrosis).

    Results: Sixteen times kidney biopsies were performed for glomerulonephritis during the study period, and one patient was excluded because of comorbidities; the remaining 14 patients included six boys with a mean age of 11.9 ± 3.5 years at the BOLD examination. None of the patients had medullary fibrosis. Among the kidney tissue parameters, only sclerosis showed a significant correlation with R2* values: medulla with R2* values under atmospheric pressure (r = 0.53, P < 0.05) and cortex with the rate of change in R2* values with low-dose oxygen administration (r = −0.57, P < 0.03). In the multiple regression analysis, only sclerosis was an independent contributor to the change in R2* values with oxygen administration in the cortex (regression coefficient −0.109, P < 0.05).

    Conclusion: Since the R2* values reflect histological changes in the kidney, BOLD MRI may facilitate the evaluation of mesangial proliferative glomerulonephritis, potentially reducing the patient burden.

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  • Kenichiro Ihara, Hideko Onoda, Masahiro Tanabe, Etsushi Iida, Takaaki ...
    Article ID: mp.2022-0137
    Published: 2023
    Advance online publication: February 04, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: To evaluate the feasibility of breath-hold (BH) high-resolution (HR) T1-weighted gradient echo hepatobiliary phase (HBP) imaging using compressed sensing (CS) in gadoxetic acid-enhanced liver MRI in comparison with standard HBP imaging using parallel imaging (PI).

    Methods: The study included 122 patients with liver tumors with hypointensity in the HBP who underwent both HR HBP imaging with CS and standard HBP imaging with PI. Two radiologists evaluated the liver edge sharpness, hepatic vessel conspicuity, bile duct conspicuity, image noise, and overall image quality, as well as the lesion conspicuity on HR and standard HBP imaging and the contrast-enhanced (CE) MR cholangiography (MRC) image quality reconstructed from HBP images. As a quantitative analysis, the SNR of the liver and the liver to lesion signal intensity ratio (LLSIR) were also determined.

    Results: The liver edge sharpness, hepatic vessel conspicuity, bile duct conspicuity, and overall image quality as well as the lesion conspicuity and the LLSIR on HR HBP imaging with CS were significantly higher than those on standard HBP imaging (all of P < 0.001). The image quality of CE-MRC reconstructed from HR HBP imaging with CS was also significantly higher than that from standard HBP imaging (P < 0.001). Conversely, the SNR of liver in standard HBP was significantly higher than that in HR HBP with CS (P < 0.001).

    Conclusion: BH HR HBP imaging with CS provided an improved overall image quality, lesion conspicuity, and CE-MRC visualization when compared with standard HBP imaging without extending the acquisition time.

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  • Mayumi Takeuchi, Kenji Matsuzaki, Yoshimi Bando, Masafumi Harada
    Article ID: mp.2022-0067
    Published: 2023
    Advance online publication: January 24, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    Purpose: Adenomatoid tumor is a rare benign genital tract neoplasm of mesothelial origin. Uterine adenomatoid tumors occur in the outer myometrium and may mimic leiomyomas. Because hormonal treatment is not applicable to adenomatoid tumors and laparoscopic enucleation is not easy as myomectomy, it is important to differentiate adenomatoid tumors from leiomyomas for the adequate treatment. The purpose of this study is to evaluate the MRI findings of adenomatoid tumor for the differentiation from leiomyoma.

    Methods: MRI findings of surgically proven 10 uterine adenomatoid tumors in 9 women were retrospectively evaluated with correlation to histopathological findings.

    Results: All 10 tumors appeared as solid myometrial masses and showed heterogeneous signal intensity with admixture of partially ill-defined slight high-intensity areas containing abundant tubular tumor cells and well-defined myoma-like low-intensity areas reflecting smooth muscle hypertrophy on T2WI including 4 lesions with peripheral ring-like high intensity. High-intensity areas on T2WI tended to show high intensity on diffusion-weighted imaging (DWI) with relatively high apparent diffusion coefficient (ADC), suggesting T2 shine-through effect due to abundant tubules. Intra-tumoral hemorrhage revealed on MRI was rare. Early intense contrast-enhanced areas on dynamic contrast-enhanced study were observed dominantly within the high-intensity areas but rarely within the low-intensity areas on T2WI.

    Conclusion: The outer myometrial mass with the admixture of well-defined low- and ill-defined high-intensity areas on T2WI may be suggestive of adenomatoid tumor. Peripheral ring-like high intensity on T2WI and DWI may also be suggestive. Dynamic contrast-enhanced MR study may be helpful for the differentiation from leiomyoma.

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  • Seiya Kishi, Masayuki Maeda, Fumine Tanaka, Ryota Kogue, Maki Umino, H ...
    Article ID: bc.2022-0120
    Published: 2023
    Advance online publication: January 24, 2023
    JOURNAL OPEN ACCESS ADVANCE PUBLICATION

    We observed a new SWI finding, “cortical brush sign,” that represents prominent venous structures in the cortex of patients with acute cerebral infarct with or without moyamoya disease and cerebral venous thrombosis. The cortical brush sign disappeared on follow-up SWI in all cases. Cortical brush sign may help to understand the pathophysiology of venous structures in the cortex at acute phase.

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