High-Contrast Lumbar Spinal Bone Imaging Using a 3D Slab-Selective UTE Sequence

Ultra-short echo time (UTE) MRI with post-processing is a promising technique in bone imaging that produces a similar contrast to computed tomography (CT). Here, we propose a 3D slab-selective ultrashort echo time (UTE) sequence together with image post-processing to image bone structures in the lumbar spine. We also explore the intermodality agreement between the UTE and CT images. The lumbar spines of two healthy volunteers were imaged with 3D UTE using five different resolutions to determine the best imaging protocol. Then, four patients with low back pain were imaged with both the 3D UTE sequence and CT to investigate agreement between the imaging methods. Two other patients with low back pain were then imaged with the 3D UTE sequence and clinical conventional T1-weighted and T2-weighted fast spin-echo (FSE) MRI sequences for qualitative comparison. The 3D UTE sequence together with post-processing showed high contrast images of bone and high intermodality agreement with CT images. In conclusion, post-processed slab-selective UTE imaging is a feasible approach for highlighting bone structures in the lumbar spine and demonstrates significant anatomical correlation with CT images.

Applying Compressed Sensing Volumetric Interpolated Breath-Hold Examination and Spiral Ultrashort Echo Time Sequences for Lung Nodule Detection in MRI

This prospective study aimed to investigate the ability of spiral ultrashort echo time (UTE) and compressed sensing volumetric interpolated breath-hold examination (CS-VIBE) sequences in magnetic resonance imaging (MRI) compared to conventional VIBE and chest computed tomography (CT) in terms of image quality and small nodule detection. Patients with small lung nodules scheduled for video-assisted thoracoscopic surgery (VATS) for lung wedge resection were prospectively enrolled. Each patient underwent non-contrast chest CT and non-contrast MRI on the same day prior to thoracic surgery. The chest CT was performed to obtain a standard reference for nodule size, location, and morphology. The chest MRI included breath-hold conventional VIBE and CS-VIBE with scanning durations of 11 and 13 s, respectively, and free-breathing spiral UTE for 3.5–5 min. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and normal structure visualizations were measured to evaluate MRI quality. Nodule detection sensitivity was evaluated on a lobe-by-lobe basis. Inter-reader and inter-modality reliability analyses were performed using the Cohen κ statistic and the nodule size comparison was performed using Bland–Altman plots. Among 96 pulmonary nodules requiring surgery, the average nodule diameter was 7.7 ± 3.9 mm (range: 4–20 mm); of the 73 resected nodules, most were invasive cancer (74%) or pre-invasive carcinoma in situ (15%). Both spiral UTE and CS-VIBE images achieved significantly higher overall image quality scores, SNRs, and CNRs than conventional VIBE. Spiral UTE (81%) and CS-VIBE (83%) achieved a higher lung nodule detection rate than conventional VIBE (53%). Specifically, the nodule detection rate for spiral UTE and CS-VIBE reached 95% and 100% for nodules >8 and >10 mm, respectively. A 90% detection rate was achieved for nodules of all sizes with a part-solid or solid morphology. Spiral UTE and CS-VIBE under-estimated the nodule size by 0.2 ± 1.4 mm with 95% limits of agreement from −2.6 to 2.9 mm and by 0.2 ± 1.7 mm with 95% limits of agreement from −3.3 to 3.5 mm, respectively, compared to the reference CT. In conclusion, chest CT remains the gold standard for lung nodule detection due to its high image resolutions. Both spiral UTE and CS-VIBE MRI could detect small lung nodules requiring surgery and could be considered a potential alternative to chest CT; however, their clinical application requires further investigation.

Feasibility of an Inversion Recovery-Prepared Fat-Saturated Zero Echo Time Sequence for High Contrast Imaging of the Osteochondral Junction

PurposeThe osteochondral junction (OCJ) region—commonly defined to include the deep radial uncalcified cartilage, tidemark, calcified cartilage, and subchondral bone plate—functions to absorb mechanical stress and is commonly associated with the pathogenesis of osteoarthritis. However, magnetic resonance imaging of the OCJ region is difficult due to the tissues’ short transverse relaxation times (i.e., short T2 or T2*), which result in little or no signal with conventional MRI. The goal of this study is to develop a 3D adiabatic inversion recovery prepared fat saturated zero echo time (IR-FS-ZTE) sequence for high-contrast imaging of the OCJ.MethodAn IR-FS-ZTE MR sequence was developed to image the OCJ on a clinical 3T MRI scanner. The IR-FS-ZTE sequence employed an adiabatic inversion pulse followed by a fat saturation pulse that suppressed signals from the articular cartilage and fat. At an inversion time (TI) that was matched to the nulling point of the articular cartilage, continuous ZTE imaging was performed with a smoothly rotating readout gradient, which enabled time-efficient encoding of the OCJ region’s short T2 signal with a minimal echo time (TE) of 12 μs. An ex vivo experiment with six cadaveric knee joints, and an in vivo experiment with six healthy volunteers and three patients with OA were performed to evaluate the feasibility of the proposed approach for high contrast imaging of the OCJ. Contrast-to-noise ratios (CNRs) between the OCJ and its neighboring femoral and tibial cartilage were measured.ResultsIn the ex vivo experiment, IR-FS-ZTE produced improved imaging of the OCJ region over the clinical sequences, and significantly improved the contrast compared to FS-ZTE without IR preparation (p = 0.0022 for tibial cartilage and p = 0.0019 for femoral cartilage with t-test). We also demonstrated the feasibility of high contrast imaging of the OCJ region in vivo using the proposed IR-FS-ZTE sequence, thereby providing more direct information on lesions in the OCJ. Clinical MRI did not detect signal from OCJ due to the long TE (>20 ms).ConclusionIR-FS-ZTE allows direct imaging of the OCJ region of the human knee and may help in elucidating the role of the OCJ in cartilage degeneration.