Philip Lee
Physical Science Research Scientist, Rad/Radiological Sciences Laboratory
All Publications
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Distortionless, free-breathing, and respiratory resolved 3D diffusion weighted imaging of the abdomen.
Magnetic resonance in medicine
2024
Abstract
Abdominal imaging is frequently performed with breath holds or respiratory triggering to reduce the effects of respiratory motion. Diffusion weighted sequences provide a useful clinical contrast but have prolonged scan times due to low signal-to-noise ratio (SNR), and cannot be completed in a single breath hold. Echo-planar imaging (EPI) is the most commonly used trajectory for diffusion weighted imaging but it is susceptible to off-resonance artifacts. A respiratory resolved, three-dimensional (3D) diffusion prepared sequence that obtains distortionless diffusion weighted images during free-breathing is presented. Techniques to address the myriad of challenges including: 3D shot-to-shot phase correction, respiratory binning, diffusion encoding during free-breathing, and robustness to off-resonance are described.A twice-refocused, M1-nulled diffusion preparation was combined with an RF-spoiled gradient echo readout and respiratory resolved reconstruction to obtain free-breathing diffusion weighted images in the abdomen. Cartesian sampling permits a sampling density that enables 3D shot-to-shot phase navigation and reduction of transient fat artifacts. Theoretical properties of a region-based shot rejection are described. The region-based shot rejection method was evaluated with free-breathing (normal and exaggerated breathing), and respiratory triggering. The proposed sequence was compared in vivo with multishot DW-EPI.The proposed sequence exhibits no evident distortion in vivo when compared to multishot DW-EPI, robustness to B0 and B1 field inhomogeneities, and robustness to motion from different respiratory patterns.Acquisition of distortionless, diffusion weighted images is feasible during free-breathing with a b-value of 500 s/mm2, scan time of 6 min, and a clinically viable reconstruction time.
View details for DOI 10.1002/mrm.30067
View details for PubMedID 38688875
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Robust multishot diffusion-weighted imaging of the abdomen with region-based shot rejection.
Magnetic resonance in medicine
2024
Abstract
Diffusion-weighted (DW) imaging provides a useful clinical contrast, but is susceptible to motion-induced dephasing caused by the application of strong diffusion gradients. Phase navigators are commonly used to resolve shot-to-shot motion-induced phase in multishot reconstructions, but poor phase estimates result in signal dropout and Apparent Diffusion Coefficient (ADC) overestimation. These artifacts are prominent in the abdomen, a region prone to involuntary cardiac and respiratory motion. To improve the robustness of DW imaging in the abdomen, region-based shot rejection schemes that selectively weight regions where the shot-to-shot phase is poorly estimated were evaluated.Spatially varying weights for each shot, reflecting both the accuracy of the estimated phase and the degree of subvoxel dephasing, were estimated from the phase navigator magnitude images. The weighting was integrated into a multishot reconstruction using different formulations and phase navigator resolutions and tested with different phase navigator resolutions in multishot DW-echo Planar Imaging acquisitions of the liver and pancreas, using conventional monopolar and velocity-compensated diffusion encoding. Reconstructed images and ADC estimates were compared qualitatively.The proposed region-based shot rejection reduces banding and signal dropout artifacts caused by physiological motion in the liver and pancreas. Shot rejection allows conventional monopolar diffusion encoding to achieve median ADCs in the pancreas comparable to motion-compensated diffusion encoding, albeit with a greater spread of ADCs.Region-based shot rejection is a linear reconstruction that improves the motion robustness of multi-shot DWI and requires no sequence modifications.
View details for DOI 10.1002/mrm.30102
View details for PubMedID 38623901
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Clinical evaluation of isotropic MAVRIC-SL for symptomatic hip arthroplasties at 3 T MRI.
Magnetic resonance imaging
2024
Abstract
3D multi-spectral imaging (MSI) of metal implants necessitates relatively long scan times.We implemented a fast isotropic 3D MSI technique at 3 T and compared its image quality and clinical utility to non-isotropic MSI in the evaluation of hip implants.Two musculoskeletal radiologists scored images from coronal proton density-weighted conventional MAVRIC-SL and an isotropic MAVRIC-SL sequence accelerated with robust-component-analysis on a 3-point scale (3: diagnostic, 2: moderately diagnostic, 1: non-diagnostic) for overall image quality, metal artifact, and visualization around femoral and acetabular components. Grades were compared using a signed Wilcoxon test. Images were evaluated for effusion, synovitis, osteolysis, loosening, pseudotumor, fracture, and gluteal tendon abnormalities. Reformatted axial and sagittal images for both sequences were subsequently generated and compared for image quality with the Wilcoxon test. Whether these reformats increased diagnostic confidence or revealed additional pathology, including findings unrelated to arthroplasty that may contribute to hip pain, was also compared using the McNemar test. Inter-rater agreement was measured by Cohen's kappa.39 symptomatic patients with a total of 59 hip prostheses were imaged (mean age, 70 years ±9, 14 males, 25 females). Comparison scores between coronal images showed no significant difference in image quality, metal artifact, or visualization of the femur and acetabulum. Except for loosening, reviewers identified more positive cases of pathology on the original coronally-acquired isotropic sequence. In comparison of reformatted axial and sagittal images, the isotropic sequence scored significantly (p < 0.01) higher for overall image quality (3.0 vs 2.0) and produced significantly (p < 0.01) more cases of increased diagnostic confidence (42.4% vs 7.6%) or additional diagnoses (50.8% vs 22.9%). Inter-rater agreement was substantial (k = 0.798) for image quality. Mean scan times were 4.2 mins (isotropic) and 7.1 mins (non-isotropic).Compared to the non-isotropic sequence, isotropic 3D MSI was acquired in less time while maintaining diagnostically acceptable image quality. It identified more pathology, including postoperative complications and potential pain-generating pathology unrelated to arthroplasty. This fast isotropic 3D MSI sequence demonstrates promise for improving diagnostic evaluation of symptomatic hip prostheses at 3 T while simultaneously reducing scan time.
View details for DOI 10.1016/j.mri.2024.04.017
View details for PubMedID 38621551
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A joint linear reconstruction for multishot diffusion weighted non-Carr-Purcell-Meiboom-Gill fast spin echo with full signal.
Magnetic resonance in medicine
2022
Abstract
PURPOSE: Diffusion weighted Fast Spin Echo (DW-FSE) is a promising approach for distortionless DW imaging that is robust to system imperfections such as eddy currents and off-resonance. Due to non-Carr-Purcell-Meiboom-Gill (CPMG) magnetization, most DW-FSE sequences discard a large fraction of the signal ( 2 - 2 * $$ \sqrt{2}-2\times $$ ), reducing signal-to-noise ratio (SNR) efficiency compared to DW-EPI. The full FSE signal can be preserved by quadratically incrementing the transmit phase of the refocusing pulses, but this method of resolving non-CPMG magnetization has only been applied to single-shot DW-FSE due to challenges associated with image reconstruction. We present a joint linear reconstruction for multishot quadratic phase increment data that addresses these challenges and corrects ghosting from both shot-to-shot phase and intrashot signal oscillations. Multishot imaging reduces T2 blur and joint reconstruction of shots improves g-factor performance. A thorough analysis on the condition number of the proposed linear system is described.METHODS: A joint multishot reconstruction is derived from the non-CPMG signal model. Multishot quadratic phase increment DW-FSE was tested in a standardized diffusion phantom and compared to single-shot DW-FSE and DW-EPI in vivo in the brain, cervical spine, and prostate. The pseudo multiple replica technique was applied to generate g-factor and SNR maps.RESULTS: The proposed joint shot reconstruction eliminates ghosting from shot-to-shot phase and intrashot oscillations. g-factor performance is improved compared to previously proposed reconstructions, permitting efficient multishot imaging. apparent diffusion coefficient estimates in phantom experiments and in vivo are comparable to those obtained with conventional methods.CONCLUSION: Multi-shot non-CPMG DW-FSE data with full signal can be jointly reconstructed using a linear model.
View details for DOI 10.1002/mrm.29393
View details for PubMedID 35906924
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Volumetric and multispectral DWI near metallic implants using a non-linear phase Carr-Purcell-Meiboom-Gill diffusion preparation.
Magnetic resonance in medicine
1800
Abstract
PURPOSE: DWI near metal implants has not been widely explored due to substantial challenges associated with through-slice and in-plane distortions, the increased encoding requirement of different spectral bins, and limited SNR. There is no widely adopted clinical protocol for DWI near metal since the commonly used EPI trajectory fails completely due to distortion from extreme off-resonance ranging from 2 to 20 kHz. We present a sequence that achieves DWI near metal with moderate b-values (400-500 s/mm2 ) and volumetric coverage in clinically feasible scan times.THEORY AND METHODS: Multispectral excitation with Cartesian sampling, view angle tilting, and kz phase encoding reduce in-plane and through-plane off-resonance artifacts, and Carr-Purcell-Meiboom-Gill (CPMG) spin-echo refocusing trains counteract T2* effects. The effect of random phase on the refocusing train is eliminated using a stimulated echo diffusion preparation. Root-flipped Shinnar-Le Roux refocusing pulses permits preparation of a high spectral bandwidth, which improves imaging times by reducing the number of excitations required to cover the desired spectral range. B1 sensitivity is reduced by using an excitation that satisfies the CPMG condition in the preparation. A method for ADC quantification insensitive to background gradients is presented.RESULTS: Non-linear phase refocusing pulses reduces the peak B1 by 46% which allows RF bandwidth to be doubled. Simulations and phantom experiments show that a non-linear phase CPMG pulse pair reduces B1 sensitivity. Application in vivo demonstrates complementary contrast to conventional multispectral acquisitions and improved visualization compared to DW-EPI.CONCLUSION: Volumetric and multispectral DW imaging near metal can be achieved with a 3D encoded sequence.
View details for DOI 10.1002/mrm.29153
View details for PubMedID 35014729
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Distortion-Free Diffusion Imaging Using Self-Navigated Cartesian Echo-Planar Time Resolved Acquisition and Joint Magnitude and Phase Constrained Reconstruction
IEEE TRANSACTIONS ON MEDICAL IMAGING
2022; 41 (1): 63-74
Abstract
Echo-planar time resolved imaging (EPTI) is an effective approach for acquiring high-quality distortion-free images with a multi-shot EPI (ms-EPI) readout. As with traditional ms-EPI acquisitions, inter-shot phase variations present a main challenge when incorporating EPTI into a diffusion-prepared pulse sequence. The aim of this study is to develop a self-navigated Cartesian EPTI-based (scEPTI) acquisition together with a magnitude and phase constrained reconstruction for distortion-free diffusion imaging. A self-navigated Cartesian EPTI-based diffusion-prepared pulse sequence is designed. The different phase components in EPTI diffusion signal are analyzed and an approach to synthesize a fully phase-matched navigator for the inter-shot phase correction is demonstrated. Lastly, EPTI contains richer magnitude and phase information than conventional ms-EPI, such as the magnitude and phase correlations along the temporal dimension. The potential of these magnitude and phase correlations to enhance the reconstruction is explored. The reconstruction results with and without phase matching and with and without phase or magnitude constraints are compared. Compared with reconstruction without phase matching, the proposed phase matching method can improve the accuracy of inter-shot phase correction and reduce signal corruption in the final diffusion images. Magnitude constraints further improve image quality by suppressing the background noise and thereby increasing SNR, while phase constraints can mitigate possible image blurring from adding magnitude constraints. The high-quality distortion-free diffusion images and simultaneous diffusion-relaxometry imaging capacity provided by the proposed EPTI design represent a highly valuable tool for both clinical and neuroscientific assessments of tissue microstructure.
View details for DOI 10.1109/TMI.2021.3104291
View details for Web of Science ID 000736740900007
View details for PubMedID 34383645
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Clinical utility of accelerated MAVRIC-SL with robust-PCA compared to conventional MAVRIC-SL in evaluation of total hip arthroplasties.
Skeletal radiology
2021
Abstract
OBJECTIVE: To compare the diagnostic performance of a conventional metal artifact suppression sequence MAVRIC-SL (multi-acquisition variable-resonance image combination selective) and a novel 2.6-fold faster sequence employing robust principal component analysis (RPCA), in the MR evaluation of hip implants at 3T.MATERIALS AND METHODS: Thirty-six total hip implants in 25 patients were scanned at 3T using a conventional MAVRIC-SL proton density-weighted sequence and an RPCA MAVRIC-SL proton density-weighted sequence. Comparison was made of image quality, geometric distortion, visualization around acetabular and femoral components, and conspicuity of abnormal imaging findings using the Wilcoxon signed-rank test and a non-inferiority test. Abnormal findings were correlated with subsequent clinical management and intraoperative findings if the patient underwent subsequent surgery.RESULTS: Mean scores for conventional MAVRIC-SL were better than RPCA MAVRIC-SL for all qualitative parameters (p<0.05), although the probability of RPCA MAVRIC-SL being clinically useful was non-inferior to conventional MAVRIC-SL (within our accepted 10% difference, p<0.05), except for visualization around the acetabular component. Abnormal imaging findings were seen in 25 hips, and either equally visible or visible but less conspicuous on RPCA MAVRIC-SL in 21 out of 25 cases. In 4 cases, a small joint effusion was queried on MAVRIC-SL but not RPCA MAVRIC-SL, but the presence or absence of a small effusion did not affect subsequent clinical management and patient outcome.CONCLUSION: While the overall image quality is reduced, RPCA MAVRIC-SL allows for significantly reduced scan time and maintains almost equal diagnostic performance.
View details for DOI 10.1007/s00256-021-03848-y
View details for PubMedID 34223946
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Flexible and efficient optimization of quantitative sequences using automatic differentiation of Bloch simulations.
Magnetic resonance in medicine
2019
Abstract
PURPOSE: To investigate a computationally efficient method for optimizing the Cramer-Rao Lower Bound (CRLB) of quantitative sequences without using approximations or an analytical expression of the signal.METHODS: Automatic differentiation was applied to Bloch simulations and used to optimize several quantitative sequences without the need for approximations or an analytical expression. The results were validated with in vivo measurements and comparisons to prior art. Multi-echo spin echo and DESPO T 1 were used as benchmarks to verify the CRLB implementation. The CRLB of the Magnetic Resonance Fingerprinting (MRF) sequence, which has a complicated analytical formulation, was also optimized using automatic differentiation.RESULTS: The sequence parameters obtained for multi-echo spin echo and DESPO T 1 matched results obtained using conventional methods. In vivo, MRF scans demonstrate that the CRLB optimization obtained with automatic differentiation can improve performance in presence of white noise. For MRF, the CRLB optimization converges in 1.1 CPU hours for N TR = 400 and has O ( N TR ) asymptotic runtime scaling for the calculation of the CRLB objective and gradient.CONCLUSIONS: Automatic differentiation can be used to optimize the CRLB of quantitative sequences without using approximations or analytical expressions. For MRF, the runtime is computationally efficient and can be used to investigate confounding factors as well as MRF sequences with a greater number of repetitions.
View details for DOI 10.1002/mrm.27832
View details for PubMedID 31131500