ISMRM 24th Annual Meeting & Exhibition • 07-13 May 2016 • Singapore

Power Pitch Session: MSK: The Most Powerful Hour

Tuesday, May 10, 2016
Power Pitch Theatre, Exhibition Hall
13:30 - 15:30
Moderators: Feliks Kogan, Hollis Potter

Click Here to view the Power Pitch introductory session

Note: The videos below are only the slides from each presentation.
They do not have audio.

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1 Bone Quantitative Susceptibility Mapping using tissue specific R2* and multi-peak fat spectrum to model ultra-short TE gradient echo signal
Alexey V. Dimov1,2, Zhe Liu1,2, Pascal Spincemaille2, and Yi Wang1,2
1Department of Biomedical Engineering, Cornell University, Ithaca, NY, United States, 2Radiology Department, Weill Cornell Medical College, New York, NY, United States
Bone quantitative susceptibility mapping (QSM) using standard IDEAL fat water/signal model often suffers from erroneous labeling of water component. We propose a new field estimation approach incorporating the negligible T2* decay of fat compared to bone water signal, and modeling fat with multiple spectral peaks. This tissue specific R2* multi-peak signal allows robust field mapping from radial ultra-short TE gradient echo data, enabling in vivo bone QSM with consistent high quality.

2 Reproducibility and regional variations of an optimized gagCEST protocol for the in vivo evaluation of knee cartilage at 7 Tesla
Markus Matthias Schreiner1,2, Stefan Zbyn2, Benjamin Schmitt3, Stephan Domayer1, Reinhard Windhager1, Siegfried Trattnig2, and Vladimir Mlynarik2
1Department of Orthopaedic Surgery, Medical University of Vienna, Vienna, Austria, 2Department of Biomedical Imaging and Imag-Guided Therapy, High Field MR Centre, Medical University of Vienna, Vienna, Austria, 3Siemens Healthcare Pty Ltd, Macquarie Park, Australia
Early onset osteoarthritis is associated with ultrastructural and compositional changes of cartilage, in particular with a loss of glycosaminoglycans (GAGs) and disorganization of the collagen matrix. Both changes remain elusive to morphological MRI. GagCEST is a promising tool for the evaluation of glycosaminoglycan content in articular cartilage. However, it is affected by many variables, thus rendering its application challenging. The implementation of a novel saturation scheme combined with optimized fixation seems to improve the robustness of the technique as indicated by increased reproducibility. Our optimized protocol seems to be sensitive to regional differences in the GAG content.

3 Muscle functional oxidative capacity varies along the length of healthy tibialis anterior
Andreas Boss1, Linda Heskamp1, Mark Jacobus van Uden1, Lauren Jean Bains2,3, Vincent Breukels1, and Arend Heerschap1
1Radiology and Nuclear Medicine, Radboud university medical center, Nijmegen, Netherlands, 2Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands,3Donders Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, Netherlands
Traditional PCr recovery experiments are performed in a non-localized way, while skeletal muscle is not homogeneous. In this study we performed localized 31P-MRS using a ladder-shaped 31P-phased array receive coil optimized for the tibialis anterior and found a pronounced variation in the rate of PCr recovery after isometric exercise along the length of this muscle in healthy volunteers. In addition, we observed similar regional differences in the time-to-peak signal intensity of muscle functional MRI obtained after exercise in the same volunteers. The reasons for this strong functional gradient along the tibialis anterior remain, however, to be elucidated.

4 Assessment of meniscus with adiabatic $$$T_{1\rho}$$$ and $$$T_{2\rho}$$$ in asymptomatic subjects and patients with early osteoarthritis: Oulu knee osteoarthritis study
Abdul Wahed Kajabi1,2,3, Victor Casula2,3, Arttu Peuna2,3,4, Simo Saarakkala2,5, Eveliina Lammentausta3,4, Ali Guermazi6, and Miika T. Nieminen2,3,4
1Department of Biomedical Engineering, University of Oulu, Oulu, Finland, 2Research Unit of Medical Imaging, Physics and Technology, University of Oulu and Oulu University Hospital, Oulu, Finland,3Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland, 4Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland, 5Department of Medical Technology, Institute of Biomedicine, University of Oulu, Oulu, Finland, 6Department of Radiology, Boston University School of Medicine, MA, MA, United States
Evaluation of meniscal degeneration in asymptomatic subjects and patients with early osteoarthritis (KL = 1,2) was performed using adiabatic $$$T_{1\rho}$$$ and $$$T_{2\rho}$$$ ($$$AdT_{1\rho}$$$ and $$$AdT_{2\rho}$$$, respectively) measurements in sagittal plane. Menisci of all subjects were also evaluated using semiquantitative MRI OA Knee Score (MOAKS). The results show that the length of $$$AdT_{1\rho}$$$ and $$$AdT_{2\rho}$$$ is directly related to clinical symptoms and the severity of meniscal degeneration. $$$AdT_{1\rho}$$$ and $$$AdT_{2\rho}$$$ may provide a non-invasive means of detecting and monitoring degenerative changes in the meniscus.

5 Diffusion Tensor Imaging of Human Achilles Tendon  by Stimulated Echo RESOLVE  (ste-RESOLVE)
Xiang He1, Kenneth Wengler2, Alex C Sacher3, Marco Antonio Oriundo Verastegui1, Alyssa Simeone4, Mingqian Huang1, Elaine Gould1, and Mark Schweitzer1
1Department of Radiology, Stonybrook University School of Medicine, Stony Brook, NY, United States, 2Department of Biomedical Engineering, Stonybrook University School of Medicine, Stony Brook, NY, United States, 3SUNY Binghamton University, Binghamton, NY, United States, 4New York Medical College, Valhalla, NY, United States
Diffusion tensor imaging (DTI) is sensitive to the injury-induced changes on the tendons microstructure. However, conventional spin-echo based DTI techniques often lead to poor tendon MR signal and difficulty on diffusion quantification, mainly due to the short tendon T2/T2* relaxation time constant. In this study, a novel method of combining stimulated-echo based DTI and readout-segmented multi-shot EPI (ste-RESOLVE) has been developed and evaluated. TE value can be as low as 20 ms for b value of 800 s/mm2, enabling robust investigation of Achilles tendon microscopic tissue integrity on clinical MR scanners. 

6 MR NeuroAngiography: Simultaneous Acquisition of Brachial Plexus MR Neurography and Subclavian MR Angiography Using phase-cycling Motion-Sensitized Driven-Equilibrium (pcMSDE)
Masami Yoneyama1, Hajime Tanji2, Tomoya Yamaki2, Daisuke Takahashi2, Makoto Obara1, Tomoyuki Okuaki3, and Marc Van Cauteren3
1Philips Electronics Japan, Tokyo, Japan, 2Kita-Fukushima Medical Center, Fukushima, Japan, 3Philips Healthcare Asia Pacific, Tokyo, Japan
Simultaneous acquisition of both MR angiography and MR neurography would be extremely helpful for diagnosing thoracic outlet syndrome. This study proposed a novel sequence, motion-sensitized driven-equilibrium (MSDE) prepared phase-cycling gradient echo (pcMSDE), for achieving simultaneous depiction of both MR angiography and MR neurography. By using this sequence, MR neurography images were obtained by MSDE (with motion sensitized gradient (MSG)) scan. MR angiography images were obtained by subtraction between “b0” scan (without MSG) and MSDE (with MPG) images. Additionally, this sequence could simultaneously offer the anatomical proton-density images and “self-fusion” images (MR NeuroAngiography) by using MR neurography and MR angiography. This sequence has great potential to help the diagnosis for any type of TOS. Further clinical investigation is needed.

7 Detection of Alterations in Intramyocellular Lipid and Creatine Diffusivities during Muscle Ischemia by Diffusion Weighted MRS
Anna M. WANG1,2 and Ed X. Wu1,2
1Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Hong Kong, China, People's Republic of, 2Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong, China, People's Republic of
We measured the apparent diffusion coefficients (ADCs), as well as the relative concentrations of both intramyocellular lipid (IMCL) and creatine in the rat muscle ischemia model. Comparing with the metabolite concentration changes, the IMCL and creatine ADCs had largely increased during muscle ischemia and the IMCL ADC increase was more drastic than creatine. The IMCL ADC, measured by diffusion weighted MRS, had shown the potential to probe the alterations in lipid droplet size and lipid metabolism in skeletal muscles.

8 Clinically Viable Diffusion-Weighted Imaging Near Metal using 2D-MSI PROPELLER DUO
Suryanarayanan Sivaram Kaushik1, Ajeet Gaddipati2, Brian Hargreaves3, Dawei Gui4, Robert Peters2, Tugan Muftuler5, and Kevin Koch1
1Radiology, Medical College of Wisconsin, Milwaukee, WI, United States, 2GE Healthcare, Waukesha, WI, United States, 3Radiology, Stanford University, Stanford, CA, United States, 4GE Healthcare, Waukesh, WI, United States, 5Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
While FSE-based multi-spectral imaging (MSI) sequences help overcome the artifacts caused by metallic hardware, diffusion-weighted imaging remains a challenge. The non-CPMG artifacts caused by adding diffusion lobes to an FSE train can be mitigated by modulating the phase of the refocusing pulses. Another solution involves splitting the contribution made by the spin and stimulated echoes (DUO acquisition). Here, we combine a 2D version of MSI with a PROPELLER-DUO sequence to obtain clinically-feasible, artifact-minimized, diffusion-weighted images in subjects that have cancerous lesions in close proximity to metallic hardware.  

9 Evaluation of Different Fat Suppression Techniques for Clinical Knee MRI at 7.0 Tesla
Michael Wyss1, Andrei Manoliu2, Georg Spinner1, Magda Marcon2, Roger Luechinger1, Daniel Nanz2, Klaas P. Pruessmann1, and Gustav Andreisek2
1Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland, 2Institute of Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
Reliable fat suppression is challenging but mandatory for clinical 7.0T imaging. Purpose of this study was to evaluate different fat suppression techniques for clinical 7.0T knee MRI. Eight volunteers were imaged at 7.0T (Achieva, Philips) using a dedicated 28-channel TX-knee coil (QED) and axial PDw-TSE sequences without fat suppression, with SPIR, with SPAIR, with SSGR and with the combination of SSGR+SPIR. 

10 3-D cones UTE-T2* maps show early cartilage degeneration 2 years after ACL reconstruction
Ashley Anne Williams1, Matthew R Titchenal1, and Constance R Chu1
1Orthopaedic Surgery, Stanford University, Stanford, CA, United States
3-D cones UTE-T2* maps were examined in 22 subjects with reconstructed anterior cruciate ligaments (ACLR) and 16 uninjured controls for evidence of alterations to the subsurface cartilage matrix suggestive of cartilage at risk for early OA 2 years after surgery. Elevated UTE-T2* values in regions of deep tibiofemoral cartilage and in side-to-side UTE-T2* differences were detected. UTE-T2* values correlated to standard T2 values in tibial and posterolateral femoral regions. Together, these findings suggest that UTE-T2* mapping detects “pre-osteoarthritic” subsurface cartilage matrix changes that may occur following ACLR and thus can help to identify subjects at risk of developing OA. 

11 Longitudinal sodium MRI of cartilage in patients with knee osteoarthritis: Baseline vs. 16 months follow-up
Guillaume Madelin1, Ding Xia1, Gregory Chang1, Svetlana Krasnokutsky2, Steven B Abramson2, and Ravinder R Regatte1
1Department of Radiology, New York University Langone Medical Center, New York, NY, United States, 2Department of Rheumatology, New York University Langone Medical Center, New York, NY, United States
In this longitudinal study, we measured the sodium concentration in knee cartilage in 12 patients with osteoarthritis (OA) with quantitative 23Na MRI at 7 T. Sodium measurements were performed at baseline and 16 months follow-up (on average), with and without fluid suppression by inversion recovery (IR). We show that only fluid-suppressed measurements show a significant decrease of mean [Na+] in different regions of cartilage over 16 months follow-up in OA patients. Quantitative 23Na IR-MRI could therefore be a useful imaging biomarker to monitor cartilage degradation over time, and help assess the efficiency of potential disease modifying OA drugs.

12 PCA-T1? Voxel-Based Relaxometry of the Articular Cartilage: a Comparison of Biochemical Pattern Changes in Knees with Osteoarthritis and ACL Injury - Permission Withheld
Valentina Pedoia1, Colin Russell1, Allison Randolph V1, Keiko Amano1, Xiaojuan Li1, and Sharmila Majumdar1
1University of California, San Francisco, San Francisco, CA, United States
MR quantitative T1ρ mapping has been extensively used to probe articular biochemical changes. While several studies are still limited to analyzing average T1ρ values, there is growing interest in the analysis of local patterns of T1ρ maps. A novel algorithm for locally studying knee relaxation times using Voxel-Based Relaxometry (VBR) was recently proposed. In this study we propose to couple VBR and Principal Component Analysis in order to analyze local pattern changes in OA and ACL patients. Specific features, behind the expected average elevation of T1ρ  values, are observed able to distinguish between OA, ACL and Controls subjects. 

13 Correlation of Bone Pathology on MRI with 18F-fluoride PET Uptake in Subchondral Bone
Feliks Kogan1, Audrey Fan1, Emily McWalter1, Edwin Oei2, Andrew Quon1, and Garry Gold1
1Radiology, Stanford University, Stanford, CA, United States, 2Radiology, Erasmus Medical Center, Rotterdam, Netherlands
Osteoarthritis (OA) is a debilitating disease that affects 27 million?Americans, causing pain, stiffness and loss of mobility. Simultaneous PET-MR imaging provides an opportunity to combine metabolic information regarding bone remodeling with high resolution images on MR. This work demonstrates that simultaneous 18F-fluoride PET/MR may provide additional metabolic information regarding bone pathology seen on conventional MR. This will allow for a better understanding of the role of bone degeneration in OA disease processes. Additionally, 18F-fluoride PET/MR may detect knee abnormalities unseen on MRI alone and is a promising tool for detection of early metabolic changes in OA. 

14 Quantitative assessment of muscle metabolism and dynamics of oxygen consumption with vPIVOT
Erin Kristine Englund1, Zachary Bart Rodgers1, Michael C Langham2, Emile R Mohler3, Thomas F Floyd4, and Felix W Wehrli2
1Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States, 2Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States, 3Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States, 4Department of Anesthesiology, Stony Brook University, Stony Brook, NY, United States
A method to simultaneously measure blood flow, perfusion, venous oxygen saturation, and muscle T2* using a 3-slice interleaved PASL, multi-echo GRE sequence is presented. The method, termed Velocity and Perfusion, Intravascular Venous Oxygen saturation and T2* (vPIVOT) was assessed in five subjects during a series of ischemia-reperfusion paradigms. Results indicate that vPIVOT faithfully measures all four parameters at 4-second temporal resolution. Dynamic measurement of these parameters was completed following a bout of dynamic plantar flexion contractions. vPIVOT allows for quantification of muscle oxygen consumption and evaluation of macro/microvascular flow dynamics, and may be useful for the development of biophysical models.

15 Synchronous Magnetic Resonance Imaging of Muscle Contraction induced by Electrical Stimulation
Xeni Deligianni1,2, Michele Pansini3, Meritxell Garcia4, Anna Hirschmann4, Arno Schmidt-Trucksäss5, Oliver Bieri1, and Francesco Santini1,2
1Department of Radiology, Division of Radiological Physics, University of Basel Hospital, Basel, Switzerland, 2Department of Biomedical Engineering, University of Basel, Basel, Switzerland, 3Radiology, Kantonsspital Basel-Landschaft, Brudeholz, Switzerland, 4Department of Radiology, University of Basel Hospital, Basel, Switzerland, 5Department of Sports Medicine, University of Basel, Basel, Switzerland
Magnetic Resonance Imaging can be used to provide structural and functional muscle information either from oxygenation or contraction imaging. Contraction imaging can be based on real-time imaging or on voluntary movements. However, synchronization of the acquisition is challenging. Here, we present a new method for accurate, quantitative measurement of muscle contraction using a commercially available electrical muscle stimulator. This allows the direct assessment of the reaction time of muscle fibers, contraction speed, displacement, and strain providing complementary information to electromyography. MR images of the vastus lateralis muscle of five healthy volunteers were acquired at 3 Tesla field strength during electro-stimulation.

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