Muscle MRI
Musculoskeletal Wednesday, 19 May 2021
Oral
579 - 588
Digital Poster
3165 - 3184
3185 - 3204

Oral Session - Muscle MRI
Musculoskeletal
Wednesday, 19 May 2021 16:00 - 18:00
  • Diffusion MRI Fiber Diameter for Muscle Denervation Assessment
    Ek T Tan1, Kelly C Zochowski1, Kenneth Serrano1, and Darryl B Sneag1
    1Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States
    Diffusion MRI-based apparent fiber diameter (AFD) in denervated muscle were smaller than non-denervated and controls by 11 µm and 23 µm respectively. Correlation of the AFD with T2 and fat fraction were stronger than that for standard FA.
    Figure 2. Quantitative maps from a 47-yo M with muscle edema pattern observed in the left infraspinatus, and anterior and middle deltoid. The MD, RD and AD maps (in µm2/ms) do not provide contrast in denervated muscles (red arrows) vs. non-denervated muscles (green arrows), but FA, AFD (µm) and T2-maps (ms) do. No fatty infiltration was observed in the FF (%) maps. Most pixels in the AFF (%) were mostly low (<20%). The diffusion maps were overlaid on diffusion trace images, while the T2-map was overlaid on the T2 magnitude image, and the FF map was overlaid on the Dixon water image.
    Table 2. Summary of in vivo results comparing healthy controls vs. non-denervated patients (Non-den.) vs. denervated patient muscles (Den.), with mean and p-values from two-sample t-tests (α=0.05), and statistical significance with Holm-Bonferroni correction for multiple comparison indicated (by *).
  • On the reconstruction of MR-fingerprinting with water and fat separation for quantitative skeletal muscle imaging
    Benjamin Marty1,2, Fabian Balsiger3, Pierre-Yves Baudin1,2, Lopez Alfredo1,2, Ericky CA Araujo1,2, and Harmen Reyngoudt1,2
    1Neuromuscular Investigation Center, NMR Laboratory, Institute of Myology, Paris, France, 2NMR Laboratory, CEA, DRF, IBFJ, MIRCen, Paris, France, 3Support Center for Advanced Neuroimaging, Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
    We determined the influence of the reconstruction parameters on fat fraction and water T1 estimated in the skeletal muscle using MR fingerprinting with water and fat separation and proposed an optimized reconstruction procedure maximizing the accuracy and precision of the MRI variables
    Figure 2: a) Image series from numerical leg #1 using 8 spokes per frame. b) Computed (black circles) and theoretical (red lines) real and imaginary parts of the signal evolution measured in a muscle ROI. c) FF and T1H2O maps, and difference maps (versus the theoretical maps) obtained without correction of the aliasing artifacts. d) Computed (black circles) and theoretical (red lines) real and imaginary parts of the corrected signal evolution measured in the same ROI. e) FF and T1H2O maps, and difference maps obtained on leg #1 with correction of the aliasing artifacts.
    Figure 3: a) Influence of the number of spokes used for reconstructing the MRF T1-FF image series on the Pearson correlation coefficient (r2), slope and intercept of the linear correlation, bias and 95% confidence interval (CI) between the computed and the theoretical FF and T1H2O values. b) Influence of the number of SVD components used for dictionary matching on the Pearson correlation coefficient (r2), slope and intercept of the linear correlation, bias and 95% confidence interval (CI) between the computed and the theoretical FF and T1H2O values.
  • 4D Phase Contrast MRI detects heterogeneous strain rate patterns along the length of the Tibialis Anterior muscle during dynamic contractions
    Thom T. J. Veeger1, Gustav J. Strijkers2, Valentina Mazzoli3, Hans C. van Assen1, Jurriaan H. de Groot4, Lukas M. Gottwald5, Aart J. Nederveen5, Hermien E. Kan1,6, and Melissa T. Hooijmans2
    1Radiology, Leiden University Medical Center, Leiden, Netherlands, 2Biomedical Engineering & Physics, Amsterdam Movement Sciences, Amsterdam University Medical Center, Location AMC, Amsterdam, Netherlands, 3Radiology, Stanford University, Stanford, CA, United States, 4Rehabilitation Medicine, Leiden University Medical Center, Leiden, Netherlands, 5Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Center, Location AMC, Amsterdam, Netherlands, 6Duchenne Center Netherlands, Veenendaal, Netherlands
    Spatially heterogeneous strain rates were detected along the length of the TA muscle during movement, with smallest and largest positive and negative strain rate eigenvalues in the most proximal and distal muscle segment, respectively.
    Fig. 2) Sagittal (top) and axial (bottom) phase contrast velocity images (left) and local expansion (middle) and contraction (right) rate maps of a representative subject for the load condition during maximal dorsiflexion velocity.
    Fig. 4) Line graphs showing local contraction and expansion rate during dorsi-/plantarflexion without and with load for five muscle segments. Individual subjects are indicated with grey lines (connecting with and without load conditions) and in black the mean and standard deviation of the group per segment and per load condition. Significant differences in local expansion and contraction rates between proximodistal segments are shown with hooked lines. Additionally, at the bottom, muscle area in number of voxels is shown as a percentage of muscle length (distal 0-100 proximal).
  • Characterization of cross-relaxation in human skeletal muscle using downfield 1H MRS at 7T
    Sophia Swago1, Abigail Cember2, Brianna Moon1, Puneet Bagga3, Neil Wilson4, Mark A. Elliott2, Hari Hariharan2, Ravinder Reddy2, and Walter Witschey2
    1Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States, 2Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States, 3St. Jude Children's Research Hospital, Memphis, TN, United States, 4Siemens Medical Solutions USA Inc, Malven, PA, United States
    To characterize cross-relaxation properties of downfield 1H resonances in skeletal muscle in vivo, we compare the T1 of three resonances with selective and nonselective inversion. The latter increases the T1 of the resonances at 8.0, 8.2 and 8.5 ppm.
    Figure 2: Single-voxel downfield spectra. A) Position of the voxel from which spectra are collected. Representative downfield spectra under selective (B) and non-selective inversion (C) conditions show potential ATP resonances at 8.2 and 8.5 ppm, and a carnosine resonance at 7.9-8.0 ppm.
    Figure 4: Apparent T1 of downfield resonances after selective and nonselective inversion. For each resonance, the T1 under nonselective inversion was significantly longer than under selective inversion. * indicates p<0.01.
  • Decreased muscular perfusion in dermatomyositis: initial results detected by Inflow-based vascular-space-occupancy MR imaging
    Yuankui Wu1, Xiaomin Liu1, Jun Hua2,3, Xiaodan Li1, Haimei Cao1, Yingjie Mei4, and Yikai Xu1
    1Department of Medical Imaging, Nanfang Hospital, Southern Medical University, Guangzhou, China, 2Neurosection, Division of MRI Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, 3F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, 4Philips healthcare, Guangzhou, China
    iVASO-derived arteriolar muscular blood volume (MBVa) decreases with disease progression in DM patients and has the potential to be used as a useful and sensitive biomarker in monitoring and diagnosis of DM disease.
    Figure 2. Scans from a 30-year-old female healthy volunteer. Axial T1-weighted image (A) and axial STIR (B). VL = Vastus lateralis; RF = Rectus femoris; VI = vastus intermedius; VM = Vastus medialis; AD = adductor magnus; GA = gracilis; BF = biceps femoris; ST = semi-tendinosus. Axial MBVa map (C) shows the distribution of arteriolar blood volume in normal muscle. The color scale shows the red end of the scale indicating an increasing MBVa and the blue end a decreasing MBVa.
    Figure 1. Arteriolar blood volume in normal muscles (N=176), morphologically-normal appearing muscles (MN muscles) (N=67), edematous muscles (N=86) and atrophic or fat-infiltrated muscles (AF muscles) (N=47). MBVa_max represents maximum arteriolar muscular blood volume, MBVa_mean represents mean arteriolar muscular blood volume. *p < 0.05 for MN muscles, edematous muscles and AF muscles compared to normal muscles. ●p < 0.001 for AF muscles compared to MN muscles. ■p < 0.001 for AF muscles compared to edematous muscles.
  • Spontaneous Muscular Activities and Estimating their Influence on Derived Diffusion Tensor Parameters
    Martin Schwartz1,2, Petros Martirosian1, Günter Steidle1, Bin Yang2, and Fritz Schick1
    1Section on Experimental Radiology, University Hospital of Tuebingen, Tuebingen, Germany, 2Institute of Signal Processing and System Theory, University of Stuttgart, Stuttgart, Germany
    Simulation of spontaneous muscular activities and their influence on derived diffusion parameters is investigated by a model-based approach for simulation and preprocessing.
    Figure 5: A: Axial diffusivity maps for LLS, NLS and the model-based preprocessing approach and for different amounts of SMAM-affected DTI (from 10% to 100%). B: 2D probability density function for the location of the SMAM occurrences in the right lower leg. The high activity rate is reflected by large deviations in the AD maps in the region of m. soleus and m. gastrocnemius medialis.
    Figure 1: A: Concept for SMAM generation and insertion into an undistorted DTI data set. SMAM activity rate and location can be estimated from DWI and transferred on the DTI data sets. B: Training of the mask generator with a skeletonized label mask m and Gaussian noise. C: Training of the generator for SMAM insertion with a separated background and foreground loss to preserve background signal intensity.
  • Quantitative muscle MRI in monitoring disease progression and nusinersen treatment effects in spinal muscular atrophy
    Louise Otto1, Martijn Froeling2, Ruben van Eijk1,3, Renske Wadman1, Inge Cuppen4, Danny van der Woude5, Bart Bartels5, Fay-Lynn Asselman1, Jeroen Hendrikse2, and Ludo van der Pol1
    1Department of Neurology, UMC Utrecht Brain Center, University Medical Center, Utrecht, Utrecht, Netherlands, 2Department of Radiology, University Medical Center Utrecht, the Netherlands, Utrecht, Netherlands, 3Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands, 4Department of Neurology and Child Neurology, UMC Utrecht Brain Center, University Medical Center, Utrecht, Utrecht, Netherlands, 5Department of Child Development and Exercise Center, University Medical Center Utrecht, the Netherlands, Utrecht, Netherlands
    qMRI in treatment-naïve patients with spinal muscular atrophy was able to measure subclinical disease progression. In young children, DIXON and DTI sequence showed ongoing fatty infiltration and normalization of thigh muscle microstructure during the first year of nusinersen treatment.

    Illustration of pipeline and steps of mask alignment of longitudinal data

    The methodology of alignment of imaging stacks is illustrated by the steps involving conversion of masks; initial and final masks in panel A and automated steps in mask alignment in panel B. In panel C, the images of time-point A and time-point B are rendered red and blue, to illustrate the incongruency between datasets before (left) and after (right) rigid, affine and b-spline registration. The non-corresponding regions can be identified as they maintain their respective color.

    Histogram and plots of qMRI parameters of treatment-naïve cohort at both time-points

    In the upper row, MD, FA and T2 are plotted against fat fraction, with each of the individual datapoints as dots, reduced to an average line using local regression with 95%-CI (shaded area). The bottom row represents the histograms of each of the qMRI parameters, the red arrow indicates significant changes and its direction. Time-point A is indicated in grey, and time-point B in green. All presented data is from the treatment-naïve cohort.

  • Multimodal MR Assessment of Skeletal Muscle in Patients with Chronic Kidney Disease and Dialysis
    Can Wu1,2, Qi Peng3, William Paredes4, Moriel Vandsburger5, and Matthew K. Abramowitz4
    1Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States, 2Philips Healthcare, Andover, MA, United States, 3Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States, 4Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States, 5Department of Bioengineering, University of California, Berkeley, Berkeley, CA, United States
    Significant changes of T1ρ, intra- and extra-myocellular lipid ratio, ADC, and FA were observed in patients with chronic kidney disease or dialysis compared to normal controls. In addition, there was significant correlation between T1ρ and DTI biomarkers (ADC and FA). 
    Figure 2. T1ρ maps of skeletal muscle in a control (a, d), a patient with CKD (b, e), and a patient with dialysis (c, f). The first row shows the thigh (a-c) and the second row shows calf (d-f). CKD: chronic kidney disease.
    Figure 4. T1ρ, MRS and DTI assessment of skeletal muscle function in controls, patients with CKD and dialysis. (a). T1ρ. (b). The ratio of EMCL/IMCL. (c). Apparent diffusion coefficient (ADC). (d). Fractional anisotropy (FA). Correlation of ADC (e) and FA (f) with T1ρ in the Thigh of all subjects. CKD: chronic kidney disease; Gastro: gastrocnemius. EMCL/IMCL: extramyocellular/intramyocellular lipids. * and ** indicate significant difference with 0.01 < p < 0.05 and p < 0.01, respectively, using Mann-Whitney U test.
  • The muscle twitch profile assessed with Motor Unit Magnetic Resonance Imaging (MUMRI)
    Linda Heskamp1, Matthew Birkbeck1,2,3, Roger Whittaker1, Ian Schofield1, and Andrew Blamire1
    1Newcastle University Translational and Clinical Research Institute (NUTCRI), Newcastle University, Newcastle upon Tyne, United Kingdom, 2Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, United Kingdom, 3Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
    MUMRI can measure twitch profiles of single motor units by altering the timing of electrical nerve stimulation in relation to the imaging acquisition window. The measured single motor unit contraction times were close to previously reported values.
    Figure 5: IsingleMU A) Video examples of a motor unit (MU; delineated in blue) in a DW image (top) and PC image (bottom). B) The signal profiles of the MUs in A. Top: Normalised DW latency profile (top), velocity profile (middle) and displacement profile (bottom) displayed against time post-stimulus. Start and end of contraction are depicted in circles. C) The spatial distribution of DW and phase changes for two MUs. Right image: Two MUs are seen on the DW image (white arrows) and a third MU appears visible on the phase image (grey arrowhead).
    Figure 1: A) Three theoretical types of muscle contraction. The light orange bar represents the muscle fibre (or set of elements of magnetisation) before contraction and the dark red bar the result after contraction. B) Overview of the computational model, including model input and output (top), and the outcome measures from the simulated net magnetisation and cumulative phase (bottom). PGSE-DWI is the PGSE diffusion weighted imaging gradient and Bipolar PC is the bipolar phase contrast gradient.
  • Quantitative muscle-MRI correlates with histopathology in skeletal muscle biopsies – a pilot study
    Lara Schlaffke1, Robert Rehmann1, Anja Schreiner1, Marlena Rohm1, Johannes Forsting1, Martijn Froeling2, Martin Tegenthoff1, Matthias Vorgerd1, and Anne-Katrin Güttsches1
    1Neurology, University Clinic Bergmannsheil Bochum gGmbH, Bochum, Germany, 2Radiology, UMC Utrecht, Utrecht, Netherlands
    qMRI parameters from human leg muscles correlate to fat fraction and inflammatory or degenerative changes as derived by gold-standard histopathological examination of biopsy samples.
    Figure 1: Histopathological features and the corresponding qMRI Map
    Figure 2: Overview of the quantitative maps of all patients (axial slice of the leg muscles)
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Digital Poster Session - Muscle MRI
Musculoskeletal
Wednesday, 19 May 2021 17:00 - 18:00
  • Dynamic MR imaging of muscle contraction during electrical stimulation in facioscapulohumeral muscular dystrophy: a longitudinal study
    Xeni Deligianni1,2, Francesco Santini1,2, Matteo Paoletti3, Francesca Solazzo3, Niels Bergsland4,5, Giovanni Savini3, Arianna Faggioli3, Giancarlo Germani3, Mauro Monforte6, Giorgio Tasca6, Enzo Ricci6, and Anna Pichiecchio3,7
    1Department of Radiology/ Division of Radiological Physics, University Hospital of Basel, Basel, Switzerland, 2Biomedical Engineering, University of Basel, Allschwil, Switzerland, 3Advanced Imaging and Radiomics Center, Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy, 4Buffalo Neuroimaging Analysis Center, Department of Neurology, Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States, 5IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy, 6Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy, 7Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
    After applying MRI of muscle contraction during electrical stimulation on the quadriceps muscles longitudinally in FSHD patients and in healthy controls, differences were observed in maximum values and rates of the strain.
    Figure 2. Maximum strain values for FSHD patients (blue-left) and healthy controls (red-right) for 2 different time points.
    Figure 3. Maximum strain values for FHSD patients that were scanned at least three times. At time points 1-4, the principal strain value was respectively t0 (mean=0.119), t1(median=0.058), t2(median=0.092), t3(median=0.073).
  • Effect of Eddy Current Correction on Muscle Diffusion Measurements
    Xingyu Zhou1,2, Melissa T. Hooijmans1,3, Crystal L. Coolbaugh1, Mark K. George1, and Bruce M. Damon1,2,4,5
    1Vanderbilt University Institute of Imaging Science, Nashville, TN, United States, 2Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, United States, 3Department of Radiology & Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam University Medical Center, Amsterdam, Netherlands, 4Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, 5Department of Molecular Physiology & Biophysics, Vanderbilt University Medical Center, Nashville, TN, United States
    We compared muscle diffusion tensor imaging with and without eddy current correction in the pre-processing pipeline. Eddy current correction improved the alignment of diffusion-weighted and anatomical images, but did not significantly affect the indices derived from the diffusion tensor.
    Figure 1. General workflow of data analysis. Mask difference between diffusion-weighted images and water images are shown. Eddy current improves the morphological match between diffusion-weighted and water images.
    Figure 2. Example of comparison of derived indices from muscle diffusion tensor with and without eddy current correction in tibialis anterior (TA) muscle. (A) Comparison of FA map, MD map, color-encoded map of the first eigenvector (ε1), and projection of ε1 on unit hemisphere within the superficial and deep compartments of TA. Color scheme of direction encoding: red: x-direction, green: y-direction, blue: z-direction; superficial and deep compartments of the TA muscle are delineated by yellow and aqua boundaries in ε1 maps, respectively. (B) Comparison of map of eigenvalues.
  • Altered creatine kinase activity and mitochondrial oxidative capacity in muscular dystrophic mdx mice after repeated muscle contraction
    Kihwan Kim1, Yuning Gu1, Yuran Zhu1, Yudu Li2,3, Sherry Huang1, Zhi-Pei Liang 2,3, and Xin Yu1,4
    1Biomedical Engineering, Case Western Reserve University, cleveland, OH, United States, 2Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, United States, 3Beckman Institute for advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States, 4Case Center for Imaging Research, Case Western Reserve University, cleveland, OH, United States
    31P-MRS was used to evaluate changes in muscle metabolism in a mouse model of Duchenne muscular dystrophy, the mdx mouse.  We observed altered creatine kinase activity and phosphocreatine recovery rate, suggesting abnormal mitochondrial function in the skeletal muscle of mdx mice.  
    Figure 1. (A) Coronal image of mouse hindlimb with a 1cm long landmark to display the length and location of 31P- saddle coil; (B) 3D 31P-MR fingerprints and 2D 31P-MR fingerprints matched to a dictionary entry (C) 3D and 2D dynamic 31P-MR spectra
    Figure 3. (A) PCr recovery rate between round 1 and round 2 stimulations (red color indicates increase in PCr recovery rate and black color indicates decrease in PCr recovery rate); (B) PCr level at the end of stimulation-induced muscle contraction and at after 16 min recovery.
  • Establishing a computational approach to investigate the biophysical basis of relaxivity contrast imaging in the context of muscle degeneration
    Natenael B Semmineh1, Sudarshan Ragunathan2, Laura C Bell2, and C Chad Quarles 2
    1Imaging Research, Barrow Neurological Institute rrow Neurological Institute, Phoenix, AZ, United States, 2Imaging Research, Barrow Neurological Institute, Phoenix, AZ, United States
    Tissue transverse relaxivity at tracer equilibrium (TRATE) can longitudinally differentiate myofiber atrophy in an ALS model.
    Figure 1: Representative tissue structure that will be used to characterize RCI in silico, as a function of ALS progression. Top row shows a 2D section of the 3D structure below.
    Figure 2: Example concentration time curves (A), ΔR2* time curves (B) and the corresponding TRATE values (C) over four diseases progression time points (TP) along with a normal myofiber case. Note each profile in ALS are dissimilar in shape and magnitude both for ΔR2* and concentration.
  • Effect of moderate exercise on diffusion indices in skeletal muscle
    Amy R McDowell1, Matthew T Lee2, Kiran K Seunarine2, and Chris A Clark2
    1Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom, 2GOS UCL Institute of Child Health, London, United Kingdom
    An examination of the effect of moderate exercise on diffusion indices in skeletal muscle in volunteers in order to quantify the effect of the exercise, and define when diffusion indices returned to baseline rest values.
    Figure 2: Individual results of MD from each participant by time. Orange points are pre-exercise (plotted from time of first scan), blue points are post-exercise (plotted from time exercise ceased). Error bars are one standard deviation shown in one direction only for clarity.
    Figure 3: Individual results of FA from each participant by time. Orange points are pre-exercise (plotted from time of first scan), blue points are post-exercise (plotted from time exercise ceased). Error bars are one standard deviation shown in one direction only for clarity.
  • Quantification of gluteal and multifidus muscle asymmetry and fat infiltration in patients with unilateral lumbosacral nerve root compression
    Mengyue Wang1, Weiqiang Dou2, Yu Zheng1, Yin Shi1, and Yuefen Zou1
    1The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, 2GE Healthcare, MR Research China, Beijing, China
    The changes of gluteal and multifidus muscles were side- and level-specific in unilateral lumbosacral nerve root compression, affected by several other factors. Muscle content is suggested as a good parameter for clinical evaluation.
    Table 1-4 and Figure 1
  • Interleaved multi-voxel 1H and 31P MRS for dynamic pH monitoring in the exercising calf muscle at 3 T with dynamic water reference.
    Alfredo Liubomir Lopez Kolkovsky1,2, Beatrice Matot1,2, Eric Giacomini1, Martin Meyerspeer3, Benjamin Marty1,2, and Harmen Reyngoudt1,2
    1NMR Laboratory, Institute of Myology, Paris, France, 2NMR Laboratory, CEA\DRF\IBFJ\MIRCen, Paris, France, 3High Field MR Center, CMPBME, Medical University of Vienna, Vienna, Austria
      An interleaved 1H/31P multi-voxel sequence for pH monitoring based on carnosine (pH1H, PRESS) and Pi (sLASER) was extended with a dynamic water reference, removing a ~0.05 bias on pH1H measured during a plantar flexion exercise. pH time courses (1-min temporal resolution) were comparable.
    Figure 5. (A,B) pH values (mean, std) derived from the co-localized (orange) 1H and (blue) 31P spectra averaged over 1-min intervals during the exercise paradigm for the gastrocnemius (left column) and soleus (right column) muscles. The 13-min exercise period is shown (shaded area).
    (C,D) Linear correlations and (E,F) Bland-Altman plots between pH1H and pH31P values measured during the exercise paradigm of all subjects. LoA = Limits of agreement.
    Figure 1. A. Pulse sequence chronogram showing the order of acquisition for each voxel and nucleus. The RF power was calibrated for each voxel prior to the dynamic acquisition. B. The volumes-of-interest, VOI 1 and VOI 2, were placed in the gastrocnemius and soleus, respectively. Typical voxels dimensions were 2x6x7 cm3. The nominal regions affected by the excitation pulses are shaded.
  • A Marker Controlled Active Contour Model for Thigh Muscle Segmentation in MR Images
    Weihong Guo1, Michael Judkovich1, Richard Lartey2, Dongxing Xie2, Mingrui Yang2, and Xiaojuan Li2
    1Mathematics, Applied Mathematics and Statistics, Case Western Reserve University, Cleveland, OH, United States, 2Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
    The proposed active contour model can segment MR thigh muscle groups with an average Dice coefficient of 92.5%. The user only needs to input a few markers inside and outside each muscle group. This step can be automated using atlas registration.
    Figure 4: Segmentation results of three muscle groups (quadriceps: yellow, hamstrings: green, others: red).
    Table 1: Dice Similarity Coefficients
  • DT-MRI with the random permeable barrier model shows larger, more heterogeneous muscle fibre diameters in Becker muscular dystrophy patients
    Donnie Cameron1,2, Jedrzej Burakiewicz1, Nienke M. van de Velde3, Celine Baligand1, Thom T.J. Veeger1, Melissa T. Hooijmans4, Jan J.G.M. Verschuuren3, Erik H. Niks3, and Hermien Kan1
    1C.J. Gorter Centre for High Field MRI, Department of Radiology, Leiden University Medical Centre, Leiden, Netherlands, 2Norwich Medical School, University of East Anglia, Norwich, United Kingdom, 3Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands, 4Biomedical Engineering and Physics, Amsterdam University Medical Centre, Amsterdam, Netherlands
    In Becker muscular dystrophy patients, DTI with the random permeable barrier model shows larger and more variable fibre diameters than in age-matched controls. Conventional DTI parameters show intramuscular differences and time-dependence but do not significantly differ between groups. 
    Fig. 1. Representative lower-leg Dixon images and STE-DTI parameter maps from a 59-year-old Becker muscular dystrophy (BMD) patient (a) and a 58-year-old healthy control (b). STE-DTI data were acquired with a diffusion time, Δ, of 330 ms, and mean, axial, and radial diffusivities are shown in units of μm2/s. The BMD patient shows severe fat replacement in the gastrocnemius medialis and lateralis, and peroneus longus and extensor digitorum longus muscles (fat fraction = 83, 77, 77, and 64%, respectively). This leads to signal voids in the comprehensively-fat-suppressed DTI data.
    Fig. 4. Fibre diameter, a, and membrane permeability, κ, from the random permeable barrier model in Becker muscular dystrophy patients and controls. Boxplots (top) show a and κ over the soleus (SOL), medial gastroc. (GAM), lateral gastroc. (GAL), tibialis anterior (TAN), tibialis posterior (TPO), peroneus longus (PER), and extensor digitorum longus (EDL). Median values = thick lines, hinges = 25th and 75th percentiles, and dots = raw data. Maps (middle) show a and κ in a 59-year-old patient and 58-year-old control. Density plots (bottom) show a and κ distributions from maps above.
  • Optimized water T2 mapping from multi-echo spin-echo acquisitions with an external fat fraction constraint
    Francesco Santini1,2, Xeni Deligianni1,2, Matteo Paoletti3, Francesca Solazzo3, Matthias Weigel1,4,5, Paulo Loureiro De Sousa6, Oliver Bieri1,2, Mauro Monforte7, Enzo Ricci7,8, Giorgio Tasca7, Anna Pichiecchio3,9, and Niels Bergsland10,11
    1Radiological Physics, Department of Radiology, University Hospital of Basel, Basel, Switzerland, 2Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland, 3Neurological Institute Foundation Casimiro Mondino (IRCCS), Pavia, Italy, 4Translational Imaging in Neurology, Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland, 5Department of Neurology, University Hospital of Basel, Basel, Switzerland, 6UMR7357 Laboratoire des sciences de l'Ingénieur, de l'Informatique et de l'Imagerie (ICube), Strasbourg, France, 7Institute of Neurology, A. Gemelli University Hospital Foundation, Catholic University of the Sacred Heart, Rome, Italy, 8Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy, 9Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy, 10Western New York Stem Cell Culture and Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, United States, 11Fondazione Don Carlo Gnocchi Onlus (IRCCS), Milan, Italy
    Water T2 can be efficiently estimated from multi-echo spin-echo acquisitions. The incorporation of an external fat fraction scan improves the accuracy and reduces the scan time. An optimized implementation of this method is released publicly.
    Figure 1: Water T2 (left), Fat Fraction (middle), and relative B1 (right) maps of a patient (top) and healthy volunteer (bottom), reconstructed from a 17-echo acquisition without fat fraction constraint.
    Figure 2: Water T2 maps for a patient, reconstructed from different numbers of echoes with (right) and without (left) an external fat fraction constraint.
  • Elliptical filter optimization for HARP based strain quantification in skeletal muscle
    Melissa T. Hooijmans1,2, Crystal L. Coolbaugh3, Xingyu Zhou2,4, Mark K. George2, and Bruce M. Damon4,5,6
    1Department of Radiology & Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, Amsterdam, Netherlands, 2Vanderbilt University Institute of Imaging Science, Nashville, TN, United States, 3Vanderbilt University Institute of Imaging Sciences, Nashville, TN, United States, 4Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, TN, United States, 5Department of Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, 6Department of Molecular Physiology & Biophysics, Vanderbilt University Medical Center, Nashville, TN, United States
    Using an easily translatable simulation approach. optimized elliptical filter parameters were found for accurate strain quantification in skeletal muscle in a range of strain levels.
    Figure 1. An overview of the individual steps used for strain quantification in a representative dataset. The original magnitude image (A), the Fourier Transform (FT) of the magnitude image (k-space) (B),an elliptical filter used to isolate the first harmonic peak (C), the inverse FT of the modified k-space (D), the unwrapped phase image (E) and the quantitative strain map (F).
    Figure 3. The actual and measured strain for the positive and negative simulated strain levels (Strain 1= black; Strain 2 = gray; Strain 3 = blue; Strain 4 = red) for each of the dynamics using the optimal elliptical filter size. The actual strain values are shown with dotted lines in the graph (Actual strain 1 (+/- 0.031) = black; Actual strain 2 (+/- 0.073) = gray; Actual strain 3 (+/- 0.115) = blue; Actual strain 4 (+/- 0.156) = red) . Each dot is the mean over the participants. Deformation in X-plane is shown on the left, in the Y-plane in the middle and in the Z-plane on the right.
  • Imaging of calf muscle contraction in pediatric patients with cerebral palsy: comparison of voluntary motion and electrically evoked motion
    Claudia Weidensteiner1,2, Xeni Deligianni1,2, Tanja Haas1, Philipp Madoerin1, Oliver Bieri1,2, Meritxell Garcia3, Jacqueline Romkes4, Erich Rutz5, Francesco Santini1,2, and Reinald Brunner6
    1Department of Radiology, Division of Radiological Physics, University Hospital Basel, Basel, Switzerland, 2Department of Biomedical Engineering, University of Basel, Basel, Switzerland, 3Department of Radiology, Division of Neuroradiology, University Hospital Basel, Basel, Switzerland, 4Laboratory for Movement Analysis, University Children's Hospital Basel, Basel, Switzerland, 5Hugh Williamson Gait Laboratory, The Royal Children's Hospital Melbourne, Parkville, Australia, 6Department of Orthopedic Surgery, University Children's Hospital Basel, Basel, Switzerland
    Calf muscle contraction speed was measured with cine phase contrast MRI in children with cerebral palsy during (a) electrical muscle stimulation (b) voluntary motion. Higher force but lower periodicity and no distinct velocity peaks were achieved for voluntary vs. stimulated contraction.
    Figure 2: Cine phase contrast MRI experiment with voluntary motion in a 11 y girl with diparetic cerebral palsy. Top left: visual paradigm for instruction and feedback for the patient. Top right: time courses of the force on the pedal with the mean force curve (over the whole experiment) in black. Bottom left: velocity vectors in the ROI in the calf at release. Bottom right: Time course of the velocity magnitude (ROI median) showing several peaks.
    Figure 1: Cine phase contrast MRI experiment with synchronized electrical muscle stimulation (EMS) in a 11 y girl with diparetic cerebral palsy. Top left: current amplitude of the EMS cycle. Top right: time courses of the evoked force on the pedal with the mean force curve (over the whole experiment) in black. Bottom left: velocity vectors in the ROI in the calf at release. Bottom right: Time course of the velocity magnitude (ROI median) showing two peaks at contraction (left) and release (right).
  • IDEAL-CPMG muscle T2-water and Dixon Fat-Fraction Maps in People with Inclusion Body Myositis and Charcot-Marie-Tooth disease Type 1A
    Amy R. McDowell1, Stephen J. Wastling1,2, Lara Cristiano3, Jasper M. Morrow1, Matthew R.B. Evans4, Christopher D.J. Sinclair1, Pedro M. Machado1, Michael Hanna1, Mary M. Reilly1, Tarek Yousry1, and John S. Thornton1
    1MRC Centre for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London, United Kingdom, 2Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom, 3Department of Pediatric Neurology and Radiology, Fondazione Policlinico Universitario, Rome, Italy, 4St Thomas Hospital, London, United Kingdom
    The IDEAL-CPMG sequence was acquired in healthy volunteers and two different muscular dystrophy disease types to obtain quantitative T2-water maps uncontaminated by the T2-fat signal. It was found that elevated T2-water may be a predictor of later progression to fatty-atrophy in muscle
    Figure 1: Example Dixon and IDEAL-CPMG T2-water maps in a healthy volunteer (HV), a person with CMT (CMT1A) and a person with IBM (IBM). Segmentation ROIs are shown in the centre. Tibialis Anterior – red, Tibialis Posterior – dark pink, Medial Gastrocnemius – yellow, Peroneus Longus – green, Soleus – blue, Lateral Gastrocnemius – purple. Red arrows indicate areas of raised T2 corresponding to oedema. Areas of high fat such as the bone marrow yield noise in the T2-water maps as there is insufficient water in this area for accurate estimation.
    Figure 2: Box plots of T2-Water in individual muscle ROIs by disease type. The central mark indicates the median, and the bottom and top edges of the box indicate the 25th and 75th percentiles, respectively. Whiskers are min and max. T2-water values show a narrower range in comparison to Dixon-FF% in each disease, especially in the medial and lateral Gastrocnemius, Dixon-FF% has a wider spread of fat fractions for both diseases. T2-water gives a more definitive separation of disease type and may show a higher specificity in a larger cohort.
  • Denoising dynamic CrCEST in skeletal muscle following exercise using low rank tensor approximations
    Neil Wilson1, Mark A Elliott2, Dushyant Kumar2, and Ravinder Reddy2
    1Siemens Medical Solutions USA Inc, Malvern, PA, United States, 2CMROI, University of Pennsylvania, Philadelphia, PA, United States
    Dynamic CrCEST allows for high resolution mapping of the creatine kinase reaction recovery kinetics following exercise over large ROIs. Here, we show that improved denoising utilizing low rank tensor approximations allows for reliable fits over smaller volumes or single voxels.
    Recovery time course for a single voxel in the lateral gastrocnemius. Without denoising (left), denoising method 1 (center), denoising method 2 (right).
    MTRasym maps without denoising (top row), with denoising method 1 (middle), and with denoising method 2 (bottom)
  • Feasibility Study of 31P Multivoxel Spectroscopy for the detection of Alkaline Inorganic Phosphate in multiple compartments of the lower leg at 3T
    Rajakumar Nagarajan1 and Gwenael Layec2
    1Human Magnetic Resonance Center, Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, United States, 2Kinesiology, University of Massachusetts Amherst, Amherst, MA, United States
    This study provides the proof of concept for a non-invasive and localized method to determine the alkaline Pi, a potential index of mitochondrial density at rest.
    Figure 2. A 36 years old healthy volunteer 2D CSI voxel location and selected single voxel spectrum and zoomed Pi region from the tibialis anterior (red), soleus (yellow) and gastrocnemius (blue) muscles
    Figure 1. A 36 years old healthy volunteer 2D CSI voxel location and multivoxel spectra on top of T1W MRI
  • Measuring motor unit morphology in upper extremities using motor unit magnetic resonance imaging (MUMRI)
    Matthew Birkbeck1,2,3, Linda Heskamp1, Ian Schofield1, Roger Whittaker1, and Andrew Blamire1
    1Translational and Clinical Research Unit, Newcastle University, Newcastle upon Tyne, United Kingdom, 2Newcastle Biomedical Research Centre, Newcastle Biomedical Research Centre, Newcastle upon Tyne, United Kingdom, 3Northern Medical Physics and Clinical Engineering, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
    MUMRI has been applied for the first time to study in-vivo single human MUs in the forearm and hand muscles and to determine the size and shapes of these MUs. This increases the clinical translatability of the MUMRI technique. 
    Figure 4: A) MU difference maps overlaid onto the MUMRI images for each of the extracted MUs. Two from the forearm in the flexor carpi ulnaris muscle and one from the hand in the abductor pollicis muscle. B) Bar charts showing MU metrics: cross sectional area (CSA) shown in green, maximum Feret diameter shown in red and minimum Feret diameter shown in blue.
    Figure 2: Data processing steps to extract the single MUs. A) MUMRI image B) Images grouped into two data sets: where motor unit is inactive and active (indicated by red arrow). Graph shows single voxel time-series from the MU territory, example alternations where MU inactive (red circle), MU active (green circles). C) MU difference map with no threshold applied. D) MU difference map with 0.5 threshold, showing good agreement with initial size of MU territory in (B).
  • MR analysis of thigh muscle myopathy using texture features and supervised machine learning
    Hon J Yu1, Saya Horiuchi1,2, Toshimi Tando1, Vincent J Caiozzo3, Virginia E Kimonis4, and Hiroshi Yoshioka1
    1Radiological Sciences, University of California, Irvine, Orange, CA, United States, 2Radiology, St. Luke's International Hospital, Tokyo, Japan, 3Department of Orthopaedics, Physiology & Biophysics, University of California, Irvine, Irvine, CA, United States, 4Division of Genetic and Genomic Medicine, Department of Pediatrics, University of California, Irvine, Irvine, CA, United States
    Texture features can classify varying degrees of muscle myopathy when properly trained in supervised machine-learning framework.
    The overall workflow of fat-fraction calculation that utilizes manual muscle segmentation, shading/intensity-correction across FOV, and classification of different tissue types based on a 3-class fuzzy c-means (FCM) algorithm.
    Plots of group-averaged fat-fraction and texture parameter values with similar vertical scales in order to better visualize their trends as a function of muscle grades.
  • 1H MRS: a tool to study age-related changes in intracellular metabolites in the deep spinal muscles?
    Sarah Catherine Wayte1, Alexander Dallaway2, Andrew David Weedall1, John Hattersley3, and Adrian John Wilson3,4
    1Radiology Physics, Department of Clinical Physics and Bioengineering, University Hospital, Coventry, United Kingdom, 2Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom, 3Coventry NIHR CRF, Human Metabolic Research Unit, University Hospital, Coventry, United Kingdom, 4Department of Physics, University of Warwick, Coventry, United Kingdom
    No difference (p>0.05) in the concentration of intracellular lipids in the spinal muscles of older and younger participants; a much higher concentration of creatine in older participants (p=0.23); no correlation between metabolite concentrations. 
    Figure 2. Individual values for the normalized concentrations of IMCLCH2 (left) and Cr (right) for the two groups together with the lower, median and upper quartiles.

    Figure 1. An example of the raw spectrum together with the fitted IMCLCH2 and Cr components. The large peak at 1.5ppm is the methylene extracellular lipid (EMCLCH2)

  • SEMI-AUTOMATIC QUANTIFICATION OF ABDOMINAL WALL MUSCLES DEFORMATIONS BASED ON DYNAMIC MRI IMAGE REGISTRATION
    Arthur Jourdan1, Arnaud Le Troter2, Pierre Daude2, Stanislas Rapacchi2, Catherine Masson1, Thierry Bege1,3, and David Bendahan2
    1Aix-Marseille Univ, Univ Gustave Eiffel, IFSTTAR, LBA, Marseille, France, 2Aix Marseille Univ, CNRS, CRMBM, Marseille, France, 3Department of General Surgery, Aix Marseille Univ, North Hospital, APHM, Marseille, France

    A novel semi-automatic post-processing method dedicated to real-time dynamic MRI aiming at a fast and reliable quantification of abdominal wall muscles deformations based on a supervised 2D+t segmentation (mean Dice similarity coefficient of 0.95), masks registration and parcellation.

    Figure 2 : Quantification of muscles deformations pipeline; A : 2D+t volume of interest in sagittal view with an arbitrary selected axial slice.
    Figure 3 : Typical magnitude of displacement maps. These maps were obtained for the subject closest to the mean values of the cohort; A : 3d general view of displacement magnitude within the abdominal wall muscles from end-exhalation to end-inhalation with three anatomical MRI slices; B : 2D axial views of the magnitude of displacement computed on the three previous anatomical MRI slices; C : 3D visualization of the magnitudes within each individual muscle group.
  • Feasibility and Reproducibility Study of Diffusion-Tensor Imaging in Rotator Cuff Muscles of Asymptomatic Volunteers.
    Cyril Tous, PhD1, Alexandre Jodoin, MD2, Detlev Grabs, MD, PhD3, Elijah Van Houten, PhD4, and Nathalie J Bureau, MD MSc FRCP(C)1,2
    1Radiology, Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada, 2Radiology, Centre hospitalier de l’Université de Montréal, Montréal, QC, Canada, 3Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada, 4Mechanical Engineering, Université de Sherbrooke, Sherbrooke, QC, Canada
    Rotator cuff tears lead to fatty infiltration and fibrosis, causing stiffness and decreased elasticity. Diffusion Tensor Imaging stabilizes regularization in elastography. Good DTI repeatability is achieved in six asymptomatic volunteers and myocytes’ tracks are retrieved.
    Figure 4) The mask delineates the supraspinatus (A-white background on muscle) where tractography is performed (A-colors) overlaid by a T1 VIBE image. The line separation (A-blue line) corresponds to the separation between the posterior and anterior bundle (B-arrows) where myocytes insert posteriorly (red tracks) and anteriorly (green track).
    Figure 2) Bland-Altman plots of FA across three scans (pairwise comparison of scans 1-2, 1-3, 2-3) for each volunteer (1 to 6) in the supraspinatus (sup) or infraspinatus (inf). Limit of agreement (loa) is 0.071 with a bias at 0.0.
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Digital Poster Session - Spine
Musculoskeletal
Wednesday, 19 May 2021 17:00 - 18:00
  • Clinical feasibility of ultrafast lumbar spine magnetic resonance imaging: a preliminary report
    Nobuo Kashiwagi1, Yuichi Yamashita2, Hitoshi Watanabe3, Hisashi Tanaka1, Katsusuke Kyotani2, Hiroto Takahashi1, Chisato Matsuo1, Takehisa Sakisuka1, Azusa Miura1, Masahiro Fujiwara1, Atsuko Arisawa 1, and Noriyuki Tomiyama1
    1Osaka University Graduate School of Mediine, Suita, Japan, 2Canon Medical Systems Corporation, Otawara, Japan, 3Department of Radiology, Yukoukai General Hospital, Ibaraki, Japan

    The diagnostic performance of a proposed ultrafast lumbar MRI protocol with a total acquisition time of 1 minute 53 seconds was highly concordant with that of the standard protocol with that of 12 minutes 31 seconds.


    Figure 1. Scan protocol

    Figure 2. A 67-year-old woman with severe back pain.

    Standard sagittal STIR image (scan time, 3:30 minutes) shows diffuse hyperintensity and a low-intensity line in the 12th thoracic vertebra, suggesting an acute compression fracture. The ultrafast STIR image (0:32 seconds) shows the equivalent lesion almost as clearly.


  • High-resolution head and C-spine MRI using a Zero-TE (ZTE) sequence at 3T
    Aiming Lu1, Carrie M Carr1, Norbert G Campeau1, Steven A Messina1, and David F Kallmes1
    1Radiology, Mayo Clinic, Rochester, MN, United States
    With optimized acquisition protocol and advanced image processing,  this work demonstrated that high quality images of the human skull and cervical spine could be obtained on a clinical 3T scanner in about 6 minutes from a single ZTE MRI acquisition.
    Representative “bright-bone” ZTE MRI images of the skull and C-spine. Upper row: reformatted axial, sagittal and coronal images. Lower row: volume-rendered images.
  • A Novel Hybrid Score Integrating Clinical and MR Features to Predict Lumbar Vertebral Osteoporosis in  Female
    Shao-Chieh Lin1, Chun-Jung Juan2, Yi-Jui Liu3, Chun-Wen Chen4, Chien-Yuan Wang5, Wu-Chung Shen6, Der-Yang Cho7, and Kai-Yuan Cheng8
    1Ph.D. program in Electrical and Communication Engineering, Feng Chia University, Taichung, Taiwan, 2Department of Medical Imaging, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, 3Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, 4Department of Radiology, Taichung Armed Forces General Hospital, Taichung, Taiwan, 5Department of Orthopedics, China Medical University Hsinchu Hospital, Hsinchu, Taiwan, 6Department of Medical Imaging, China Medical University Hospital, Taichung, Taiwan, 7Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan, 8Department of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan

    A newly proposed hybrid scoring system LvOPOS in diagnosing the LvOPO specific to women with relevant to both clinical and MR features.

    ROC curves of the clinical and imaging predictors in diagnosing the LvOPI.
    The criteria and performance of all predictors.
  • A comparative study of R2*, UTE-T2* and T1rho mapping for evaluation of degenerative alterations in human intervertebral discs
    LiLan Wu1, JianJun Zhou2, and Pu-Yeh Wu3
    1Department of Radiology, Fudan University Affiliated Zhongshan Hospital Xiamen Branch, Xiamen, China, 2Department of Radiology, Fudan University Affiliated Zhongshan Hospital, Shanghai, China, 3GE Healthcare, Beijing, China
    The current study demonstrated the feasibility of quantitative evaluation of human IDD in vivo by R2*, UTE-T2* and T1rho mapping. We found that T1rho value is superior to UTE-T2* and R2* values for differential diagnosis of the early IVD, while UTE-T2* value is optimal for differential diagnosis of advanced IVD. T1rho mapping can be considered an effective tool for distinguishing IDD at the earlier stage of the degenerative process.  
    Fig.1MR images of the lumbar spine .Every IVD was cut into 5 uniform parts in each UTE,R2*and T1rho.
    Fig.2 Post hoc multiple comparisons among three Disc degeneration groups
  • Normal fetal development of the cervical, thoracic and lumbar spine: a post-mortem study based on magnetic resonance imaging
    Shuai Zhang1, Xiangtao Lin2, Ximing Wang2, Xiang Feng3, and Rui Diao2
    1School of Medicine, Shandong First Medical University, School of Medicine, Shandong First Medical University, Jinan, China, 2Department of Radiology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, China, 3MR Scientific Marketing, Diagnosis Imaging, Siemens Healthcare Ltd, Beijing, China
    The cervical, thoracic, lumbar, and L1–L5 centrum ossification centers show good correlation with gestational age in the second and third trimesters. The L1 centrum ossification center is best suited as a marker for fetal cervical, thoracic, and lumbar development.
    Fig 1. Sample segmentations of cervical (A), thoracic (B), and lumbar (C) centrum ossification center volumes.
    Fig 2. Regression lines for the volumes of the cervical (A), thoracic (B), and lumbar (C) centrum ossification centers.
  • Spinal Giant Cell Tumor of Bone: Immunohistochemistry and Preoperative Magnetic Resonance Imaging Features for Prognostic Prediction
    Qizheng Wang1, Siyuan Qin1, Yang Zhang2, Enlong Zhang3, Xiaoying Xing1, Min-Ying Su2, and Ning Lang1
    1Radiology, Peking University Third Hospital, Beijing, China, 2Center for Functional Onco-Imaging, Irvine, CA, United States, 3Radiology, Peking University International Hospital, Beijing, China

    For patients with spinal GCTB, preoperative MRI observed multiple cystic changes and vertebral compression≥ 50%, suggesting a poor prognosis. The expression of vascular endothelial growth factor and p53 tumor suppressor gene may not be associated with postoperative recurrence.

    Fig. 1. Flowchart of the enrolled patients. GCTB, giant cell tumor of bone; MRI, magnetic resonance imaging; TES, total en bloc spondylectomy.

    Fig.2. Top panel: A 35-year-old man,(A) and (B): MR images showed a mass on the T12 vertebra, bilateral pedicle and lamina with extension into the spinal canal, managed with en bloc resection (C), at a 36-month follow-up review, there was no evidence of recurrence (D), and now the patient is still on visit.

    Bottom panel: A 35-year-old woman, maximum diameter of lesion is 55mm (E),with pathologic fracture of the T12 vertebra (F) , managed with en bloc resection (G). The sagittal T2-WI MR image at 12-month follow-up, recurrence was detected (H), and confirmed by pathology with puncture.

  • Effects of different acceleration factors on lumbar body fat quantification using 3D mDixon Quant technique
    Yu Song1, Qingwei qing Song2, Yingkun Guo1, Gang Ning1, and Xuesheng Li1
    1Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China, 2Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian, China
    The 3D mDixon Quant sequence combined with SENSE and CS technology is reliable for assessing the lumbar vertebral body fat content. When the AF of CS was selected to 6, the image quality and the measurement accuracy were maintained while the imaging time dramatically reduced.
    Figure.1 Male, 24 years old, BMI= 21.47kg /m2, Fig. 4A and Fig. 4B are 3D mDixon Quant water image and FF image, respectively
    Table 2 The difference of lumbar vertebrae fat fraction(FF) and image quality in different AF
  • Quantitative T2 parametric value in assessment of abnormal lumbar paraspinal muscle in patients with low back pain
    Yinqi Liu1, Huiting Deng1, Weiyin Liu2, and Kun Zhang1,3
    1Department of Radiology, First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China, 2MR Research, GE Healthcare, Beijing, China, 3College of Integrated Traditional Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, China
    This study aims to evaluate the abnormality and deterioration of paraspinal muscles with T2 mapping and to quantitatively compare T2 value differences of lumbar paraspinal muscle between patients with low back pain and healthy participants .
    Figure 1 ROIs of the bilateral multifidus (MF) and erector spinae(ES) respectively were drawn on T2mapping imaging
  • Evaluation of Lumbar Disc Degeneration Using Ultrashort Echo Time Magnetization Transfer (UTE-MT) Imaging in Cartilaginous Endplate
    Jin Liu1, Yajun Ma2, Jianwei Liao1, Xiaojun Chen1, Wei Li1, Lin Yao1, Zhihai Su3, Long Qian4, Jiang Du2, and Shaolin Li1
    1Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China, 2Department of Radiology, University of California, San Diego, CA, United States, 3Department of Orthopedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China, 4MR Research, GE Healthcare, Guangzhou, China
    Our findings suggest that deficits in CEP composition, as indicated by high UTE-MTR, associate with more severe disc degeneration in patients. It is supposed that UTE-MTR of cartilaginous endplate may be a useful biomarker to predict early disc degeneration.
    Figure 1: UTE-MT imaging in lumbar of a 67‐year‐old male volunteer. Figure A: UTE-MT-ON; Figure B: UTE-MT-OFF; Figure C: UTE-MTR map
    Figure 2: Correlation between cartilaginous endplate UTE-MTR and Pfirrmann grade of disc in 62 subjects. Cartilaginous endplate UTE-MTR showed a positive correlation with Pfirrmann grade of disc.
  • BOLD and IDEAL-IQ evaluation for lumbarparaspinal muscle changes in patients with chronic low back pain
    Zeng Xiao min1, Huang Yi long2, Nie Li sha3, and He Bo1
    1The First Affiliated Hospital of Kunming Medical University, Kunming, China, 2The First Affiliated Hospital of Kunming Medical University, kunming, China, 3GE healthcare, China, Beijing, China
    The change of lumbar paraspinal muscle function may be earlier than morphology.
    Figure.1 Two figures show BOLD pseudo-color images of CLBP group(A) and control group(B).Corresponding R2*values in CLBP group are higher than that in control group.
    Figure.5 Mean Differences Between the Control and the CLBP Groups for FF value (%)
  • High-Contrast Lumbar Spinal Bone Imaging Using a 3D Slab-Selective UTE Sequence
    Amir Masoud Afsahi1, Zhao Wei1, Michael Carl2, Saeed Jerban1, Hyungseok Jang1, Nicole Le1, Jiang Du1, Eric Y. Chang1,3, and Ya-Jun Ma1
    1Department of Radiology, University of California, San Diego, San Diego, CA, United States, 2GE HealthCare, San Diego, CA, United States, 3Radiology Service, Veterans Affairs, San Diego Healthcare System, San Diego, CA, United States
    By 3D slab-selective UTE MRI, we are able to have a high resolution in lumbar spinal bone comparable to CT as gold standard. This is specially important when we need images in patients more sensitive to X-Ray exposure like children, pregnant women or anybody who needs periodic imaging.
    Figure 4. CT (A) and UTE (B) lumbar spinal bone images from 72-year-old male patient with spinal fractures. Bone fractures can be seen clearly in both CT and UTE images.

    Figure 1. 3D ZTE (A) and UTE (B) sequences. The ZTE sequence utilizes a non-selective rectangular RF pulse with short duration for excitation, followed by 3D center-out radial sampling. To minimize echo time, readout gradients are turned on prior to signal excitation so that the gradient encoding can begin simultaneously with signal excitation. The 3D UTE sequence enables slab selection by using a soft-half pulse for excitation together with a slice-selective gradient. After excitation, the spatial encoding gradient is turned on and simultaneous data acquisition begins.

  • Multimodal MRI evaluation of paraspinal muscles and TNF- α in rats with discogenic low back pain after rehabilitation training
    Kaiwen Yang1, Baofa Luo1, Yilong Huang1, Lisha Nie2, and Bo He1
    1Medical imaging department, The First Affiliated Hospital of Kunming Medical University, Kunming, China, 2GE Healthcare,MR Research China, Beijing, China
    Based on functional MRI, this study explored the influence mechanism of rehabilitation exercise on rat paraspinal muscles and intervertebral discs. It is found that rehabilitation exercise can reduce TNF-α content and improve paravertebral muscular atrophy.
    Figure.3 Color-coded T2-calculated, R2* and fat fraction maps. In T2-calculated maps, blue represents areas of short T2 values. T2 maps of normal (A), DLBP(B) and swimming group (C). In R2* maps, blue represents areas of lower R2* value. R2* maps of normal (D), DLBP group(E) and swimming group (F). In fat fraction maps, white represents areas of higher fat fraction. Fat fraction maps of normal (G), DLBP(H) and swimming group(I).
    Figure.1 Behavioral test results of three groups within one month after operation. (A)Gait test; (B) hot-plate test; (C)acetone test; (D)tail suspension test; (E)grip strength test. Data are reported as mean ± standard deviation of mean; *p<0.05, **P<0.01(Kruskal-Wallis test).
  • DCE-MRI for the Assessment of Outcome of CyberKnife Stereotactic Radiosurgery for Patients with Spinal Metastases
    Yongye Chen1, Enlong Zhang 2, Qizheng Wang 1, Huishu Yuan1, Huishu Yuan1, Hongqing Zhuang1, and Ning Lang1
    1Peking University Third Hospital, Beijing, China, 2Peking University International Hospital, Beijing, China
    DCE-MRI can be used to evaluate local tumor response. In our study, Ktrans, Kep and Ve were found to be of great value in evaluating the efficacy of CyberKnife radiosurgery in spinal metastases. ΔKtrans had the highest diagnostic efficiency, with an AUC of 0.821.
    One case in the non-PD group. (A): Axial T1WI-enhanced MRI showed a huge soft tissue mass around the vertebra before treatment; (B): Three months after treatment, axial T1WI enhanced MRI showed the lesion soft tissue mass was significantly reduced; (C): Pretreatment Ktrans was 0.342 min-1; (D): Post-treatment Ktrans was 0.121 min-1, decreased by 64.6%; (E): Pretreatment Kep was 2.445 min-1; (F): Post-treatment Kep was 0.959 min-1, decreased by 60.8%.
    One case in PD group. (A): Enhanced T1WI scan axial view showed a soft tissue mass invading the spinal canal on the left side of the vertebra, and the spinal cord was compressed; (B): Axial T1WI enhanced image showed that the soft tissue mass of the lesion was slightly larger than before, and the low signal cystic area is seen behind the spinal canal; (C): Pretreatment Ktrans was 0.503 min-1; (D): Post-treatment Ktrans was 0.750 min-1, increased by 49.1%; (E): Pretreatment Kep was 2.487 min-1; (F): Post-treatment Kep was 4.187 min-1, increased by 68.4%.
  • Comparison of T2 relaxation time from synthetic MRI and conventional T2 mapping in the diagnosis of intervertebral disc degeneration
    Xiaoqing Liang1, Weiyin Vivian Liu2, Yitong Li1, and Xiaoming Li3
    1Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, 2MR Research, GE Healthcare, Beijing, China, 31Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
    The utility of synthetic MRI is slightly better than conventional T2 mapping in diagnosing intervertebral disc degeneration. Moreover, one-time MAGiC scan on lumbar vertebrae should be concerned for clinical diagnosis.
    Figure 1. T2 histogram-derived parameters obtained from MAGiC and conventional T2 mapping have moderate to high correlations.
    Figure 2. Receiver operating characteristic curves analysis.
  • Histogram analysis of IDEAL-IQ and UTE images better assists to detect abnormalities of the lumbar vertebral bone marrow in patients with different stages of chronic kidney disease
    Yan Xiong1, Weiyin Vivian Liu 2, Fan He1, Yanan Wang1, Yao Zhang1, Shuang Hu1, and Xiaoming Li1
    1Wuhan Tongji Hospital, Wuhan, China, 2MR Research, GE Healthcare, Beijing, China
     Using histogram analysis of IDEAL-IQ and bi-component analysis of UTE sequence to study chronic kidney disease-Mineral bone disease
    Figure 2. Representative bi-component analysis of UTE on L4 with four echoes.
    Figure 3 ROC curve of lumbar bone marrow IDEAL-IQ for differentiating patients with 30 < eGFR < 90 from patients with eGFR < 15. The area under the curve [AUC] of L4-water-kurt and L3-R2*-max were 0.856 (p= 0.009) and 0.822 (p= 0.018), respectively. Abbreviations: L4-water-kurt, kurtosis of water image in L4; L3-R2*-max, maximum R2* value in L3
  • Automated differentiation between benign and malignant vertebral compression fracture using a deep convolutional neural network on MRI
    Takafumi Yoda1, Satoshi Maki2, Koji Matsumoto1, Hajime Yokota3, Yoshitada Masuda1, and Takashi Uno3
    1Department of Radiology, Chiba University Hospital, Chiba, Japan, 2Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan, 3Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
    The ability of CNNs to distinguish osteoporotic vertebral fractures and malignant vertebral compression fractures using MRI was comparable or superior to that of the spine surgeons. Our models could be a useful tool for the differential diagnosis of OVF and MVF.
    Figure 1. The deep learning framework Tensorflow was used to construct the CNN architecture. In the present work, we used the Xception architectural model, which had been already trained using images with ImageNet.
  • The assessment of cartilage endplate and its relationship with the corresponding disc degeneration using UTE imaging
    Zhilin Ji1, Weiqiang Dou2, Yuefen Zou1, Yin Shi1, Yu Zheng1, and Hongyuan Ding1
    1The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, 2GE Healthcare, MR Research China, Beijing, P.R. China, Beijing, China
    we aimed to investigate UTE's feasibility for assessing the CEP damage and evaluate the relationship between the CEPs’ grading and intervertebral disc degeneration. Strong correlation was observed between CEP and intervertebral disc degeneration. So, UTE can assist to assess the CEP damage.
    Fig2. Subtracting a 3D ultrashort Echo Time (UTE) image acquired at short TE of 0.03 ms (a) by the one acquired at long TE of 6 ms (b), a resultant subtracted 3D UTE image (c) of a lumbar spine with relatively normal cartilage endplate (CEP) is presented at sagittal view. Well structural CEP (denoted by white arrow) is hyperintense as well as adjacent hypointense vertebral endplate. The effect of nucleus pulposus, annulus fibrosus was removed after image subtraction.
    Fig3. On the subtracted 3D UTE images between short and long TEs, cartilage endplates (CEPs) were classified into six grades. Representative CEP images at each grade are shown (a: type I, b: type II, c: type III, d: type IV, e: type V, f: type VI ).
  • Evaluation of lumbar facet joint and intervertebral disc degeneration using histogram analysis of T2 and T2*values
    Xiaoqing Liang1, Weiyin Vivian Liu2, and Xiaoming Li1
    1Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, 2MR Research,GE Healthcare, Beijing, China
    LFJ degeneration occurs earlier and progresses more slowly than IVD degeneration. Histogram analysis of T2 and T2* values is feasible for detecting IVD but not LFJ degeneration. 
    Figure 2. ROC analysis of T2 and T2* histogram parameters for identifying normal (Pfirrmann grades Ⅰ and Ⅱ) and abnormal (grades Ⅲ to Ⅴ) discs.
    Figure 1. Degeneration incidence of lumbar facet joint (LFJ) and intervertebral disc (IVD) in different age groups. * P < 0.05, **P < 0.01, ***P < 0.001.
  • Fetal magnetic resonance imaging of normal lumbar spine development in vivo
    Xing Yin1, Xin Zhao1, Liying Zhang1, Qingna Xing1, Rui Yuan2, and Zhijun Niu3
    1Radiology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, 2Ultrasound, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China, 3Obstetrics and Gynecology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
    There are good linear correlations between the heights of LVBOC and GA, lengths of LVBOC and GA, heights of intervertebral gap and GA.The LVBOCs may show linear T2 hyperintensity in the mid-sagittal plane (14/465 vertebra). The positions of conus level lies from L1 to L3. 
    Figure 1 24 gestational weeks. Figure 1A, measuring of height and length of L5 vertebral ossification body center, and height of L3-4 IVP. Figure 1B, the location of conus medullaris.
    Figure 2 24 gestational weeks, the mid-sagittal plane of lumbar spine showed linear T2 hyperintensity in L2 and L4 vertebral ossification body center.
  • Diffusion Kurtosis Imaging and Intravoxel Incoherent Motion in diagnosis of active sacroiliitis with ankylosing spondylitis
    Xiaolin Guo1,2, lixia Qian2, Yueluan Jiang3, and Zhongshuai Zhang4
    1Medical Imaging, Shanxi Medical University, Taiyuan, China, 2Department of Radiology, Shanxi Bethune Hospital, Taiyuan, China, 3MR Scientific Marketing, Diagnosis Imaging, Siemens Healthineers China, Beijing, China, 4MR Scientific Marketing, Diagnosis Imaging, Siemens Healthineers China, Shanghai, China
    This study applied IVIM and DKI advanced diffusion imaging techniques to quantitively diagnosis the active sacroiliitis with AS. The results show IVIM-DWI and DKI are feasible for diagnosis of SIJ activity of AS.
    Table 1:Diffusion parameters in active group and chronic group
    Table 2. AUCs for IVIM-D,IVIM-f, DKI-MD, DKI-MK and ADC