† People involved in the organization of the challenge. ‡ People contributing data from their institutions.§ Equal senior authors.

A new system for catheter steering is presented that allows large deflections through the use of an integrated array of steering coils. Additionally, two imaging techniques for tracking the catheter tip and visualization of surrounding areas, without interference from the active catheter, were shown. Together the demonstrated steerable catheter, control system and the imaging techniques will ultimately contribute to the development of a steerable system for interventional MRI procedures.

Quantifying the extent and evolution of cerebral edema developing after stroke is an important but challenging goal. Lesional net water uptake (NWU) is a promising CT-based biomarker of edema, but its measurement requires manually delineating infarcted tissue and mirrored regions in the contralateral hemisphere. We implement an imaging pipeline capable of automatically segmenting the infarct region and calculating NWU from both baseline and follow-up CTs of large-vessel occlusion (LVO) patients. Infarct core is extracted from CT perfusion images using a deconvolution algorithm while infarcts on follow-up CTs were segmented from non-contrast CT (NCCT) using a deep-learning algorithm. These infarct masks were flipped along the brain midline to generate mirrored regions in the contralateral hemisphere of NCCT; NWU was calculated as one minus the ratio of densities between regions, removing voxels segmented as CSF and with HU outside thresholds of 20–80 (normal hemisphere and baseline CT) and 0–40 (infarct region on follow-up). Automated results were compared with those obtained using manually-drawn infarcts and an ASPECTS region-of-interest based method that samples densities within the infarct and normal hemisphere, using intraclass correlation coefficient (ρ). This was tested on serial CTs from 55 patients with anterior circulation LVO (including 66 follow-up CTs). Baseline NWU using automated core was 4.3% (IQR 2.6–7.3) and correlated with manual measurement (ρ = 0.80, p < 0.0001) and ASPECTS (r = −0.60, p = 0.0001). Automatically segmented infarct volumes (median 110-ml) correlated to manually-drawn volumes (ρ = 0.96, p < 0.0001) with median Dice similarity coefficient of 0.83 (IQR 0.72–0.90). Automated NWU was 24.6% (IQR 20–27) and highly correlated to NWU from manually-drawn infarcts (ρ = 0.98) and the sampling-based method (ρ = 0.68, both p < 0.0001). We conclude that this automated imaging pipeline is able to accurately quantify region of infarction and NWU from serial CTs and could be leveraged to study the evolution and impact of edema in large cohorts of stroke patients.

Resolution Enhanced TOSSI is a new MRI pulse sequence for the generation of rapid T2 contrast with high spatial resolution. TOSSI provides T2 contrast by using non-equally spaced inversion pulses throughout a bSSFP acquisition. In RE-TOSSI, these energy and time intensive adiabatic inversion pulses and associated magnetization preparation are removed from TOSSI after acquisition of the data around the center of k-space. Magnetization evolution simulations demonstrate T2 contrast in TOSSI as well as reduction in the widening of the point spread function width (by up to a factor of 4) to a near ideal case for RE-TOSSI. Phantom experimentation is used to characterize and compare the contrast and spatial resolution properties of TOSSI, RE-TOSSI, bSSFP, HASTE and TSE and to optimize the fraction of k-space acquired using TOSSI. Comparison images in the abdomen and brain demonstrate similar contrast and improved spatial resolution in RE-TOSSI compared to TOSSI. Comparison bSSFP, HASTE and TSE images are provided. RE-TOSSI is capable of providing high spatial resolution T2-weighted images in 1 second or less per image.

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