Although both relaxation and diffusion imaging are sensitive to tissue microstructure, studies have reported limited sensitivity and robustness of using relaxation or conventional diffusion alone to characterize tissue microstructure. Recently, it has been shown that tensor-valued diffusion encoding and joint relaxation-diffusion quantification enable more reliable quantification of compartment-specific microstructural properties. However, scan times to acquire such data can be prohibitive. Here, we aim to simultaneously quantify relaxation and diffusion using MR fingerprinting (MRF) and b-tensor encoding in a clinically feasible time.
Methods:We developed multidimensional MRF scans (mdMRF) with linear and spherical b-tensor encoding (LTE and STE) to simultaneously quantify T1, T2, and ADC maps from a single scan. The image quality, accuracy, and scan efficiency were compared between the mdMRF using LTE and STE. Moreover, we investigated the robustness of different sequence designs to signal errors and their impact on the maps.Results: T1 and T2 maps derived from the mdMRF scans have consistently high image quality, while ADC maps are sensitive to different sequence designs. Notably, the fast imaging steady state precession (FISP)-based mdMRF scan with peripheral pulse gating provides the best ADC maps that are free of image distortion and shading artifacts.
Conclusion:We demonstrated the feasibility of quantifying T1, T2, and ADC maps simultaneously from a single mdMRF scan in around 24 s/slice.The map quality and quantitative values are consistent with the reference scans.
Diffusion-weighted magnetic resonance imaging (DW-MRI) is a non-invasive technique to probe tissue microstructure. Conventional Stejskal–Tanner diffusion encoding (i.e., encoding along a single axis), is unable to disentangle different microstructural features within a voxel; If a voxel contains microcompartments that vary in more than one attribute (e.g., size, shape, orientation), it can be difficult to quantify one of those attributes in isolation using Stejskal–Tanner diffusion encoding. Multidimensional diffusion encoding, in which the water diffusion is encoded along multiple directions in q-space (characterized by the so-called “b-tensor”) has been proposed previously to solve this problem. The shape of the b-tensor can be used as an additional encoding dimension and provides sensitivity to microscopic anisotropy. This has been applied in multiple organs, including brain, heart, breast, kidney and prostate. In this work, we discuss the advantages of using b-tensor encoding in different organs.
Objective: To optimize anastomotic technique and gastric conduit perfusion with hyperspectral imaging (HSI) for total minimally invasive esophagectomy (MIE) with linear stapled anastomosis. Summary Background Data: Esophagectomy is the mainstay of esophageal cancer treatment but anastomotic insufficiency related morbidity and mortality remain challenging for patient outcome. Methods: A live porcine model (n=50) for MIE was used with gastric conduit formation and linear stapled side-to-side esophagogastrostomy. Four main experimental groups differed in stapling length (3 vs. 6 cm) and anastomotic position on the conduit (cranial vs. caudal). Tissue oxygenation around the anastomotic site was evaluated using HSI and was validated with histopathology. Results: The tissue oxygenation (ΔStO2) after the anastomosis remained constant only for the short stapler in caudal position (-0.4±4.4%, n.s.) while it dropped markedly in the other groups (short-cranial: -15.6±11.5%, p=0.0002; long-cranial: -20.4±7.6%, p=0.0126; long-caudal: -16.1±9.4%, p<0.0001) Tissue samples from deoxygenated stomach as measured by HSI showed correspondent eosinophilic pre-necrotic changes in 35.7±9.7% of the surface area. Conclusions: Tissue oxygenation at the anastomotic site of the gastric conduit during MIE is influenced by stapling technique. Optimal oxygenation was achieved with a short stapler (3 cm) and sufficient distance of the anastomosis to the cranial end of the gastric conduit. HSI tissue deoxygenation corresponded to histopathologic necrotic tissue changes. These findings allow for optimization of gastric conduit perfusion and anastomotic technique in MIE.
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