The non-invasively measured initial systolic time interval (ISTI) reflects a time difference between the electrical and pumping activity of the heart and depends on cardiac preload, afterload, autonomic nervous control and training level. However, the duration of the ISTI has not yet been compared to other time markers of the heart cycle. The present study gauges the duration of the ISTI by comparing the end point of this interval, the C-point, with heart cycle markers obtained by echocardiography. The heart rate of 16 healthy subjects was varied by means of an exercise stimulus. It was found that the C-point, and therefore the end point of ISTI, occurred around the moment of the maximum diameter of the aortic arch in all subjects and at all heart rates. However, while the time difference between the opening of the aortic valves and the maximum diameter of the aortic arch decreased significantly with decreasing RR-interval, the time difference with respect to the moment of the C-point remained constant within the subjects. This means that the shortening of the ISTI with increasing heart rate in response to an exercise stimulus was caused by a shortening of the pre-ejection period (PEP). It is concluded that the ISTI can be used as a non-invasive parameter indicating the time difference between the electrical and mechanical pumping activity of the heart, both inside and outside the clinic.

Purpose DWI is a promising modality in breast MRI, but its clinical acceptance is slow. Analysis of DWI is hampered by geometric distortion artifacts, which are caused by off‐resonant spins in combination with the low phase‐encoding bandwidth of the EPI sequence used. Existing correction methods assume smooth off‐resonance fields, which we show to be invalid in the human breast, where high discontinuities arise at tissue interfaces. Methods We developed a distortion correction method that incorporates high‐resolution off‐resonance maps to better solve for severe distortions at tissue interfaces. The method was evaluated quantitatively both ex vivo in a porcine tissue phantom and in vivo in 5 healthy volunteers. The added value of high‐resolution off‐resonance maps was tested using a Wilcoxon signed rank test comparing the quantitative results obtained with a low‐resolution off‐resonance map with those obtained with a high‐resolution map. Results Distortion correction using low‐resolution off‐resonance maps corrected most of the distortions, as expected. Still, all quantitative comparison metrics showed increased conformity between the corrected EPI images and a high‐bandwidth reference scan for both the ex vivo and in vivo experiments. All metrics showed a significant improvement when a high‐resolution off‐resonance map was used ( P < 0.05), in particular at tissue boundaries. Conclusion The use of off‐resonance maps of a resolution higher than EPI scans significantly improves upon existing distortion correction techniques, specifically by superior correction at glandular tissue boundaries.

Separating the decay signal from diffusion-weighted scans into two or more components can be challenging. The phasor technique is well established in the field of optical microscopy for visualization and separation of fluorescent dyes with different lifetimes. The use of the phasor technique for separation of diffusion-weighted decay signals was recently proposed. In this study, we investigate the added value of this technique for fitting decay models and visualization of decay rates. Phasor visualization was performed in five glioblastoma patients. Using simulations, the influence of incorrect diffusivity values and of the number of b-values on fitting a threecomponent model with fixed diffusivities (dubbed "unmixing") was investigated for both a phasor-based fit and a linear least squares (LLS) fit. Phasor-based intravoxel incoherent motion (IVIM) fitting was compared with nonlinear least squares (NLLS) and segmented fitting (SF) methods in terms of accuracy and precision. The distributions of the parameter estimates of simulated data were compared with those obtained in a healthy volunteer. In the phasor visualizations of two glioblastoma patients, a cluster of points was observed that was not seen in healthy volunteers. The identified cluster roughly corresponded to the enhanced edge region of the tumor of two glioblastoma patients visible on fluid-attenuated inversion recovery (FLAIR) images. For fitting decay models the usefulness of the phasor transform is less pronounced, but the additional knowledge gained from the geometrical configuration of phasor space can aid fitting routines. This has led to slightly improved fitting results for the IVIM model: phasor-based fitting yielded parameter maps with higher precision than the NLLS and SF methods for parameters f and D (interquartile range