The clinical utility of QSM: disease diagnosis, medical management, and surgical planning

Eskreis‐Winkler, Sarah; Zhang, Yan; Zhang, Jingwei; Liu, Zhe; Dimov, Alexey; Gupta, Ajay; Wang, Yi

doi:10.1002/nbm.3668

Cited by 93 publications

(94 citation statements)

References 138 publications

(186 reference statements)

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“…Quantitative susceptibility mapping (QSM) is an emerging MRI technique that can reveal disease‐related changes in tissue iron, myelin and calcium content, and venous oxygenation. Therefore, QSM shows potential for an increasing range of clinical applications . Magnetic susceptibility (

χ

) is an intrinsic tissue property relating the magnetic field induced within the tissue to the applied magnetic field.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, QSM shows potential for an increasing range of clinical applications. 1 Magnetic susceptibility (χ) is an intrinsic tissue property relating the magnetic field induced within the tissue to the applied magnetic field. The relationship of χ (r), the tissue susceptibility distribution over space (r), to the resulting phase variations (φ (r)) can be expressed by the following convolution with the dipole field distribution (d (r)) where B 0 denotes the main magnetic field 2,3 :…”

Section: Introductionmentioning

confidence: 99%

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The effect of low resolution and coverage on the accuracy of susceptibility mapping

Karsa

Punwani

Shmueli

2018

Magnetic Resonance in Med

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Purpose Quantitative susceptibility mapping (QSM) has found increasing clinical applications. However, to reduce scan time, clinical acquisitions often use reduced resolution and coverage, particularly in the through‐slice dimension. The effect of these factors on QSM has begun to be assessed using only balloon phantoms and downsampled brain images. Here, we investigate the effects (and their sources) of low resolution or coverage on QSM using both simulated and acquired images. Methods Brain images were acquired at 1 mm isotropic resolution and full brain coverage, and low resolution (up to 6 mm slice thickness) or coverage (down to 20 mm) in 5 healthy volunteers. Images at reduced resolution or coverage were also simulated in these volunteers and in a new, anthropomorphic, numerical phantom. Mean susceptibilities in 5 brain regions, including white matter, were investigated over varying resolution and coverage. Results The susceptibility map contrast decreased with increasing slice thickness and spacing, and with decreasing coverage below ~40 mm for 2 different QSM pipelines. Our simulations showed that calculated susceptibility values were erroneous at low resolution or very low coverage, because of insufficient sampling and overattenuation of the susceptibility‐induced field perturbations. Susceptibility maps calculated from simulated and acquired images showed similar behavior. Conclusions Both low resolution and low coverage lead to loss of contrast and errors in susceptibility maps. The widespread clinical practice of using low resolution and coverage does not provide accurate susceptibility maps. Simulations in images of healthy volunteers and in a new, anthropomorphic numerical phantom were able to accurately model low‐resolution and low‐coverage acquisitions.

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χ

) is an intrinsic tissue property relating the magnetic field induced within the tissue to the applied magnetic field.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of low resolution and coverage on the accuracy of susceptibility mapping

Karsa

Punwani

Shmueli

2018

Magnetic Resonance in Med

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“…Therefore, our data demonstrated that the increased copper levels in the cortex and cerebellum may contribute to impairments in movement behavior and locomotor activity. QSM is a post-processing technology that uses a high pass filter phase image to distinguish between the influences of paramagnetism and diamagnetism on susceptibility-weighted imaging signals (Eskreis-Winkler et al, 2017). QSM has been used in several studies to quantify iron or copper levels in patients with WD (Fritzsch et al, 2014;Dusek et al, 2017Dusek et al, , 2018Saracoglu et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Application of 9.4T MRI in Wilson Disease Model TX Mice With Quantitative Susceptibility Mapping to Assess Copper Distribution

Han

Dong

et al. 2020

Front. Behav. Neurosci.

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In the current study, we used 9.4-tesla magnetic resonance imaging (9.4T MRI) and inductively coupled plasma mass spectrometry (ICP-MS) to investigate the distribution of copper in the brain samples of a murine model of Wilson's disease (WD) following penicillamine (PCA) treatment. We also evaluated if the distribution of copper in the brain samples of mice was correlated with behavioral symptoms. Results from the behavioral experiments showed that 7 days of PCA treatment decreased the total distance traveled in the open field and the number of rearing and climbing instances among the toxic milk (TX) mice as compared with model group. We also observed that the open arm ratio in the elevated plus-maze (EPM) was reduced, escape latency in the Barnes maze test was increased, and avoidance in the open field was enhanced in TX mice following 14 days of PCA treatment as compared with those in untreated TX mice. We found that PCA treatment for 21-28 days improved the cognitive abilities, exploratory behavior, and movement behavior of TX mice. The PCA-treated mice also exhibited varying degrees of magnetic susceptibilities in the cortex, corpus striatum, hippocampus, and amygdaloid nucleus across the treatment period. Low copper concentrations were found in all of the analyzed brain regions of PCA-treated mice after 21-28 days as compared with the model group (P < 0.05). However, copper concentrations were increased in the primary motor cortex and cerebellum at 7 days post-PCA treatment as compared with those in the model group (P < 0.05). After 14 days of PCA treatment, the copper concentrations in the sensorimotor cortex, corpus striatum, hippocampus, and amygdaloid nucleus were higher than those detected without treatment. The results from a Pearson's correlation analysis revealed that there was a significant (P < 0.05) correlation between copper concentrations and magnetic susceptibility in all of the brain regions that were analyzed. Therefore, our results indicate that copper concentration and magnetic susceptibility are associated with alterations in mood-related behavior, recognition memory, and movement behaviors in TX mice that are treated with PCA. The redistribution of copper in the TX mouse brain during PCA treatment may aggravate changes in behavioral performance.

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“…[12][13][14] Furthermore, R 2 * measurements cannot differentiate between para-and diamagnetic structures. 15 Recently, QSM [15][16][17] has been investigated as an alternative method for quantifying BMD, with promising initial results. 18,19 Dimov et al showed that susceptibility values were closely correlated with CT measurements of BMD in a porcine hoof, and were able to generate susceptibility maps in which cortical bone was homogenous and diamagnetic, as expected from theory.…”

Section: Introductionmentioning

confidence: 99%

Association of bone mineral density and fat fraction with magnetic susceptibility in inflamed trabecular bone

Bray

Karsa

Bainbridge

et al. 2019

Magnetic Resonance in Med

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Purpose To evaluate the relationship between bone mineral density (BMD) and magnetic susceptibility, and between proton density fat fraction and susceptibility, in inflamed trabecular bone. Methods Two different phantoms modeling the fat fraction (FF) and BMD values of healthy bone marrow and disease states were scanned using a multiecho gradient echo acquisition at 3T. After correction for fat‐water chemical shift, susceptibility mapping was performed, and susceptibility measurements were compared with BMD and FF values using linear regression. Patients with spondyloarthritis were scanned using the same protocol, and susceptibility values were calculated in areas of inflamed bone (edema) and fat metaplasia, both before and after accounting for the contribution of fat to the total susceptibility. Results Susceptibility values in the phantoms were accurately described by a 2D linear function, with a negative correlation between BMD and susceptibility and a positive correlation between FF and susceptibility (adjusted R 2 = 0.77; P = 3·10 −5 ). In patients, significant differences in susceptibility were observed between fat metaplasia and normal marrow, but these differences were eliminated by removing the fat contribution to the total susceptibility. Conclusions BMD and proton density fat fraction both influence the total susceptibility of bone marrow and failure to account for the fat contribution could lead to errors in BMD quantification. We propose a method for removing the fat contribution from the total susceptibility, based on the observed linear relationship between susceptibility and FF. In inflamed bone, the overall increase in susceptibility in areas of fat metaplasia is at least partly due to increased fat content.

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The clinical utility of QSM: disease diagnosis, medical management, and surgical planning

Cited by 93 publications

References 138 publications

The effect of low resolution and coverage on the accuracy of susceptibility mapping

The effect of low resolution and coverage on the accuracy of susceptibility mapping

Application of 9.4T MRI in Wilson Disease Model TX Mice With Quantitative Susceptibility Mapping to Assess Copper Distribution

Association of bone mineral density and fat fraction with magnetic susceptibility in inflamed trabecular bone

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