Ultrashort echo time quantitative susceptibility mapping (UTE‐QSM) for detection of hemosiderin deposition in hemophilic arthropathy: A feasibility study

Abstract

Purpose The purpose of this study was to investigate the feasibility of ultrashort echo time quantitative susceptibility mapping (UTE‐QSM) for assessment of hemosiderin deposition in the joints of hemophilic patients. Methods The UTE‐QSM technique was based on three sets of dual‐echo 3D UTE Cones data acquired with TEs of 0.032/2.8, 0.2/3.6, and 0.4/4.4 ms. The images were processed with iterative decomposition of water and fat with echo asymmetry and least‐squares estimation to estimate the B0 field map in the presence of fat. Then, the projection onto dipole field (PDF) algorithm was applied to acquire a local field map generated by tissues, followed by application of the morphology‐enabled dipole inversion (MEDI) algorithm to estimate a final susceptibility map. Three healthy volunteers and three hemophilic patients were recruited to evaluate the UTE‐QSM technique’s ability to assess hemosiderin in the knee or ankle joint at 3T. One patient subsequently underwent total knee arthroplasty after the MR scan. The synovial tissues harvested from the knee joint during surgery were processed for histological analysis to confirm iron deposition. Results UTE‐QSM successfully yielded tissue susceptibility maps of joints in both volunteers and patients. Multiple regions with high susceptibility over 1 ppm were detected in the affected joints of hemophilic patients, while no localized regions with high susceptibility were detected in asymptomatic healthy volunteers. Histology confirmed the presence of iron in regions where high susceptibility was detected by UTE‐QSM. Conclusion The UTE‐QSM technique can detect hemosiderin deposition in the joint, and provides a potential sensitive biomarker for the diagnosis and prognosis of hemophilic arthropathy.

Ultrashort echo time Cones double echo steady state (UTE‐Cones‐DESS) for rapid morphological imaging of short T2 tissues

“…The UTE Cones (UTE‐Cones) sequence uses twisted trajectories (ie, 3D spiral arms) to efficiently encode the 3D k‐space for data readout 22,23 . Moreover, various data analysis and signal preparation schemes including T 1 and mapping, 24‐26 quantitative susceptibility mapping, 27‐30 magnetization transfer, 31,32 adiabatic inversion recovery, 33‐36 and adiabatic T 1ρ spin locking 37‐39 have been combined with Cones sampling for quantitative UTE imaging, further demonstrating the efficacy and adaptability of the UTE‐Cones sequence in morphological and quantitative imaging of short T 2 tissues such as the osteochondral junction (OCJ), menisci, ligaments, tendons, cortical bone, and hemosiderin.…”

Assessment of vertebral fractures and edema of the thoracolumbar spine based on water‐fat and susceptibility‐weighted images derived from a single ultra‐short echo time scan

“…22 Previous studies have shown that an extension of the wellknown IDEAL algorithm can be used to generate water, fat, and quantitative susceptibility maps. 23,24 Beyond that, the water-and fat-separated images were used to suppress long T 2 components which proves itself beneficial in pseudo-CT imaging or in the context of PET attenuation map generation. [22][23][24][25][26][27][28] However, also typical UTE-Dixon imaging requires the acquisition of multiple echoes which prolong the repetition time (TR) and conventional Dixon does not consider the short T * 2 decay of water signal.…”

Simultaneous Quantitative Susceptibility Mapping of Articular Cartilage and Cortical Bone of Human Knee Joint Using Ultrashort Echo Time Sequences

“…The potential clinical application of UTE-QSM has been shown in several papers. For example, UTE-QSM was used for detecting hemosiderin deposition in patients with hemophilic arthropathy ( 22 ). The susceptibility was presented as high intensity in affected regions with high iron concentrations.…”

“…However, related studies mainly focused on imaging the cortical bone and didn’t quantify soft tissue susceptibility. UTE-QSM has not been applied to explore the articular cartilage of human in vivo ( 21 , 22 ). Simultaneous susceptibility mapping of the articular cartilage and cortical bone with a single MRI scan is still lacking and highly needed.…”